the
abner wellborn calhoun
medical library
1923
Book
presented by
BOBERT A. HANCE'S
(late comfort's)
fHOMSONIAN MEDICINE STORE,
WHOLESALE AND RETAIL,
No. 729 MARKET STREET
Composition Powder.
Spiced Bitters.
Ladies' Spiced Bitters.
No. 4 Bitters.
No. 3 Powder.
Conserve of Hollyhock.
Anti-acid Powders.
Injection Powders.
Nerve Powder.
Compound Lobelia Pills.
Anti Dyspeptic Pills.
No. 3, or Anti Canker Pills.
PHILADELPHIA.
(, Third Preparation of Lobelia.
< Prepared Lobelia Emetic.
( Tincture of Lobelia.
I Comp. Valerian Carminative.
\ No. (i, or Rheumatic Drops.
J No. 5 Syrup.
i Cholera Mixture.
S Cough Syrap.
' Croup Syrup.
Worm Syrup.
Butternut Syrup.
, Wine Bitters.
An extensive supply of the medicine recommended in the following
pages, a general assortment of Shaker Herbs, and articles connected with.,
the Botanic Drug business, also a supply of Thomsonian and Botanic
Books constantly on hand and for sale.
The following Preparations are neatly put up and accompanied with
the necessary directions for use :—
< Tooth Powder.
Headache Snuff.
Toothache Drops,
i Healing Salve.
Strengthening Plaster.
Stimulating Liniment.
! Tetter Ointment,
i Meadow Fern Ointment.
| Nerve Ointment.
Adhesive Plaster,
j Cure-all Salve.
; Hair Tonic.
NOTICE.
It cannot but be evident to every one that medicine, to have its proper
effect, must be genuine, pure, and uninjured by age or exposure. As
well may we expect good results from the use of unwholesome articles
of food as from spoiled articles of medicine. Hence it is all important
that those who would be benefited by the use of Thomsonian Medicines
should look well to their qualities.
These remarks are deemed necessary, as large quantities of Thomso¬
nian Medicine, particularly Composition Powder, Capsicum, Bayberry,
and No. 6, are manufactured by Druggists and others, and being com¬
posed of bad materials, are unfit for use as medicine.
Persons not particularly interested in advancing the prosperity of the
Thomsonian Practice, take advantage of opportunities for working off
cheap and damaged articles in the way of Thomsonian compounds, when
the fraud is not easily detected except by good judges. In this way
essential injury is done the Thomsonian System, and the benefit thai
would be received from the use of good medicine is not realized.
N. B. Medicine should be kept from the air, and in a dry place.
Concentrated Preparations
ACTIVE PRINCIPLES OF MEDICINAL PLANTS.
Podophyllin,.
Leptanclrin, .
Cimicifugin, or
Macrotin,
'Aconitin,
Alnuiue,
Anipelopsine?
Apocynin,
Asclepidin, .
Baptism,
■Barosmin,
Canloph.yl.line,
Cerasine,
Chimaphillin,
Colocynthin,
Cornine,
Corydalia,
Cypripedine,
Digitaline ?
Dioscorein,
Eryngine?
Enonymine,
Eupatoidin?
Eupatorine ?
Eupurpurin,
Fraserine,
Gelseminine,
Geranine, '
Gillenine?
4 Gossypiin,
Heliauthemin,
Helonin ?
Humulin,
Hydrastia Snip.,
Hydrastine, .
from Mandrake.
Culver's Root.
Black Cohosh.
Aconite Leaves.
Tag Alder.
American Ivy.
Dogsbane.
Pleurisy Root.
"Wild Indigo.
Buchn Leaves.
Blue Cohosh.
Cerasus.
Pipsissewa.
Colocynth.
Dogwood.
Turkey Pea.
Ladies' Slipper.
Foxglove.
"Wild Yam.
Corn Snakeroot.
Wahoo.
Eupator. Agerat.
Boneset.
Queen of Meadow,
Am. Colomba.
Yellow Jessamine.
Cranesbill.
American Ipecac.
Cotton Root.
Frostwort.
Unicorn Root.
Hops.
Golden Seal.
Hydrastia mur., .
Hyoscyamine,
Irisin, .
Jalapin,
Juglandin? .
Lobeline?
Menispermin,
Myricin,
Panduratin, .
Phytolaccin,.
Populin,
Pruning,
Ptelein,
Rhusin,
Rumicin ?
Sanguinarina,
Sanguinarin,
Sanguinarine,
Sanguinarina Snip.,
Scutellarine,.
Senecionine,.
Stillingine, .
Trilliin ?
Yeratrin?
Yerbenine? .
Yiburnine? .
Xanthoxylin,
from Golden Seal.
" Henbane.
" Bine Flag.
" Jalap.
" Butternnt.
" Lobelia.
" Yellow Parilla.
" Bayberry.
" Conv. Pandnrat.
" G-arget or Poke.
" Aspen Poplar.
" "Wild Cherry.
" "Wafer Ash.
" Snmach.
" Yellow Dock.
" Bloodroot (Alkal).
" " (Resinoid.)
" " (Com'b).
a a
" Sknlleap.
" Liferoot.
" Stillingia.
" Birthroot.
" American Hellebore.
" BlueYervain.
" ■ High Cranberry.
" Prickly Ash.
OILS.
Oil Capsicum (Cayenne, African).
" Cubeba (Cubeb Berries).
" Ergota (Ergot).
" Filix Mas (Male Fern).
" Lobelia Inil. (Lobelia Seed).
" Piper Niger (Black Pepper).
" Stillingia (Stillingia).
" Xanthoxylum (Prickly Ash).
" Liriodendron (Yellow Poplar).
" Santonica (Levant Wormseed).
" (Essential) Erigeron Can. (Fleabane).
" " Erecthites Hier (Fireweed).
THE
PRACTICE OF MEDICINE
ON
THOMSONIAN PKINCIPLES,
ADAPTED AS WELL TO THE
USE OF FAMILIES AS TO THAT OF THE PRACTITIONER.
CONTAINING
A BIOGRAPHICAL SKETCH OF DR. THOMSON,
PROPOSITIONS ILLUSTRATIVE OF THE PHILOSOPHY OF THOMSONIANISM; A BRIEF
HISTORY OF THE SYMPTOMS, PECULIARITIES, AND GENERAL COURSE OF
DISEASE IN ITS DIFFERENT FORMS AND VARIETIES;
WITH
PRACTICAL DIRECTIONS FOR
ADMINISTERING THE THOMSONIAN MEDICINES,
INCLUDING THE
VARIOUS METHODS OF ADMINISTERING YAPOUR BATHS, EMETICS, &C.
AND
51 fflMn, ahjM tn ijj? Wnt
BY J. W. COMFORT, M.D.
SEVENTH EDITION.
PHILADELPHIA:
LINDSAY & BLAKISTON.
186 7.
Entered, according to the Act of Congress, in the year 1850, by
J. W. COMFORT, M.D.,
in the Clerk's Office of the District Court of the United States, for the
Eastern District of Pennsylvania.
STEREOTYPED BY J. F A G A N .
PRINTED BY C. SHERMAN.
PR. SAMUEL THOMSON,
THE
PHILOSOPHER IN MEDICINE,
AND
FOUNDER OF THE THOISONIM SYSTEM OF MEDICAL PRACTICE,
Wnrk
IS WITH DUE RESPECT INSCRIBED
BY
THE AUTHOR.
TO THE READER.
This work is presented to the public as a Practical Guide in
the treatment of disease, in accordance with the principles of
medical science discovered and promulgated to the world by
Samuel Thomson.
The author does not claim to have made improvements upon
the fundamental principles of the Thomsonian system of practice.
Daily observation affords confirmatory evidence that this system
is based upon correct principles; and that the remedial means
therein employed, are adapted to the cure of every variety of dis¬
ease that is curable by means of medical treatment. What I
have aimed at in the following pages, besides a desbription of the
symptoms and peculiarities of the principal varieties of disease as
detailed by medical authors, has been to point oat that treatment
best adapted to the different forms and stages of disease under
various conditions of the system.
In the directions for conducting the treatment, repetitions in
relation to preparing medicines have been introduced, which may
appear superfluous or unnecessary; but, designed as a plain family
guide, it was deemed right to pursue this plan, that the work
might be better adapted to answer the purpose intended.
The Practice of Medicine, based upon correct principles, needs
not the " garb of mystery, too often employed to conceal imperfec•
tion, and to give to false knowledge the appearance of science
Samuel Thomson, influenced by benevolent motives, made known
his medical discoveries and system of practice, without a sem¬
blance of disguise. Taught in the school of Nature, he imparted
TO THE READER.
the knowledge thus acquired for the benefit of mankind an ex¬
ample worthy of a great mind and a philanthropic spirit. The
author of this work has endeavoured to follow the example of
Thomson in simplifying the Practice of Medicine, and to give
such practical information as he has found from experience and
observation most essential for the successful treatment of disease
in its various forms and phases.
Although some articles of medicine are recommended in this
work not used by Dr. Thomson, still I am not an advocate for
enlarging the list of medical agents beyond the limits embracing
those articles and compounds best adapted to effect all the essen¬
tial objects required for the eradication of disease, and the resto¬
ration of health. Indeed, the more the practice is simplified arid
restricted to the employment of general remedies, the more suc¬
cessful will it prove. The medicines introduced to the notice of
the reader, not mentioned by Samuel Thomson, have been found
beneficial for the purposes to which they are recommended to be
applied, and others contained in his materia medica, regarded as
being of a less useful character, have been excluded.
J. W. C.
4
PREFACE TO THE THIRD EDITION.
A biographical sketch of Samuel Thomson has been
introduced into the present edition, with a view to give
an elucidation of Thomson's Theory and General Prin¬
ciples, upon which his practice is based, in his own lan¬
guage. Adapted to the common-sense understanding of
the general reader, his reasonings enforce conviction, to
the unprejudiced mind, of the truth of his general
doctrines.
The " Principles of Medicine," as presented in the
former editions, have been modified, with a view to
afford clearer and more extended explanations in relation
to the laws of life—the agents and causes which, most
materially influence their operation, either as supporters
or destroyers of vital action; inasmuch as it is from this
source of knowledge alone that true medical principles
can be conceived of, and correct general rules laid down,
for the treatment of disease.
Philadelphia, May 1, 1850.
CONTENTS.
Page.
Biography of Dr. Samuel Thomson 13
Principles of Medicine 39
PRACTICE OF MEDICINE.
CHAPTER I.
Sect. I. Ague—Intermittent Fever.... 55
II. Remitting or Bilious Fever 61
III. Continued Fever—Typhoid, Typhus, Nervous, Conges¬
tive, &.c 68
CHAPTER II.
Eruptive Diseases.
Sect. I. Small-Pox 79
II. Vaccination—Cow-pox—Kine-pox 87
III. Varioloid—Modified Small-pox 91
IV. Varicella—Chicken-pox—Swine-pox 92
V. Measles 93
VI. Scarlet Fever 96
VII. Nettle-rash—Hives 104
VIII. Erysipelas—St. Anthony's Fire—Rose 105
IX. Shingles 109
X. Scald Head 110
XI. Tetter 112
XII. Itch 115
XIII. Ring-worm * 116
XIV. Chafing in children 117
XV. Prickly heat 117
(i)
CONTENTS.
CHAPTER III.
Diseases affecting the Chest and Lungs.
Sect. I. Acute Bronchitis (Seated Cold) 118
II. Chronic Bronchitis (Deeply-seated Cold) 122
III. Pulmonary Consumption 125
IV. Asthma, or Phthisic 133
" V. Summer Catarrh, or Cold—Hay Fever 136
VI. Whooping-cough 137
VII. Pleurisy 140
VIII. Catarrh—Colds—Influenza—Gripp 143
CHAPTER IV.
Diseases affecting the Mouth and Throat.
Sect. I. Croup—Hives 146
II. Quinsy 150
III. Mumps 152
IV. Common sore Throat 153
V. Acute Laryngitis 154
VI. Aphthous sore Mouth—Infant's sore Mouth 156
VII. Elongated Uvula—Falling of the Palate 157
CHAPTER V.
Diseases affecting the Stomach and Bowels.
Sect. I. Colic 158
II. Cholera Morbus 159
*
III. Cholera Infantum—Cholera of Infants 162
IV. Bilious Colic 169
V. Colica Pictonum—Painter's Colic 172
VI. Dysentery 174
VII. Diarrhoea—Belax 178
VIII. Peritonitis (Inflammation of the Peritoneum) 180
IX. Constipation 184
X. Dyspepsia—Indigestion 187
XI. Worms in the Stomach and Bowels 196
XII. Piles 201
CONTENTS. iil
CHAPTER VI.
Sect. I. Rheumatism 206
II. Lumbago—Rheumatism in the Loins 214
III. Gout 215
CHAPTER VII.
Diseases of the Kidneys and Bladder.
Sect. I. Inflammation of the Kidneys 220
Chronic Diseases of the Kidneys 223
II. Inflammation of the Bladder 224
III. Diabetes—Excessive flow of Urine 228
IV. Retention of Urine (Inability to discharge Urine) 230
V. Stranguary [Difficulty and Pain in voiding Urine) 234
VI. Incontinence of Urine (Involuntary fiow of Urine) 236
VII. Suppression of Urine (The Kidneys ceasing to form
Urine) 238
CHAPTER VIII.
Disease of the Liver.
Sect. I. Acute Inflammation of the Liver 240
Chronic Disease of the Liver 242
II. Jaundice 246
CHAPTER IX.
Sect. I. Apoplexy 249
II. Paralysis—Palsy 254
III. Epilepsy (Convulsion Fits—Falling Sickness) 261
IV. Infantile Convulsions ' 264
V. Chlorosis—Green Sickness 267
VI. Hysteria—Hysteric Fits 270
VII. Fainting 276
VIII. Hypochondriasis (Dejection of Mind—Loio Spirits).... 277
IX. St. Vitus's Dance 282
X. Tetanus—Locked Jaw 286
XI. Hydrophobia (Bite of a Mad Dog or other rabid Animal) 290
XII. Neuralgia—Tic Douloureux 294
iv
contents.
CHAPTER X.
Sect. I. Dropsy
1. Ascitis (Dropsy of the Belly).
2. Hydrothorax (Dropsy of the Chest) 301
3. Anasarca (Cellular Dropsy) 302
4. Hydrocele (Dropsy of the Scrotum) 306
5. Hydrocephalus (Dropsy of the Brain). 307
CHAPTER XI.
Sect. I. Scrofula 309
II. Goitre 315
CHAPTER XII.
Sect. I. Suspension of Animation from Drowning 317
II. Suspension of Animation from Carbonic Acid Gas 318
III. Suspended Animation from Lightning 319
CHAPTER XIII.
Various Forms of Diseases of the Eyes.
Sect. I. Inflammation of the Eyes from taking Cold 320
II. Rheumatic Inflammation of the Eyes 322
III. Suppurative Inflammation of the Eyes 324
IV. Scrofulous sore Eyes 327
V. Blindness (total or partial) 331
VI. Iritis (Inflammation of the Iris) 333
VII. Stye 336
VIII. Fistula Lachrymalis ( Obstruction in the Duct which con¬
veys the Tears from, the Eye into the JYostril) 337
CHAPTER XIV.
Sect. I. Insanity—Mental Derangement 338
1. Mania—General Insanity 340
2. Partial Insanity 341
II. Delirium Tremens — Mania a potu (Craziness from *
Drinking) 344
contents.
v
CHAPTER XV.
Sect. I. Ordinary Headach 351
II. Sick Headach 352
III. Toothach 356
CHAPTER XVI.
ect. I. Earach 358
II. Running of the Ears 359
III. Deafness and Dulness of Hearing 362
CHAPTER XVII.
Sect. I. Palpitation of the Heart 363
II. Organic, or Structural Diseases of the Heart 365
CHAPTER XVIII.
Discharges of Blood.
Sect. I. Bleeding from the Lungs 370'
II. Epistaxis {Bleeding from the Nose) 373
III. Bleeding from Wounds 376
IV. Bleeding from the Stomach—Vomiting Blood 378
V. Bloody Urine 381
CHAPTER XIX.
Sect. I. Cancer 382
CHAPTER XX.
-Sect. I. Sprains 389
II. Bruises 391
III. Severe Shocks from violent Blows or Falls 391
IV. Wounds of the Scalp 394
V. Wounds produced by sharp Instruments 398
VI. Lacerated Wounds 400
» VII. Punctured Wounds from sharp-pointed Instruments .... 401
VIII. Wounds of Joints 402
vi CONTENTS.
IX. Bums and Scalds 4^4
X. Chilblains 407
XI. Treatment of Frozen Limbs 407
XII. Biles 409
XIII. Carbuncle 410
XIV. Abscess of the Female Breast 412
XV. Whitlow or Felon.. 413
XVI. Hip Disease 415
XVII. White Swelling 418
XVIII. Ulcers 421
1st. Simple or healthy Ulcer 421
2d. Unhealthy Ulcer 422
CHAPTER XXI.
Venereal Disease.
;Sect. I. Gonorrhoea 427
Syphilitic Sore or Chancre 432
Bubo—Swelling in the Groin 435
Secondary Symptoms of Syphilis 43f-
CHAPTER XXII.
Sect. I. Obstructed Menstruation 439
II. Treatment of Fluor Albus, or Whites 441
CHAPTER XXIII.
Miscellaneous.
'Bee-stings 442
Nervousness—Weak Nerves 442
Polypus of the Nose 444
Cramp in the Legs and Feet 445'
Prolapsus Ani—Protrusion of the Bowel 445
Hernia, or Rupture 447
Strangulated Hernia 447
CHAPTER XXIV.
«
Epidemic Cholera—Asiatic Cholera 450
CONTENTS. Vii
THOMSONIAN COURSE OF MEDICINE.
General Directions for administering a Course of Medicine ... .461
Blood-letting 47
Hot-air or Vapour Bath 474
Partial Steaming 481
Warm-water Foot Bath 482
Of the utility of Lobelia Emetics in the Cure of Disease in general 482
Of the use of Cathartics, or Purgative Medicines 489
Injections or Enemas 495
THOMSONIAN MATERIA MEDICA.
Lobelia Inflata 501
Preparations of Lobelia i 505
Third Preparation of Lobelia 506
Compound Lobelia Pills 508
STIMULANTS
Which raise and sustain Vital Action, and assist the Efforts of Nature
to remove Disease.
Capsicum—Cayenne Pepper 510
Thomson's Composition Powder 514
Black Pepper 515
Ginger 515
ASTRINGENTS.
Thomson's No. 3, or Medicine for Canker.
Bayberry (Myrica Cirifera) 517
Upland Sumac (Rhus Glabrum) 521
White Pond Lily (Nymphia Odorata) 522
Wild Red Raspberry (Rubus Strigosis) 522
Witch Hazel (Hamamelis Virginiana) 523
»Gallae (Galls) 523
Evan Root (Guem Rivale) 523
viii CONTENTS.
523
Marsh Rosemary (Statia Limonium)
Dewberry (Rubus Procumbens)
Crow-foot—Cranes Bill (Geranium Muculatum)
Beach-drop ( Orbanche Virginiana) 525
Alum Root (Heuchera Americana) 525
TONICS—BITTERS
To Strengthen the System and Promote Digestion.
Peruvian Bark (Cinchona Officinalis} 526
Quinine 528
White Aspen and Black Aspen Poplar (Populus Tremuloides, and
Populus Grandidentata) 529
Balmony (Chelone Glabra) 529
Barberry (Berberis Vulgaris) 530
Golden Seal (Hydrastis Canadensis) 530
Virginia Snake-Root (Serpentaria Virginiana) 530
Centuary (Chironia Angularis) 531
Red Dog-wood—Red Willow (Cornus Sericea) 531
Gentian 531
Wild Cherry (Prunus Virginiana) 532
Quassia 532
Tulip Poplar (Liriodendron Tulipifera) 533
Columba 533
Thoroughwort—Boneset (Eupatorium Perfoliatum) 533
Yellow Root (Xanthoriaza Apufolia) 533
Chamomile {Anthemis JYobilis) 533
Myrrh 534
Thomson's No. 6, or Rheumatic Drops 535
No. 5 Syrup, or Restorative Cordial 536
Unicorn (Helonias Dioicia) 537
Bitter Almonds, Peach-Meats, and Cherry-Stones 538
Wine Bitters 538
Spice Bitters 538
Ladies'Spice Bitters 539
Conserve of Hollyhock 539
Wormwood 549
Bitter Root—Indian Hemp—Wandering Milkweed (Apacynium An-
drosemifolium) 549
CONTENTS. ix
NERVINES
To quiet Restlessness, calm Nervous Agitation, and promote Sleep.
American Valerian (Cypripedium Humile, pubescens, parvijlorum,
condidum and spectabile) 541
Scull-cap (Scutellaria Lateriflora) 541
Hops 542
Garlic 542
Carbonate of Ammonia 543
Camphor 544
Oil of Turpentine 545
White Turpentine 547
Oil of Amber 547
Oil of Horsemint 547
Oil of Juniper 548
Oil of Peppermint 548
Oil of Anise-seed 548
Oil of Caraway 548
VEGETABLE BALSAMS.
Balsam Copaiva 549
Balsam Tolu 549
Balsam Fir 550
MISCELLANEOUS MEDICINES.
Pennyroyal 550
Ditany 550
Catnip 551
Hoarhound .. #. 551
Scabious (Erigeron Philadelphicum, and E. Canadense) 551
Honey 551
Pipsissewa (Pyrola Umbellata) 552
Cleavers 552
Burdock 552
Cubebs 552
Prickly Ash (Zanthoxylum Fraxineum) 553
CONTENTS.
Sarsaparilla
Purple Archangel (Lycopus Virginicus
Guiacum Wood
555
Precipitated Carbonate of Iron
Tansy 556
Slippery Elm (Ulmas Fulva
Yellow Dock 556
Strengthening Syrup 557
ACIDS.
Vinegar... 557
Lemon-Juice 558
Elixir of Vitriol 558
ALKALIES—ANTI-ACIDS.
Super-carbonate of Soda 558
Bi-carbonate of Soda 558
Sal aeratus 559
Hickory Ashes 559
Charcoal 559
Lime-water 561
Prepared Chalk 561
Stimulating Liniment 562
Ward's Paste 562
COUGH MIXTURES.
Cough Powder 564
Garlic Syrup 564
Oxymel of Garlic 564
VOLATILE LOTIONS AND LINIMENTS.
Granville's Lotion 565
Ammonia Liniment 565
Camphor Liniment 565
Soap Liniment 565
CONTENTS. Xi
Simple Cerate 565
Basilicon Ointment 566
Gum Elastic 566
Tar Ointment 566
Tar Water 566
Thomson's Salve 567
Astringent Ointment 567
Persimmon Ointment 567
Pitch Plaster 567
Turpentine Plaster 567
Gum Hemlock Plaster 567
Mustard Plaster 568
POULTICES.
Emollient and slightly Stimulating Poultices 568
Stimulating and Astringent Poultices 569
Mallows Poultice 569
Catnip Poultice 569
Charcoal Poultice 569
Yeast Poultice 569
Myrrh Poultice 570
Wild Indigo Poultice 570
Gum Arabic 57C
Cider.., 571
Arrow-root 571
Barley Water 571
Milk Porridge 572
Oat Meal Gruel 572
Essence of Beef, or Beef Tea 573
Chicken Tea 573
Crust Coffee 573
Panada 573
Mutton Broth 574
Wine Whey 574
Egg Soup 574
Sugar 574
Drying Roots and Herbs 575
xii
CONTENTS.
POISONS AND THEIR ANTIDOTES.
CONCENTRATED ACIDS.
Nitric and Oxalic Acids 576
Muriatic and Sulphuric Acids 576
Prussic Acid 576
CONCENTRATED ALKALIES.
Caustic Potash, Caustic Soda, pure Volatile Alkali, and Quicklime.. 576
Creosote 577
Corrosive Sublimate 577
Arsenic 577
Antimony .. . 578
Copper. * 578
Lunar Caustic—Nitrate of Silver 579
Nitre—Saltpetre 579
Alcohol.,., 579
Poisoning from the Fumes of Lead 580
Swamp Sumac (Rhus Vernix), Poison Vine, Poison Oak 580
Opium . 580
Belladonna—Deadly Nightshade 580
Strychnia—Nux Vomica 581
Datura Stramonium—Gympson Weed 581
Purified Animal Charcoal an Antidote to all Vegetable Poisons.... 582
BIOGRAPHICAL SKETCH
OF
SAMUEL THOMSON.
History furnishes many striking evidences of the fact, that those
who discover new and important truths in science, however bene¬
ficial to mankind, always meet with opposition and persecution;
more especially when the new discoveries come in collision with
theories and doctrines that have received the sanction of the re¬
putedly wise and learned.
Why was the great Newton persecuted, but for the fact that his
discoveries proved the astronomical theories of that age to be
erroneous ?
Galileo made the discovery that the earth revolved round the
sun ; but this new doctrine came in collision with the opinions of
the holy fathers of the church ; and to avoid persecution, if not
martyrdom, he was compelled to denounce, as damnable heresy,
what he knew to be truth.
Hervy, who discovered the circulation of the blood, was de¬
nounced, and otherwise basely treated, by the medical profession.
Jenner, after having practised vaccination thirty years, and having
furnished abundant evidence in proof of the protective power of
vaccination against small-pox, made an appeal to his medical
brethren to aid him in introducing the practice into use, and was
treated by them with contempt and ridicule.
And what was the course pursued by our American Congress,
when Fulton made application to government for means to aid him
in his endeavours to prove the practicability of propelling boats by
steam-power ? A resolution was passed by that body of wise men,
casting the reflection upon Fulton of being affected with insanity.
(xiii)
Xiv BIOGRAPHICAL SKETCH OF SAMUEL THOMSON-
With these historical facts before us — and hundreds of others
there are of a like character — what, but calumny and persecution,
could be anticipated from the medical profession towards the tounder
of the Thomsonian theory and system of practice, directly opposed,
as it is, to their theoretical dogmas and general practice ?
Endowed with a deep, searching intellect, a oenevolent spirit,
strong moral honesty, and unbounded firmness, Thomson was well
suited for the task which Providence allotted to him. Labouring
with the philanthropic desire of benefiting his fellow-man, by re¬
moving the veil of darkness and imposition, which had so long been
thrown over the medical science of the world, he sacrificed every
thing at the shrine of duty. Few arte aware of the opposition he
had to encounter; received at the very outset with taunts and per¬
secutions, stigmatised with all the opprobrious names that human
ingenuity could invent, borne down, oppressed, and at one time
incarcerated in a loathsome dungeon, still he nobly persevered in
the good work. Manfully he met the raging storm ; singly and
alone, except when now and then cheered by the enlivening influ¬
ence of a few congenial friends, he toiled undauntedly on, with a
determination to effect the grand object he had in view : that of
making known to the world a safe and effectual system of medical
practice.
The history of Thomson affords a striking example of the fact
that education does not always make the man. It shows from what
an humble source this great system of medicine originated, wThose
influence is not only being felt in the United States, but even in
the Old World. Yes, the name of Samuel Thomson, the poor,
unaccomplished, plebeian farmer-boy, like that of our great philo¬
sopher Franklin, will be, in time to come, as familiar in the mouth
of the Frenchman, German, and Englishman, as it is in that of the
American.
John Thomson, the father of Samuel Thomson, was born in
Northbridge, Worcester county, Massachusetts. About the year
1768 he moved his family to the township of Alstead, Cheshire
county, New Hampshire. This part of the county was in a wild
state, and there were no roads, and the nearest house was a mile
distant. They were very poor, with nothing to commence the
•vorld except a spirit of energy and industry.
In such a wilderness, and under such circumstances, on the 9th
of February, 1769, Samuel Thomson was born. He was the fourth
«
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XV
child, and the youngest of three brothers, there being one sister still
younger than himself.
Such were the pressing necessities of the family that they set
him to work while yet a mere lad. His father took him into the
fields and gave him employment, and even at this tender period,
before the mental faculties, as it were, had yet become developed,
he evinced striking symptoms of the peculiar bent of his mind.
«' I was," says he in his Narrative, "very curious to know the
names of all the herbs which I saw growing, and what they were
good for; and, to satisfy my curiosity, was constantly making in¬
quiries of the persons I happened to be with for that purpose. All
the information I thus obtained, or by my own observation, I care¬
fully laid up in my memory, and never forgot." Such precocity is
by no means common. An old doctress, who practised entirely
with plants, attended the family, and on account of the benefits
they had received from her skill, they became very much attached
to her. The lad took advantage of the opportunity thus offered,
and used to accompany her in her rambles to collect roots and
herbs; he would ask their names, and to what particular diseases
they were applied; he would also ascertain their taste and appear¬
ance, and thus he acquired a knowledge of their different qualities
and uses.
Thomson had but a very limited share of school-learning, deriving
knowledge chiefly from his own observation. Possessed, however,
of strong powers of reasoning and reflection, he became what may
be termed an original thinker. To learn the medical properties and
uses of plants and herbs, was the early natural bent of Thomson's
mind. On chewing some of the leaves and pods of a certain herb,
which proved to be the Lobelia Inflata, the sensations produced by
it were so remarkable that it made a lasting impression upon the
mind of young Thomson, and he frequently gave it to those he was
in company with merely through diversion. " While in the field
at work," says he, "I often found this herb, and used to give
it to those who worked with me to see them spit, and sometimes
vomit; but I never observed any bad effects produced by it, which
simple experiments eventually led me to observe the value of it in
disease."
It was upwards of twenty years from the time that Thomson first
observed the singular effects produced upon the system by chewing
the lobelia plant, before it occurred to him that it possessed any
Xvi BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
valuable medical powers. " Mowing in the field," he observes,
"with a number of men, I cut a sprig of it (Lobelia) and gave it
to the man next me, who eat it; when we got to the end of the
piece, which was about six rods, he said that he believed that what
I had given him would kill him, for he never felt so in his life.
He was in a profuse perspiration, trembled, and was pale as a corpse.
He laid down and vomited freely several times. I then helped him
into the house, and in about two hour§ he ate a very hearty dinner,
and in the afternoon was able to do a good half day's labour. He
afterwards told me that he never had any thing to do him so much
good before ; his appetite was remarkably good, and he felt better
than he had done for a long time. This circumstance gave me the
first idea of the medical virtues of this plant, which I have since
found by twenty years experience, in which time I have made use
of it in every disease I have met with to great advantage, and re¬
gard this discovery as one of great importance."
But for this apparently accidental discovery of the medical virtues
of lobelia, Thomson could never have completed his System of
Medical Practice. No other article, possessing qualities adapted
to effect so many important purposes in the treatment of disease,
is to be found either in the vegetable or mineral kingdom.
Thomson's practice, at the first, was purely empirical, not having
any general principles to govern him in applying remedies. It was
not to the writings of medical theorists that Thomson recurred for
instruction. The book of Nature was his tutor;—he studied the
laws which govern the elements, and, by his great power of tracing
effects to causes, finally gained a knowledge of those general prin¬
ciples in relation to the laws of life, and the nature and cause of
disease, which form the basis of the Thomsonian System of
Medicine.
Previous to the discoveries of Samuel Thomson, there never had
been a system of medicine established upon fixed general principles.
The regular practice has ever been fluctuating, and at this day not
less so than formerly. Not that the laws which govern the human
constitution are changeable, for nature is governed by fixed general
laws, but the continued changing of the theories of medicine ; and
the uncertainty of the regular practice arises from the want of a
knowledge of established first principles, without which all expe¬
rience in medicine is of little use. No one can demonstrate a pro¬
position in geometry without being acquainted with the first prin
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XVII
ciples of that science ; neither can disease be treated correctly and
scientifically, unless the rules for conducting the treatment be based
upon correct first principles. However learned a man may be, if
he has embibed erroneous views with regard to the nature of
disease, his practice will be erroneous. Had Samuel Thomson
received a regular medical education, he too, probably, like many
in the profession, would have discovered the want of established
medical principles, and deplored the imperfections of the practice
without adding any useful knowledge to the science.
Shortly after the death of his mother, which occurred in 1790,
Thomson was seized with an attack of the same disorder. He
refused to employ any of the regular medicines, urging that he pre¬
ferred to die a natural death. The doctor endeavoured to frighten
him into a compliance with his advice; but he obstinately refused,
saying that he had observed the effect of the medicines on his
mother, that she constantly ^rew worse under the operation of them,
and he had no desire to hazard it himself. He prescribed his own
remedies, and recovered.
Thomson was married, on the 7th of July, 1790, to a Miss Susan
Allen, and in about a year his first child was born.
At the time he had obtained a family, we still find him engaged
in enlarging his store of knowledge of the vegetable kingdom, and
in close and arduous inquiry to discover the most effectual means
of counteracting disease. Although Thomson was a sceptic as to
the efficacy of the usual mode of practice, still, in case of illness in
his family, he applied to a regular physician, not having sufficient
confidence in his own ability, at this time, to induce him to assume
so great a responsibility. Mrs. Thomson being subject to frequent
violent attacks of sickness, he prevailed on the family physician to
move into a house on his farm, in order that he might be near in
case of emergency.
Thomson informs us, in his " Narrative," that at this time he
had not the most distant idea of ever engaging in the practice of
medicine, further than to administer in his own family ; but that
during the doctor's residence on his farm, which was about seven
years, there was sickness in his family almost all the time. " Since
I have had more experience," says he, " and became better
acquainted with the subject, I am satisfied, in my own mind, of the
cause. Whenever any of the family took a cold, the doctor was
sent for, who would always either bleed or give physic. Taking
2
*.viil BIOGRAPHICAL SKETCH OF SAMUEL THOMSON-
away blood reduced the heat and gave power to the cold they had
taken, which increased the disorder, and the coldness of the
stomach caused canker (unhealthy secretions); purging draws the
determining powers from the surface inwardly, weakens the power
of inward heat, and tends to fasten disease in the system.
" Again, other consequences of such treatment are, that perspira¬
tion ceases, because internal heat is the sole cause of this important
evacuation, and a settled fever may take place, which will continue
as long as the cold keeps the upper hand. My experience has
taught me that by giving hot medicine, the internal heat was
increased; and by applying the steam externally, the natural
perspiration was restored ; and by giving medicine to clear the
stomach and bowels of canker, till the cold is driven out, and the
heat returns, which is the turn of the fever, they will recover the
digestive powers, so that food alone will keep the heat where it
naturally belongs, for food is the fuel that sustains the vital fire, or
life of man."
It was in a case of extreme illness in his second daughter, after
the physician had declared he could do no more, that Thomson, in
the last extremity, driven by necessity to the resources of his own
powerful mind, conceived the idea of applying steam, or vapour,
to the body, for the purpose of eradicating disease ; and by his
trial he was fully confirmed in the belief of its utility. In the case
of the child, the first experiment afforded relief, and he continued
to apply it at frequent intervals for the space of a week, using, at
the same time, cold water upon the face and body, as the condition
of the patient appeared to require, in order to suppress the outward
heat. By these means, and giving some simple warming medicines
internally, he succceeded in curing one of the most desperate cases,
probably, ever restored by medical skill.
Mrs. Thomson being in a critical condition after confinement,
and the family physician being away, and no other within six miles,
Thomson, after obtaining the consent of his wife, determined on
making a trial of the steam-bath in this case. " I gave her some
warm medicine to raise the inward heat, and then applied the
steam, which was very much opposed by the midwife ; but I per¬
sisted in it, according to the best of my judgment, and relieved her
in about an hour, after she had lain in a critical situation foui
hours without any thing being done."
Subsequently Thomson's family were attacked with measles,
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. SIX
and two of the children had the disease very severely; in one the
eruption struck in and a state of stupor ensued. In this case,
steam was applied, which, together with the use of warming teas,
succeeded in bringing the disease out, and the child recovered.
*.n the other case, the lungs became severely affected, threatening
consumption. The treatment, as used in the other case, was
applied, but proved insufficient to effectually relieve the lungs,
when the thought occurred to Thomson to make a trial of the
emetic herb (lobelia), which relieved the symptoms, and the patient
soon got well.
The good success which attended Thomson's plan of treating
disease, began to be noticed by his neighbours, and induced some
to apply to him for relief in sickness, whilst others spoke of his
practice with sarcasm and ridicule. His mind, however, was not
constituted to be shaken in its purpose by the envious or malicious, *
or by the foolish stories of idle, prating gossips. When called, he
attended, and often acted the fart of both doctor and nurse.
Finally the applications for his services became so frequent that
his t'ime was almost wholly occupied in attending upon the sick.
"I began," says he, "to be sent for by the people of this part of
the country so much that I found it impossible to attend to my
farm and family as I ought; for the cases I had attended, I had
received very little remuneration, not enough to compensate me for
my time, and I found that my duty to my family required that I
should either give up the practice of medicine altogether, or make
it my regular business. I consulted with my wife, and asked the
advice of my friends what was best for me to do. They all agreed
that, as it seemed to be the natural turn of my mind, if I thought
myself capable of such an important undertaking, it would be best
to let my own judgment govern me, and do as I thought best. I
maturely weighed the matter in my mind, regarding the practice
of medicine as the most responsible calling any one could engage
in; yet my inclination for the practice was so strong that it seemed
impossible for me to divest my mind of it."
This was the critical period in Samuel Thomson's life; the
turning point of his history. The decision to be made was of mo¬
mentous consequences to mankind, for upon it devolved the fate
of a system of medical practice, entirely new, based upon correct
principles, and never before conceived of;—a system of treatment
embracing the agents and means required to cure disease, not only
XX BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
in the hands of the scientific, but, founded in truth, and consistent
in itself, both in theory and practice, particularly well adapted to
the common-sense understanding of intelligent people.
On the one hand were presented to his mind recollections of
the difficulties and trials he had met with in the desperate cases
that had come under his charge; the weight of responsibility that
must rest upon him ; his want of learning, and ignorance of the
ways of the world — unknown and unacquainted with mankind.
On the other hand, he was urged on by the almost irresistible
promptings of his genius. Finally he determined " to make use
of that gift which, I thought," says he, " the God of nature had
implanted in me."
" I thought of what St. Paul says in his Epistle to the Corin¬
thians, concerning the different gifts by the same Spirit: some had
the gift of prophecy ; another, the gift of healing; to another, the
working of miracles. I am satisfied, in my own mind," he
observes, "that every man is made and capacitated for some par¬
ticular pursuit in life, wThich, if he engages in, he will be more
useful than he would be in following a calling or profession that
was not allotted to him by his Maker. This is a very important
consideration for parents, and they should not compel their sons to
learn trades or professions contrary to their inclinations and the
natural turn of their minds; for it is certain, if they do, they never
can be useful or happy in following them."
Possessed of extraordinary powers of originality of thought, free
from the bias of education or preconceived opinions, the mind
of Thomson was prepared to receive instruction from the teachings
of Nature. Like the great Newton, he adopted a just method of
reasoning, extending his inquiries to first principles. Already he
had acquired a knowledge of the medical qualities and uses of many
important medicinal agents ; and had tested and proved the efficacy
of the animating, life-giving power of heat, as made manifest to his
understanding by observing its effects upon his own person and upon
all animals and vegetables; and thus led him to regard this element
as the main-spring of vital movement—the " principle of life."
Embarked on a voyage of discovery, in which his mental powers
were wholly and earnestly employed, Thomson suffered no fact to
escape his observation, which could in any way assist him in
obtaining knowledge in relation to the nature and causes of disease.
The result of his inquiries, after years of observation and reflection,
BIOGRAPHICAL SKETCH OP SAMUEL THOMSON. xxi
was the conviction that cold, or loss of heat, was the general cause
of disease ; and that, however produced, there is, in all cases of
disease, a lessening of the power of internal heat. The truth of »
these convictions was still further enforced upon his mind by the
beneficial effects produced by his method of treatment.
Lobelia emetics he had found to prove effectual in relieving the
stomach of foulness, and that they might be employed as a general
remedy in disease, with great benefit to the patient.
We also find that Thomson, at this time, entertained some
original ideas in relation to what he terms « Canker'''1—its cause
and remedy.
His experience in the treatment of measles, scarlet fever, and
small-pox, afforded convincing evidence, to his mind, that these
different forms of disease all partake of the same nature, except that
in the latter there is a stronger tendency to canker and putrefaction;
and that they require the same general plan of treatment, regardless
of the name of the disease.
In relation to medical education, Thomson remarks :—" Whether
I should have been more useful had it been my lot to have had a
medical education, and learned the profession in the fashionable
way, is impossible for me to say; probably I should have been
deemed more honourable in the world ; but I am inclined to think
that my mind would have been guided by the false theories and
doctrines of the day, and led away from Nature, and, in this way,
been prevented from making the discoveries which, I believe, will
prove a great blessing to mankind. * * * I wish my
readers to understand that I do not intend to convey the idea that
learning is not necessary and essential in obtaining a knowledge of
any profession; but a man may be college-bred, and yet possess
very little useful knowledge; and I also contend that natural
genius may enable a man to become useful, and even great in his
profession, in any science, without the advantages of a classical
education. Some of the greatest philosophers, statesmen, physi¬
cians, and divines, the world has ever known, have been self-
taught."
After Thomson had come to the determination to give up all
other business, and devote his time wholly to the practice of medi¬
cine, " I found it necessary," says he, " to fix upon some system
or plan for my future government in the treatment of disease; as
my practice had been the result of accident, as it were, and the^
XXli BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
necessity arising out of the particular cases that came under my
care, without any fixed plan. I deemed this necessary, not only
as a guide to myself, but that whatever future discoveries I should
make might be so arranged that my whole system could be easily
taught to others, and preserved for the benefit of the world. I had
no assistance other than my own observation and reflection, unaided
by learning or the opinions of others. I took nature for my guide,
\nd experience for my instructor; and, after considering every part
of my subject, came to certain conclusions concerning disease and
i*he whole animal economy, which the experience of more than forty
years has perfectly satisfied me is correct. My practice has inva¬
riably been conformable to the general principles upon which my
system is founded; and in no instance have I had reason to doubt
its correctness or applicability to every variety of disease incident to
the country.
" That all diseases are the effect of one proximate cause, and
should 5e treated upon the same general principles, is the foundation
upon which I have erected my fabric, and which I shall endeavour
.to explain in as concise a manner as possible, that my readers may
be convinced of its correctness."
Thomson, in his Theory, assumes the following grounds or
positions:—
1. That heat is life, and cold, death; or, in other words, that
heat is the cause of life and motion, and the absence of heat is
death.
2. That the constitutions of all mankind are governed by certain
.fixed laws.
3. That cold, or loss of heat, is a universal cause of disease;
and that in all cases of disease, however produced, there is a
lessening of the power of internal heat.
If the stomach become cloyed with too much food, or disordered
by food of an unsuitable kind, and digestion thereby suspended,
the natural temperature of the body will be lowered, and the
patient will become chilly, even in a warm temperature.
4. That when the power of inward heat is lessened, perspiration
ceases, and the system becomes thereby diseased.
5. That, as heat or warmth is a friend, and cold an enemy, the
means employed for curing disease should be such as will strengthen
the friend, in order that the enemy may be overcome.
.6. That all diseases to which the human body is liable are alike
\
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXlii
in principle; that is, in all cases, and under all circumstances of
disease, there is, to a greater or less degree, a weakened condition
of the living power, or principle of life.
7. That fever is not disease, but the manifestation of nature's
efforts to clear the system of disease. In the language of Thom¬
son, " What is commonly called fever is the effect, and not the
cause, of disease. It is the struggle of nature to throw off*
disease."
8. That coldness, or loss of inward heat, produces canker, or
unhealthy secretions, on the mucous membrane or lining of the
stomach and bowels, which prevents the digestion of food, and
keeps the stomach and bowels cold.
9. That whatever will increase the internal heat, remove obstruc¬
tions from the system, restore the digestive powers of the stomach,
and produce a natural perspiration, is universally applicable in all
cases of disease, and therefore may be considered as a general
remedy.
Convinced, by a long course of observation, of the truth of the
above positions, " my next ♦business," says Thomson, " was to
ascertain what kinds of medicine and treatment would best answer
the purpose, in conformity to these general principles in other
words, to discover the best way to aid and assist nature to remove
disease, and restore health.
" The first and most important consideration was to find a medi¬
cine that would establish a natural internal heat, so as to give
nature its command over the body. The emetic herb (No. 1),
Lobelia injlata, I found would effectually cleanse the stomach, and
aid in raising the heat and promoting perspiration ; but the system
would not hold it (the heat) a sufficient length of time to effect the
desired object. It was like a fire made of shavings—a heat for a
short time, then it would go out.
" After much trouble and experience, and trying every thing
within my knowledge, I at length fixed upon the medicine which I
have called No. 2, Cayenne pepper (or capsicum), for that purpose ;
and, after many years' experience in its use, I am perfectly con¬
vinced that it is the best thing that can be used to hold the heat in
the system until the stomach and various avenues of the body are
cleared of their obstructions, so as to produce a natural digestion
of the food, which will nourish the body, establish perspiration, and
restore the health of the patient. I found it to be perfectly safe
*
Xxiv BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
in all cases, and have never known any bad effects to arise from
its use.
« My next grand object was to get something that would clear
the stomach and bowels from canker, or the white, feverish coat
that was attached to the mucous membrane, which is more or less
affected by it in all cases of disease to which the human family are
subject. Canker and putrefaction are caused by cold, or want of
heat; for whenever any part of the body is so affected with the
cold as to overpower the natural heat, the tendency to putrefaction
commences; and if not checked by medicine, or if the natural con¬
stitution is not strong enough to overcome its progress, it will com¬
municate with the blood, when death will end the contest between
the heat and cold, or the powers of life and death, by deciding in
favour of the latter. In this case, too, as in the others, I have used
a great variety of articles which are useful in removing this feverish
coat or canker; but my preparation called No. 3, is the best for
that purpose of any remedy that has come within my knowledge,
though many other things may be used to good effect, which will
be described in their appropriate place, under the head of com¬
pounded medicines.
" My general plan of treatment," he observes, " has been, in all
severe, or seated cases of disease, to cleanse the stomach, by giving
an emetic, or No. 1, and produce as great an internal heat as I
could, by the use of Cayenne pepper, or other stimulants under the
head of No. 2; and, when necessary, made use of the steam bath,
in which I always found a great benefit, especially in fevers. After
this I have given medicine to clear the stomach and bowels of
canker (morbid secretions); and in all cases where the patient had
not previously become so far reduced as to have nothing to build
upon, I have, by persevering in my general plan of treatment, been
successful in restoring the patient to health."
In Dr. Thomson's Theory and System of Practice, we find sim¬
plicity, consistency, and a kind of philosophical reasoning well
suited to the common-sense understanding of the general reader.
Thomson's medical doctrines, however, are too simple for those
educated physicians who, as Thomson expresses it, " have had all
the common sense forced out of their heads by the false knowledge
they get at college." Neither have his doctrines been regarded as
scarcely worth a passing notice by those medical theorists who,
"ambitious for fame, have abandoned the book of Nature, and,
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXV
oCorning to receive the truth from her unerring teachings, have
soared away into the airy regions of speculation; and there, far
removed from the fountain of true science, theory after theory has
been ushered before the world, most of which, however, have
barely survived their inventors."
The following extracts are taken from " Robinson's Lectures."
"After bewailing the defects and disasters of medical science,
Dr. Rush consoled himself with the animating prospects of that
hope, which he often proclaimed from his desk, that the day would
arrive when medical knowledge should have attained to that apex
of perfection that it would be able to remove all the disease of
man ; and leave not for life a single outlet, a single door of retreat,
but old age ; for such is my confidence,-said he, in the benevolence
of the Deity, that he has placed on earth remedies for all the mala¬
dies of man. I remember still, with a thrill of love and gratitude
to that admired and venerable professor, with what enthusiasm and
transport, and prophetic vehemence, he used to pronounce that
sentiment at the close of his lectures. His confidence in the beqe-
volence of that Deity was boundless; and his own soul largely
partook of that divine character of the Almighty. We shall not,
shortly, look upon his like again. Quam de invenient parem?
" The influence of this hope, so feelingly expressed, and deeply
felt by every noble mind, that all diseases shall yet yield to the
power of medicine, in its perfect state, ought to be abundantly suf¬
ficient to determine us to examine with candour every new disco¬
very that is presented by the care and experience of man, whatever
may be his state or condition in life. Great men are not always
wise; and the very meanest is not beneath the care of a kind Pro¬
vidence, nor the influence of his holy Spirit.
" 'For thy kind heavenly Father bends his eye,
On the least wing that flits across the sky.'
"Dr. Thomson was not brought up in the schools and colleges
of the learned. But he was trained in one far superior for eliciting
the powers of an original mind, the severe school of adversity, that
perilous ordeal where the feeble-minded perish ; but the great of
heart come out of the fires, purified and resplendent in ten-fold
brightness. They rebound by the very impulse and pressure of the
blow that was designed to crush them, and reach their elevation
m the sky; to refute an objection made against the goodness of
XXvi BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
Divine Previdence, that the virtuous were often not only destitute
of the blessings of fortune, but of nature, and even the necessities
of life."
Again, the same writer observes:—
" Those who devote themselves to a new theory; who have to
stand alone in defence of new truths, and to combat alone the doc¬
trines and practice of the self-reputed leaders in medical science,
require a large portion of the self-denying spirit of the Grecian
sage. And Dr. Thomson seems to have been admirably endued
with that supreme devotion to his object which has brought the
martyr to the stake, and the patriot to pour out his blood on the
field of battle. I cannot help uniting with Dr. Thomson in his
own sentiment, that Providence must have presided over his
labours, with an especial care, for the good of mankind."
Thomson pursued, with assiduity and firmness, his system of
practice, and his fame began to spread. The greater part of the
cases he was called to were of a deeply-seated character, and often
such as had been abandoned by the regular doctors; but when he
undertook a case, he persevered in the treatment, even to the sacri¬
fice of not only his rest, but his health; and his practice was suc¬
cessful to that degree, that, in many instances, patients were cured
in- so short a time, that they came to the conclusion, afterwards,
that very little had ailed them.
In relation to the treatment Thomson received, he says:—
" While I was attending those who were sick, and relieving their
distress, they were ready to flatter, and give me great credit for my
practice; but after I had nearly worn myself out in their service,
they began to think it was not done in a fashionable way; and the
doctors made use of every means to ridicule my mode of treatment,
for the purpose of more successfully maintaining their credit and
ascendency with the people. This kind of treatment I did not then
understand so well as I do now; as I have since learned, from
hard experience, how to appreciate reports of doctors, when excited
on account of the restoration of their old, abandoned patients to
health, by one who does not believe or practise in their peculiar
way.
" The words c quack' and ' quackery,' when used by the doctors
against me, effected the object intended, which was to prejudice
the people against my practice; but I would ask the candid and
reflecting part of the community, which is the greatest quack, the
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXVli
one who relieves their infirmities by simple and safe means, or he
who administers poisons and breaks down the constitution of the
patient, and leaves death to relieve them from pain ?"
The following incident, related by Dr. Thomson, occurred on
his meeting with a doctor at the funeral of a young man who had
died very suddenly. On entering the room, the physician, who
had attended the young man, addressing Dr. Thomson, said, " ' I
understand you have a patent to cure such disorders as that,'
pointing to the corpse. I said no ; and then intimated what I
thought of him. He put on an air of great importance, and said
to me, 'What can you know about medicine? You have no
learning; you cannot parse one sentence of grammar.' I replied
that I did not know that grammar was made use of as medicine;
and if the treatment this young man had received was according to
grammar, I had no inclination to become acquainted with it." The
doctor became enraged, and threatened to horsewhip Thomson,
who replied that " he might do what he pleased, provided he did
not poison him with his grammar."
v Desirous of introducing his system of practice in other parts, and
to give himself and family some respite from the toils of a laborious
practice, he left home and went to New York, to ascertain the cha¬
racter of the yellow fever, as it was prevailing there at this time.
" I had been," he observes, " in constant employment among the
people in my neighbourhood and the adjoining towns and country
for four or five years, and had been very successful, not having lost
one patient during the whole time. My house had been constantly
filled with patients from all parts of the country, for which I had
received little or no compensation for my services. Myself and
family were broken down and worn out with nursing and attending
to them night and day, so that I was obliged to leave home to free
myself and family from so heavy a burthen."
In the course of a few days after his arrival at New York,
Thomson applied to the mayor of the city, and also to the board
of health, to ascertain whether or not an opportunity would be
afforded him to try the effects of his medicine and system of prac¬
tice on the prevailing fever. They informed him that he could
practise, but that he could obtain no compensation for it by law.
During his stay in New York, several cases of the disease came
under his immediate care, and the practice proved successful,
effecting speedy cures. The first case he attended was a Mr.
XXviii BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
McGowan, the teacher of a Catholic school, and an acquaintance of
the man with whom he boarded. He pursued his usual course of
treatment, for increasing the power of internal heat, cleansing the
stomach and bowels, and producing perspiration. The medicine
given caused severe pain and distress, so much so that the friends
of the patient became alarmed; but Thomson told them that this
was a favourable symptom, as it was the consequence of returning
sensibility; or, in other words, the heat contending with, the cold ;
the patient having been in a cold and insensible condition pre¬
viously. After the patient had remained in this condition about an
hour, perspiration ensued, and he became easyand on the follow¬
ing day was able to be about, and soon recovered his health, under
the treatment.
After three months' absence from home, during which period
Thomson had many convincing proofs of the truth of his theory and
of the efficacy of his system of practice, he returned to his family,
and was often called on to practise in the neighbourhood; but he
declined most part of these applications, in consequence of the ill
treatment he had formerly received.
He continued to visit different parts of the country for the purpose
of collecting medicine and introducing his plan of treatment. The
success he met with was altogether unprecedented; curing case
after case regarded as incurable.
The outset of Thomson in the medical world was, when we take
his success as a criterion, exceedingly flattering; but when we
regard the treatment he received from the hands of others, it was
far from encouraging.
During a visit to Newburyport, he came in contact with a Doctor
French, a vicious, unprincipled man, who, in consequence of
Thomson's professional prosperity, became his bitterest enemy.
He had restored patients that Dr. French had pronounced incurable ;
and each new achievement of Thomson's engendered increased
hatred. He opposed him, insulted him, denounced him as a mur¬
derer, in fact did every thing in his power to injure his reputation ;
but all was unavailing; and it was not until he had threatened to
shoot him, that Thomson considered himself forced, to take legal
action upon the matter. He deemed it necessary for his own pre¬
servation to compel him to suffer the punishment of the law. Still
his malice continued unabated.
But he was not alone and friendless in his difficulties; a few
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. Xxix
noble spirits upheld and aided him in his time of trouble, and, by
their praiseworthy actions, have made themselves entitled to the
everlasting gratitude of every true Thomsonian; among the rest,
pre-eminent for his exertions in behalf of Thomson, we must not
pass over in silence the name of Judge Alexande| Rice, whom he
thus mentions:—" For all his time and trouble, through the whole
of my persecutions and trials, and for his kindness and friendship
on all occasions, I shall ever consider myself under the greatest
obligations." A man who would thus bravely stand by a fellow-
being in such a dark hour, when the whole world, as it were, was
arrayed against him, deserves, at least, this simple notice, as a tri¬
bute to his memory.
Thomson's practice employed every moment of his time, his
scene of action being the principal towns in Eastern Massachusetts
and Southern New Hampshire, and many in the surrounding states.
Now came the darkest spot of the whole history; a transaction
that casts a stigma upon the perpetrator and his minions, which
will brand them so long as the name of Samuel Thomson exists in
the memory of man, as consummate, inveterate, malicious villains!
I speak it plainly, and am fully prepared to prove the assertion;
to afford evidence that the behaviour toward Thomson is an ex¬
ample equalled in atrocity only by the cruelties of the barbaric
ages. The facts are plain and undeniable, and best told in Thom
son's own language.
"On my arrival at Salisbury, my friends informed me that Dr
French had been very busily employed in my absence ; and that
he and a Deacon Pecker, who was one of the grand jury, had been
to Salem, to the court, and on their return had said that there had
been a bill of indictment found against me for wilful murder!
They advised me to leave, and keep out of the way; but I told
them I should never do that; for if they had found a bill against
me, the government must prove the charges, or I must be honour¬
ably acquitted. About 10 o'clock at night, Dr. French came to
the place where I stopped, with a constable, and made me a pri¬
soner in behalf of the commonwealth. I asked the constable to
read the warrant, which he did; by this I found that Dr. French
was the only complainant, and the justice who granted the warrant
ordered me before him to be examined the next morning. I was
then taken by the constable to Dr. French's house; while there, a
prisoner, Dr. French abused me and insulted me in the most
XXX BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
shameful manner that can be conceived of, without any provocation
on my part. He continued his abuse to me till between two and
three o'clock, when he set out for Salem for the indictment. After
he was gone, I found, on inquiry of the constable, that after he had
caused me to indicted, he came home before the bill was made
out; and finding that I was at Salisbury, fearing I might be gone,
and he should miss the chance of gratifying his malicious revenge
against me, he went to a brother doctor, who was a justice of the
peace, before whom he made an oath that he had probable ground
to suspect, and did suspect, that I had, with malice aforethought,
murdered sundry persons in the course of the year past, whose
names were unknown to the complainant; upon which a warrant
was issued against me, and I was arrested as before stated, in
order to detain and keep me in custody till the indictment could be
obtained. The examination was deferred until near night. The
constable took me to his house, in the mean time, and put me in
the back room and left me alone, all of them leaving the house.
When they came back, some of them asked me why I did not make
my escape, which J might very easily have done, out of a back
window; but I told them that I stood in no fear of the conse¬
quence, having done nothing whereby I ought to be punished.
Just before night, Dr. French arrived with a sheriff, and ordered
me to be delivered up by the constable to the sheriff; after Dr.
French had again vented his spleen upon me by the most savage
abuse that language could express, saying that I was a murderer,
that I should either be hung or sent to state-prison for life, and he
would do all in his power to have me convicted. I was then ironed
by the sheriff, and conveyed to the jail in Newburyport, and con¬
fined with a man who had been convicted for a criminal offence,
and sentenced to solitary confinement for one year. I was not
allowed a chair or a table, and nothing but a miserable straw bunk
on the floor, with one poor blanket, which had never been washed.
I was incarcerated in this prison on the 10th day of November,
1809; the weather was very cold, and no fire, not even the light
of the sun, or a candle; and, to complete the whole, the filth ran
from the upper rooms into our cell, and was so offensive that I was
almost stifled with the smell. I got no sleep that night, for I felt
something crawling over me, which caused an itching, and not
knowing what it was, inquired of my fellow-sufferer; he said that
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXXi
it was lice, and that there were enough of them to shingle a
meeting-house.'
" In the morning, just light enough came through the iron grates
to show the horror of my situation. At breakfast time I was called
on through the grates to take our miserable fare; it consisted of an
old tin pot of musty coffee, without sweetening or milk, and was so
bad as to be unwholesome ; with a tin pan, containing a hard piece
of Indian bread, and the nape of a fish, which was so hard I could
not eat it. Mr. Osgood came to see me; my situation affected him
very much ; he asked liberty of the jailor to furnish me with a bed,
which was granted; — I put it on the old one, and allowed my
fellow-sufferer a part of it, for which he was very thankful. I had
provisions enough brought me by my friends for us both, and I
gave him what I did not want; the crusts and scraps that were left,
his poor wife would come and beg, to carry to her starving children,
who were dependent on her. Her situation and that of her hus¬
band were so much worse than mine, that it made me feel more
reconciled to my fate ; and I gave her all I could spare, besides
making his condition much more comfortable, for which they
expressed a great deal of gratitude.
"In a few days after my confinement, Judge Rice came to see
me, and brought with him a lawyer. On consulting upon the case,
they advised me to petition to the judges of the Supreme Court to
hold a special court to try my cause, as there would be no court
held by law, at which it could be tried, till the next fall; and as
there could be no bail for an indictment for murder, I should have
to remain in prison nearly a year, whether there was anything
against me or not. This was the policy of my enemies, thinking
that they could keep me in prison a year, and, in all probability, I
mould not live that time, and their ends would be fully an¬
swered
On the 20th of December, 1809, the Supreme Court convened
for the trial of Thomson, at which Judge Parsons presided, with
judges Sewall and Parker assistant judges.
The history of the trial would occupy too much space to be
given here. The testimony against Thomson amounted to nothing,
and even Dr. French's evidence was more in favour of Thomson's
practice than against it.
After the testimony of some eight or ten witnesses had been
given, and among them that of three physicians, Judge Parsons
XXxil BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
asked the solicitor-general what they had in evidence for a grand
jury to find a bill of indictment upon.
The judge was about to charge the jury, when the solicitor"
general arose and said that if it was not proved to be murder, it
might be found manslaughter. The judge said, You have proved
nothing against the man, and repeated, that he wondered what they
had for a grand jury.
In his charge to the jury, the judge stated that the prisoner had
broken no law, common or statute, and quoted Hale, who says,
"Any person may administer medicine, with an intention to do
good; and if it has the contrary effect from his expectation, and
kills tfte patient, it is not murder, nor even manslaughter. If
doctors must risk their lives for their patients, who would practise ?"
He quoted also from Blackstone, who says, " Where no malice is,
no action lies."
The charge being given to the jury, they retired about five
minutes, and returned into court, and gave in their verdict of not
guilty.
" I was thus honourably acquitted, without having had an oppor¬
tunity to have my witnesses examined, by whom I expected to
have proved the usefulness and importance of my discovery before
4 a large assembly of people, by the testimony of about twenty-five
creditable men, who were present at the trial, besides contradicting
all the evidence produced against me. After the trial was over,
was invited to the Sun Tavern to supper, where we enjoyed our¬
selves for the evening. When we sat down to the table, several
doctors were present, who were so offended at my acquittal, that
they left the table; which made me think of what the Scripture
says, that the < wicked flee when no man pursueth ; but the right¬
eous are bold as a lion.' "
After recovering his health and strength, he recommenced prac¬
tice, and employed much of his time in giving information to
others, in different parts where he visited.
In 1813, Thomson repaired to Washington, and obtained a
patent to secure him in his just rights to his medical discoveries,
and, as he thought, afford a protection against laws made to support
the fashionable practice of physic.
On his return, he remained several days in Philadelphia, for the
purpose of conferring with Drs. Rush and Barton upon the subject
of his medical discoveries. He was treated with courtesy by these
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXxiii
two physicians ; and Dr. Barton agreed to make a trial of Thom¬
son's remedies, and Dr. Rush also said he would agree to any
thing that Dr. Barton consented to in relation to the subject. Soon
after this, Dr. Barton died, and not long after, Dr. Rash also died.
" Thus I was," remarks Thomson, " deprived of the influence of
these two men, which, I am confident, would have been exerted in
my favour."
Thomson now devised the plan of forming societies for the pur¬
pose of mutual instruction, ^nd to afford strength and encourage¬
ment to the members against the strong current of opposition set¬
ting so heavily against the practice.
In the spring of 1815, Thomson visited Philadelphia, by request.
About twenty families purchased his Family Guide, and the right
to practise. So far as the writer's knowledge extends, these fami¬
lies and their children, without an exception, still employ the
Thomsonian medicine and plan of treatment.
Societies were formed in many places—the system was gaining
rapidly in the confidence of the people. Agencies were formed,
and medical stores established; persons possessed of the right turn
of mind, and more especially those who had been under treatment
a considerable length of time for some deeply-seated complaint,
and thereby becoming acquainted with the practice, engaged in it;
and, as long as they pursued Thomson's general plan of treatment,
were very successful, giving general satisfaction to those upon
whom they practised.
Honest, almost to a fault; unsuspecting and confiding, the con- «•
fidence of Thomson was easily won. Applicants for agencies were
accommodated, and full confidence placed in their honesty; but
this agency business soon became a source of much trouble and
annoyance to Dr. Thomson ; for, when once detected dishonesty
in an agent, he viewed him in the light of a bitter enemy ; and this
cause alone—I mean the difficulties occurring between Dr. Thom¬
son and his agents—operated as a stumbling-block to the progress
of Thomsonianism, which, previous to these occurrences, was fast
advancing in public favour. Whether Dr. Thomson was justifiable
in the course he pursued with some of his agents, is a matter of
doubt with many of his friends.
But still greater obstacles to the advancement of Thomsonianism
were presented. The practice, up to the time that Thomson
obtained his patent, was under his own direction, or in the hands
3
XX XIV BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
of nurses who had been with him, and adopted his course ot
practice.
But, as the system became more popular, there was an increased
demand for practitioners, and the practice fell into other hands ;
into the hands of those who, in many instances, were not only
entirely deficient in medical knowledge, but who did not compre¬
hend the general principles of Thomson's system. Such practi¬
tioners rarely, if ever, carry out the Thomsonian principles in their
treatment of disease, but are very apt to give in to the prejudices
of others, and do just what they apprehend will best suit the fancy
of patients or their friends.
The steam-bath was, by the regular faculty and their adherents,
represented in such a way as to convert it, in popular estimation,
into a " monster of hideous mien and some professedly Thom¬
sonian practitioners, to avoid the odium of the term " steam-
doctor," omitted its application, even where its use was essentially
necessary for the restoration of the health of their patients.
Then, again, there were others who, influenced more by selfish
motives than by a regard to the welfare of society, assumed to be
leaders in the revolutionary movements brought about through the
genius and indefatigable exertions of Dr. Thomson; and with a
view, it would seem, of placing upon their own brows'the laurels
so deservedly won by Thomson, instituted a practice differing as
wTidely from Thomson's as they could, not to render their practice
altogether inefficient. "Works were published and announced to the
* world as containing an improved system of botanic practice, but in
reality the reverse of an improvement on Thomson's system, con¬
taining very little, .if any thing, that was really valuable, that was
not obtained through Thomson's discoveries. These and other
projects put into execution, all tending to mar the prosperity of his
system of practice, and to lead the enquiring public into error,
proved a source of deep regret and aggravation to Dr. Thomson ;
who had, up to the present period of his life, devoted all the powers
of his genius in maturing his system of practice, and had succeeded
in raising a medical superstructure, based upon true principles, and
built up, as it were, inch by inch, by new acquisitions of know¬
ledge, gained by a long and laborious course of observation and
experience, at the bed-side of the sick.
Suits were instituted against certain parties, for infringements
BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXXV
upon his rights ; but the general result of such movements was a
pecuniary loss to Dr. Thomson.
We do not regard Thomson's as a perfected system of medicine.
It needs extension beyond the limits its founder gave it. But no
material part of it can be dispensed with, in general practice,
without impairing its efficacy. The medicines may be prepared
and compounded in various ways, without impairing their qualities.
The hot-air bath will effect the same object for which Thomson
employed the steam-bath; but it will not do to depend upon the
warm-water bath in place of the steam or hot-air bath. The astrin¬
gents are among the most essential of Thomson's medicines, and
yet, in some of the botanic works, this class of medicines is scarcely
noticed. And, again, a peculiar feature in Thomson's system, is
the entire exclusion of cathartics; whereas, in the botanic practice,
purgative medicines are used extensively, even those which have
the most prostrating tendency, as croton oil and mandrake.
Taking a firm stand against the innovations of pretended im¬
provers upon his practice, Thomson soon arrayed against him an
army of opposers from among the professed friends of medical
reform. He was charged with illiberality, obstinacy, and disregard
for any thing beyond his own private interests. The intelligent,
unprejudiced mind, however, will discover, in the faithful history
of Thomson's life, a just refutation of any such charges.
The unprecedented success that had attended Thomson's mode
of treatment, in all the various forms of disease that had come under
his care, fully warranted him iri pursuing the course which he did
pursue in relation to the subject of improvement upon his system.
He had avoided the use of any article possessing poisonous or dele¬
terious qualities, inasmuch as his great object was to assist
nature.
The field of his labours had now become enlarged to such an
extent that a great part of his time was passed in visiting different
parts of the Union, giving information to the people, by calling
meetings, for the purpose of explaining his system of practice, by
lecturing to them in his plain, domestic, unostentatious manner;
appointing agents, and exerting his influence in protecting his
system from the threatened innovations of pretended improvement.
The friends of Dr. Thomson were generally intelligent and well-
informed. Among the few members of the medical profession who
regarded Thomson as a true medical reformer was Doctor Benjamirj
XXXvi BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
Waterhouse, who was, for forty years, professor of Materia Medica
in Cambridge University.
The following is part of a letter from Dr. Waterhouse to James
Parker, of Sharon:
"Your general idea, that 1 think favourably of the labours of
Samuel Thomson is founded in truth. Without ever reading the
writings of Hippocrates and other Greek physicians, Thomson is
imbued with their spirit of closely following nature.
#.# # # * * # *
Thomson has done great service to the science and practice of
medicine ; and I wish his science had been commensurate to his
experience and natural sagacity. But he sowed the seed, and left
the harvest to be gathered by those following him, as is commonly
the case."
In a letter in reply to one from Dr. Thomson, Dr. Waterhouse
writes as follows:—
" Cambridge, December 8, 1835.
To Samuel Thomson,
Botanic Practitioner of Medicine.
*
Dear Sir :—To the questions put to me yesterday, I answer
that I remain firm in the opinion that you were the discoverer of
the remarkable medicinal virtues of the Lobelia Injlata, as a safe
emetic, and other rare qualities, in effectually deterging the stomach
and intestines of foul and morbid matter, a prime object in the
removal of all disorders consequent on imperfect digestion, the
fruitful source of almost all our chronic disorders. The efficacy
and safety of this vegetable I have had ample and repeated proofs
of in a number of cases and in my own person, and have reason to
value it equal to any article in our materia medica.
Your joining to the emetic effects of Lobelia the vapor-bath, is,
in my opinion, a happy practice, if conducted with requisite care
and caution, but not to be intrusted to any that are not duly
instructed in the danger attendant upon a careless and harsh use of
a warm bath, without every convenience and accommodation in
such seasons as the present.
That you yourself were the originator of this compound process,
very extensively known under the title of the Thomsonian Practice,
or System, I have no doubt whatever. I mean the uniting the
warm bath with the thorough elimination of the whole alimentary
* BIOGRAPHICAL SKETCH OF SAMUEL THOMSON. XXXvii
canal. I value it, and recommend it on this account.—It effects
in three or four days, what we regular physicians use to occupy as
many weeks. As a public teacher of the practice of physic, I
have told my pupils, for nearly half a century past, that when they
have learned how to restore the long-impaired organs of digestion
to their pristine or natural state, they have acquired two-thirds of
their profession ; and on that simple principle is based the whole
doctrine of my printed Lecture on the pernicious effects of smoking
cigars, and the inordinate use of ardent spirits.
Benjamin Waterhouse."
In 1832, the season that Cholera prevailed epidemically in this
country, Thomson published a circular, extending an invitation to
his agents, and the friends of his system, to meet in convention, at
Columbus, Ohio. He also devoted three months to travelling, for
the purpose of soliciting the co-operation of his friends in the
movement. The convention assembled in December, 1832, and
organized under the name of the " United States' Botanic Conven¬
tion." The subjects presented by Dr. Thomson to the notice of
the convention were:—the nature of Cholera, and the proper plan
of treating it; the devising of means for extending the knowledge
of his system among the people, and for perpetuating it, in its sim¬
plicity and efficiency, for the benefit of mankind.
After having been in session several days, the convention -ad¬
journed to meet the ensuing year, at Baltimore; and in this way
continued to meet annually, at different points, for several years.
The addresses from Dr. Thomson to the different conventions
are interesting documents. His address to the first convention
closes with the following language:—
" The privilege and consolation of such an interview, I shall not,
probably, ever again enjoy. I wish to inspire the most perfect
harmony and unanimity in all your deliberations. When my hoary
head lies down in dust, may the cause survive the ruins of the
grave. The hope of leaving you in harmony and peace, pressing
forward, as one man, in the great pursuit, shall cheer my mortal
hour. These benevolent desires animate my mind, and support me
in my trials ; and to transfuse such views and feelings to posterity,
is the best legacy I can bequeath the world, when I shall retire
behind the curtain that veils all futurity from mortal eyes."
The limits of this sketch will not admit of a further relation of
XXXviii BIOGRAPHICAL SKETCH OF SAMUEL THOMSON.
the events and incidents attending the checkered life of Samue.
Thomson. Enfeebled by age, he retired to Boston, and employed
the remainder of his life chiefly in preparing medicines, giving
advice to the sick, &c. He died on the fourth of October, 1843,
in his seventy-fifth year.
Phrenological Character. — The following description of the
phrenological constitution of Samuel Thomson, is given by a writer
in the Boston Thomsonian Manual:—" Dr. Thomson had Firmness,
full; Combativeness, active, not imperious ; Self-Esteem, medium ;
Reverence, small; Conscientiousness, full; Benevolence, in the
extreme, but expansive ; the reflective faculties, Causality and Com¬
parison, very large; sustained by a full development of the percep-
tives. They gave him the cast of intellect adapted to effect a great
work, if thrown into the right sphere of action. All his animal, or
purely physical organs, were active, comparatively full, but well
balanced. As a whole, we find the high, expansive, intellectual
forehead, the correspondent lineaments of countenance, which, in
person, presence, portraiture, made him an uncommon man;—his
likeness being as distinct from all others as that of Washington, and
as marked in its outlines as was the history of his life. * * *
He was so constituted as to adjust him to the great work to which
he was called. Like Cyrus, he was ' girded, in the omnipotence
of nature, for it.'
" Posterity—the millions yet unborn—will appreciate the value
of Samuel Thomson's system of practice, and enroll his name among
the greatest of the benefactors of the human race."
PRINCIPLES OF MEDICINE.
I. Matter, in all its diversity of character, quality, form and
combination, may be classed in two great divisions, namely * Or¬
ganic and Inorganic Matter.
II. Organic Matter includes the two vast kingdoms of nature;
the animal and the vegetable kingdom.
III. Inorganic Matter includes all bodies not possessed of life,
and which are not endowed with a capacity for life.
V. Without organization, there cannot be life; and again, or¬
ganized bodies, though possessed of a capacity for life, require the
impression of " stimulants, to call it into activity."
V. " Life is the consequence of the operation of stimuli or ex¬
citants, on organized matter."—Brown.
" Life is the organism in motion,"—Richrand.
" A proper organization, and suitable temperature, produce life
and motion. Caloric, or heat, is the cause of life and motion."—
Thomson.
" Caloric, whatever be its nature, is the first and most important
of all stimulants; and if it ceases to animate the economy, others
lose their influence over it."—Broussais.
There is, in an egg, a point of organized matter—a germ en¬
dowed with a capacity for life. Place the egg in a temperature
of 98 degrees of heat, and vital movements will commence in the
elements composing the germ. Under the stimulating power of
heat, the germ is nourished, organs developed, and a perfect animal
formed. If the egg becomes chilled, vital movement ceases, dis¬
organization and decomposition ensue.
In the early period of human animal life, heat is derived from
the mother; and, after birth, heat is generated within the body.
The generation of heat within the body is as necessary to vital
action in man, as external heat is necessary to sustain vitality in
the chick, before it bursts from the shell.
(xxxix)
xl
principles of medicine.
VI. It is by the animating power of heat, that the system be
comes susceptible to the impression of other life-supporting agents
as air, light, electricity, galvanism, food, drinks, and medicine.
Animals that remain torpid and insensible during winter, are
reawakened into life and activity, on the return of warm weather.
Upon the same principle, the steam or vapour bath proves a power¬
ful auxiliary remedy in the cure of disease, by imparting caloric
and electricity to the blood; and, in many instances of slight ail¬
ments, is sufficient of itself to restore to the system the power ne¬
cessary to establish health.
VII. " If the system be deprived of caloric for a certain length
of time, all the preservative, recuperative, and sanative phenomena
cease. It is the same, also, as respects oxygen."—Broussais.
VIII. Caloric (heat) brings into play the nerve power, (assumed
to be an electro-galvanic influence,) which, operating through the
medium of the nervous apparatus, carries on and governs all the
vital functions—respiration, circulation, digestion, nutrition, assimi¬
lation, &c.; selects and expels effete or worn-out matter, by the
pores of the skin, the kidneys, and other depuratory organs; car¬
ries on all the various secretions; endows the organs with sensa¬
tion ; and enables the organization to resist the influence of causes
that tend to its destruction.
If the premises advanced in the above paragraph be true, they
prove (theoretically) the correctness of the practice introduced by
Dr. S. Thomson; which has for its object to promote and sustain
the function of calorification, or as Dr. Thomson terms it, " the
power of inward heat," as a means of aiding the vital functions,
under the control of the nervous influence, to overcome disease,
and re-establish health. It is through the agency of vital energy,
inseparably connected with the function of calorification, that the
causes of disease are resisted, and health restored, when the sys¬
tem is invaded with disease. This is universally true, under all
circumstances, in relation to general disease.
IX. "While the assimilation of food, in vegetables, and the whole
process of their formation, are dependent on certain external influ¬
ences which produce motion, the development of the animal or¬
ganism is, to a certain extent, independent of these external influ¬
ences; just because the animal body can produce within itself that
source of motion which is indispensable to the vital powers.
* * * * The mutual action between the elements of
the food and the oxygen conveyed by the circulation of the blood
to every part of the body, is the source of animal heat."—Liebig.
A good digestion, and a proper supply of food and air, are
-equisite, not only to supply the wastes of the system, but also to
PRINCIPLES OF MEDICINE.
produce the amount of heat and nervous energy necessary to
maintain healthy action in the system. " The stomach is the fire¬
place of the system, and food, the fuel that furnishes the heat, upon
which life and motion depend."
X. "The law of organic life is fixed; it cannot be changed;
but the iorces that bring this law into activity, heat, electricity,
and magnetism, are never fixed, but are constantly subject to dis¬
turbances from perturbating influences."
XI. The laws of life always operate in the fullest degree of per¬
fection, under the attending circumstances. To operate in their
greatest degree of perfection; or, in other words, to maintain a
state of perfect health, it is requisite that all the forces that influ¬
ence the operation of the laws of life, shall be in the most favour¬
able condition.
XII. A deficiency in the supply of either aliment, atmospheric
air, or heat, and its associated elements, light, electricity, and
magnetism, renders the operation of the laws of life imperfect, and
necessarily occasions disease.
XIII. Nutrition, the process by which nutritive material is
converted into living organic structure, is the first vital action,
and constitutes, during life, the basis of every other vital move¬
ment, or function. Derangement of the nutritive action of an
organ, necessarily impairs its functions.
The various functions, digestion, respiration, and circulation,
subserve the purpose of furnishing the necessary supply of nutri¬
tive materials; and calorification and enervation are the sources
of motion.
XIV. Simultaneously with the nutritive, or assimilative action,
there is a constant decomposing process being carried on, by which
worn-out material is taken up and expelled, mainly by the kid¬
neys, and through the pores of the skin. The latter constitutes
the great outlet of morbific humours from the system; and this
fact makes manifest the importance of promoting perspiration as
a means of clearing the system of disease.
XV. "In the inferior animals, and vegetables, the vital actions
are capable of suspension, without their destruction ; the organic
force diminishes, but is not entirely extinguished. On the renewal
of stimuli, the vital phenomena again reappear, and the organic
force is renewed. These facts are seen in hybernating animals,
and in vegetables in the temperate latitudes, having alternate sea¬
sons of opposite temperature. The abstraction of the stimulus of
V
Xlil PRINCIPLES OF MEDICINE.
heat diminishes the vital actions; the functions of the various
organs essential to life are gradually suspended, and almost every
trace and sign of animation are lost. With the renewal of the
stimulus of caloric, whether artificial or solar, reanimation com¬
mences ; the vital actions are reawakened; they are manifested
in their fullest energy; and the organic force, which had been
nearly extinguished, acquires its former intensity."
In the higher order of animals, and in man, " vital action, once
commenced, cannot be again suspended for any length of time;
they have different degrees of energy; but, if once terminated, or
reduced to a certain point, they are not again renewed; their ces¬
sation is permanent, and with them ceases the organic forces.
This constitutes death." The human system is endowed with
power to react against causes that tend to its destruction. The
impressions produced by the causes of disease being communicated
to the brain by the nerves of sensibility, a recuperative action is
instituted, with the design of expelling the cause of disease.
XVI. Nature is the real physician: in other words, diseases are
cured, wounds healed, and injuries repaired, by processes of ac¬
tions or movements under the control of the vital principle, or laws
of life. These curative processes are manifested by fever, inflam¬
mation, vomiting, diarrhoea, and convulsions.
XVII. The nervous, or electro-magnetic, fluid, which, under
the vivifying influence of caloric, and acting in conformity to the
organic laws, is the immediate or proximate agent of every vital
movement, is generated from red globules of blood, as they circu¬
late through the nerve centres. All recuperative, life-sustaining
actions are carried on through the agency of the nervous fluid.
The nerves of the internal mucous membranes, especially those
of the stomach, exercise a controlling influence over the digestive
nutritive, and all other vital functions. The amount of nerve-
force generated will be in the same ratio to the quantity of red
globules of blood circulating through the nerve-centres; and, con¬
sequently, to abstract blood, by the lancet, or to prevent its forma-
tian by poisonous drugs, taken into the stomach, that impair diges¬
tion, retards the curative operations of nature.
XVIII. In disease, the digestive functions are either impaired
or suspended, and, consequently, the system is partially or wholly
deprived of a supply of the means of subsistence, from the natural
source. This important fact, it would seem, has never been taken
into consideration by medical theorists, inasmuch as their general
course of treatment directly tends to lessen the amount of blood,
or to produce greater prostration of the digestive functions. The
supply of nutritive material from food being cut off, in conse-
PRINCIPLES OF MEDICINE.
xliii
quence of a suspension of the digestive functions, vital action soon
would cease, were it not that nature, but more properly, the
Author of nature, has provided a means for sustaining life, by a
process of reaction, constituting fever. The pores of the skin are
" locked up," retaining the heat; the action of the heart is quick¬
ened, giving increased impetus to the circulation of the blood
through the nerve-centres, to sustain the various functions; and,
being impelled through the lungs more rapidly, with a correspond¬
ing increase of respiration, the blood thereby becomes more highly
vitalized, and better adapted to sustain the recuperative actions,
necessary to overcome the influence of the cause of disease. In
malignant forms of disease; for instance, in that class termed
" continued fevers," the life of the patient depends upon the con¬
tinuance of the recuperative action—the fever—until a favourable
crisis is effected.
XIX. It is by action—by vital movement—that disease is over¬
come. The direct tendency of cold, poison, and other causes of
disease, is to suspend vital motion, weakening the power that sus¬
tains nutrition, or vital chemistry. The lower order of animals,
those not endowed with the power to react, never have fever;
neither can inflammation be established in them; whereas, in the
higher order, and in man, the brain is made to know of the exist¬
ence of disease; and establishes a recuperative process, consti¬
tuting fever and inflammation. Hence, most of the symptoms of
disease are the result of the protective power of the economy in
operation;—the efforts of the system to sustain itself, and to throw
off disease.
The most fatal cases of disease are those unattended by fever;
for instance, in small-pox and scarlet fever, the specific poison,
producing the disease, operates, in some cases, with such deadly
power, that the vital forces are at once prostrate below the point
to admit of reaction;—the patient remaining cold, and partly in¬
sensible, from the commencement of the disease, until the spark
of life is extinguished. The cold plague, as it was termed, which
proved so alarmingly fatal in some parts of the old world, was
characterized by coldness and absence of fever. This was, also,
a peculiar feature of the Asiatic, or epidemic, cholera;—the func¬
tions of nutrition, and, consequently, that of calorification and
enervation, being, in manv cases, suspended, in the very outset of
the disease.
XX. The amount of vital power in the system is always less in
disease than it is in health. In fever, of even the highest grade,
there is always a diminution of the life-power;—nature fans the
fire of life by forcing the blood through the lungs at an increased
ratio, and quickening the respiratory movements. These are the
xliv
PRINCIPLES OF MEDICINE.
means furnished by the Creator to supply the necessary wants of
the system, when the stomach cannot digest food.
XXL The stomach is the great repository from which the body
receives its support; and its condition exerts a widely-extended
influence over the system. Being the recipient organ for all iood,
drinks, and medicines; and, from its " central and exposed posi¬
tion, and extraordinary sympathies," this organ is especially liable
to become disordered, and its functions impaired, from many
sources; and seems to be the organ which is first affected, in
nearly every variety of disease. While the functions of the
stomach remain unimpaired, the causes of disease are repelled;
but when suspended, or impaired, from any cause whatever, the
secretions become vitiated, the circulation flags, the nutritive
action diminished, and the animal temperature lowered. These
conditions are the immediate consequences of disorder, or suspen¬
sion of the functions of the stomach. Under favourable circum¬
stances and conditions, nature will rally, and bring into operation
a counteracting influence, for the preservation of the system, con¬
stituting the recuperative processes, previously described.
The influence of cold, in engendering disease, may be traced
to its prostrating effects upo'n the digestive and nutritive functions.
Food, taken into the stomach unsuited to the state of the digestive
functions, is a common source of disease. Food, remaining undi¬
gested in the stomach, becomes an enemy to health; and, at par¬
ticular seasons, and under certain conditions, actively poisonous
agents are formed, by chemical changes taking place between the
elements of food and the acrid secretion of the stomach, producing
cholera morbus, epidemic cholera, malignant dysentery, &c. At
seasons when an epidemic disease is prevailing, inaccuracies in
diet, form a very common exciting cause of the disease, in those
predisposed to it.
XII. Vomiting, and all other disease-expelling and curative
actions, are instituted and carried on by a power generated at the
base of the brain,—the medulla oblongata. This is the seat or
throne of power, whence proceeds the commands for all move¬
ments designed to protect the system from disease. The nerve-
centres, throughout the system, apprise the great centre of
the condition and wants of the system, through the medium of the
nervous cords, which may be compared to telegraphic wires
The great centre, taking cognizance of the intelligence thus con¬
veyed, commands the movements, within its control, best adapted
to overcome enemies and supply existing wants. Thus, the
infant stomach, oppressed with too much food, or disturbed by the
presence of foul or acrid substances, is relieved by vomiting.
The knowledge of the condition of the stomach being telegraphed
PRINCIPLES OF MEDICINE.
xlv
to the base of the brain, through the medium of sensitive nerves,
vomiting is induced; and this is a provision of nature to relieve
the stomach. A badly-organized stomach, or one in which the
nerves, or sensibilities, are not in a condition to convey to the
brain the knowledge of the presence of acrid substances, will be
subjected to pain and distress, in consequence of the transmission
of the acrid materials from the stomach to the bowels, there pro¬
ducing an effect which calls for reaction, to expel the acrid sub¬
stances.
XXIII. In medicine, error in theory leads to error in practice.
The physician, educated to regard fever as constituting disease,
and the increased action of the heart and arteries, necessary to
sustain the curative actions, as evidence of excess of vital power,
is led to practice blood-letting and purging, and to prescribe anti¬
mony, nitre, calomel, digitalis, and various other poisonous agents,
with a view to moderate, or suppress those actions; and, notwith¬
standing the evil consequences of such practice, the same course
of treatment is pursued, as long as the theory, by which the prac¬
tice is governed, is believed to be true.
XXIV. Nature always conducts her operations, for eradicating
disease, in the best way possible, with the resources furnished by
internal and external conditions and circumstances.
Every movement, whether voluntary or involuntary, is attended
with an expenditure of nervous fluid, derived from arterial, red
blood. Active exercise demands an active circulation of the blood
through the nerve-centres, which generate the nerve-force requisite
to produce muscular action. One. in whose system there is a defi¬
ciency of red blood, will, in ascending a flight of stairs, experience
an increase, in the action of the heart, to probably 160 or 180
beats per minute; this increased action being absolutely and essen¬
tially necessai'y, in order to generate power to perform the required
exertion. The exercise of running is accompanied by a more vio¬
lent action of the heart; otherwise the muscular action required
could not be performed.
XXV. In disease, whenever the action of the heart is aug¬
mented, there exists a necessity for it. Thus, in fever, inflamma¬
tion, extreme debility, &c., its energy is invoked for the accom¬
plishment of an object or design, ultimately for the preservation
of the system. Physicians should study the designs of nature, and
endeavour to assist her efforts.
XXVI. Medical treatment, to prove beneficial, must harmonize
with the principle of life. Pain may be relieved by stupifying the
brain with narcotics; fever may be subdued by prostrating the
xlvi PRINCIPLES OF MEDICINE.
vital powers; the heart's action may be lessened by the adminis¬
tration of digitalis and other sedatives; and inflammatory action
maybe reduced by cathartics, and general depletion ; but such
treatment operates always against nature; directly and invariably
tending to deprive the system of the means of support, and to
weaken its power of resisting the causes of disease. " Physicians,
observes a celebrated teacher of medicine, " have always looked
at the outside of disease, and have been doctoring symptoms,
"without understanding the nature of disease."
XXVII. Perfect health may be defined to be that state in which
external and internal conditions and influences are favourable to
the free and undisturbed operation of the laws of life.
XXVIII. Disease consists, essentially, in diminished vital power.
XXIX. Symptoms do not constitute disease. They are the im¬
mediate consequences of diminished vital power; or they may
arise from the restoring efforts of the constitution. Thus, the
first symptoms in disease, as languor and debility, coldness of the
surface, and chilliness, are the immediate effects of a loss of vital
power; whereas, when reaction takes place, many of the accom¬
panying symptoms, as fever, pain, inflammation, vomiting, diar¬
rhoea, and convulsions, are the consequences of the vital force
resisting the cause of disease.
XXX. Disease is produced by agents or causes which exert an
influence upon the system, not congenial to the vital principle, or
which are not in relation with, or adapted to, the laws of life.
Exposure to cold and dampness; sudden vicissitudes of tem¬
perature, more especially when the system is in an exhausted con¬
dition ; exclusion from the open air, and close confinement to
business; unwholesome food taken into the stomach ; excesses in
eating and drinking, and in the indulgence of the animal passions;
and specific poisonous agents, such as produce small-pox, measles,
and scarlet fever, are the general sources of disease.
Cold and dampness are fruitful sources of disease. Their direct
effect upon the system is to weaken the vital power, and conse¬
quently diminish and subvert the healthy order of action in the
system; and whatever organ or part of the body is weakest, pro-
portionably to its natural degree of vitality, that will be the part
most likely to become diseased. Hence, of any number of persons
exposed to cold and dampness, each may have a different form of
disease. Thus, one may have a pleurisy; another, rheumatism
a third, a simple catarrh; a fourth, bronchitis; a fifth, quinsy; a
sixth, neuralgia; a seventh, sick headach; whilst another may be
taken with bilious fever, and another with erysipelas. In this
PRINCIPLES OF MEDICINE.
xlvii
way, almost every variety of disease may be brought on by the
same cause.
Marsh Miasmata.—The poisonous effluvia, or vapour, arising
from decomposition of vegetable matter, together with cold and
dampness, are believed to be the principal causes of the fevers
that prevail during the latter part of summer, and in autumn, more
particularly in low, marshy districts of country. It is certainly
tine that fevers prevail most in marshy places, and near ponds of
stagnant water. Newly-cleared land evidently gives rise, also, to
noxious vapours, from the decomposition that ensues on the expo¬
sure of the fresh earth to the sun. This will account for the pre¬
valence of disease in newly-settled places.
The first effect of this miasmata upon the system is to weaken
the vital powers; the strength becomes enfeebled; the appetite
fails; there are languor, chilliness, and aching pains; precisely
such symptoms as might be produced by exposure to cold and
dampness. These symptoms are the direct consequences of the
poisonous effluvia weakening vitality; and, as the constitution
rallies to expel the poison, fever is produced.
The greater part of medicines employed in the regular practice,
have no relation to the laws of life, but are repugnant to nature,
and injurious to the constitution. Such agents will modify symp¬
toms, or change the form of disease; but often, where a cure is
effected, it is the result of the sanative efforts of the constitution,
in spite of medicine.
XXXI. When fever prevails, it furnishes evidence of the exist¬
ence of an offending cause in the system, and the treatment insti¬
tuted should have for its object the removal of that cause. Thus,
a Thomsonian emetic will, in many instances, dispel fever, by
evacuating the stomach of acrid secretions and undigested food,
from which cause so frequently proceed febrile symptoms, more
especially during infancy and childhood.
XXXII. Dr. Samuel Thomson, in his "Remarks on Fevers,"
says:—" What is commonly called fever, is the effect, and not the
cause of disease. It is the struggle of nature to throw off disease.
The cold causes an obstruction, and fever arises to remove it.
This is universally the case. Remove the cause, and the effect will
cease."
This theory of fever, advanced by Dr. Thomson, and doubtless
original with him, was maintained by Hypocrates, Sylvius, and
others of the early writers on medicine. But the failure of their
practice arose from the employment of remedies which tended to
aggravate, rather than assist, the efforts of nature. The medical
faculty have never made the proper distinction between pure
stimulants, which raise and support vital action, and those which
xlviii
PRINCIPLES OF MEDICINE.
provoke an unnatural action, and ultimately exhaust the strength.
It is to Samuel Thomson we are indebted for the discovery and
selection of medicines which harmonize with the laws of lite, and,
if judiciously applied, are adapted to the cure of every variety of
disease.
" When a patient is bled," says Dr. Thomson, " it lessens the
heat, and gives power to the cold; like taking out of one side of
the scale and putting it into the other, which doubles the weight,
and turns the scale in favour of the disease. By giving opium,
the feelings are deadened ; the use of antimony, calomel and nitre,
tends to destroy what heat remains; or, more properly, destroys
the power in the system of producing heat."
" I remember, with pain," says Dr. Eberle, " the unfortunate
lot of an amiable and intelligent friend. He was a man of healthy
constitution, and fond of indulging in the pleasures of the table.
He was seized with simple synochial fever from cold. His phy¬
sician bled moderately; the fever went on unchecked; he bled
again and again, daily; after the seventh bleeding, there was still
too much quickness and tension in the pulse; the lancet was
inserted the eighth time, and the patient sunk almost immediately
into a state of collapse. Stimulants, both externally and inter¬
nally, the most diffusive and potent, were now diligently applied ;
but all in vain; he lived but a few hours longer." Tens of
thousands of lives are annually destroyed by blood-letting.
" The fashionable practice, when fever rises, is to destroy the
heat-producing power; and the same means which they often
employ to cure the sick, would destroy the health of a well person.
How much more reasonable it is, when fever rises, to help it to
overcome the effects of the cold, that caused the disease!" —
Thomson.
The means recommended by Dr. Thomson, for " raising the
heat of the system," and for " keeping the inward above the out¬
ward heat," are the same that are required to sustain the genera¬
tion of the nervous power necessary to maintain a proper balance
in the circulation of the blood, and to sustain the curative, life-
preserving actions in resisting the various causes of disease.
XXXIII. In tracing the progress of fever to a favourable crisis,
we find it terminating in a restoration of the secretions, and bv
establishing some critical evacuation, more particularly by sweat
and urine. This fact points out the design of nature in establish¬
ing fever, or reaction. The plan of treatment established by Dr.
Thomson will assist the constitutional efforts in bringing on a crisis
in disease; and, without in the least degree aggravating the fever,
but, on the contrary, at the same time that it aids its efforts, will
generally moderate the violence of its symptoms. But, take a
case of remittant fever, where the symptoms are all favourable;
PRINCIPLES OF MEDICINE.
xlix
Ueed this patient every day, purge with active cathartics, give
him freely of ice-water to drink, and pursue this course for a
week, and in nine cases out of ten, the fever will, at the end of this
time, assume a malignant type; and the patient, very probably,
die, in consequence of the sy^em being deprived, by the treat¬
ment, of the power to resist disease.
It is by reaction, or the power of vital resistance, that the organ¬
ization is sustained against all debilitating causes. Dr. Parrish, in
lecturing before his class, related the case of a man who had been,
for a length of time, subject to frequent losses of blood from piles,
and subsequently underwent an operation, by which he lost a large
quantity of blood. This, a few days after the operation, threw
the system into a state of tumultuous excitement; the face red,,
eyes sparkling, with a full*, bounding pulse, and the carotid arteries
throbbing very strongly; and, as the doctor stated, the patient
exhibited symptoms which every surgeon would have said de¬
manded bleeding, when, at the same time, the patient was drained
of almost all his blood.
Not many months since, one of the physicians to the Blockley
Hospital, a man of extensive experience, having been fourteen
years in practice, on examining a patient in one of the wards,,
inquired of one of the house physicians why that patient had not
been bled, and immediately directed a pint of blood to be drawn..
The doctor was informed, however, that this patient had a surgicaL
operation performed a few days previous, and that secondary
hemorrhage had taken place, and the patient had been already
nearly bled to death.
The frequent abstraction of blood has repeatedly produced
symptoms of inflammation of the brain, and the arterial system,
been thrown into a state of great excitement, presenting the same
symptoms, which, according to the doctrines of the schools of
medicine, require the use of the lancet; the loss of blood being, at
the same time, the sole cause of'the excitement: the constitution
reacting against the threatening danger arising from the loss of
blood. Often has inflammation of the brain ensued in remittent
fever, and the disease assumed a malignant character, by bleeding
or purging, or by both; reducing vitality so low, that nature has
been driven to rally all her powers to " save a wreck" the
clashing forces struggle for the ascendency, which,, too often,
is decided in favour of the foe to life, aided by the college skill of
the doctor." Excessive loss of blood is not always followed,,
however, by reaction; in some instances, the system remains in a
state of debility, accompanied by some: chronic disorder; as
dvspepsfa, liver complaint, consumption, dropsy, &c.
XXXIV. "In disease of the constitution, feveris nature's hand¬
maid. In local disease, her chief reliance is upon inflammation."'
4
1 PRINCIPLES OF MEDICINE.
Inflammation is required in the healing of wounds. Blooa
furnishes the material for repairing injuries, and its presence is
also necessary for sustaining vitality in parts surrounding an mjuiy.
A splinter, lodged in the flesh, and allowed to remain, creates a
necessity for inflammation, in order to effect suppuration; the
means by which bodies become detached and separated from
living tissues. The poison from a bee sting, occasions severe
pain ; blood is sent quickly to the part, and there deposits coagu¬
lated lymph, blocking up the cells of the cellular tissue, for the
purpose of preventing the poison being absorbed and carried into
the circulation. If the poison be neutralized, by the application
•of ammonia, then there will be no occasion for inflammation.
XXXV. If, from exposure to cold and dampness, or from any
other cause, an obstruction takes place in the capillary vessels of
the pleura, the knowledge of this condition is communicated to
the brain; the energies of the heart and arteries are invoked; the
iblood rushes to the part, to overcome the tendency to disorganiza¬
tion; and, if the circulation be restored, there will be no necessity
for inflammation. If, however, the reaction fail of removing the
obstruction, inflammation is the next step taken, in the curative
process; which, under the most favourable circumstances, will
terminate in resolution; or, if this cannot be effected, there will
be an effusion of serum, or an exhalation of lymph; or the inflam¬
mation may terminate in the formation of pus, in consequence of
the loss of vitality in the pleura.
XXXVI. Inflammation of the brain, as it frequently occurs, as
a consequence of exhaustion of vitality in the complaints of chil¬
dren, is the protective power of the economy, in operation, to sus¬
tain the vitality of the brain; and if the designs of nature, in
establishing inflammation, be accomplished, the crisis will be
favourable.
In hip disease, the condition of the parts make it necessary that
inflammation shall be established. The vitality of the diseased
parts cannot be preserved without inflammation; and, under
favourable circumstances, and correct treatment, the inflammation
may terminate in resolution, and the parts be restored to a
healthy condition. Under circumstances less favourable, there
will be false anchilosis of the joint,—the joint becoming stiff! This
is, next to resolution, the most favourable termination of the recu¬
perative act i n. If the vitality of the tissues cannot be preserved
by the restorative effort, suppuration becomes necessary; — the
■ dend parts become separated from the living parts by the suppu-
purative inflammation. Sometimes the head of the bone loses its
■vitality, requiring to be removed by a slow process of suppuration,
-or caries, effected by an inflammatory action.
PRINCIPLES OF MEDICINE.
li
XXXVII. Inflammation of the bowels, as it occurs, for instance,
in dysentery, is established for the purpose of preserving the
vitality of the mucous membrane. The most fatal cases of dysen¬
tery are those unattended by any marked symptoms of inflamma¬
tion;—the violence of the cause of the disease producing disor¬
ganization of the mucous membrane, in the outset of the disease.
The death of the parts, in fatal cases of dysentery, is not the con¬
sequence of the inflammation.
XXXVIII. The condition of the lungs, at the time tubercles arc
deposited, is the opposite to inflammation. When tubercles become
enlarged, nature establishes an inflammatory action around the
tubercles, for the purpose of bringing about suppuration, the only
way by which tuberculous matter can be removed from the lungs.
XXXIX. If a dose of violent poison, such as arsenic, prussic
acid, opium, or varatria, be taken in sufficient quantity to cause
death, in the course of a few hours, there will be no marks of
inflammation in the stomach, after death. The vital principle will
be destroyed before any curative effort can be established. If a
portion of bone loses its vitality, either by the use of mercury, or
from syphilitic poison, or from scrofula, inflammation is absolutely
necessary, in order to remove the diseased bone, and to repair the
injury, by the deposition of new bone. When the vitality of a bone
is not too far reduced, it may be restored to a healthy condition,
by means,of inflammation.
XL. A broken bone cannot unite without inflammation. Cases
have occurred where broken bones have been prevented from
uniting, by bony union, in consequence of the parts having been
frequently subjected to motion, breaking up the knitting of tfee
bone, until, finally, the inflammation has subsided; and the parts
not being supplied with sufficient blood to furnish material, and
sustain the action necessary to unite the broken bone, a false joint
has been formed.
Dr. Physic devised a plan for effecting a reunion of the bone, in
such cases, by forcing a threaded needle through the limb, between
the surfaces of broken bones, and leaving the thread in the part,
for the purpose of exciting inflammation, and thus furnishing the
means necessary for a reunion of the bone.
Although inflammation be a restorative action, it is liable to be¬
come perverted into an unhealthy one, and the accomplishment
of the object for which it is instituted, prevented. Thus, if a per¬
son of'scrofulous constitution, or whose system-is in an otherwise
unhealthy condition, should receive a bruise which destrovs the
vitality of a portion of flesh, the inflammation that ensues will oe
extremely liable to assume an unhealthy character, the efforts of
iii
PRINCIPLES OF MEDICINE.
nature being too feeble to establish healthy inflammation; and,
instead of being circumscribed, as in case of a bile, it may spread
over a considerable extent of surface, forming what is called ery¬
sipelas ; and when matter is formed in the injured part, instead of
being confined to the spot where it is secreted, as it is when the
inflammation is of a healthy character, it spreads to a greater or
less extent through the surrounding parts, which become swollen,
doughy, and without extra heat attending, and may require a long
time for the parts to become restored to a healthy condition, in
consequence of the want of power, in the system, to establish an
efficient inflammatory action. A simple incision in the flesh, from
a sharp instrument, that heals rapidly in a healthy constitution,
may become converted into an indolent ulcer in one of an unhealthy
constitution. An injury upon the shin, that would be followed by
healthy inflammation, and the part restored to a healthy condition
in a short time, in a young man, would be apt to become con¬
verted into an indolent ulcer, and probably continue for years, in
an old man in feeblq health. The healing power is sometimes
almost destroyed in constitutions poisoned by the use of mercury:
the simple scratch from a pin, causing a long-continued running
sore. Blisters have occasionally been observed to become gan¬
grenous, in consequence of extreme prostration of the healing
powers of the system; the constitutional energies becoming too
far exhausted to establish healthy inflammation, and to sustain the
action necessary to heal the parts. Inflammation may assume an
unhealthy character, in consequence of the severity of an injury.
This fact is frequently noticed in gun-shot wounds, the surround¬
ing tissues being deadened by the force of the concussion, the
vessels of the parts have not sufficient power to carry on a healthy
inflammatory or restorative action.
" Let us suppose," observes Astley Cooper, " that two women
each receive a blow on the breast, one with a vigorous and healthy
constitution, and the other with a system worn down with care,
anxiety and disappointment, and in a constant state of chronic,
feverish excitement, in which the secretions are imperfectly per¬
formed, and is thus predisposed to the formation of cancer: in the
first individual, the inflammation will be strictly healthy, going
through its several stages until the cure is accomplished; but in
the other, owing to constitutional peculiarity, the same extent of
injury will produce cancerous disease; an affection over which all
remedies hitherto tried have little control, and extirpation is but
an uncertain mode of relief."
Inflammation in internal organs is no less curative in design,
than when it is confined to external parts of the body. Poison,
taken into the stomach, is followed by inflammation of its mucous
membrane, unless the dose be so large as to destroy the vitality
of this organ. The direct tendency of poison is to destroy the
PRINCIPLES OF MEDICINE.
liil
principle of life; and inflammation is the means which nature
employs to counteract the effects of the poison, and preserve the
life of the parts. The inflammatory action, existing in the mu¬
cous membrane of the stomach, in those forms of disease called
fevers, is the restorative power of nature in action. No person
ever recovered from a low form of fever, without some degree of
inflammation having existed in the stomach. In inflammation of
the stomach, medicine should be given that will excite the secre¬
tions. Inflammation of the throat is relieved, and'its efforts aided,
by gargling with pepper tea, which excites the secretions, and
relieves the congested vessels. It is ascertained that the mucous
membrane of the stomach seldom exhibits marks of inflammation
when patients die soon after an attack of some highly malignant
form of disease; for instance, yellow fever: the force of the cause
of disease having suddenly prostrated the living principle so low
that the constitution is unable to establish an inflammatory action.
XLI. In pleurisy, inflammation of the lungs, rheumatism, ery¬
sipelas, and all other forms of disease attended with inflammation,
conditions obtain which call for inflammation—the disease always
existing before inflammation ensues. Thus, in pleurisy, the nutri¬
tive action being arrested, in a portion of the pleura, by debili¬
tating influences, and its disorganization threatened, are conditions
which call for a supply of arterial blood, and an inflammatory
action, as the only means of effecting a restoration of the nutritive
or assimilative a.ction, and sustaining the organization. Not less
salutary are the effects of inflammation in rheumatism and ery¬
sipelas.
XLII. Curative in design, the results of fever and inflammation
are always beneficial, under favourable conditions.
XLIII. Finally, whenever nature is called upon to repair an
injury, or to protect an organ or tissue from disorganization, she
performs the work by means of inflammation, aided, sometimes,
by fever.
XLIY. It must be borne in mind, however, that the efforts of
nature often require the aid of medicines, and other means, for
regulating and sustaining her restorative actions. In the case of
a common bile, for instance, or in any other case of acute inflam¬
mation, there may be an undue accumulation of blood in the dis¬
eased parts, causing unnecessary pain and swelling, and retarding
the cure.
More especially are the resources of art demanded in diseases
attended with inflammation of internal organs, such as pleurisy,
6
liv
PRINCIPLES OF MEDICINE.
inflammation of the lungs, dysentery, peritonitis, inflammation of
the brain, &c.
XLY. The general course of treatment introduced by Dr.
Samuel Thomson, and described, with some modifications, in the
following pages, will prove beneficial in the way of affording
assistance to nature,—the great physician, in all the varieties of
fever and inflammation.
Thomsonian Theory of " Canker"
XLVI. Dr. Thomson introduced into general use, in his system
of practice, a class of remedies for removing the " canker, or
vitiated secretions," that forms on the stomach and bowels, to a
greater or less extent, in all cases of disease, and interrupts the
process of digestion, and tends to prostrate all the functions of the
stomach, and constitutes a general cause of the continuance of
disease.
The correctness of Thomson's views, in relation to the collec¬
tion of vitiated secretions upon the mucous membrane of the
stomach and bowels, in disease, have long since been realized and
established by the most positive evidence; and so important is it
to effect its removal, that the treatment best adapted to effect this
object, constitutes a leading object in the practice of medicine.
PRACTICE OF MEDICINE.
CHAPTER I.
SECTION I.
AGUE—INTERMITTENT FEVER.
Causes of Ague.—It is the general belief that ague is caused by
noxious or poisonous vapors in the air, called Malaria or Marsh
Miasma, arising from the decay and decomposition of vegetable
matter in marshes, and from grounds inundated and then drained.
Newly cleared land is supposed to give rise to deleterious exhala¬
tions from the decomposition produced by the exposure of the fresh
earth to the sun and air. Cold and dampness are frequently the
exciting cause of the disease.
The same cause or combination of causes that produce ague in
one, may cause dysentery in another, jaundice in another, and in
another neuralgia. And then again, one possessed of a good con¬
stitution, and who is in vigorous health, may be exposed to the
same causes of disease without being affected. The more perfect
and active the digestive functions, the less will be the liability to
disease.
Symptoms and general course of Ague.—Before a fit of ague
comes on, the patient usually experiences loss of appetite, general
debility, more or less distress at the pit of the stomach, dejection
ol spirits, aching in the head and limbs, and increased sensibility
to cold.
The cold stage or chill.—The chill comes on with creeps along the
back, and an irresistible desire to yawn and stretch. There is a
general coldness and contracted state of the skin, presenting that
rough appearance called goose-flesh, and a sensation down the
back as from trickling of cold water; the mind is confused and
dejected, the pulse is small, contracted, frequent and firm. The
jaws begin to quiver or chatter, and a general shivering .takes
place over the whole body; sometimes these rigors are so violent
as to shake not only the bed, but even the floor and partition. The
I
56
AGUE, OR INTERMITTENT FEVER.
breathing is hurried, and sometimes accompanied with a hacking
cough, and a feeling of stricture across the breast. Vomiting is
not an unusual occurrence, more particularly about the termination
of the chill. The secretions of the mouth are suspended, occasion¬
ing urgent thirst. The urine in this stage " is clear, colorless, with¬
out sediment, and often copious." The chill in »some instances
continues but a few minutes, and in others for several hours.
Sooner or later reaction commences, and the patient experiences
flashes of heat through the body, which increase until the chill is
entirely gone and the fever becomes fully developed; distressing
vomiting often occurs at this period.
The reaction or hot stage.—The blood, which during the chill was
confined to the internal organs and vessels, when reaction takes
place is attracted to the surface: the countenance becomes flushed
and the skin dry and hot; the pulse rises and becomes full and
strong; the mind becomes more active, with a rapid flow of ideas;
there is pain in the head, back and extremities, and not unfre-
quently more or less delirium, or, as it is commonly expressed, the
patient is " light-headed." The urine is scanty, and high-colored,
but without sediment. The duration of the fever varies in different
cases, but finally effects a crisis by a restoration of the secretions
from the skin and kidneys, and thus terminates in
The sweating stage or crisis.—As perspiration takes place the
breathing becomes less difficult; the pulse softens, and a general
abatement of all the distressing symptoms takes place as the per¬
spiration becomes general and free. The urine is high-colored
and deposits a reddish sediment on standing. As the sweating con¬
tinues the symptoms of disease continue to lessen until finally the
patient is apparently free of disease. " In this way (observes Dr.
J. B. Williams, F. R. S., &c. &c.) we see that a paroxysm of in¬
termittent fever is a sort of struggle between the protective power
of the system and the poison (malaria;) and hence we can easily
perceive why, when the paroxysm of ague is imperfect, the effects
of the disease on the system are more severe, and why the body
actually suffers more under these circumstances, than it does when
the fit is complete and vigorous."
These stages, viz: the cold, the hot, and the sweating stage,
form what is termed a paroxysm of intermittent fever. These
paroxysms occur periodically, either every day, every other day,
or once in three days, and generally about the same hour of the
day. When the paroxysm occurs at the same hour every day, the
patient is said to have quotidian ague. When it comes on at the
same hour every other day, it is termed tertian, and when there is
an intermission of two whole days between each paroxysm, it is
called quartan ague. As a general rule, when the paroxysm
AGUE, OR INTERMITTENT FEVER.
57
occurs every day, it comes on in the morning; in the tertian ague
at noon ; and in the quotidian, the ague fit occurs in the afternoon.
During the intermission or interval between the paroxysms, the
patient will in some instances be entirely free from all unpleasant
symptoms, except debility : more frequently, however, the patient
experiences a considerable degree of indisposition, with loss of
appetite, costive bowels, furred tongue, and much weakness.
Intermittent fever, like every other form of disease, is subject to
various modifications, depending upon the circumstances under
which the disease occurs, in relation to the condition of the patient,
and various other causes which may tend to modify the disease.
Thus, if the disease be connected with a diseased condition of the
liver, the skin and whites of the eyes will be yellow, and it will be
said the patient is bilious, or that he has a bilious intermittent; and
when the intermissions are imperfect, the patient remaining ill and
feverish, and uncomfortable in a less degree than during the pa¬
roxysm, then the complaint is said to be a remittent fever.
When the disease attacks persons of shattered and exhausted
constitution, the efforts of nature or the vital powers may be too
feeble to establish an efficient reaction, forming what is called
congestive intermittent. The cold stage will be unusually long,
with stupor and deep-seated pain in the head; vertigo, faintness and
great oppression across the chest. The fever will be Very slow in
coming on, the skin being scarcely warm, and the patient will
continue greatly oppressed, with a pale countenance and great
oppression and anxiety of breathing.
Signs which distinguish ague and fever from hectic fever.
I. In hectic fever there is an absence of the distress in the back
and limbs, which attends a paroxysm of intermittent fever.
II. Hectic fever occurs at irregular periods; whereas in inter¬
mittent fever the paroxysms come on at regular periods, seldom
varying more than an hour in the time of their occurrence.
III. In hectic fever the hot stage is attended with a circum¬
scribed flush on one or both cheeks; without pain in the head,
which is a most distressing symptom in ague.
IV. The pulse, in hectic fever, instead of being moderated by
the subsidence of the paroxysm, remains quick.
V. The tongue, which is furred in ague, is clean and smooth in
hectic.
VI. In hectic fever the urine is muddy during the paroxysm,
and clear after. In ague it is muddy or turbid after a paroxysm.
VII. The mind is full of hope and confidence in hectic, and
desponding in intermittent fever.
58
AGUE, OR INTERMITTENT FEVER.
Not dangerous.—Intermittent fever very seldom proves fatal
except where it occurs in broken-down constitutions, or when
complicated with extensive derangement of some important organ.
In low marshy districts of country the disease is apt to become
chronic, from the continued exposure to the cause; the counte¬
nance is sallow, the abdomen distended, and the spirits sunken
and dejected.
Favorable signs.—Each succeeding paroxysm occurring at a
later period; scabby eruptions about the mouth and nostrils;
cleaning of the tongue and restoration of the natural secretions of
the skin and mucous membranes, and an improvement in the
appetite, indicate a favorable termination of the disease.
It frequently happens that an unusually severe paroxysm, with¬
out there being any assignable cause, terminates the disease, the
patient becoming convalescent. ,
Treatment.— Thomson's course of medicine, by its prompt action
upon the stomach, bowels and skin, and by the fresh impulse given
to the circulation and the secretions,*will prove the most effectual
method of curing intermittent and all other varieties of fever;
at least it is the most certain and speedy way of cleansing the
stomach, and preparing the system for the application of tonics.
A very effectual plan is to commence with a course of medicine
an hour or two before the time at which the chill comes on. In
ordinary cases, where the paroxysms occur every other day, the
course of medicine will seldom require to be repeated more than
two or three times to effect a cure, provided a proper intermediate
course of treatment be pursued.
Treatment during the paroxysm.—1st. Of the cold stage. Dur¬
ing the chill the patient should drink hot teas, as composition,
cayenne, or pennyroyal, and be placed in a vapor bath, or be
covered warm in bed, and hot bricks or jugs of hot water placed
at the feet and back. This will assist to bring on reaction and
overcome the chill.
Where the vital powers are in an exhausted condition, and in¬
sufficient to establish reaction, constituting what is termed conges¬
tive intermittent, an emetic of the third preparation of lobelia should
be given to relieve the stomach of its foul contents and to arouse
its sunken energies; and external warmth be applied around the
patient. After free vomiting the system will generally react, but if
if should not, the medicine must be continued, and the same admin¬
istered by injection to the bowels, together with mustard plasters
to the stomach, wrists and ankles. In some rare cases fatal con¬
gestion has taken place during the cold stage, for want of power
in the system to produce reaction. The most effectual means for
A'GUE, OR INTERMITTENT FEVER.
59
bringing on reaction, and relieving internal congestion, are the
application of the vapor bath and the free use of the third prepa¬
ration of lobelia. *
Treatment during the hot stage.—When the fever conies on, all
dry heat may be removed from around the patient, but the hot
medicine will be proper with a view to aid the reaction to bring
on a crisis by perspiration. Where the fever is of a violent cha¬
racter, and the patient greatly distressed, an emetic should be given,
and the patient kept relaxed by broken doses of lobelia, given
either alone or in the stimulating teas, and the surface bathed with
whiskey, vinegar, sal eratus water, or simple water. Where the
thirst is urgent, the patient craving cold drinks, they may be al¬
lowed him in small quantities. A draught of cold water will in
some instances cause perspiration, in the latter period of the hot
stage. Acidulated drinks, as lemonade, are very grateful to pa¬
tients, and may be taken in moderate quantities. The thirst, how¬
ever, arising from suspended secretion of the mucous membrane
of the mouth and throat, will be more effectually relieved by cap¬
sicum tea than by cold drinks. Simple herb teas, as mint, dittany,
pennyroyal and balm, are proper in any stage of the disease.
Bathing the surface with spirits or vinegar when the fever is
violent affords relief to the patient. Hot bricks wrapped in cloths
wet with vinegar, will in some instances afford relief even during
the fever.
When the sweating stage comes on, all cold drinks are inad¬
missible. The patient should keep in bed and take warm drinks
to favor and continue the perspiration. When the perspiration
ceases, dry warm clothing should be put on. There is an ad¬
vantage in bathing the surface with No. 6, or salt and brandy,
after the sweating, and still much more benefit will be derived by
the vapor bath at this period.
Treatment during the intermission.—The treatment during the
interval between the paroxysms is to be regulated according to the
circumstances of the case, and the condition of the patient. Thus
in the first stage of the disease pure stimulants, as cayenne and
composition, should be used. The compound lobelia pills answer
the place of the teas, two or three of which may be taken every
few hours.
Indications for the use of tonics.—When there is no fever be¬
tween the paroxysms, and the tongue begins to clean, and assume
a more natural appearance, tonics will come in play.
Peruvian hark.—This is probably the most effectual tonic in
intermittent fever, and given at a proper time, or under certain
I
60 /GIE, OR INTERMITTENT FEVER.
conditions of the system, no bad consequences probably would
ever arise from its use, even in large doses.
The advocates of Homeopathy in £roof of their theory, assert
that Peruvian bark continued to be taken by a person in health
will produce a disease resembling intermittent fever. In certain
conditions of the stomach, for instance where there is a redun¬
dancy of acid, or the secretions otherwise deranged, Peruvian
bark or other astringents, as hemlock and marsh rosemary, may
produce a sense of oppression and constriction at the stomach,
and even occasion intermittent fever. Peruvian bark, however,
will not disorder a healthy stomach, nor will it produce intermit¬
tent fever, except under peculiar circumstances.
In preparing Peruvian bark I usually combine it with a portion
of Virginia snakeroot and orange peel, or with spice bitters, and
give in the form of a decoction. It may also be prepared in tinc¬
ture, or taken in good wine, as Madeira, or Sherry. Barks are
also frequently taken in substance mixed with some kind of liquid,
such as milk, coffee, cinnamon water, clove tea, cider, brandy and
water, or simple water. The bark may be taken in teaspoonful
doses, and these repeated several times a day when there is an
absence of fever; or take from half to an ounce of the bark an
hour or two previous to the time at which the chill is expected.
When there is much acidity of the stomach a portion of sal eratus,
or sup. carb. soda should be combined with the bark. This, as
well as other tonics, may be administered by injection with the
same benefit as when swallowed, provided the injection be retained.
Quinine pills.—Pills composed of equal parts of quinine and
capsicum, form a substitute for barks and all other tonics; and on
account of the facility with which the pills are taken, they are
generally preferred to any other preparation. Quinine contains
the active principle of the Peruvian bark. I cannot discover any
objection to its use in a proper state of the stomach. A few hours
before the period at which the chill comes on, the quinine or what¬
ever tonic is used, should be given freely; when the patient is
taking quinine, it will be proper to omit the use of bayberry and
all other vegetable astringents.
A great variety of tonics have been employed for ague or inter¬
mittent fever, which, in many cases, probably answer equally as
well as the Peruvian bark and its preparations, such as Thomson's
No. 4 bitters, various species of the poplar and willow, the broad-
leafed dogwood bark, columbo, gentian, quassia, Virginia snake-
root, and thoroughwort or boneset.
Relapses are very liable to occur if the patient be exposed to the
night air or dampness, or becomes over fatigued.
REMITTENT FEVER.
61
Precautions.—Avoid cold and dampness; dress warmly, and
never go out in the morning or evening with an empty stomach.
Il the patient resides in a marshy district he should continue the
use of tonics in order to invigorate the system.
The cold shower bath may also be used as a preventive, where
there is no particular organic disease, as an enlargement of the
spleen or liver.
The plan adopted by some practitioners, and which generally
proves successful in preventing a relapse, is to give the patient,
say—half an ounce of Peruvian bark, or eight to ten grains of
quinine, about the seventh day after the last chill, and then at the
end of the next seven days give a less quantity, and in this way
continue giving the tonic, every seventh day, lessening the quantity
each time.
If there are symptoms indicating a return of the disease, the
patient should go to bed, cover warm and take freely of composi¬
tion or of capsicum tea, or, what is better, go through a course of
medicine; and then take quinine.
SECTION II.
REMITTENT FEVER.
A continuance of the fever to a greater or less degree during
the interval between the paroxysms, constitutes the principal dis¬
tinction between remittent and intermittent fever: in the latter, the
reaction effecting a crisis at each paroxysm, terminates the fever,
and it disappears until the succeeding paroxysm; but where the
efforts of the constitution are insufficient to effect a crisis, the con¬
test continues and the fever is prolonged, constituting remittent fever.
Causes.—Remittent fever is produced by the same cause or
combination of causes as intermittent fever. Persons who attend
upon the sick, especially in cases of malignant disease, by being
exposed to the deleterious exhalations from the patient, together
with the loss of their natural rest, and the confined air in the sick¬
room, are liable to be taken ill, and frequently it happens that they
will have the same form of disease as the patient on whom they
' had attended. Hence it often occurs that where one member of a
family is taken sick with a "bad fever," as it is called, other mem¬
bers of the family are subsequently taken down with much the
same form of disease.
Symptoms.—The first symptoms resemble those that usually
62
REMITTENT FEVER.
occur in the first stage of intermittent fever, namely: languor ana
heaviness, yawning and heavy sighing, loss ot appetite and dis¬
tress at the pit of the stomach, pain in the head, back and limbs,
alternate sensations of heat and cold, followed by a chill.
As reaction takes place and the fever rises, the pains in the
head, back and limbs are increased. There is much distress at
the pit of the stomach, with a total disgust for food; with nausea,
retching and vomiting, sometimes of bilious matter, at others of a
glairy mucus without bile; the tongue is thickly furred; the whites
of the eyes in most instances become yellow, and the skin of a
yellowish or sickly mixture of red and yellow; digestion is lost,
and the bowels are torpid or very seldom moved; the stools are
unnatural, generally either clay colored, or much darker than
natural; the breathing is more or less oppressed, and a sense of
tightness or stricture across the chest; the urine is scanty and
high colored; the pulse full, frequent, but seldom very hard or
tense, and the skin generally dry and hot.
These symptoms continue until the succeeding morning, when
a gentle perspiration appears on the superior portions of the body
and sometimes over the whole surface. The fever now abates,
but a crisis is not effected, and the fever consequently does not
■entirely disappear, at least only for a limited period; the pulse con¬
tinues quick and irritated, and the skin is above its natural tem¬
perature. Usually in the course of an hour or two, the fever again
rises, and continues as during the preceding day and night, and
then abates for a short time in the morning, and in this way the
struggle between the vital powers and the cause of disease con¬
tinues until a crisis takes place, and the patient becomes conva¬
lescent; or the disease assumes a more malignant character, by the
vital energies becoming exhausted in the struggle. There is, how¬
ever, great diversity in the symptoms and character of what is
termed remittent fever, scarcely ever two cases presenting precisely
the same aspects or regular train of symptoms. Thus in one the
liver may be more disordered, and this will modify the symptoms;
in another the liver may be less and the stomach more deranged,
and the symptoms will be modified accordingly. The degree of
loss of vital force tends to modify the symptoms to a great extent.
In most instances of remittent fever the symptoms are worse on
every alternate day.
In some cases the remissions or declining of the fever occur
soon after daylight, in others after the sun is up, and in others not
until noon or after. Great variations also occur in relation to the
degree and duration of the remissions. In some the fever will
almost or entirely disappear for an hour or two, or even for three
or four hours, whilst in other cases the fever is so slightly mode¬
rated as scarcely to be noticed by the patient or attendants. In
some rare cases the remissions are observed to occur in the even-
REMITTENT FEVER.
63
ing or during some part of the night. These irregularities are
observed particularly in the fevers that prevail in the spring and
during the hot summer months.
If the disease continues over the ninth day or second week
without a favorable crisis being brought about, the symptoms are
very liable to assume a more aggravated and sometimes dangerous
character.
In some instances the liver is prominently affected, losing en¬
tirely the power of secreting bile, and in a state of congestion,
causing a sense of great fulness and pain in the right side; violent
retching and vomiting occurs, " without the ejection of bile, the
matter thrown up consisting of glairy mucus," together with what
may have been taken into the stomach; the bowels are extremely
torpid; the tongue is clean, or seldom remains furred but for a
short time, beginning to clean along the middle; and towards the
termination of the disease, a copious discharge from the bowels of
a dark pitch-like matter. " The liver frequently recovers its action
and relieves itself by pouring a large quantity of black bile, or per¬
haps blood, into the bowels, as is manifested by the copious, dark
colored or tar-like alvine discharges, which usually occur in such
cases. These large and very peculiar discharges, may indeed be
regarded as the favorable crisis of such fevers as prevail during
hot weather, for convalescence generally soon follows their appear¬
ance, and except the disease be arrested by remedial treatment in
the early period of its course, there are but few recoveries in which
such discharges do not occur." The symptoms accompanying
remittent fever present an almost infinite variety of modifications,
but which it would be useless to attempt to describe, as the dis¬
ease in all its diversity of character requires to be treated upon
general principles, adapting the remedies to the character of the
symptoms, and not to the name of the complaint.
Favorable symptoms.—A general perspiration with a warm
skin; a soft pulse ; the appearance of scabby eruptions about the
mouth; the urine depositing a copious sediment; the nervous
system maintaining its integrity; and the tongue moist and begin¬
ning to clean along its edges. Thirst is more favorable than its
absence.
Unfavorable symptoms.—Low muttering delirium ; a tympanitic
state of the abdomen; involuntary offensive discharges from the
bowels ; a very diminished secretion of urine; the tongue soft and
relaxed, possessing no elasticity; hiccough; the skin relaxed and
inelastic; by pinching it up, it returns to its natural position very
slowly; cold wrists and hot hands, £?hd the breath and perspiration
having a peculiar death-like odor. Where there is a chain of
these bad symptoms existing, the case may be considered as a)-
G4
REMITTENT FEVER.
most hopeless. Still recoveries do occasionally take place where
many of these symptoms have existed. I have known patients re¬
cover in whom there were at the same time continued low mutter¬
ing delirium, involuntary discharges from the bowels, tympanitic
state of the abdomen, hiccough, twitchings of the tendons, picking
of the bed clothes, deep heavy sighing, and cold sweats over the
face and breast. It frequently happens that a patient has a symp¬
tom which is considered as indicating great danger—hiccough for
instance—but when unconnected with other bad symptoms, neither
this nor any other single symptom is to be considered as a neces¬
sary cause of alarm.
Treatment of remittent fever.—A prompt and persevering course
of treatment should be instituted in the early stage of the disease,
with a view to cut short its course, and thus prevent the disease
extending to other organs than those primarily affected.
Thomson's course of medicine constitutes the most effectual
means, not only for hastening the crisis, but for relieving the symp¬
toms. The course of medicine should be repeated daily in the
first stage of the complaint, or at longer or shorter intervals as the
case appears to require. Where there is violent pain in the head
with a high fever, it will be proper to commence the course by an
enema, containing a portion of lobelia. One or two teaspoonsful
of lobelia powder administered in this way in lukewarm water,
and retained, will not only relax the system, but in most instances
will answer the place of an emetic given in the usual way. This
method of producing relaxation is very effectual, and is of the first
importance in the treatment of acute disease in its early stage,
when the arterial system is struggling hard to overcome obstruc¬
tions to the circulation of the blood, and it also tends to equalize
the nervous influence, and aids in restoring the secretions. When¬
ever the system is relaxed by lobelia, and the patient becomes rest¬
less, or complains of the external heat, and the breathing oppressed,
the face, breast, and hands, should be bathed with vinegar and
water, spirits, or camphor and water; this affords great relief to
the patient.
Patients laboring under a severe form of disease, often expe¬
rience a good deal of distress under the operation of lobelia.
The lobelia arouses the sensibilities, and thus, causing the patient
to feel his diseased condition, occasions distress and pain. It has
been observed by most persons who have practised on the Thom-
sonian plan, that lobelia emetics, which cause the most distress to
the patient, generally pro ve the most beneficial in the treatment of
seated fevers.
During the intervals between the courses of medicine, pure
stimulants, as composition or capsicum tea, should be given occa-
REMITTENT FEVER.
65
sionally, aiid frequent broken doses of lobelia, either in powder
infusion, tincture, or in pills.
When patients prefer taking medicine in the form of pills, the
compound lobelia pills may be employed as a general medicine,
more especially in the early stage of disease, or until a crisis takes
place and tonics are demanded.
When the fever is very high, the face and breast, and even the
whole surface may be bathed with cold water, vinegar and water,
alcohol, brandy, camphor and water, or sal eratus water. This is
more especially adapted to the early period of the disease, or when
the vital powers are sufficiently strong to bear these cold applica¬
tions to the surface. Bathing the surface with whiskey is per¬
fectly safe, however, in any stage of the disease, and where the
patient is greatly exhausted this will generally aflbrd x*elief and
apparently give strength to the system. .
A great variety of teas and preparations for drink may be used
in fevers, as pennyroyal, balm, mint, lemonade, apple tea, crust
coffee, &c. A tablespoonful of cold water may be frequently
taken where the thirst is urgent and the patient desires cold
drinks.
Where the brain is much affected the feet should be kept warm
and occasionally placed in warm water, containing mustard and
salt, or hickory ashes. Injections are of especial benefit under
these circumstances in diverting the nervous influence, and con¬
sequently the blood from the head to the bowels. Not only in this
are the enemas beneficial, but they relieve the bowels and aid in
restoring their lost function. I have occasionally observed dis¬
charges of black vitiated bile, evidently from the liver, by relaxa¬
tion produced from an injection of lobelia; the obstruction in the-
liver is in this way overcome, and the organ enabled to relieve it¬
self from a state of congestion and oppression.
Further remarks in relation to the course of medicine.
1st. Of steaming.—When the patient is unable to sit up, or the'
system relaxed by the lobelia, the vapor may be applied according
to the directions given for steaming in bed, or hot bricks wrapped
in damp cloths may be placed at the feet and each side ')f 'In¬
patient. I have had patients in a vapor bath on a corch or mat¬
tress from an hour to an hour and a half at a time, and without
proving in the least degree debilitating, but in many instances, by
proper attention, grateful and refreshing. In a case of recovery
from one of the worst forms of fever, where the patient had symp¬
toms which are generally considered as denoting a fatal termina¬
tion, he was steamed in this way every day, for eight or nine days
in succession, and with the most marked benefit.
When the heat of the surface is high, it will be difficult to excite
5
REMITTENT FEVER.
perspiration even by the vapor, without reducing the heat of the
skin by bathing with whiskey or vinegar. The shower bath is
proper after steaming, provided the patient be able to sit up during
the steaming. A sudden dash of cold water over a patient after a
thorough vapor bath, is always safe and frequently very beneficial
2d. Of the emetic.—It is always proper to prepare the emetic
in bayberry tea, and the stronger the decoction the more effectually
will it cleanse the stomach. In the early period of the disease*
when the fever is violent, and the tongue dry and parched, the
lobelia powder should be steeped in bayberry tea, adding half a
teaspoonful of nerve powder, and from half to a teaspoonful of
capsicum to each dose; or the patient may take the pepper sepa¬
rately in tea. In a later period of the disease, when the sti'ength
is greatly exhausted, the third preparation of lobelia may be used,
adding a portion of lobelia powder. The following is a good
form:
Two teaspoonsful of the liquid of the third preparation.
One teaspoonful of green or brown lobelia.
And a teacup half or two-thirds full of bayberry tea.
To be sweetened and taken at once, and the same repeated two
■or three times, or as often as is found necessary.
Stimulants.—There is no better stimulant in cases of fever than
African pepper. Mixed with Virginia snakeroot or ginger, it is
less disagreeable to take, and not so apt to produce distress in the
stomach. The tea sweetened, to be taken in half teacupful doses
•every few hours, or a less quantity more frequently.
Injections.—These cannot be administered too often; it is ad¬
visable to give one both before and after the emetic. In very bad
cases, attended with delirium, and a tympanitic state of the abdo¬
men, I have found it necessary to use a tablespoonful, and even
more, of the third preparation of lobelia in each injection, in order
to produce a sensible impression upon the bowels.
Steaming after the operation of the emetic.—It is not in all cases
necessary to administer the bath after the emetic; nor should the
patient be disturbed so long as he is comfortable and in a perspira¬
tion ; when this ceases, and the patient becomes uneasy, then it
will be proper to give the bath. When the patient can sit up he
should be showered with cold water, or washed with vinegar or
spirits; if in bed, change the bed-clothes and also the clothes of the
patient.
After the course, a hot brick or bottle of hot water should be
placed at the feet, wrapped in a damp cloth, and, if the patient can
REMITTENT FEVER.
67
bear it, have one kept to the stomach. Care is necessary, how¬
ever, not to oppress and distress the patient with dry external heat,
more especially when there is fever. V/hen there are cold sweats,
dry heat should be applied.
When there is great tenderness of the abdomen, flannels wet
with No. 6, or pepper sauce should be applied, and also a hot brick
to favor perspiration and a proper action in the skin. Hops stewed
in vinegar and thickened with ginger, or a poultice composed of
two parts of elm powder and one of composition, adding lard to
prevent its drying, applied to the abdomen, will prove more bene¬
ficial than bathing.
As the tongue becomes moist and manifests a tendency to clean
at the edges, the " canker medicine" should be used, in combina¬
tion with stimulants and tonics. A teacup two-thirds full of bay-
berry tea made very strong, adding a teaspoonful of composition
in powder, is one of the most effectual of remedies for scouring
the morbid secretions from the coats of the stomach. This or
some other form of the bayberry or No. 3, should be given two or
three times a day.
In all malignant forms of disease termed fevers, where there is
a strong tendency to putrefaction, No. 3 or bayberry in strong
decoction, adding the No. 6 or third preparation of lobelia, is pro¬
bably the most effectual of all other remedies. Charcoal or pre¬
pared chalk may be given mixed with the teas taken.
The pepper sauce has also obtained high repute as a medicine
in malignant fevers, in consequence probably of its powerfully
antiseptic qualities.
Tonics.—As the secretions become restored and the tongue
cleared, or begins to clean along the edges, together with com¬
plete cessations of fever, the tonics recommended in the treatment
of intermittent fever should be employed. Quinine is probably the
best tonic when the disease occurs in the autumn and spring;
whereas, during the hot summer months, quinine does not suit so
well as decoctions of the usual Thomsonian bitters.
A tea of the Virginia snakeroot is proper as a drink in any stage
of the fever, and at the same time it tends to support the strength.
A tea of the scull cap or of the valerian may be used as a nervine,
or the powder added to the other medicines.
Diet.—During the early stage of the disease, and until it assumes
a favorable aspect, great attention to diet is necessary. When
the stomach is unable to digest food, as is the case in the early
period of remittent fever, nothing should be allowed the patient but
crust coffee, barley water, elm gruel, &c. Many patients are in¬
jured by taking improper articles of food which the stomach can¬
not digest.
68 CONTINUED FEVER.
In a more advanced period of the disease, essence of beef,
chicken tea, and egg soup, will be required in order to sustain the
strength of the patient. When there is extreme prostration of
strength, wine-whey, and bran and water are to be resorted to, in
connection with the kinds of nourishment above mentioned.
SECTION III.
CONTINUED FEVER.
Under this head may be classed all those malignant forms of
disease denominated Typhoid, Typhus, Nervous, Putrid, Conges¬
tive, Yellow Fever, &c.
"We hear continually," observes Dr. Watson, of London, "both
in and out of the profession, different species of fever spoken of.
By the public, typhus, brain fever, bilious, low, putrid, nervous.
And systematic writers are to the full as particular: mucous fever,
ataxic, adynamic, gastro-enteric, and so forth. Now admitting
that fever shows itself under various forms, I am persuaded that
the effect upon the mind, of all this subdivision, is bad and hurtful.
It encourages a disposition already too prevalent, to prescribe for
a disease according to its name. There is no line of genuine dis¬
tinction between continued fevers, that can be relied on. They
run insensibly into each other, even the most dissimilar of them;
and are traceable often to the same contagion."
All of these different modifications of what are usually termed
malignant fevers, are produced by poisonous agents conveyed into
the system, or by a combination of influences which operate pow¬
erfully in prostrating vital energy; and in some instances the ener¬
gies of life are so far destroyed in the outset of the disease that the
patient dies without any fever having been developed.
A case of continued fever that would be termed Typhoid by one
physician, by another would be called Congestive; and by another,
probably, low Bilious; whilst another would affix some name dif¬
ferent from either of the others. Continued fever occurs in every
grade of malignancy, from the mildest form of remittents to the
most fatal kind of yellow fever, where the principle of life is de¬
stroyed in the onset of the disease, and terminating in the death of
the patient without the system being able to establish reaction 01
fever. In these cases the patient remains in a deep stupor as if
stunned by a blow upon the head, or poisoned by a large dose of
arsenic. Even in such cases, the disease is called fever; but we
might with as much propriety say that a person killed by taking
arsenic or prussic acid, died of fever.
CONTINUED FEVER.
69
The following case shows the insidious and disguised manner
in which disease of the most malignant character sometimes takes
hold of the system. A young man of this city, whose health had
become impaired by a succession of colds, became subject to
bleeding at the nose, which occurred at frequent intervals, during
the term of some weeks. In this exhausted state he bailed some
offensive water from a cellar that was very damp, and remained
in the cellar for some hours. Soon after this he grew worse, and
I was desired to attend him. He was able to walk about the room,
though extremely feeble and dull: he would converse, though with
considerable hesitation; his skin was of the natural temperature
or nearly so, but pale, relaxed, and without elasticity; his tongue
was but very slightly coated, scarcely sufficient to change its
natural appearance, and the pulse was apparently natural, mani¬
festing no indications of irritation or unnatural excitement. This
patient gradually grew worse and died in about two weeks, though
the most powerful stimulants were used with a view to arouse the
energies of the stomach and bring on reaction. There was no
sign of fever, except an occasional flush on the cheeks towards
the termination of the disease, neither did he complain of pain;
and the stomach appeared altogether insensible to the most active
stimulants from the commencement. There was a moisture on
the skin during nearly the whole period of his illness. There was
a peculiar expression of the countenance—a vacant stare, as though
the chain of sympathies was broken up, the brain not perceiving
what was going on in the system. This peculiar expression of
countenance, which might not be noticed by a common observer,
together with what is termed the " sardonic laugh," are always
alarming.
When the system is much diseased, it is more favorable to find
the patient complaining of distress, than to hear no complaint, as
though he did not feel his diseased condition. This rule applies
more particularly to the forms of disease under consideration.
Dr. William Rush, of this city, stated in a lecture, that of two
hundred cases of yellow fever, as it was called, that came under
his care in the hospital, during the prevalence of the disease in
Philadelphia, no two cases presented precisely the same modifica¬
tions of symptoms.
When one member of a family is taken ill of a malignant form
of disease, such as physicians term Typhus or Congestive fever, it
is a very common occurrence that several others of the family are
subsequently taken down with disease of the same character. And
so common is it for other persons in the neighborhood, who have
been with the sick patients, to be also attacked with the disease,
that some late writers, and among them Dr. Watson, of London,
consider continued fever capable of being communicated from
one to another, and that the disease is caused by an animal poison.
70
CONTINUED FEVER.
Whether these low forms of fever be contagious or not, it will
be a good rule to view them as contagious, and use such precau¬
tions as will be most likely to prevent their being communicated to
the attendants upon the sick.
" Where choice can be made, a large apartment should be
selected for the sick person. Unless the weather be very hot, there
should be a fire in the room, for it acts as a ventilator. The air of
the chamber should be kept fresh by having a window and door
always open, or (according to the weather) both window and door.
Bed-curtains, carpets, and all superfluous articles of furniture,
should be removed. Great diligence should be used in keeping
the patient clean by ablutions, and by frequently changing his
sheets and his body-linen; and these should be immersed at once in
water; and all discharges from the sick person's body should be
instantly carried out of the room."
No persons but those necessary to attend upon the patient should
remain in the room; and even the attendants should avoid being
over the patient any more than is absolutely necessary. When
friends visit the patient, it should be soon after a meal, as then they
will be much less liable to contract the disease than when the
stomach is empty. Chloride of lime should always be kept in the
room; and a portion of it put into the vessels used to receive the
evacuations from the stomach and bowels.
The Symptoms attending continued fever i.n its different stages
and modifications are extremely diversified: scarcely any two
cases present the same group of symptoms.
"It often happens that for several days before the disease assumes
its distinct and prpper aspect, and before the patient is rendered
unable to pursue his usual occupations, he is affected with certain
morbid symptoms, which may be considered premonitory of the
fever; so that it is sometimes difficult to mark the precise begin¬
ning of the disease. These preliminary symptoms result apparently
from an altered condition of the nervous system," (loss of nervous
energy.) " The poison in the blood disturbs the functions of ani¬
mal life before it causes any palpable derangement in the mechan¬
ism of the circulation. The expression of the patient's countenance
alters; he becomes pale, languid, and abstracted. Those about
him observe that he looks very ill. He is feeble, and easily tired;
reluctant to make any exertion of mind or body; listless, and often
apprehensive of some impending evil. He loses his appetite; his
tongue becomes white and inclined to tremble; his bowels irregu¬
lar, often confined, sometimes affected with diarrhoea; his senses
lose their natural delicacy. He has uneasiness or wandering pains
in various parts of his body; and occasionally there is some giddi¬
ness : drowsiness, perhaps, during the day, and unsound and unre-
CONTINUED FEVER.
71
freshing sleep at night. To collect all this into une expressive
word, the patient evidently droops."
In many cases, however, the patient is seized suddenly with ex¬
treme illness, without having experienced the usual premonitory
symptoms of continued fever.
Before fever is developed, the patient usually has a chill or
shivering fit, attended with violent pain in the forehead, much op¬
pression, and general distress. The expression of the face is dull,
heavy, absent, and puzzled. The patient presents very much the
appearance of a person made stupid by drink; and he staggers a
little if he attempt to walk. The muscular power is sensibly en¬
feebled ; sometimes the patient will struggle against this; but in a
few hours, or in a day or two at farthest, he takes to his bed.
Such are the general appearances and symptoms presented in
the early stage of continued fever, designated by different authors by
the various titles of Typhus, Typhoid, Congestive, Nervous, Yellow
and Malignant fevers. Symptoms of the same character prevail
in other forms of disease, where there is extreme prostration of
vital energy; for instance, in the most aggravated cases of small¬
pox, scarlet fever, pleurisy, and inflammation of the lungs.
The stage of chilliness is usually followed by some degree of
reaction '• the pulse becomes quicker than natural, the skin hot and
dry; violent pain in the head, thirst, and throbbing of the temples.
The mind continues dull and confused, and sometimes there is de¬
lirium, though not so frequently in the early as in a later period of
the disease. The patient sighs frequently, and, if his sensibilities
are not too much blunted, he appears* much distressed and is very
restless. If febrile symptoms be pretty strongly developed, the
tongue will be furred and dry; in some instances white, and in
others it will be brown or black. The patient experiences a dis¬
gust for food of every description. The respiration is quicker
than natural, and frequently accompanied with slight rattling in
the air-passages. The aspect of the patient is peculiar: the features
are fixed and inexpressive, or expressive merely of apathy and in¬
difference. Sometimes, even during the first stage of the disorder,
when the bowels are relaxed, the prostration of strength is so great,
or the tendency to stupor and indifference is so marked, that the
stools are passed under him as he lies in bed, without any apparent
endeavor on the part of the patient to prevent it; and without any
notice of his wants being made to the nurse. The urine, during
the same stage, is scanty and high-colored, and often ill-smelling.
In mild cases, and under judicious treatment, the patient will be¬
gin to improve soon after the first week.
In general, no change for the better takes place at the end of
seven or eight days, but what are called the typhoid symptoms
develope themselves more distinctly; the pulse becomes more
frequent, weaker, and more compressible. The tongue grows
72
CONTINUED FEVER.
drier and browner; muscular debility increases; the patient lies on
his back, and ^inclines to slide down towards the foot of the bed.
If he retain the power to turn himself on his side, or to draw his
knees up, it is a favorable omen. His voice becomes weak, and
often, in bad cases, there are little convulsive startings of the ten¬
dons, and irregular, involuntary, and tremulous movements of the
limbs. From the commencement of the disease, the abdomen is
usually distended more than is natural, and feels harder than it
does in health; and frequently uneasiness is manifested when pres¬
sure is made upon the belly. Dr. Chomel remarks, that another
symptom, not commonly met with in other diseases, is a little
gurgling movement in the bowels, which may be felt by applying
the hand to the belly.
During the second week of the disease, the patient is very com¬
monly affected with delirium. His mind wanders at first in the
night only; and the delirium commonly appears on his awaking
from disturbed sleep. Sometimes he is desirous of getting up, and
talks incessantly and earnestly in a loud voice, and can only be
kept in bed by the imposition of some restraint. Usually, how¬
ever, his rambling is of a tranquil kind, and without agitation.
His mind seems elsewhere; he is inattentive to all that passes
around him; but he lies still, muttering disjointed words or sen¬
tences, like a man talking in his dreams. Deafness is a common
symptom in this stage of the disease, and this is considered
more favorable than the opposite condition, where the sensibility to
sounds is morbidly acute. Loss of vision is much rarer; yet the
eye is dull—unlike the brillia»nt eye of acute phrenitis, (inflamma¬
tion of the brain;) it corresponds with the expression of the coun¬
tenance, which is rather perplexed than wild. The patient in this
stage of the disease rarely complains of pain; his tongue is dry,
but he feels no thirst. The taste, the smell, the sense of touch, are
all impaired; even external inflammation may take place, espe¬
cially about the hips and sacrum, and go on to gangrene, without
any complaint of pain from the patient. He imagines he sees
motes in the air, and grasps to catch them; he picks the bed¬
clothes, and appears altogether careless about the issue of his dis¬
order. If asked how he does, he will probably declare that he is
quite well. The foeces and urine are passed involuntarily; some¬
times there is retention of urine, requiring the use of the catheter
to relieve the bladder.
Another symptom very apt to appear in this stage of the disease
is a species of eruption, consisting of small red blotches, over the
abdomen, and sometimes on the limbs. The eruption does not
come out all at once; nor is its duration always the same. Some¬
times it disappears entirely after two or three days. Sometimes,
on the other hand, it lasts a fortnight or more. In the latter case
it is probable that successive crops of the spots continue to arise
CONTINUED FEVER.
73
This eruption is not a constant attendant of continued fever, though
in some epidemics it is seldom absent. Professor Mitchell says,
that in regular typhus fever, the eruptions, instead of being red, are
dark. Another form of eruption is occasionally observed in low
fevers, consisting of vefy small transparent vesicles, looking like
' very fine drops of sweat.
Continued fever usually terminates in convalescence or the
death of the patient by the end of the third week from its com¬
mencement. This, however, is only a general occurrence; there
are many recoveries during the first week; and some cases ter
minate in death during this period. That variety of malignan
disease inappropriately termed yelloic fever is almost exclusively
confined to mercantile towns in warm climates, where there is no
regular winter. It is not only confined to cities in warm climates,
but principally to places near the wharves. Prof. J. K. Mitchell,
of Philadelphia, advances the theory that yellow fever is caused by
a species of poisonous vegetable, propagated in certain localities,
and under certain influences, as the mould on bread, decayed
wood, &c. That this poisonous agent, invisible to the naked eye,
floats in the air near the place of propagation, and being inhaled,
finds its way into the blood, and produces the malignant disease
called yellow fever. This, however, is mere speculation. The
symptoms in yellow fever are sometimes of a violent character in
the commencement of the reaction; there is an intensely hot skin,
flushed face, the eyes red, extreme headach, tormenting thirst, in¬
tolerance of light, pain in the loins and lower extremities, a sense
of weight and tension at the pit of the stomach, and a white, and
sometimes clean tongue. Distressing retching and vomiting occurs,
the ejections sometimes so acrid as to excoriate the throat. There
is a burning heat and tenderness at the pit of the stomach, as
though the patient had swallowed some corroding acid. There is
extreme restlessness and deep sighing; a hopeless expression of
countenance, and frequently delirium.
The fever, in many instances, does not continue more than two
or three days, when it subsides without any critical evacuation
occurring, either by sweat, urine, or stool, leaving the patient
extremely exhausted, with a weak and easily compressible pulse,
and soon followed with yellowness of the skin and whites of the eyes.
"The patient now remains in a state of tranquil indifference, amount¬
ing to a sort of stupor, without any apparent concern as to present
or future situation. This is an ominous calm ; for after a few
hours the pain and burning sensation in the stomach return with
increased violence; the vomiting becomes frequent and distress¬
ing—the fluid brought up containing minute flakes or flocculi,
resembling the crust washed from a port-wine bottle, but little or
no bilious matter," and every thing that is swallowed is forcibly
ejected. " This second paroxysm continues commonly from twelve
74
CONTINUED FEVER.
to thirty-six hours, when the energies of the system are worn out
in the struggle. The pulse sinks, the extremities become cold and
clammy, the tongue is black, and the matter thrown up consists
of a black ropy fluid, resembling coffee grounds suspended in a
glairy fluid." The burning in the stomach and bowels is distress¬
ing in the extreme. " Diarrhoea usually occurs at this period—
the discharges being green, or black. Hiccough, violent delirium,
hemorrhages, stupor and convulsions are apt to occur in fatal
cases."
Although the above describes the general characteristics of yel¬
low fever, still a great diversity of modifications is presented in
different cases. Thus in some instances the principle of life is
destroyed in the onset of the attack, and the patient expires with¬
out any symptoms of reaction occurring. "In other instances
violent and furious delirium, or mania, ushers in the disease, termi¬
nating in a few hours in insensibility and convulsions. Some¬
times it commences and proceeds to a fatal termination in so insi¬
dious a manner, that the patient himself and those about him are
scarcely aware that he is much indisposed. In such cases there
is, however, always a remarkable change in the expression of the
patient's countenance,- as well as in his usual temper and habits
In almost all instances of this disease, the countenance is expres¬
sive of intense anxiety and despair during its early period, and of
gloom or sullen abandonment in the last stage."
Treatment of Continued Fever in its various modifications.—In
all cases of disease of a malignant character, an energetic course
of treatment should be instituted in the early stage of it, before the
energies of the system become exhausted by the disease. If it be true
that continued fever is caused by a poisonous agent in the blood,
nature will require time to work the poison out of the. system, and
the disease, therefore, cannot be cut short at once by any course
of treatment, however thorough. Still, by lending a helping hand,
the duration of the disease may be more or less shortened, the
crisis rendered more complete, and, in fine, the disease brought to
a favorable termination, that otherwise might have proved fatal.
The disease commencing with a state of extreme prostration
and stupor, active stimulants, particularly the third preparation of
lobelia, should be given freely, also stimulating injections adminis¬
tered, and stimulants and friction applied to the surface, together
with external warmth, with a view of aiding the feeble efforts of
the constitution to bring about reaction.
The third preparation of lobelia, besides constituting an efficient
emetic, is a powerful diffusive stimulant, and also possesses anti¬
septic properties. Combined with a strong tea of bavberrv, this
mixture may be ranked as the best preparation of medicine, for
the treatment of low or malignant fevers. The necessity for the
CONTINUED FEVER.
75
continuance of its use, and for the frequency of the repetition of
the doses, must be determined by the character of the symptoms,
as well as by the effect produced. It can uo no harm. In observ¬
ing the effects of this as well as other preparations of medicine, it
must be borne in mind, that medicine often accomplishes most
benefit, when it causes most distress.
Emetics should be given in all cases. In some instances the
patient will be benefited by being vomited with lobelia every day.
until the disease forms a crisis; and then, again, others will not
require it oftener than once in two or three days.
Capsicum—Cayenne pepper.—In all cases of disease where the
stomach has lost the power to digest food, an important part in
the treatment, is to administer such medicines as are best adapted
to sustain the function of calorification and enervation, or, as
Dr. Thomson terms it, " the power of inward heat." Cayenne is
a pure and permanent stimulant, and well adapted to fulfil the im¬
portant indication above mentioned. It may be administered in ful'
doses every few hours, or in smaller doses more frequently repeated
When the tongue is thickly coated, the cayenne should be mixed
in a strong tea of bayberry; at least, occasionally it should be
given in this way.
When the stomach continues to reject the medicine, it should
be given in small doses. A teaspoonful of purified charcoal, or of
prepared chalk, mixed with a dose of cayenne, or composition tea,
will remain on the stomach, in many instances, when simple
cayenne tea would be rejected. When there is evidence of a
great accumulation of acid in the stomach, either the charcoal or
prepared chalk will prove beneficial, given freely with other medi¬
cines, such as cayenne and bayberry composition, or with simple
herb teas; for instance, pennyroyal, dittany, or mint.
The Steam or Vapor Bath.—Properly applied, the vapor bath is
not only safe, but more or less beneficial in all cases of disease.
When the patient is too feeble to bear the exertion of sitting up,
the bath should be applied on a bed or matress, the patient re¬
maining in a horizontal posture. In this way the application of
steam may be continued from three-quarters of an hour to an hour
at a time, provided a proper attention be observed in bathing the
face and breast of the patient with vinegar, spirits, or cold water,
allowing a free circulation of air in the room, and administering
cayenne or composition tea.
" In all cases," observes Dr. Thomson, "where the heat of the
body is so far exhausted as not to be rekindled by using the medi¬
cine, and chills or stupor attend the patient, then applied heat by
dteam becomes indispensably necessary."
CONTINUED FEVER.
The most rem ark a Die recoveries from diseases of dangerous
character that I have witnessed, have been where the- vapor bath
has been administered frequently; at least daily.
When the patient is able to sit up to have the1 bath adminis¬
tered, it is a good rule to use the shower bath, at the close of the
steaming.
Warm poultices kept applied to the abdomen, are highly benefi¬
cial, in many instances.
It matters not whether the disease comes on with great excite¬
ment and delirium, or with a state of congestion and oppression, as
regards the general course of treatment. The emetic and injec¬
tions proper in a state of congestion and extreme torpor, are equally
applicable where there is great excitement in the system. I have,
in repeated instances, observed a dose of the third preparation of
lobelia, given in bayberry tea, to have great influence in mode¬
rating, and, in some instances, in overcoming delirium; and on
the return of the delirium, by repeating the dose, these symptoms
again disappear; in this way, patients have in some instances been
kept comparatively calm and quiet, and able occasionally to sleep,
who would have been in a state of extreme restlessness and deli¬
rium without the medicine.
Much distress will sometimes be produced by the medicine
arousing the sensibilities, and exciting the recuperative powers of
the system into action. It is more favorable when the medicine
causes the patient to feel sensibly his diseased condition, than when
he appears unconscious of it.
External warmth.—If warmth applied by means of warm bricks
or bottles of hot water be agreeable to the patient, it should not be
neglected. A moist heat will, in many instances, render a patient
comfortable, when a dry heat will prove oppressive. "When there
is high fever, bathing the surface with vinegar and water, or alcohol
and water, will be soothing to the feelings of the patient, and may
be done without any risk of doing injury.
When the head is morbidly hot, cloths wet with cold water, or
vinegar and water, should be kept steadily applied, provided it be
agreeable to the feelings of the patient. If symptoms of inflamma¬
tion of the brain prevail, the hair should be cut off, and a warm
poultice applied over the scalp. The poultice may be made of
slippery-elm powder, or Indian mush. Cloths, wrung out of warm
water, may be substituted for poultices. Injurious consequences
are liable to follow the application of ice or blisters to the head, ip
continued fever.
Injections.—The importance of employing stimulating injections
in all cases of malignant disease cannot be too strongly impressed
CONTINUED FEVER. 77
upon the minds of those who have the management of such cases.
Indeed they constitute the most effectual means of preventing pu¬
trefaction of the contents of the bowels, and of preventing stagna¬
tion of blood in the bowels. When there is a strong tendency to
putrefaction, or the abdomen becomes distended from accumula¬
tions of gas in the bowels, from one to three teaspoonfuls of the
liquid of the third preparation of lobelia, in half a pint of bayberry
tea, should be administered by injection, and repeated every hour
or two, as the urgency of the symptoms may demand. In some
instances, even these powerfully stimulating injections will be re¬
turned until four or five are administered. In a milder form of
disease, and in its early stage, injections of a less stimulating cha¬
racter will be sufficient to accomplish the desired object.
Tonics.—When the tongue manifests a tendency to clean along
the edges, with an occasional absence of fever, tonics will be
proper, such as are recommended in the treatment of remittent
and intermittent fever, as quinine, Peruvian bark, Virginia snake-
root. &c. The Virginia snakeroot may be used, however, in any
stage of the disease. It answers very well given in decoction
with capsicum or composition tea. Recoveries from these low
forms of fevers are usually very slow, and the tonics and other
remedies require occasionally to be changed.
Nourishment.—Barley-water, gum arabic, mucilage, elm-gruel,
toast-water or crust coffee, essence of beef, or egg-soup may be
given as nourishment. In the latter stages of the disease, and
when extreme debility prevails, essence of beef should be given
freely in combination with pepper-tea; and this, is probably the
best kind of nourishment after the operation of an emetic, in anv
stage of the disease. Egg-soup may be given in place of the beef-
tea, when the latter cannot be obtained. " If plenty of beef-tea
(essence of beef) does not suffice," give also wine-whey, clear wine,
or brandy and water. If the wine should flush the face, it must
be given in small quantities or omitted altogether. " If the patient
relishes the beef-tea, or the wine, that is no small warrant of the
propriety and usefulness of its administration."
Some patients crave acids, such as sound cider, salt and vine¬
gar, or lemon juice and sugar, and where a desire for such articles
is expressed, they should be allowed to be taken, commencing
with small quantities, and, if found to agree with the stomach, their
use should be continued. In certain conditions of the stomach, a
mixture of lemon juice and sugar will prove the most suitajf5^ kind
of nourishment.
Favorable Symptoms.—An improvement in the cond'
mind; a natural expression of countenance; a gener
78
CONTINUED FEVER.
spiration; an ability to sleep; cleaning of the edges ol the tongue,
with a relish for some kind ofrfood, are favorable omens.
" In some instances the amendment is so gradual, that we can
scarcely say when it begins. In other cases, the favorable crisis
is preceded by an aggravation of most of the' former symptoms,
and a marked increase of the general distress. This," observes
Dr. Watson, "is a very curious circumstance; and it did not es¬
cape the notice of our great dramatist:
"' Before the curing of a strong disease,
Even in the instant of repair and health,
The fit is strongest. Evils that take leave..
In their departure most of all show evil.''
Under Thomsonian treatment, signal benefit is often observed to
arise from the operation of medicine that occasions much distress.
When the system is made to feel its diseased condition, it causes
a reaction of the vital energy, the recuperative powers are aroused
into action, and favorable results effected.
Unfavorable Symptoms.—Muttering, half-conscious, dreaming
btupor; twitching of the tendons at the wrist; coldness of the ex¬
tremities, or hot hands and cold wrists; a knitting of the brows,
and constant working of the muscles of the face; involuntary
discharge of the foeces and urine; and a purplish or bruised-like
appearance of the skin, are symptoms indicative of approaching
dissolution.
During recovery, especial care must be observed to avoid im¬
proper articles of food, and also to abstain from over-eating. Re¬
lapses aie often brought on by over-taxing the stomach with too
much food.
SMALL-POX.
79
CHAPTER II.
ERUPTIVE DISEASES.
SECTION I.
SMALL-POX.
Small-pox may be distinguished from other species of eruptive
d sease, by peculiarities in the appearance and progress of the
eruption. It is highly contagious, and, like measles and scarlet-
fever, very rarely occurs more than once in the same person.
Previous to the introduction of vaccination by Dr. Jenner, the
mortality from small-pox was very great; hence it has been
dreaded more than any other contagious disease.
Cause.—Small-pox is produced by a specific poison, introduced
into the system either by inoculation, or by inhaling the effluvia
emanating from the body of one affected with the disease.
Small-pox is divided by writers into two varieties—the distinct
and confluent. There is no essential difference between these,
other than that the latter is a more severe grade of the disease.
When the pustules, instead of remaining separate and distinct, run
together and form irregular masses or patches, it is termed con¬
fluent; when the pustules do not thus run together, it constitutes
the distinct variety.
Symptoms and general cause of small-pox.—The first symptoms
in small-pox are such as attend the early stage of many varieties
of acute disease; more especially do they resemble the premoni¬
tory symptoms of ague, remittent and continued fever.
Chilliness and languor, loss of appetite, aching pains in the back
and lower extremities, thirst, nausea and vomiting, with pain and
distress at the pit of the stomach, are the usual symptoms accom¬
panying the forming stage of small-pox.
As the constitution reacts, fever becomes developed, and gene¬
rally, in the course of three or four days, the eruption appears.
The fever, in small-pox, presents the same character as ordinary
bilious fever, such as a hot and dry skin, furred tongue, costive
bowels, pain in the head, and scanty, high-colored urine. Bleed¬
ing from the nose is apt to occur during the first and second day
of the fever. " The mind is dejected and confused, and towards
the end of the third day the tongue usually acquires a bright red
color."
80
SMALL-POX.
Shortly before the appearance of the eruption, an unusual ten¬
dency to perspiration generally occurs in adults, and frequently
much drowsiness and sometimes coma" (or stupor) " supervenes
at this period." " In children the eruption is sometimes preceded
by convulsions; but tendency to free perspiration very rarely
occurs in them." In many cases the hands and feet are cold
throughout the whole course of the disease, more especially in very
young children.
The eruption first appears on the face, and generally in the course
of twenty-four hours is spread over the body and limbs, " consist¬
ing at first of red points, which by the middle of the second day
present small elevations, with inflamed bases, which as yet dis¬
charge no serous fluid if punctured, but the cuticle appears dis¬
tended by a sort of semi-transparent plastic lymph. Towards the
end of the second day, some of these pustules present small de¬
pressions in the centre; and on the following day these character¬
istic depressions become conspicuous in nearly all of them. " The
number of the pustules indicates the quantity of the variolous poi¬
son which has been reproduced in the blood." Where there are
but few pustules, they often remain elevated and pointed, with but
very slight central depression ; but where they are numerous they
become flattened, with distinct depressions in the centre. As the
pustules increase in size, their flattened form becomes more con¬
spicuous. About the fourth day they assume a whitish color, and
become surrounded by a pale fed areola. When the pustules are
very numerous, these areola run into each other, and give a uni¬
form appearance of redness between the pustules.
The fever always remits or entirely disappears, and pain and'
other distressing feelings abate, when the eruption is fully out.
By the fifth or seventh day of the eruption, the serous fluid con¬
tained in the pustules begins to change its color, " marking the
stage of suppuration." As suppuration goes on, these pustules be¬
come distended with pus, and, losing their flattened form, acquire
a spherical shape.
The face begins to swell, generally, by the eighth day, and
occasionally the eyes become entirely closed. The fever usually
returns during this stage of the disease, constituting the secondary
fever. In confluent small-pox, the natural aspect of the face is
completely changed at this period of the disease.
" Towards the end of the tenth day, the swelling of the face
begins to subside," and the hands and feet, and other parts of the
body, become swollen and tender.
Soreness of the throat, and a copious discharge of saliva, almost
invariably accompany the suppurative stage.
" As the disease advances, the pustules become gradually yel¬
lower and more opaque, and arrive at their full state of maturity
about the twelfth day. After the pustules have acquired their per-
SMALL-POX.
81
feet state of development, they sometimes remain stationa -y for
several days; but more commonly a brownish spot makes its
appearance on the centre of each pustule as soon as the process
of suppuration is completed, acquiring at the same time a rougher
aspect, and deeper yellow. Soon after this change the pustules
begin to shrink, becoming gradually drier, darker, and harder,
until the matter is converted into a brown crust." These scabs
are frequently formed on the face, when the " pustules on the
extremities have scarcely arrived at maturity." When the scabs
fall off, they leave red or purplish spots, which are slow to acquire
the natural color of the skin. The mild form of small-pox rarely
leaves the skin permanently marked or pitted.
Such is the process by which the constitution works out of the
blood the poison of small-pox,—first, by the reaction or fever, by
which it is thrown to the skin, and then, by certain mysterious
actions, there is formed on the surface the specific poison which
caused the disease.
These sanative operations of the constitution, however, are liable
to be perverted by various causes, and the disease to assume a
malignant and dangerous character. In some cases the pustules,,
instead of becoming yellow, are red, purple or blue, constituting
bloody small-pox; a fatal form of the disease.
Confluent small-pox assumes various modifications. In some
instances the disease is highly inflammatory, commencing " with
strong chills, succeeded by intense febrile heat; a frequent, full,,
and hard pulse; high-colored and scanty urine; flushed counte¬
nance; sometimes delirium, and in children often with convul¬
sions." The tongue is dry and harsh, and frequently coated with
a dark or black fur, accompanied with excessive thirst. In some-
instances the brain becomes greatly affected, giving rise to violent
delirium or stupor, and convulsions.
" The tendency to profuse perspiration, so conspicuous in the-
distinct small-pox, is rarely observed in the confluent variety; but
profuse diarrhoea sometimes occurs shortly before the appearance
of the eruption, and still more commonly during the suppuration."
The pustules are generally " irregular in shape, and much less ele¬
vated than in the distinct small-pox, and the parts not covered
with the eruption are apt to be pale and flaccid."
" In the more aggravated cases of small-pox, it often assumes a.
typhous character." " The chilly stage is unusually protracted;
the pulse remains small, weak and frequent, and the patient com¬
plains of much muscular prostration. Various symptoms of nerv¬
ous disturbance are apt to occur—such as vertigo,, faintness,.
twitching of the tendons, and even convulsions. .The urine is
colorless, and the face pale and sunken. The pustules come out
slowly and irregularly, appearing simultaneously on every part of
SMALL-POX.
the body, yet sometimes first on the extremities." " The eruption
sometimes disappears on some parts without passing into the pus¬
tular state; and slight causes, such as cold, or mental agitation,
may cause the whole eruption to recede; in which case convul¬
sions or apoplexy, or fatal congestion and effusion into the lungs,
are apt to supervene. Suppuration goes on slowly and imper¬
fectly, the pustules becoming filled with a thin watery pus. The
intermediate skin is seldom much tumified, and remains pale."
In these severe cases of confluent small-pox, the patients are
liable to swelling of the glands of the groin and arm-pit, and some¬
times troublesome abscesses form. In some cases, the air-passages
become clogged by the profuse secretion of a viscid mucus, ren¬
dering respiration extremely difficult; in other instances, the
breathing is interrupted by swelling of the glottis.
" During the period of maturation, a peculiar greasy, disagree-
•able odor proceeds from the body of the patient. If taken into the
:sick-chamber blindfolded, one might name the disease at once by
this smell. About the same time also, many patients are torment¬
ed by itching of the surface, so that they are provoked to scratch
■off the heads of the pustules; and by so doing they often insure
the formation of pits. In many cases of confluent small-pox,
this itching appears to constitute the chief part of the patient's
suffering."
Treatment.—Small-pox should be treated on general principles,
the same as other forms of disease accompanied with fever. To
cleanse the stomach by emetics, to promote the action of the bowels
by injections, and to sustain the vital powers by suitable nourish¬
ment and pure stimulants, constitute the most important points in
the treatment.
A course of medicine administered in the early stage of small¬
pox tends to relieve the distress, and where the eruption is slow to
come out, or the patient greatly distressed, it should not be omitted.
It will, however, be proper at any period of the disease when the
condition of the patient seems to require it.
During the cold or forming stage, the patient should be kept
-warm; but after the fever is established, the covering should not
be too great, nor the room kept uncomfortably warm. It is also
important that the room should be well ventilated.
When the eruption is fully out, and the pustules are distinct and
not very numerous, and the symptoms wear a favorable aspect, it
will not be requisite to give much medicine. An occasional dose
of the composition or pepper-tea, or, if the patient be a child, simple
herb teas, as pennyroyal, sweet marjoram, or balm, will be suffi¬
cient. The bowels to be relieved, when necessary, by injections.
When the symptoms are very distressing at any period of the
disease, a course of medicine will prove the surest means of relief,
SMALL-POX.
83
And if the patient be unable to bear the fatigue of sitting up, emetics
may be given without previously administering the vapor bath.
Much benefit may be derived from broken doses of lobelia and a
free use of cayenne, when the fever is violent.
The Vapor Bath.—During the chilly or forming stage of small¬
pox, more especially when the efforts at reaction are feeble, and
the cold stage consequently becomes more protracted, the vapor
bath is of essential benefit, and, when followed by an emetic, will
seldom fail to bring on reaction. The bath also prepares the skin
for the reception of the eruption.
During the continuance of the disease, an occasional vapor bath
will prove beneficial, by promoting the secretions and exhalations
from the skin. It constitutes the most effectual means for allaying
the itching of the surface, so troublesome and harassing in many
cases of the disease. In the latter stage of the eruption, when the
scabs are coming off, the vapor bath will be of especial advantage
in restoring the skin to a healthy condition, and thereby prove a
preventive to the various affections which sometimes follow the
disease as a consequence of an unhealthy condition of the skin.
While steaming, the patient may be washed or sponged over with
soap and water, or with a weak solution of sal eratus in water.
The temperature of the water should be regulated to suit the feel¬
ings of the patient.
A strong decoction of sumac berries and leaves, or of bayberry
powder, adding a portion of cayenne, may be given once or twice
a day, in ordinary cases, or substituted for the composition and
cayenne, and given several times a day. This also forms a useful
gargle for the throat, in the latter stages of the disease.
If costiveness prevail, or the patient be affected with (Jiarrhoea,
injections must be resorted to. They will prove beneficial in all
cases.
Cold drinks.—Where the thirst is urgent, moderate quantities
of cold water, or lemonade, may be allowed the patient, more
especially after taking a dose of stimulating medicine.
The Diet.—During the early stage of the disease but little nour¬
ishment will be desired. Crust-coffee, barley-water, elm-gruel, &c.,
are suitable in ordinary cases, until the pustules begin to assume a
yellow appearance, when a more generous diet may be allowed,
as chicken-tea, milk porridge, toast and milk, soft-boiled eggs,
custards, &c. In the confluent form of small-pox, where the symp¬
toms indicate great prostration of the vital powers, wine whey
and the essence of beef should be given as nourishment. Five or
ten grains of the carbonate of ammonia may be added to a wine-
glassful of the-whey, as it tends to prevent acidity of the stomach,
84
SMALL-POX.
and also affords a grateful stimulus. Constipation of the bowels
may be in a great measure overcome by a diet consisting princi¬
pally of unbolted wheat-flour gruel, calves' foot jelly, stewed
prunes, Indian gruel, well boiled, or bread cut in thin slices, well
toasted, and softened with sweet cream or boiled milk.
To allay itching of the surface.—The vapor bath efficiently ap¬
plied, followed by sponging the surface with sal eratus water, or
tincture of bayberry, constitutes the most effectual means of allay¬
ing the itching of the surface. Salt and water is also useful in
allaying itching. When the skin becomes cracked, and the parts
swollen and tender, an ointment made of lime-water and sweet
oil, or a poultice composed of slippery elm, white pond lily and
ginger, should be applied.
When the disease is of a typhous, or otherwise malignant cha¬
racter, the treatment should consist of such means, both external
and internal, as are best adapted to support the prostrate and
sunken energies of the constitution, and to assist the stomach to
cast off offensive matters, which tend to weaken and oppress its
powers. There is, probably, no better form of emetic, in such
cases, than the liquid of the third preparation of lobelia, in a strong
tea of the sumac or bayberry. A teaspoonful of the third prepa¬
ration of lobelia to a teacup half full of the above tea, and the dose
repeated every hour or two, should be continued until the symp¬
toms become more favorable. I have found it necessary in some
instances, to continue the use of the third preparation for several
days and nights in succession, together with wine-whey, and
essence of beef, as nourishment.
For children, a milder form of emetic may be employed; for
instance, lobelia powder mixed with composition,/)!" bayberry tea.
During the progress of suppuration, but more particularly when
the scabs begin to form, patients are very liable to be restless and
greatly distressed. There is, probably, no remedy for this equal to
the vapor bath. I have seen patients in great suffering and dis¬
tress, rendered comparatively comfortable and quiet, in a few
minutes after applying the vapor bath. Applied in bed, the patient
will bear it from half an hour to an hour, and even longer.
I knew an instance in which, a patient being steamed at a time
when the scabs were fully formed, and almost dry, they came
off in a body, and left the surface almost raw, the disease being
of the confluent form, and the eruption covering almost the
entire surface. An ointment made of sweet oil and lime-water
was spread on soft cloths, and applied over the body, and in two
or three days the soreness was nearly removed.
Various methods have been recommended to prevent pitting;
none of these, however, have proved to any great extent effectual.
Some propose the application of gold-leaf over the face, in the
SMALL-POX. 85
early period of the eruption; but as the face swells, the gold-leaf
is broken, and will require constant patching, in order to exclude
the air and light. Others recommend opening each pustule, and
applying lunar caustic. A liniment made by dissolving half an
ounce ot gum camphor in two Jluid ounces of olive oil, has been
used as a means of lessening pitting. It is applied to the face in
the early stage of the pustules. The quantity of pustules on the
iace will be less numerous, if means be used to equalize the circu-
ation in the early stage of the eruptive fever.
The eleventh and thirteenth days are said to be the most dan¬
gerous periods of the disease.
During suppuration, or in the latter period of the disease, the
system should be nourished by the most nutritious diet that the
stomach can take, such as wine-whey, milk-porridge, essence of
beef, mulled egg, &c. It is not in every case, however, that nour¬
ishing food can be taken, except in small quantities; and under
these circumstances, pepper and other stimulants must be given to
sustain vital energy. If the throat be very sore, substances such
as jellies and rye mush can be swallowed with less difficulty than
thin liquids. Essence of beef, and chicken-tea, will be swallowed
more readily by mixing finely powdered elm-bark with them.
The elm may also be added to the medicines for the same pur¬
pose.
When the eyes are very sore, they should be kept covered with
soft cloths, wet frequently with rose-water or raspberry-leaf tea,
adding a portion of powdered elm.
When females are in a state of pregnancy, an attack of the
small-pox is considered by the medical profession as always dan¬
gerous. .
A Case.—I was called to attend on Mrs. P , who had
strong symptoms of approaching abortion. She was in her third
month of pregnancy,—a period at which abortions are very liable
to occur. A full course of medicine was given, which eased the
pains for a time. On the following day, however, they returned,
and I thought abortion must take place. The third preparation of
lobelia was now given freely, until very copious vomiting ensued,
when the pains ceased and did not again return. On the fol¬
lowing day an eruption appeared, which proved to be genuine
small-pox. The eruption came out so thick that it ran together,
and formed what is termed the confluent small-pox. The case
proved to be of a severe character, but the patient recovered per¬
fectly, and without having any return of bearing-down pain, or
other symptoms threatening abortion.
The above case illustrates the safety and advantage of treating
all violent forms of disease upon general principles, not regarding
the name by which the disease may be designated. Thus, the
86
SMALL-POX.
same means that prevented the abortion, were precisely such as
were adapted to throw the small-pox to the surface. And if the
symptoms of abortion had been occasioned by other causes than
that of small-pox poison, still the. same general plan of treatment
would be indicated. Thomsonians do not require to wait for a
disease to become developed, so that they can give it a name
before they administer medicine. Hot medicine, and, in violent
attacks, a course of medicine, cannot be given amiss. The same
means that will assist nature in bilious fever, will do the same in
small-pox, or in any other disease. It is at least probable that the
thorough treatment pursued in the above case, prevented abortion
by cleansing the stomach, and throwing the small-pox poison to
the surface.
The distinct variety of small-pox seldom proves fatal under ju¬
dicious treatment; and even in the confluent form, unless under
unfavorable circumstances, the system, by proper assistance, will
"work out its own salvation." When the vital powers are greatly
prostrated, and the disease assumes a typhoid or malignant cha¬
racter, it almost always proves fatal.
Favorable Symptoms.—A well-developed eruptive fever; the
pustules remaining distinct, round, and filling with thick yellow
pus, and a blush or areola encircling their base.
Unfavorable Signs.—When the reaction or fever that brings
out the eruption is imperfectly developed, indicating want of vital
power, accompanied by a sudden subsiding of the swelling of the
hands and face, with pallid countenance, or a striking in of the
eruption, the case may be considered as of a highly alarming cha¬
racter. Whenever the symptoms assume an unfavorable aspect,
a thorough course of treatment is required to arouse the sinking
energies of the system.
The question is frequently asked, whether the stimulating medi¬
cines, given freely, will not make the eruption greater than it
would have been without it? To this, it may be replied: If the
disease be not thrown fully to the surface, the eruption may be less,
but the constitutional symptoms will be more violent and danger¬
ous than where the eruption is greater, and the disease effectually
thrown to the surface by pure stimulating medicines. To cast the
disease off by the surface is the method established by nature, and
these curative efforts should be aided.
VACCINATION COW-POX.
8?
SECTION II.
VACCINATION—COW-POX.
The practice of vaccination originated in England, about the
year 1796. It was introduced by Dr. Jenner.
In the year 1775, Jenner, who was then a student of medicine,
one day heard a dairy-maid in the office, in conversation with his
preceptor, declare that she was not afraid of the small-pox, (which
was at the time prevailing in the neighborhood,) for she had taken
the kine-pox, and that dairy-maids that had taken the disease
from the cows never took the small-pox. This declaration of the
milk-girl, first gave Jenner the idea of introducing the cow-pox by
vaccination, as a means of protecting the system from small-pox.
Although it had been known in some of the dairy counties in
England many years previous to the time of Jenner, that cows
were subject to an eruptive disease, which, being communicated to
the hands of the milkers, produced pustules, which protected them
from small-pox, yet no one before Jenner ever thought of intro¬
ducing a preventive to the small-pox, by inoculation with the cow-
pox matter.
The opposition that Jenner met with from the medical profes¬
sion, in introducing this new practice, was of the most hostile cha¬
racter. Two physicians in London went so far as to declare
through the public journals, that introducing the disease from an
animal into the human system would convert mankind into a sort
of mongrel, partaking of the nature both of man and beast. It was
even denounced from the pul-pit, as an invention of Satan, and that
the devil first introduced the practice by vaccinating Job.
After many years of devoted attention to this subject, Jenner
presented an essay to the Board of Physicians, of London, con¬
taining an account of his experiments in vaccination, and fur¬
nished proof of the protection it afforded against small-pox. They,
however, returned the essay, with the advice to suppress its publi¬
cation, or otherwise he would be considered as either a "fool or a
knave."
The frightful and ridiculous accounts related concerning vacci¬
nation, during its early struggles against popular prejudice, were
probably not even surpassed in inconsistency, by the multitude of
gross and palpable misrepresentations extensively circulated,, con¬
cerning the Thomsonian system of medicine.
The practice of vaccination, however, finally gained the confi¬
dence of many medical men, and it soon became generally adopted.
Jenner, on his first visit to the United States for the purpose of
VACCINATION COW-POX.
introducing vaccination, met with strenuous opposition from the
medical profession of Boston, where he first landed. Dr. Benja¬
min Waterhouse, then a professor at Yale College, was the first
of the medical faculty who adopted vaccination. He then intro¬
duced it into his own family, and about the same time Thomas
Jefferson's family were vaccinated; and in a few years after, the
practice of vaccination became generally adopted, not only in
England and the United States, but throughout all civilized
countries.
There is too much evidence to admit of a doubt that vaccina¬
tion affords a protection, in general against small-pox: that it occa¬
sionally fails of affording protection to the system, is equally cer¬
tain ; but it should be borne in mind, that there are many assign¬
able causes for these failures, such as, when the matter used is of
spurious character, or its virtue destroyed by long keeping; or
where erysipelatous inflammation takes place, and destroys the
genuine character of the disease; or where the patient is affected
with an eruptive disorder, and thus the vaccine disease perverted
or changed.
I attended a female, not long since, who had the small-pox in
a most violent form, and who had been vaccinated. On examin¬
ing the mark on her arm, I discovered a large smooth scar, nearly
the size of a quarter of a dollar, showing that the scab must have
been three or four times as large as a genuine vaccine scab, and
that the inflammation had probably so modified the disease as to
afford no protection against small-pox. The family of this female
had been vaccinated, and they all escaped the small-pox. It is at
least probable, that in the greater part of those cases of small-pox
that occur after vaccination, the failure of vaccination in affording
protection, has been in consequence of imperfection in the vaccine
virus; its nature being changed by erysipelatous inflammation;
the vesicle having broken, and the fluid escaped; or from the scab
being injured or rubbed off soon after it had formed.
Concerning Vaccination causing JVeic Diseases.—That eruptive
diseases are sometimes occasioned by vaccination, is admitted:
but many, and probably the great majority of instances of disease
occurring after, and attributed to vaccination, arise from other
causes, independent altogether of the vaccine virus. How often
do consumption, scrofula, and chronic inflammation of the eyes
occur as a consequence of small-pox; great numbers also die
of the disease. Although small-pox may tend to purify the sys¬
tem, as Dr. Thofnson asserts, yet there ai*e few, probably, who
have witnessed bad cases of it, that would willingly take it, rather
than run all the risks attendant upon vaccination.
Characteristics of a genuine Vaccine Scab.—Not larger in cir-
VACCINATION COW-POX.
89
cumference than a five-cent piece, nearly round, with an indenta¬
tion, or eye, in the centre; smooth on the upper surface, with a
bold and regular rounded edge; of a mahogany color, horny ap¬
pearance, and brittle.
How to preserve the Scab.—Kept from the light, and in a cool
place, in a sealed glass vial, a scab will continue good for years.
The usual way of preserving the virus is to wrap it in a small
piece of clean paper, and inclose it in bees-wax.
To prepare the matter for Vaccination.—Take a portion of the
brittle part, near the middle of the scab—place it on a piece of
glas^ or china, and put a drop of cold water on it, and when suf¬
ficiently soft, mash it with a knife-blade; or, shave off a small por¬
tion of the scab, and then add sufficient water to the part shaven
off to make it of about the consistency of honey.
Season most favorable.—In very cold or very hot weather, vac¬
cination is very liable to fail, requiring in some instances to be
repeated several times before it will take.
Age—A child should not be vaccinated until after it is at least
two months old. The usual time is about the fourth or fifth month.
Precautions.—Be sure that the matter to be used is genuine. Do
not vaccinate a child affected with any eruptive disease. Persons
predisposed to erysipelas should not be vaccinated at a time when
that disease is prevailing.
Place of Insertion.—The part to be preferred for introducing
the matter, is about midway between the top of the shoulder and
the elbow, just below the insertion of the deltoid muscle, on ac¬
count of there not being so much motion in that part; or, it may
be done below the elbow, or under the knee on the calf.
The General Characteristics of the Genuine Vaccine Disease.—
First: Little or no inflammation until or after the third day from
the time the puncture is made.
Second: About the fourth or fifth day, a small point of inflam¬
mation appears, which gradually enlarges, and in about two days
a small vesicle is formed, which is depressed in the centre, and
without inflammation in the adjoining skin. The vesicle enlarges,
remains circular, with a regular and well-defined margin, more
depressed in the centre, and a small crust begins to form in the
centre of the depression, by the seventh or eighth day.
Third: Bj ween the seventh and eighth days, there is an areola
or blush of inflammation formed around the margin of the pustule.
This circle of inflammation enlarges, and frequently by the ninth
90
VACCINATION COW-POX.
day it will be two or three inches in diameter, but remaining
circular. The crust in the centre grows darker," the turgid margin
shining, as if the lymph were assuming the character ol pus."
Fourth: The vesicle generally reaches its acme by the eleventh
day, when the surrounding inflammation begins to subside, first
immediately around the pustule, and gradually declines towards
the circumference, where it leaves at last a mere ring.
Fifth: The fluid in the vesicle becomes thick and turbid, and
soon forms into a smooth crust, of a dark brown or mahogany
color. The crust, in many instances, does not loosen and fall off
under three weeks. " It leaves a permanent circular cicatrix,
about five lines in diameter, and a little depressed, the surface
being marked by many little pits, or indentations, denoting the
number of cells of which the vesicle had been composed."
The Constitutional Symptoms attending the course of the vaccine
disease, are generally very slight, especially in children. In some
instances, there are chills and fever, and headache, which may
need some attention, though generally they soon subside without
any treatment. The glands under the arm are apt to be swollen
and sore, and care should be taken to avoid lifting the child with
the hands under the arms, as is the usual practice.
Characteristics of spurious or imperfect Vaccination.—First:
There is generally considerable inflammation and raising of the
skin, on the second day after the puncture is made.
Second: The scabbing commences by the third or fifth day
from the commencement of the inflammation, and runs its course
in a much shorter time than the genuine.
Third: There is no depression in the centre of the pustule; it is
raised up high, and has an irregular margin.
" When the inflammation commences on the formation of the
vesicle, and assumes an erysipelatous character early, with much
swelling, and the pustule assumes a blue appearance, it should not
be considered as genuine."
Local Treatment.—When the inflammation becomes so great as
to require attention, as it often does when the disease is of a
spurious character, the parts should be bathed occasionally with
tincture of lobelia, and a salve of simple -cerate, or a preparation
of sweet oil and lime-water applied. In some instances, a poultice
of slippery elm and ginger, kept wet with the tincture of lobelia,
answers better than salves. In severe cases, accompanied with
much pain, the bowels should be relieved by injections, and the
patient kept slightly nauseated with lobelia, or if necessary a vapor
bath and an emetic given. When the swelling is very great the
arm should be kept at perfect rest, in a sling, or on a pillow.
VARIOLOID MODIFIED SMALL-POX.
91
SECTION III.
VARIOLOID—MODIFIED SMALL-POX.
This is an eruptive disease, which bears some resemblance to
small-pox. It is in general, however, of a much milder character,
and runs its course in about half the time required for small-pox.
It is the prevailing opinion among medical men, that varioloid
is genuine small-pox, operating upon a system which has previously
undergone vaccination.
Symptoms.—The first symptoms are lassitude, languor, loss of
appetite, chilliness, pain in the head, back and limbs, sickness and
vomiting, and sometimes delirium. The fever, in some instances,
is as violent as in severe cases of small-pox, though, in general, it
is of a mild character.
By the third or fourth day of the fever, the eruption begins to
appear, and in the early stage resembles the eruption in this stage
of small-pox. There is seldom any fever after the eruption comes
out. There is no secondary fever in varioloid, such as occurs in
the suppurative stage of small-pox. In varioloid the eruption gene¬
rally comes out at different periods, in successive crops; first on
the face and breast, and often disappears there, by the time it first
appears on the feet.
By the fourth or fifth day the pustules begin to dry, and by the
sixth or seventh day, begin to fall off; whereas, in small-pox, the
scabs seldom fall off before the fifteenth day.
The appearance and course of the eruption in varioloid, is very
diversified. In many instances there is a rash resembling measles,
which precedes the eruption. It frequently happens that a portion
of the eruption dries up in the course of two or three days, whilst
another portion will become filled with a watery limpid fluid, by
the first or second day, and by the fourth day, usually burst, and
another set will become pustular, somewhat resembling small-pox
pustules, and remain four or five days longer before they form
into scabs. In some cases the eruption becomes confluent, by the
vesicles running together in masses or patches; but even in this
form of the disease, there is seldom any secondary fever.
Varioloid is not often fatal under judicious treatment; much less
so than genuine small-pox.
Treatment.—The general points of importance to be kept in
view in the treatment of varioloid, are to cleanse the stomach by
emetics, preceded, if necessary, by the vapor bath; the bowels to
92
VARICELLA CHICKEN-POX SWINE-POX.
be regulated by injections; and the constitutional efforts sustained
by pure stimulants, and appropriate nourishment.
In the more violent cases, where the patient is much distressed,
the emetic or course of medicine should be repeated at proper inter¬
vals, as long as the symptoms present an unfavorable aspect.
In many mild cases, simple herb teas, and a proper attention to
diet will be sufficient in the way of treatment.
The vapor bath may be employed in any stage of the disease,
and will be of especial benefit where the skin remains in an un¬
healthy condition after the eruption has passed off.
Varioloid seldom leaves the skin permanently pitted.
SECTION IV.
VARICELLA—CHICKEN-POX—SWINE-POX.
Chicken-pox is an eruptive disease, and generally of a mild
character. Some medical writers maintain that varicella is a
modification of small-pox; others contend that it is a separate and
distinct disease.
Chicken-pox is almost universally confined to children, and a
second attack, in the same individual, is of very rare occurrence.
Neither small-pox nor vaccination affords any protection against
chicken-pox, nor does chicken-pox prevent small-pox.
Peculiarities of Chicken-pox.—In general there is some slight
fever, for one or two days, when the eruption begins to be dis¬
closed, first appearing on the neck and back, in the form of small
vesicles, filled with a pellucid fluid, which dry away and disap¬
pear on the seventh or eighth day,—before small-pox passes through
its first stage.
The vesicle of chicken-pox will discharge itself, on being punc¬
tured with a pin. A small-pox pustule is cellular, and will not dis¬
charge its contents if punctured.
In chicken-pox the eruption comes out in successive crops,
some drying away whilst other crops are appearing, and thus
continue for some days. The eruption produces a tingling feeling
in the skin.
Chicken-pox, however, like other forms of disease, assumes va¬
rious modifications. Severe cases closely resemble genuine small¬
pox, leaving the same kind of pits in the skin.
Chicken-pox is seldom attended with danger, instances of death
from it being very rare.
MEASLES.
93
Treatment of Chicken-pox.—Where the case is so severe as to
demand particular attention, the treatment should be conducted on
the same plan as is recommended in the mild form of small-pox;
cleansing the stomach by emetics; injections to relieve the bowels,
and occasionally some mild stimulant, such as composition or gin¬
ger-tea, or herb teas, such as pennyroyal, mint, &c. Where large
sores are formed, they should be covered with some simole salve,
to exclude the air, and favor the healing process.
SECTION V.
MEASLES.
Measles are contagious, and seldom occur more than once in
the same individual.
This disease may be contracted at any period of life; but mostly
occurs in childhood. The middle of winter is the season in which
it generally prevails.
The disease usually becomes developed either on the fifth or
seventh day, after exposure to the contagion; but occasionally, it
is not manifested until two, or even three weeks from the time the
disease is contracted or imbibed.
Symptoms.—Restlessness, chilliness, and shivering; pain in the
head; an increased flow of tears, and a discharge of watery
humors from the nostrils, are the usual symptoms in the first stage
of the disease. Fever comes on, the throat becomes sore, there,
is hoarseness and a dry cough, thirst, nausea, and vomiting; hur¬
ried and oppressed breathing, and pain in the loins and back.
Sometimes there will be profuse sweating.
In about four or five days from the commencement of the fever
the eruptions appear in small red spots, similar to flea-bites, first
on the face, and then spreading over the body and limbs. As
these spots enlarge, they unite and form red patches, of an irregu¬
lar shape, leaving a portion of the skin retaining its natural color
and appearance.
When the disease is of a violent character, slight delirium often
occurs about the third day from the commencement of the fever;
and in children, convulsions are not unfrequent, a few hours pre¬
ceding the appearance of the eruption.
The eruption on the face usually reaches the height of its de¬
velopment on the second day after its first appearance, and on
the following, begins to fade and subside. The face is mostly
swollen, and in severe cases so much so as nearly to preclude
94
MEASLES.
sight. The eruption on the body fades away in the same progres*
sive manner in which it made its appearance; so that about the
eighth day from the commencement of the fever, it disappears
finally on the back of the hands, where it remains longest.
In measles, there is usually more or less fever during the con¬
tinuance of the eruption; more especially at night. Short and
difficult breathing, and a harassing cough, frequently prevail.
Looseness of the bowels is apt to take place when the eruption
begins to decline, which is not unfavorable at this stage of the
disease; but where a diarrhoea occurs just before the eruption is
making its appearance, it is to be considered as an unfavorable
occurrence, as it tends to interfere with the regular progress of the
disease, or cause it to retrocede. Active purging with cathartics
in the early stage of the disease, may prevent the eruption from
coming out, and be the means of bringing on convulsions.
Measles occasionally resemble scarlet fever so closely that it
would be difficult to distinguish between them. This, however, is
a matter of little consequence, as the same course of treatment is
applicable in both diseases.
Although measles, in general, are not dangerous, yet, in persons
of feeble constitution, and delicate health, they occasionally be¬
come a very formidable disease, assuming the form termed con¬
gestive or typhous. In this form of the disease the vital powers
are prostrate; a proper reaction or fever does not ensue, or takes
place very slowly and imperfectly. The countenance is pale, and
the breathing slow and oppressed; the pulse feeble and laborious;
the extremities cold—in short, all the vital energies are depressed.
Infants are peculiarly liable to this form of the measles.
Treatment.—In ordinary cases of measles, much medicine is not
required. The vapor bath and an emetic in the early stage, will
lighten the disease and render the patient much more comfortable;
after which, give small doses of the tincture of lobelia, and warm
teas—as, composition, ginger, pennyroyal, summer savory, balm,
&c., in order to keep a determination to the surface, and promote
perspiration. It is a good practice to administer daily an injection
of composition tea, adding from a fourth to a half of a teaspoonful
of green lobelia.
The oppressed breathing and harassing cough may be relieved
more or less by placing the system under the influence of lobelia.
When the disease is of a more violent character, the patient
much distressed, or the eruption slow in coming out, a course of
medicine, or at least an emetic and injection, should be given, and
if the symptoms continue violent, repeated every day, until there is
a manifest improvement.
If the weather be cold, the patient's room should be kept com¬
fortably warm and of an equable temperature, and the patient
MEASLES.
95
should avoid exposure to a current of air. Still, a proper ventila¬
tion of the room will be advisable, which may be effected without
risk, when the patient is in bed. When a stove is used in the
room, a basin of water should be kept on it, to prevent the air
from getting too dry.
Where coal is burned, every precaution should be used to
prevent the escape of gas into the sick-room, as it is exceedingly
pernicious, retards the recovery of the patient, and increases the
liability to sore eyes, running from the ears, and swelling of the
glands.
Where several children of the same family are sick at the same
time, let them be kept separate, if possible; for if several children
sick with measles be crowded together in the same room, the dis¬
ease will be much more difficult and dangerous.
The vapor bath may be administered with great benefit in all
cases of measles; it not only tends to shorten the disease, but
makes the patient more comfortable, and lessens the liability to
diseases that are apt to follow measles.
Affections liable to follow Measles.—There is no disease which
leaves the system so susceptible to the morbid influence of cold, as
measles. In fact, the effects which frequently ensue as a conse¬
quence of measles, are more unpleasant and troublesome than the
primary disease.
Coughs, consumption, inflammation of the lungs, scrofula, dis¬
eases of the eyes, rheumatism, eruptions about the head, and
running from the ears, are not of uncommon occurrence after
measles.
The liability to these affections, however, will be greatly les¬
sened when the Thomsonian practice is employed. A vapor bath
about the time the eruption disappears, and the skin is peeling off,
will tend to restore a healthy action in the skin, and diminish the
liability to secondary forms of disease. If the tongue have an un¬
healthy appearance, and other symptoms which indicate a disor¬
dered stomach arid bowels, a full course of medicine should be
given, and some stimulants used to keep up a determination to the
surface, together with a dose of the bayberry or sumac-tea
once a day.
Death seldom occurs from measles under Thomsonian treat¬
ment. Under unfavorable circumstances, however, as when two
or three patients are crowded in a small room, badly ventilated;
or when it occurs in persons predisposed to consumption, or o
scrofula, it occasionally becomes an unmanageable disease.
The treatment for disorders following measles must, of course,
be regulated by the condition of the patient: in slight affections
criving some simple tonics; and where the symptoms indicate much
derangement, vapor baths, injections and emetics may be required,
90
SCARLET FEVER.
followed by tonics, and such things as are considered good for
restoring health; for instance, a strong decoction of pipsissewa,
yellow dock-root, aud sarsaparilla.
If there be a discharge of offensive matter from the ears, they
should be syringed every day with castile soap-suds; then wet
a piece of cotton or wool with tar-water, or tincture of myrrh,
or Haarlem oil, and put it in the ear, pressing it in so that the liquid
may pass into the cavity. A drop of Haarlem oil put into each
ear every day, during the first four days of the disease, may pre¬
vent running.
Diet.—During the early stage of measles, and until the patient
becomes convalescent, the diet must be light; elm-gruel, crust-
coffee, barley-water, &c.
SECTION VI.
SCARLET FEVER.
Scarlet fever assumes many grades of violence, from a very
mild to that of a most malignant form of disease. It is generally
treated of under three varieties.
First. The simple or milder variety.
Second. The inflammatorij, where reaction or fever is of a
high grade: and
Third. The malignant, where the vital powers are greatly en¬
feebled by the force of disease. The treatment, however, is to be
conducted upon the same genera] principles, varying in prompt¬
ness according to the violence of the disease.
General character and course of the simple variety.—Beginning
with the usual premonitory symptoms of acute disease, such as
paleness of the skin, loss of appetite, lassitude and chilliness, which
continue for an indefinite period, " varying from one to three or
four days," when reaction takes place, and the patient experiences
flushes of heat, pains in the head, loins, and extremities, and sickness
of the stomach; the skin becomes dry and hot, and the pulse fre¬
quent and quick.
" Generally, within the first forty-eight hours after the com
mencement of the fever, a scarlet eruption comes out, first on the
face, and then, successively, on the neck, trunk, and extremities."
" The rash consists of innumerable red points, which, running into
each other, give a diffused blush over the skin." In some cases
SCARLET FEVER.
97
the eiuption appears in patches, " leaving the skin, in the interme¬
diate space, of its natural color."
Usually, by the fourth or fifth day, the eruption and fever begin
to decline; critical evacuations ensue, such as a copious discharge
of urine, depositing a reddish sediment; a general warm perspira¬
tion, and sometimes diarrhoea. About the eighth day after the com¬
mencement of the eruption, the skin begins to roughen and peel oft",
at which time there is considerable itching over the surface.
Sometimes the disease assumes a more violent character; there
is much distress and sickness at the stomach, together with severe
headache, and general weakness. The reaction or fever comes on
early, "with a feeling of stiffness and dull pain in the muscles of
the neck and under the ears, and angles of the jaws." The throat
becomes swollen, which renders it difficult for the patient to swal¬
low ; a hoarseness of the voice takes place, and there is a " sense
of constriction in the throat." The fever assumes a high grade
of violence; the skin is dry and harsh; the tongue dry and of a
bright red along the edges, and over its surface the little glands or
papillae may be seen projecting. " The eruption does not come
out as early in this as in the milder form of the disease, and it is
seldom diffused over the whole surface—appearing in irregular
and not very large patches, on different parts, more particularly
about the elbows. In some instances, the rash disappears and re¬
appears partially, at unequal periods of time, but without any cor¬
responding change in the general disorder, and the whole duration
of the complaint is thus lengthened.
If the disease begin to decline by the fourth or fifth day of the
fever, the throat rarely ulcerates, the swelling and inflammation
subsiding as the disease abates. When the disease is more pro¬
tracted, " small ulcers are apt to form on the palate and tonsilsr
which are soon converted into superficial sloughs." " There is
always a considerable quantity of viscid mucus secreted in the-
fauces, which often concretes into white flakes on the inflamed
parts, and presents the appearance of ulcers, where in reality none
exist." As the disease gives way, " the sloughs in the throat
begin to separate, and leave red ulcerated surfaces, which gene¬
rally heal without difficulty. Sometimes* however, instead of
separating about the eighth day, the sloughs enlarge, become
brown, and discharge an acrid sanious fluid; and in such cases
the glands about the neck are generally swollen, hard and painful;
and the patient is harassed with painful diarrhoea and tenesmus..
The inflammation occasionally extends into the trachea, and the
patient dies under symptoms of acute bronchitis. The brain
often becomes prominently affected during the eruptive stage,,
giving rise to deep and sometimes fatal stupor."
Malignant Scarlet Fever.—This form of the disease is marked
98
SCARLET FEVER.
by a general prostration of vital power. The reaction, though it
may be apparently vigorous in the commencement, soon declines
into a low, or typhoid fever.
The eruption comes out irregularly, and is usually pale in the
commencement, but acquires a dark or livid hue in the progress
of the disease. The eruption often strikes in soon after its first
appearance, and in two or three days reappears on some part of
the'body.
The, skin varies in its temperature; generally it is not very high,
though occasionally there is a burning, acrid heat over the surface.
The brain is much affected early in the disease. The patient be¬
comes delirious; the eyes are inflamed and dull, and the cheeks
suffused with a livid flush, readily distinguished from the bright
red which occurs in a less malignant form of the disease. " The
tongue is dry and covered with a brown or dark fur, and the
breath fetid." The ulceration of the throat assumes a very ma¬
lignant character, and frequently it is converted into black and
offensive sloughs, accompanied Avith an acrid secretion from the
inose, which excoriates the parts with which it comes in contact.
" The fever and ulceration of the, throat frequently exist without
there being any eruption developed during any period of the dis¬
ease: this is called putrid sore-throat. In some instances, the vital
powers are prostrated in the commencement of the disease to such
a degree that reaction does not take place." " The patient be¬
comes pale, faint and oppressedthere is much distress and op¬
pression at the stomach, with nausea and vomiting, giddiness,
a sense of weight in the head, and extreme debility. The breathing
is oppressed, and sometimes there is a mixture of paleness and
lividity on the cheeks. " The pulse is slow, irregular and weak,"
" The bowels are torpid in the beginning, but towards the termi¬
nation of the disease diarrhoea almost always occurs in fatal
cases." The eruption is at first pale, or of a copperish hue, which
subsequently becomes purple.
Malignant scarlet fever, in some instances, terminates fatally as
early as the second, third or fourth day. In other instances, the
vital powers will struggle with the cause of disease for weeks,
occasioning a low typhoid fever, until finally either the disease or
the energies of the system are exhausted, thus terminating either
fatally or in convalescence.
A milder form of scarlet fever may assume a dangerous charac¬
ter, from two or more patients being sick of the disease in the
same room; more especially if the room be small, and the patients
near each other. The exhalations from a patient sick of scarlet
fever, will sometimes occasion a tingling in the nose, and even in
the skin of the physician or nurse; and when patients are placed
near each other, the disease will always become aggravated by it
and, in many instances, prove fatal.
SCARLET FEVER.
99
Scarlet fever, in its mild form, occasionally so closely resembles
measles, that it becomes difficult to distinguish between them. The
indications of treatment being the same, however, in both diseases,
the difficulty of determining the name will occasion no embarrass¬
ment in directing the treatment.
Causes.—Though evidently contagious, still there is the most
conclusive evidence that the disease is frequently produced by
atmospheric causes, together with exposure to cold and dampness.
Treatment of Scarlet Fever.—A course of medicine, administered
in the early period, will generally moderate the symptoms through
the whole subsequent course of the disease, and in some instances
will almost break it up at once.
In the mild form of the disease, after giving a course of medi¬
cine, or simply an emetic, as long as the symptoms are of a mild
character, nothing more will be required than to give occasionally
of some mild stimulant, such as composition or ginger-tea, or
simple herb teas, such as pennyroyal, catnip, sweet-marjoram, &c.,
and an occasional enema, to relieve the bowels; together with small
doses of the tincture of lobelia, more especially at night.
When the patient continues to be much distressed, a course of
medicine should be administered daily, and small doses of lobelia
given every hour or two, in composition, bayberry, or pepper-tea.
It is not always requisite to administer the vapor bath previous to
giving an emetic, as in some instances free vomiting should be
produced two or three times in every twenty-four hours. When
the skin is very hot and dry, it will be difficult to jfroduce perspi¬
ration, even by the vapor bath, without frequently washing or
sponging the surface with cold water, or tepid vinegar and water,
or, what is still better, sal eratus water. A tablespoonful of cold
water may be allowed the patient occasionally. During the early
stage of the fever, and when the patient is restless, and the skin
hot and dry, cold ablutions may be employed, provided they do
not occasion chilliness. But in a later period of the disease it will
be safer to use tepid ablutions, to reduce the heat of the skin, and
quiet restlessness. ,
Injections constitute an important part of the treatment of scarlet
fever. They should be prepared in the usual form—either of com¬
position tea, adding from half a teaspoonful to a teaspoonful of
lobelia powder; or of bayberry tea, adding a teaspoonful of the
third preparation of lobelia.
In severe cases the injections should be repeated every few
hours. An occasional injection prepared of lobelia powder and
warm water, will be found of benefit in relaxing the system, when
the fever is very high; the injection should be retained in the
100
SCARLET FEVER.
bowels fifteen or twenty minutes. Sometimes this will occasion
free vomiting, and prove of especial benefit. Persons unacquainted
with the strange symptoms sometimes occasioned by lobelia injec¬
tions retained, would very naturally become alarmed by their occur¬
rence ; the patient will become restless, tossing about, with vomit¬
ing, and frequent retching; the system becomes greatly relaxed,
the eyeballs are turned up, the lids partly closed, the countenance
pale, and the breathing accompanied with a kind ot sobbing.
During the continuance of these symptoms, the face, breast and
hands should be bathed with vinegar, or vinegar and water. The
most signal benefit is derived from placing the system fully under
the influence of lobelia, in the early stage of scarlet fever, before
the throat becomes seriously affected, as it frequently does in this
disease. This will prove the most effectual preventive of malig¬
nant disease of the throat. Under the powerful influence of lobelia,
the nervous energy is concentrated in the great sympathetic sys¬
tem of nerves, and its whole force brought to bear against the cause
of disease; and however great maybe the distress and its opera¬
tion, it almost invariably produces the best kind of results, I have
seen a simple scarlet rash cured by a lobelia injection. Genuine
scarlet fever, however, like small-pox and measles, will rufi a defi¬
nite course, and all that can be accomplished by medical treat¬
ment, is to guide the disease to a favorable termination by lending
a helping hand to nature.
Care will be necessary not to keep the patient too warm, exter¬
nally, when the fever is high. A hot stove-room is very oppres¬
sive to the sick, unless water be kept constantly evaporating on the
stove, to prevent the air from becoming too dry.
The vapor bath proves a powerful auxiliary agent for the cure
of scarlet fever; and the more frequently and more thoroughly it
is administered, the better it will be for the patient. It can never
do any harm, except by compelling a patient to sit up longer than
his strength will bear. If the patient be too weak to sit up without
being over-fatigued, the vapor may be applied on a bed or matress.
There is, probably, no means better adapted to aid the efforts of
nature to remove scarlet fever poison, and every other kind of
poison from the blood, than the steam or vapor bath.
Precaution.—More than one patient affected with scarlet fever
should never be admitted into the same room, where it can be
avoided. This precaution is of the very greatest importance. If
the poisonous effluvia emanating from the body of one laboring
under scarlet fever, be inhaled by another patient sick of the same
disease, it will be like adding poison to poison, and will often prove
fatal under any treatment that can be adopted
SCARLET FEVER.
101
Treatment of Malignant Scarlet Fever.—Generally, the reaction
commences violently, the system being thrown into a state of
tumultuous excitement; but, from the power of the cause of dis¬
ease, the vital energies soon become exhausted, and the fever
assumes a low malignant or typhoid character. In other instances
the vital powers are overwhelmed in the outset of the disease, and
are unable to bring on reaction. The patient remains cold, and in
a state of stupor, or he is thrown into convulsions. In either case,
the treatment should be prompt and energetic, consisting of
emetics, of either the liquid of the third preparation of lobelia, or
the lobelia powder prepared in composition tea. This, together
with stimulating injections, and external warmth, will be the surest
means of establishing reaction. To sustain the curative efforts of
nature, active stimulants should be employed, as the third prepara¬
tion of lobelia, in composition, bayberry, and cayenne-tea. Wine
whey, and carbonate of ammonia, will also be of advantage in the
advanced stages of the disease, when the strength of the patient is
far exhausted.
If the skin be dry, a moist heat should be kept around the patient,
by hot bricks wrapped in damp cloths; but where the skin is
cold and clammy, a dry heat will be proper, together with warm
frictions and stimulants to the surface, and when the patient is
oppressed by too much external heat, the surface should be bathed
with tepid water, vinegar and water, or whiskey.
Malignant Sore Throat. — "The capsicum," says Dr. Eberle,
" appears to be a particularly valuable remedy in this variety of
the disease. This article was first employed in malignant scar¬
latina, by Dr. Stephens, in a very fatal epidemic which prevailed
at St. Christopher's, (West Indies,) in 1787, and it has since re¬
ceived the decided approbation of many eminent practitioners."
The form in which the faculty employ it, is similar to Dr. Thomp¬
son's pepper sauce—a tablespoonful of capsicum, and twoteaspoons-
ful of fine salt, to half a pint of boiling water. Strain, and add an
equal quantity of good vinegar. For an adult, a tablespoonful
every half hour; for children, a less quantity, in proportion to their
age. The throat to be frequently gargled or washed with it.
" Stephens asserts that he employed this remedy in about four
hundred cases, and with surprising success. The ulcers in the
fauces soon cast off their sloughs, and commenced to heal; a
general pleasant warmth was diffused through the system; and
the vital powers speedily assumed a more active condition."
There is, however, such an antipathy against cayenne pepper, that
nurses sometimes refuse to give it, because it makes the child
cry, and they have heard others say it is too hot for children. I
have never observed any ill effects from the use of cayenne pepper,
either in the young or old; but many children die, who probably
might have been restored to health, by a free use of this pure
102
SCARLET FEVER.
stimulant. The capsicum-tea I find to answer as well, or even
better than the pepper-sauce, more especially in cases where the
stools are of a green cast, or emit a sour smell. As much cay¬
enne as will lay on a five-cent piece, and double the quantity of
composition powder, mixed in a tablespoonful of bayberry-tea,
answers better, in many instances, than giving the tea without the
powder; the dose to be repeated every two or three hours.
If the patient be affected with diarrhoea, purified charcoal or
prepared chalk may be mixed with other medicines given, with a
view to improve the acrid condition of the secretions and ex¬
cretions.
In protracted cases, ulceration of the mucous membrane of the
bowels sometimes takes place, giving rise to painful diarrhoea,
attended with extreme emaciation of the flesh, and a dry husky
condition of the skin. When these symptoms prevail, such reme¬
dies must be employed as are adapted to correcting the secretions,
and sustaining the healing action. Stimulating poultices applied
warm to the abdomen, will afford relief and may prove especially
beneficial.
Applications to the Throat, externally.—In all cases where the
glands of the throat or neck are swollen, a warm poultice should
t be applied. This may be made of Indian mush, well boiled, adding
a portion of lard and ginger, and when the poultice is spread, cover
the surface of it with lobelia powder. The poultice should be re¬
newed, or warmed occasionally, and not allowed to become cold.
. Slippery elm or flaxseed will answer as well as the Indian mush.
Gargles.—In the early stage of the disease, the tincture or tea
of lobelia answers well as a gargle. Capsicum tea or pepper
sauce, however, forms the best gargle in the more advanced stages
of scarlet fever, and may be used during the whole course of the
disease. Swabbing the throat with the capsicum tea or pepper
sauce is still more effectual than the use of gargles, especially if
the throat be ulcerated; and in young children who cannot use
the gargle, the swab must necessarily be used. This is to be done
with a piece of sponge or rag, tied firmly 011 the end of a stick.
Dip the swab in the preparation, and rub over the throat. This
is sometimes a difficult operation in children, but the benefit to be
derived from it should induce nurses and parents to be persevering
in its use. A soft piece of wood placed between the jaws, will
enable the nurse to apply the swab more effectually. The child's
head should be held firmly at the time.
When clothing is removed from patients affected with a conta¬
gious disease, it should be immediately put in cold water, instead
of being thrown into a closet or in a corner.
SCARLET FEVER.
103
The Diet, in the early period of the disease, should consist of
liquids, such as barley-water, arrow-root gruel, crust coffee, elm
gruel, and gum arabic water. In a later period of the disease, a
more nutritious diet may be allowed the patient, as milk-porridge,
essence of beef, egg-soup and custards. In a sinking state of the
system, wine-whey, with carbonate of ammonia, will be proper.
When there is difficulty of swallowing, slippery-elm powder,
mixed with the liquids to be taken, will enable the patient to swal¬
low with much less difficulty. The elm-powder, added to milk-
porridge, renders the latter more easy of digestion.
Scarlet fever is liable to be followed by dropsical affections,
from exposure to cold, or inaccuracies in diet, before the patient
has fully recovered from the primary disease. As long as the
tongue remains coated, or does not present a healthy appearance,
care should be taken to avoid exposure to cold or dampness; and
the diet should be confined to such articles as are easy of diges¬
tion. I attended a little boy, in Second street, who had anasarca,
or general dropsy, following the scarlet fever. Under the treat¬
ment, the symptoms all became more favorable, and the patient
began to recover rapidly; but, from eating heartily of broiled
mackerel, which his stomach could not digest, dropsy of the chest
ensued suddenly, and the case terminated fatally in less than forty-
eight hours.
An occasional vapor bath, followed by a shower bath, the surface
being rubbed dry, and bathed over with some stimulating prepa¬
ration, as pepper sauce, or No. 6 and water, in equal parts, will tend
to prevent dropsy, or other affections that might otherwise ensue
as a consequence of scarlet fever. The spice bitters, or other
tonics, as Virginia snakeroot, or Colombo, should be given two or
three times a day, to assist in restoring digestion.
Where dropsy has ensued, the bath should be administered daily,
as above directed, and followed sometimes by an emetic; broken
doses of lobelia given either in tincture or pills, together with an
occasional dose of composition or pepper-tea, or, if the patient
prefer it, the compound lobelia pills. In the early stage of dropsy,
the compound lobelia pills may be used in the place of all other
remedies; between courses of medicine, and in slight attacks,
they may be found sufficient to remove the complaint. When
the dropsical symptoms disappear, a strong tea of poplar bark,
or of some other tonic, may be employed.
A Case.—I was called to attend a young man who had been ill
of scarlet fever about a week. The rash had been, from the be¬
ginning, alternately appearing and disappearing. The fever wras
of a low grade, and attended with delirium. The principal medi¬
cines used in this case, and which proved successful, were the
»04
NETTLE-RASH HIVES.
liquid of the third preparation of lobelia, in a strong decoction
bayberry tea,—a teaspoonful of the former to a teacup hall lull ol
the latter, repeated every two or three hours, in continued succes¬
sion, for several days and nights; together with an occasional in¬
jection of the same kind of compound. This medicine always
quieted the delirium for an hour or two, and occasionally under its
influence the patient would sleep. As the delirium returned, the
dose was repeated, and these symptoms would again subside.
The patient generally vomited once or twice in the course of
twenty-four hours, but seldom' complained of sickness at the
stomach. Under this treatment, together with an occasional
vapor bath, administei'ed on a matress, the patient recovered.
The diet consisted principally of wine-whey and essence of beef.
The Thomsonian practice is generally successful in scarlet
fever, when applied in the first outset of the disease, though oc¬
casionally it baffles the most thorough and judicious treatment,
more especially when there is more than one patient sick of the dis¬
ease in the same room. The treatment pursued in the above case
is given in order to point out a course that may prove successful
in other desperate cases. In bad cases of scarlet fever, the floor
should be sprinkled three or four times a day with a few tea-
spoonfuls of the chloride of soda, or the chloride of lime should be
placed in vessels about the room. This is more especially neces¬
sary where there is more than one patient in the same room.
SECTION VII.
NETTLE-RASH—HIVES.
This is an eruption resembling the rash produced by striking the
skin with nettles. The skin is raised and whitish on the top, with
a hardness around the margin of the swelling, and more or less
inflammation, and is attended with painful itching and tingling.
There is a tendency in nettle-rash to disappear and reappear
suddenly, and thus continue for several successive days.
In some instances, the eruption comes on only at night, with
an itching and tingling over the whole body; and when the skin is
scratched or irritated, large wales immediately rise up, with a pale¬
ness or whiteness on the centre, and light-red margins, attended
with intolerable itching and stinging pain.
Occasionally the disease becomes chronic, the swelling remain¬
ing stationary for weeks, or even months.
ERYSIPELAS ST. ANTHONY'S FIRE, OR ROSE.
105
Cause.—Nettle-rash is caused by a disordere.d condition of the
stomach and bowels. Eating shell-fish will sometimes bring it on.
Balsam copaiva, where it disagrees with the stomach, will occa¬
sionally produce this kind of eruption.
Treatment of Nettle-rash.—The vapor bath, and a lobelia emetic,
will, in many instances, remove the disease at once. If the first
operation fail of effecting a cure, repeat it at proper intervals, until
the general health is restored, giving occasionally composition or
spice bitters; and cleansing the bowels by using injections, prepared
in the usual form.
In milder cases, purified charcoal, taken in composition tea, two
or three times a day, together with one or two injections, will be
sufficient to rectify the constitutional derangement.
Lime-water is useful in all cases of nettle-rash, as the complaint
is always attended with an excess of acid in the stomach and
bowels. The dose for a child is from a teaspoonful to a table-
spoonful in boiled milk, taken two or three times a day.
A friend of mine informs me that half a teacupful of saffron tea,
sweetened, and taken at bed-time, will overcome the symptoms.
The Diet should be simple, avoiding all gross food. Where the
disease has become seated, let the accustomed diet be changed to
other articles of equally nutritious qualities.
Local Applications.—In recent cases, the tincture of lobelia,
vinegar and water, or alcohol and water, may be applied imme¬
diately to the eruption. In chronic cases, the stronger stimulants
should be applied to the swellings, as the No. 6, third preparation
of lobelia, pepper-sauce, or stimulating liniment, &c. All eruptive
diseases of this kind are to be treated upon general principles,—
the grand object to be kept in view, being to correct the constitu¬
tional disorder that gives rise to eruptions.
SECTION VIII.
ERYSIPELAS—ST. ANTHONY'S FIRE, OR ROSE.
This form of disease is characterized by a redness of the skin,
swelling, and a tingling burning pain.
Erysipelas probably never occurs except there be previous de¬
rangement of the general health. Usually the first symptoms are
languor, chilliness, headache, loss of appetite, and other signs of a
106 ERYSIPELAS ST. ANTHONY'S FIRE, OR ROSE.
disordered stomach. These symptoms are usually followed by
two or three days' fever, before the erysipelas makes its appear¬
ance. In some instances the fever is violent; in other cases it is
of a milder character, and occasionally, though very rarely, the
inflammation appears simultaneously with the fever.
" The inflammation comes out in the form of an irregularly cir¬
cumscribed stain or blotch, which soon spreads over a greater or
less extent of the contiguous surface." There is always more or
less swelling, even at the commencement of the inflammation, and
a burning, tingling pain, but the part does not throb or pulsate,
except in very violent cases, and where suppuration takes place in
the cellular tissue.
Usually by the third or fourth day, blisters are formed on the
inflamed surface, filled with a " limpid or yellowish serum." In
the course of two or three days, the blisters break, occasionally
forming crusts, or large scales. In less than a week, in favorable
cases, the inflammation and swelling begin to subside; the skin
becomes pale, or of a yellowish cast, and presents a rough appear¬
ance, and shortly after the old skin peels off*.
Erysipelas is generally confined to the skin, though in some in¬
stances, the inflammation extends to the adjacent cellular tissue.
In cases of this kind, the pain is more severe, and the parts be¬
come extremely tender, and painful on the slightest pressure. The
constitutional disturbances are generally severe, and the com¬
plexion sallow, indicating derangement in the functions of the liver.
Frequently, in the severe form of the disease, suppuration takes
place in the parts beneath the skin, and the patient experiences
irregular chills: " the redness of the skin and the pain subside, but
the swelling increases; there is much doughiness, and the parts
remain in this state for some time" before the pus will find its way
to the surface. When the fluid escapes, it frequently has the ap¬
pearance of whey, and contains shreds of cellular tissue, like tow,
or shreds of cotton.
The face and limbs are most liable to erysipelas. When it
attacks the face, the swelling, in many instances, is so great as to
entirely close the eye-lids. More or less mental derangement
usually attends such cases, especially when tl\e inflammation ex¬
tends over a considerable portion of the scalp.
The danger from erysipelas is not great, except when the brain
is attacked by it, or when it occurs in vitiated or broken down con¬
stitutions, and the disease assumes a typhous character. There is
a form of erysipelas which attacks females about a year old, ap¬
pearing first on the privates, and subsequently becomes inwardly
seated, and generally fatal. I have seen a case of this kind,
attended with sloughing of the vagina, and where the inflamma¬
tion finally extended over nearly the whole of the body. Thi6
patient died in about three weeks from the commencement of the
ERY9IPEL1S ST. ANTHONY'S FIRE, OR ROSE. 107
attack. In this case the stomach and bowels were much disor¬
dered previously to the occurrence of the erysipelas.
In many instances, the disease is brought on by eating unwhole¬
some food.
Treatment.— A Thomsonian course of medicine will, in many
instances, check at once the farther spread of the inflammation.
Where the inflammation is on the face or head, it is a good prac¬
tice to evacuate the bowels by injections, in the commencement of
the course of medicine. In mild cases, and where the general
health is not much impaired, the treatment may be correspondingly
mild. An enema to evacuate the bowels, together with hot teas,
to keep up a moderate perspiration, will be sufficient in the way
of constitutional treatment, as long as the symptoms continue
favorable.
Where the countenance is sallow, indicating derangement of
the liver, or where the fever is high, or the patient much distressed,
the treatment should be more thorough. The enemas should be
repeated occasionally, always containing a portion of lobelia. An
emetic should be given as often as every day, in violent cases, and
continue to give broken doses of lobelia, in composition or bay-
berry tea, or lobelia may be given in the form of pills. A tea-
spoonful of lobelia powder, given by injection in warm water, and
fetained in the bowels, will in general relax the system more, and
prove more serviceable than when administered in any other way.
Free vomiting may often be effected in this way. In all severe cases,
attended with high fever, it is important to keep the system more or
less relaxed by small doses of lobelia; and likewise to give occa¬
sionally, either composition or pepper tea. The room should be
kept of a moderate temperature. Very hot stove-rooms are
pernicious.
The parts affected should be kept elevated, if practicable:—-
thus, if on the face, the head must be raised higher than the body,
or if on the limbs, they should be kept elevated, to favor the return
of the blood from the inflamed part.
Of all means for the cure of erysipelas, emetics are the most
effectual. Besides fulfilling other important indications, they have
an influence in restoring the secretions of the liver. It is the
opinion of some medical writers, that the liver is more or less dis¬
eased in all cases of erysipelas. Emetics may be given without
previously administering the vapor bath, but when the inflamma¬
tion is on the face, it will be proper to use the warm foot bath, and
an injection, previously to giving the emetic; and to continue
warmth to the feet, by hot bricks wrapped in damp cloths.
' Injections.—A case of erysipelas came under my care recently,
where the symptoms assumed a typhoid grade, and the sensibility
108
ERYSIPELAS—ST. ANTHONY'S FIRE, OR ROSE.
of the bowels was so low that injections of a tablespoon!ul of the
third preparation of lobelia in bayberry tea, were not felt by th^
patient until after they had been repeated-several times. When
the sensibility of the bowels was restored, the injection occasioned
violent pain and distress several hours. The erysipelas which had
spread over nearly the entire surface of one of the Legs, assumed a
more favorable aspect immediately after the injection, it having
aroused a new and more healthy action in the system.
The Diet should be confined to the lightest kind of food, as slip¬
pery elm gruel, barley-water, crust-coffee, &x. In mild cases, or
where the patient is on the recovery, more generous diet may be
allowed, such as milk-porridge, custards, boiled chicken, toast
and tea, &c.
Where the attending fever is of a low typhoid character, with
great prostration of strength, stupor, or low muttering delirium and
coldness of the extremities, active stimulants and tonics should be
employed. The remedies most to be relied on in such cases, are
the liquid of the third preparation of lobelia, in a strong tea of the
bayberry or sumac to cleanse the stomach; quinine as the best of
tonics; and essence of beef, and wine whey as nourishment. I
have used quinine with marked benefit, in erysipelas, attended with
extreme debility. From twelve to thirty grains may be given
every twenty-four hours. •
Local Applications.—As a local application to the inflamed sur¬
face, the liquid part of the third preparation of lobelia has done
well in all cases where I have employed it: for although a power¬
ful stimulant, patients generally experience less burning in the part
than before its application. Soap liniment, opodeldoc, sweet oil
and lime water, or tar ointment, may either of them be applied
to the parts affected. There are some skins which all kinds of
grease disagree with; in such cases, scorched flour or powdered
slippery elm bark may be applied in a dry state. When the inflam¬
mation is on a limb, and the part remains swollen after the inflam¬
mation subsides, a bandage should be applied, commencing at the
extremity of the limb, and bandaging upward.
Where there is evidence of an accumulation of matter in the
parts, deep incisions should be made in order to give the matter an
early opportunity to escape.
Children predisposed to erysipelas should not be vaccinated
until the general health is restored.
As a general rule, poultices do not answer a good effect in ery¬
sipelas, except when the parts ulcerate, or become gangrenous;
then the application of stimulating poultices may be useful. In
case of simple ulceration, use a poultice composed of elm, ginger,
pond lily, and pounded cracker; but in case of gangrene, or mor-
SHINGLES.
109
tification, the charcoal or yeast poultice will be more appropriate.
A portion of cayenne or of composition powder should be added
to the poultice.
In cases of erysipelas in children, the tincture of lobelia answers
very well to bathe the inflamed surface. Salt and vinegar is
equally beneficial.
Erysipelas is much less dangerous where there is active inflam¬
mation, than where the parts are much swollen, and feel doughy, with
less redness, and less heat. Erysipelas is occasioned by debility,
and it is by an inflammatory action that the vitality of the affected
surface is preserved; therefore when the inflammation is of a low
grade the third preparation of lobelia should be applied freely ex¬
ternally, and given in frequently repeated teaspoonful doses inter¬
nally, until the stomach is thoroughly cleansed and the secretions
restored—then give quinine freely.
SECTION IX.
SHINGLES.
This complaint is characterized by a cluster or band of vesicles
or blisters on an inflamed surface, commencing, in most instances,
on the right side of the abdomen. In some instances, this band of
vesicles extends down towards the gioin; in others, it passes up-
t wards. It is very rarely that the eruption occurs on the left side
of the body.
" This disease bears a very close resemblance to erysipelas,"
and arises from a disordered state of the system. " Loss of appe¬
tite, lassitude, slight headache, nausea, more or less febrile irrita¬
tion, together with scalding heat and tingling in the skin, and
shooting pains through the chest and stomach, are the symptoms
which usually precede the eruption."
The vesicles are transparent until the fourth or fifth day, when
they acquire a yellowish or milky appearance,, and in the course
of a day or two break and form brown crust, and in a few days
after fall off'. In some instances, the skin ulcerates, leaving scars
after the parts heal.
Shingles very seldom attack any but young persons, and rarely,
if ever, occur in children under three years of age.
Not dangerous.—Shingles are rarely dangerous. The eruption,
however, occurring in a highly diseased or exhausted constitution,
may be followed by dangerous consequences from the supervention
110
SCALD-HEAD.
of gangrene. "There is-a vulgar but erroneous notion that the
eruption proves fatal when it surrounds the whole ol the body."
Treatment of Shingles.—Little need be said in relation to the
treatment of this disorder. The same local applications may be
used, as are recommended in erysipelas; and when the general
health is much affected, an emetic to cleanse the stomach will be
proper. Mild stimulants, as composition, ginger, pennyroyal, &c.,
may be used to promote perspiration. If the bowels require at¬
tention, use enemas. Lime-water, with milk, is good to correct
the secretions, where the stools are acx'id or of a greenish cast.
The diet should be light, consisting of gruels, milk, toast and
milk, elm-gruel sweetened with loaf-sugar, adding a portion of
lemon juice. Cold drink, of which lemonade is generally the most
grateful, may be allowed the patient in moderate quantities. When
the bowels are costive, a gruel made of unbolted wheat flour has
a good effect.
The patient should be cautioned against rubbing off the heads
of the blisters, as troublesome ulceration may follow as a conse¬
quence of their premature rupture.
SECTION X.
SC A.LD-HEAD.
This name is given to a certain form of eruption, which comes
on the head. It commences with small ulcers, which discharge a
humor that forms into thick crusts or scabs. In some instances,
nearly the whole of the scalp becomes affected, forming a con¬
tinuous mass or scab, attended with paroxysms of intolerable
itching, and emitting an offensive odor. Sometimes the humor
discharged is extremely acrid, producing an eruption wherever it
co'mes in contact with the skin, and, in this way, the disease not
unfrequently spreads partly over the face, and extends down the
neck to the back and shoulders. The glands about the ears are
also often swollen.
Scald-head is occasionally met with in adults, though it is very
generally confined to children, and, unless correctly treated, may
continue even for years.
Treatment—A most important point, in the treatment of scald-
head, is tne exclusion of air from the parts affected. To accom¬
plish this, cut the hair off close, and apply some kind of salve or
SCALD-HEAD.
Ill
plaster that will exclude the air, such as Thomson's healing salve
or an ointment made of tar and suet, and put on a cap, either of
bladder or of oiled silk. This will prevent the formation of scabs,
though the discharge of matter will continue until the parts heal.
The cap should be taken off every day, and the parts that suppu¬
rate be cleansed. By gently pressing a dry cloth on the parts, the
pus will adhere to it, and in this way be removed. Then apply
fresh ointment, and put on the cap, which should be rubbed over
on the inside with tallow or oil, to prevent its adhering too closely
to the salve or ointment.
The eruption should never be wet with any kind of wash, ex¬
cept the tincture of myrrh, or bayberry. These may be used every
time the head is dressed. Tincture of bayberry, or soot tea, may
be employed as a wash to allay the tormenting itching so common
in this complaint.
Constitutional Treatment.—In bad cases, a sweat and an emetic
should be given every week or oftener, as the symptoms indicate.
This will greatly facilitate the cure. Lobelia, given in small doses,
is of especial benefit in all kinds of eruption. It may be given in
pills, or in tincture, several times a day, in quantities merely suffi¬
cient to excite slight nausea.
The composition powder, mixed with sugar and warm water,
should be taken once or twice a day; more especially, if the tongue
be coated. The bayberry or sumac tea may be used for the same
purpose.
The spice bitters, or any other simple tonic, may be given to
strengthen digestion.
Extract of Pipsisseiva, given in the form of pills, is a favorite
medicine with some practitioners, in eruptive complaints.
Costiveness may generally be relieved by proper articles of diet,
as stewed prunes, gruel made of unbolted flour, with the addition
of a few raisins, stewed figs, rye mush, roasted apples, and ripe
fruit in season. The diet of course is not to be confined to such
articles exclusively.
The following preparation may be used in the place of the exter¬
nal application above mentioned:
Liver of sulphur, three drachms,
Spanish soap, one drachm,
Lime water, eight ounces,
Rectified spirits of wine, ten drachms.
To be mixed and melted together, and applied to the affected
parts night and morning.
After the complaint is cured, the head should be bathed every
112
TETTER.
day with tincture of myrrh to prevent a return of the eruption
On the first appearance of its return, salve should be applied, ana
the parts excluded from the air; and, if the general health be bad,
constitutional treatment should be resorted to.
There is a scabby eruption that prevails among children, gene¬
rally commencing back of the ears, and frequently spreading over
the cheeks, and on the head, resembling scald head. This erup¬
tion is to be treated in the same manner as scald head:—apply
ointment to exclude the air, keep the parts dry, and restore the
general health by appropriate constitutional treatment.
Tar water.—Scaly eruptions on the face and other parts of the
surface, may be cured in many instances, by simply washing the
parts with tar water, two or three times a day.
SECTION XI.
TETTER.
There are various forms of eruptions, to which the name tetter
is generally applied, all of which, however, depend chiefly upon a
disordered state of the stomach and bowels, and require much the
same kind of treatment.
That which is termed dry tetter, consists of red blotches on the
skin, covered with pimples, which itch very much. The eruption
forms white scales, like fine bran, which fall off, leaving the skin
apparently healthy. The eruption reappears and repeats the same
operation as before, and in this way, will continue to disappear and
reappear indefinitely.
Pustular Tetter.—In this variety, the eruption appears in clus¬
ters of small vesicles or blisters, containing at first a thin serum,
which in a few days becomes yellowish, and breaking, forms thin
crusts or scabs, which fall off, leaving the skin, in many instances,
in a healthy condition, except a slight degree of redness; occa¬
sionally the skin becomes excoriated. There is a sense of smart¬
ing, and sometimes pain, attending the eruption. Not unfrequently
the eruption reappears at intervals, and the disease may be pro¬
longed in this way for weeks or even months.
Corroding, or Eating Tetter, as it is called, commences with
small painful sores or ulcers, which soon spread into large spots of
various forms and sizes, and discharge a thin watery humor.
This humor is sometimes so acrid, as to produce new sores
wherever it comes in contact with the surrounding surface. This
TETTER.
113
species of tetter is apt to spread rapidly, and occasionally forms
deep ulcers, which are difficult to cure.
Another Species.—There is another species of tetter, appearing
in the form of hard, dry, red spots, usually about the size of a mil¬
let seed. This eruption is mostly observed on the face and neck,
though in some instances, it extends over the whole body. De¬
pending in general upon chronic derangement of some internal
organ, especially torpor of the liver, and obstinate constipation of
the bowels, it not unfrequently becomes a seated disorder, and can
be cured only by restoring the disordered functions of the system.
General Constitutional Treatment in Tetter.—Every variety of
tetter may be produced by constitutional disorder, and as a gene¬
ral rule it is brought on by derangement in the system. Generally,
there is a superabundance of acid in the stomach, the digestion is
feeble, and the bowels constipated. The constitutional treatment
must be adapted to the character of the symptoms; an occasional
emetic or full course of medicina, and the use of such means as are
proper to assist digestion, rectify morbid secretions, and restore
the function of the bowels, will be required in all obstinate cases.
An emetic or course of medicine once a week, together with a
liberal use of purified charcoal, say, from three to four teaspoons-
ful, daily, mixed in cayenne or spice bitter tea, and from two to
four of the compound lobelia pills given every night, will rectify the-
constitutional derangement in all ordinary cases. In some cases,
the constitutional derangement or debility may be rectified by a
change of habit. For instance, if the habits-be sedentary, the
patient should take exercise in the open air, especially after meals;
and use especial care to keep the feet warm and dry. A change
of residence from one part of the country to another, or from the
city to the country, will, in many instances, cure long standing
complaints, where medicine, without change of residence, may fail.
The diet should be such as best suits the patient's constitu¬
tion, avoiding, however, hot bread, sweet cakes, fat or salt meat,
or strong coffee. Bread made of unbolted flour, is proper in all
cases of costiveness. Eating freely of parched corn, promotes the
natural action of the bowels, and is also a remedy much prized by
some in the cure of acidity of the stomach. Washing or sponging
the body occasionally with salt water, or rising from bed, and
using friction to the skin with the flesh brush, or a dry salted towel,
will give tone to the nervous system, and increase the constitu¬
tional strength. The vapor bath, followed by the shower bath,,
may be used when the patient is too chilly to bear the washing
with cold salt water alone. Exercise in the open air, cleanliness,,
and warm clothing, are of importance in all long standing disor¬
ders of the skin.
8
114
TETTER.
Local treatment in Dry Tetter.—There are various washes and
ointments that may be used with benefit. The best, howevei, ac¬
cording to my experience, is a tincture of sumac berries in No. 6.,
or the third preparation of lobelia, to be applied frequently, and the
parts anointed, especially at night, with Thomson's healing salve,
tar ointment, or yellow dock ointment.
Local treatment in Pustular Tetter. — An application that will
prove favorable in one case of pustular tetter, will act unfavorably
in others, so that it is not always an easy matter to select the pro¬
per remedy in each particular case. To protect the parts from
the air is an essential part of the treatment in all cases. The fol¬
lowing is a popular remedy for tetter:
Take an ounce of pounded yellow dock root,
Half a pint of sweet oil,
Half a pint of spermaceti oil,
And a pint of vinegar.
Stew these together until the vinegar is all evaporated. To be
applied two or three times daily, and the parts covered with some
kind of dressing to exclude the air. In some cases of pustular, or
running tetter, all kinds of salves and ointments disagree, aggra¬
vating the disease and causing it to spread rapidly. In such cases
the parts should be dressed, and wet occasionally with salt and
brandy, tincture of myrrh or tincture of bayberry. If these should
not prove of benefit, and the eruption be located on the hands or
on parts that will admit of it, bind on scorched flour, dry slippery
elm, prepared chalk, or charcoal, in order to absorb the acrid dis¬
charges from the sore.
Pustular tetter sometimes spreads over a considerable portion
of the surface. I saw a case in which the eruption spread over
the whole surface of the lower extremities. The disease had
existed over two years, and during the greater part of this time
the patient was unable to sleep covered in bed, on account of the
itching. The skin and adjacent tissues had become thickened and
much harder than natural. Severe cases like the one above de¬
scribed, require constitutional treatment, especially the vapor bath,
emetics and injections; and these should be continually adminis¬
tered at proper intervals for weeks or even months, before the dis¬
ease will be cured. The object of continuing the use of emetics
is to evacuate from the stomach the acid which feeds the eruption.
Treatment of Eating or Corroding Tetter.—This variety of tetter
demands a more active course of treatment, especially where there
is a tendency in the disease to spread rapidly. A full course of
medicine should be given and followed by the usual stimulants and
ITCH. 115
astringents, such as composition, ginger, capsicum and bayberry,
in order to promote perspiration, and to correct the secretions of
the stomach and bowels.
The yeast poultice, or a compound of white pond lily, elm and
ginger, wet with a strong tea of raspberry leaves, to be applied to
the parts affected, and renewed at proper intervals until the ulcers
assume a healthy appearance, when the salve or ointment may be
used as recommended in pustular and dry tetter.
SECTION XII.
ITCH.
This disease, it is said, is caused by an insect which penetrates
e skin, and produces small vesicles or pustules, attended with an
intolerable itching.
The wrists, and between the fingers, are the parts affected,
though it is occasionally observed on various other parts of the
body, excepting the face.
Treatment.—The sulphur ointment will cure the real itch sooner,
probably, than any other application. There are other remedies,
which may be used with benefit, as frequently washing with salt
water, or the preparation recommended by Dr. Thomson, which
is spirits of turpentine, with about four times as much of No. 6:
to be well shaken before applied.
Sulphur ointment is made by rubbing together one ounce of the
Jlour of sulphur, and four ounces of lard. This ointment is to be
applied every night. It is recommended that a part of the body
only be covered with the ointment at a time,—say, one-fourth.
The addition of a few drops of the oil of lemon or bergamot will
conceal the disagreeable smell of the ointment.
The following is said to be an effectual cure in this disease:—
Half an ounce of muriate of ammonia, mixed with two ounces and
a half of water. The affected parts to be washed every day with
the mixture.
Another preparation:—Mix together one drachm of sulphuric
acid, and one ounce of lard, and apply the ointment.
116
RING-WORM.
SECTION XIII.
RING-WORM.
This name is applied to an eruption consisting of very minute
vesicles or blisters, closely compacted together, and forming a
ring or circle. There is great diversity in the size of the ring,
varying from an eighth of an inch to two or three inches in
diameter. In the centre of the larger rings, the skin is of it§
natural appearance. " The eruption is always attended with a
troublesome itching and tingling sensation." In four or five days
the vesicles break, and form crusts or scales, which, in general,
fall off by the eighth or ninth day. In some instances, new circles
of the eruption appear in succession for several weeks.
Occasionally we see cases of eruptions resembling ring-worm
spread over a great portion of the surface cf the body and limbs,
and proving obstinate of cure, unless a very thorough course of
treatment be instituted.
Treatment.—Ring-worm may be readily cured, in most instances,
by washing the part with the third preparation of lobelia, or with
No. 6 and sumac berries; or a strong tincture of some astringent.
Ointments of every kind are often found to disagree with the
complaint.
VV"hen the eruption proves obstinate under local application, it
will be proper to use constitutional treatment. Take a dose of
composition or spice bitters, two or three times a day; or, a teacup
half full of composition tea, mixed with a teaspoonful of purified
charcoal, may be taken night and morning. Lime-water, in milk,
answers a good purpose, taken two or three times a day. A
course of medicine, however, is the most effectual means of
cleansing the system of all morbid humors.
Mr. T. M , a machinist employed in the laboratory of the
University of Pennsylvania, was affected with an eruption which
covered the whole of the surface of the abdomen, and a consider¬
able portion of the back and limbs. The eruption presented a red
appearance, and large quantities of white scales like dandruff were
constantly forming and falling off. He had the advice of the
Professors of the institution, and followed it for two years,
without getting any better. He applied to me as a last resort, and
was effectually cured in a few weeks. A full course of medicine
was administered once a week, a vapor bath every other day,
composition and charcoal three times a day„ and the eruption
washed with No. 6.
CHAFING IN CHILDREN PRICKLY HEAT.
117
SECTION XIV.
CHAFING IN CHILDREN.
Fat children are liable to chafe about the neck and other parts
"where the skin is doubled upon itself.
Treatment.—Apply scorched flour, or interpose a piece of muslin
or linen slightly scorched, to absorb the secretions of the skin, which
cause the excoriations.
Washing the parts with tar-water, will cure such sores in many
instances. Scaly eruptions about the head may be cured by
washing with tar-water. A strip of patent lint, or a narrow strip
of old soft muslin or linen, covered with tar ointment, and placed
on the chafe, where the skin is folded, will cure it.
Where the buttocks become excoriated, or break out in sores
from an acrid condition of the stools, apply some soothing liniment,
as a mixture of lime-water and sweet oil, and correct the secre¬
tions of the bowels by injections; and, if the stomach be disordered,
give an emetic. Prepared chalk, or lime-water, may be used with
advantage, in correcting the acrid state of the secretions of the
stomach and bowels. Lime-water is taken with boiled milk; the
chalk may be mixed in strong bayberry tea, and sweetened.
SECTION XV.
PRICKLY HEAT.
Prickly Heat, as it is called, is believed to be caused by impuri¬
ties in the blood being thrown to the surface. Children are most
liable to this eruption in Very warm weather, and during the period
of teething. Derangement in the digestive powers is, in almost
every instance, the original cause of the complaint. The eruption
is mostly confined to the neck, breast, and shoulders.
Treatment.—A few doses of lime-water, together with the use
of'the tincture of lobelia, in small quantities, merely sufficient to
produce slight nausea, will generally correct the derangement in
the stomach and bowels. But the eruption will continue in many
cases until the teeth are through the gums, and the irritation has
subsided.
118
acute bronchitis,
Local Applications.—Bayberry, or sumac tea, made very strong,
will allay the itching; a teaspoonful of the tincture of lobelia, with
an equal quantity of the bayberry tea, frequently applied, will cure
the eruption.
It sometimes happens that the eruption strikes in suddenly, and
the child becomes very sick; in which case an emetic of lobelia,
in composition tea, will be proper, and injections administered,
prepared in the same manner as the emetic. Eruptions will dis¬
appear when a child is under the operation of lobelia; this, how¬
ever, is very different from a striking in of the disease irom loss
of internal vital energy.
CHAPTER III.
DISEASES OF THE CHEST AND LUNGS
SECTION L
ACUTE BRONCHITIS—SEATED COLD.
The name bronchitis is applied to a diseased condition of the
mucous membrane of the wind-pipe, and air-vessels of the lungs.
In severe colds the bronchial vessels are more or less diseased, and
sudden attacks of bronchitis are usually called " violent cold,"—a
much more appropriate term than bronchitis, which means inflam¬
mation of the bronchial vessels; whereas the disease is not neces¬
sarily accompanied with inflammation. Common sore throat
which is so frequently connected with colds, is not called bronchi¬
tis, unless the mucous membrane of the air-vessels become diseased.
There is a disease called laryngitis, signifying inflammation of the
larynx. This is a very common complaint under the common-
sense name of sore throat.
Symptoms.—This disease is greatly diversified, both in character
and symptoms. Generally there is, in the first place, great lassi¬
tude, chilliness, loss of appetite, much oppression at the chest; the
head feels heavy, the skin is cold, and the face pale. The breath¬
ing becomes shorter, and sometimes difficult. The cough is mostly
slight at first, consisting of a mere hack, and, in some instances.
OR SEATED COLDv
119
dry; or the expectoration, in the commencement, is frothy, or
clear and tough, like the white of an egg, In some instances,
there is no pain in the chest; in other cases, it is nearly constant.
Sometimes pain is only felt during the act of coughing. In most
cases of acute bronchitis, there is more or less fever in the after
part of the day, and an increase of cough at night. In many in¬
stances, the patient sleeps but little, until the disease forms a crisis.
The cough, in the majority of cases, is dry at first, and, in Some-
instances, the complaint passes away with but little expectoration.
Usually, however, in the course of a few days from the commence¬
ment of the dry cough, a tough mucus is expectorated; and during
the continuance of this kind of expectoration, the oppression in
breathing, pain in the head, and fever, are more or less severe,
indicating the existence of inflammation in the mucous membrane
of the air-passages. " But in proportion as. the inflammation ap¬
proaches to resolution," (a favorable termination) " the appearance
and qualities of the sputa are changed; the mucus loses by degrees
its transparency, is mixed with masses that are opaque, and of a
yellow, white or greenish color; and these masses, few at first,
increase more and more in number, until they constitute the whole
of the sputa. Such expectoration as this is commonly accompa¬
nied by a marked remission in the different symptoms of the
bronchial inflammation; it announces that the- inflammation is
terminating in resolution. It is such as the ancients spoke of as
being concocted or ripe."
In the young and plethoric, reaction comes on early in the- dis¬
ease : the pulse is high, the countenance- becomes flushed, and the
breathing hurried; whereas, in the aged and feeble, there is seldom
much inflammation or fever, as the system is not able to establish
and support an inflammatory action.
" Infants are especially liable to this form of disease. In them,
the disease manifests itself by a short, quick, oppressed and wheez¬
ing respiration; uneasiness on being placed in the recumbent posi¬
tion ; slight cough, somewhat hoarse at first, but humid and rattling
as the disease advances; a uniformly pale and anxious countenance,
pulse frequent and tense; skin above the natural temperature on
the trunk, but the hands and feet commonly cool, or at the regular
temperature."
Bronchitis varies greatly in different cases in regard to its grade
of violence. In some instances a crisis is effected in a few days;
whilst in others it will require weeks, or even months, and, in
some rare instances, the vital energies are depressed so long in the
commencement of the attack, that 110 reaction occurs, the-patient
remaining cold, with weak pulse, stupor, and great oppression.
Causes.—Exposure to cold and moisture* is the most common
cause of those violent colds which medical men- call acute bronchitis^
120
ACUTE BRONCHITIS,
Favorable Signs.—Improvement in respiration, an easy expec¬
toration of a thick yellow matter, and more especially when the
secretions of the nose are restored, the stools of a natural color,
and a general warmth and moisture of the skin. It is in the acute
form of the disease that the free expectoration of a thick yellow
secretion is to be considered as particularly favorable, as chronic
bronchitis is generally attended by such a discharge of matter,
and may continue many years.
Unfavorable Symptoms. — Great distress and oppression, cold
skin; little expectoration and ropy, like the whites of eggs; tend¬
ency to stupor or delirium, and a suspension of the secretions of
the mucous membrane of the nose. These symptoms, most of
which frequently attend the early stage, are not to be considered
alarming, unless where they continue an unusual length of time,
or reappear in a late period of the disease.
Treatment.—Slight attacks of acute bronchitis in general require
nothing more than an occasional dose of the composition or pepper
tea, with broken doses of lobelia; the use of a warm foot-bath, and
a strict attention to diet, keeping the body and feet warm.
When the symptoms are more distressing, emetics will be pro¬
per : a full course of medicine is best in severe cases. The func¬
tions of the skin will be greatly assisted by the application of the
vapor bath.
There is no plan of treatment upon which so much reliance can
be placed, as courses of medicine. During the intervals between
the courses, the patient should take cayenne or composition, and
broken doses of lobelia. The compound lobelia pills taken in quan¬
tities sufficient to occasion slight nausea, will supply the place of
all other medicines in the early period of the disease. It will be
advisable, however, that the patient drink some kind of warm
tea, such as pennyroyal, or dittany, to promote perspiration.
Expectorants.—In the early stage of the disease, or as long as
the cough is hard and dry, or the expectoration resembles the
white of an egg, the patient should be kept slightly nauseated with
lobelia, given in broken doses, either in the form of pills, tincture,
or infusion. There are other articles which may be used to ease
the cough, and promote expectoration, such as a tea of bran, flax¬
seed, elm, or liquorice root, acidulated with lemon juice, and
■sweetened with honey, or rock candy; equal parts of olive oil,
vinegar, and honey, stewed together, and taken frequently, in tea-
spoonful doses. Onions or garlic sliced and covered with sugar,
• and kept from the fire, will form a syrup which answers a good
purpose, more especially in patients of weak nerves.
Carbonate of ammonia, given in hot wine whey, will afford great
relief in eases of extreme oppression of breathing.
OR SEATED COLD.
121
When the bowels are costive, injections should be used. Lo¬
belia administered in this way, in simple lukewarm water, some¬
times excites an almost magic influence in equalizing the circula¬
tion, and counteracting an undue determination of blood to the
lungs.
Inhaling the steam of hot water, or of vinegar and water, is
very soothing and useful when the cough is dry, or expectoration
difficult.
The best gargle for sore throat is cayenne tea, or pepper sauce.
The use of these excites the secretions, and thereby relieves the
inflammation. For children, milder gargles should be employed,
such as sage tea and honey, vinegar and honey, &c.
The Diet, in the early period of the disease, should consist of
light food, as barley water, tapioca, rice, sago, crust coffee, elm
gruel, &c. The expectoration becoming copious and yellow, with
other favorable symptoms, the patient may be allowed a more
strengthening diet, as fresh beef, mutton, soft boiled eggs, stale
bread, &c.
The expectoration presenting a favorable appearance, and the se¬
cretions of the nose being re'stored, the quantity of lobelia may be
lessened, and three or four times a day the patient should take a tea¬
cup half full of strong bayberry or No. 3 tea, adding a teaspoonfui
of composition powder, or half a teaspoonful of capsicum to the
tea, or the composition or pepper may be taken in the usual way.
The spice bitters may be used as a substitute for the composition.
The continuance of this, as well as other forms of disease, de¬
pends in a great degree upon the condition of the digestive func¬
tions. As a general rule, a favorable crisis is formed soon after
the tongue begins to clean, and the patient recovers his appetite.
The Tincture of Myrrh, or Thomson's JVo. 6, may be used with
benefit, more especially in the latter stage of the disease, and where
the patient is affected with flatulency, or oppression at the sto¬
mach after meals, which is a proper time for taking it.
Night Sweats.—From the debility usually induced in protracted
cases of bronchitis, night sweats are apt to occur. Under these
circumstances, the medicine at bed-time should consist of a strong
tea of the bayberry, or No. 3, or when liquids oppress the stomach,
the compound lobelia pills may be employed, and in the morning,
the surface bathed with No. 6 or pepper sauce; avoiding exposure
to cold air. The clothing to be put on perfectly dry. A flannel
garment wet with salt and vinegar, dried and worn next the skin,
is recommen led by some experienced physicians to check night
sweats. The vapor bath I have found of benefit, in some cases, in
preventing night sweats. A very moderate temperature of steam..
122
CHRONIC BRONCHITIS,
however, will relax the system. It should, therefore, be as hot as
the patient can bear, washing the face and breast during the steam¬
ing with vinegar or spirits and water, and at the close the patient
may be showered, rubbed dry, and the surface bathed with salt
and vinegar. Depending, however, upon debility, it will be diffi¬
cult, in many instances, to prevent night sweats until the system
gains additional strength.
Remark.—All the different forms of acute disease of the chest,
lungs, and air-passages, must be treated, if treated correctly, upon
general principles, such as have been recommended in acute bron¬
chitis, without regard to the particular name or location of the
disease. ,
SECTION II.
CHRONIC BRONCHITIS —OR DEEPLY SEATED COLD.
From repeated colds, unwholesome air, and improper diet; bad
treatment, such as bleeding and active purging; confirmed dys¬
pepsia, or other constitutional disorders, acute bronchitis is liable
to become protracted for many weeks, or even months, and to
become a deeply seated complaint. It then receives the name of
chronic bronchitis.
To describe all the various modifications of symptoms which
attend chronic bronchitis, would be a task difficult to perform, and
of but little practical utility. The disease appears in every grade
of violence, from a slight affection to that of a deeply confirmed,
and sometimes incurable disease. A majority of the cases of con¬
sumption arise from neglected or badly treated catarrh, or bron¬
chitis. Clergymen are extremely liable "to an affection of the throat
which is usually called bronchitis, or the clergyman's sore throat.
Symptoms in a ivell-marhed case of Chronic Bronchitis.—A trou¬
blesome cough, and free expectoration; general debility and wast¬
ing of the flesh; short, oppressed, and wheezing respiration; pale¬
ness of the countenance, and blueness of the lips; chilliness in the
early part of the day, followed by more or less hectic fever; night
sweats, and extreme sensibility to cold; loss of appetite with ten¬
derness and distress at the pit of the stomach; and an unhealthy
condition of the stools; more or less pain in the side or chest, par¬
ticularly on coughing; and an inability to lie on one side.
The symptoms, however, in chronic bronchitis vary, as the cha¬
racter and circumstances of the case differ. Thus, while, in some
OR DEEPLY SEATED COLD.
123
cases the cough is frequent and harassing, in others there is but
little cough or raising, except in the morning. Night sweats and
hectic fever, though common, do not always attend the complaint.
The degree of derangement of the digestive powers varies greatly
in different cases, and the condition of the digestive functions
exerts a controlling influence over the disease of the bronchial ves¬
sels. In fine, it is upon the integrity of the stomach, that, in a
great degree, depends the cure of the disease in the lungs and
throat.
Stone and glass cutters are peculiarly subject to affections of the
air-vessels of the lungs, from mechanical irritation kept up by in¬
haling particles of dust.
Treatment of Chronic Bronchitis.—To correct the disordered
condition of the stomach, promote digestion, and supply the lungs
with fresh wholesome air, are objects of primary importance in
the cure of chronic bronchitis.
Thomson's Course of Medicine is the most effectual means of
cleansing the stomach and bowels; it also promotes the healthy
functions of the skin, and of the mucous membrane of the bronchial
vessels. The course of medicine should be given as the circum¬
stances of the case require. A very good rule to be observed is,
—that so long as the patient has an appetite, and is getting better,
to omit the course. Morning is the best time for giving a course
of medicine in chronic diseases. The skin should be bathed wTith
some stimulant after the last bath in the course. An emetic in the
morning before rising, the patient previously drinking some com¬
position tea, will answer, in many instances, the place of a full
course. The lobelia emetic must be prepared in bayberry or No. 3
tea. Half a pint of a strong tea of bayberry, or of bayberry and
sumac, taken in the morning fasting, will in many instances, ope¬
rate as an emetic, and by cleansing the mucous coat of the sto¬
mach of foul tenacious secretions, place it in a more favorable con¬
dition for the reception of food. Many cases of chronic bronchitis
have been cured by adopting the practice of administering an
emetic every morning for a week or more in succession. The
propriety of this course of treatment must be judged of by the
effect produced.
Tonics.—The Peruvian bark, Colombo, Virginia snakeroot, wild
cherry bark, gentian, spice bitters, Thomson's No. 4 bitters, should
be given either singly or combined, where there is much debility
and night sweats, and not confine the patient to a particular kind,
but keep changing. I have used the elixir of vitriol with decided
benefit, in cases of night sweats; from fifteen to twenty drops may
be given in a wine-glass of a tea of Peruvian bark, or of some
124
CHRONIC BRONCHITIS.
other tonic, and repeated three or four times a day. The bay
berry or No. 3 should not be used at the time ot using the Peru¬
vian bark or elixir of vitriol.
Fresh Air.—In chronic bronchitis the patient should use mode¬
rate exercise in the open air as much as possible, provided it prove
agreeable to his feelings; and he must observe an especial care to
keep the body and feet protected from the cold. There is an
instrument recently introduced into use, called a respiratory, by
wearing which the patient can go out in severe cold weather, and
experience no inconvenience in the lungs from the cold. Recove¬
ries from this disease are greatly facilitated by fresh air.
A change of residence, more particularly to a pine country, or
to the sea-board, provided salt air agrees with the patient, will, in
many instances, prove of signal benefit. In other instances a re¬
moval from sea air is Attended with striking improvement in the
health of the*patient.
Vegetable Balsams. — These are sometimes found of especial
benefit in cases of chronic disease of the bronchial mucous mem¬
brane. The balsam copaiva, balsam tolu, and Canada balsam, are
those generally employed. The balsam copaiva is considered the
best; to be given at first in doses of from twenty to thirty drops,
gradually increasing the quantity to fifty or sixty drops, and re¬
peated three or four times a day. (The dose and mode of prepar¬
ing the other balsams will be found in the Materia Medica.)
Astringents.—The bayberry or No. 3 in strong decoction, add¬
ing a teaspoonful of No. 6, or a small portion of pepper, should be
given as often as once a day, where the tongue is coated. A very
good mode of preparing bayberry for taking is to rub the powder
up with honey, and then add a portion of luke-warm water, or
what is better, a tea of aspen, poplar, or some other tonic. Powder
taken without being scalded, will make more impression upon the
stomach than when taken in decoction. The No. 3 pills may be
used in place of the above preparations, if the patient be averse to
liquids.
The purified charcoal and white mustard seed may be used with
advantage when the bowels are costive.
Inhaling the smoke of cayenne pepper, though a harsh remedy,
has, in many instances, been attended with the most signal benefit.
It is applicable to cases of long standing. The proper mode of
doing it is to put a small portion of cayenne pepper on a red-hot
shovel, the patient being covered with a blanket to confine the
smoke; or let the patient breathe the smoke whilst in a vapor bath.
I recently met with a gentleman from Massachusetts who had
been affected with a harassing cough, attended wiih considerable
CONSUMPTION.
125
expectoration, which continued for many months without any
abatement, although he had been under treatment in a Thomsonian
infirmary. At length resorting to the inhaling of pepper smoke,
his cough was cured in a few days. This gentleman described
the effect of the smoke upon the lungs to be at first almost suffo¬
cating, and very distressing, but in a short time the sense of suffo¬
cation passed off, perspiration became profuse, and the secretions
from the eyes, nose and mouth ran copiously during the operation.
The secretions from the lungs, in a few hours after the first opera¬
tion, changed their aspect, and were raised easily, and the mucous
membrane was speedily restored to a healthy condition. The
inhalation of the smoke of pepper is adapted to cases of long
standing, attended with profuse expectoration of yellow thick se¬
cretion, and where the substance of the lungs is not affected. It
is when the mucous membrane of the air tubes is in a weakened
condition, requiring the application of a powerful stimulant, in order
to excite them to a more healthy action, that a recourse may be
had to this severe application.
The External Applications proper for the chest, are stimulating
liniments, mustard poultices or plasters, or strengthening plasters.
Cayenne pepper strewed on the plaster will render it more
efficient.
Diet.—The most nourishing kinds of food should be used, as
eggs, custards, stale wheat bread, and all kinds of wholesome ar¬
ticles that suit the stomach. Meats are allowable, unless they be
found to disagree with the stomach, avoiding veal, fresh pork,
sausages, and all food fried in fat. A milk diet generally agrees
with the patient, such as porridge, rice and milk, boiled milk and
toast. Where the bowels are costive, a gruel made of unbolted
wheat flour, or bread made of the same article, should be used.
SECTION III.
PULMONARY CONSUMPTION.
The organs of respiration are subject to various forms of con¬
firmed and deeply seated disease, constituting different varieties
of consumption. These are:—Tubercular or Scrofulous Consump¬
tion; Bronchial Consumption, or Chronic Bronchitis; Pleuritic
Consumption, or Chronic Pleurisy; arid Throat Consumption^ 01
Ulceration of the Wind-pipe.
126
CONSUMPTION.
1st. Tubercular Consumption.—This variety of consumption com¬
mences with the formation of small roundish bodies (called tuber¬
cles) throughout the lungs; and as they increase in size and
suppurate, that part in which suppuration takes place is destroyed,
or the structure changed and rendered incapable of performing its
natural function.
Tubercles, in the first place, are about the size of a millet seed,
and are generally found in clusters or masses. There can be no
doubt that tubercles exist in the lungs of some persons for many
years without increasing in size, or causing any considerable in¬
convenience.
Tubercular consumption prevails to a great extent in the United
States and in Great Britain, and is of all the varieties of consump¬
tion the most difficult to cure. This form of consumption occurs,
almost exclusively, in scrofulous constitutions, or in persons of an
hereditary tendency to tubercles. There are few cases of this
form of consumption that commence in persons above thirty-five
years of age, the disease occurring almost exclusively at an earlier
period of life.
The Causes which usually bring on tubercular consumption in
constitutions predisposed to the disease, are repeated colds or ca¬
tarrhs, indigestion, sudden check of perspiration after exhausting
exercise, the introduction of antimony or mercury into the sys¬
tem,* the intemperate use of spirituous liquors, copious bleeding,
excessive venereal indulgence, active purgative medicines, con¬
finement in iil-ventilated apartments, and unwholesome food. If
one or both parents be predisposed to scrofula, or tubercular con¬
sumption, all their children will be liable to pulmonary consump¬
tion; whilst in other instances, this hereditary disposition will exist
in some of the children only, the rest being entirely exempt from it.
Children are more apt to partake of the constitution of the mothei
than that of the father. There are instances, however, where both
parents have been consumptive, and all their children robust and
healthy; and then, again, both parents may be healthy, and theii
children delicate and consumptive.
Symptoms.—Tubercular consumption usually commences with a
short dry cough, which may continue for many months without
expectoration, except of small portions of glairy mucus. The
breathing is short and oppressed, with a sense of tightness or un¬
easiness in some portion of the breast whilst taking a full inspira¬
tion. There is much debility, and a gradual wasting of the flesh;
the appetite fails, digestion is impaired; the skin is pale and sickly-
* Tubercles have been produced in the lungs of animals by giving them
mercury by way of experiment.
CONSUMPTION.
127
looking; there is extreme sensibility to cold; the voice altered from
its natural tone; the nerves weak, and the hands often tremulous.
Patients may, however, have all the symptoms above described,
and yet be exempt from even a predisposition to consumption."
" Cough is one of the earliest symptoms of consumption, and it
is that which commonly first attracts the attention and awakens
the fears of the patient, or the patient's friends. It is at first gene¬
rally slight, occasional and dry; it occurs upon the patient's getting
out of bed in the morning, or if he makes any unusual exertion in
the course of the day. It feels to him as if it was caused by irri¬
tation about the throat. Sometimes it will cease for a while, as
in the warm weather of summer, and recur in winter when the
external temperature is lower. By degrees it begins to be trouble¬
some in the night, and to be attended with more or less mucous
expectoration.
" Now when such a cough steals upon a person gradually, and
when no reason can be assigned for its occurrence, that circum¬
stance alone is enough to excite suspicion as to its nature and
cause. But chronic cough may exist without any tubercular dis¬
ease of the lungs. It may depend upon a disordered state of the
stomach; the pneumogastric nerve may be irritated there; it may
be the cough of chronic catarrh; it may result from disease of the
heart; it may be the nervous, barking, importunate cough of
hysteria."
As the disease progresses, emaciation and debility increase; the
cough becomes more harassing, and the breathing shorter and
more oppressed; night sweats occur, which leave the patient in an
extremely languid condition. There is chilliness in the fore part
of the day, followed by a flush on one or both cheeks, and a burn¬
ing in the palms of the hands and soles of the feet. The tongue is
usually coated with a thin white fur, or sometimes clean and of a
pale pink color. The symptoms just described may also prevail
where there is no seated disease of the lungs. They often accom¬
pany dyspepsia, chlorosis, and marasmus.
Sooner or later in the disease, the tuberculous masses become
softened into the consistency of pus, and portions of the suppu¬
rated matter are discharged into the air-vessels, and coughed up
in the form of a thick yellow-like or greenish matter, assuming
the character of genuine pus, and frequently streaked with blood.
When this change in the character of the expectoration occurs,
the cough, in some instances, becomes less distressing, but the
general weakness increases, the flesh continues to waste, night
sweats become more profuse, arid usually there is a slight chill in
the morning and towards evening. After the evening chill, hectic
fever comes on, during which the pulse is seldom less than 120
per minute. In the absence of fever the pulse is soft, languid and
weak, but seldom beats less than 100 per minute. As the d sease
128
CONSUMPTION.
advances, the expression of the countenance becomes changed, the
eyes assume a pearly whiteness; the voice becomes weak and
hoarse, or hollow; the feet swell, and a diarrhoea comes on, ac¬
companied with rapid exhaustion; the mind is, in many instances,
free from depression, and but little impaired until near the termi¬
nation of the disease, when there is apt to be some degree of deli¬
rium, and " occasionally total imbecility about a week previous to
death."
Of other Modifications of Symptoms.—In some instances tubercu¬
lar consumption runs its course, at least to an advanced stage,
with scarcely any prominent symptom of disease in the lungs,—
there being no pain or difficulty of breathing, except on taking
exercise, and but little cough or expectoration. There is a general
wasting of the flesh, night sweats, failing of the appetite, the coun¬
tenance is pale, and the flesh soft and flabby. Frequently, in these
cases, there is more or less blood raised, and sometimes the lungs
bleed freely. As the disease advances, however, the cough be¬
comes more troublesome, with frequent inclination to vomit, and a
rapid wasting of flesh and strength. The bowels are generally
either much constipated, or relaxed; the nose becomes pointed and
cold, the lips pallid or bluish, and the expression of the countenance
is changed.
Persons acquainted with the different sounds given off in a
healthy and a diseased condition of the lungs, by applying the ear
to the chest, and by tapping over the breast with the ends of the
fingers, may, in general, form a pretty correct opinion in relation
to the healthy or unhealthy condition of the lungs. Those who
desire information in relation to the physical signs of consumption,
should consult the following works:—Gerhard on the Chest, and
Bath and Rogers's " Manual of Auscultation and Percussion."
2d. Bronchial Consumption.—This variety of consumption, which
probably occurs next in frequency to the one just described, is
seated in the mucous membrane of the air-passages of the lungs
and wind-pipe. Chronic bronchitis is the term usually applied to
this form of disease, which, from old age, bad digestion, neglect,
or improper treatment, is apt to terminate in confirmed consump¬
tion. This form of disease is mostly confined to children, and to
the aged. The general character, symptoms, and treatment are
described under the head of chronic bronchitis. The great ma¬
jority of the cured cases of consumption have been of this varietv.
In some instances chronic bronchitis accompanies tubercular
consumption, the two forms of disease being blended.
3d. Consumption consequent on Pleurisy.—From bad treatment,
or under unfavorable circumstances, pleurisy is occasionally foL-
CONSUMPTION.
120
lowed by the formation of an abscess in the chest, which is apt to
produce ulceration of the lungs and thus cause pulmonary con
sumption.
The Symptoms which characterize abscess in the chest, are
cough and difficulty of respiration; a sense of oppression or load
in the chest on lying down; more or less pain and tenderness to
pressure in the affected side; hectic fever, and, above all, a dull
sound given by percussion on the chest. These symptoms, together
with the previous existence of pleurisy, will afford strong evidence
of the existence of an abscess.
Sometimes the abscess ulcerates through the lungs into the air-
vessels, and is discharged by coughing. There are night sweats,
hectic fever, and wasting of flesh and strength. After the abscess
is in this way discharged, the patient may experience a mitigation
of his sufferings, and occasionally there are recoveries; but more
frequently the disease terminates fatally, and sometimes death takes
place suddenly.
4th. Throat Consumption.—This variety of consumption consists
of ulceration of the throat and wind-pipe.» It is usually rapid in
its course, and when fully seated before proper treatment is applied,,
it is most commonly fatal.
*
Cause. — Throat consumption is generally brought on by the
neglect of repeated colds. Sometimes it follows measles and
whooping cough. Chronic bronchitis sometimes terminates in
ulceration of the throat aud wind-pipe.
Symptoms.—In the first place there is derangement of the gene¬
ral health, such as want of appetite, feeble digestion, cold and tor¬
pid bowels, a diminished temperature of the body, and extreme
sensibility to cold. There is uneasiness and pain in the wind-pipe,
which is increased by coughing; the patient frequently puts his
hand to the throat, in consequence of the uneasy sensation in that
part. The voice sooner or later becomes changed to a hoarse and
feeble whisper. More or less pain is experienced in the throat on
" bending the head backwards, or on turning it round." The
cough is apt to be severe in the morning, and is almost always
brought on by attempting to swallow. The expectoration is slight
in some instances, in others copious.
When the disease is fully established, the countenance becomes'
pale, and the skin sallow; the flesh wastes away; chilliness occurs
followed by hectic fever towards evening, and profuse sweating;
during sleep: the mind is dejected and irritable, and there is a
haggard expression of countenance.
There are cases, however, of disease of the' throat, in which the
9
130
CONSUMPTION.
voice becomes indistinct, or entirely lost, and still the patient con¬
tinues to enjoy good health.
Treatment of Scrofulous Consumption. — Tubercular or scrofu¬
lous disease of the lungs, when fully seated, is generally incurable
under any and all plans of treatment. To mitigate the symptoms,
and in some degree check the progress of the disease, is generally all
that can be reasonably looked for from medical treatment, after
tuberculous matter has become developed throughout both lungs.
We have good reason to believe, however, that, in some instances
where tubercles exist in the lungs, a strict attention to the preser¬
vation of the general health, a favorable climate, and a judicious
use of remedies, may prevent a further growth or increase of the
tubercles, and even effect their removal by absorption, and the
lungs be restored to a healthy condition.
The formation of tubercles is a consequence of original defective
organization; or it maybe the effect of debility induced by various
depressing influences.
Persons predisposed to consumption, should avoid all debilitating
influences, such as unwholesome food, the impure air of small and
ill-ventilated apartments, exposure to wet and cold, over-fatigue,
intemperance, sedentary and solitary habits, purgative and all
kinds of poisonous drugs,.and too close application to business or
study; and adopt such a system of diet and regimen as will tend
to invigorate the physical strength. The diet should consist of the
most nourishing kind of food, but easy of digestion and adapted to
the condition of the stomach. Moderate exercise in the open air
is highly important, observing the strictest precaution, however, to
protect the body and feet from cold and dampness. Sponging the
surface in the morning with cold salt-water, together with the
application of friction to the surface with a flesh-brush, or salted
towel, tend to invigorate the system, and to lessen the liability to
take cold. Change of climate, especially a removal from a cold
to a warm atmosphere, has often proved of signal benefit in improv¬
ing the health, and warding off consumption.
There is no plan of medical treatment, upon which so much
reliance can be placed, in the prevention and cure of consump¬
tion. as full Thomsonian courses of medicine. Although this, and
every other plan of treatment may fail of arresting the progress
of the disease, still it should be tried, inasmuch as it will do no
injury, and may do much good, more especially if the tubercles be
in the incipient stage of development, or confined to a small por¬
tion of one lung.
Besides courses of medicine, lobelia should be given in broken
doses in all cases of consumption, either in the form of tincture,
svrup, or pills. There is, probably, no remedy that exerts so bene¬
ficial an influence in diseases of the lungs, as lobelia inflata.
COM SUMPTION.
131
Composition, spice bitters, cayenne and conserve of hollyhock,
are medicines that may be used, as the fancy of the patient or
judgment of the practitioner may dictate. They are ^perfectly
safe even where the case is beyond the reach of remedies.
Costiveness is to be overcome by the use of purified charcoal,
white mustard-seed, well-parched corn, unbolted flour gruel, rice-
mush, and ripe fruit, when it can be obtained. If these means do
not prove effectual, injections must be used. It is a good practice
to use an injection every night, in all cases of disease of the lungs,
attended with costiveness. A very ready way of preparing an
injection is to mix a large teaspoonful of composition powder and
half a teaspoonful of green lobelia powder in half a pint of luke¬
warm water, not allowing it to settle, but have the powder thrown
into the bowels with the liquid.
Case 1.—Thomas B , aged 23 years, had been affected
with chronic dry cough, shortness of breath, pain in the side, wast¬
ing of flesh, and other symptoms of approaching consumption, for
more than a year, during which time he was under medical treat¬
ment, and continuing to get worse, he was advised by his physi¬
cian to go to a warmer climate. This advice he did not follow,
but determined to try the Thomsonian practice. A course of medi¬
cine was administered, and repeated once a week, and the usual
intermediate treatment pursued. There was scarcely any percep¬
tible improvement until after the eighth course. Soon after the
emetic was taken, (in the eighth course) the patient became dis¬
tressed, with violent pain, which continued half an hour or more,
followed by what are called the alarming or crises symptoms.
After continuing in a most singular state—turning and twisting,
getting out of bed, winding himself in the bed-clothes, sobbing,
uttering broken sentences, rubbing his abdomen, &c., for a period
of eight hours, he vomited freely, and on having an injection
administered, he passed a considerable quantity of false membrane,
or skinny-like substance, with hardened faeces, from the bowels,
took some nourishment, and slept soundly, perspired freely, and
from this time improved rapidly, and regained his health.
Case 2.—W. B in his nineteenth year was attacked with
a dry hard cough, pain in the breast, short breathing, chilliness in
the morning, wasting of the flesh, and occasionally raised some
blood. He remained in this condition about two years, occasion¬
ally undergoing the operation of a course of medicine, and taking
daily more or less of Thomsonian medicine. Finally, a more
thorough plan of treatment was adopted; a course of medicine
administered every other day, until twelve courses were given,
which brought about a favorable crisis in the disease, followed by
a gradual restoration to health.
32
CONSUMPTION.
Case 3.—Miss E. P , aged 16, of delicate frame, had symp
toms of approaching consumption, which occasioned much anxiety
with her parents, they having lost two daughters of consumption
under the old-school practice. This young lady had a dry cough,
distress in the left side of the chest, immediately below the clavicle,
frequent faintness, and difficulty or oppression ot breathing. After
these symptoms had continued several months, Thomsonian treat¬
ment was employed, and after three courses of medicine, and the
use of purified charcoal and tonics for some weeks, the patient was
restored to health.
Such cases as the above, and such results from Thomsonian
treatment are by no means of rare occurrence, and although the
facts do not prove the curableness of tubercular consumption, after
it has become seated, they furnish pretty strong evidence of the
practicability of curing many cases where the symptoms of
approaching consumption are strongly developed.
Treatment of Bronchial Consumption. — The character and
symptoms of this form of disease are described under the head of
chronic bronchitis. A vast majority of the cured cases of con¬
sumption have been of this variety,—the disease being seated in the
mucous membrane of the bronchial vessels. This disease, though
generally under the control of medical treatment, frequently does,
under unfavorable circumstances, prove incurable: as when it oc¬
curs in persons far advanced in life, or when the constitution is
vitiated by intemperance.
Confinement in the foul air of ill-ventilated apartments, an
unwholesome diet, and frequent careless exposure of the feet to
dampness, are also unfavorable to the cure of the disease.
The course of treatment laid down for chronic bronchitis, will
be proper in this variety of consumption, the latter being an ag¬
gravated or long continued disease of the mucous membrane of
the bronchial vessels.
In Consumption from Chronic Pleurisy, the same general plan
of treatment should be adopted as in the former varieties, namely,
—to cleanse the stomach and bowels, and promote a healthy ac¬
tion of the general system by an occasional course of medicine;
broken doses of lobelia as an expectorant, as well as to lessen
morbid excitement; the No. 3 pills, or a strong decoction of bav-
berry once or twice a day to prevent the accumulation of morbid
secretions on the mucous coat of the stomach; the vapor bath to
promote the action of the skin, and assist in equalizing the circu¬
lation; stimulants and tonics to restore and sustain the digestive
and nutritive functions; and injections to relieve the bowels' when
required.
ASTHMA, OR PHTHISIC.
133
Throat Consumption requires a plan of treatment similar to that
required in chronic bronchitis.
As the same general or constitutional treatment may be applied
with safety to all diseases of the chest, any anxiety on the part of
the patient, or friends, or practitioner, respecting- the peculiar forms
which these diseases may assume, may be dispensed with, and
these general directions with regard to the treatment persisted in.
Even diseases of the heart have been cured by Tbomsonian courses
of medicine, with proper attention to diet and regimen.
SECTION IV.
ASTHMA, OR PHTHISIC.
Asthma is a disease of the organs of respiration, generally oc¬
curring by fits or paroxysms.
In some persons, the predisposition to asthma is induced. In
others it is hereditary, beginning its attacks in childhood, and
occurring at intervals through the whole course of a long life.
Sometimes children will be affected with phthisic for a few years,
and, as they advance in age, become entirely free from its attacks.
Although asthma may occur at any age, still those who are past
the meridian of life are most liable to it.
..
The Season of the year in which Asthma occurs, varies in different
individuals. Thus while in some the attacks are principally con¬
fined to cold and damp weather, others are only liable to it during
mid-summer. Others again may have it during any season.
Causes.—Asthma is in general a disease .of enervation,—a defi¬
ciency of the nervous power which governs the function of respi¬
ration. Hence it may be brought on in a person predisposed to
the disease, by any cause that tends to weaken or impair the ner¬
vous influence, such as exposure to cold and dampness, inaccura¬
cies in diet, over-exercise or fatigue, venereal excesses, and cer¬
tain electric conditions of the atmosphere. The disease, in the
great majority of instances, is associated with feebleness of diges¬
tion. Absence of day-light depresses the nervous powers, and this
will explain the cause why the disease generally comes on at night,
and subsides on the approach of day-light.
Asthma, in some instances, arises from organic disease of the
heart. In other instances, a mere functional derangement of the
circulating organs will occasion an attack; and, on the other hand,
an attack of asthma may be attended by palpitations of the heart,
134
ASTHMA, OR PHTHISIC.
which entirely subside as the paroxysm ot asthma passes off.
Asthma may be considered in general as a secondary allection, the
primary seat of the disease being in the stomach.
Not a Fatal Disease.—Asthma seldom proves fatal, though in
some cases, it is extremely difficult to cure. When connected with
organic disease of the heart, it may prove fatal at any time.
Symptoms.—Asthma is characterized by a sense of tightness
across the chest, great difficulty of breathing, and a distressing
sense of suffocation. It is seldom accompanied by fever.
An attack of this disease is generally preceded by a sense of
weight and fullness at the pit of the stomach, sour eructations,
heart-burn, flatulency, weight over the eyes, and itching of the skin.
When the paroxysm comes on during sleep, the patient is apt to
have frightful dreams, and to wake up in great distress, with a
sense of tightness through the breast, great difficulty of breathing,
and a short dry cough. " These symptoms soon acquire a most
appalling degree of violence. The breathing becomes wheezing,
extremely laborious, gasping and suffocative; the countenance is
expressive of intense anxiety and distress, and the heart usually
palpitates violently. The desire for fresh air, in very violent cases,
is inexpressibly urgent; the patient insists on the doors and win¬
dows being thrown open; and is totally unable to remain in a
recumbent posture. The extremities are generally cold, and the
skin moist and clammy; the face is bloated and livid, or pale,
and the veins of the neck hard and turgid. After these symptoms
have continued for an indefinite time, the breathing becomes less
laborious and anxious, and towards morning a copious expectora¬
tion of viscid mucus generally ensues, which always brings with
it considerable relief. During the ensuing day the patient usually
feels but little oppression or uneasiness in the chest. On the next
night, however, the paroxysm of suffocative respiration returns;
and in this way the disease proceeds, with remissions by day and
exacerbations by night for three or four days in succession, and in
some instances much longer, before it finally subsides."
Paroxysms of asthma may occur at any period of the day or
night, though they usually come after midnight. In some instances
they continue without any complete intermissions of the difficult
breathing, for several days or even weeks, but always worse
at night.
Treatment of Asthma.—In many instances, where the attack is
slight, the tincture of lobelia given in composition or pepper
tea, and placing the feet in warm mustard water, will be suffi¬
cient to afford great relief, and sometimes will overcome the
symptoms.
ASTHMA, OR PHTHISIC.
135
The Vapor Bath.—I have found the vapor bath not only to assist
in breaking up paroxysms of asthma, but in many cases almost
indispensable, as th'e emetic in some instances will not operate
effectually, unless a vapor bath be previously administered.
►
The Hot Mr Bath from Burning Alcohol.—When the skin is cooi
and inclined to moisture, the hot air bath will answer as well, and
be attended with much less trouble than the steam bath, more
especially in hot weather, when fire is not required in sick¬
rooms.
The stimulating liniment, pepper sauce, or No. 6, should be
applied over the surface after the bath. Previously to applying
the stimulant to the surface, let the patient be showered, or washed
over with spirits or vinegar, and then rubbed dry.
Emetics.—Immediately after the bath, an emetic of lobelia must
be given prepared in the usual way. If the patient be of full habit
with redness of the face, and strong pulse, the brown lobelia should
be preferred to any other form of lobelia as it is an important
object in the treatment to effect relaxation of the system. On the
other hand, if the patient be weak, pale, and the flesh soft, the
third preparation of lobelia will be the form of emetic best adapted
to the case.
A Course of Medicine given in the evening, or before the time
the asthma comes on, or as soon as the first symptoms arise,
indicating its approach, will in general keep off the paroxysm, or
at least greatly moderate its violence in bad cases. The tinc¬
ture of lobelia will often fail of making sufficient impression on the
stomach; but the brown powder, or the third preparation, I never
knew to fail in relieving the most severe paroxysms of asthma.
Injections.—These are important in the treatment of asthma,
and, in some instances, will afford instant relief. Lobelia admin¬
istered in this way, and retained, will relax the system as effec¬
tually as when taken into the stomach, and generally will excite
free vomiting.
The Skunk Cabbage answers a good purpose in many cases of
asthma, though in general far inferior to lobelia.
Treatment during the remission or interval between the parox¬
ysms.—Broken doses of lobelia, either in tincture or the compound
lobelia pills, together with an occasional dose of composition or
pepper, will often be sufficient. Where the disease becomes pro¬
tracted, however, and the system is in a feeble condition, tonics
will be useful. Boneset tea, taken cold, I have found to be de»
136 CATARRH, OR COLD HAY ASTHMA.
cidedly useful in some cases. The scutilaria or scull-cap, may b«
used as a tonic, and answers as a nervine.
English Garlic operates as a stimulant on the nervous system,
and is, therefore*well adapted to cases of asthma; more especially
when the disease, being protracted, requires an occasional change
in the medicine. Let the patient chew and swallow a clove of the
garlic every morning before breakfast.
Stimulating Applications to the Surface.—In asthma the skin is
usually below its natural temperature, and inclined to moisture.
When this condition of the skin prevails, the stimulating liniment,
No. 6, or pepper sauce, should be applied over the surface before
going to bed. A plaster of the stimulating liniment spread over a
piece of bladder or silk oil-cloth, and bound on the pit of the
stomach, will have a tendency to prevent the occurrence of the
paroxysm. The same application may also be made to the soles
of the feet.
Diet.—The first symptoms, in many instances, on the approach
of an attack of asthma, are, an unpleasant sense of weight, or
stricture, and coldness at the pit of the stomach; and this fre¬
quently occurs soon after eating. The stomach not being able to
digest what had been taken, is oppressed, and asthma follows as a
consequence of that condition of this great central organ. As long
as the patient is liable to the attacks, especial care should be
observed to avoid any article of difficult digestion, more especially
at the evening meal. When the patient craves acids, the pepper
sauce, or lemon-juice and sugar, will frequently be grateful to the
stomach, and favor expectoration.
A Cold Shoiver Bath every morning, by giving tone and vigor
to the nervous system, will often prove especially useful in asthma,
more particularly in hot weather. It may also prove a preventive
to the disease. A dash of cold vinegar upon the breast will some¬
times afford relief during the paroxysm, by producing reaction.
SECTION V.
SUMMER CATARRH, OR HAY ASTHMA.
There is a catarrhal affection of the mucous membrane extend¬
ing from the nose to the lungs, which comes on in warm weather,
and in some persons it occurs periodically every summer. It is a
■disease of enervation—deficiency'of nervous energy.
HOOPING-COUGH.
137
The dust from fresh dried hay is very apt to bring on the disease
m those predisposed to it, and from this circumstance, it is in some
places called " hay fever." Other kinds of dust, however, will
have the same effect.
In some delicate persons the slightest exposure to cold or damp
air, will occasion catarrh. Dr. J. K. Mitchell mentions the case
of a female who would invariably be seized with a catarrh from
taking hold of a tumbler of cold water.
Symptoms.—At first there are symptoms of indigestion, and a
sense of fulness in the head. There is watering of the eyes, and
the nose discharges copiously a thin secretion. A cough gene¬
rally comes on, and an expectoration resembling that which attends
ordinary colds.
Treatment.— Tonics are particularly indicated. Colombo, gen¬
tian, Virginia snakeroot, bayberry, xanthoxylum, balmony, and
poplar, may either or all be employed.
If the tongue be coated, or there be other symptoms of a foul
stomach, a strong decoction of the bayberry should be taken as
often as once a day, and if this be ineffectual, an emetic may be
administered. The surface of the body should be bathed occasion¬
ally with some stimulant, as pepper sauce, or No. 6.
Eating raw onions relieves the symptoms in most cases.
As a preventive use the shower bath, or sponge the body with
cold water every morning for a few weeks before the time at
which the disease usually comes on.
SECTION VI.
HOOPING-COUGH.
This disease is contagious, and occurs but once in the same
individual. It is almost exclusively confined to childhood, and
generally prevails as an epidemic.
This, like most contagious diseases, runs a certain course, or
succession of stages, constituting its " rise, progress and declen¬
sion." In some instances, however, the disease may be cut short
by medicine; in others the disease will continue longer than the
usual period, notwithstanding the treatment may be thorough and
applied with judgment.
Hooping-rough is seldom fatal, except when under unfavorable,
circumstances, as in weak and delicate infants a few months old, or
when it attacks children of scrofulous constitutions. Under these
ciroumstances it is liable to be followed by consumption, or other
138
HOOPING-COUGH.
forms of disease of serious character. When the disease com.
mences in the autumn, the cough is apt to continue until the suc¬
ceeding summer.
Symptoms.—The disease commences like an ordinary cold or
catarrh, with languor, sneezing, hoarseness, cough, and occasion¬
ally oppression in breathing. The tongue is mostly contracted
and pointed, and of a darker color than natural, and is in most
instances nearly clean, or very slightly coated. There is more or
less cough from the commencement, but it does not differ from the
cough attending common colds, until after the lapse of eight or
nine days, or two weeks, when the hooping commences, distin
guished by a continued succession of short hard efforts at cough
ing, until apparently all the air is expelled from the lungs, and the
little patient turns red or purple in the face. Then there is a long-
drawn inspiration attended with a peculiar crowing, or hooping
noise. As soon as the lungs are filled with air, the coughing
returns, until the lungs are again exhausted of air; and in this
manner the paroxysm of coughing goes on until a quantity of
mucus is discharged from the lungs, or the patient vomits. As
soon as the coughing fit is over, the patient is generally active and
lively; and very commonly craves for food after vomiting.
The fit of coughing may last from half a minute or less, to four
or five, or even ten minutes. Usually, after the third week from
the commencement of the hooping, there is a copious discharge of
a viscid mucus, after a spell of coughing. In very aggravated
cases, the child is sometimes thrown into convulsive fits, from con¬
gestion of blood in the brain, occasioned by the violence of cough¬
ing, and the suspension of breathing during the paroxysm.
After the expectoration has continued free for a week or two,
the parostysms of coughing in many instances begin to decline,
both in frequency and violence, whereas in other cases the disease
continues for six or eight weeks before there is any abatement in
the violence of the cough.
Treatment of Hooping-Cough.—Throughout the entire course of
the disease the treatment should be adapted to the character of the
symptoms. Nauseating doses of lobelia promote expectoration—-
generally ease the cough—quiet restlessness, and promote the secre¬
tions of the skin. In bad cases, where the breathing is much op¬
pressed, or the patient is very restless, an emetic will be proper.
The vapor bath will assist the operation of the emetic.
Injections must be used when the bowels are costive, or other¬
wise disordered. Lobelia, (say a quarter of a teaspoonful of the
green powder) administered in this way, in lukewarm water, and
retained ten or fifteen minutes, will have a decidedly beneficial
effect, especially where there is an undue determination of blood
HOOPING-COUGH.
139
to the head or lungs. Under its influence the circulation becomes
more equalized, the system becomes relaxed, and very often free
vomiting is produced.
When the face remains swollen and suffused with blood, an
unusual length of time after the paroxysms of coughing, attended
with stupor, stimulating injections and an emetic of lobelia should
be given, and the feet be placed in warm water with a portion of
mustard or cayenne added to it, or a vapor bath administered.
This will prove the most effectual plan of treatment for preventing
spasms.
In a more advanced stage of the disease, when the secretions
become profuse, attended with severe fits of coughing, which come
on periodically, an emetic or an injection, as above described,
administered previous to the time at which the paroxysms of cough¬
ing commonly occur, will mitigate the cough and favor the expul¬
sion of the viscid mucus from the lungs.
Alkalies.—Super-carbonate of soda or saleratus-water, should be
given two or three times a day, when there is evidence of acidity
in the stomach: lime-water and milk may be given for the same
purpose.
Cough Medicines.—Liquorice-root tea; flaxseed tea, with lemon
juice; a mixture of honey with sweet oil; onion or garlic syrup,
are all good for the cough. The tincture or syrup of lobelia, how¬
ever, is the best expectorant, and may be used in combination with
any of the above-named articles.
The yolk of a fresh egg, beaten up with two or three teaspoons-
ful of sugar, and a teaspoonful of it given at a time, and repeated
frequently, will moderate the violence of the cough in some cases,
more especially in the latter period of the disease.
Stimulants are more particularly indicated in the advanced stage
of the disease, when the appetite is bad, and the system in a feeble
condition. A small portion of the composition powder in a wine¬
glass of bayberry tea, and administered once or twice a day, will
cleanse the mucous membrane of the stomach, and also furnish a
stimulus to the vital powers of the system.
The compound lobelia pills will supply the place of all other
medicines in ordinary cases, when the patient can be induced to
swallow pills.
Haarlem Oil.—Five or six drops of Haarlem oil given in a tea-
spoonful of boiled milk three or four times a day, will be useful in
many cases of Hooping-cough, more especially in the latter stage
of the disease. For adults, the dose should be increased to twenty
or thirty drops.
140
PLEURISY.
Oil of Amber.—This oil rubbed along the spine, morning and
evening, will prove serviceable in allaying the violence ot the
Hooping-cough.
The Cold Bath, if the patient remain in a feeble condition after
the Hooping-cough, will have a signal influence in toning the sys¬
tem. It is safer to commence with the tepid bath, with the water
at about 90 degrees, and gradually diminish the temperature as
the patient can bear it. The patient should be suddenly dipped,
or showered, and immediately rubbed dry, and wrapped in a
warm blanket. The proper time for administering the bath is the
morning.
Change of Air.—To move from the city to the country, or from
the country to the city; or even a change of residence in the same
neighborhood, will sometimes speedily cure the lingering cough
and debility which is apt to follow Hooping-cough.
SECTION VII.
PLEURISY.
Pleurisy is an inflammation of the membrane that lines the
internal surface of the chest, which is called the pleura. This
membrane also forms the external coating of the lungs.
Any portion of the pleura is liable to become diseased, but that
on the right side is more commonly affected.
•It is asserted by medical authors that pleurisy mostly attacks
the robust and plethoric, but, under my own observation, the dis¬
ease has occurred almost exclusively in the dyspeptic, the feeble,
or the intemperate.
Under Thomsonian treatment, pleurisy is seldom fatal, unless
complicated with extensive derangement of some important organ;
or when it attacks age or debility, or vitiated constitutions.
Causes.—Exposure to wet and cold; sitting in a current of air,
or in a cold room, after severe fatiguing exercise, or sleeping in
damp sheets, are common causes of pleurisy. Persons are often
liable to be attacked with the disease after severe surgical ope¬
rations.
Symptoms.—An acute or lancinating pain in the side of the
chest; hurried and painful breathing; a short dry cough, attended
PLEURISY.
141
with slight expectoration of a glairy and almost colorless phlegm,
are the symptoms which characterize pleurisy. The pulse in
general is hard and frequent, the face flushed, the tongue coated,
the skin dry and hot, and the urine scanty and high-colored.
The symptoms, however, in this, as in other forms of disease,
are modified by the various circumstances under which the dis¬
ease may. occur, as the age of the patient, the strength of the con¬
stitution, the extent of derangement of important organs, especially
of the stomach and liver; or the degree of susceptibility of the
lungs to become affected. Thus in the young and vigorous the
reaction is apt to be strong, whilst in the aged and feeble the
countenance may remain pale, and the pulse weak. In some cases
the breathing is greatly oppressed, whilst in others there is but
little oppression and no pain. The cough, which is usually ha¬
rassing, is almost wanting in some instances. The expectoration,
though in general colorless in the commencement, is occasionally
tinged with blood, from the first, and when the disease extends to
the substance of the lungs, the expectoration is mostly copious,
and consists of a ropy mucus, mixed with blood. The condition
of the stomach modifies also the character of the symptoms, and
influences, to a great degree, both the violence and the duration of
the disease. The liver being torpid, or the flow of bile obstructed,
the skin and eyes become yellow, or the countenance presents an
appearance of a " sickly mixture of red and yellow." Such a case
would be called Bilious Pleurisy.
• Inflammation of the pleura is very liable to produce adhesions
between the side of the chest and lung, an occurrence, however,
not productive of danger, and seldom of much inconvenience.
Under unfavorable circumstances, an abscess is sometimes form¬
ed, which is always attended with more or less hazard to the
patient.
Favorable Signs.—A free expectoration of a thick yellow mat¬
ter; an increased flow of urine, which, on standing, deposits a
sediment; a general and warm perspiration, together with an
abatement of the pain and oppression, indicate a favorable termi¬
nation of the disease.
The unfavorable signs are, an increase of pain and oppression
4 in a late period of the disease; the cough continuing dry an un¬
usual length of time, or the expectoration resembling a dirty
mixture of blood and water; a sense of suffocation, and a sudden
raising up in bed, or a " constant effort by the patient to bare the
breast and to raise his head and shoulders;" a weak and irregular
pulse ; a livid appearance of the lips and countenance ; a sense of
burning on the surface and coldness internally, together with a
rattling in breathing, and a tendency to delirium or stupor. These
142
PLEURISY.
symptoms, though indicative of great danger, should not be con*
sidered as necessarily of fatal omen, for recoveries occasionally
happen after symptoms of the most alarming character have been
presented.
Treatment.—Slight attacks of pleurisy will, in general, require
nothing more than warm teas, and small doses of lobelia^ together
with the vapor or foot-bath to excite perspiration, the patient to be
kept warm.
When the symptoms are of a severe or violent character, a full
course of medicine must be administered, and this repeated daily
until the symptoms abate; and between the courses broken doses
of lobelia in the form of pills, powder or tincture must be given,
together with the free use of cayenne or composition, and an oc¬
casional injection composed of composition tea, adding a teaspoon-
ful of green lobelia to each injection.
The Vapor Bath is of great advantage in pleurisy. When the
patient's strength will not permit his sitting up, the vapor can
be applied in bed, and in this way continued for hours, if ne¬
cessary.
An Emetic must be given occasionally after a vapor bath, or
whilst the patient is in a perspiration by other means.
A dry heat should not be applied around a patient when there is
much fever, as it will increase the distress before perspiration is
induced.
A warm poultice applied to the side, will, in many instances, be
attended with an immediate mitigation of pain. The poultice
may be made of Indian mush, well boiled, or of boiled potatoes
mashed, or slippery elm and flaxseed stewed together. A portion
of ginger should be added to the poultice, and, when spread, the
surface should be covered with powdered lobelia. The poultice
should not be allowed to get cold, but be kept warm by means of
a hot brick, or a jug of warm water placed in contact with it.
Bilious Pleurisy, as it is called, usually commences with the
symptoms of ordinary bilious fever. This and every other variety
of pleurisy, however, must be treated upon the same general prin¬
ciples. In bilious pleurisy the course of medicine should be more
frequently repeated than in simple pleurisy. If the patient has
vomited freely, and the stomach continue a long time unsettled,
throwing up every thing that is taken, then the purified charcoal
will be likely to prove serviceable in settling the stomach. It may
be given in pepper tea, or any other of the teas used as medicine,
COMMON CATARRH AND INFLUENZA.
143
and the dose repeated every hour, or every few hours, as may be
deemed necessary.
The Diet, during the active stage of the disease, must be re¬
stricted to the lightest kind of food, as elm gruel, barley-water,
crust coffee, arrow-root, gum arabic water, or flaxseed tea, sweet¬
ened with honey.
As the disease abates, and the tongue cleans, a more nourishing
diet may be allowed the patient, such as chicken tea, essence of
beef, soft-boiled or poached eggs, milk porridge, &c.
In cases of extreme prostration of strength, essence of beef,
wine-whey, or even clear wine may be requisite to sustain the
strength of the patient.
In some instances, the treatment will require to be continued
several days before an abatement of the disease will be perceptible.
The expectoration of a thick yellow matter is one of the first, as it
is is also one of the surest indications of a favorable change being
about to take place.
Some medical writers state, that an increased oppression of
breathing and suppression of expectoration are apt to occur in
pleurisy about the fifth or sixth day.
Tonics, such as spice bitters, Colombo, Virginia snakeroot, &c.,
must be given, when the patient remains weak after the disease
has formed a crisis, and the fever has subsided. A dose of com¬
position or bayberry tea should be taken once or twice a day
during the convalescence, until the tongue becomes clean and of a
healthy appearance.
SECTION VIII.
CATARRH—COLDS—INFLUENZA—GRIPPE.
Catarrh, or Colds, prevail to a greater extent than disease in any
other form. At particular seasons, especially in the spring and
winter, when south winds prevail, the majority of persons exposed
to the weather will be more or less affected with catarrh. Not
only do catarrhal affections prevail more during the general thaws
of spring and in open winters, but other forms of disease also pre¬
vail, to a much greater extent during those seasons when the
atmosphere is chilly and charged with moisture and damp from
rain, or from the thawing of frozen earth. The majority of cases
of consumption originates from neglected colds, contracted during
winter and spring. There is scarcely a form of disease that may
144
COMMON CATARRH AND INFLUENZA.
not be produced by exposure to cold and dampness. Even conta¬
gious diseases, such as scarlet fever and measles, are much more
common during winter and spring than at other seasons of the year:
and in many instances children are taken down with a contagious
disease from certain conditions of the atmosphere, without their
having been exposed to any one affected by the disease.
Catarrhal Affections, like other forms of disease, arise from a
loss of heat, and diminution of the nervous energy. When south
winds prevail during spring and winter, the atmosphere is highly
charged with moisture, which condenses on the walls, and thus
renders houses damp and unhealthy; the clothing of those exposed
to the weather becomes damp, which, together with exposure of
the feet to the wet ground, will almost necessarily occasion more
or less disorder of the system. If the power of digestion be enfee¬
bled, the system will be rendered more susceptible to cold, than
when the digestive functions are in a healthy condition. Persons
often become affected with severe cold whilst confined to the house
and in a warm room. If the power of producing heat and nervous
energy be diminished in consequence of loss of digestion, the patient
will consequently become cold and chilly, and the same symptoms
may be produced as prevail in colds taken through exposure.
Symptoms of Common Catarrh.—Most of the symptoms attend¬
ing ordinary catarrh, are such as usually prevail in the first stage
of almost every form of disease; such as lassitude, chilliness, loss
of appetite, torpid bowels, and a dry skin. There is usually more
or less cough. The secretions from the nose are thin and watery.
Soreness of the throat is very common in colds, attended with dry¬
ness of the parts, and pain on attempting to swallow. The breath¬
ing is much oppressed in some instances, and but slightly so in
others. Generally more or less fever comes on in the after part of
the day, and the patient is restless at night. •
A severe form of catarrh, or cold, sometimes prevails epidemi¬
cally, popularly called influenza. It differs from ordinary catarrh
only in the severity of the symptoms. There is more chilliness in
the commencement; the pain in the head is more severe, attended
with a sense of tightness across the forehead. The strength is
extremely prostrate, early in the attack; digestion suspended, or
at least the stomach and bowels are extremely torpid; often at¬
tended with distress at the pit of the stomach, giving origin to the
name "grippe" as frequently applied to the disorder. The sense
of taste is lost; there is a copious flow of thin watery humor
discharged from the nose; the eyes are tender and watery; there
is a troublesome cough; oppressed breathing; frequently fever,
though in some instances the skin remains cool and damp. In
most cases there is a profuse expectoration of frothy mucus, and
COMMON CATARRH AND INFLUENZA. 145
in a later period of the disease, the sputa is thick and yellow, or
greenish.
It is useless in a practical point of view to make a distinction
between bronchitis, catarrh, and colds in general, for the same
plan of treatment is demanded in all these various modifications
of disease; the treatment to be adapted to the symptoms without
reference to names of disease.
Favorable Symptoms.—Cleaning of the tongue; a free expecto¬
ration of thick yellowish, or cream-like mucus; the discharge of
thick secretions from the nose; a tendency to warm perspiration,
and a returning appetite, are favorable. It usually requires from
four or five days to a week, to effect a crisis in the disease, and in
some cases two or three weeks are required.
Treatment.—Ordinary catarrh requires nothing more than an
occasional dose of composition, capsicum tea, or simple herb teas,
such as pennyroyal and dittany, and a strict attention to diet, and
care to avoid exposure to cold or dampness.
When patients are exposed to the open air, while engaged in
their usual avocations, or to sudden changes, of temperature, the
medicine, such as capsicum and composition powder, should be
taken in cold water. Taking freely of hot teas will open the pores
of the skin, and may render the patient, at the time, more liable to
lake fresh cold, if exposed to dampness, or a current of cold air.
Still, perspiration induced in this way does not render the system
so liable to cold as when it is brought on by severe exercise-
When the patient is in bed, or not exposed to the cold air, hot
teas should be taken to promote perspiration, assisted by warm
applications to the feet. Simple teas of pennyroyal, dittany, or
camomile, are beneficial, and may be drunk freely, to induce
perspiration.
When liquids oppress the stomach, the compound lobelia pills
will answer as a general medicine.
When the cough is hard and dry, the patient must be kept
Slightly nauseated with lobelia, and cough mixtures employed, such
as flaxseed or elm tea, with the addition of a portion of lemon
Juice and loaf sugar; onion syrup; bran tea; lemon juice with loaf
sugar; or liquorice root tea may be used.
For sore throat wrap a stocking around the neck on going to
bed, and keep the neck warmly covered at all times. Molasses
and butter melted together, adding a portion of cayenne pepper,,
taken at bed-time, will be useful.
There are cases of catarrh or influenza that require thorough
treatment, especially vapor baths and emetics, or full courses of
medicine. The vapor bath is especially beneficial in all cases, and!
cannot be employed too frequently. In severe cases it is import-
146 CROUP—HIVES.
ant that the patient be kept in a warm room, and hi.\e warm
applications to the feet. When the complaint becomes protracted,
the patient continuing feeble, tonics must be given, the best of
ivhich is quinine.
CHAPTER IV.
DISEASES AFFECTING THE MOUTH AND THROAT.
/ SECTION I.
CROUP—HIVES.
This dangerous disease is peculiar to childhood, usually occur¬
ring between the first and fifth year.
Causes.—Exposure to cold and dampness; having the feet damp
many hours together; and the presence of undigested food in the
stomach, are the general causes of croup. Some children are
peculiarly liable to this form of disease; whilst others will beaj
almost any degree of exposure without having an attack of it.
Symptoms.—The disease sometimes comes on suddenly; the
child, for instance, g^es to bed as well as usual, and is sud¬
denly attacked with it during the night. Generally, however, its
approach is gradual, with the usual symptoms that accompany a
cold. Slight oppression of breathing, with a peculiar hoarse and
shrill cough; the eyes watery and heavy, and the child dull and
fretful. These symptoms frequently continue some days before the
disease assumes a violent form. The cough becomes at length
more troublesome and shrill, and agitates the child very much;
the face becomes swollen and red; the breathing more difficult;
the skin dry and hot, with a quick and tense pulse; and as the
disease advances, the breathing becomes extremely difficult, accom¬
panied with a hissing noise. Sometimes the cough is quite dry,
and in other cases there is a copious secretion from the wind-pipe
from the commencement of the disease. If the symptoms be
not relieved, and the disease progress in violence, the breathing
becomes still more distressing, the child manifesting by its counte¬
nance and actions, the greatest degree of suffering; the head is
CROUP HIVES.
147
thrown back; the eyes are half closed, and cast about with an
imploring expression for relief; the face grows pale, and covered
with large drops of cold sweat; the lips livid; the voice becomes
extinct; the extremities grow cold; slight stupor ensues; and
finally the heat and sensibility continue to diminish until the breath¬
ing ceases.
Spasmodic Croup, (as it is termed,) generally comes on suddenly,
and without fever. The cough is not of that peculiar sound that
generally characterizes common croup, and, in some instances,
there is an entire absence of cough.
Frequently Fatal.—The great danger attendant on croup, arises
from obstructions in the throat or wind-pipe preventing the free
admission of air to the lungs. The obstruction may consist either
in the formation of a false membrane in the wind-pipe,—filling up
its cavity; swelling and inflammation in the epiglottis; or from
spasm in the muscles of the throat. The free admission of air into
the lungs being obstructed, the blood loses its vitality in propor¬
tion as the supply of air is lessened, and is thus rendered incapa¬
ble of supporting life. Croup terminates fatally to the patient,
unless checked in its early stage by appropriate treatment.
Treatment.—The means to be relied upon for the cure of croup
are, emetics, injections, and the vapor bath.
Emetics.—In the early period, when the symptoms are of a mild
character, and the child in good health otherwise, an emetic of the
tincture of lobelia may give immediate relief, and remove the dis¬
ease. If this should not afford relief in a short time, say, ten or
fifteen minutes, the dose should be repeated at frequent intervals,
and injections administered composed of composition tea, with
. the addition of a teaspoonful of lobelia powder, and the feet placed
in warm water. As a substitute for the tincture, infuse a large
teaspoonful of brown lobelia in water not quite scalding hot, and
give the tea freely. The same may also be administered by injec¬
tion and retained. The distress sometimes occasioned by the ope¬
ration of the medicine can do no harm under any circumstances.
The lobelia strikes at the very root of the disease, and though
patients may suffer under its influence, it will do more for the
patient than any other medicine.
Vapor Bath.—Unless the patient be entirely relieved by the
above means, the steam bath should be administered, and, during
the steaming, the head and face bathed with whiskey, or vinegar
and water; and if the patient be faint, cold vinegar or water dashed
on the breast. It is said that a sudden dash of cold water on the
148
CROUP HIVES.
breast, in croup, has been found beneficial by exciting reaction,
when the child had become affected with stupor.
When the symptoms are not so urgent as to require an imme¬
diate emetic—for instance, when the child has had a cold for two
or three days more or less, which begins to manifest symptoms of
approaching croup, the vapor bath should be administered, pre¬
viously to the emetic, in order to ensure an effectual operation.
After the bath, a prompt emetic must be given, and frequently
repeated until the disease be expelled. The liquid of the third
preparation of lobelia, with an equal quantity of brown lobelia,
forms the most efficient emetic: to be given in bayberry or sumac
tea. For very young children, or in the outset of the disease,
when there is much heat of the skin and rigidity of the tissues, the
brown or green lobelia may be prepared in the above tea, or in
composition tea, omitting the third preparation. The lobelia cannot
be given too freely to a child in croup, and the more effectually the
system becomes relaxed under its influence, the greater certainty
there will be of effecting a cure.
When the system is relaxed under the influence of lobelia, the
patient is usually thirsty, and if a child be allowed to take the
breast freely, it may do harm, by oppressing the stomach with food
that it is not able to digest. Therefore, it will be safer to give the
child small portions of water frequently, or, what is still better,
composition, ginger, or simple herb teas.
<
Injections.—These should be frequently administered in bad
cases of croup, not only with a view to relieve the bowels, but
more especially to excite an afflux of blood to the bowels, and in
this way to lessen th$ determination to the throat. I have, on
several occasions, observed signal benefit from the administration of
an injection of a small teaspoonful of green lobelia powder in luke¬
warm water, and retained in the bowels ten or fifteen minutes, or
even longer. No injury will arise if it should remain for hours.
Under the influence of lobelia thus administered, free vomiting will
very generally be produced, the system will become relaxed, and
the symptoms of croup diminish, and sometimes entirely disappear
by this alone.
The treatment should be pursued as long as symptoms of croup
continue, or until the case prove hopeless. There are few cases
of croup, probably, which might not be cured by Thomsonian
remedies, if early and perseveringly applied. But after the disease
has reached a certain stage—for instance, the wind-pipe nearly
closed by the formation of a false membrane within its cavity, or
effusion has taken place in the substance of the epiglottis, and thus
permanently enlarges it, the obstruction in breathing which must
necessarily attend either of these conditions, will be almost cer¬
tainly fatal.
CROUP HIVES.
149
External Applications.—In the first stages of all cases of croup,
a portion of cotton, wet with camphor, whiskey, or vinegar, may
be applied to the throat. A poultice composed of brown lobelia,
pulverized, adding a portion of slippery elm, wet with hot water,
and applied to the upper part of the throat, is highly recommended
by some practitioners. The poultice must not be allowed to be¬
come cold. By having two poultices, and changing them as the
one applied becomes cooler, full benefit will be obtained without
exposing the throat, except momentarily, to the air. It is im¬
portant to protect the skin of the throat, after a poultice has been
applied; and, after the removal of the poultice, the skin may be
bathed with No. 6, or stimulating ointment.
Cases of croup are sometimes cured even after the symptoms
have assumed a character indicative of a fatal termination. Dr.
Chapman mentions a case of croup to which he was called, in
which the disease had continued for three days, without the symp¬
toms having been relieved, and as a last resort, they placed the
child in a vapor bath, and as soon as the patient began to sweat,
the symptoms were relieved. The child was kept in the bath
three hours, and recovered. I knew an instance of croup, where
a child nine months old, took two ounces of the third preparation
of lobelia, in the course of seven hours, and was cured, when a
much milder course of treatment would very probably have failed.
The free use of the third preparation of lobelia, and the continued
application of the vapor bath, together with stimulating injections,
will be the most effectual means where the powers of life are far
exhausted. The steam bath, by warmipg the blood, and expand¬
ing the tissues, gives the air greater access to the lungs—the
vitality of the blood is increased in proportion as the supply of air
is greater, and the warmth imparted to the skin attracts the blood
to the surface, and tends to equalize its circulation. I have never
applied the vapor bath in a case of croup, without relief to the
symptoms, though in far-gone cases the benefit will not be of long
continuance. A child, held on the lap, will bear a moderate steam¬
ing for several hours at a time, provided a proper attention be
paid to bathing the head and surface of the body, and giving stimu¬
lants. The vapor should be of a temperature sufficient to keep the
skin warm, and the patient in a moderate perspiration. In violent
cases, the lobelia may be given during the application of the bath.
Children are subject to asthma or phthisic, which, in many of
its symptoms, resembles croup. But any one acquainted with the
croup cough, will be able to distinguish it from asthma. With
regard to treatment, however, that which would be most effectual
in croup, would be equally appropriate in asthma.
Recapitulation.—In the early stage of croup, attended by fulness
of the face and fever, give brown lobelia in infusion with warm
150
QUINSY.
water. Giving it by injection, say the fourth of a teas} oonful of
the brown lobelia in a little warm water, and retained, will prove
very effectual in relaxing the system.
In cases that are more difficult, apply the vapor bath, and give
the third preparation of lobelia.
If the tongue be thickly coated, there will be more necessity for
the frequent application of the steam bath, and for the free use of
the third preparation of lobelia given in strong bayberry tea.
SECTION II.
QUINSY—INFLAMMATORY SORE THROAT.
The term Quinsy is applied to a sudden inflammation and swell¬
ing of the tonsil gland, situated on each side of the throat, and
behind the root of the tongue.
Sometimes the inflammation is confined to one side, in other
.nstances both tonsils are affected, and very frequently the inflam¬
mation extends to the uvula and soft palate. It occurs in every
degree of violence from that of a slight affection to that of a most
painful, and even formidable disease.
Symptoms.—At first there are symptoms of constitutional dis¬
order, as chilliness, loss of appetite and furred tongue, followed by
more or less fever. The throat becomes swollen, and swallowing
is painful. As the inflammation and swelling increase, the efforts
to swallow become more difficult and painful, and in some in¬
stances the patient is entirely unable to swallow. There is at first
a sense of dryness and constriction in the throat, and a feeling as
though something were sticking there. The dryness of the throat
soon gives place to a copious secretion of transparent mucus which
is frothy and viscid, and adheres to the inflamed surface, so as to
be detached with difficulty; and the patient is tormented by con¬
tinual and painful efforts to hawk up, or to swallow this mucus.
In ordinary cases, however severe the disease may be, there is
scarcely any affection of the breathing. But the throat is so
blocked up, that the voice becomes thick, guttural and inarticulate.
Inflammation of the tonsils is extremely liable to terminate in
suppuration. In many instances an abscess will be formed, and
discharge in a few days from the commencement of the inflamma¬
tion. There is chilliness at the time the abscess is forming, and
usually pains shoot from the throat to the ear.
Causes —Persons predisposed to quinsy are liable to an attack
QUINSY.
151
from a sudden check of perspiration, more especially after severe
exercise or fatigue. Exposure to cold damp air, and standing on
damp ground, are the principal exciting causes of this disease.
Quinsy is rarely attended with much danger, when properly
treated from the commencement.
Treatment.—To promote perspiration, and to cleanse the sto¬
mach and bowels, are important in the treatment of quinsy. A
full course of medicine will be proper in the commencement, as
the surest means of moderating the violence of the disease, and in
some instances, it will put a stop to a farther increase of the
inflammation and swelling.
In mild cases, where the inflammation is not severe, and the
constitutional health but little disturbed, much medicine will not be
required. An injection once a day to relieve the bowels; the use
of mucilaginous drinks, such as elm gruel and barley-water; an
occasional dose of composition tea, and a warm poultice kept to
the throat, will suffice in the way of treatment.
In violent cases, the patient should be kept slightly nauseated by
broken doses of lobelia in composition, or such other warm teas
as are good to promote perspiration. When there is great diffi¬
culty in swallowing, the lobelia may be administered by injections,
in small portions of luke-warm water, and retained. Vomiting
may be very readily effected in this way, and prove of benefit in
any stage of the disease.
After the stomach has been cleansed by an emetic, one of the
jest remedies that can be given is powdered gum guiacum. It
may be administered in teaspoonful doses, mixed in a mucilage of
slippery elm, and repeated twice a day.
A strong tea -of bayberry or sumac, with a portion of cayenne
pepper, given occasionally, and more especially when the coating
on the tongue begins to soften, is peculiarly serviceable to cleanse
the stomach.
The feet should be kept warm, and occasionally placed in warm
water, or, what is still better, a vapor bath administered.
Gargling very cold water, or vinegar and water, in the throat,
appears to be particularly serviceable in this affection. If the
cold gargle should not feel pleasant to the throat, it should not be
used. Gargles of pepper sauce, or of bayberry and pepper, may
also be employed with a view to excite the secretions and cleai
the throat of mucus. The tincture of lobelia may be usefully em
ployed as a gargle.
Poultices.—Slippery elm, ginger, and green lobelia, form a good
poultice, to be applied warm to the throat, and to keep the poultice
from getting cold, five or six thicknesses of flannel should be ap-
152
MUMPS.
plied over it; or, in place of a poultice, spread a plaster of stimu¬
lating liniment, or salve, on a piece of silk, oil-cloth or bladder
and apply to the throat; this last application is preferable to a
poultice, at night, on account of the liability of the poultice to
become dry and cold.
Inhaling.the vapor from vinegar and water will give relief, and
hasten the cure.
Quinsy usually runs its course to a favorable termination in a
few days, the inflammation and swelling of the throat subsiding
by the fifth or sixth day from the commencement of the attack.
Very commonly, however, where but one tonsil is affected at first,
the other subsequently becomes inflamed, and thus prolongs the
disease.
If the swelling and inflammation continue five or six days without
abating, and then is accompanied with chilliness, and pain shooting
from the throat to the ear, it is a pretty sure indication that sup¬
puration has commenced. When the matter is discharged, the
patient experiences instant relief, and the disease may be consi¬
dered as cured.
When an abscess is formed in the tonsil, and the patient greatly
distressed from the swelling, it may be opened with a lancet, in
order to allow the matter to escape—an operation attended with
no danger, and one which gives immediate relief. After the ab¬
scess has discharged, a gargle of bay berry or sumac tea should be
used, adding a portion of the No. 6, or tincture of myrrh.
The Diet should consist of soft solids, such as rye mush, jel¬
lies, &c.
Preventives.—Those predisposed to quinsy, should make it a
practice to gargle the throat every morning with cold water, and
occasionally sponge the body with cold water, immediately on
rising in the morning, and keep the feet dry and warm.
SECTION III.
MUMPS.
This is a disease of the parotid glands, which are situate below
the ears, and behind the angle of the jaws. It is contagious and
often prevails epidemically.
Sometimes the gland on one side only is affected, which does
not prevent the disease from occurring subsequently on the other
side; but, where both glands are affected, there is rarely ever a
second attack.
COMMON SORE THROAT.
153
Children and young persons are most liable to this disease.
Mumps is not a dangerous affection, though, from exposure to
cold, it is liable to be translated to other glands—in the male, to
the testes, and in the female to the mamma), and the former, par¬
ticularly, sometimes requires judicious and thorough treatment.
Symptoms.—There is swelling below the ear, extending partly
over the cheek and neck, and stiffness of the jaws. The swelling
increases and the parts become hard and extremely tender, and in
some cases the patient is scarcely able to move the jaws. The
swelling usually begins to lessen by the fourth or fifth day. There
is more or less fever from the commencement, attended with rest¬
lessness, and sometimes slight delirium.
Treatment—Mild cases seldom require other treatment than
keeping the parts warm, and the use of some mild stimulant, with
a view to promote moderate perspiration, as composition, ginger,
or pennyroyal tea.
When the symptoms are more severe, the bowels should be re¬
lieved by injections, and the stomach cleansed by an emetic. If
the symptoms continue to be distressing, broken doses of lobelia
should be given, with warm tea.
The Local Applications to the swelling, should consist of volatile
liniments; sweet oil and spirits of hartshorn ; or camphor, opodel¬
doc, &c., and the parts kept warm with flannel or cotton. Especial
care should be taken to avoid taking cold.
When the disease is translated to the testes, a full course of
medicine should be administered, and the patient be kept in a per¬
spiration by being in bed, and drinking of warm teas, and broken
doses of lobelia. In severe cases, the patient should lie on his back,
and have the testes supported by a soft cushion, and frequently
bathed with volatile liniments, or apply a soft emollient poultice.
SECTION IV.
COMMON SORE THROAT.
Sore Throat is a common attendant on colds, and is usually pre¬
ceded by chilliness and flushes of heat, checked perspiration, and
impaired digestion. The throat is dry at first, and there is pain
on attempting to swallow, with a cough, and sometimes an in¬
clination to vomit. A discharge of a thick yellowish mucus
takes place sooner or later, and the soreness and inflammation
subside.
154
ACUTE LARYNGITIS.
The treatment should consist of hot medicines to warm the sto¬
mach and bowels, and promote perspiration, assisted, it necessary,
by the warm foot bath or vapor bath, and the feet should be kept
warm.
An emetic will be of benefit in severe cases, and small doses
of lobelia should be given to produce slight nausea.- This is
more particularly indicated when the skin is dry or when there
is fever.
The best Gargles for sore throat are capsicum tea, or pepper
sauce. When the inflammation subsides, and a thick yellowish
mucus is secreted, astringent gargles should be used, such as
sumac or bayberry tea.
There is a variety of other remedies useful for colds and sore
throat, as flaxseed, or slippery elm tea, with the addition of a por¬
tion of lemon juice, and sweetened with rock candy, honey and
vinegar. Molasses and fresh butter stewed together, with the
addition of a portion of red or black pepper, is a good remedy for
ordinary sore throat.
A stocking filled with hops moistened with hot vinegar, and
applied to the throat at night, will generally put a stop to a further
increase of the inflammation.
The Constitutional Treatment for sore throat, is precisely such
as should be employed in bronchitis, catarrh, quinsy, or any other
disorder of the kind. Herein is the excellency of the Thompsonian
system: embracing a few general principles, which are applicable
to all cases. The human constitution is governed by genera] laws
which are unvarying and unchanging. And although disease may
appear in a variety of forms, yet it is always the same in principle,
requiring the application of but few general remedies to suit the
circumstances of the case.
SECTION V.
ACUTE LARYNGITIS.
Acute laryngitis consists of an active inflammation of the
parts composing the larynx, or upper portion of the wind-pipe.
It is a species of croup that sometimes attacks adults, and of
which it is said, Washington died.
" The symptoms of acute inflammation of the larynx are these.
The patient complains of sore throat. If you look into his throat
ACUTE LARYNGITIS.
155
you will commonly perceive some redness of the vellum and uvula,
and of the fauces generally. But there is a degree of restlessness
and anxiety about the patient, more than proportionate to the appa¬
rent inflammation. Among the earliest symptoms that bespeak
danger is difficulty of sival/oiving, for which no adequate cause is
visible in the fauces (throat); and to this is presently added diffi¬
culty of breathing, for which no adequate cause can be discovered
in the thorax. The mode and character of the respiration are
peculiar; it is attended with a throttling noise; the act of inspiring
is protracted and wheezing, as though the air were drawn in through
a dry narrow reed. If you ask the patient what is the seat of his
distress, inhere the disease is situated, he points with his finger to
the upper part of the throat. If he coughs, he coughs with a pecu¬
liar harsh, stridulous, husky, abortive sound. He either speaks
quite hoarsely, or (what is more common) all power of audible
voice in the larynx is lost, and he speaks by means of his lips and
tongue only, in a whisper. There is tenderness in the upper part
of the throat. The face is flushed; the skin hot and dry; the pulse
hard. As the disorder advances, the patient's general distress
increases; but some of the symptoms alter; his countenance be¬
comes pale and livid, anxious and ghastly; his eyes protrude; he is
miserably unquiet, impatient for some relief, declares or makes
signs that he wants air, and begs that the windows may be opened;
and if he does not obtain timely relief, he perishes — he dies
strangled."
Treatment.—In this form of disease, prompt and energetic reme¬
dies are demanded; such as are required for the Cure of severe
cases of croup in Children. If there be strong reaction, use the
brown lobelia in preference to any other preparation of it, with a
view to relax the system fully in the very onset of the disease,
immediately after administering a vapor bath. The vapor bath,
lobelia emetics, and the usual stimulating injections, are the means
most to be relied upon in the active stage of the disease, and after
relaxation is effected, or the febrile symptoms abate, the third pre¬
paration of lobelia must be given freely, and administered by injec¬
tion in bayberry or composition tea. If the difficulty of swallow-
ing prevent getting medicine into fhe stomach, the injections must
be repeated frequently, say every half hour. In the early stage of
the disease, when the febrile symptoms are violent, the brown
lobelia may be administered by injection with the same effect upon
the system as if taken into the stomach.
Chronic Laryngitis—Common Sore Throat.—Common inflam¬
mation of the larynx, except where it exists as a consequence of
consumption, is generally curable by swabbing the throat with the
liquid of the third preparation of lobelia, severil times a day, and
156
APHTHOUS SORE MOUTH.
continuing this treatment, together with an occasional course of
medicine; or simply a lobelia emetic, and the use of the compound
lobelia pills every night. Much benefit may be derived by spong¬
ing the neck and breast every morning with cold salt water; and,
after rubbing the surface dry, apply stimulating liniments, or tinc¬
ture of capsicum.
SECTION VI.
APHTHOUS SORE MOUTH.
Infant's Sore Mouth.
In this disease there is a secretion which forms in patches over
the tongue and mouth, resembling whey curd. In some cases the
disease spreads and covers the tongue, and occasionally extends to
the stomach and bowels, appearing at the anus,—these parts be¬
coming excoriated.
Local Treatment.—In the first place rub off these white patches
with a dry rag; then wet a finger, and cover it with fine bayberry
powder, and rub over the tongue and sides of the mouth. Then
lay on the tongue some finely powdered chalk, mixed with an
equal quantity of loaf sugar. These applications will generally
cure it after a few repetitions. Rubbing the dry powder over the
surface stimulates the mucous glands, and induces a more healthy
condition of the secretions.
Constitutional Treatment, in mild cases, is seldom necessary,
more than to allow the child to swallow the chalk and sugar laid
on the tongue. ,
In more obstinate cases, give the child two or three times a day,
a tablespoonful or more of the strong decoction of bayberry or
sumac, with the addition of half»a teaspoonful of powdered chalk,
sweetened. If there be symptoms of the disease having spread
throughout the stomach and bowels, besides the above mixture,
give three or four times a day, half a teaspoonful of composi¬
tion powder, in a tablespoonful of bayberry tea; and use injec¬
tions to regulate the bowels. If this is not sufficient, apply the
vapor bath to warm the blood, and give an emetic to cleanse the
stomach.
«
ENLARGED UVULA.
157
SECTION VII.
ENLARGEMENT OF THE UVULA —FALLING OF THE
PALATE.
The uvula, a small fleshy body, hanging from the middle of the
arch of the palate, over the root of the tongue, is liable to become
elongated, from exposure to cold and damp weather, or from an
acid or otherwise disordered stomach. Sometimes there is but a
slight lengthening of the uvula, and in other instances it becomes
greatly enlarged, having sometimes the appearance of a bladder
of water, and is very troublesome to the patient from the unplea¬
sant sensation occasioned by it in the throat.
From a frequent occurrence of this affection, the uvula is liable
to become permanently elongated, and excite frequent coughing,
which, in some instances, does injury to the luqgs. Cough of long
standing is sometimes cured by the removal of a part of the uvula.
Treatment.—Recent cases of this affection may, in general, be
readily cured by a few doses of composition, or of bayberry and
pepper, and using a gargle of black pepper and whiskey, or a
strong decoction of some vegetable astringent, as bayberry, sumac,
witch-hazel, or marsh rosemary, adding cayenne pepper; or, by
applying the dry powder of bayberry or composition to the uvula.
The most convenient way of doing this, is to place the powder in
a teaspoon, and place the spoon under the uvula, then raising it
up, so as to allow the uvula to come in contact with the powder,
and become coated with it.
When the uvula becomes permanently lengthened, and excites
troublesome coughing, a portion of it should be cut off, provided
the above gargles have no effect in exciting it to contraction. The
clear No. 6, or the third preparation of lobelia, may be also used
as a gargle where the parts have been long affected.
158
COLIC.
CHAPTER V.
DISEASES AFFECTING THE STOMACH AND BOWELS
SECTION I.
COLIC.
Colic is usually divided by medical writers into at least three
varieties, namely, Accidental or Flatulent Colic, Bilious Colic, and
Colica Pictonum, or Painter's Colic.
Flatulent Colic is produced by a collection of wind or flatus in
the stomach or bowels, from indigestion. Persons of weak diges¬
tion and acid stomach, are liable to colic from inaccuracies in diet,
or from drinking freely of cold liquids, such as lemonade, ice-water,
or cold milk. Colic generally comes on an hour or two after eat¬
ing, yet sometimes immediately after. Before the pain seizes the
patient, he generally feels a sensation of fulness and distress at the
pit of the stomach. In some instances, the food passes into the
bowels imperfectly digested, and the colic does not come on until
several hours after eating, and the pain is chiefly about the um¬
bilicus or navel. When the pain is severe, the patient bends his
body forward, and twists about with his hands pressing hard upon
the abdomen. The bowels are constipated, and there is an absence
of fever. The pain is generally lessened whenever there is wind
forced upward or downward. Sickness at the stomach almost
always accompanies colic ; and if free vomiting take place, the
distress is greatly mitigated, and sometimes entirely relieved.
Treatment.—There is a variety of stimulants, either of which
may answer in mild cases; such as capsicum or composition tea,
Thomson's No. 6, oil of juniper, spirits of turpentine, hot brandy
toddy, or essence of peppermint. The teas must be drunk as hot
as the patient can bear tnem.
Emetics.—A prompt emetic of lobelia is the most effectual
means of curing colic, when the pain is in the stomach. The
liquid of the third preparation of lobelia to be given in hot compo¬
sition or bayberry tea; or the lobelia powder and No. 6, used in
place of the third preparation.
CHOLERA MORBUS.
159
The Vapor Bath not only has a tendency to relieve colic, but
it assists the operation of the emetic; the bath, however, will
seldom be necessary except in very severe cases, and in case the
system be very cold or torpid.
Injections.—When the pain is seated in the bowels, injections
may be given, prepared in the usual way. A prompt emetic, how¬
ever, will generally overcome pain in the bowels. When the sti¬
mulating injections are expelled suddenly, without affording relief,
the lobelia powder should be administered in warm water, and
care should be observed to retain them as long as possible.
External Applications.—Flannels wrung out of hot water, or
wet with hot whiskey, or No. 6 ; or hot bricks, wrapped in damp
cloths, should be kept to the stomach and bowels. Heat applied
to the feet is also beneficial.
Anti-acids.—In most cases of colic there is acid in the stomach,
interfering with the free operation of emetics, which require to be
neutralized by alkalies, such as sal eratus, bi-carbonate of soda, or
a tea of hickory ashes. Soot tea answers the same purpose, and
will, of itself, when drunk freely, cure mild cases of colic.
When lobelia is riot at hand, or cannot be readily obtained, a
teaspoonful of mustard in warm water, a tumbler of warm soot-
water, or warm camomile or boneset tea, may be given to produce
vomiting.
Infants are peculiarly liable to colic pains, which may be re¬
lieved generally by the most simple remedies; as, warm tea of
catnip, ginger, calamus, or mint. Adding a few drops of the es¬
sence of peppermint, or tincture of lobelia, will render the teas
more effectual.
Soot tea is very good for colic in infants; emetics, however,
are sometimes necessary, and always safe.
SECTION II.
CHOLERA MORBUS.
This form of disease is occasioned by indigestion from unwhole¬
some food, or from want of vital power in the system. It is com¬
mon in hot weather, but more particularly in autumn.
Symptoms.—Cholera morbus usually comes on suddenly, com¬
mencing with distress and pain at the pit of the stomach and in
160
CHOLERA MORBUS.
the bowels, followed by severe vomiting and purging. When the
symptoms are violent, the strength is rapidly exhausted, and great
distress is felt at the pit of the stomach. The thirst is excessive—
and, in many instances, the patient is harassed by cramps in the
muscles of the abdomen and lower extremities, and the pulse is
usually irregular and feeble. The severe and continued retching,
and strong efforts to vomit, generally occasion more or less bile to
be thrown up, which is observable also in the evacuations from
the bowels.
The aggravated form of this disease which prevailed a few years
since, received the name of Asiatic cholera.
Cholera is generally rapid in its course, and, under unfavorable
circumstances, frequently terminates fatally; as, when it occurs in
vitiated and broken-down constitutions, the patient subjected to an
improper course of treatment, such as large doses of narcotics, or
calomel; or when the vital powers are prostrated by the loss of
blood.
Causes.—There are certain atmospheric influences that evidently
predispose the .system to cholera morbus. The general exciting
causes of the disease are a sudden check to perspiration; unwhole¬
some food, or that which is hard of digestion; intemperance, and
drinking copiously of cold water on an empfy stomach. In some
seasons, almost every person that is sick will have more or less of
bowel complaint. Intermittent fever sometimes commences with
a violent attack of cholera morbus. During the season that the
cholera prevailed throughout this country, almost every person
had, more or less, a looseness and disorder of the bowels, showing
very plainly that there must have been a cause existing in the air
which tended to weaken the vital principle and enfeeble the powers
of digestion.
Treatment of Cholera Morbus.—The most important remedies
for the cure of cholera morbus are, active emetics and injections.
The vapor bath should be administered, or hot bricks, or bottles
of hot water, wrapped in damp cloths, placed around the patient.
As long as the symptoms of retching and purging continue, to¬
gether with pain and cramp, the third preparation of lobelia must
be given in full and frequent doses. A milder stimulant—com¬
position, for instance—will, in many instances, be thrown off the
moment it is swallowed, without producing a sufficiently beneficial
result. I have witnessed cases in which every thing swallowed
had been rejected instantly, with the exception of the third prepa-
ltion of lobelia, which remained several minutes before it was
thrown off, and would bring morbid matter from the stomach,
which could not have been thrown off without it. I know of no
form of medicine of such efficacy, in all bad cases, as the third
CHOLERA MORBUS.
161
preparation of lobelia in bayberry tea. Patients in many instances
have continued retching and vomiting for hours in succession,
raising scarcely any thing, yet, by taking a vapor bath to warm
the blood, and restore the nervous power or excitability of the
system, followed by a prompt emetic, large masses of undigested
food have been thrown off, and the stomach become settled in a
short time. Therefore it will not do to be satisfied without giving
an efficient emetic, as long as the stomach continues its efforts to
relieve itself, or the system remains in a collapsed state. Even
though the stomach should not contain any thing that requires to
be removed, and the retching continues from an unsettled, or, as
it is termed, 'an irritable condition of the stomach, the emetic
would be as likely to quiet the stomach as any medicine that could
be given.
Dr. George M'Clellan stated in one of his lectures, that in the
post-mortem examinations that he made where patients died of
cholera, he invariably found the stomach more or less filled with
masses of undigested food, and in many instances observed sub¬
stances that must have been swallowed many days previous to
their death. The doctor adopted the practice of giving prompt
emetics in every case that came under his care, and by this course
of treatment he succeeded in raising every patient to whom it was
applied.
Flannels wrung out of hot brandy or No. 6, should be applied
over the abdomen.
After the disease is checked, which it almost always is under
'.horough Thomsonian treatment, the patient must remain quiet,
and warm in bed, and take occasionally some spice bitters and
pepper tea; or the No 5 syrup, or cholera syrup, may be taken
occasionally.
The digestion being left weak, care will be necessary to regu¬
late the diet, and to avoid all kinds of fruit, pastry, and every thing
difficult of digestion. Milk porridge, barley water, custards, &c.,
will be proper; and, if the patient desire it, he may take mode¬
rately of boiled or broiled ham, and also the thin part of a salt
mackerel boiled, but neither broiled nor fried.
To allay thirst, the mouth and throat may be gargled frequently
with cold water, but cold liquids must not be swallowed, except in
very small quantities. Capsicum tea, by exciting the secretions,
will generally allay thirst.
A mustard plaster over the pit of the stomach will have a ten¬
dency to allay the vomiting and relieve the pain; taking care to
remove the mustard, however, before it produces a blister.
11
162
CHOLERA INFANTUM.
SECTION III.
CHOLERA INFANTUM—CHOLERA OF INFANTS.
(Vomiting and Purging of Infants.)
Infants are especially liable to bowel complaints arising from
indigestion, particularly when they are teething. When there is
both vomiting and purging, it is called cholera infantum. It sel¬
dom comes on suddenly violent, as happens in the cholera of adults;
but generally commences with diarrhcea, which continues several
days, before vomiting takes place: occasionally, however, the
vomiting and purging come on simultaneously.
Infantile cholera, like that of adults, arises from a loss of the
power of digestion; the food being imperfectly digested, becomes
:sour and acrid, and offends the stomach and bowels, similar to an
irritating cathartic, like mandrake or jalap—the constitution en¬
deavoring to cast off the undigested matter by vomiting and diar-
.rhcea.
Cholera of infants is usually much more protracted in duration
than that of adults; generally continuing for several days, and
not unfrequently becoming chronic. In many instances, however,
the vital powers sink rapidly, and the disease, if not subdued,
will become suddenly fatal. When the disease is unchecked, the
strength soon becomes greatly exhausted; the flesh wastes rapidly;
the countenance becomes shrunken and pale; the extremities cold;
the belly swollen and hot; the skin dry and husky, or cool and
flaccid; the discharges from the bowels frequent, watery, and
acrid; the little patient dozes with his eyes half closed, and rolls
his head when awake. The eyes become sunken and glassy; the
lips blue; the breath cool; and finally the patient sinks into a state
of insensibility, and in many instances dies with symptoms of
dropsy on the brain. Patients have recovered from this disease,
however, even after the occurrence of the above symptoms. A
feverish state of the system is always more favorable than an oppo¬
site condition. In many instances the evacuations from the bowels
consist of a deep green fluid—the green color, probably, is owing
to the acid in the bowels, acting upon the coloring matter of
ihe bile.
Thomsonian treatment will generally succeed in curing cholera
infantum, if timely and properly administered.
Treatment of Cholera Infantum.—The same general course of
•■treatment is required in this form of disease, as in that for adults—
CHOLERA INFANTUM.
163
relying chiefly upon the vapor bath, emetics, and injections, in the
earl) stage, together with the use of stimulants to support the vital
powers, to determine the blood to the surface, and to promote
healthy secretions; astringents to " remove the canker;" anti-acids
and absorbents to neutralize acid; and finally tonics to restore
digestion.
The Vapor Bath.—Whoever has witnessed the effects of steam¬
ing in cholera infantum, must become convinced of its utility. I
have, in many instances, seen little patients made comfortable, at
least for a time, by the bath, when they before were suffering the
most severe spasms of pain. It is a universal opinion among prac¬
titioners of the old school, that the liver is in a state of torpor in
this disease, and by failing to secrete bile, occasions the stools to
be of a light color.
From the close sympathy existing between the skin and the
liver, the vapor bath, by its prompt action upon the skin, tends to
restore action in the liver'. Besides this, the vapor bath, when
well applied, warms the blood, and also thins it, by quickening its
circulation through the lungs. Steaming will also increase the
natural sensibility of the system, and cause the emetic and other
remedies to operate more promptly and effectually. The best
mode of steaming infants is to do it on the mother's lap, or if they
can sit on a chair this will be better. The steaming may be con¬
tinued from fifteen minutes to half an hour, and repeated as often
as the case may require, washing over the surface occasionally
while in the bath, with spirits, vinegar, or simply with water.
The shower bath, or dipping the child instantly from the steam
into a tub of cold water, may be practised with perfect safety,
except in very low cases, when there is not heat or nervous energy
sufficient to excite reaction. Exciting reaction in this way, it is
in many instances of especial benefit, more particularly in chronic
cases. After this, the patient should be clothed warmly, and have
a flannel bandage over the abdomen, which may be wet occasion¬
ally with No. 6, or the third preparation of lobelia.
There is no form of disease in which I have found the vapor
bath more beneficial than in bowel complaints. To keep the
head constantly wet with vinegar and water, when steaming, is
both grateful and bc-neficial to the patient.
Emetics may be prepared in various ways. I have generally
found the following form to answer as well as any other:
An even teaspoonful of green lobelia,
Ditto of No. 6,
In a small teacup, half full of very strong bayberry or No.
3 tea. The lobelia to be added to the tea when mode-
164
CHOLERA INFANTUM.
rately hot. To be strained and sweetened; and to an
infant give a tablespoonful every ten or fifteen minutes,
until free and full vomiting is produced.
In severe cases I have used the third preparation of lobelia,
together with a portion of the green lobelia, adding the bay-
berry tea. Green lobelia in composition tea does very well in
mild cases.
In cases where I have deemed it necessary to continue the use
of a diffusive stimulant, and occasionally to relieve the stomach by
vomiting, I have given the liquid of the third preparation of lobelia
in a small quantity of .boiled milk. The best time for giving an
emetic is immediately after steaming; still it may be given at any
time without the previous use of the bath.
In some cases it may be necessary to repeat an emetic every
two or three hours; in other cases once or twice a day; and in
others still less frequently: the nature of the case, however, will
point out when an emetic is necessary. I have never witnessed
any injury to arise from the frequent repetition of prompt and elli-
cient emetics in cholera infantum; but, on the contrary, patients
are apt to be permitted to suffer, and even to sink, from oppression
of the stomach, which might have been relieved by the early admi¬
nistration of emetics, before the powers of the constitution had
sunk under the effects of the disease; and the heat and nervous
energy become too far exhausted for medicine to have a proper
effect. The operation of an emetic has a beneficial influence upon
the liver in arousing it from a state of torpor.
Injections.—In the early stage of bowel complaint, an injection
repeated three or four times will, in some instances, be sufficient to
check the further progress of the disease. They should be pre¬
pared in the usual form, of composition tea and green lobelia, or
tincture of lobelia; or of a strong decoction of some suitable as¬
tringent, such as bayberry, sumac, raspberry leaves, or dewberry
root, adding a portion of No. 6 and green lobelia, or a small tea-
spoonful of the third preparation of lobelia. When the evacua¬
tions are green, denoting the presence of acid, or if they be of a
frothy acrid character, a portion of sal-eratus, or a teaspoonful of
the bi-carbonate of soda, should be added to the injection. When
the parts become sore and irritated from repeated evacuations, 01
the frequent introduction of the syringe pipe, a gum elastic tube,
made for the purpose, placed on the pipe of the syringe, will cause
much less irritation than the metallic-pipe, and by introducing the
gum elastic tube four or five inches, the injection will have a more
decidedly beneficial effect. In those cases where injections, given
with an ordinary syringe, are immediately rejected,, the gum elastic
tube, or a large catheter must be used for the purpose of throwing
CHOLERA INFANTUM.
165
the injection so far into the bowels as to prevent its immediate ex¬
pulsion, without having the desired effect.
In all protracted cases of this complaint, the mucous membrane
of the stomach and bowels becomes coated with thickened secre¬
tions, forming a false membrane, and which may often be seen in
the ejections from the stomach, and in the evacuations from the
bowels. Until this false membrane is removed, digestion cannot
be restored; and until the digestive functions are restored, the
diarrhoea will continue. The false membrane that forms on the
mucous membrane of the stomach and bowels, resembles that
which forms on the wind-pipe in some cases of croup. The reason
why so many children die of bowel complaints under the old
school practice is, doubtless, because the medicines employed are
not adapted to the removal of the false membrane, coating the
stomach and bowels. Small portions of cayenne given in bayberry
tea, composition powder, (prepared as mentioned in the next para¬
graph below,) bayberry powder, or spice bitters, (prepared in the
same way,) or a strong tea of these articles, are the means to be
employed, together with frequent steaming of the patient, and the
use of prompt emetics and injections.
Composition Powder.—As much of the composition powder as
will lay on a ten cent piece, rubbed up with an equal quantity of
sugar, and then stirred into a tablespoonful of strong bayberry, or
sumac tea, and given, repeating it every two or three hours, will
in general prove far more beneficial than the composition tea. In
slight cases, this dose repeated two or more times a day, will be
suiiicient to check the disease, at its commencement. The compo¬
sition, prepared in this way, may be given in all cases, and when
repeated two or three times a day, or as the case may require, it
frequently has proved more effectual in my hands than any prepa¬
ration of cholera syrup that I have ever used.
Capsicum, though unpleasant to administer to children, is never¬
theless one of the most valuable medicines in all cases of disordered
bowels. There are few cases, probably, of cholera infantum, that
may not be cured by a timely and free use of cayenne pepper.
An additional quantity of capsicum, added to the composition or
spice bitters, will render their use more effectual. A very good
way to administer pepper to children, is to add it to a small quan¬
tity of boiled milk. It is generally more effectual, however, given
in the form of simple tea sweetened.. When the tongue is dry and
the patient thirsty, the pepper tea should be used instead of the
composition and bayberry. I frequently combine pepper with
ginger, making a strong tea of them, and give a teaspoonful, with
the addition of ten or fifteen drops of the tincture of lobelia, every
half hour.
166
CHOLERA INFANTUM.
External Applications.—These may consist of stimulating lini¬
ment, No. 6, or the third preparation of lobelia, applied to the ab
domen; or warm poultices over the region ot the bowels, composed
of composition powder, slippery-elm, and green lobelia, moistened
with warm water, enclosed in gauze or book muslin, and applied
to the parts. The poultices must be kept warm, for it they be¬
come cold they will be likely to do harm. It is a good plan to
have two poultices, and change them when they become too cold
or dry. Mustard plasters over the stomach are useful in some
cases, more particularly where the stomach remains irritable an"'
the patient continues retching after the operation of an emetir
The mustard must be removed before it draws a blister.
Anti-acids.—A weak tea made by pouring boiling water upon
common soot, and sweetened, will relieve colic pains by causing
the removal of the flatus from the stomach. The soot tea, or sal-
eratus, or bi-carbonate of soda, is sometimes necessary to be given
to neutralize the acid in the stomach, before an emetic will operate
effectually.
Diet.—During the active stage, or until the disease be checked,
a most careful attention will be necessary in the selection of food.
It is better to give the patient no food, at least for a reasonable
length of time, than to introduce such into the stomach as it can¬
not digest. Bermuda arrow-root, gum arabic, crust coffee, milk
porridge, Irish moss, oat-meal gruel, and barley-water, form the
most suitable articles of diet. It will be proper, in severe cases,
to use some one of the above articles for infants that have not been
weaned, for the mother's milk will in some cases be thrown up in
solid masses soon after it is swallowed, or passed off by the bowels
in an undigested state. The excessive thirst attending the disease
will induce an infant to take the breast almost constantly, and take
large quantities of milk into the stomach, which sometimes forms
into masses of cheese-like substance, and will greatly increase the
suffering, and even endanger the life of the patient. Drink, as
well as food, should be given in very small quantities. A tea-
spoonful of gum arabic water, or of barley-water, is as much as
should be given at once, to infants, in cases where the stomach is
very weak; this quantity, however, may be given frequently. By
dissolving gum arabic in composition, or spice bitter tea, it will
supply both food and medicine. The following constitutes a suit¬
able article of diet in cases of bowel complaints in general, to wit—
tie a portion of wheat flour in a bag, put it in a kettle of boiling
water, and boil it four or five hours; then scrape off the wet part
and grate the flour and make a gruel. To be salted to suit the
\aste.
As long as food passes through the bowels undigested, such
CHOLERA INFANTUM.
167
articles of diet must be given as are least disposed to sour or fer¬
ment, such as baked flour gruel, elm gruel, boiled milk, thickened
with elm, or baked flour, gum arabic mucilage, and crust coffee;
and even these should be used in very small quantities. The thirst
may arise from a curative action in the stomach, and if large
quantities of liquids be taken, the stomach may thereby become
oppressed, and unable to recover its natural action.
A mixture of salt and vinegar is a favorite remedy in some
families in all cases of complaints of the bowels. This remedy has
in some cases proved of signal benefit. The vinegar should not be
diluted, and should have as much salt mixed with it as it will dis¬
solve. To an infant a teaspoonful may be given every two or
three hours.
As the stomach and bowels become settled, and the stools pre¬
sent a more favorable appearance, such as small portions of natu¬
ral faeces, with thick secretions, in appearance like small flakes of
a skin-like substance, together with bilious matter, showing that
the functions of the liver are being restored, then stronger food
may be given, as chicken tea, essence of beef, with crackers or
stale bread, and milk porridge. Salt should be added to the food,
as this is a most important article in most cases where patients are
recovering from sickness. Patients, in recovering from cholera,
very often have a craving for salt food, as old bacon, and salt fish,
which may be found not only to gratify the patient, but to tone
the stomach, and cause an immediate improvement in the symp¬
toms. The thin part of salt mackerel boiled, or a small piece of
salt ham boiled, or broiled, may be given, and the use of it con¬
tinued, provided it be found not to disagree with the stomach or
bowels. "I have seen many children recover," says Dr. Rush,
" from being gratified in an inclination to eat salted fish, and the
different kinds of salt meat. In some instances, they evince an
appetite for butter, and the richest kinds of gravies from roasted
meat, and eat them to the obvious relief of all their symptoms."
Patients are subject, however, to morbid cravings for food which
may be found to disagree with the digestive organs, and it will
therefore be necessary to exercise proper discretion in granting
much indulgence to extraordinary cravings for particular articles
of food or drink. A child may crave sweet cakes, as ginger¬
bread and pound cake, but this kind of food should not be allowed
in any case; or there may be a craving for cold water, which if
given too freely will prove injurious. To restore digestion, the
No. 5 syrup may be used, or a tea made by steeping poplar and
bay berry bark in boiling water. The tea to be sweetened with
loaf sugar, and given in tablespoonful doses three or four times a
day. This preparation will in many instances cure ordinary diar¬
rhoea, both in children and in adults, and is not unpleasant to take.
It becomes more effectual by the addition of a portion of No. 6.
168
CHOLERA INFANTUM.
Country Air.—When the disease becomes chronic, and medi
cines have failed of effecting a cure, or if the child be subject to
frequent relapses, there is probably no means so likely ot success,
as a change of air. It frequently happens that taking a child with
this disease from the city to the country air, will in a few days
restore the appetite, and the patient will begin to gain rapidly in
flesh and strength.
The Cold Salt Water Bath.—In most cases of chronic disease of
the bowels, where the patient continues feeble and emaciated, much
benefit may be derived by dipping the patient every morning in a
tub of cold salt water. If the patient be excessively weak, it will
be prudent to temper the water at first by adding a portion of hot
water. After being dipped, the child should be wrapped in a
olanket, and placed in a warm bed, in order to favor reaction;
and if the child becomes warm in fifteen minutes or half an hour,
it will most certainly be beneficial.
Lancing the Gums is often of benefit in the early stage of cholera
infantum; more particularly when the diarrhoea first commences;
but where the disease has prostrated the strength of the little suf¬
ferer, and more particularly if the gums be spongy, cutting them
will prove useless, for the teeth will not grow under the circum¬
stances just mentioned.
Injections Retained.—A strong tea of poplar bark, or of Peru¬
vian bark, administered by injections and retained, and those re-
oeated as often as twice a day, will strengthen the bowels. They
may be employed in any stage of this complaint.
Preventives.—Cleanliness; cold baths in the morning; avoiding
all unripe fruit, sweet cakes, pastry, &c.; lancing the gums when
teething; residence in the country, and a flannel bandage over the
abdomen, are good preventives.
Poulticing the Abdomen.—Since the first edition of this work
was published, I have observed great benefit to be derived from
the use of warm poultices to the abdomen. Take of composition
and slippery elm powder equal parts, adding a portion of lobelia
powder, wet the poultice wifh hot water, and then mix some lard
with it to prevent the poultice drying. If the above compound be
found too stimulating, a greater proportion of elm may be used;
■or a poultice of Indian mush, adding a small quantity of ginger.
BILIOUS COLIC.
1C9
SECTION IV.
BILIOUS COLIC.
When colic is accompanied with bilious vomiting, or the skin
and whites of the eyes become sallow, it is termed bilious colic.
The supposition that an overflow of bile occasions the disease, has
given rise to the name bilious colic, when, in reality, the liver is in
most instances in a torpid condition, and secretes less bile than
when in a state of health. The digestion being impaired or sus-
ended, the bowels cold and inactive, the bile is not used, but
eing retained in the duodenum, it is drawn into the stomach by
the act of vomiting, and thrown up. A vitiated state of the bile
is, doubtless, a frequent cause of the sickness and vomiting; but this
unhealthy condition of the bile is an effect and not the cause of the
disease.
Bilious colic is more liable to occur in autumn, and especially
in localities where ague and bilious fever prevail. Many persons,
however, are subject to attacks of colic at all seasons of the year.
In most instances, the general health is considerably deranged
before the attack of colic is manifest. The appetite is impaired,
the tongue furred, and the bowels costive, or otherwise disordered.
The skin is dry, and frequently there is pain and soreness in the
back; an uneasy sensation at the stomach, chilliness, bad taste in
the mouth, and headache. These symptoms are followed by cut¬
ting pains in the stomach and bowels; sickness at the stomach,
and vomiting; frequently bile is thrown up. The pain increases
by spells, and, in many instances, assumes a very violent charac¬
ter. The bowels in almost every instance are obstinately consti¬
pated, having lost their power of action. As the disease continues,
the abdomen becomes sore and tender to pressure, and in most
instances the complexion has a sallow tinge. The duration of the
disease varies greatly in different cases, and as it occurs under
different circumstances: sometimes it is overcome in a few minutes,
by proper treatment in the commencement; and in other cases it
will continue with more or less sevei'ity, at intervals, several days
in succession.
Treatment of Bilious Colic.—A full course of medicine, timely
administered, will overcome the pain, and check the further pro¬
gress of the disease in a great majority of cases.
Lobelia Emetics are more effectual in general than any other
curative means in the treatment of bilious colic. Even where the
oain is wholly confined to the bowels, it is generally relieved by
170
BILIOUS COLIC.
free vomiting, together with the relaxation produced by the lobelia.
In sudden attacks, where the pain is violent, an emetic of the third
preparation of lobelia, or of lobelia powder and No. 6, must be
given, without waiting to administer the vapor bath. If, alter the
full operation of the emetic, the pain still continues, a lull course
of medicine will be necessary, or the emetics repeated, together
with the application of hot fomentations to the abdomen, or the
application of hot bricks, wrapped in damp cloths, to.that part.
In some cases, the emetic will require to be frequently repeated.
When the .patient has warning of the approach of colic, a regular
course will be more likely to keep it off than a simple emetic
without the bath and enema.
There are many persons subject to periodical attacks of colic.
Such persons are generally dyspeptic, and exhibit marks of a
torpid liver. I have known several cases of this kind, of long
standing, effectually cured by an occasional course of medicine,
together with appropriate intermediate treatment, and strict atten¬
tion to diet.
Injections.—The bowels being obstinately constipated, will re¬
quire the aid of injections, more especially if the pain be chiefly in
the lower bowels. The usual stimulating injections may be used,
and they always should contain lobelia. In obstinate cases, a
stomach tube, or large catheter, introduced eight or ten inches into
the bowels, and an injection passed through it, will prove more
effectual than when the injection is given by the syringe alone.
The introduction of the tube, however, requires care, and some¬
times it is difficult to accomplish it, even by those who have had
experience in the operation. Injections of spirits of turpentine are
highly recommended by many practitioners. The mode of pre¬
paring it is, to mix together a tablespoonful of turpentine and the
yolks of two eggs, adding a pint of warm water; or, mix the tur¬
pentine with some dry slippery elm powder, and then add warm
water. When the turpentine injections are found to afford more
relief than the usual Thomsonian injections, they may be employed
freely.
Charcoal.—When the patient has been vomiting a great deal
and the stomach rejects composition, cayenne, &c., mix a tea
spoonful of purified charcoal in each dose of the medicine, and
give it freely. The retching and straining efforts to vomit, may,
however, prove beneficial, by exerting an influence over the circu¬
lation and secretions of the liver.
The Warm Bath generally affords considerable relief, and ma}
be used to prepare the system for an emetic; but it is inferior in
point of efficacy to the vapor bath.
BILIOUS COLIC.
17
External Applications. — Besides the vapor and warm bath
much benefit may be derived by the application over the abdo¬
men of warm stimulating poultices, hot fomentations or mustard
plasters. The mustard must not be allowed to remain on so long
as to cause a blister.
After the disease is subdued, but the nervous system continues
weak and agitated, the valerian or scull-cap tea may be adminis¬
tered; the latter answers both as a nervine and a tonic. To pre¬
vent a relapse, the patient should take occasionally stimulants and
tonics, and pay strict attention to diet.
To remove soreness of the abdomen either during or after the
attack, the vapor bath and stimulating poultices are the most
effectual of any means that can be employed..
Persons subject to periodical attacks of colic, should use cay¬
enne freely with their food, or immediately after meals; and if
costive, take a tablespoonful of white mustard seed once or twice
a day, or make free use of purified charcoal.
White Turpentine taken in the form of pills, is a favorite medi¬
cine with some practitioners, as a preventive of colic.
However severe the attack, I have never yet known of a case
of death from bilious colic under Thomsonian treatment. The
treatment will require to be perseveringly applied in different cases.
Many permanent cures have been effected in persons who had
been subject to periodical attacks for many years.
A Case.—J. M. E. had been subject to attacks of bilious colic,
and applied to the Homoeopathic practice, after the regular treat-
menrtmd failed. The Homoeopathic medicine gave him almost
instant relief from the pain, and he continued to use the medicine
whenever the attack of colic came on, until finally the spells be¬
came much more frequent, and attended with neuralgic paim
throughout the system. He became alarmed, and placed himself
under Thomsonian treatment; and by taking a few courses of
medicine, at proper intervals, and stimulants intermediately, he
was effectually cured. This patient had not more than two returns
of the spells, after the first course of medicine was given him.
The above case affords an example of the difference between
the Homoeopathic and Thomsonian principles; the Homoeopathic
medicine, by its poisonous properties, creating another disease
stronger than bilious colic, or deadening the sensibilities, and in this
way relieving the pain; the Thomsonian assisting nature to throw
off the disease by means that harmonize with the system.
172
COLICA PICTONTJM.
SECTION V.
COLIC A PICTONUM—PAINTER'S COLIC.
This most distressing malady, which has received a variety of
appellations, such as painter's colic, lead colic, and dry belly ache,
is caused by exposure to the fumes, but more particularly to the
dust, of white lead. Painters, and more especially those who
assist in the manufacture of white lead, are particularly liable to
this form of disease.
Symptoms.—As the system becomes gradually poisoned by the
metallic substance, the general health is correspondingly impaired.
There is an uneasy sensation at the stomach; failing of the appe¬
tite; constipation of the bowels; general debility and lassitude; a
sense of weight and constriction in the abdomen, with transient
pains in the stomach and bowels. By degrees the symptoms be¬
come more distressing; the pain in the stomach and bowels in¬
creases; the abdomen is hard, and instead of being distended, as
in other forms of colic, it is retracted, and the natural action of
the bowels is suspended. Vomiting almost always accompanies
this disease; and immediately after vomiting, the patient expe¬
riences more or less mitigation of the pain. This disease is not
only of an agonizing character, but it is apt to be protracted in
duration, continuing in many instances for two or three days with
but slight mitigation of the suffering. In the more violent cases
the pain extends from the bowels up to the chest and into the arms,
and downward to the bladder and rectum, accompanied with a
distressing sensation of weight and bearing down, and frequently
great difficulty in evacuating the bladder. Cold sweats break out
over the face and extremities; and, in some instances, there are
delirium, stupor, and convulsions. If the disease be not subdued, the
vital powers begin to sink; the abdomen becomes swollen and
puffy, yet with an abatement of the pain; the thirst is excessive ;
the sight is impaired; the feet become swollen; the countenance
pale and haggard; there is difficulty of breathing, and finally the
patient sinks into a state of stupor, terminating in death.
By a continued exposure to the poisonous influence of lead, the
vital powers become so far exhausted, as to be insufficient, even
by the aid of medical means, to eradicate the poison from the sys¬
tem, and to restore the organs to a healthy condition. Paiients
that have had two or three attacks of painter's colic seldom recover
fully from the effects of the poison. The appetite is bad; digestion
greatly impaired; the natural temperature of the body very low;
painter's colic.
173
the extremities always cold; the bowels continue obstinately con¬
stipated; the spirits sunken and depressed; the complexion sallow
and of a leaden hue; the flesh wastes away; the skin is dry, harsh,
and contracted; the temper is peevish and sullen, and the counte-
tenance is expressive of gloom and suffering. In the first attack
of the disease, however, it is almost always curable; though it
requires several days in almost every instance to effect a favorable
crisis in the disease. In most instances a cure may be effected,,
aided by the recuperative efforts of nature, during the first attack.
Treatment.—Painter's colic requires the same general plan of
treatment recommended for the cure of bilious colic.
The Vapor Bath, besides fulfilling other important indications,
will prove more effectual than any other means used to remove the
poison from the blood. Besides applying the steam, hot poultices
or warm fomentations should be applied to the abdomen.
Emetics are as essential in this form of disease as they are in
that of bilious colic, or cholera morbus. In many cases free
vomiting affords almost the only relief from pain, until the disease
be subdued. The third preparation of lobelia answers well for the
emetic. The straining efforts to vomit when the system is relaxed
by lobelia, though distressing at the time, are doubtless, in many
instances, beneficial to the patient.
The Compound Lobelia Pills may be given in sufficient quantity
to keep the patient constantly under their influence.
Stimulants. — Cayenne, composition, or bayberry tea and cay
enne, must be employed as general remedies, unless the compound
lobelia pills be used freely.
Injections.—These will be of great service to moderate the pain,
and may be' administered frequently, especially if they afford relief.
They may be prepared as directed in the treatment of bilious colic.
Injections of essence of beef, or milk porridge retained, will not
only soften hardened fseces in the bowels, but also afford nourish¬
ment to the system.
The extreme torpor of the bowels which prevails in lead colic,
renders the use of cathartics particularly pernicious; for unless
'elected by vomiting, they remain so long in the bowels that they
become absorbed, increase the suffering, and always injure the
patient. More patients die from the effects of cathartics than from
lead colic.
Astringents are especially beneficial in all cases of painter's
174
DYSENTERY.
colic. A strong decoction of the compound of the bayberry and
sumac berries, does better than the tea of the bayberry alone. I
succeeded in curing a case of the disease that had become chronic,
the patient having been several years employed in Mr. Wetherill's
white lead manufactory, where he was daily exposed to the dele¬
terious fumes of this noxious mineral. In this case I found astrin¬
gents peculiarly beneficial, administered three or four times a day,
with the addition of a small portion of capsicum.
This patient also used injections of the same, and occasionally
had a vapor bath and an emetic. Large quantities of a thick mem¬
branous substance were passed from his bowels by the injections.
It must be borne in mind that painter's colic is not to be cured,
in general, short of several days, and in some instances not under
two or three weeks. The grand object always to be kept in view
in the treatment, is to assist the efforts of nature to work off from
the system the poison and its effects, by such means as have been
mentioned, and persevere in their use, varying them to suit the
nature of the case.
During convalescence the patient should take tonics, and once
or twice a day, a teacup half or two-thirds full of a decoction of
the bayberry or sumac berries, with from half to a teaspoonful of
cayenne added, and avoid exposure to the fumes of lead.
Precautions.—Those engaged in the manufacture of white lead
o o
should make use of fat meats, or use freely of palm oil at meals,
and never be exposed to the lead in the morning with an empty
stomach. A tablespoonful of palm oil taken in the morning is said
to afford protection to the stomach against the effects of this mineral
poison.
It has recently been discovered that a free use of sulphuric acid
lemonade affords an almost sure protection to the system against
the fumes of white lead.
SECTION VI.
DYSENTERY.
This disease is characterized by severe griping pain in the
bowels; a frequent inclination to go to stool; and the evacuations
consist of blood and mucus. Sometimes the evacuations consist
chiefly of mucus;—at other times they are very bloody.
These dysenteric symptoms are generally preceded by lassitude,
chilliness, with flushes of heat, loss of appetite, torpid bowels, bad
taste in the mouth, and nausea.
DYSENTERY.
175
Prom the commencement of dysentery,-until there is considera¬
ble amendment, the natural Ireces of the bowels are retained, or
voided in very small quantities, consisting in general of small hard
balls, called scybalae. The passing of these hard balls through the
diseased bowels, is attended with severe pain.
Dysentery prevails most during the latter part of summer, and
also in autumn.
Causes. — Perspiration suddenly checked by cold, especially
where the system is exhausted from over-exertion, is a common
cause of dysentery. "A cold and moist autumn succeeding a
warm and dry summer, is peculiarly favorable to the production
of dysentery.'"
Dysentery frequently prevails as an epidemic in low marshy
districts of country, probably from the combined influence of marsh
effluvia and dampness. The same causes that produce dysentery
in one person may occasion bilious fever (as it is called) in ano¬
ther ; and hence it often happens that both forms of disease prevail,
and some patients will have all the symptoms of dysentery and
bilious fever, at the same time.
Among the occasional causes of dysentery may be mentioned
unripe fruit, and other unwholesome articles of food, taken into
the stomach.
Fatality of the Disease.—When dysentery prevails, epidemically,
it frequently proves fatal, and particularly so under the old school
practice. Except under very unfavorable circumstances, how¬
ever, the Thomsonian practice, promptly and judiciously applied,
seldom fails of bringing the disease to a favorable termination.
Dr. Thomson, in his Narrative, makes mention of a malignant
form of dysentery which prevailed in the town of Jericho, in 1807,
where out of twenty cases under the treatment of the medical
faculty, but two recovered. The inhabitants became alarmed, and
sent an express for Dr. Thomson, who began to treat the disease
according to his system of practice, and of thirty cases which
came under his treatment, all except two recovered. " I had,"
says the doctor, " but little medicine with me, and had to make
use of such as I could procure at this place. I found the cause of
the disease to be coldness and canker; the digestive powers being
lost, the stomach became clogged, so that it would not hold the
heat. I made use of red peppers, steeped in a tea of sumac ber¬
ries, and sometimes the bark and berries, to raise the heat and
clear off the canker, which had the desired effect. After taking
this tea, those who were strong enough, I placed over a steam, as
lon^ as they could bear it, and then put them in bed. Those who
were too weak to stand, I contrived to have set over the steam,
and this repeated as occasion required." To restore digestion, the
176
DYSENTERY.
doctor made use of a syrup made of black birch bark and cherry
stones bruised.
Treatment of Dysentery. — Courses of medicine repeated at
proper intervals, and a well regulated treatment between the
courses,'will cure dysentery sooner and more effectually than any
other kind of treatment. The course should be repeated daily in
bad cases.
During the intervals between the courses, or when the disease
is of a mild form, not requiring a course of medicine, any one of
the following preparations may be given at intervals of one or two
hours, viz:—
A strong decoction of bayberry or sumac, adding a portion ol
cayenne pepper, and sweetened; cayenne in tea, pills, or in cold
water; or the compound lobelia pills taken at the rate of from two
to four pills every two hours.
The composition powder rubbed with a little sugar, with suffi
cient lukewarm water added to make it easy to swallow, will
prove more effectual than the tea of composition.
When the patient is not very feverish, and the tongue is thickly
coated and not very dry, the following preparation will prove
highly beneficial, given every hour or two—namely, take two tea-
spoonsful of No. 6, one teaspoonful of fine bayberry powder, and
one teaspoonful of sugar. Mix these well, and if too thick to
swallow, add a little warm water.
The Vapor Bath is signally beneficial in dysentery, and should
be frequently administered. After the bath, and the patient is
rubbed dry, apply stimulating ointment, the third preparation of
lobelia, or No. 6, over the surface of the abdomen. Bottles of hot
water, or hot bricks wrapped in damp cloths, should be kept to the
feet and body.
Asa substitute for the vapor bath, in mild cases, wrap the body,
from the hips to the arm-pits, with a bandage of flannel. The
constant application of warmth and pressure is of great import¬
ance, and well adapted to all cases of bowel complaints, both acute
and chronic.
Injections.— Injections assist the restorative action, and remove
acrid secretions. They should be composed of astringents and
stimulants. A strong decoction of bayberry, dewberry root, or
raspberry leaves, adding a teaspoonful of the liquid of the third
preparation of lobelia and a tablespoonful of sweet oil or lard to
half a pint of the tea; or scald a teaspoonful of pepper with the
other articles, add a teaspoonful of lobelia powder, and stir the
mixture. Lobelia in some form, either the powder or liquid of the
third preparation,, should generally be added. If the stimulating
DYSENTERY.
L77
injections cause much pain, and increase the bearing down feel¬
ing some time after its operation, then milder injections must he
employed; for instance, a strong decoction of bayberry, adding
to half a pint of it a teaspoonful of green lobelia powder, or a
large teaspoonful of lobelia powder infused in half a pint of warm
water.
When the stools are very offensive, purified charcoal should be
added to the injections, and also be given occasionally with the
medicine otherwise taken. In the place of the charcoal the chalk
mixture may be used; or the bi-carbonate of soda or sal-aeratus.
Castile soap and water forms a mild, and in many cases, a very^
efficient injection in cases of dysentery. On making a trial, if it
be found to agree with the case by mitigating the violence of the
pain, it should be employed.
The chief objection to frequent injections, is the irritation pro¬
duced by the metallic pipe of the syringe. It should be well
covered with tallow; or a gum elastic tube made for the purpose,,
placed on the metallic pipe.
Professor Chapman, in a lecture on dysentery, in 1840, stated
that at Vera Cruz, the only successful treatment in the malignant
dysentery that prevailed there was a free use of cayenne peppei
tea, and injections of the same.
A case of dysentery occurred in Chester county, of the most
severe character, in which a quarter of a pound of cayenne pepper
was used by injection and given in tea during one night, together
with a large quantity of the No. 6, and bayberry tea. The patient
speedily recovered, and no doubt by means of this finergetic treat¬
ment.
Poulticing the Abdomen.—Warm poultices composed of slippery
elm and composition; or of Indian musk, with a portion of cay¬
enne added, applied to the abdomen warm, will always prove
beneficial, and sometimes will entirely remove the griping pains.
Diet.—This must be of the lightest kind df food, such as barley-
water, arrow-root gruel, weak chicken tea, sago, rice, slippery elm,
Iceland moss, the bene plant, &c. When the patient becomes
convalescent, stronger food may be given, as boiled Qhicken and
wild game, custards, eggs, ancl almost any kind of wholesome^
diet.
To assist in restoring digestion, the spice bitters and other tonics
may be employed.
Favorable. Symptoms. —" The appearance of bile, and natural
feces in the stools, indicate a favorable change." When the pain*
and inclination to stool, " and tenderness of the abdomen abate, at
12
178
DIARRHOEA RELAX.
the same time that the skin is uniformly moist, we may regard the
case as approaching a state of convalescence; and more certainly
if the stools assume a more natural appearance."
SECTION VII.
DIARRHOEA—RELAX.
This complaint is a consequence of indigestion. It prevails most
(during hot weather, and presents in different cases great diversity
of character, being in some instances an obstinate and painful dis¬
ease, and in others a slight affection. Children are extremely liable
to this form of disorder throughout the hot summer months, and
also in the damp and changeable weather of autumn. Diarrhoea
is a milder form of disease than cholera morbus or cholera in¬
fantum.
General Causes. — Diarrhoea may be produced by any cause '
which weakens the power of digestion. The usual causes are,
continued spells of damp, murky weather; wearing damp clothes;
a sudden check to perspiration, when the system is exhausted by
fatigue; unwholesome articles of food, especially sour fruit; and
drinking too freely of cold liquids, as ice water or lemonade.
Symptoms.—At first there is usually loss of appetite, general de¬
bility, coldness of the feet, and bad taste in the mouth. The patient
experiences unpleasant sensations at the pit of the stomach: there
is generally a rumbling through the bowels, followed by copious
evacuations, consisting of thin offensive secretions, and imperfectly
digested food, and frequently attended with pain. The skin is
•either cool and clammy, or dry. When the disease comes on sud¬
denly, and is attended with vomiting, it is called cholera morbus.
The color of the stools, in many instances, is light, indicating a
want of bile: in other instances they are partly composed of
"vitiated bile.
Diarrhoea, Dysentery, and Cholera Morbus, may arise from the
■same cause, or combination of causes.
Distinguishing Signs between Diarrhoea and Dysentery. — In
diarrhoea, the bowels are in a relaxed condition, with copious
evacuations, consisting chiefly of imperfectly digested food, and
DIARRHCEA RELAX.
179.
generally free from blood or mucus. In dysentery the bowels are
costive, the natural faeces retained, and the stools consist princi¬
pally of blood and mucus, small in quantity, and the disease is
attended with severe griping, and a frequent inclination to go to
stool.
Treatment of Diarrhoea. — In slight cases, a few doses of compo¬
sition or bayberry tea, with the addition of No. 6, will, in general,
check the disorder, and correct the digestion. A variety of other
remedies may be used for this complaint, such as cholera syrup,
Thomson's No. 5 syrup, lavender brandy, burnt brandy and loaf
sugar, chalk mixture, lime-water, and purified charcoal. A mix¬
ture of salt and vinegar has been employed with remarkable suc¬
cess, in many families, in the treatment of bowel complaints that
prevail in hot weather.
When the symptoms are more distressing, or the case proves
obstinate, the most effective means will be a full course- of medi¬
cine, succeeded by the use of the hot medicine, and the patient
kept comfortably warm and quiet.
Warm stimulating poultices applied to the abdomen are parti¬
cularly serviceable in diarrhoea and in bowel complaints generally.
In the commencement, in many instances, but more especially
when the disorder has been checked, bitters should be used to re¬
store digestion.
F/avnel Bandage.—Persons subject to frequent attacks of diar¬
rhoea, will derive benefit from wearing a flannel bandage covering
the whole of the abdomen. This will keep the skin regularly warm,
and prevent a sudden check to perspiration from vicissitudes of
weather. This simple plan of bandaging the belly will often pre¬
vent the " summer complaint'''' in children, even during their second
summer, provided they be bathed daily, and a proper attention be
paid to their diet.
When the disease becomes protracted, and the symptoms dis¬
tressing, a prompt course of treatment should be pursued until the
disease be removed. The vapor baths and emetics should be re¬
peated as the nature of the case may require. In cases of children
1 have frequently witnessed more benefit derived from one vapor
bath and an emetic, than would have been accomplished probably
in two or three days under a mild course of treatment. When
medicine has to be forced upon children, it is always best to give
such as will be the most effectual to break up the disorder. Let
the No. 3, or bayberry powder, be made into a strong decoction,
and to a teacup half full of this tea, add an even teaspoonful of
composition powder. This given two or three times a day, will
prove an effectual remedy in most cases of simple diarrhoea. An¬
other very effectual preparation for checking diarrhoea, is half a
180
INFLAMMATION OF THE PERITONEUM.
teaspoonful of prepared chalk mixed with half a wineglassful of
No. 5, or cholera syrup. To be given several times daily.
Injections of bayberry tea, adding a portion of No. 6 and green
lobelia, or a teaspoonful of the third preparation of lobelia, will be
found especially beneficial to strengthen the bowels.
Diet. — Especial attention to diet is necessary in all cases of
bowel complaints. In general, milk porridge, well prepared, will
agree with the stomach, and in some cases will check the disorder,
by confining the diet to it alone, or with the addition of stale bread
cut thin and toasted thoroughly, or soda or water crackers. Fruit
of every description is apt to disagree with the bowels in diarrhoea,
unless it be fresh picked, and eaten with some solid food.
Boiled rice and milk, Bermuda arrow-root, elm gruel, sago,
tapioca, fresh eggs slightly cooked, essence of beef, boiled chicken,
crust coffee, and Irish moss, are such articles as are generally
adapted to cases of diarrhoea. Rice scorched, ground, and made
into coffee is a favorite remedy with some for this complaint.
Cases of chronic diarrhoea have been cured by a free use o*
capsicum at meals.
SECTION VIII.
PERITONITIS.
(Inflammation of the Peritoneum.)
Disease of the peritoneum (the membrane lining the cavity of
the abdomen, and which also forms the external coating of the
bowels) is not of very frequent occurrence, excepting, however,
that form of it connected with what is called child-bed fever, or
puerperal inflammation: when it does take place, however, it is in
many instances extremely difficult to cure, unless a vigorous and
persevering course of treatment be instituted in the first onset of
the disease-
Causes. — Long exposure of the body to cold after fatiguing
exercise, is the usual cause of peritonitis. It may arise, also, from
other causes, as taking too freely of ice water; mechanical inju¬
ries of the bowels ; the escape of faeces into the cavity of the belly
from wounds of the intestines, or by ulceration through the coats
of the bowels; wet and cold feet; and, in females, from bad man-
INFLAMMATION OF THE PERITONEUM.
181
agement during, or after confinement. In two fatal cases that
came under my notice, one was brought on by washing the body
in cold water, the patient remaining undressed, and completely
chilled more than' half an hour; the other case was produced by
standing some hours in cold water, up to the waist, in a well.
Inflammation of the peritoneum sometimes comes on after tap¬
ping for dropsy; the stimulus of distension being removed, the
vessels are left in a feeble condition, and unable to carry on the
circulation when inflammation ensues.
Symptoms. — The first symptoms are such as usually occur in
the commencement of other forms of disease, such as chilliness,
lassitude, pain in the limbs, and distress at the pit of the stomach.
The symptoms which characterize this disease, are extreme tender¬
ness to pressure over the surface of the abdomen, the patient
assuming a bent posture in order to relax the muscles of the belly;
he cannot sit up, nor usually lie on his side, but remains always
upon his back. The knees are drawn up towards the abdomen;
the breathing is short, and effected chiefly by means of the ribs,
in order to avoid the usual movement in the abdomen that accom¬
panies respiration. The febrile symptoms are usually of an aggra¬
vated character; the pulse is quick, and sometimes full in the
commencement of the fever, but soon becomes feeble; and the
countenance is expressive of anxiety from the commencement.
The pain is of an acute and lancinating character, generally con¬
fined at first to a small space, and spreading gradually, and some¬
times shifting suddenly from one spot on the belly to another.
In most instances there is at the commencement, and always in
the latter stage, if the disease terminate fatally, more or less vomit¬
ing. " Generally, in the course of from twenty-four to thirty-six
hours from the beginning of the attack, the abdomen becomes
swollen, tense, and elastic from flatulent distension of the intestines,
and is extremely tender. The pulse is frequently over 140 per
minute, and in all cases quicker than natural. The secretion of
urine is invariably more or less diminished, and in some instances
almost wholly suppressed. When the peritoneal coat of the bladder
is the seat of inflammation, the evacuation of urine will almost
uniformly be suspended, and much pain felt in the pelvis. The
peritoneal covering of the inferior surface of the diaphragm is
occasionally the principal or sole part of this membrane that is
inflamed, and in this case almost constant hiccough attends."
In general, peritoneal inflammation terminates by the sixth or
seventh day, either favorably or fatally. In some cases its course
is much more rapid, the patient sinking by the second or third day
from the commencement. Occasionally, however, the disease is
182
INFLAMMATION OF THE PERITONEUM.
prolonged to the thirteenth or fourteenth day ; and sometimes be*
tvomes a chronic disease.
Alivays Dangerous. — This disease is extremely liable to termi¬
nate in gangrene. " When this occurs, the abdominal pain suddenly
subsides; the pulse becomes very small, frequent, and often inter¬
mitting; great muscular prostration ensues; the extremities be¬
come cold and clammy; and the countenance pale, hollow and
contracted;" there is a sort of gulping up of liquids swallowed,
and occasionally there is more or less delirium, but more com¬
monly the mind is clear to the last.
When peritoneal inflammation ensues after confinement (con¬
stituting puerperal inflammation) the lochial discharge ceases, and
the secretion of milk is suspended, or nearly so. Under such cir¬
cumstances, the disease is usually rapid in its course.
Treatment. — There is probably no form of disease requiring
more vigorous treatment than peritonitis. The first and most im¬
portant remedy is a vapor bath, which should be continued for
hours together; or blankets wrung out of hot water be kept con¬
stantly applied to the abdomen; the patient being on a cot or
mattress, if too weak to sit up; and at the same time frequent and
full doses of the third preparation of lobelia should be given, toge¬
ther with injections of composition tea, adding to each injection a
teaspoonful of lobelia powder. The injections to be repeated fre¬
quently, and retained a few minutes if practicable; and as often
as every hour or two, an additional injection, consisting of from a
teaspoonful to a tablespoonful of the liquid of the third preparation
of lobelia in bayberry tea. The patient must not be subjected to
the fatigue of getting up to evacuate the bowels. In place of the
vapor bath, blankets wrung out of hot water may be applied to
the abdomen, or a large poultice composed of elm powder, green
lobelia and ginger, applied all over the belly, as hot as can be
borne, to be kept warm by the frequent application of cloths,
wrung out of hot water. This will also prevent the poultice getting
dry.
It is important to relax the system in the early stage of the dis¬
ease, by giving, besides the third preparation of lobelia, frequent
doses of an infusion of the brown lobelia. The more the svstem
becomes relaxed by the lobelia in the early period of the disease,
the greater will be the chance for the inflammation to establish a
favorable crisis.
When the patient sinks into a state of extreme exhaustion, as is
frequently the case even when a favorable crisis has been effected,
diffusive stimulants should be employed, such as wine whev, car¬
bonate of ammonia, esserice of beef, brandy and water, and cap¬
sicum tea.
INFLAMMATION OP THE PERITONEUM.
183
' There is a period in some cases of abdominal inflammation
when the disease is nearly subdued, yet a tendency to gangrene
exists from deficiency of vital power. At such a time the pain
will vanish, the pulse become weak, the vital powers sink, and a
coldness overspread the body. These symptoms are too often in¬
dicative of mortification; but every experienced practitioner must
have occasionally witnessed cases of recovery even from this
alarming state." Therefore the free use of stimulants under these
circumstances may have the effect to turn the scale in favor of
recovery, and even if mortification should have taken place, stimu¬
lants can do no injury.
Especial care must be observed to avoid giving the patient
during the active stage of the disease, such articles as are prone
to fermentation, especially sugar, and gruels. Even the medicines
should be given without sweetening. It is said that sap-sago
cheese, grated and mixed with warm water, is the best article, of
food that can be taken in cases of peritoneal inflammation, as it is
the least disposed to generate gas in the stomach and bowels.
Next to this, essence of beef and egg soup should be preferred;
but in the early period the patient will be as well, if not better,
without food of any kind.
Many women have died within the last few years of peritoneal
inflammation after confinement. One physician in Southwark lost
fourteen women in the course of a few months. No case of death
from this complaint has happened under the Thomsonian treatment
in Philadelphia. Dr. Samuel M'Clellan, Professor of Midwifery
in the Pennsylvania College, in a lecture to his class, in the winter
of 1843, stated, that the treatment he had found most successful,
was to apply blankets wrung out of hot water to the abdomen, use
emollient injections very frequently, and give simple rhubarb tea.
This course of treatment, though much more rational and safe
than that generally pursued by the profession, would doubtless
prove far less effectual than thorough Thomsonian treatment, such
as the employment of the vapor bath, prompt emetics and injec¬
tions, containing lobelia. Fomentations to the abdomen or hot
poultices should be employed in all cases.
184
CONSTIPATION.
SECTION IX.
CONSTIPATION—COSTIVENESS.
Costiveness, in general, is a consequence of diminished peristal¬
tic action of the bowels, from diminished nervous power. The
habitual use of purgative medicines destroys the natural tone of
the bowels, and thus proves one of the most common causes of
constipation. A patient becomes uncomfortable in consequence of
the sluggish state of the bowels, and a dose of physic is taken. In
a few days, however, the same bad feelings return with loss of ap¬
petite, furred tongue, and bad taste in the mouth; there is heavi¬
ness and languor, and oppression at the stomach. The patient
supposes he is bilious, requiring another dose of physic to purge
oft' the accumulation of bile, and in this way continues to use some
kind of cathartic at frequent intervals, harassing the stomach and
destroying the natural action of the bowels. Costiveness is some¬
times constitutional, and in general it arises from causes which
depress the nervous energy, such as sedentary habits, foul air,
intemperance, and all kinds of deleterious medicines, whether min¬
eral or vegetable. The practice of giving anodynes to infants
weakens the tone of their bowels, and in numerous instances the
foundation of habitual costiveness is thus laid. It is very common
in the old practice for a physician to recommend laudanum, or
some other preparation of opium, for children and infants when
sick, and on the following day prescribe a dose of oil to move the
bowels, which had become torpid in consequence of the anodyne;
the physic disturbs the stomach and impairs digestion; and the
little patient consequently becomes fretful;. another dose of anodyne
is administered, which benumbs the sensibility of the nervous sys¬
tem, and the child sleeps, but the medicine instead of removing the
disease, rather increases the difficulty; costiveness continues, and
another cathartic is prescribed, and thus one medicine is given to
counteract the bad effects of the other. Not only is such a course
generally pursued in the treatment of infants and children, but a
similar one is resorted to by many physicians in the majority of
cases of sickness in adults that are placed under their care. It is
very rare to find a person affected with obstinate constipation
of the bowels, who has never been in the practice of taking
cathartics.
There are persons constitutionally costive, whose bowels are
not moved oftener than once a week, and yet the general health
remains good. Such instances, however, are very rare, for most
persons feel more or less uncomfortable without an evacuation as
•often as once in twenty-four or forty-eight hours.
CONSTIPATION.
185
Although purgative medicines may relieve distress of the head,
pain, and other uncomfortable feelings arising from constipa¬
tion, still, they will impair the digestive and nutritive functions,
leaving the bowels in a worse condition than before the cathar¬
tic was taken. To provoke the bowels to action by the use
of cathartics is one thing; to promote the natural action of the
bowels is quite a different matter. I will not presume to say that
there are no cases of constipation in which small portions of rhu¬
barb or bitter root may be serviceable. The true nerves of sensi¬
bility, by which the bowels are stimulated to expel their contents,
are seated in the lower portion of the rectum, and nowhere else;
and no matter how irritating a substance may be, it will not move
the bowels until some portion of it reaches these nerves of true
sensibility, situated at the lower extremity of the intestine.
Means to remove Costiveness.—There are a great diversity of
remedies and means to restore the action of the bowels.
A proper Diet.—Certain articles of food will in a great many
instances keep the bowels regular, such as stale bread, or gruel
made of ground wheat unbolted, Indian bread, ripe fruit, rye mush,
oat-meal gruel, and calves'-foot jelly. No certain plan of diet can
be proposed that will suit every one. Bread mado, of unbolted
wheat flour will probably agree with almost every one, and its
efficiency has been so well attested as not to admit a doubt of its
utility. I have known obstinate cases of constipation overcome by
the free use of a gruel made of the unbolted flour, together with
the use of cayenne pepper, and the entire absence of every kind of
cathartic. In the use of the unbolted bread or gruel, other kinds
of food need not be excluded. Animal food is necessary to the
health of some, and should be used when it agrees with the sto¬
mach. Beef, mutton, and all kinds of wild game are as readily
di nested as vegetables.
O O
Charcoal.—Finely pulverized charcoal, taken in large teaspoon-
ful doses, repeated three or four times a day, is a valuable remedy
for costiveness, especially when constipation is accompanied by a
sour stomach or heartburn. Costiveness arising from pregnancy,
may, in most instances, be removed by the free use of charcoal.
In the latter stage of pregnancy, however, it is sometimes neces¬
sary to resort to the use of stimulating enemas, in order to evacu¬
ate the bowels. The charcoal should be first moistened and rub¬
bed into a paste, and it will then mix readily with liquids. I gene¬
rally direct it to be taken in composition or spice bitters tea. It
may be ta'ken also in simple warm water, or in boiled milk. The
dose is from a teaspoonful to a tablespoonful, repeated three or
four limes a day before meals.
186
CONSTIPATION.
White Mustard Seed is a favorite remedy used by many to stim¬
ulate the bowels, and overcome costiveness. The usual dose of
the mustard seed is a tablespoonful once or twice a day, taken in
warm water or molasses.
Capsicum.—This is one of the purest and best of stimulants, and
is especially beneficial in most cases of torpid bowels. Taken
freely at meals, it will not only assist the action of the bowels, but
will be sufficient, if used freely, to cure many cases of dyspep¬
sia. There are many kinds of food that will sit well on the sto¬
mach, if highly seasoned with cayenne, which, without it, would
occasion oppression, and distress the stomach. Those who do not
relish food highly seasoned with pepper, may take the cayenne
immediately after eating, in a little cold water, or, as some prefer,
swallow the whole pods of the bird-pepper. These pods are not
thicker than a small goose-quill, and scarcely ever an inch in
length, so that half a dozen may be swallowed at a time, and no
burning produced in the mouth. Ten or fifteen of these pods
taken daily will be sufficient, in general, to keep the bowels regu¬
lar. The use of cayenne in cases where there is a superabundance
of acid in the stomach and bowels, will sometimes occasion pain
in the bowels, and other unpleasant sensations; and occasionally
active purging comes on; the cayenne increasing the sensibility of
the bowels and the acids operating as a cathartic. As soon as
the acids are expelled, the patient may increase the quantity o.f pep¬
per taken to twice or three times the quantity before taken, with¬
out any cathartic effect being produced by it.
Parched Corn eaten freely, is a good regulator of the bowels,
and relieves heartburn. The corn should be well parched, and then
it may be taken freely in any case. The best kind is the little
"chicken corn," or, as some call it, "pop corn."
Astringents.—When the tongue is thickly furred, and not dry or
parched, the astringents recommended by Thomson will be useful
in cleansing the cankered bowels and increasing their tone. The
best astringent is the bayberry, or a compound of bayberry and
sumac. The No. 3 pills may be used in place of a decoction of the
above powder. Injections assist very much in cleansing the bow¬
els of morbid secretions, and also have a tendency to increase their
tone.
Bitters.—Vegetable bitters are particularly indicated when the
system is relaxed, as in recovery from sickness when the bowels
remain torpid. A teaspoonful of bayberry powder taken two or
three times a day will be sufficient to keep the bowels regular, in
those cases where tonics are indicated. The golden seal, balmony
DYSPEPSIA.
187
or black aspen poplar may be employed for the same purpose. In
continuing the use of tonics it is proper to change one for another,
or to compound them differently every few days.
Injections should be used occasionally, until, by other means, the
natural action of the bowels be restored. When constipation is
attended with piles, an injection of a strong decoction of the witch
hazle, at bed-time, retained in the bowels until morning, will in
general procure a passage from the bowels, and also assist in cur¬
ing the piles.
Cleanliness, exercise in the open air, the warm bath, the shower
bath, the daily use of the flesh-brush or salted towel over the sur¬
face, and whatever else will invigorate the nervous system, will
have a salutary effect upon digestion, and assist the peristaltic
action of the bowels.
The habit of soliciting a stool at a certain hour daily, more
especially in the evening, though it may fail at first, if persevered
in, will generally prove successful.
Three or four of the compound lobelia pills, taken at bed-time,
have proved successful, in many cases, in regulating the bowels
and in promoting the secretion of bile.
SECTION X.
DYSPEPSIA—INDIGESTION.
Digestion is accomplished by a series of actions extremely com
plicated, liable to derangement from various causes. Hence dys
pepsia is a common complaint, and prevails in all classes of so
ciety.
Causes.—Dyspepsia in many instances is a consequent of ori¬
ginal feebleness of constitution. Apart from this, the following are
among the common causes of dyspepsia, or bad digestion:
1. Exposure to Cold and Dampness—especially damp feet.—
This is a common cause of dyspepsia during damp seasons of the
year. It is a singular fact, that exposing the feet to dampness, is
far more liable to occasion derangement in the function of diges¬
tion, and cause disease, that getting the feet thoroughly wet, and
even standing in water.
2. Tobacco.—The inordinate use of this article is a fruitful source
188
DYSPEPSIA.
of dyspepsia. It causes imbecility of mind, and in some instances,
melancholy.
3. Purgative Medicines. — The long-continued use of cathartics
impairs the functions of the stomach and bowels, and in frequent
instances, where there is but slight derangement in the stomach at
first, " the drugs are poured down," and the case becomes one of
confirmed dyspepsia.
4. Anodynes. — All the various preparations of opium, such as
laudanum, Godfrey's cordial, &c., enervate the stomach, and
weaken the power of digestion. Hence the seeds of dyspepsia are
often sown in childhood by the prevailing practice of giving ano¬
dynes during infancy.
5. Sedentary Habits.—Persons engaged in sedentary pursuits—
seamstresses, shopkeepers, shoemakers and tailors, are liable to
dyspepsia, especially when confined to small and ill-ventilated
apartments.
6. Unwholesome Food and Over-eating.—Many who by a proper
diet might enjoy good health, are tormented with indigestion, in
consequence of the use of food difficult to digest, such as hot bread,
fresh pork, hot cakes, sausages, pies, &c. Hearty suppers, espe¬
cially of such food as sausages, hot cakes, and strong coffee, cause
restless and disturbed sleep, frightful dreams, and nightmare. Over¬
eating is probably a more common cause of dyspepsia than the
qdality of food.
7. Blood-letting. — Many cases of dyspepsia may be traced to
the profuse depletion frequently practised by physicians in the
various forms of acute disease. The system becoming exhausted
from loss of blood, the organs are left in a languid condition, inca¬
pable of performing their functions properly, and in many instances
confirmed dyspepsia is occasioned.
8. Poisonous Medicine. — Professor Chapman asserts that the
majority of cases of chronic disease of the liver so prevalent in
the Southern States, may very justly be attributed to the inordinate
use of mercury, it being a practice among the physicians to admi¬
nister it in enormous doses. Digestion never can be properlv per¬
formed whilst the liver is diseased, and therefore, all such "cases
are more or less dyspeptic. Calomel is often converted into corro¬
sive sublimate, by combining with certain acids that are very liable
to be formed in the stomach in disease. A late writer in the medi¬
cal profession asserts that calomel is always inert until portions of
it are converted into corrosive sublimate, and that the system must
DYSPEPSIA.
189
become poisoned with corrosive sublimate in order to effect sali¬
vation. Arsenic is often employed as a medicine, both by the old
school and the homeopathic physicians. It may change the symp¬
toms of disease, but it cannot be employed, even in homeopathic
doses, without danger of laying the foundation of a dyspepsia, much
more difficult to cure than the complaints for which it may be pre¬
scribed. The same may be said with regard to many other articles
employed as medicine, particularly veratria, strichnine, and prussic
acid, frequently used in the homeopathic practice.
9. Intemperance is a fruitful cause of dyspepsia. The practice
of taking a morning dram, which prevails in some districts of
country, is usually followed sooner or later by indigestion. It is
much more injurious to the stomach to drink any kind of liquor,
when the stomach is empty, than soon after meals.
10. Abstinence may be practised too rigidly to be compatible
with health, and it may even produce dyspepsia. The exclusive
use of a vegetable diet, together with cold water at breakfast and
supper, in the place of something warm, will enervate the stomach,
in many instances, notwithstanding it may agree with some.
There are cases in which an exclusively vegetable diet suits the
stomach; but with the great majority of mankind, animal food,
such as beef, mutton, or wild game, will be found more easy of
digestion than a vegetable diet. Experience, however, proves that
a mixed diet, partly animal and partly vegetable, is more easy ol
digestion than an exclusively animal or an exclusively vegetable diet.
11. Bad Teeth. — Irritation of the gums arising from teeth that
are either decayed or affected with tartar, is a frequent cause of
dyspepsia.
A lady from Natchez consulted Professor Chapman for dyspepsia
of long standing, and the doctor perceiving the bad condition of
her teeth, suspected this to be the cause of the dyspepsia; the de¬
cayed stumps were removed, the mouth put in good condition, and
the dyspepsia was soon cured. Subsequently this lady had a new
set of teeth put in, but being badly done, the dyspepsia returned
with great violence. The teeth were removed, and by being pro¬
perly adjusted, so as not to irritate the gums, she was soon restored
to perfect health.
12. Piles often produce dyspepsia, and in many instances it may
be cured by their removal.
13. Mental Depression.—From the close sympathy existing be¬
tween the brain and stomach, moral impressions have a controlling
influence over digestion. If a person, soon after eating a hearty
190
DYSPEPSIA.
meal, hear bad news, digestion will at once be weakened, if not
suspended. Close application to study soon after meals, by con¬
centrating the nervous energies in the brain, weakens the power
of the stomach to perform digestion.
In fine, any cause that weakens the nervous energy impairs the
digestive functions; hence venereal excesses are a common cause
of dyspepsia.
Symptoms of Dyspepsia. — There are scarcely two cases of dys¬
pepsia with precisely the same group of symptoms. They vary
from simple oppression caused by difficult digestion, to the most
tormenting feelings, both physical and mental. The"most common
symptoms are cold hands and feet; oppression, tenderness, and
distress at the pit of the stomach; heart-burn; frequent belching;
sour eructations; costiveness; drowsiness after meals; lowness of
spirits; restlessness at night; disturbed sleep; frightful dreams;
extreme sensibility to cold; and not unfrequently a feverish feeling
after meals. Pain in the head; pain in the left breast and sides,
and palpitation of the heart, are symptoms frequently attending
dyspepsia.
Dyspeptics are generally affected with what the world calls
nervousness; the spirits at times depressed, and the imagination
dwelling upon ideal evils; the temper sour and easily disturbed.
In some cases of dyspepsia the stomach is extremely sensitive,
the least deviation from certain articles of diet causing severe pain
and tenderness; and in others the sense of feeling is so low that
the patient can scarcely be persuaded to believe that his digestior
is bad, because he " don't feel bad at his stomach."
In the more aggravated form oj dyspepsia, the mind is liable tc
become much depressed, approaching in some instances to ex¬
treme melancholy, with harassing belchings; water-brash; stools
clay-colored, indicating the absence of bile; the skin dry and
husky, yet sometimes cool and clammy; wasting of the flesh, and
sometimes ulceration of the tongue and mouth.
Treatment of Dyspepsia. — Dr. Thomson's course of medicine,
administered at proper intervals, as the symptoms indicate, toge¬
ther with proper intermediate remedies, will effect a cure in a
great majority of cases. If the continuance of the disease depend
upon bad habits, a cure cannot reasonably be looked for whilst
they are continued.
If close confinement in unhealthy apartments be the cause of
dyspepsia, exercise and fresh air will be as essential as medicine.
When dyspepsia arises from a bad condition of the teeth, they
should be attended to by a dentist who is properly acquainted
with his profession.
In most cases of dyspepsia it is necessary to keep the feet not
DYSPEPSIA. 191
oniy protected from wet, but there should be cork or gum-elastic
in the soles of the shoes, except in the summer season. It is oi
little use for the dyspeptic to take medicine if the feet are not pro
periy protected from dampness.
Emetics. — An emetic of lobelia, prepared in the usual form, or
the compound lobelia pills taken in quantities of from one to two
or three every half hour until free vomiting is effected, will some-
imes relieve the stomach sufficiently without the necessity of a
full course of medicine.
To promote a healthy action of the skin, an occasional vapor
or warm bath, and the daily use of the flesh-brush or salted towel,
will be the most effectual means.
Capsicum. — The free use of cayenne pepper at meals, will be
sufficient to cure dyspepsia in many instances. It is useful to pre¬
vent heart-burn and water-brash, and has a tendency to regulate
the bowels.
The Compound Lobelia Pills probably constitute one of the best
reparations ever employed for the cure of ordinary dyspepsia.
From two to four pills should be taken every night at bed-time;
and if the patient be confined to the house, the pills may be taken
at intervals of an hour or two, in order to keep the system mode¬
rately under their influence. Taking them in quantities sufficient
to cause vomiting every few days will answer the place of courses
of medicine.
Composition Powder. — Dyspepsia of a mild character may be
cured by taking a dose of composition two or three times a day.
VV hen the patient is exposed to the weather it is best not to pre¬
pare the composition in boiling water, but first moisten the pow¬
der, and then add half a teacupful of lukewarm water, stir it well,
and swallow it before it settles.
The Spice Bitters may be taken in the same way and for the
sa ne purpose as composition.
The Conserve of Hollyhock is a mild stimulant and tonic, and
useful in cases of feeble digestion. It is a convenient medicine foi
persons travelling.
Charcoal—Purified charcoal being an absorbent and anti-sep-
tic, and operating as a mechanical stimulant to the bowels, may
be used with advantage in cases of sour stomach, attended with
costi veness.
192
DYSPEPSIA.
Wheat Bran.—A tablespoonful of wheat bran taken every morn
ing fasting, is a good remedy for costiveness.
Parched Corn eaten freely will overcome costiveness in ordina¬
ry cases.
White Mustard Seed has been found successful in curing cases
of dyspepsia. The dose is a tablespoonful, to be repeated two or
three times daily.
Tonics*—In dyspepsia accompanied with a pale tongue, want of
appetite, relaxed skin, and general debility, the stronger tonics
must be used, such as Dr. Thomson's No. 4 bitters, quassia,
wormwood, gentian, &c., either prepared in decoction, tincture,
or extract. Extract of gentian will, in general supply the place of
all other tofiics, and when formed into pills is so easily taken, that
most patients will prefer it to taking decoctions.
When there are symptoms of dyspepsia with extreme insensibil¬
ity of the stomach, benefit may be derived from mechanical means,
as riding on a rough trotting horse, or in a rough carriage after
dinner, or punching or kneading the stomach as discovered and
introduced by a Mr. Halstead of New York, who was cured of
dyspepsia, attended by extreme insensibility of the stomach, by
making a false step, by which his stomach received a severe jar.
Alkalies.—When there is offensive gas ejected from the sto¬
mach, the use of lime-water will be beneficial.
In cases of simple acidity of the stomach, the super-carbonate
of soda, or sal-ceratus, will neutralize the acid. Prepared chalk
may be used for the same purpose, and in some instances will have
a better effect than soda or sal-aeratus.
The following was a favourite remedy with the late Dr. Physick
of this city.
Take a quart of hickory ashes, and a teacupful of common
soot, pour on them a gallon of boiling water. The dose a
wineglassful after meals.
A decoction of wormwood and hickory ashes fulfils the purpose
both of a tonic and anti-acid.
In some cases of dyspepsia, acids will be found to be more bene¬
ficial than alkalies, even when there already exists a superabund¬
ance of acid in the stomach. A mixture of vinegar, salt and pep¬
per, will be of benefit in many cases. From ten to thirty drops of
the elixir of vitriol, in a wineglassful of water, or of bitter tea,
three or four times a day, will be grateful to the stomach, and
assist digestion.
DYSPEPSIA.
193
Pain in the stomach.—Dyspepsia is very frequently attended
with pain in the stomach, though, by no means, a necessary con¬
sequence of indigestion, for many dyspeptics experience no pain.
Some experience pain, only when the stomach is empty, and even
when there is no oppression from gas in the stomach; and they
are promptly relieved by taking food. This kind of pain may be
also relieved, by taking alkalies, especially lime-water and milk,
or, absorbents, as wheat bran, charcoal, and prepared chalk. When
the case proves obstinate, a course of medicine administered once
a week and the patient taking three or four times a day a tea-
spoonful of charcoal in spice bitters tea, and from 3 to 5 compound
lobelia pills every night at bed-time, will effect a cure unless the
disordered condition of the stomach depend upon organic disease
of the stomach, or of some other important organ.
In many cases of dyspepsia pain in the stomach occurs imme¬
diately after eating, and continues during the whole process of
digestion, or, until vomiting ensues, which gives instant relief. In
other instances the pain does not come on until from two to four
hours after meals, and continues several hours. Some will be
attacked with violent spells of colic, at uncertain periods, accom¬
panied with shooting pains through the back and between the;
shoulders.
Pain in the stomach, that occurs during the process of digestion,,
may often be relieved, by taking stimulants in hot water, such as.
Thomson's No. 6 composition and cayenne. Infusions or decoc¬
tions of bitter tonics, the volatile tincture of guiacum, spirits of
turpentine, camphor, and spirits of lavender may be used for the
purpose of allaying pain in the stomach. When these means prove
ineffectual, or, when the attack is violent, an emetic of lobelia, or
a full course of medicine should be given.
Many persons of full habit and who exhibit an appearance of
health, are subject to a distressing, burning pain in the stomach
after meals, which may be at once relieved by taking a teaspoon-
ful of the super-carbonate of soda dissolved in a tumbler of water
Pain in the lower bowels may be relieved by injections. Distress
and pain in the stomach may often be relieved by injections con¬
taining lobelia. Warm fomentations, warm stimulating poultices,
or mustard plasters applied over the seat of pain, are beneficial in
all cases.
Gouty people are sometimes attacked with spasm of the sto¬
mach, or as it is popularly termed gout in the stomach, for which
a course of medicine, and a free use of stimulants, and the volatile
tincture of guiacum are the most appropriate remedies. For in¬
stance, after administering a course of medicine, give the patient
half a teaspoonfull of the tincture of guiacum in a tea-cup half full!
of cayenne or composition tea; repeating it as often as may be;
deemed requisite.
13
DYSPEPSIA.
There is another modification of uneasiness and disorder of the
stomach, of which the distinguishing characteristic is the vomit¬
ing, or, rather eructation of a thin watery liquid, sometimes sour¬
ish, but usually insipid and tasteless, and often described by the
patient-as being cold. This is termed pyrosis or water-brash. The
first symptom of it is a pain in the stomach, with a sense ol con¬
striction, as if the stomach was drawn towards the back. The
pain is increased by raising the body into the erect posture, and
therefore the body is bended forward. The pain is often very
severe; and after continuing some time, it brings on an eructation
•of a thin watery fluid, in considerable quantity. It usually comes
on in the morning and forenoon when the stomach is empty. Ob¬
stinate costiveness usually accompanies this form of dyspepsia.
Water-brash, unless connected with organic disease of the sto¬
mach, may generally be cured by a lobelia emetic, given as often
;as once a week; together with using daily such means as will re¬
gulate the bowels and improve the condition of the stomach. The
:remedies recommended in the treatment of costiveness in a pre¬
vious section, will be applicable here. To improve the condition
•of the stomach in this form of dyspepsia, astringents are required;
^either a strong decoction of bayberry or sumac, or the No. 3 pills,
described in the latter part of this work, should be taken freely.
This distressing complaint, however, is often difficult of cure as it
is not unfrequently associated with inveterate dyspepsia, and some¬
times arises from organic disease of the stomach.
*
Many cases of dyspepsia of long standing have been cured by a
persevering course of Thomsonian treatment, especially by full
courses of medicine, repeated at proper intervals, a free use of
cayenne at or immediately after meals, and once or twice daily a
teacup half full of bayberry tea, made very strong of the astrin¬
gent principles, adding a portion of cayenne, or composition
powder. By pursuing this treatment, a skinny substance wiF
sooner or later be passed from the bowels, and also thrown up b\
vomiting, and after the mucous membrane becomes clear of the
false membrane which coats it to a greater or less extent in all
cases of dyspepsia, the digestion will, in most instances, be restored
or greatly improved under the use of tonics.
Diet.—No system of diet can be proposed suited to all cases of
dyspepsia. Boiled milk and toast, and cream toast agree with
most dyspeptics. Milk, when taken cold and in large quantities,
-sometimes forms an indigestible mass, of a cheese-like substance,
.occasioning great oppression at the stomach.
As a substitute for milk when it disagrees with the patient ca¬
cao or chocolate, black tea, or, what is better, the anti-dyspeptic
;cacao, prepared by A. Comfort, of Philadelphia, may be used. In
DYSPEPSIA.
195
some cases of dyspepsia, coffee, well prepared, may be taken, not
only with impunity, but with advantage. Much of the evil arising
from the use of coffee, is owing to the bad quality of the article,
and to the careless manner in which it is frequently roasted and
prepared. There are cases of dyspepsia, however, where even
the best coffee is injurious.
Animal Food. — All kinds of wild game, when in season; fresh
fish, eggs, chicken, turkey, fresh beef and mutton, are the most di¬
gestible. Salt fat pork agrees with many. Fresh pork and veal
disagree with the dyspeptic in almost every instance, yet, some
cases have been cured by eating broiled fresh pork; such cases,
however, are very rare. In some cases, animal food of every de-
scription will disagree with the stomach. All kinds of soups are
objectionable, from their liability to sour in the stomach, unless
combined with solids, though, in small quantities, they may not
disagree. There is not the same objection to essence of beef, as
to soups.
Bread made of unbolted wheat flour has become a favorite
article of diet for dyspeptics, and answers a good purpose in
preventing costiveness. Toasted bread agrees well with almost
every one. It should be cut in thin slices and toasted through,
so as not to have it doughy in the middle. Bread should not
be eaten until at least twelve hours old. Hot cakes should be
avoided. Cakes, however, made of Indian mush which has been
previously well boiled, will agree with many. Regularity in meals
is important. No food should be taken between meals. If a per¬
son of feeble digestion eat a piece of gingerbread or pie> an hour
before dinner, the appetite will be weakened, and then if the patient
eat the usual meal, the food will oppress the stomach.
One great and indispensable principle in the treatment of dyspep¬
sia, is that of restricting the quantity of food taken at any one
time. Over-distension greatly retards the process of digestion.
The stomach should also have time to digest a meal, and even
allowed to rest an hour before more food is taken. Dr. Aberne-
thy, who cured more cases of dyspepsia, probably, than any other
medical man of the old school practice, owed his success, it is be¬
lieved, mainly to restricting the amount of food taken at a time,
within the limits of the capacities or powers of the stomach; and
enjoining upon his patients to allow six hours interval between meals.
" Animal food is easier of digestion in the human stomach than
vegetable food. It is nearer in its composition to the textures into
which it is to be incorporated by assimilation And it is
notorious that vegetable food, when the stomach is weak, is fol¬
lowed by more flatulence, that is, is digested with more tardiness
and difficulty, than animal food. Nevertheless, a mixture of the
two. oi well-boiled or roasted flesh or fowl, with a moderate por-
196 WORMS IN THE STOMACH AND BOWELS.
tion of thoroughly cooked vegetables, is better suited, in my opin¬
ion, for a feebie stomach, than a rigid adhesion to either kind of
aliment singly."
Change of Air. — A change of residence from the city to the
country, or from the country to the city, or removing to a different
neighbourhood, will, in many instances, restore digestion, when
other means have failed. I have observed the most remarkable
change effected in dyspeptics by a few weeks' residence in a pine
country, or on the sea-board. The benefit which dyspeptics re¬
ceive from visiting mineral springs, arises, probably, in the majo¬
rity of cases, from the change of air, cheerful society, absence from
care, and probably from the interruption of bad habits. A tour,
in fine weather, and through a pleasant country; a voyage to sea,
or a few weeks residence in a mountainous country, will often do
more towards curing the desponding dyspeptic than any course of
medical treatment that can be devised.
Cleanliness in person and in dress, promotes digestion, and ex¬
hilarates the mind. An occasional vapor bath, followed by a
shower bath, is one of the best means for promoting a healthy ac¬
tion in the skin. When the patient is languid and nervous, a
shower bath every morning will prove a powerful tonic to the ner¬
vous system, and in some instances will cure dyspepsia. The daily
use of the flesh-brush or salted towel will also invigorate the sys¬
tem, cheer the spirits, and promote digestion.
SECTION XI.
WORMS IN THE STOMACH AND BOWELS.
In treating of worms, Dr. Thomson makes the following obser¬
vations. " A great deal is said about worms causing sickness, and
there is scarcely a disease that children are afflicted with, which
is not attributed to worms. The doctors talk about worm com¬
plaints, worm fevers, worm colics, &c., and give medicine to de¬
stroy the worms: by so doing they frequently destroy their pa¬
tients."
The views of Dr. Thomson concerning worms, to wit: that
they are produced by a disordered state of the stomach and bowels,
and feed upon foul secretions, are doubtless correct.
Different Species of Worms.—There are
WORMS IN THE STOMACH AND BOWELS.
197
1st. The Long Thread Worm, which varies from an inch and
a half, to two inches in length. About -two-thirds of its length is
almost as thin as a horse-hair, the remaining and posterior part
being considerably thicker, terminating in a rounded or blunt ex¬
tremity.
2d. The Maiv or Thread Worm. — " This is a very small white
worm—the male being not above two lines in length, with rounded
or blunt extremity anteriorly, tapering to a point posteriorly. The
female is considerably larger, being from four to five lines in length,
terminating in an extremely fine extremity posteriorly, resembling
the point of the finest needle. These worms are found only in the
large intestines, and principally in the lower part of the rectum,
where they are often collected in almost countless numbers," oc¬
casioning a most annoying sensation of itching and tickling in the
rectum. " Many individuals are infested with them in childhood,
but get rid of them as they advance in years. Some, however, are
troubled with them during the whole of a long life, though they
are represented as less annoying after middle age than before.
They usually appear periodically, both in children and adults, after
intervals of from three to six weeks. During the interval they are
neither felt nor seen in the discharges. Their periodical return is
announced by a sense of itching and burning at the extremity of
the rectum, felt principally in the evening, sometimes producing
tumefaction and eruption of the neighbouring skin. This irritation
continues to recur every night for perhaps a week or more, and
then ceases. During this time the worms are discharged alive and
active in every alvine evacuation." The nidus of these animals,
and perhaps the food also, appears to be the mucus which lines
the alimentary canal. Buried in this substance, they resist the
effects of the most violent cathartics and vermifuges, oil of turpen¬
tine and croton not excepted."
3d. The Large Round Worm. — This is a species of worm
varying in length from three to ten or twelve inches, and about
the size of a common goose-quill. These worms inhabit the
small intestines, and occasionally ascend into the stomach. " The
symptoms indicating their presence are equivocal, but are com¬
monly considered to be, starting in the sleep, itching of the nose,
irregular, or excessive appetite, emaciation, &c. Nevertheless,
these worms are often suspected of being present where they do
not exist."
4th. The Tape Worm. — The tape worm sometimes acquires a
great length,—thirty to forty feet, and even longer. " It is about
half an inch in breadth, flat, white, and composed of a series of
198
WORMS IN THE STOMACH AND BOWELS.
joints, resembling in shape, a gourd-seed. It inhabits the upper
portion of the bowels and stomach.
The symptoms usually accompanying the presence of worms in
the stomach or bowels are — paleness of the countenance, with
occasional flushes on the cheeks; picking the nose; variable appe¬
tite, sometimes voracious — at other times entirely gone; copious
secretion of saliva; and a furred tongue. The belly is swollen,
and there are transient pains through the bowels, and starting in
the sleep. These symptoms, however, may all exist, independently
of the presence of worms, and even when there are worms, most
of the attending symptoms may arise from a disordered condition
of the stomach and bowels.
" The reason," says Dr. Thomson, " why children are more
troubled with what are called worm complaints, is because they
are more subject to be disordered in their stomach and bowels
than grown persons. When children are sick, and their breath
smells bad, it is said they have worms, and every thing is laid to
them; but this is owing to disease caused by canker, for there is
nothing in the nature of worms- that can affect the breath. In
cases of this kind, the only thing necessary is to cleanse the sto¬
mach by getting rid of the cold phlegm, and restoring the digestive
powers, when there will be no difficulty with the worms."
The practice of giving poison to kill worms in the stomach and
bowels, as Dr. Thomson says, " is like the story related by Dr.
Franklin, of a man who was troubled by a weasel in his barn,
and to get rid of the weasel he set fire to the barn and burnt it
up." " I had the following relation," says Dr. Thomson, " from
the doctor who attended the cases; — three children had what he
called a worm fever; and he undertook to kill the worms. One
of the children died, and the doctor requested liberty to open it, to
find out what would destroy worms, in order to know how to cure
the others; but the parents would not consent. A second died, and
the parents consented to have it opened; but after searching the
stomach and bowels, to their surprise, no worms could be found.
The third soon after died. The fact was, their death was caused
by canker on the stomach and bowels, and the medicine given in¬
creased the difficulty by drawing the determining powers inward,
which aided the cold to promote the canker."
Treatment.—The difficulty of ascertaining whether a child that
is sick has worms, should occasion no embarrassment with regard
to the treatment to be pursued. The stomach and bowels being
disordered, the indications for the treatment will be the same whe¬
ther the patient be affected with worms or not.
" I have had," says Dr. Thomson, " a great deal of experience
WORMS IN THE STOMACH AND BOWELS.
199
in what are called worm complaints; and after having become
fully acquainted with the real cause, had no difficulty in curing all
that I have undertaken." *******
" My practice," says he, " has been what I recommend to others
to do in cases that are called worm complaints; to give the com¬
position powder, or No. 2, to warm the stomach, a tea of No. 3,
to remove the canker, and the bitters, or either of the articles de¬
scribed under No. 4, to correct the bile. If they are bad, carry
them through a course of the medicine, and give the bitters. When
there are nervous symptoms, give the nerve powder. Injections
should also be frequently given. The butternut syrup is very good.
If there should be danger of mortification, make use of No. 6, both
in the medicine given and in the injections."
The composition I have found to be most effectual when the
powder is given in lukewarm water, or in a strong decoction of
bayberry or sumac. This mixture given two or three times a day,
together with small doses of the tincture of lobelia, repeated every
two or three hours, will, in many instances, remove all symptoms
supposed to be occasioned by worms.
The compound lobelia pills given immediately after meals, will
be found beneficial in such complaints, and they may be used as a
substitute for the composition and tincture of lobelia.
A mixture of vinegar ana salt given three or four times a day,
is of especial benefit in correcting a disordered stomach, especially
when the patient craves acids.
Milk boiled with a portion of tansy may be used to restore diges¬
tion ; and sometimes it will cause the expulsion of worms from the
bowels.
Lime-Water. — When the stools are green, or of an acrid cha¬
racter, or if the patient be affected with sour breath, and acid
eructations, lime-water should be given to correct the secretions.
The usual way of administering lime-water is to add about an
equal quantity of boiled milk. To be taken two or three times a
day.
Charcoal. — When the bowels are constipated, a teaspoonful of
purified charcoal may be taken two or three times a day in boiled
milk. This will overcome costiveness, and it is highly beneficial
in the cure of what are called worm complaints.
Emetics, or a Course of Medicine should be given occasionally,
as long as there is fever, or the tongue continues furred, and com¬
position powder, capsicum, or spice bitters, to be administered
twice or three times daily. When the fever has disappeared and
the tongue is moist and cleaning, bitters may be given. Extract
of gentian in the shape of pills, or any other simple bitter, may be
200
WORMS IN THE STOMACH AND BOWELS.
.aken to strengthen the stomach, after it has been cleansed by the
treatment before mentioned. When the patient continues in deli¬
cate health, after the above treatment, a cold shower bath in the
morning, or a change of air, will be found particularly useful. A
change of medicine occasionally will be proper in long standing
cases; thus a certain kind of bitter may be given for a few days
in succession and then change it for another; salt and vinegar
may agree with the stomach for a time, and then require to be
laid aside for some other remedy.
Oil of Turpentine is ranked as the best remedy for worms in
the old school practice.
Worm Seed, or Jerusalem Oak, (Chenapodium Anthelmenticum)
's much used for expelling worms. Of the efficacy of this article
[ cannot speak from observation, never having used it. The Vo-
atile Oil of the worm seed is generally used; the dose for a child
tS from four to ten drops mixed with sugar, given in the morning
on an empty stomach, and in the evening at bed-time; this may
be continued several days in succession.
Treatment for the removal of the Thread Worm. — This species
of worm being located in the rectum, is usually termed seat worm.
These may, in many instances, be removed by the daily adminis¬
tration of injections, composed of a strong decoction of bayberry
or sumac, adding a teaspoonful of No. 6 ; or mix from two to three
teaspoonsful of composition powder, in less than half a pint of
lukewarm water, and administer by injections at bed-time, and
repeat every night, the patient retaining it as long as he can. This
will remove the false membrane or tough slimy substance that coats
the bowels. After the worms are expelled the injections should be
administered every few days, to prevent their return. If the general
health be deranged, constitutional treatment will be required ; such
as the daily use of stimulants and bitters, and occasionally an
emetic, or a full course of medicine.
These small worms are contained in a tough mucus, lining the
bowels, and being imbedded in it will frequently resist the most
powerful cathartics, but administering stimulating injections to
excite the secretions and render them less dense and tenacious,
followed by the use of injections of a strong decoction of bayberry
or sumac, adding a portion of No. 6, will seldom or never fail of
expelling the worms when their use is persevered in. In obstinate
cases of seat worms, an injection of a simple decoction of the bay¬
berry or sumac should be administered at bed-time, and retained
in the bowels through the night; in the morning administer ano¬
ther, containing a portion of the No. 6, or the third preparation of
lobelia.
PILES.
201
Treatment for Expelling Tape Worms. — Every species of in¬
testinal worms is supported by the cold mucus or " canker," lining
the bowels. Dr. Thomson's general plan of treatment, namely;
first to give stimulating medicine to warm the stomach and bowels,
then use the No. 3 to remove the " canker," and bitters to restore
digestion, is adapted to all cases of worm complaints. This is a
plan of treatment adapted to all cases of disease of the stomach
and bowels, whether worms be present or not.
No small amount of injury has been done by experiments that
nave been practised by physicians upon patients supposed to be
affected with tape worm. A great variety of remedies and modes
of treatment are recommended by different medical writers; one
claiming to have been successful in expelling tape worms by a
certain method of treatment; whilst another declares that a different
and even opposite course of treatment has proved more successful
in their expulsion. Dr. Eberle gives no less than seven dif¬
ferent plans of treatment recommended by men who have been
considered eminent in the profession. Most of the remedies em¬
ployed by the medical profession for the expulsion of tape worms,
such as tin filings, and irritating cathartics, frequently cause the
formation of a false membrane on the mucous surface of the bowels,
which will sometimes pass off in the form of a white skin, in pieces
varying from half an inch to a foot, or even two or three feet in
length, and this substance no doubt has frequently been mistaken
for tape worm. Some writers speak of having cured many hun¬
dred cases of tape worms, but probably, in forty-nine cases out of
every fifty, the supposed tape worm was nothing more than the
white skinny substance above alluded to.
SECTION XII.
PILES.
This is a disease of the veins of the rectum, which prevails to a
great extent in both sexes, and in all classes of society.
Piles commence by an enlargement of the veins in the rectum,
forming tumors filled with dark blood, which, when inflamed, be¬
come extremely painful on going to stool, and frequently discharge
a considerable quantity of blood ; they are then called bleeding
piles. When blood is not discharged they are termed blind piles.
Sometimes the tumors emerge from the anus, forming external
piles; when confined within the rectum they are denominated in¬
ternal piles.
202
PILES.
1st. External Piles. — These are at first formed within the rec¬
tum, by the blood collecting and forming into clots in the enlarged
veins, and are afterwards forced down by the passage of hardened
foeces, and by straining efforts to evacuate the bowels, sometimes
attended with extreme pain, which may continue many hours.
Piles are soft at first, but generally become harder in the course
of a few days. When inflamed they look red, and are smooth like
a cherry, but more frequently they have the appearance somewhat
of a half-dried red or purple grape.
In severe cases of piles, where the disease has continued some
years, a portion of the intestine is in many cases forced down
every time the foeces are passed from the bowels, and requires to
be pressed up by the hand. In some instances the patient will be
unable to return the protruded intestine, in consequence of the
inflammation and extreme tenderness of the parts. Under these
circumstances the patient is compelled to remain in a recumbent
position, being unable to walk or even to sit upright. The extreme
pain which sometimes continues for many hours after the bowels
have been moved, is caused by the piles being pushed down, and
when the sphincter muscle of the rectum contracts, it grasps them
firmly, and thus operating as a ligature upon them, occasions in¬
tense pain.
2d. Excrescences in the form of whitish fleshy bodies are apt to
be formed around the verge of the anus, in consequence of fre¬
quently repeated inflammation of the diseased veins, by which
their sides, as it were, are glued together, and adhesive matter is
thrown out, which becomes organized, and a hard vascular tumor
is produced. These excrescences are apt to occasion irritation
and chafing of the parts, and although containing numerous small
blood-vessels, they may be cut away with a pair of sharp scissors,
without the least hazard to the patient, when they exist singly and
stand out prominently, and are of a solid texture, readily distin¬
guished from the soft spongy tumors formed by relaxation and
distension of the mucous membrane of the rectum.
3d. Internal Piles may exist far in the rectum, without occa¬
sioning pain, or much inconvenience, the discharge of blood being
the first symptom of their existence. By the frequent passing of
hardened foeces, a relaxed condition of the bowels, or by the use
of purgative medicine, the intestine is gradually drawn downward,
and finally is protruded beyond the anus every time the bowels
are moved, forming prolapsus ani. Under these circumstances
there is generally much constitutional derangement and more or
less fever.
Piles at first seldom continue long; they disappear and some¬
times do not return, but more generally they return at intervals,
PILES.
203
until finally the parts become permanently diseased, proving a
continued source of annoyance, and frequently causing severe
pain.
Piles vary in size in different patients, from a pea to a walnut.
Their number also is equally variable. Sometimes there is but
one; in other instances, there may be two or more; and in others,
again, they are so numerous and large as to cause, by their pro¬
trusion through the anus, a permanently widened state of that
aperture, and a habitual relapse, not only of the tumor itself, but
also a portion of the bowel.
When a number of piles exist low down in the rectum, the
passage of hard faeces is rendered extremely difficult and painful
in consequence of the cavity of the intestine being nearly closed
by the formation of these tumors into a body near the orifice of
the rectum.
" Among the most common consequences of piles is a kind of
tenesmus, or inclination to stool, with a protrusion of the inner
tunic of the rectum, so as to form a prominent and extremely sen¬
sitive ring around the anus — particularly after each attempt to
expel the faeces."
Piles are very liable to burst, followed by a discharge of blood,
on which the tumors disappear, and the distressing symptoms abate
until other piles are formed, which also burst and their contents
are discharged; and in this way some patients will be subjected
to frequent discharges of blood, which may become so profuse as
finally to weaken and impair the general health.
Causes of Piles. — The free use of purgative medicines may be
regarded as the most common cause of piles. They may, however,
be produced by any cause that weakens digestion, or occasions an
obstruction to the free circulation of blood through the veins of
the rectum; such as venereal excesses, the intemperate use of ar¬
dent spirits, sedentary habits, long-continued diarrhoea, dysentery,
tight lacing, gravel in the bladder, lifting heavy weights, preg¬
nancy, difficult labors, obstinate costiveness. obstructions in the
liver, and disease of the lungs.
Treatment. — In the early period of the formation of piles, the
use of injections of some active astringent, as a strong decoction
of bayberry bark, dewberry root, sumac, or witch hazel leaves,
will relieve the symptoms, and may check a further development
of this annoying complaint. The injection need not, however, be
restricted to astringents alone; they will often prove more benefi¬
cial by the addition of a portion of cayenne and lobelia.
When a pile is inflamed and painful, relief may be obtained by
the patient sitting over steam, or by the application of a warm
poultice of wheat bread, slippery elm, Indian mush, or flaxseed.
•204
PILES. »
Soft cloths wrung out of warm water may be applied in place of
a poultice. Besides these applications, the patient should take
freely of composition, or bayherry and cayenne and broken doses
of lobelia, with a view to equalizing the circulation of the blood.
This will in some degree lessen the determination of blood to the
rectum.
A course of medicine, or at least a vapor bath and a lobelia
emetic, will in many instances prove especially beneficial in re¬
lieving inflamed piles. Constitutional disorder is a frequent cause
of the continuance of piles; and it will be requisite to place the
system in a more healthy condition, by constitutional treatment, in
order to effect a cure of piles. The compound lobelia pills may
be used as a general medicine in all cases; and when the patient
prefers medicine in the form of pills, the No. 3 pills may be used
in the place of composition and bayberry and cayenne.
To prevent Costiveness. —" Throw physic to the dogs," and
employ the means pointed out, in a former section, under the head
of costiveness.
Astringent injections retained will cure piles in many instances,
not of too long standing. Their use almost invariably affords re¬
lief, whether the complaint be of long continuance or recent occur¬
rence. Take, for instance, equal parts of bayberry bark, witch
hazel and sumac leaves; steep a sufficient quantity in boiling water
to make half a pint of a very strong decoction; strain it, and use
on going to bed, retaining it until morning. In general, there
will be no difficulty in retaining the injection until morning, and
then there is usually a natural movement of the bowels, even
though the patient be of costive habit. The injections should be
repeated every night, as long as there remains a necessity for their
employment.
Injections prepared and used as above directed, have succeeded
in some instances in checking habitual discharges of blood from
the rectum; and by the additional aid of constitutional treatment,
the general health has been restored, where the wan appearance
of the patient showed plainly the consequences of the long-conti¬
nued drain kept up by the bursting of piles.
Astringent Ointments. — Various astringent ointments may be
used; for instance, the green persimmon ointment, or an ointment
made by stewing, in lard, mutton suet, or tallow, some vegetable
astringent; marsh rosemary, witch hazel leaves, or crane's bill.
A sufficient amount of the astringent substance should be used
to render the ointment actively astringent; and when stewed an
hour or more it must be strained. The ointment, besides being
applied externally, may be introduced into the rectum.
PILES.
205
Pitch, or Tar Pills, are highly recommended as an internal re¬
medy in cases of piles, attended with obstinate costiveness.
Ward's Paste. — The composition of this is given in the lattei
part of this work. It has long been extolled as a valuable internal
medicine in chronic piles by the medical profession, both in this
country and Europe.
Vinegar, Lemon Juice, and Essence of Spearmint, have each
been used as a wash for piles. The mode of applying each of
these articles is to wet a piece of cotton with the liquid, and bind
it on by means of a T bandage.
Puncturing. — An external pile not larger than a cherry, and
existing singly and distinct, with a small base, may be punctured
with the point of a lancet, and the clot of blood squeezed out, with¬
out any risk; but under other circumstances, more especially where
large knots of piles exist, it will be hazardous to open them. Opera¬
tions upon piles should be performed only by experienced surgeons,
except in simple cases, and for the removal of excrescences, before
spoken of, that have small bases, and are hard like solid flesh, and
not red or purple like a pile.
When the introduction of the injection pipe is attended with
difficulty and pain, in consequence of the existence of large piles
low down in the rectum, a gum elastic tube or large catheter
should be used; or previous to introducing the metallic pipe, push
a small tallow candle, softened by heat, two or three inches up the
rectum. The relief derived by this simple operation of introducing
a piece of softened tallow candle, is often most striking, in cases
where the pile has been pushed down and then strangulated by
being grasped by the sphincter muscle. The best position for the
patient to be placed in to push up a pile above the sphincter muscle
is on the knees, with the buttocks raised, and the breast low.
Pressure. — In cases of long standing, where the tissues about
the lower part of the rectum have become permanently relaxed,
and protrude through the anus, a pile truss should be worn ; or the
parts supported by means of a compress* kept applied by means of
a T bandage.
There are cases of piles, and diseased conditions of the rectum,
where nothing short of an operation for their removal by the liga¬
ture, or by excision, or a portion of the tissues destroyed and
adhesive inflammation induced by the application of pure nitric
acid, will promise hopes of cure. Operations of this kind, however,
should be conducted by experienced surgeons only.
206
rheumatism.
Diet. — In all severe cases of piles, attended with constipation
of the bowels, especial attention to diet will be requisite. Gruel
made of unbolted wheat flour, or bread made of the same material;
rye mush; cream toast; Indian mush; stewed prunes in small
quantities, eaten with stale bread or biscuit; ripe fruit an'd calves'
foot jelly, are suitable articles of diet in cases of obstinate costive-
ness, and where the piles are highly sensitive or sore and inflamed.
Animal food can be used in connection with the above articles in
all cases where it agrees with the patient.
CHAPTER VI.
SECTION I.
RHEUMATISM.
Causes. — Cold and dampness are the exciting causes of rheu¬
matism in almost every instance. Where, however, there is a
predisposition to the disease existing, inaccuracies in diet, over¬
exertion, loss of rest, or any other depressing influence may occa¬
sion the disease. I never knew a case of rheumatism that was not
preceded or accompanied by a greater or less degree of derange¬
ment of the digestive functions. Patients, however, will sometimes
insist that nothing is wrong about the stomach or bowels. The
low degree of sensibility in the stomach and bowels induces patients
to consider that no derangement exists in these organs, when at
the same time, their functions may be so far depressed and de¬
ranged, as to give rise to the most painful affections in other parts
of the system, as gout, rheumatism, headache, neuralgia, erysipe¬
las, &c.
Parts Affected. — Rheumatism generally attacks the fibrous
tissues around the larger joints: the hip, shoulder, elbow, or knee,
and frequently the small joints become affected, more especially
those of the fingers. The synovial membrane of the joints, con¬
taining what is called the "jointwater," often becomes affected in
rheumatism. Although in general confined to joints, rheumatism
sometimes attacks the muscles only; those of the back, neck, and
shoulders, are most liable to be affected in this way. When in the
back it is called lumbago. The membrane covering the eyeball is
liable to rheumatic inflammation. The head, heart, brain and womb
are also liable to this form of disease.
RHEUMATISM.
207
Varieties. — When rheumatism attacks the young and athletic,
the disease is usually accompanied with inflammation of the dis¬
eased parts, attended with pain, extreme tenderness, and frequently
a redness of the skin, and generally there is more or less fever,
especially at night. Such a case would be termed acute or inflam¬
matory rheumatism. •
When the disease occurs in the aged and infirm, and especially
in those of broken-down constitutions, the powers of nature are
often too feeble to establish an efficient curative action; the affect¬
ed parts will remain pale, and seldom much swollen; though some¬
times the synovial membrane, especially of the knee joint, becomes
affected, the joint water is increased in quantity, and causes the
parts to swell out, sometimes twice the natural size; the disease
will be fixed in certain joints and not shifting about; there will be
absence of fever, no thirst, the tongue pale, and the affected joints
much less tender than in the former variety. This is called chronic
rheumatism. The symptoms, however, in different cases, present
great diversity of character, from the most acute and inflammatory
to that of the lowest grade of chronic rheumatism ; so that in some
instances it will be difficult to decide whether to call the disease
acute or chronic.
Acute rheumatism is often made chronic by bleeding, purging,
and poisoning the patient with nitre, antimony, &c. Many a pa¬
tient has been kept on his back for months by medical treatment,
and in fact prevented from ever getting entirely well, who would
have recovered perfectly in a few weeks, even without medicine,
if kept warm.
Mercury sometimes occasions disease of the joints resembling
rheumatism, and it also affects the membrane that covers the bone,
and is most apt to be seated on the long and flat bones—the tibia
or shin bone, the arm bones, shoulder blade, skull, &c. Sometimes
it commences with a protuberance rising on the bone, without in¬
flammation or pain, and either remaining stationary, or gradually
disappearing under proper treatment, or, as is more commonly the
case, the part becomes extremely painful, and is frequently followed
by suppuration. This mercurial disease is not always confined to
the covering of the hone, but occasionally the substance of the bone
itself is diseased, occasioning its decay, attended with a discharge
of acrid and offensive matter.
Symptoms of the Acute or Inflammatory variety of Rheumatism.—
The disease generally approaches in a gradual manner, with a
sense of coldness or numbness in the limbs, loss of appetite, weak¬
ness and languor. These symptoms continue for several days, or
even weeks, in some instances, before the parts become either
swollen, painful, or inflamed. In other instances the attack is sud¬
den, commencing with a chill. Pain, tenderness, with more or less
208
RHEUMATISM.
swelling and redness about the joints, with a lull, hard pulse, hot
skin and flushed countenance, attend inflammatory rheumatism.
" The patient generally lies on his back, and avoids every motion
of the body or limbs; or if he does move, he experiences g sudden
aggravation of pain; he cries out, and muscular motion is promptly
checked.* There is little languor or debility, and but little disturb¬
ance of the mental faculties." The tongue is usually coated, and
there is generally perspiration on the face, and frequently on the
whole body, which is acid, and exhales a peculiar, sour odor. The
urine is high-colored, scanty, and deposits a sediment. ' 1 he pain
and distress are more aggravated at night, frequently attended with
high fever, and sometimes slight delirium: or as it is usually ex¬
pressed, the patient is " light headed." In some instances all the
limbs are affected at the onset, the patient being entirely helpless.
In other cases the disease is confined first to the lower extremities,
and then sooner or later it extends to the shoulders, neck, elbows,
and hands. If the patient fall to sleep, he is apt to be awakened
by a sudden jerk or contraction of the muscles, causing severe
pain.
The function of the liver in many instances is conspicuously dis¬
ordered in rheumatism, attended with sallowness of the skin and
whites of the eyes, and occasional sickness and vomiting of bile.
After a spell of vomiting, the patient experiences temporary abate¬
ment of the rheumatic pains. Although bile be thrown oft* by vo¬
miting, it does not prove that there is an unusual quantity formed ;
digestion being suspended or greatly impaired, the usual quantity
of bile is not used in the process of digestion.
Not dangerous.—Rheumatism rarely proves fatal, except when
seated in the brain, or translated to the heart, or other important
internal organ.
Duration of Rheumatism.—The length of time required for the
cure of rheumatism, varies in different cases, from a few days, to
weeks and even months. The inflammatory variety is often cured
in the course of a week or ten days; whereas where there is but
little reaction, in consequence of constitutional debility, or the in¬
flammatory action subsides without effecting a crisis, as it often
does in consequence of a prostration of the vital energies by blood¬
letting, purging, and administering nitre, mercury, antimony, &c.,
the disease is apt to become deeply seated in the system, and re¬
ceives the name of chronic rheumatism. " Some practitioners,"
says Dr. Willan, "continue to let blood in most cases of acute
rheumatism, thinking themselves justified in their mode of practice
by the sizy appearance of the blood. The same principle might
lead them to empty the whole sanguiferous system; for every time
blood-letting is repeated, the blood becomes more dense or sizy.
RHEUMATISM.
209
1 have further observed that, by bleeding repeatedly, the pains,
swellings, and febrile symptoms, were not only aggravated at the
time, but often protracted infinitely; at least, I have seen them
continue, under such a mode of practice, upwards of two months.'*
Treatment of Acute or Inflammatory Rheumatism.—It is admitted
even by the opponents of Thomsonism, that the practice is adapted
to the cure of rheumatic complaints. Experience has fully tested
the insufficiency of the regular practice in the cure of rheumatism;
and that in many instances, where this practice has failed, the dis¬
ease has been cured by the aid of warm weather alone.
Courses of Medicine constitute the most effectual means for the
cure of rheumatism, and should be repeated daily, or less frequent¬
ly, as the circumstances of the case may demand. The more fully
the system is relaxed by lobelia, the more effectual will be the
treatment. When it is not convenient to steam the patient in the
usual way, lobelia emetics may be administered without previously
administering a bath.
A course of Medicine, early administered, before the disease be^-
comes seated, will in some instances effect a crisis, provided the
patient be kept warm in bed, and use be made of stimulants and
lobelia, to continue perspiration and keep the system relaxed.
Upon the degree of integrity of the general health retained, depends
in a great measure the rapidity of the cure. Thus, if the digestive
powers be greatly prostrated, or if there be chronic disease of the
liver, the treatment wilk require to be continued for weeks, in many
instances, before the rheumatism can be cured.
When the disease has become seated, and the patient cannot be
moved without great pain, and more especially during the early
period of the disease, the regular vapor bath may be omiited, for
in some instances it is better for the patient to be kept at rest, with
a moderate and regular heat around him, than to have the inflamed
parts aggravated by getting out of bed, and by frequently chang¬
ing the clothing. ,
During the interval between courses of medicine, or when
courses are not administered, the patient should take freely of cay¬
enne and bayberry, or composition, and broken doses of lobelia.
The compound lobelia pills are well adapted to the cure of rheuma¬
tism ; from two to five may be taken every hour or two as the case-
may require. To promote perspiration, the patient should take of
composition, pepper, or simple herb teas. In many cases the com¬
pound lobelia pills, used freely, will supply the place of all other-
medicine. Many cases of acute rheumatism have been cured by
the lobelia pills alone, not even using the vapor bath. They should
be taken in sufficient quantity to excite vomiting at least once »
14
210
RHEUMATISM.
day. No other compound appears to be so well adapted to the
cure of acute or inflammatory rheumatism as the compound lobe¬
lia pills. Keeping the system constantly under the influence of
these pills, always relieves the rheumatic pains. And although the
patient may complain of the sickness from the pills, he should be
reminded that the sickness relieves the rheumatic pains, and also
facilitates the cure.
The Vapor Bath. There is a period in rheumatism, or a cer¬
tain condition of the system, when the vapor bath will prove most
signally beneficial. As a general rule it is the most effectual, either
before the disease becomes firmly seated, or whilst it is forming a
crisis, or after it has reached its height, and also on its'decline.
In most cases, however, it is beneficial in all stages of the disease,
provided the patient can bear, without inflicting too much pain,
rthe motion of the joints required in getting from the bed, and main¬
taining the sitting posture required in steaming in the regular
way.
The steam bath is as much called for in rheumatism where the
patient perspires freely, as where the skin remains dry. The steam
•benefits the patient more by warming the blood than by causing
perspiration. The temperature of the steam should be as high as
the patient can bear, and when he complains of the heat being
oppressive, apply cold vinegar, or water; or whiskey over the sur¬
face.
The patient should be showered after steaming, or washed with
spirits or vinegar, rubbed dry, and the parts affected bathed with
stimulating liniment, No. 6, or pepper sauee.
Injections are beneficial in all cases. When the rheumatism is
principally seated in the lower extremities, injections of the third
preparation, or of some form of lobelia, in the No. 3 tea, are espe¬
cially demanded. The circulation in the lower extremities is to a
greater or less degree influenced by stimulating injections.
From a half to a teaspoonful of lobelia powder administered by
injection and retained, and thus repeated every few hours, will
prove eminently beneficial in many cases, but more particularly
where there is high fever and violent pain.
The parts affected by rheumatism possess a low degree of sen¬
sibility in health, but when they become so much diseased as to
excite reaction and occasion inflammation, it frequently requires
several weeks before the parts are restored to a healthy condition,
even under the most judicious and persevering course of treatment.
The condition of the stomach, bowels, and liver, influences in a
^great degree both the violence and duration of rheumatism.
Often requires perseverance in the treatment. The following
RHEUMATISM.
211
was one of those cases of rheumatism, accompanied with liver
complaint, that often prove extremely difficult of cure except by a
persevering course of treatment.
Case.—Mr. J , whose health had been feeble for two or
three years, attended with sallowness of the skin, was attacked
with rheumatism, so as to be helpless. I was applied to, and ad¬
ministered two courses of medicine with marked benefit at the
time, but he soon relapsed. I give it as my opinion to the patient,
who was a man possessing high intellectual attainments, that there
was a false membrane coating his stomach and bowels through¬
out, which must be removed by a persevering course of treatment
before the rheumatism could be cured. Discouraged at not find¬
ing more permanent relief from the operations he had undergone,
he determined on making a trial of the regular practice. Colchi-
cum, and a variety of other remedies were used both internally
and externally, but with no good result, on the contrary with a
manifest exhaustion of strength. I received a message requesting
me to call on Mr. J again. I found him evidently worse
than when I left him. He said he had become convinced that
what I had previously told him in regard to the false membrane
was correct, and desired that a thorough course of treatment
should be pursued until the stomach and bowels should be cleared
of this false membrane. Accordingly, a thorough course of treat¬
ment was pursued, and in about two weeks the false membrane
began to be discharged, sometimes passing from the bowels in
pieces a foot long. At the end of three weeks the patient was
cured, and has ever since enjoyed better health than during seve¬
ral previous years.
Salt and Brandy.—Patients, after an acute attack of rheuma¬
tism, sometimes remain feeble, with want of appetite, the tongue
coated, or if it cleans off, soon becomes furred again, more or less
of the rheumatic pains continue, the countenance is pale, and
the muscles relaxed. Under these circumstances, salt and brandy
taken in tablespoonful doses, several times a day, will give new
tone to the stomach, and effect a sudden and striking change for
the better in the patient's general health. In addition to the salt
and brandy the patient may take freely of cayenne at meals, and
a teaspoonful of tincture of guiacum after each meal.
If the bowels remain costive, patients must use the syringe, at
least once a day, until by the use of such means as cayenne, char¬
coal, white mustard seed, and suitable diet, their natural movements
are re-established.
A cold 'Shower Bath taken every morning, has effectually curea
rr.anv cases of rheumatism, where the case has been slow to get
212
RHEUMATISM.
well under the use of medicine alone. The cold shower bath
should always be given after the vapor bath, that is, when the pa¬
tient is able to sit up to have the vapor bath applied.
Tonics.—When the disease is on the decline, the patient feeble,
clear of fever, and the tongue moist and cleaning, a decoction of
peruvian bark, or of some other of the vegetable bitters, should be
taken freely. Guiacum, or as it is commonly called gum guiac, is
much employed in rheumatism, when the inflammation is on the
decline. The dose of the powdered guiacum is from half a tea-
spoonful to a teaspoonful, mixed with molasses, 01* with slippery
elm powder and sugar, adding sufficient water to render it easy to
take. To be repeated three or four times daily. Tincture of guiac,
may be employed in the place of the gum. The dose is a tea-
spoonful. It may be taken mixed with sugar and water, or milk.
When mixed with water it turns white. Guiacum is used in every
stage of chronic rheumatism.
The Diet in rheumatism, as in every other disease, should be
adapted to the condition of the digestive powers. In the acute or
inflammatory form of the disease, digestion is in general, either
suspended or much enfeebled, requiring the lightest kinds of food,
such as crust coffee, barley water, elm gruel, toast and tea, milk
porridge, &c. When a patient is suffering acute pain, the diges¬
tion is imperfect; and when the stomach is oppressed with food *
that it cannot digest, the rheumatic pains will be necessarily aggra¬
vated.
In a more advanced period of the disease, or when it becomes
chronic, a stronger diet will be required, such as soft boiled, or
poached eggs, stale bread and butter, moderate quantities of fresh
beef, roasted or broiled; mutton, and wild game, together with
wholesome vegetables. In some cases animal food agrees with
the stomach, and in others an almost exclusive vegetable diet is
required.
Local Applications.—There is probably no form of disease in
which so many different local applications have been recommend¬
ed as rheumatism. In some instances local applications are ser¬
viceable, and in others they prove almost useless. And again an
application that agrees with one case, will increase the pain in
another; and the same application that may ease pain in one stage
of the disease, may prove entirely useless, or even injurious at
another period. In general, however, a moist heat applied by means
of hot bricks or bottles of hot water wrapped in damp cloths, and
changed sufficiently often to maintain a proper degree of warmth
and moisture, or wool or raw cotton, laid on the parts affected,
having the part next the skin covered with scrapings of gum cam-
RHEUMATISM.
213
phor, are the best kind of application for inflammatory rheu¬
matism. Wetting the cotton or wool occasionally with No. 6,
will be beneficial. Dr. Thomson recommends one part of tur¬
pentine to be added to four parts of No. 6, for 'bathing in rheu¬
matism.
Granvill's Lotion, Volatile Liniment, Stimulating Liniments, or
any of the essential oils may be employed in Rheumatism as an
external application.
A slice of thin fresh beef, bound on a part affected with acute
rheumatic inflammation, will relieve pain.
Cases of rheumatism frequently occur, which are neither abso¬
lutely acijte, nor absolutely chronic. The inflammation, without
being intense in any one joint, lingers in many; and the fever,
though not entirely absent, is moderate. The joints are not hot
and painful, the skin is dry, and there is some thirst.
CHRONIC RHEUMATISM.
Chronic rheumatism is characterized by absence of fever, and a
low grade of inflammation, or more properly absence of inflamma¬
tion in the parts affected. In some cases there are local heat and
swelling, with some degree of tenderness to pressure, and pain is
produced by a movement of the joints affected. There is, how¬
ever, no fever, at least during daytime. In some instances, pain is
produced by external warmth, especially at night, on getting warm
in bed. There is another kind of chronic rheumatism, where the
joints are cold and stiff, and the patient always rendered more
comfortable by external warmth. In chronic rheumatism, the
smaller joints, especially those of the knuckles and fingers, are very
liable to become crippled: they look knobby, and the fingers are
drawn out of their natural position, being always turned out¬
wardly from the thumb.
Treatment of Chronit Rheumatism.—In all cases the constitu¬
tional treatment should be conducted upon general principles,
adapting the remedies to the condition of the system. Thus a pa¬
tient experiences benefit by an occasional course of medicine. It
will be right to administer the course as often as may be deemed
requisite. As a general rule, chronic rheumatism does not de¬
mand courses of medicine, except at intervals of from one to three
or four weeks.
Among the most efficient remedies for chronic rheumatism,
besides courses of medicine, and vapor and shower baths, are the
compound lobelia pills, the No. 3 pills, cayenne, guiacum, white
mustard seed turpentine, and salt and brandy. While some of
these remedies will agree well in particular cases, others of them
will prove more beneficial in other cases.
Warm clothing;' hot salt-water baths; warm frictions, with the
214
LUMBAGO.
warm hand, horse hair mitts, or the flesh-brush, and stimulating
liniments, are adapted to the cure of chronic rheumatism.
Gum elastic.—Sheet gum elastic has obtained considerable ce¬
lebrity as an external application in chronic rheumatism. The
sheet gum is to be wrapped around the affected joint, and as often
as once in every forty-eight hours, it should be taken off and wash¬
ed clean with soap and water, and re-applied after washing the
skin with soap and water.
Sea-bathing in warm weather, travelling in a mountainous coun¬
try, or migrating to a warm climate, has often cured chronic rheu¬
matism, where all medical means had failed.
SECTION II.
LUMBAGO—RHEUMATISM IN THE LOINS.
The term Lumbago is applied to rheumatic affections of the
muscles of the loins, and also to abscess of the lumbar region.
Symptoms.—Lumbago from rheumatism is usually sudden in its
attack, attended with extreme pain on attempting to straighten the
back, the patient consequently keeps his body bent forward, by
which the affected muscles are kept relaxed. This species of
lumbago is generally accompanied with a rheumatic affection of
other parts.
The symptoms attending lumbago are such as accompany other
forms of disease in the lumbar region, for instance disease of the
kidneys, sprains of the muscles of the loins, and " crick of the
back." It is useless, however, in a practical point of view, to at¬
tempt making nice distinctions between these different complaints,
inasmuch as general constitutional treatment, adapted to a case
of lumbago, would not disagree with any other of the affections of
the loins.
»
Treatment.—A severe attack of lumbago demands the same
general treatment as a severe attack of rheumatism in other parts
of the system, such as courses of medicine, broken doses of lobelia,
and pure stimulants, especially cayenne.
Twenty or thirty drops of the spirits of turpentine, three or four
times a day, are an effectual remedy in many cases of lumbago
The use of turpentine, and an occasional vapor bath, togethei
with a strengthening plaster to the back, may succeed in curing
light cases. The stomach and bowels, however, are in most in¬
stances disordered, and require a course of medicine, and the use
GOUT.
215
of stimulants, such as capsicum and composition, prickly-ash, No-
6, and tincture of guiacum.
Steaming the back by means of hot bricks or bottles of hot
water wrapped in damp cloths, is a good remedy.
Prickly-ash.—This medicine in decoction, taken freely, is de
cidedly useful in chronic rheumatism wherever it be located. The
prickly-ash, finely pulverized, may be added to the spice bitter*
in the proportion of one part of the former to four parts of the
latter.
SECTION III.
GOUT.
Gout is a constitutional disease, being always connected with a
disordered state of the digestive organs. The disease usually comes
on by fits or paroxysms, and the attacks, in most instances, occur
at night. The pain is generally seated in the ball of the great toe,
though it is liable to attack other parts of the limbs, and also inter¬
nal organs, more especially the stomach and kidneys.
Its hereditary tendency.—Some families are peculiarly predis¬
posed to gout, almost every male member of a family being more
or less affected by it in advanced life, when the digestive powers
usually fail. This hereditary tendency to gout may be transmitted
from parents to children, through several generations. The same
debilitating cause that would produce gout in one predisposed to
the disease, might occasion pleurisy, erysipelas, or some other form
of disease in another.
JYot confined to the luxurious and indolent.—Gout prevails most
among high livers, still it does occasionally attack individuals who
have lived temperately, and have led an active life.
Causes.—When there is a predisposition to gout, an attack may
be brought on by almost any debilitating cause, such as exposure
to cold or dampness, over-exertion, or taking more food into the
stomach than can be digested. The disease is most apt to occur in
persons of a peculiar conformation of body, with large alimentive-
ness, and who are habituated to eating largely of the richest kinds
of food, together with the free use of wine and brandy. At length
the digestive powers become enfeebled. The habit of eating hear¬
tily having become established, more food is taken than the sto¬
mach can digest; the imperfectly digested food forms acids, the
general system becomes disordered, and gout follows.
When this disease attacks individuals who lead an active life
216
GOUT.
and are temperate in their habits, it is owing to constitutional dis¬
order; ihe general health being more or less impaired previously
to the gouty attack.
The Symptoms of Constitutional Disorder ivhich generally pre¬
cede an attack of Gout, are, uneasiness and distress at the pit of
the stomach; frequent belching of wind; sour eructations; furred
tongue; a sense of tightness and weight in the abdomen; "giddi¬
ness; great lassitude; yawning, and stretching of the limbs; cramps
in the muscles of the legs; drowsiness, with disturbed sleep, de¬
pressed spirits, and debility. In some instances a disagreeable
itching of the skin comes on a few days previous to the attack,
and in most cases the urine has a deep red color." Coldness of
the extremities, with a sensation of numbness, is very often expe¬
rienced before an attack of gout.
Characteristic Symptoms.—In most instances an attack of gout
commences at night. It is attended by severe pain, tenderness,
and throbbing in the ball of the great toe, with chilliness or rigors,
soon followed by reaction; the skin becomes hot and dry, and the
pain violent and throbbing, as though there was a continued suc¬
cession of electric shocks passing through the tender part. At the
approach of daylight, the pain abates, and a profuse perspiration
ensues. "In some instances the pain and fever continue with una¬
bated violence, until about the middle of the following night, when
they decline under a moderate flow of sweat—the patient sinking
into a quiet sleep towards morning. In very severe attacks, how¬
ever, no obvious remission of the symptoms takes place, until the
third or fourth morning. Yet in all instances, the sufferings of the
patient are greater during the fore-part of the night than in the day.
When the affected part is examined in the morning, after the ac¬
cession of the paroxysm, it is found swollen, red, and the veins of
the foot greatly distended with blood." The tenderness is so great,
that the least pressure or motion *in the part, occasions excrucia¬
ting pain. The temper during the paroxysm, is irritable, the pa¬
tient being difficult to please.
The duration of the first attack of gout, varies from four or five
to eight or nine days; " but in subsequent attacks, it is often pro¬
tracted beyond the second, or the end of the third week. After
the disease has subsided in one foot, it sometimes attacks the other,
and passes regularly through its course as in the first instance.
After an attack of gout the general health of the patient is usu-
allv much better than it was for some time previous to the attack.
The disease, however, returns at longer or shorter intervals: in
some instances only once in a few years; in others every year,
and after the constitutional energies become greatly enfeebled, the
;patient will seldom be entirely clear of it, excepting during mid¬
summer
GOUT.
217
Gout attacks especially the male sex. Some few women, how
ever, suffer it, in its regular and decided form.
Chronic Gout.—From great exhaustion of constitutional energy,
gout is apt to assume the chronic form, and instead of occurring
in paroxysms at different periods, the parts become permanently
affected, not with acute inflammation, but by " chronic, wandering
and irregular pains, bearing much resemblance to chronic rheu¬
matism."
" The pain in chronic gout is usually moderate during the day,
the patient experiencing only a sense of alternate heat and coldness
in the affected parts; at night, however, it is generally severe and
aching. A feeling of numbness and weight is experienced in the
diseased parts, slight cramps are apt to occur during the fore-part
of the night, and the sleep is restless, and interrupted by sudden
startings. The affected joints retain their natural, or present only
a slight purplish hue ; but they become oedematous, tender, and
more or less stiff, and the neighbouring muscles are weakened or
diminished in size. The inflammation often passes successively
from one joint to another, or leaves its original seat, and fixes upon
some distant joint, and after having remained there for awhile, re¬
turns to the part it had left."
" There is rarely any very conspicuous fever ; but the digestive
and biliary organs are generally very prominently deranged. The
dyspepsia attending this form of the disease is particularly charac¬
terized by great oppression, and flatulent distension of the stomach
after a full meal, together with heartburn, and occasionally a sense
of coldness in the stomach. The bowels are usually torpid or
affected with mucous diarrhoea; the urine is turbid, and often
charged with mucus; the skin dry, contracted and sallow; the
bilious secretion deficient; and both the animal and vital functions
much impaired. The temper in this variety of the disease is al¬
ways very irritable, dissatisfied, morose, irresolute, and sometimes
gloomy or hypochondriacal.
Gout is not exclusively confined to external parts, but is liable
to attack the stomach and other internal organs, and also the brain.
Cold applications to the diseased extremities, copious bleeding,
continued active purging, or any other debilitating influence may
occasion gout to be translated to internal parts. " When an acute
attack of gout passes to the brain, coma, furious delirium, or symp¬
toms of apoplexy, speedily ensue." When it fixes upon the sto¬
mach, violent cramps or spasms of this organ ensue, which in
many instances terminate fatally, or reaction becomes established,
exhibiting symptoms of inflammation in the stomach.
Treatment.—A paroxysm of gout will require the same general
plan of treatment as any other violent attack of disease. A course
218
GOUT.
of medicine will relieve the violence of the symptoms and assist in
bringing about a crisis.
In the premonitory stage, before the reaction or pain comes on,
a course of medicine will lighten the severity of the pain, and
shorten the paroxysm.
Treatment during the Paroxysm.—An attack of gout should be
treated in the same manner as a case of bilious colic, or inflam¬
matory rheumatism ; applying the remedies as the urgency of the
symptoms may require. The bowels to be relieved by the use of
enemas; the system warmed by the vapor bath, and the stomach
cleansed by emetics. During the paroxysm, the vapor bath may
be administered frequently, provided the patient finds relief from it.
The capillary vessels should be relaxed by the free use of lobelia,
either given by the mouth or administered by injection and re¬
tained ; free vomiting generally relieves the severity of the pain.
The compound lobelia pills, or pills made of equal parts of brown
lobelia, cayenne, and super-carbonate of soda, may be employed
as a general remedy, between courses of medicine, and in all cases
where the patient can take them better than decoctions.
If the tongue be thickly coated, and more especially when the
fur on the tongue begins to soften, an occasional dose of bayberry
or sumac tea must be given, adding a portion of cayenne.
Tonics.—The stomach having been cleansed, and the secretions
restored, tonics must be employed. Peruvian bark, quinine, quas¬
sia, Thomson's No. 4 bitters, or any of the usual vegetable bitters.
Injections of a strong tea of Peruvian bark, administered and re¬
tained, will answer a good purpose.
The chief remedy employed in the old school practice, in the
treatment of gout is colchicum. The celebrated Dr. Sydenham
condemns the use of evacuant remedies in gout, especially blood¬
letting and purging with colchicum. It was nature's prerogative,
he said, to exterminate the peccant matter in her own way; namely,
by depositing it in the joints, whence it might be dispersed by in¬
sensible transpiration. Evacuant remedies had no other effect than
that of recalling into the blood this peccant matter, which nature
had thrust forth to the extremities of the body; whereby it hap¬
pened that the virus which should have been eliminated through
the joints, fell upon some of the viscera; and so the patient, who
was in no danger before, became in peril of his life.
\
Local Remedies.—In general, stimulating and volatile liniments
afford more or less relief. The parts should be wrapped in flannel
or cotton, provided the pain be not increased thereby.
#
GOUT.
210
After a paroxysm of gout, the treatment should be directed to
effect a restoration of the general health, and thus to overcome the
liability to another attack. This may in many instances be accom¬
plished by an occasional course of medicine, together with the
adoption of a judicious, and well-regulated system of diet and
regimen. The continued use of the compound lobelia pills at night,
will have a good effect pn the bowels. In some cases where indi¬
viduals are subject to attacks of gout, the habit of eating too freely
of rich food has become so fixed with them that the stomach con¬
tinues to be oppressed with more food than can be properly di¬
gested, and from this cause the patient is subjected to continued
returns of gout.
" The instances are not few" (observes Dr. Watson of England)
of men of good sense, and masters of themselves, who, being
warned by one visitation of gout, have thenceforward resolutely
abstained from rich living, and from wine and strong drinks of all
kinds, and who have been rewarded for their prudence and self-
denial by complete immunity from any return of the disease; or,
upon whom, at any rate, its future assaults have been few and
feeble. On the other hand, many who are liable to gout, are taught
by sharp experience that a single debauch, or a casual glass or
two of champagne, even unusual indulgence in the use of animal
food, may suffice to bring their enemy suddenly upon them. I am
sure it is worth the young man's while who has had the gout, to
become a teetotaller. But the case is different with the old, and
with those whose health has been broken by the inveterate disease.
They must be allowed a certain quantity of their good cheer, or
they become an easier prey to the disease. In such cases you
must trim, as well as you can, between opposite dangers; between
the Scylla of excess, ^md the Charybdis of debility."
In the chronic form of gout, besides an occasional course of
medicine, the use of strong infusions of vegetable bitters, or the
free use of quinine, will be required. Gum guiacum, spirits of tur¬
pentine, and savine (juniperus sabina), may also be found useful in
the chronic form of the disease.
Gout in the Stomach or Kidneys.—When the stomach or kidneys
become affected with gout, the same general course of treatment,
as already described, must be adopted. The stomach in these
cases, however, is very often almost insensible to the impression
of stimulants, requiring large and frequently repeated doses of the
3d preparation of lobelia, or some other form of active stimulant,
in order to produce the effect desired. Hot stimulating poultices
should be applied over the seat of the pain, and the steam bath
administered as hot as the patient can bear. Injections must be
employed. They should be made active with cayenne and lobelia,
or the 3d preparation, and administered frequently.
220
INFLAMMATION OF THE KIDNEYS.
CHAPTER VII.
SECTION I.
INFLAMMATION OF THE KIDNEYS.
The kidneys may become diseased from various causes, such as
exposure to cold and dampness, intemperance, blows, contusions,
and strains, the use of cantharides and other irritating diuretics,
translated rheumatism or gout, and the formation of gravel.
Symptoms—Arising from disorder of the general system, or from
exposure to cold, constitutional derangement, such as chillines
and languor, loss of appetite, torpid bowels, flushes of heat, and
fever, precede inflammatory action in the kidneys. When this
takes place there is tenderness to pressure, and pain in the region
of the kidneys, which is greatly aggravated by a sudden jar, from
making a false step, or by suddenly bending the body forward
The pain is apt to shoot down towards the bladder and thighs.
" With these symptoms are usually conjoined fever, nausea, and
sickness, retching and vomiting, colicky pains and constipation.
The urine assumes a variety of appearances,—it may be high co¬
lored, ropy, depositing sediment, foetid, or bloody.
Acute Ivjlammation of the kidneys generally terminates favor¬
ably, except when it occurs in constitutions broken down by de¬
bauchery, or the vital powers greatly depressed by other causes.
The Favorable Signs are a subsiding of the pain; a general warm
perspiration; a copious discharge of urine, generally either turbid
or charged with mucus; cleaning of the tongue; and subsidence of
the sickness and vomiting.
Where acute inflammation of the kidneys does not terminate in
resolution (the restoration of natural action) by the seventh or
eighth day, suppuration may ensue, and an abscess be formed.
The symptoms denoting the formation of an abscess, are shiver-
ings and fever, occurring at irregular intervals, resembling ordina¬
ry ague or hectic fever; a pulsation pain in the kidney; a feeling
of heaviness or numbness in the affected part; and great irritation
of the bladder and urethra. Abscess of the kidney may "point
externally, and be discharged, or it may open into the abdomen,
and occasion severe and fatal peritonitis." In other instances the
INFLAMMATION OF THE KIDNEYS.
221
matter passes down the ureters into the bladder, and is discharged
with the urine. In some instances an abscess will continue to dis¬
charge in this way for many months, and even years.
Treatment.—Inflammation of the kidneys, occasioned as it is
in almost every instance by derangement of the general health, de¬
mands for its cure the general plan of treatment required in all
acute or recent attacks of disease. It is therefore not necessary
to know whether the kidneys be affected or not, in regard to the
course of treatment to be pursued, as Thomson's regular course of
medicine is adapted to the cure of all sudden attacks of inflamma¬
tion and pain, in whatever part it may be located.
In recent attacks, attended by violent pain, the. course of medi¬
cine should be repeated daily, and the system be kept under the
influence of lobelia to cause relaxation of the capillary vessels, and
remove the obstructions to the circulation of the blood. Straining
efforts to vomit will not increase the pain when the system is re¬
laxed, except momentarily.
Injections.—The kidneys may be greatly influenced by medi¬
cines administered by injection. To move the bowels the injec¬
tions should be made stimulating, and contain a portion of lobelia.
When the skin is hot and dry, the secretions of the mouth suspend¬
ed, and the pain in the kidney severe, lobelia should be administer¬
ed by injection with the view of producing continued nausea, and
the patient should take freely of pennyroyal or other simple herb
teas, and an occasional dose of pepper or composition.
The Vapor Bath.—From the close sympathy existing between
the skin and the kidneys, the vapor bath will prove highly benefi¬
cial, and may be administered frequently. Where the patient can¬
not bear the fatigue of sitting up, the steam should be applied to
the patient on a couch or mattress. Not only is the vapor bath
useful by exciting perspiration, but it attracts the blood to the sur¬
face and thus lessens the undue determination to the diseased part.
The same effect is produced by the emetic. The vapor bath is
more especially indicated where the secretion of urine is nearly,
or wholly suspended; for where the functions of the kidneys are
suspended, those of the skin should be promoted, otherwise the
urea will remain in the blood and occasion serious consequences.
'In some instances, however, the patient requires to be kept in a
state of perfect rest, and other means should be used for promoting
perspiration, such as warm fomentations to the loins, and hot
bricks wrapped in damp cloths placed at the feet. Warm
drinks should be taken, composition, pennyroyal or dittany tea
222 INFLAMMATION OF THE KIDNEYS.
The foregoing treatment to be persevered in until the disorder
abates.
Astringents, or anti-canker medicine.—After the pain has subsid¬
ed, and more especially if the patient's tongue be coated, a strong
tea of sumac leaves, berries or bark, or of all combined, should be
taken, adding a portion of cayenne; and after the tongue becomes
clean, tonics must be given. A strong tea of poplar bark may be
used.
To stimulate the kidneys to action, after the inflammation has
abated, balsam fir, balsam copaiva, spirits of turpentine, or oil of
juniper may be employed.
The Symptoms of Calculi, or Gravel in the Kidneys, independent¬
ly of inflammation, are—excruciating pain in the region of the
kidneys down to the bladder; constant sickness at the stomach,
with frequent retching and vomiting; pain in the inside of the
thigh; retraction and pain in the testes, and strangury.
The gravel may pass off and give perfect relief, or the parox¬
ysms may continue, and inflammation ensue.
I visited a patient who had symptoms of gravel in the kidneys,
under the care of Dr. Fonerden. The patient had taken two or
three courses of medicine, and at the time I saw him, the system
was very much relaxed under the influence of lobelia, and he had
what are termed the alarming symptoms; and the family of the
patient being unacquainted with the effects of the medicine, were
-much alarmed. During this relaxation, the patient, in voiding
urine, passed a calculous or gravel stone, about three-quarters of
an inch in length, as thick as a common goose-quill, and was im-
diately relieved.
Gravel in the kidneys arises from a disordered condition of the
digestive organs, and is generally associated with full living, par-
.icularly in persons, predisposed to gout.
When the calculi are first formed in the kidneys, they are gene¬
rally of acid deposites. The urine will be high-colored and will
change litmus paper to red, and deposits a sediment of red, yel¬
low, or pink color on standing. This acid character of the urine
frequently attends childhood and persons about the age of forty.
As the constitutional energies become more enfeebled, the cha¬
racter of the gravel is apt to change from that of an acid to an
alkaline deposite; the urine becomes pale, and deposites a white
sediment or crust on standing.
Treatment of Gravel in the Kidneys.—To relieve the pain, and
facilitate the expulsion of the gravel, and at the same time to
lessen the tendency to severe inflammation, a regular course of
medicine will prove most effectual.
INFLAMMATION OF THE KIDNEYS.
223
Beside the course of medicine, injections of the lobelia powder
should be given occasionally with a view to relax the system, and
lessen the determination of blood to the kidneys. A teaspoonful
or two of the third preparation of lobelia, in a teacup half full of
bayberry tea, should also be given every hour or two, when the
pain is severe, and cloths wrung out of hot water applied to the
loins. Whether the disease be gravel or inflammation in the kid¬
neys, lumbago, gout, or rheumatism, the treatment here recom¬
mended will be proper in each case.
Alkalies should be used in combination with the other medicines,
when the urine is high-colored,—sal-aeratus or the bi-carbonate of
soda; the former is to be preferred. Alkalies may be occa¬
sionally used, as long as the urine indicates the existence of
acid. The sal-seratus or soda may be added to sumac or poplar
bark tea.
Acids.—When the urine is pale, and deposites a white crust or
sediment, acids should be used, as vinegar, or the pepper sauce,
especially at meals. Lemon-juice may be used in drinks, or a
beverage may be made of other kinds of acid fruit.
Predisposition to the formation of gravel is to be overcome by
restoring the general health by the use of pure stimulants, "anti-
canker medicine" and tonics, besides the use of alkalies or acids,
as the case may require. An occasional course of medicine will
be very useful to restore the general health.
Confirmed or Chronic disease of the Kidneys.—The kidneys
may be diseased in various ways. Acute inflammation may ter¬
minate in a sub-acute or chronic inflammation; and again the
function, and even the structure of the kidneys may be very much
diseased without inflammation. In some instances the kidneys
have been diseased to a great extent, the patient at the same time
scarcely sensible of it. In cases of this kind, the complexion of the
patient will present a dirty pale apppearance, and there will be
somnolency, or an unusual tendency to stupor.
Treatment.—Tn confirmed disease of the kidneys, besides gene¬
ral constitutional treatment, stimulating diuretics should be em¬
ployed, such as vegetable balsams, spirits of turpentine, and oil of
juniper.
Change of Air.—In deeply-seated complaints, benefit is derived
in many cases, from a change of residence, where medicine fails
of effecting any permanently good result. A few weeks' residence
at the sea shore, or in a pine country, or among mountains; at the
224 INFLAMMATION OF THE BLADDER.
mineral springs, Schooley's mountain, Saratoga springs, and othfti
like places of fashionable resort, has in many instances renovated
the general health, and removed the tendency to gravel, wliei *
medical treatment had failed.
SECTION II.
INFLAMMATION OF THE BLADDER.
This is a disease of rare occurrence, except in a chron'c form,
the bladder not being liable, generally, to acute inflammation.
Causes.—Acute inflammation of the bladder is sometimes occa¬
sioned by repelled gonorrhoea. It has also been produced by the
use of cantharides, (Spanish flies,) and by the excessive use of tur¬
pentine. The disease is accompanied by a disordered state of the
digestive functions. Inflammation of the bladder may also be
brought on by injuries inflicted by blows, retention of urine, by
the use of forceps in labor, or by the injudicious introduction of
the catheter. When the bladder is> predisposed to disease, expo¬
sure of the feet to cold and dampness may occasion inflammation,
—still the disease is of rare occurrence.
The Symptoms are,—an almost constant desire to pass urine;
burning pains in the region of the bladder, which frequently shoot
through the testes, and down the thighs; and extreme tenderness
in the region of the bladder. The patient is seldom able to pass
much urine, and that which is voided is of a deep red color, and
frequently tinged with blood. There is much distress at the sto¬
mach, with sickness and vomiting. The bowels are costive, and
if the inflammation extend to the rectum there will be generally
more or less dysenteric symptoms.
More or less reaction attends acute inflammation of the bladder.
The skin is dry and hot, the pulse quick, the tongue coated and
dry, with excessive thirst; the patient is extremely restless, and
the countenance is expressive of great anxiety. When the neck
of the bladder is inflamed, there will be retention of urine, and
any attempts to introduce the catheter or bougie, cause extreme
suffering.
Terminations.—Inflammation of the bladder may terminate either
in resolution, suppuration, gangrene, or a thickening of the coats
of the bladder.
INFLAMMATION OF TIIE BLADDER.
225
Favorable Signs.—When the inflammation is about to terminate
in resolution, which signifies a restoration of the parts to their na¬
tural condition, there will be general perspiration, with a uniformly
warm skin; subsidence of the pain; the parts less tender to pres¬
sure; and a free discharge of urine, with but little pain.
Suppuration.—Inflammation of the bladder very rarely termi¬
nates by suppuration. When this does occur, the pain and fever
are lessened;.the patient experiences chills or rigors, and a white
matter is discharged with the urine.
Gangrene occurs much more frequently than suppuration.
When gangrene is about to take place, the pain and fever sudden¬
ly cease; there is great prostration of strength; "cold extremeties;
profuse and clammy perspiration;" pulse weak and frequent; hic¬
cough; confusion of mind; and a death-like expression of coun¬
tenance.
Sudden and severe attacks of acute inflammation of the bladder
usually run their course to a favorable or to a fatal termination,
by the seventh or ninth day. In some instances the disease be¬
comes seated, or as it is expressed in medical language, the inflam¬
mation assumes the chronic form.
Treatment.—Severe attacks of inflammation of the bladder, re¬
quire energetic treatment in the early period, and a persevering
course to be continued until the disease abate, or the case prove
hopeless of cure. As in all severe attacks of disease, repeated
courses of medicine must be chiefly relied upon, or the system kept
under the influence of lobelia, which will aid in equalizing the nerv¬
ous influence, and will promote perspiration.
Injections to the bowels must be used freely in order not only
to remove their contents, but also to influence the action of the
bladder. The lobelia powder, administered by injection, and re¬
tained, will tend to relax the neck of the bladder, and favor the
escape of urine; and besides this, it fulfils other important indica¬
tions, equalizing nervous influence, and promoting the various se
cretions. Occasionally lobelia administered in this way will pro¬
duce sickness and vomiting, and greatly relieve the pain in the-
bladder.
The Vapor Bath is useful in inflammation of any internal organ
or tissue. It attracts the blood to the surface, and powerfully as¬
sists to equalize its circulation; it relieves pain; aids the efforts of
nature to overcome obstructions; and renders the system more
susceptible to the impressions of medicine. The bath is to be re¬
peated as the circumstances of the case may require; and if the:
2*26
INFLAMMATION OP THE BLADDER.
patient, find relief by the bath, it may be administered very fre¬
quently. If, however, the patient be more easy when kept quietly
in bed, with warm poultices applied to the parts, the bath may be
dispensed with for the time. Most physicians of the old school
recommend the vapor bath in this disease.
Poultices composed of Indian mush and flaxseed, stewed an hour
or more, then adding ginger and green lobelia, or composition
powder, must be constantly applied to the abdomen. A poultice
prepared by stewing wormwood and tansy in vinegar, and thick¬
ened with Indian meal or slippery elm, may be used.
Diet.—During the active stage of the disease, the stomach will
not digest any food except it be of the most bland and mild cha¬
racter,—elm gruel, flaxseed tea, adding a small portion of loaf
sugar,—barley water, and crust coffee.
If the tongue be thickly coated, the patient should take occa¬
sionally a strong decoction made of sumac leaves and berries, add
ing a portion of cayenne, or of the third preparation of lobelia.
This preparation is also well adapted to those cases where suppu¬
ration occurs in the bladder, or the inflammation assumes the
•chronic form.
Chronic Inflammation of the Mucous Membrane of the Bladder
is a common form of disease.
Symptoms. — "Slight lancinating pains, attended with a sense
of burning in the region of the bladder, and a feeling of weight
and tenderness in the perineum; frequent and harassing desire to
pass urine, with occasional spasmodic action of the bladder and
urethra. The urine is loaded more or less with a tenacious mu¬
cus. Slow fever generally attends, accompanied with thirst; ge¬
neral debility, particularly about the back and loins; and in pro¬
tracted cases, much emaciation and exhaustion supervene. There
is, generally, considerable derangement of the digestive functions;
loss of appetite; sometimes nausea and vomiting; costiveness;
tongue covered with a white or brown fur, and the skin harsh and
dry.
Chronic inflammation of the bladder is often associated with
gout, and scrofula. It prevails most in the aged and infirm, and
more especially in the intemperate.
Treatment.—Chronic inflammation of the bladder is to be cured
by a course of treatment best adapted to restore the general health,
together with stimulating injections to the bowels, composed of a
■strong decoction of sumac leaves or berries, adding a portion 01
cayenne and lobelia ; and a free use of an infusion or tea, of either
INFLAMMATION OF THE BLADDER. 22'7
pipsissewa, sumac bark, leaves, or berries, uva ursi or bear-berry,
or buohu. In disease of the urinary organs, honey should be used
in the place of sugar to sweeten the teas with, unless the former is
found to disagree with the stomach. An infusion of peach-tree
leaves is highly spoken of by some practitioners. Balsam copaiva
has been used with much benefit in this disease. Equal parts of
balsam fur and tincture of myrrh, shaken together in a phial may
be employed with benefit in seated disease of the kidneys or
bladder.
An occasional Course of Medicine, the patient being kept in a per- *
spiration for several hours after, will in general prove the most
effectual method for the cure of chronic as well as acute inflam¬
mation of the bladder.
When the patient is infirm and far advanced in life, it will gene¬
rally be useless to attempt to effect a cure, more especially if the
disease be of long standing. The treatment in such cases should
oe of a palliative character.
The same symptoms that accompany chronic inflammation of
the bladder attend also disease of the prostate gland, stone in the
bladder, stricture of the urethra, and ulceration of the neck of the
bladder. The constitutional treatment, however, will require to
be the same in each case, under similar conditions of the general
health. Thus if the stomach be disordered, an emetic will be pro¬
per whether the patient be affected with stone, or with simple in¬
flammation of the bladder. If there be retention of urine from
spasm of the neck of the bladder, or from stricture of the urethra,
the vapor or warm bath, and injections to the bowels, to relax the
parts, will be equally applicable in either case.
A German applied to me, affected with retention of urine; the
introduction of a catheter twice a day had been required for the
three preceding weeks. A full course of medicine was given, and
he did not need the use of the catheter after. Even where reten¬
tion of urine is occasioned by stone in the bladder, a full course
of medicine may overcome the difficulty in many instances, al¬
though permanent relief is not reasonably to be expected by it.
Where there is a stone in the bladder, it can be removed only by
an operation.
In all cases of disease of the urinary organs, especial care must
he taken to protect the feet from wet or dampness.
t
DIABETES.
SECTION III.
DIABETES—EXCESSIVE FLOW OF URINE.
The more prominent Symptoms of this form of disease, are—a
profuse discharge of urine; excessive thirst; voracious appetite;
clean tongue ; dry skin ; and wasting of the flesh.
Character bf the Urine.—Various derangements in the system
may exist, accompanied by an increased flow of urine, but essen¬
tially different from diabetes. Diabetic urine contains sugar, giv¬
ing it a sweet taste and smell; " and if dropped and partly dried
upon linen or paper, it is glutinous, and adheres to the fingers."
The amount of urine discharged varies in different cases, but it is
always very great; and in some instances, seven or eight quarts
have been discharged in the course of twenty-four hours, and this
continued for several weeks in succession.
Causes. — A depraved state of the digestive functions, and an
exhausted state of the vital powers, are the essential causes of this
complaint.
The disease prevails commonly in old age, and in constitutions
broken down by intemperance or debauchery. It sometimes pre¬
vails in children after protracted cholera infantum.
The disease difficult of cure.—Occurring as a consequence of a.
worn-out or broken-down state of the system, genuine diabetes i?
very rarely cured. Recoveries from it, however, do happen unde-
a judicious and persevering course of treatment.
Where the disease is not overcome, the strength and flesh con
tinue to waste, hectic fever occurs, and frequently consumption of
the lungs, dropsy, or apoplexy supervenes.
instances have occurred in which several members of the same
family died of diabetes, thus showing, as it would seem, an heredi¬
tary tendency to the disease.
The disease, in some instances, terminates its course in a few
weeks, whilst in others it will continue for many months, or even
years.
Treatment.—The important indications are to restore the diges
tive and nutritive functions. To accomplish this, the chief depen¬
dence must be upon courses of medicine in the early stage of the
disease. There are no means so effectual in revolutionizing the
system, and in restoring the important vital functions, from a dis-
DIABETES.
2*29
eased to a more healthy condition, as the regular courses of medi¬
cine. Yet in diabetes, unless administered in the very onset of the
disease, and under favorable circumstances in relation to the con¬
stitutional vigor of the system, even these will be found unavailing.
If the constitution be broken down, or the patient advanced in life,
it would not be advisable to subject him to any unpleasant opera¬
tion by medical treatment, for under these circumstances there
cannot be a reasonable hope entertained of effecting a cure. It
must be borne in mind, however, that the system is liable to dis-
' orders attended with a profuse discharge of urine, differing essen¬
tially from diabetes. True diabetes is comparatively a rare
complaint; whereas an excessive flow of urine is of frequent oc¬
currence.
Repeating the Course of Medicine.—In the early stage of the dis¬
ease the course of medicine may be frequently repeated, provided
the patient experience benefit by the operation. When the condi¬
tion of the stomach does not require the emetic, the bath may be
applied daily, with a view to increase the action of the skin, and
cause a determination to the surface. The vapor bath may also
have an influence in changing in some degree, at least for a time,
the thickened state of the blood, which in diabetes is observed to
be thick like molasses. The caloric and electricity imparted by
the vapor bath, exert a most decided influence in vitalizing the
blood, by facilitating its circulation through the lungs, and by re¬
storing its natural temperature. The patient should be showered
with cold water at the close of the steaming, unless it be found to
occasion chilliness afterwards. A sudden shock to the system in
this way is always beneficial, provided the patient has heat enough
to react against the cold. When the patient is too feeble to bear
sitting up, the vapor bath may be applied in bed, and in this way
a moderate perspiration continued by it for an hour or two. When
the skin is very dry and harsh, it may be difficult to excite perspi¬
ration, and the patient will consequently be more or less oppressed
with heat, and require frequent sponging over the face and body
with tepid water, or vinegar and water, until perspiration be brought
on. Capsicum tea or other stimulants should be given, together
with nauseating doses of the tincture of lobelia.
The sumac leaves and berries made into a strong decoction,
adding a portion of cayenne, should be occasionally given;
and during the first period of the disease, frequent doses of the
tincture of lobelia, or the compound lobelia pills, should be admin¬
istered.
Tonics will be proper, more especially when the symptoms as¬
sume a more favorable aspect. Quinine, or any of the vegetable
bitters, may be used ; occasionally changing them
230
DIABETES.
The No. 3 pills may be used as a substitute for the sumac tea,
if the patient prefer this convenient form.
Stimulating liniments, pepper sauce, or No. 6, should be applied
to the surface of the body and limbs, after a vapor bath, and fric¬
tion to the skin daily persevered in.
Diet.—The food must consist of the most nourishing kind that
the stomach will bear. Eggs, beef, mutton, milk, &c., answer well
in many cases. Meat, in the early period of the disease, however,
and more especially if there be fever, may be improper.
Vegetables, in most instances, disagree with the stomach, and in
some cases, even a small piece of bread will do injury. It is im¬
portant in diabetes that all kinds of food that furnish sugar should
be avoided. Hence almost every vegetable substance is inadmis¬
sible. The gluten of wheat may be used, as this cannot become
converted into sugar in the stomach.
Animal Food is recommended in diabetes. In some instances,
however, it will not suit the stomach, when custards, eggs, milk-
porridge, &c., may be substituted.
From the feeble state of the digestive powers, and the vora¬
city of the appetite, there is an extreme liability to eat more than
is proper.
The clothing should be very warm, and especial attention is
necessary to keep the feet dry and warm.
Exercise in the open air is beneficial where the patient is able
to get out, either to walk or to ride.
Diabetes, however, is very seldom cured, when it occurs in de¬
praved or otherwise broken-down constitutions : these commonly
form an insuperable barrier to the. success of the practitioner,
though a ray of hope may be still held out, as in the most desperate
cases cures are sometimes effected.
SECTION IV.
RETENTION OF URINE.
{Inability to discharge Urine.)
The urine may be retained in the bladder either from inflamma¬
tion or constriction in the neck of the bladder; mechanical obstruc¬
tions in the neck of the bladder or urethra: or from a loss of the
power to contract the bladder, and expel its contents.
RETENTION OF URINE.
231
1st. Inflammation in the JVeck of the Bladder is one of the most
common causes of obstruction to the passage of urine. The in¬
flammation may arise from a diversity of causes, such as the
application of fly blisters to any part of the body or limbs; the
internal use of turpentine or cantharides; disease of the prostate
gland, or of other parts in close sympathy with the bladder; expo¬
sure to cold and dampness; an acrid state of the urine; repelled
gonorrhoea; and constitutional disorder, more especially in gouty
patients.
2d. Mechanical Obstructions.—These are gravel in the neck of
the bladder, or urethra; stricture of the urethra; enlargement of
the middle lobe of the prostate gland; prolapsus uteri; and
pressure of the uterus upon the neck of the bladder during preg¬
nancy.
3d. Paralysis, or a loss of power to contract the Bladder, occurs
from injury of the brain and spinal marrow; palsy of the lower
half of the body; malignant disease, as typhus fever; blows or falls
upon the back; over-distension of the bladder from retention of
urine caused by mechanical or other obstructions; injuries sustain¬
ed during child-birth; and from exhaustion of nervous power
through bad habits or from old age.
Treatment.—Whether the retention of urine be occasioned by
inflammation, or spasm in the neck of the bladder, or urethra, or
from mechanical obstruction, the constitutional treatment proper in
the one case, will be applicable in the others. Mechanical obstruc¬
tions, however, in many instances, require other means besides
constitutional treatment.
In ordinary cases, retention of urine may be relieved by evacua¬
ting the bowels by injections containing a portion of lobelia, to¬
gether with the use of means for equalizing the circulation, and
producing perspiration, by hot stimulating teas, and the vapor or
warm bath, or a blanket wrung out of hot water, folded several
times and laid over the abdomen; or by applying a bag of hops,
wet with hot vinegar, to the region of the bladder.
Injections.—One of the most effectual remedies for stoppage of
urine, is the use of injections of lobelia powder, in lukewarm water,
and caused to be retained in the bowels. This, together with the
application of warmth to the surface, as above mentioned, will sel¬
dom fail of removing the difficulty, unless the retention should arise
from gravel in the urethra, or neck of the bladder, or from other
mechanical obstructions. Even when there is a mechanical ob¬
struction, the above means should be used, with a view to relax
the parts, which will not only afford relief, but will render the
232 RETENTION OF URINE.
removal of the mechanical obstruction less difficult. Medical men
resort to tobacco injections, in severe cases, for the purpose ol
producing relaxation. This, however, sometimes produces serious
consequences, from the poison of the tobacco being absorbed into
the blood. The lobelia will answer every good purpose that could
be desired from the tobacco, and without any risk to the patient
of bad consequences from its employment, even in large quantities:
it contains no poisonous properties. In aggravated cases it may
be found necessary to use powerfully stimulating injections to the
bowels, with a view to prevent stagnation of the blood, in the dis¬
eased parts. For this purpose, the liquid of the third preparation
of lobelia will be proper, and may be used in larger or smaller
quantities, as the case requires.
The Vapor Bath fulfils several important indications in the stop¬
page of urine. It seldom fails of affording more or less relief from
pain, and, in some instances, will be sufficient, when well applied,
to remove the obstruction, more especially when it is occasioned
by inflammation, or spasmodic contraction in the neck of the blad¬
der, brought on by exposure to cold and wet.
Emetics.—In some instances retention of urine is associated with
extensive derangement of the stomach, so that emetics may be
found not only advantageous, but necessary; and when the ob¬
struction is not overcome by the means above mentioned, it will
be proper to give an active emetic of the third preparation of lo¬
belia, or some like preparation, such as the brown lobelia, given in
bayberry tea, adding a teaspoonful of capsicum to each dose.
The vapor bath previous to the emetic will render the latter more
effectual.
Retention of urine is always more or less dangerous when con¬
tinued over twenty-four jhours without any urine passing. It is
therefore highly important to persevere in the treatment until the
obstruction be partially or wholly removed. Thus in some cases
it may be found necessary to keep the patient fully relaxed, for
many hours together, under the influence of the lobelia injections,
and also to repeat the emetics every two or three hours, together
with the frequent application of the vapor or warm bath, or a
constant moist heat kept around the patient. The drink should
consist chiefly of elm gruel, flaxseed tea, watermelon-seed tea,
barley water, &c. It sometimes happens, though very rarely, that
a patient will be several days without passing water and yet expe¬
rience no serious injury from over-distension of the bladder. I
have a patient at this time, who has on several occasions been a
week without passing water.
Introduction of the Catheter. — When the catheter can be intro-
RETENTION OF URINE.
233
duced, it gives instant relief, but when the urethra or neck of the
rtladder is highly inflamed, it will be worse than useless to attempt
to pass a catheter* When the system is fully relaxed, the catheter
may, in some instances, be introduced by one acquainted with the
proper manner of using it. Much harm, however, often arises by
repeated attempts to pass the catheter when there is much inflam¬
mation. It is in paralysis of the bladder that the use of the cathe¬
ter sometimes becomes indispensable. But in those cases attended
with a burning pain in the neck of the bladder, with tenderness to
pressure, and a continued and painful desire to pass urine, the
catheter cannot be introduced safely even by the most skilful sur¬
geon, and every attempt made to introduce it, only tends to increase
the difficulty. First employ means for equalizing the circulation
of the blood and of the nervous fluid, and relax the system by lo-
oelia, and when the symptoms of irritation of the neck of the blad¬
der disappear, the catheter may be introduced if necessary.
Scabious (Erigeron Philadelpheum.)—A strong tea of this herb,
drunk freely, has proved of great benefit in cases of retention of
urine from irritation of the neck of the bladder. The addition of
honey not only improves the taste of the tea, but it increases ma¬
terially its diuretic properties.
Tapping the Bladder.—When gravel is lodged in the neck of
the bladder, or in the urethra, and in cases of stricture, every effort
to overcome the obstruction may sometimes prove abortive. Un¬
der these circumstances, the last and only resource is in tapping
the bladder, as the only means of saving the patient's life. This
operation, of course, will demand a surgeon, and one who is fully
acquainted with the anatomy of the parts.
In retention of urine from falling of the womb, or from its re¬
troversion, the introduction of a bougee may be sometimes neces¬
sary.
Treatment of Retention of Urine from Paralysis of the Bladder.
The chief dependence here must be in the use of the catheter, sti¬
mulating injections to the bowels, together with the employment
of such remedies as tend to give tone to the bladder, either by
general constitutional treatment, when the circumstances of the
case require it, and by the use of stimulating diuretics, such as the
oil of juniper, balsam of fir, or Peruvian balsam.
In low forms of fever, the bladder, in some instances, loses the
power to contract and expel the urine, and becomes greatly dis¬
tended, -which, if not relieved, may occasion serious consequences.
This should be borne in mind by those who have the charge of
patients very ill of typhus, or other malignant forms of fever; and
when there is evidence of a great accumulation of urine, as will
be manifested by a hard tumor in the right side of the belly, means
234
strangury.
should be used for evacuating it; and when hot fomentations to
the abdomen, and stimulating injections to the bowels fail ol pro¬
ducing a discharge of urine, it should be drawn off by the intro¬
duction of a catheter.
In severe injuries of the back, paralysis of the bladder frequently
occurs, and requires the repeated use of the catheter until the
power of contraction is restored to the bladder.
When it depends upon the debility consequent upon old age, then
fresh air, vapor baths, friction to the surface, stimulating diuretics,
and if the patient can bear it, occasionally a shower bath in the
morning must be employed. The urine should be drawn off before
the bladder becomes greatly distended, for if this be permitted to
occur, it tends still further to weaken the bladder. In some in¬
stances, to prevent distension of the bladder, the use of the catheter
will be required three or four times in the course of twenty-four
hours, in order to afford an opportunity to the bladder to regain
power to contract and expel its contents.
Onions mashed fine, and applied to the perineum, are said to
have had a good effect, in many instances, in restoring the tone of
the bladder.
SECTION V.
STRANGURY.
(Difficulty and Pain in Voiding Urine.)
When the urine is voided with great difficulty, and in small
quantities, attended with severe burning pain, and a continued de¬
sire to urinate, it is called strangury. The difference, therefore,
between strangury and retention of urine is, that in the former,
he urine passes, though it may be by mere drops, and attended
with a painful desire to void it; whereas in the latter, there is a
complete obstruction to the passage of urine.
Causes.—Strangury is in almost every instance associated with
constitutional disease. It is liable to occur at any period of life,
sometimes attending the period of teething in children, and it is
very common in old age. The application of a fly blister to anv
part of the body, will occasion strangury in some: and the same
effects are sometimes produced by the internal use of turpentine.
Gout, gravel, and piles, are often attended with difficulty and
pain in voiding urine. The intemperate use of spirituous lionoi s ,
enereal excesses; exposure to cold and dampness, or whatever
STRANGURY.
235
else tends to derange tne general health, may occasion strangury
in persons predisposed to it. " Nervous and hysterical females are
liable to extremely violent pains in the neck of the bladder and
urethra, and which are generally most intensely felt immediately
after discharging urine." Strangury in the old and feeble, is some¬
times occasioned by an enlargement of the prostate gland, but
more commonly it arises from other causes, as disease of the coats
of the bladder, irritating acids in the urine, and gravel.
Treatment.—Infants may be relieved of strangury by the warm
hip bath, or fomentations to the belly, together with the use of in¬
jections to the bowels, composed of half a teaspoonful of the tinc-f
ture of lobelia, or the same quantity of green lobelia in composition
tea. If the general health be much deranged, an emetic, or full
course must be given, followed by the use of flaxseed, scabious,
parsley, or watermelon-seed tea, and occasionally by small doses
of the tincture of lobelia.
When strangury is occasioned by a 'blister, this of course should
be removed, and the patient take mucilaginous drinks, as elm,
flax-seed tea, &c. If this does not remove the difficulty, recourse
should be had to fomentations and injections. When it arises from
the use of turpentine, the same constitutional treatment above re¬
commended, will be proper.
Associated with gout, the chief dependence must be on consti¬
tutional treatment, with a view to correct the acrid state of the
urine, and to restore the general health. As a means of affording
relief during severe attacks, the warm bath, vapor bath, or hot
fomentations should be used, together with injections containing a
portion of lobelia. The patient may experience relief by drinking
freely of scabious tea.
When it arises from gravel, constitutional treatment will be also
proper, for which an occasional course of medicine will prove the
most effectual. When the urine is high-colored, and deposits a
reddish or yellow sediment on standing, alkalies should also be
used, such as sal-seratus, bi-carbonate of soda, or a tea of hickory
ashes.
Scabious tea, sweetened with honey, and drunk freely, affords
almost instant relief in some cases.
Haarlsem oil is a favorite remedy with many for gravel, and
difficulty of passing water. The dose for a child is from 4 to 6
drops, and for an adult, from 15 to 20 drops.
When strangury is occasioned by irritation from piles, a strong
decoction, made by steeping witch hazel, or sumac leaves in boil¬
ing water, should be administered by injection, and retained in the
bowels for several hours, which will lessen irritation in the piles,
and in this way the occurrence of strangury may be prevented.
The lobelia injections and hot fomentations may be found neces¬
sary to relieve the immediate symptoms of painful irritation.
236
INCONTINENCE OF URINE.
When accompanied with hysterical symptoms, an emetic or a
full course of medicine will be necessary. The same constitu¬
tional treatment that will cure hysteria, will also remove strangury.
When strangury arises from prolapsus, or other displacement of
the womb, the same constitutional treatment will be proper, more
especially the enemas containing lobelia; the vapor bath, and hot
fomentations. It sometimes happens, however, in displacement
of the uterus, and more especially in its retroversion, that the in¬
troduction of a gum-elastic bougee into the bladder to draw off the
urine, becomes necessary before the displacement of the uterus can
be overcome.
Females affected with fluor albus, or whites, are subject to severe
burning pain on voiding urine, in consequence of an extremely ir¬
ritable state of the urethra. Injections of a strong decoction, pre¬
pared by steeping witch hazel or sumac leaves in boiling water,
adding a small portion of capsicum, should be used two or three
times a "day, with a female syringe, beside resorting to the usual
means for restoring the general health, by which the parts will be¬
come strengthened.
When attendant upon old age, or occurring in constitutions
exhausted by debauchery and intemperance, a permanent cure of
strangury is not to be anticipated: a relief of the symptoms will
be all that can in general be effected by any course of treatment
whatever.
Injections into the Bladder.—Warm water injected into the blad¬
der with an ordinary syringe, will immediately relieve strangury
in many cases, more especially when the urine is scanty, high-
colored, and acrid.
Honey taken in teaspoonful doses, three or four times a day, has
been used with signal benefit in some cases of strangury. It may
be employed to sweeten medicine when it is found to agree with
the stomach.
SECTION VI.
INCONTINENCE OF URINE.
(Involuntary Flow of Urine.)
Incontinence of Urine, though not in general attended with pain,
is nevertheless, in many instances, a very troublesome complaint.
It prevails most during childhood, and in old age.
incontinence op urine.
237
Inability to retain the urine, with children, is commonly owing
to constitutional weakness in the urinary organs. Sometimes it
arises from an acrid state of the urine; and occasionally it is caused
by gravel. Weakness of the urinary organs may be induced by ,
:quently having wet and cold feet.
The aged and feeble are especially liable to incontinence of
urine, from weakness or paralysis of the sphincter muscle of the
bladder, which is designed to retain the urine at the command of
the will. In some instances the action of this muscle is completely
lost, and the urine is continually passing oft' by drops as fast as it
enters the bladder from the kidneys. This complaint is frequently
associated with palsy and gout. Involuntary discharges of urine
often take place in protracted fevers, where patients are extremely
low; and observation proves it to be an unfavorable symptom.
In fine, the same causes that produce retention of urine in one, may
occasion strangury in another, and in another an inability to retain
the urine. Thus gravel, or stone in the bladder, which frequently
occasions a stoppage of urine, will in other instances cause the
urine to pass off involuntarily.
Treatrnent. — Incontinence of urine in children, is in most in¬
stances removed by the natural increase of constitutional strength.
When the general health is impaired, constitutional treatment will
be required, such as, an emetic to cleanse the stomach, and if the
stools exhibit an unhealthy appearance, injections may be used to
advantage, not only in correcting the bowels, but also to add
strength to the urinary organs. The injections are to be prepared
in the ordinary form. A strong tea made of the sumac bark, leaves
or berries, or of the aspen poplar bark, will be beneficial in strength¬
ening the urinary organs, either in the young or old. For an adult,
a teacup, two-thirds full, and for a child, a wineglassful of the tea
may be taken two or three times a day. If the urine be high-co¬
lored, and deposite a sediment on standing, alkalies must also be
used, such as bi-carbonate of soda, sal-eratus, a tea of hickory
ashes, or lime-water.
A cold shower bath in the morning; friction to the surface with
a salted towel, nourishing diet, exercise in the open air, and what¬
ever else tends to invigorate the system, will also strengthen the
urinary organs.
Children often evacuate the m*ine involuntarily at night during
sleep : and in some instances this habit continues even to adull
'age. Involuntary discharge of urine frequently takes place undei
tl?e influence of a dream. " Incontinence of urine," says Mr.
Charles Bell, " never takes place but when the boy is asleep upon
his back; and the cure is a very simple one. He is to accustom
himself to sleep upon his face or side ; the urine is not passed, nor
is he excited to dream of making urine, while he keeps this dos-
238
SUPPRESSION OP URINE.
ture. The circumstance is unaccountable, until we reflect upon
this master-spring of the neck of the bladder—the sensible spot, a 1
ittle behind and beloio the orifice of the bladder. When a person
lies upon his belly, the urine gravitates towards the tundes; but
when he lies upon his back, it presses upon this sensible spot, and
distends that part of the bladder which is towards the rectum.''
Long continued inability to retain the urine, more especially when
associated with old age, is in general an incurable complaint.
Benefit may be obtained, however, by the use of such remedies as
a strong tea of sumac, aspen poplar, vegetable balsams, spirits of
turpentine, and gum myrrh. Equal parts of tincture of myrrh and
balsam fir, shaken together, will be found serviceable in many cases.
SECTION VII.
SUPPRESSION OF URINE.
(The Kidneys ceasing to form Urine.)
Suppression is to be distinguished from retention of urine. In the
former, the kidneys cease to select the urine from the blood, con¬
sequently none is formed ; whereas in retention, the urine is formed,
but tlje passage by which it escapes from the bladder is obstructed.
The chief danger attending retention of urine is over-distension of
the bladder; but when the urine is not formed in consequence of a
'oss of action in the kidneys, the suppression is of serious conse-
juence if long continued.
The loss of action in the kidneys is a consequence of great de¬
rangement in the system, and seldom occurs except in the last stage
of disease, when the living powers are fast sinking, and the patient
beyond the reach of recovery. Suppression of urine, however,
does occasionally take place under circumstances different from
those above mentioned, that is: it sometimes occurs when the liv¬
ing powers are not so far exhausted but that the patient may re¬
cover by energetic treatment.
Symptoms.—The suppression may be either partial or complete,
and the only certain method of determining the suppression is bv
introducing a catheter into the bladder.
Suppression of urine cannot continue long without producing
serious consequences. " There is fever, thirst, a taste similar to
that of urine in the mouth, and a smell of urine in the perspiration;
o these, nausea, vomiting, sometimes of fluids, having a urinous
SUPPRESSION OF URINE.
239
odor, and hiccough succeed; and to these, oppressed breathing, de¬
lirium, and eventually stupor and convulsions."
Treatment.—Suppression of urine, except when it occurs in the
latter stages of disease, calls for prompt and energetic treatment,
with a view to excite action in the kidneys. When the suppression
takes place with a group of other symptoms, denoting a fatal ter¬
mination, as in the last stage of a disease, all remedial measures
must of necessity prove useless. When there is a probability of a
recovery being effected, stimulating injections should be adminis¬
tered to the bowels, and a tablespoonful of the third preparation
of lobelia may be used in each injection, and repeated frequently.
Steaming is of the greatest importance, not only to throw the
urea out of the blood by perspiration, but to sustain and augment
the vitality of the blood by the heat and electricity imparted to it,
and by quickening its circulation through the lungs.
Emetics will also aid in restoring action in the kidneys.
Hot stimulating poultices must be applied to the urinary region,
or small of the back, and kept warm.
The patient should be kept in a perspiration,—this is very im-'
portant.
Case. — A gentleman near Germantown, had been confined to
his room nearly the whole of the winter, and having, as he sup¬
posed, suppression of urine, desired me to attend him. No urine
had passed during seventy-four hours, and as there was no disten¬
sion of the bladder, there was strong evidence of suppression.
A thorough course of medicine was administered, and stimulating
injections repeated frequently, together with the free use of stimu¬
lating medicine. Not long after this treatment had been com¬
menced, the kidneys resumed their functions, and the patient re¬
covered rapidlv; the means used for restoring action in the kid¬
neys, had the effect also of removing the original disease, which
had occasioned the suppression.
240
ACUTE INFLAMMATION OF THE LIVER.
•CHAPTER VIII.
DISEASES OF THE LIVER.
SECTION I.
ACUTE INFLAMMATION OF THE LIVER.
Acute inflammation of the liver does not occur frequently in
temperate climates; whereas chronic functional derangements of
this organ, unattended with any symptoms of acute inflammation,
are very common.
Causes.—Inflammation of the liver may be induced by blows or
other injuries in the region of the liver; a sudden check to perspi¬
ration after violent fatiguing exercise; by gall stones, which are
hardened secretions formed in the gall bladder, and found in the
ducts; or it may be occasioned by the same influence that pro¬
duces intermittent, or remittent fever.
The symptoms attending acute inflammation of the liver, are ex¬
ceedingly diversified. Generally there is deep-seated pain in the
right side about the false ribs; which is considerably aggravated
by pressure. There is usually pain in the shoulder, and in some
instances the pain is confined exclusively to that part. A deranged
condition of the stomach and bowels always accompanies this dis¬
ease, attended with more or less nausea and vomiting. The stools
are generally light-colored; and the urine yellow, or red.
Professor Mitchell mentions the case of a boy whose liver was
wounded by the discharge of a gun, in which no pain was expe
rienced except in the shoulder. In another instance, a negro who
was run through the liver with a sword-cane, complained of pain
in the shoulder, and insisted strongly that the wound was there.
Pain in the shoulder is not, however, a constant attendant on in¬
flammation of the liver. Neither does costiveness always prevail,
for sometimes there are acrid secretions from the liver, which cause
purging.
Many of the symptoms which attend acute inflammation of the
liver, such as pain in the chest, short and hurried breathing, diffi¬
culty of lying down, fever, and a dry hard cough, so closely re¬
semble the more prominent symptoms of inflammation of the lungs,
that either of these complaints might very readily be mistaken for
INFLAMMATION OF THE LIVER.
241
the other. A mistake, however, that would lead to no bad conse¬
quences, as the same general plan of treatment is required in each
form of the disease, and in every other case of acute inflammation
of internal parts, regardless of the name or precise location of the
disease.
As the disease continues, the nervous system becomes affected;
there is great anxiety, and sometimes delirium.
The duration of acute inflammation of the liver varies from four
or five to ten or twelve days, when it terminates either in a resto¬
ration of the natural action of the organ, or in the formation ot
an abscess; or it may become a chronic disease.
There is always more or less danger attending acute inflamma¬
tion of the liver. Much, however, will depend upon the prompt¬
ness of treatment in the early stages of the disease.
Inflammation of the liver is frequently complicated with pleu¬
risy, and inflammation of the lungs.
Treatment.—Acute inflammation of the liver requires the same
general course of treatment as pleurisy, or inflammation of the
lungs. A full course of medicine must be given early in the dis¬
ease, and repeated daily, if the symptoms be violent, until a crisis;
be effected. If the patient cannot sit up, a moist heat may be ap¬
plied to the feet and around the body, in place of the vapor bath..
The system should be relaxed by broken doses of lobelia. Injec¬
tions are especially indicated, not only to relieve the bowels, but
to equalize the circulation, and also to effect a relaxation of the-
system by lobelia administered in this way. In all sudden attacks
of pain or inflammation, or fever, besides the regular course of
medicine, the system must be continued under the influence of lo¬
belia, sufficient to occasion relaxation of the capillary vessels, and
thereby remove the obstructions to the general circulation, and
obviate undue determination of blood to the part diseased.
Retching and vomiting, although exceedingly harassing to the-
patient, are nevertheless often beneficial in assisting the liver to<
relieve itself of stagnant blood, and vitiated bile.
Stimulants must be given with a view to equalize the circula¬
tion ; to maintain a determination to the surface; and to excite the
secretions of the mucous membrane of the stomach and bowels..
More especially should pure stimulants be freely used in the ad¬
vanced stage of the disease. Capsicum tea is the best stimulant;
and if the skin be dry, portions of lobelia powder or tincture mus1
be added.
Local Applications.—A warm poultice must be applied to the
affected side, and a hot brick, or a bottle of hot water, placed so.
16
242
CHRONIC DISEASE OF THE LIVER.
as to keep the poultice warm; or cloths wrung out of hot water,
and applied as hot as can be borne by the patient.
The Diet must be light, consisting chiefly of gruel, bai ley-water,
crust coffee, &c. In the more advanced period of the disease,
when the strength is greatly exhausted, it will be necessary to give
wine-whey and essence of beef.
Bitters may be used to restore digestion, after the tongue begins
to clean, or the disease has formed a crisis.
The symptoms denoting the formation of an Abscess in the Liver
are—irregular chills or rigors; pain and sense of fulness in the
region of the liver; and night sweats. When this group of symp¬
toms is manifested after acute inflammation of the liver, of several
■days' continuance, it furnishes strong evidence that suppuration
ihas taken place. The abscess may point to the surface and be dis¬
charged externally; or the pus may be discharged through the
gall ducts into the bowels; or it may escape into the cavity of the
.abdomen, and occasion fatal peritonitis. Abscess of the liver has
in some instances penetrated the lungs, and its contents been dis¬
charged by coughing.
An abscess having formed, the indications for the treatment
are,—to support the strength of the patient by the use of pure
stimulants and bitters, and by a nourishing diet. The articles of
diet, however, must be such as are suited to the condition of the
enfeebled digestive powers.
CHRONIC AFFECTIONS OF THE LIVER.
Although acute inflammation of the liver is of rare occurrence
in our climate, yet no organ in the body, with the exception of the
stomach, is more liable to chronic derangement of its function, than
the liver. Intemperance in the use of alcoholic liquor is a frequent
cause of chronic disease of the liver. It may, however, proceed
from a disordered stomach. A deranged liver is almost always a
torpid one. Dyspepsia is mostly attended with a deficiency in the
secretions of bile, from a want of proper circulation of blood
through the liver. Costiveness is in general the consequence of a
want of bile, and the use of purgative medicines with a view to
overcome a costive habit is very injurious, as they aggravate
and weaken the bowels, without restoring the action of the liver.
The intemperate use of alcoholic drinks is very apt to produce,
finally, torpor of the liver, and in some instances this organ becomes
greatly enlarged, as a consequence of intemperate habits. Pro¬
fessor Chapman thinks, that the majority of the cases of liver com
plaint, so prevalent in the southern states, are occasioned by the
CHRONIC DISEASE OP THE LIVER.
243
large doses of mercurial preparations, so much employed in those
parts.
A disordered stomach lessens the nervous power which governs
the function of the liver, and consequently the circulation of the
blood through the liver is enfeebled, and the secretion of bile di¬
minished; and if the cause that occasions the disorder in the liver
be continued, as in habitual drunkenness, the liver may lose its
power to perform its functions. The continued use of active ca¬
thartics, more especially of mercurial preparations, is pernicious
not only to the stomach and bowels, but also to the liver. Close
and intense study, confinement in illy-ventilated apartments, and
exposure to cold and dampness, depressing passions, and excessive
losses of blood, frequently occasion torpor of the liver. Derange¬
ment of the functions of the liver, however, are in most instances
but one link in a chain of disordered functions, from loss of vital
power in the system.
Torpor of the liver is associated with acute disease, such as
dysentery, cholera morbus, pleurisy, erysipelas, and autumnal
fevers. When patients are bled largely during an acute disease,
the excessive loss of blood may occasion torpor of the liver, con¬
tinuing for years, accompanied with dyspeptic symptoms.
If the debilitating influence occasioning torpor of the liver be
continued, the circulation will become more obstructed and feeble,
and finally the organ may lose its power to secrete bile, occasion¬
ing inveterate dyspepsia, dropsy of the abdomen, or jaundice.
Hence disease of the liver, which at first is but a link in a chain of
disordered functions, the seat of which is in the stomach, may
finally be the cause of a new train of disordered action throughout
the system, requiring a long course of treatment to effect a cure.
Symptoms attending chronic affections of the liver are extremely
diversified. The most obvious symptom indicating obstruction to
the flow of bile, is a yellowness of the skin and whites of the eyes.
Sometimes there may be a low grade of inflammation in the liver,
occasioning shooting pain in the side and shoulder, accompanied
with a dry, harsh, contracted state of the skin; loss of appetite,
bad taste in the mouth, extreme restlessness at night; and dizziness
of the head. In such cases digestion is always impaired, there are
flatulency and distress after meals, attended with heartburn, and
constipation of the bowels. In some cases the patient will be affect¬
ed with occasional diarrhoea, the stools presenting various appear¬
ances, sometimes clay-colored; in other instances bilious; or they
may be slimy and hard, or have a gfeen appearance. Sometimes
the liver becomes enormously distended and hard, filling at least
half the cavity of the abdomen, and its margins are distinctly felt
by pressing the hand on the abdomen.
244
CHRONIC DISEASE OF THE LIVER.
Treatment.—Depending for the most part upon a disordered sto¬
mach, the indications for the cure of disease of the liver are, tc
correct the disordered condition of the stomach and bowels, and
to warm and invigorate the system by the use of stimulants and
tonics, and by a well-regulated diet.
Torpor of the liver may be more readily overcome, in most in¬
stances, by a course of medicine, than by any other means. If the
disease become seated, it will be necessary in most cases to repeat
the courses of medicine, and during the intervals between them, to
use bitters freely; and if the bowels be costive, take three or
four of the compound lobelia pills after each meal and also at bed¬
time.
Acids.—Especial relief may sometimes be obtained by the use
of pepper sauce, taken in moderate doses three or four times a day,
and more especially at meals. This preparation is most likely to
prove serviceable when there is a desire felt for something of the
kind.
The Vapor Bath by its influence in restoring the functions of the
skin, may be employed with benefit in diseases of the liver or of
any other internal organ. Thomsonians, therefore, in applying
remedies, do not require a particular investigation to ascertain the
precise location of the disease, nor to know what name nosologists
would very learnedly apply to it; for the same general treatment
will be applicable to every other form of disease. Thus the vapor
bath which proves beneficial in curing disease of the liver, will be
equally applicable to disease of the kidneys, bladder, lungs, pleura,
bowels and head, and in fine it may be administered in any dis¬
ease with safety, though it may not always prove especially bene¬
ficial.
Emetics.—The most efficient means to remove obstructions of
the liver, in general, are the application of the vapor bath, follow¬
ed by a prompt emetic. Cases of very stubborn character have
been cured by continued vomiting from sea-sickness, the patient
being in a relaxed condition, similar to that produced by the influ¬
ence of lobelia upon the system. In cases of long standing, how¬
ever, and when the disease is associated with old age or an
exhausted constitution, the frequent repetition of a course of me¬
dicine might be harassing to the patient, and fail to effect a cure.
A change of organization in the liver having taken place, as it
sometimes happens when tht disease has been long-continued, a
palliation of the symptoms is all that can be reasonably looked for
from medicine,—as a radical cure, under such circumstances, ia
rarely to be accomplished.
The function of the liver may be influenced to a greater or less
CHRONIC DISEASE OF THE LIVER.
245
degree by means of medicine administered to the bowels. Hence
injections will be useful, not only to relieve the bowels, but when
properly prepared, to exert a beneficial influence on the liver.
Lobelia administered in this way, and retained, diffuses its influence
throughout the whole system, and at the same time that it occa¬
sions relaxation of the organs, it tends to restore their proper
functions. Again, injections are useful to cleanse the bowels of
morbid secretions, which they are more or less coated with, in
nearly, if not in all cases of seated disease. The morbid secretions
•alluded to, usually pass off" in the form of flakes, and sometimes in
pieces, from a few inches to a foot, or even a yard in length, hav¬
ing somewhat the appearance of an intestine. Patients not aware
of the frequency of its occurrence, sometimes become alarmed at
the passage of this kind of substance from the bowels. There are,
however, few if any recoveries from seated disease, in which there
has not been more or less of this morbid secretion passed from the
bowels.
Foot Bath.—The following mode of preparing and using a foot
bath, is recommended by many practitioners who have tried it,
namely: " Into a glass vessel, capable of holding a pint or more
of fluid, put eight ounces of water, and then pour in four ounces
of nitric, and the same quantity of muriatic acid. One ounce of
this mixture to a gallon of water, will form a bath of medium
strength. The feet and legs of the patient are to be immersed in
this bath at the temperature of about 96°, and kept there twenty
minutes or half an hour, just before going to bed. This should be
done every night, and the same bath will remain good for five or
six nights." The utility of the warm foot bath cannot be doubted,
and as there can no harm arise from the use of the acids, they
should be added as above directed.
If the tongue be coated with fur, a strong decoction of the bay-
berry or sumac, with the addition of a teaspoonful of composition
powder, or half the quantity of capsicum, may be taken once or
twice a day.
The use of bitters is called for in chronic affections of the liver.
If there be any cases in which the bitter root (apocynum androsoe-
mifolium) may be used with advantage, it is in chronic affections
of the liver. It must be given in pills, or the powder taken in
lukewarm water, but not in sufficient quantity to produce purging.
In every form of seated disease, where medicine is required for
many weeks or months in succession, an occasional change of
remedies will be proper.
«
Dandelion.—The dandelion, in the form of an extract or decoc¬
tion, has been used with especial advantage in chronic diseases of
the liver.
246
JAUNDICE.
Change of habits.—Torpor of the liver, and indigestion are some¬
times the consequence of retirement from active business. In such
cases the patients should, if practicable, resume their former ac¬
tive habits.
A sea voyage has often cured diseases of the liver of long stand¬
ing. A few weeks' residence near the sea shore, by effecting a
favourable change in the constitution of the blood, will often re¬
move chronic disease of the liver.
SECTION II.
JAUNDICE.
A diseased condition of the system, attended with either sup¬
pression or retention of bile, occasioning a yellow tinge in the skin
and whites of the eyes, is termed jaundice.
Jaundice may arise from various morbid conditions of the liver,
some of which are curable, and others again incurable. When
jaundice depends upon mere functional derangement of the liver,
from a deficient supply of nervous influence; or when it arises
from mechanical obstruction in the ducts that convey the bile from
the liver to the intestines, a cure may generally be effected: but
on the other hand when the structure of the liver becomes changed,
as it sometimes does, especially from long-continued intemperance,
an alleviation of the symptoms is all that can be accomplished by
medical treatment.
" When people have what is called jaundice," says Dr. Thom¬
son, " it is the prevailing opinion that they have too much bile,
and it is said they are bilious. This is a mistaken notion, for there
is no such thing as there being too much gall: it would be more
correct to say there was not enough. The difficulty is caused by
the stomach being cold and foul, so that the food is not properly
digested; and the bile not being appropriated to its natural use, is
diffused through the pores of the skin, which becomes of a yellow
color."
Symptoms. — The most prominent symptoms in jaundice, are,
yellowness of the skin and whites of the eyes, and loss of appetite;
bad taste in the mouth, costive bowels; the stools are of a lighter
color than natural, though sometfmes bilious, and occasionally
there is diarrhoea. The urine is the color of saffron, and sometimes
very dark, and communicates a bright yellow tinge to white linen.
The mental powers are enfeebled, and the skin is dry. The pulse
JAUNDICE.
247
is frequently unaffected: it is sometimes slower, and at other times
quicker than natural. Yellowness of vision is frequently one of
the first symptoms indicating the approach of jaundice, which
may arise from the humors of the eye becoming tinted with the
yellow coloring matter of the bile, and transmitting yellow rays
3f light. The patient is generally either restless and unable to
sleep, or continues in a state of somnolency or partial stupor.
The color, in jaundice, may vary from a light yellow to that of
a deep green, or almost black. The jaundiced appearance of the
skin is sometimes confined to the face and neck, in other instances
it is diffused over the whole surface of the body and limbs.
The approach of Jaundice.—Generally the disease comes on in
a gradual manner, associated with symptoms of indigestion ; " a
general feeling of languor; disinclination to bodily and mental ex¬
ertion ; an irritable and dejected temper; weakness of appetite;
constipation; acid eructations; slow and painful digestion; flatu¬
lent pains in the bowels; a slight feeling of fulness and tension in
the epigastrium, (pit of the stomach); restlessness at night; turbid
urine, usually depositing a copious pitchy sediment; slow and
languid pulse; more or less nausea ; and frequent transient chills,
alternating with flushes of heat." In some instances there is In
intolerable itching over the surface in the commencement of
jaundice.
Sometimes the disease comes on suddenly, with severe pain and
distress at the pit of the stomach, attended with frequent vomiting,
and an entire disgust for food.
Jaundice has occasionally been brought on by moral causes:
severe fright, intense study, grief, fanaticism on the subject of reli
gion, &c.
The duration of an attack of jaundice is extremely varied. In
some instances it passes away in the course of a few days, whilst
in others it will continue for months, and occasionally the disease
assumes the chronic form, in consequence of permanent derange¬
ment of the digestive functions, and continues for years accompa¬
nied with symptoms of dyspepsia.
Treatment.—Jaundice being merely a symptom, arising from
previous disease, it is to be overcome or removed by correcting
the derangement of the general health.
If the svmptoms be violent, the treatment must be thorough and
early applied. A course of medicine should be given, and repeated
every day or every other day, until the complaint assume a more
favorable aspect. Besides a course of medicine, the compound
lobelia pills may be given, together with an occasional dose of cap
248
JAUNDICE.
sicum in composition. Although courses of medicine constitute
the most effectual means for the cure of jaundice in general, there
are cases of it, and more especially those oi long standing, where
the liver has become changed in its structure, the complexion of a
greenish or very dark yellow hue, the patient far advanced in
years, or the constitution broken down by long-continued intem¬
perance or by the free use of poisonous drugs, in which courses
of medicine, especially the emetics, do but little good, except when
the patient is distressed with undigested food in the stomach, severe
colic, &c.
Tonics. — The most powerful kinds of bitters are required in
jaundice". In sudden and violent attacks, bitters may be employed
after the symptoms abate, but when the disease comes on in a gra¬
dual manner, they may be used from the first, in combination with
stimulants. A tablespoonful of the expressed juice of green worm¬
wood, added to an equal quantity of whiskey, taken three times a
day before meals, has been used by some with especial benefit.
Dr. Thomson, in treating of jaundice, says : " I have attended
many cases of this kind, and never had any difficulty in effecting
a cure. My method is to give No. 2, or the composition powders,
to raise the internal heat, and No. 1 to cleanse the stomach, and
p&>mote perspiration ; then give the bitters, No. 4, to regulate the
bile and restore the digestive powers. If the complaint has been
of long standing, and the system is much disordered, they must
be carried through a regular course of medicine; and repeat it as
occasion may require, and at the same time give the bitters two
or three times a day, until the appetite is good and digestion re¬
stored."
Sometimes jaundice is occasioned by gall stones being lodged in
the gall ducts, attended with violent paroxysms of pain in the right
side, near the pit of the stomach, and continued straining efforts to
vomit, the stomach at the same time forcibly rejecting any thing
that is swallowed. In a case of this kind, the vapor bath must be
applied ; and the system placed in a state of relaxation by lobelia
administered by injections; besides giving full and frequent doses
of the third preparation of lobelia, until the symptoms are relieved.
Gall-stones have been removed in many instances, by the operation
of emetics.
Straining efforts to vomit, when the system is warm after a va¬
por bath, and by having hot bricks wrapped in damp cloths placed
around the patient, and the muscular tissues relaxed by the influ¬
ence of lobelia, will prove the surest means of removing obstruc¬
tions, either in the gall ducts, or in the liver.
A warm stimulating poultice, applied to the pit of the stomach
<may relieve pain in the liver.
The warm foot-bath, prepared in the manner described in the
APOPLEXY.
249
treatment lor chronic disease of the liver, has been used with mark¬
ed advantage in jaundice.
Haarloem oil has been used with good success in some cases of
jaundice. .
Bitters, such as barberry, golden seal, and Thomson's No. 4, put
into hard cider, will be found good for the patient in many in¬
stances, more especially when there is a desire for cider.
Celandine, agrimony, blood-root, hempseed boiled in milk, be¬
sides many other articles and compounds, have been recommended
as specific remedies for jaundice, not one of which, however, can
be relied upon. Although patients may recover from jaundice,
under the use of celandine, hempseed, or some other of the reputed
specifics, there is no evidence that the disorder would not have
been removed sooner under Thomsonian treatment. Many cases
of jaundice have been cured by a persevering course of Thomso¬
nian treatment.
«
Change of Air.—In jaundice a change of residence, more espe¬
cially a residence near the sea, during the summer season, will
frequently be attended with a decided improvement in the general
health, even where medicines appear to do little or no good.
Diet.—In jaundice ijie digestive powers are always weak, and
therefore a strict attention to diet must be observed. In the com¬
mencement of the disease, and more especially if the symptoms be
violent, the diet should be confined to the lightest kinds of food.
In cases of long standing, it may be more nourishing, but it must
be easy of digestion. As a general rule, in jaundice, butter and
all kinds of fat meats disagree with the stomach.
Jaundice occasionally accompanies mental derangement, and
requires moral treatment, especially a residence in an insane
asylum. *
CHAPTER IX.
SECTION I.
APOPLEXY.
Symptoms. —A sudden suspension of consciousness ; loss of the
power of voluntary motion ; stupor; heavy and laborious breath¬
ing ; and a slow and full pulse, are the symptoms which charac-
250
APOPLEXY.
terize apoplexy. The symptoms attending apoplexy are necessa¬
rily modified by the degree of severity of the fit. It might be
difficult, in some instances, for even experienced physicians to de¬
termine whether the disease should be called apoplexy or palsy.
The name, however, is a matter of little consequence, inasmuch as
it should have no influence in governing the treatment.
An attack of apoplexy occasionally comes on suddenly, without
any precursory symptoms. More commonly it is preceded by gid¬
diness, and a sense of weight and deep-seated pain in the head,
ringing in the ears, and dimness of sight. • These symptoms may
last a few hours, or they may continue for a week, or even for
months previous to the attack, and occasionally disappear without
the occurrence of an apoplectic fit.
In some cases the attack comes on suddenly, the patient sinking
at once into a profound stupor, from which he cannot be in any
degree aroused — resembling a deep sleep — and each respiration
attended with a puffing of the lips, and a frothy saliva blown out
with a sputtering noise. These*cases generally prove fatal in a few
hours. In other cases, the patient may be seized with deep-seated
pain in the head ; sickness and vomiting j tremor of the limbs: diz¬
ziness ; confusion of mind; and then gradually sinks into a state
of stupor, from which he will partially recover, so as to converse,
and be able to sit up, and probably walk about, but will still com¬
plain of pain and distress in the head, attended with giddiness and
confusion of ideas.
Sometimes an attack of apoplexy comes on with palsy of one
side, loss of speech, pain in some part of the head, and vertigo,—
the patient retaining his consciousness. By degrees, in some in¬
stances, the brain becomes more oppressed and consciousness is
gradually lost, until finally a deep stupor ensues.
Deep intoxication sometimes so nearly resembles apoplexy that
it may be difficult to distinguish between them. The breath, how¬
ever, will detect intoxication, together with the relaxed state of the
muscles, particularly those of the jaws, the reverse of which occurs
in apoplexy.
In cases of suspended animation and fainting, the pulse and re¬
spiration are almost imperceptible, whereas, in apoplexy, the pulse
is usually as strong as in health, and respiration full.
True Apoplexy ahvays Dangerous.—When there is a total loss
of consciousness, the respiration accompanied with deep snoring, >#
a sputtering from the lips, loss of the power of swallowing, the
eyes fixed, and the urine and foeces passed involuntarily in the bed,
the case may be considered as almost hopeless. Still we are in¬
formed that recoveries do take place, even after these symptoms
have occurred.
APOPLEXY.
251
Duration of the Apoplectic attach. — This varies from a few mi¬
nutes to several days. In fatal cases the patient may live but two
or three hours; or the case may not terminate under a week or
more, from the commencement of the attack. In milder cases, the
patient may recover perfectly in a short time ; but more commonly
the patient remains weak, both mentally and physically, for months
or even years.
Medical writers of extensive observation, among whom I may
mention Hippocrates, consider the occurrence of fever, in the earlv
stage of apoplexy, a favorable symptom. When the pupil of the
eye will contract by the near approach of a lighted candle ; when
there is a warm and gentle perspiration; the breathing free and
regular, without noise or sputtering; together with the ability to
swallow; and a copious discharge of urine is observed, hope may
reasonably be entertained of a recovery.
Cause of Apoplexy.—The general immediate cause of apoplexy,
is stagnation of blood in the brain, suspending the function of in¬
nervation, or the generation of the nervous fluid, that governs the
voluntary movements and produces consciousness.
Apoplexy is most liable to attack persons of a peculiar con¬
formation, namely, those who have large heads, thick necks,
red faces, square shoulders, and a short stature. Very often, be¬
fore an attack of apoplexy, the patient will experience at times
violent pain in the head, ringing in the ears, together with slight
derangements in the functions of the brain, such as impaired me¬
mory, squinting, double vision, falling of one of the eyelids, imper'
feet articulation, numbness of one or more of the limbs. "Among
the mental conditions ihat bespeak a tendency to apoplectic dis¬
ease, I have, (observes Dr. Watson) several times noticed a strange
and vague dread, of which the patient can give no reasonable ex¬
planation ; a sense of apprehension and insecurity, not accounted
for by the apparent state of his general powers and functions; a
painful degree of indecision and irritability; with a dislike and
fear of being left alone.
Among the remote or predisposing causes of apoplexy are ad¬
vanced age; intemperance in eating and drinking; the long-con¬
tinued use of active cathartics; and the habit of being bled
frequently. The professor of Materia Medica in Jefferson College,
in the winter of '44, told his class that he believed many people
had died of apoplexy, occasioned by frequent bleedings, as formerly
was the practice with the disciples of Rush, of bleeding in almost
all cases of sickness.
Exposure to extreme cold, by exhausting the heat of the body,
and causing the blood to recede from the surface and form internal
congestion, is capable of producing apoplexy.
Severely protracted chills have been observed to terminate in
apoplexy.
252
APOPLEXY.
Positions of the body which favor a flow of blood to the head,
or impede its return to the heart, stooping with the head low, and
lifting great weights, have been known to bring on a fit of apo¬
plexy. It is only, however, where the predisposition to apoplexy
exists, that it is liable to be brought on by such causes.
Among the occasional causes of apoplexy may be mentioned,
excessive evacuations. The celebrated Boerhaave cites a case of
apoplexy, apparently produced by excessive bleeding from the
nose. Diabetes and cholera sometimes terminate fatally with
symptoms of apoplexy. Excessive loss of blood is frequently fol¬
lowed by an extraordinary determination of blood to the brain.
Experiments which have frequently been tried on animals, by ab¬
stracting large quantities of blood, and finally by bleeding them to
death, go to prove, as has been observed on dissection, that dropsy,
together with an engorged state of the blood-vessels of the brain
and spinal marrow, are a general consequence of excessive losses
of blood.
Treatment.—Such means and remedies must be employed in the
treatment of apoplexy, as are best adapted to equalize the circula¬
tion of the blood throughout the system, and restore the functions
of the brain, which are always either impaired or suspended in
this disease.
Emetics. — The most important indication for the cure of apo¬
plexy, and also for the preventing of an attack, is the evacuation
of the foul contents of the stomach by emetics. Where the apo¬
plectic attack is fully formed, attended with a sputtering of the
lips, deep stupor, and an inability to swallow, it will be useless to
attempt to get medicine into the stomach except by means of a
stomach tube, and even this would prove useless except in cases
where the attack is caused by an overloaded stomach.
Injections.—These are of the first importance in the treatment
of apoplexy. The third preparation of lobelia should be employed,
or some other combination of lobelia;—for instance, the lobelia
powder and No. 6. One, two, or three tablespoonsful of the third
preparation of lobelia maybe administered at a time, in half a pint
of lukewarm water, composition, or bayberry tea. This must be
frequently repeated, with a view to attract the circulation from the
head, and thus lessen the pressure of blood upon the brain, and to
arouse the nervous energy of the system to carry on the circula¬
tion more equally, and with a more healthy activity.
If a patient have an attack of apoplexy within a few hours after
a hearty meal, free vomiting will be imperatively demanded. The
third preparation of lobelia must be poured into the mouth, and
will be much more likely to be swallowed than a preparation of
APOPLEXY.
253
lobelia less stimulating. The impression of a powerful stimulant
in the throat will excite the act of swallowing, and the medicine
will be taken into the stomach, when the lobelia powder in luke¬
warm water, or composition tea would fail to excite the act of
swallowing, whilst the patient- is unconscious. When the functions
of the brain are suspended, as they are in apoplexy, large doses
of medicine will be required in order to effect vomiting; or as an
efficient aid to excite vomiting, the lobelia powder may be admin¬
istered by injection in lukewarm water and retained. A table-
spoonful of the powder may be used in the injection, which must
be repeated promptly if necessary.
No unfavorable consequences will arise from exciting vomiting
in apoplexy. It is not so much a determination of blood to the
brain that occasions apoplexy, as it is stagnation of blood in the
capillary vessels of the brain. To restore circulation, there are
no means upon which we can place so much confidence as emetics.
"A robust man," says Dr.' Eberle, "about fifty years of age,
fell down in a fit of apoplexy about an hour after taking a full
meal of animal food, together with several glasses of brandy and
water. The coma was profound, and the respiration stertorous
and sputtering. He was immediately bled to the extent of about
forty-eight ounces, but although the pulse was considerably reduc¬
ed, no perceptible improvement ensued. Twenty grains of the sul¬
phate of zinc were with difficulty introduced into the stomach, and
free vomiting ensued in about ten minutes after. Almost immedi¬
ately after the contents of the stomach were thrown off, he became
Detter." The patient recovered. The sulphate of zinc, being an
active poison, would have proved detrimental, had it not been
speedily thrown off. On account of the danger attending the ad¬
ministration of active poisonous emetics, most medical writers
recommend milder articles,—camomile tea, ammonia in water, or
mustard in warm water. But the sensibility of the stomach is
generally too dormant to be acted upon by these milder remedies.
The liquid of the third preparation of lobelia is the most effectual
emetic. Apoplexy, however, is a disease which frequently baffles
all remedial means.
% %
Favorable Symptoms.—When the stupor becomes less profound,
with some degree of awakened sensibility; the breathing regular
and not stertorous, and no sputtering from the lips; together with
a general warm perspiration, hope may be entertained of a favor¬
able termination of the disease.
The compound Lobelia pills may be given in all cases as a gene¬
ral medicine, between courses of medicine, and during the patient's
recovery.
If the tongue be thickly coated, a teacup of strong bayberry or
'254
PARALYSIS—PALSY.
sumac tea, with an even teaspoonful of cayenne, should be given
two or three times a day.
A mixture of salt, vinegar and pepper when the patient has an
inclination for acids, will be proper occasionally.
Bitter tonics should be given wheji the tongue is cleaning, and
the patient clear of fever.
External applications. — Besides the steam-bath, warm applica¬
tions to the feet and legs; frequently rubbing the skin with the
warm hand and the application of powerful stimulants to the sur
face, are of considerable importance.
Preventive measures.—When symptoms arise which denote the
approach of apoplexy, such as headache and giddiness, dimness of
sight, numbness of the extremities, drowsiness, faltering of the
tongue, night-mare and stupor, a course of medicine should be
given as the most efficacious means of preventing an attack.
SECTION II.
PARALYSIS —PALSY.
Symptoms.—These are a loss of the power of voluntary motion,
sometimes of feeling, in one half or some portion of the body, the
patient not losing his consciousness.
In some instances there is loss of the power of motion, but
without loss of feeling in the parts. In other cases sensibility
and the power of motion are both lost. This is termed numb
palsy.
In general the paralyzed parts are colder than other parts of the
body; they become soft and flaccid, sometimes puffy and dropsi¬
cal. Very often patients complain of great coldness in the affect¬
ed parts.. Sometimes peculiar tingling, or creeping sensations
are felt in the afflicted parts, as if small insects were creeping over
them."
When palsy arises from disease of the brain, it is generally at¬
tended with an impairment of the mental powers — amounting in
some instances, to complete imbecility. The memory especially,
is apt to suffer in this affection; and sometimes in a very singular
manner." Thus some patients will lose the power of recollecting
certain words, or names, sometimes even their own names, the
memory being good in relation to other things. " The natural
temperament and disposition also sometimes suffer a total change
PALSY.
255
from a stroke of palsy. Individuals of amiable and placid disposi¬
tions have become sullen, peevish and irascible; and persons of
an irritable and passionate temperament, have been rendered mild
and simpering by a paralytic seizure."
Varieties of Palsy.—Paralysis of the whole of one side of the
body is called Hemiplegia.
When both legs and the hips are palsied, it is termed Para¬
plegia.
When a single limb, or a particulai part of the body is para¬
lyzed, it constitutes the Paralysis Partiales of authors.
1. Hemiplegia — Palsy of one side.— Palsy of one side of the
body is more observed than any other form. " This disease is
very closely allied to apoplexy," the latter being in general a more
severe form of disease. An attack of apoplexy is very often either
preceded or followed by palsy.
Generally a stroke of palsy is preceded by symptoms of consti¬
tutional disturbance,—loss of appetite, costive bowels, distress or
extreme insensibility of the stomach, giddiness and pain in the
head, continual drowsiness, more or less impairment of speech,
confusion of mind, and loss of memory.
Sometimes patients recover from a stroke of palsy in a few days
after the attack ; occasionally the disease terminates fatally, but
most commonly the patient recovers gradually, until he is able to
move about; continuing in this state in some instances many years
without further improvement. Sometimes the recovery is complete.
It is a very common belief that few persons survive the third
stroke of palsy; and although it may be true in general, it is not
invariably the case; for instances have occurred where patients
have survived ten and even fifteen strokes of palsy, and lived many
years after.
Paraplegia—Palsy of the lower half of the body.—This form of
palsy usually comes on in a gradual manner. The patient at first
experiences numbness in the legs, succeeded by more or less diffi¬
culty in walking: his gait is awkward, and he requires a cane to
assist in balancing his body. The bladder becomes more or less
paralyzed, the urine being voided in a small weak stream, and at
length passes off involuntarily. The bowels are generally consti- (
pated; but when the sphincter muscle of the anus becomes para¬
lyzed, the fceces are evacuated without the consent of the will. In
some cases the palsy is complete, the patient being unable to walk,
or even to support himself in a sitting posture. In other instances
he retains some degree of power over the motions of his legs, so
that with the assistance of a cane or crutches, he is able to move
about.
In persons past the age of forty, this form of palsy is generally
256
PALSY.
occasioned by diseases of the brain. In children, the paralysis id
in most instances caused by injuries of the spine.
2. Partial Palsy. — Sensibility and voluntary motion depend
upon a nervous fluid, which is generated at the great centres of
the nervous system, the brain and spinal marrow, and is conducted
from these centres to every part of the system, through the medium
of the nerves, which act as conducting wires to the nervous
fluid. There are nerves of motion, and nerves of sensation. If
a nerve of motion be cut, the part to which it is distributed will
become paralyzed. If a nerve of sensation be destroyed or in¬
jured so that it is incapable of conducting the nervous fluid, the
part to which it leads will lose the power of feeling. If a portion
of the brain or spinal marrow lose the power to generate nervous
fluid, that part of the body will become affected whose nerves arise
from that part. Thus one side of the body having lost the power
of feeling, we know that the disease is seated in that portion of the
spinal marrow in which its nerves of sensation originate. If that
portion of the spinal marrow from which the nerves of motion
arise, is diseased, the parts will become paralyzed to which they
lead. And if both the anterior and posterior columns of one half
the spinal marrow lose their functions, that side of the body will
be affected with loss both of motion and feeling.
In partial palsy, when a single muscle or small portion of the
body is paralyzed, it is generally owing to disease in the nerve
which is designed to distribute nervous power to the part. Para¬
lysis of one side of the face alone, is sometimes occasioned by
injury of the nerves leading to the part affected.
Of the Causes of Palsy.—A loss of power in the stomach is fre¬
quently the original cause of palsy, more especially when the dis¬
ease attacks one side of the body. Although the immediate cause
of paralysis is a loss of function in some portion of the brain or
spinal marrow, still the original cause, in most instances, is seated
in the stomach. The functions of the brain and spinal marrow, as
well as those of every other organ in the body, are, to a greater or
less degree, influenced and governed by the state and condition of
the stomach. Thus a person advanced in years, and predisposed
to palsy from a weakened condition of some portion of the brain
or spinal marrow, will be liable to an attack of it from prostration
of the powers of the stomach. Both apoplexy and palsy are fre¬
quently brought on by undigested food in the stomach, long-con¬
tinued exposure to severe cold or dampness, the intemperate use
of spirituous liquors, loss of rest, over-exertion, grief, fear, and b}
other depressing influences.
"Among the exciting causes of partial paralysis, the poisonous
PALSY. 257
influence of lead is the most remarkable. The tendency of this
article, to produce paralysis of the fore-arm and wrists, is pecu¬
liarly strong, as is evident from the frequent occurrence of palsy
in persons who work in lead-mines, plumbers' shops, and in manu¬
factories of white lead."
Treatment of Palsy in General. — In the early stage of palsy, a
vigorous course of treatment is'demanded, with a view to restore
the lost function of that portion of the brain or spinal marrow, the
immediate cause of the disease. Whether the loss of nervous
power be occasioned by pressure of blood upon the parts, or from
loss of power through mere debility, or whether it depend upon
disease originally seated in the brain, a course of medicine will be
especially indicated, besides the continued use of such remedies
and means as will prove most successful in equalizing the circula¬
tion, and restoring the function of the stomach and bowels, with
a view to restore the lost function of the brain and spinal marrow.
The Course of Medicine should be commenced with an injection.
In most instances the bowels.are extremely insensible, requiring
the injections to contain strong stimulants, in order to produce the
desired effect. A tablespoonful of the third preparation of lobelia,,
in half a pint of bayberry tea, forms a suitable injection in palsy,
though in some instances double or treble the above quantity will
be required in order to make a sensible impression upon the bowels.
When the patient is unable to sit up, the vapor bath will of
course be applied in bed. It is always better to steam the patient
on a couch or mattress, and thus avoid dampening the bed upon
which he usually lies. Patients upon a couch or cot-bed will bear
the continued application of the vapor for several hours in suc¬
cession ; the body to be washed over frequently with whiskey, vine¬
gar, or cold water during the steaming.
When the patient is so situated as to be able to bear the steam
a considerable length of time, an emetic should be given during
the process of steaming. The best form of an emetic is the liquid
of the third preparation of lobelia, adding a portion of brown lobe¬
lia powder, given in a strong tea of the bayberry or sumac.
I have observed more benefit from emetics, than from any other
means. To assist the operation of the emetic, and to bring the sys¬
tem more completely under the influence of lobelia, it will be highly
important to administer an injection of lobelia powder, in lukewarm■
water. The course of medicine proves most effectual when the
patient becomes very sick, and the system is fully relaxed under
the operation.
The Compound Lobelia Pills, may be used with benefit. I have
a case of palsy now under treatment, and the patient has so far re*-
17
"258
PALSY.
cove^d as to be able to walk. The use of the above pills, toge¬
ther with an occasional emetic and the steam bath, followed by a
shower hath, two or three times a week, has constituted the principal
treatment in this case. She is now using bitters, and the bowels
are relieved by injections.
Palsy, however, is a disease from which patients recover very
« ovvly, and therefore, in deeply seated cases, it will not be neces-
fc.ry to pursue a very thorough course of treatment, except during
the earlier stages of the complaint; or when the symptoms assume
a more unfavorable aspect. Thus after administering a few courses
of medicine, repeating them every day, or every few days, the
course of medicine may be omitted, except occasionally, say at in-
terva'f of one, two, or three weeks, as the circumstances of the
case may seem to require.
When there is oppression at the pit of the stomach, fever, foul
itongue, or general distress, an emetic should be given.
Capsicum is the best remedy to warm the stomach and bowels
:and restore the secretions of the mucous membrane. It may be
taken in the form of pills, powder, or decoction. The compound
lobelia pills contain a large portion of pepper, and answer as a
substitute for other preparations of pepper. In all cases of palsy,
the mucous membrane of the stomach and bowels is more or less
coated with morbid secretions, which must be removed, or the
disease will continue. When the tongue begins to clean around
the edges, or the coating which covers its surface begins to soften, -
then the capsicum should be taken in bayberry tea. The pepper
stimulates the secretions, sustains the circulation, and causes a
determination to the surface; the bayberry combining with foul
secretions of the stomach and bowels, causes them to become
detached, leaving the mucous surface clean.
A mixture of salt, vinegar and pepper, is grateful to the stomach
in many cases, and is usually found beneficial when the patient
craves acid. The pepper sauce, or simple salt and vinegar, may
be employed in many cases of disease, with signal benefit to the
patient.
In palsy the bowels are generally costive, requiring an occa¬
sional injection. In palsy of the lower half of the body, the mos1
powerfully stimulating injections will be required, in order to make
a sufficient impression upon the bowels.
Mustard Seed.—A tablespoonful of white mustard seed taken
'two or three times a day, will stimulate the bowels to action, and
is well suited to cases of palsy. Mustard Seed and Horse-Radish
were favorite remedies with the late Dr. Barton, of Philadelphia,
who used them with much advantage in the Pennsylvania Hospital
in cases of palsy..
PALSY.
259
Tonics.—In an advanced period of the disease, or when the
system is in a relaxed and feeble condition, strong tonics will be
required; such as Peruvian bark, quinine, Thomson's No. 4 bitters,
wormwood, or quassia. Prickly ash bark or berries may be added
to the bitters with advantage.
External Remedies.—Besides the vapor and shower baths there
should be a continued application of warmth to the affected side;
the skin occasionally to be bathed with pepper sauce, third prepara¬
tion of lobelia, stimulating liniment, or No. 6. Frictions of the
surface with a flesh-brush or salted towel several times a day, will
be of advantage. Occasionally a pepper poultice or mustard plas¬
ter should be applied to the nape of the neck, extending eight or
ten inches below the spine. When mustard is applied, it should
not remain on so long as to produce a blister.
Paraplegia.—{Palsy of the lower extremities,) requires the same
constitutional treatment as above described, adapting the remedies,
however, to the circumstances of the case.
The bladder is frequently paralyzed in this form of palsy, some¬
times requiring the use of a catheter, to prevent an over-distension
of the bladder. The bowels require stimulating injections, and the
free internal use of compound lobelia pills, capsicum, pepper-sauce,
or mustard-seed; and as often as once a day, a teacup two-thirds
full of a strong tea of bavberry, adding a teaspoonful of cayenne
pepper.
The Hip Vapor Bath is adapted to this form of palsy. The parts,
however, being in some instances devoid of feeling, are liable to
be scalded by the steam, unless particular attention is paid to re¬
gulate its temperature. Especial care will also be necessary to
prevent the feet from being burned by hot bricks when they are
placed near them.
Children are sometimes affected from birth with unusual debility,
and want of power over the legs. Such cases require the cold
salt water bath or shower bath, frictions of the surface with a
salted towel, fresh air, wholesome food, stimulating applications to
the skin, together with internal constitutional remedies when the
general health is bad. If the digestion be feeble, or the bowels
disordered, with a foul tongue and bad breath, an emetic must be
given, and repeated when necessary.
Palsy of the lower half of the body, when of long standing, is
often incurable. It is therefore important to institute a thorough
course of treatment in the early stage of the disease, before it
becomes immovably fixed. Palsy, however, sometimes arises from
causes that cannot be removed, even though prompt remedial
measures be early applied.
PALSY.
For Palsy of the Tongue the patient should keep some stimulant
in the mouth, such as pepper, ginger, cloves, conserve of holly¬
hock, &c. In severe cases the third preparation of lobelia must
be employed. When the muscles of the throat are affected, the
patient will be able to swallow such substances as rye mush, jel¬
lies, and oysters, when thin liquids cannot be swallowed without
the greatest difficulty.
In Paralysis of the Optic Nerve, termed amaurosis, a course of
medicine frequently repeated in the early stage of the disease, will
prove the most efficient means of cure. This disease frequently
originates in a disordered stomach. It is not every case of amau¬
rosis, however, that can be cured even by the most prompt and
persevering course of treatment. The electro-galvanic battery
has been employed with good success in some cases of amaurosis.
Palsy of one side of the Face has been cured by emetics. A full
course of medicine will be more effectual. If the paralysis arise
from a destruction of the nerve, as when the nerve is cut, there is,
of course, no cure for such a case.
Mercurial Tremor.—(Shaking Palsy.)—" This disease affects
workers in mercury, chiefly those employed in silvering mirrors.''
Symptoms of Shaking Palsy.—At first there is slight tremor in
the limbs, and sometimes salivation; " afterwards convulsive agi¬
tation of the limbs whenever they are moved. The articulation
becomes imperfect. The hands are so agitated, that a partly filled
cup cannot be conveyed to the mouth without spilling the liquid.
On attempting to walk, the limbs dance and perform irregular
movements. Whilst sitting still, the patient may remain free from
chorea; but on every exertion of the volition, and on every occa¬
sion of mental agitation, the irregular movements are renewed.
The sleep is disturbed; the patient wakes alarmed by terrific
dreams; nervousness and debility attend, and the bowels are con¬
stipated."
Treatment.—In the onset of the complaint, a removal from the
influence of the cause; vapor baths, and an occasional course of •»
medicine, together with the use of stimulants and tonics, and exer¬
cise in the open air, may succeed in effecting a cure, or at least
prevent the disease from getting worse.
epilepsy.
26
SECTION III.
EPILEPSY.
('Convulsion Fits—Falling Sickness.)
An attack of this disease is characterized by a loss of conscious¬
ness, and by a jerking or convulsive motion of the muscles. Some¬
times the fit comes on suddenly, without any previous symptoms
indicating its approach; at other times it is preceded by various
symptoms of constitutional disorder, with giddiness, stupor, pain
in the head, and confusion of mind. Some patients experience a
sensation like that produced by a stream of cold vapor, commenc¬
ing in the feet and gradually extending itself until it reaches the
head, when the patient immediately becomes insensible. If the
patient be standing or sitting when he is seized with a fit, he sud¬
denly falls and is totally insensible; the eyeballs are distorted, the
breathing greatly interrupted, the face swells, and convulsions
ensue, which generally continue from five minutes to half an hour.
In some cases the convulsive action of the muscles, particularly
those of the face, is frightfully violent; the whole face is agitated;
the eyeballs roll; the lips and eyelids are convulsed; the tongue
is often spasmodically thrust from the mouth, which, with the
grinding of the teeth and foaming at the mouth, gives the counte¬
nance a horridly wild expression. Sometimes the teeth are firmly
pressed together; at other times the jaws are widely and fixedly
distended. The limbs of both sides of the body are equally con¬
vulsed in some cases, but more frequently the muscular spasms are
stronger on one side; and occasionally one limb only is affected
with spasm. "The heart palpitates rapidly; the pulse is usually
contracted, irregular, and frequent; and respiration oppressed,
laborious, and, in violent cases, sonorous. About the termination
of the paroxysm, a considerable quantity of frothy saliva usually
flows from the mouth; and in some cases the fceces and urine past
off involuntarily." Sometimes the convulsions stop suddenly, but
more commonly they decline gradually. The breathing becomes
more free, the countenance assumes a more natural aspect, and
the patient falls into a profound sleep. He is generally languid and
stupid, and when he awakes, he has no recollection of what has
passed.
The character of an epileptic fit varies greatly in different cases
In some instances it passes off in a few seconds—in others it con¬
tinues for hours. The paroxysm is most apt to be protracted ir
children.
Some patients are subject to convulsions at night only; othe*
262
EPILEPSY.
are liable to an attack at any period of the day. "W ith some, the
fits come on at regular intervals. Dr. Eberle mentions a case
where the paroxysm returned regularly on the night of each lull
moon.
Sometimes there will be but one paroxysm. In other instances
the patient will have them in continual succession during a period
ol many hours, sometimes passing from one into another, until he
has had twenty, forty, or even sixty fits, in the course of twenty-
foui hours.
Causes.—Convulsions may be caused by disease seated exclu¬
sively in the brain or spinal marrow; or the epileptic paroxysm
may be induced by a disordered condition of the stomach or bow¬
els, the functions of the brain being thereby sympathetically de¬
ranged. Sudden fright has been known to bring on epilepsy.
Excessive loss of blood has frequently led to convulsions.
In children, convulsions afe often occasioned by undigested food
in the stomach, and worms in the stomach or bowels.
In some families the children are peculiarly liable to convulsions
during the period of teething.
Small-pox, scarlet fever, and measles are occasionally attended
by convulsions, more especially just before the eruption appears;
and also when the eruption leaves the surface for the internal
organs, or, as it is commonly expressed, when the disease strikes
in. The use of laudanum predisposes children to epilepsy. Sup¬
pressed menstruation, and diseases of the uterine organs are some¬
times attended with convulsions.
Venereal excesses and abuses, and the intemperate use of alco¬
holic liquors, are among the exciting causes of epilepsy.
A sudden check to the menstrual flow, from exposure of the feet
to dampness, is liable to cause violent hysteric convulsions.
Distinguishing Symptoms between Epilepsy and Hysteric Convul¬
sions :
1. In epilepsy there is a total loss of consciousness, whereas
in hysteria some degree of sensibility remains.
2. The eyes are more distorted, and the face more suffused and
livid in epilepsy than in hysteric convulsions.
3. In epilepsy there is usually foaming at the mouth, which is
absent in hysteria.
4. In hysteria the paroxysm does not terminate in a deep sleep,
as it does at the close of an epileptic paroxysm.
5. Hysteric convulsions are generally attended by involuntary
paroxysms of laughing or crying, and a sensation of a ball in the
throat, none of which accompany epilepsy. Epilepsy and hysteria
may proceed from the same cause, the symptoms being of a more
aggravated character in the former than in the latter.
EPILEPSY.
263
Treatment.—An important indication in the treatment of epi¬
lepsy, and every species of convulsion, is to overcome the spasmo¬
dic action of the muscles. The third preparation of lobelia is the
remedy chiefly to be relied upon, this being the most efficient anti¬
spasmodic medicine in use. In many instances an attack of epi¬
lepsy may be prevented by the patient taking a tablespoonful or
even a teaspoonful of the third preparation of lobelia, when the
first symptoms of an approaching attack make their appearance.
Many persons, however, have no warning of the approaching pa¬
roxysm, but fall suddenly into a state of insensibility. The third
preparation of lobelia may be given during the convulsions, with¬
out any risk of strangling the patient, the stimulus of the medicine
in the throat sometimes exciting the action of swallowing, and
thus the medicine will be easily taken into the stomach. When
the third preparation is not at hand, the tincture or a simple tea
of lobelia may be used.
Emetics.—An oppressed or otherwise disordered stomach is a
frequent cause of convulsions in children, demanding the use of
emetics. If the convulsions be so strong as to prevent swallowing
the medicine, it must be administered freely as soon as the parox¬
ysm subsides, with a view to prevent a return of the convulsions.
The third preparation of lobelia is the most efficient emetic. The
lobelia, however, may be given in tincture, or the powder alone in
lukewarm water.
Injections.—These, when rightly prepared and administered, are
almost as effectual in overcoming convulsions, as medicine taken
into the stomach. They maybe administered during the paroxysm,
provided the convulsions do not prevent it.
In Adults who have been subject to frequent attacks of epilepsy,
during several successive years, the disease often proves incurable.
Yet an effort should be made, for in some instances cures have
been effected, even under circumstances which have promised little
hope of success. Whenever patients have warning of an attack
several hours previous to its occurrence, a course of medicine
should be administered, and whilst steaming, keep the head wet
with cold water, or vinegar, or occasionally dash a tumbler of cold
water in the face. If a full course be not given, the feet of the
patient may be placed in warm water—an injection administered,
followed by full and frequent doses of the third preparation or some
other form of lobelia, and the head kept wet with spirits, vinegar,
or cold water. A dash of cold water in the face, or the applica¬
tion of volatile salts to the nostrils, will sometimes prevent an attack,
at least for a time.
Patients are apt to injure the tongue during the paroxysm of epi-
264
INFANTILE CONVULSIONS.
lepsy, unless prevented by the insertion of a piece of wood or cork
between their teeth. In cases of long standing, it may be useless
to attempt to do more during a paroxysm, than to protect the pa¬
tient from injury.
After a Paroxysm, in children, and in all cases where there is
reason to believe'that the disease is occasioned by a disordered
stomach, or bowels, an emetic must be given as soon as the patient
can be made to swallow. If the stupor continue, injections must
be administered. Vomiting may be effected in this way, by the
lobelia powder, administered in warm water, and retained in the
bowels.
When convulsions are caused by suppressed menstruation, or a
disordered condition of the uterine organs, the patient must be
kept warm in bed, stimulating enemas used to the bowels, warm
applications to the feet, and an emetic given whenever the symp¬
toms demand it. Thus, if a female be subject to epilepsy or even
hysteria, at a certain time in the month, she should go through a
course of medicine a day or two previous to the time when the
paroxysm is apt to occur, and continue for several days the use of
the means above mentioned.
Epilepsy is generally incurable when it is caused by an organic
disease of the brain or spinal marrow. When it arises from othei
causes, such as undigested food in the stomach, affections of the
bowels, liver, or uterine organs, a cure may be effected.
SECTION IV.
INFANTILE CONVULSIONS.
Convulsions frequently occur in childhood, and more especially
in infancy. During this tender period, the functions of the brain
are liable to become disordered, or suspended, from various causes.
In some large families of children, the predisposition to convul¬
sions is so strong that every one of them will have fits during the
period of teething. In other families this form of disease is very
rare, although the gums may be equally irritated and painful, and
the digestion even more impaired.
Causes.—Undigested food in the stomach, irritation of the gums
from teething, or worms in the stomach and bowels, are the gene¬
ral causes of convulsions in infants and children.
The use of anodynes, laudanum, and various other preparations
INFANTILE CONVULSIONS.
265
containing opium, predisposes infants to convulsions by their ten¬
dency to produce congestion of blood on the brain. The follow¬
ing circumstance was related to me by a lady, intimately acquaint¬
ed with the family in which the melancholy affair happened. A
nurse wishing to visit a friend, gave an infant a dose of laudanum,
that it might not need attention in her absence. Soon after it was
given, the child was seized with convulsions, which continued to
return at frequent intervals, requiring constant watching day and
night up to the time when this statement was made to me, being
a period of two years. The faculties of the mind were destroyed
by the fits, with scarcely the possibility of remaining- for life other
than an idiot.
Thousands of children have their intellectual powers injured
by being forced to swallow anodynes. Laudanum occasions
sleep by producing partial congestion of the blood in the brain;
and it eases pain by benumbing the sensibility of the nervous
system.
• Children are peculiarly liable to convulsions during the early
stages of eruptive disease,—small-pox, measles, and scarlet fever.
More especially are they apt to occur a short time previous to the
eruption. On the event of the eruption striking in, convulsions
are very frequently observed. In very young infants, the cold
stage of " fever and ague " is sometimes accompanied by con¬
vulsions.
In children, as well as in adults, the cause of convulsions is some¬
times seated originally in the brain or spinal marrow, rendering
medical means unavailing.
Fatality.—Death from convulsions, though of rare occurrence
in adults, is by no means uncommon in infants and children. " In
ordinary constitutions there is but little to be apprehended from
convulsions during infancy, when the attacks are slight and of
short duration; and this observation applies especially to those
instances which, instead of leaving the infant in a dull lethargic
condition, are almost immediately succeeded by the natural cheer¬
fulness of the child."
Unfavorable Symptoms.—When the convulsions are of long con¬
tinuance, attended with a dark or purple appearance of the coun¬
tenance, palsy of one side, or of a limb, squinting, and difficult and
stertorous breathing, the case is to be considered unfavorable for
recovery.
Treatment.—Infantile convulsions are caused in the great ma¬
jority of instances by constitutional disorder, the seat of which is in
the stomach and bowels, and require for their cure that kind of
treatment best adapted to cleanse the stomach and bowels, and
266
INFANTILE CONVULSIONS.
restore their natural functions, and also to equalize the circulation
of the blood and nervous fluid. The various preparations of lobe¬
lia, and the vapor bath are the means most to be relied upon.
When a child has symptoms of approaching spasms, such as
twitching of the muscles, and fever; an emetic should be given at
once, as this will prove the surest preventive to an attack.
Convulsions often occur in a far advanced stage of disease of
the brain, produced by previous disease, especially bowel com¬
plaint and cholera infantum; and also under other circumstances
where it will be useless to give an emetic, with the view of curing
the patient.
Anti-Spasmodics are especially called for in the treatment of
convulsions ; the third preparation of lobelia is the best probably
that can be used. I have never heard of an instance of a child
being suffocated by stimulating medicine, but there have been in¬
stances where death has been occasioned by castor oil being
poured into the throat. The simple tea of brown lobelia, made by
pouring warm water upon the pulverized lobelia seed, will prove
most effectual in relaxing the system, and it may be either given
by the mouth, or administered by injections.
Injections should be given because of their tendency to attracl
the circulation to the bowels, and thereby lessen the pressure of
blood upon the brain. If the patient remain in a state of stupor
after the paroxysm, stimulating injections should be administered.
From one to two teaspoonsful of the third preparation may be
administered in each injection, in bayberry or composition tea,
and this repeated every few minutes.
I have administered lobelia- in the form of tea, and the third
preparation, in frequently repeated doses, until at least the strength
of an ounce of lobelia has been retained in the stomach before
vomiting was effected, and it is not possible in some cases to effect
vomiting. Some weeks since I attended a child in convulsions
and deep stupor, and after having given freely of lobelia, and
administered several injections, I introduced the feather end of a
goose-quill, into the throat six or eight inches, and in this way-
excited vomiting, and the child recovered speedily. Some cases
require much perseverance in the treatment, before vomiting can
be brought on.
CHLOROSIS.
267
SECTION V
CHLOROSIS—GREEN SICKNESS.
Symptoms.—The term chlorosis is applied to a form of disease
peculiar to young women and girls in which there is marked pale¬
ness of the skin, absence of the natural red color of the lips,
swelling of the eye-lids, a soft and flabby state of the skin, loss of
flesh, general coldness of the system, a tendency to a swelling of
the feet and ankles, loss of appetite, and torpor of the bowels. The
tongue is pale, and usually more or less furred ; yet sometimes
clean, but always paler than natural. Menstruation is deficient,
and sometimes this evacuation is entirely suppressed. There is
frequently a craving for pickles, chalk, or cinders.
As the disease becomes more deeply seated, the countenance is still
more pallid, and sometimes assumes a yellow or greenish appear¬
ance. " The skin is smooth, but is preternaturally dry. The ten¬
dency to dropsical swellings of the feet and ankles increases, but
there is seldom any further wasting of the flesh. The tongue
clears and becomes smooth, but continues pale, with a slight but
peculiar appearance of transparency, and has a lilac hue. The
patient is affected with languor, lassitude and even serious weakness,
being at once reluctant and unable to undergo fatigue." There
are often severe attacks of pain in the side and head, palpitation of
the heart, faintness and a sensation of suffocation. The bowels are
inactive, with occasional attacks of diarrhoea; the stools are dark,
fetid and scanty. The digestion is always greatly impaired, yet
patients will sometimes have a craving appetite for food, as well as
for indigestible substances, such as tea-leave^, coffee-grounds', mor¬
tar from old walls, chalk, pickles, or charcoal, &c.
There is a peculiar tendency in this disease to a bleeding from
the nose, stomach and bowels, or uterus. The blood discharged is
pale and watery, sometimes scarcely producing a stain on linen.
An attach of chlorosis, though not free from danger, is generally
curable by judicious treatment early applied, before the disease
assumes an inveterate character.
In chlorosis the amount of heat and nervous energy generated in
the system is much less than is produced in a state of health; every
organ in the body is in a torpid condition; the secretions are di¬
minished, but little bile is formed; the mucous membrane of the
stomach and bowels is coated with thickened secretions, forming
a false membrane; digestion, assimilation and nutrition, are im-
268
CIILOROIS.
perfectly performed; and the blood is in an unhealthy and impo¬
verished condition.
Treatment.—The general course of treatment to be adopted for
the cure of the above form of disease is as follows:
1st. To warm the system by the use of pure stimulants and ex¬
ternal warmth.
2d. Courses of Medicine. — To be administered as the circum¬
stances of the case may demand.
3d. Injections to evacuate and tone the bowels, and also to act
upon the uterine functions, through nervous influence.
4th. The continued use of pure stimulants and the strongest kinds
of bitters or tonics. Gentle exercise, fresh air, and a nourishing
diet, are important curative means in the treatment.
Course of Medicine.—Under the influence of a course of medi¬
cine, a new action is awakened throughout the whole system. The
steam imparts warmth to the blood, equalizes its circulation,
strengthens the nervous energy, increases the sensibility of the sto¬
mach to the impression of medicine, and for a time restores the
functions of the skin. By the emetic the stomach is relieved of
matter which may have oppressed its functions; the efforts to
vomit whilst the system is relaxed, tend to remove obstruction in
the liver and in other important organs. The stimulus of the me¬
dicine augments the secretions, and occasions a determination to
the surface. Injections relieve the bowels, and exert a beneficial
influence upon the uterine organs, the functions of which are always
deranged in chlorosis. Lastly, but not least in importance, under
the operation of the course of medicine, more or less of the false
coating or " canker" becomes detached and removed from the mu¬
cous membrane of the stomach and bowels. This false membrane
must be removed before the general health■ can be restored. I have
known, on several occasions, quarts of a skinny-like substance dis¬
charged by the bowels in cases of chlorosis, which probably had
been formed in the early period of the disease.
Repeating the Course.—As a general rule the course of medicine
will require to be administered most frequently in the earlier period
of the disease. When the disease has become deeply seated, and
the system cold, torpid, and much weakened, it may not be neces¬
sary to repeat a course oftener than once in two or three weeks.
Preparing the Emetic.—In all cases where there is great want
of tone in the stomach, and a general torpor prevails throughout
the system, the liquid of the third preparation, of lobelia is the most
appropriate emetic. It should be given in a strong tea of bayberry
or sumac. There is no form in which lobelia can be prepared to
CHLOROSIS.
269
operate so effectually and at the same time so easily, and with so
little retching, as that of the third preparation of lobelia combined
with a powerfully astringent tea.
Milk-porridge, or gruel, seasoned with salt and pepper, must be
given both during and after the operation of the emetic. This is
an important part of the course of medicine in all cases of chronic
disease, attended with marked debility.
Of Injections.—Stimulating injections to the bowels, by attract¬
ing the vital energies to the uterine organs, are well adapted to
cure cases of suppressed or obstructed menstruation. The injec¬
tions may be prepared of bayberry tea, adding to each injection a
teaspoonful of the third preparation of lobelia, or a teaspoonfuf o
No. 6, and a teaspoonful of green lobelia powder; or use compo
sition, or pennyroyal tea, adding the green lobelia, cayenne ana
No. 6. The injections to be repeated once or twice a day, and
continued. Besides these, a strong tea of poplar or Peruvian bark,
used by injection at night, and retained until morning, will be
useful.
White mustard seed or prepared charcoal maybe used to aid in
stimulating the bowels to action when costiveness prevails.
The Compound Lobelia Pills may be used as a general medicine
in all cases of chlorosis. Ten or twelve of these pills may be
taken daily, as they furnish a moderate and permanent stimulus
to the stomach and bowels, and exert a beneficial influence in cor¬
recting their secretions. When liquids oppress the stomach, or
the patient prefers medicine in the form of pills to decoctions, tonics
as well as the stimulants may be given in this form—such as qui¬
nine pills, and pills composed of bitter extracts.
Tonics.—Bitter tonics may be employed in any stage of this or
any other form of chronic disease, when the patient is clear of fe¬
ver. They are particularly called for after the patient has been
awhile under the treatment already described. Besides the usual
tonics, precipitated carbonate of iron may be given with especial
benefit in this and in other cases of chronic disease. The dose is
a teaspoonful, mixed with an equal quantity of ginger, with a
sufficient quantity of water to render it easy to take. The tincture
of guaiacum is a favorite tonic with some practitioners in chlorosis
and in other cases of obstructed menstruation.
' Gum myrrh is a useful tonic in chlorosis. It may be formed
into pills, and three or four taken after each meal, or the myrrh
may be finely pulverized, mixed with quinine, precipitated carbo¬
nate of iron, or bitter extracts, and the compound formed into pills.
The following is a very good general course to pursue in this com'
270
CHLOROSIS
plaint. — A course of medicine once a week; and between the
courses a teaspoonful of composition powder prepared in lukewarm
water taken every morning before or after breakfast; and from
one to three compound lobelia pills two or three times a day. After
this course of treatment has been pursued a week or two, give
tonics throughout the day between the courses of medicine, and
the compound lobelia pills at bed-time. If the patient becomes dis¬
gusted with any particular tonic, substitute others. Pills made of
equal parts of pulverized myrrh and precipitated carbonate of iron
constitute one of the most efficient of tonics.
The. Diet must not be confined to vegetables. Wild game, fresh
beef and mutton, eggs, and whatever is found to agree with the
stomach may be given. Pastry and hot bread of every descrip¬
tion must be avoided.
The patient should seek the open air; use gentle exercise; keep
the feet well protected from dampness; and occasionally sponge
the surface with salt and water in the morning, particularly when
the weather is warm.
SECTION VI.
HYSTERIA—HYSTERIC FITS.
Hysteria presents in different cases a great diversity of symp¬
toms. It mostly occurs in paroxysms, popularly called hysteric
fits.
Hysteria never occurs in childhood, it being almost exclusively
confined to the period which intervenes between the fourteenth and
fiftieth years. It is almost peculiar to females; still, the disease, in
a mild form, is occasionally observed in men, more especially those
who lead a sedentary life, and are delicate, and of a nervous
temperament.
Symptoms.—At one time " the fit consists of excessive laughter
alternating with crying or screaming; and at another with mental
alienation, rapid and incoherent talking, singing, suffocating spasms
in the throat, a wild and furious expression of countenance, raving,
gnashing the teeth, tearing out the hair, beating the breast with
the hands, biting, &c. Occasionally these symptoms subside with¬
out terminating in convulsions. More commonly, however, con¬
vulsions of a terrific character speedily ensue." During the spasms
" the body is usually rigidly bent backwards, or variously and
HYSTERIA.
271
most powerfully contorted; the breast is projected forward and the
head drawn backwards; the face is swollen and flushed ; the eye¬
lids are closed and tremulous; the nostrils distended; the jaws
often firmly shut; but there is no distortion of the countenance;
the cheeks are at rest, unless when, as often happens, the patient
is uttering screams or exclamations. If the hands are left at
liberty, she will often strike her breast repeatedly, and quickly, or
carry her fingers to her throat, as if to remove some oppression
there; or she will sometimes tear her hair, rend her clothes, or at¬
tempt to bite those about her. The whole muscular system is
thrown into such violent spasms-that scarcely any effort of the
bystanders is sufficient to restrain the contortions, or prevent the
patient from being thrown out of bed."
" When the paroxysm ceases, the patient is left in an exhausted
or stupid and somnolent condition, which, if there be no return of
the fit, in the course of an hour or two passes away without leav¬
ing any other affections than a feeling of general soreness, and a
slight pain in the head and pit of the stomach." In many instances
the convulsive paroxysms continue to return at frequent intervals
for several hours.
Sometimes, instead of spasms there are stupor and insensibility;
the limbs are in a relaxed condition, the jaws firmly closed, the
eyes shut, the countenance nearly natural, the breathing irregular,
the pulse slow and regular, the extremities are cold, and the power
of swallowing is lost. Young females sometimes remain in this
condition many hours, or even the whole day or night, and reco¬
ver from this condition depressed in spirits, fatigued, and crying.
In some instances the patient experiences distress in the abdo¬
men ; a ball appears to roll about, and rise to the pit of the sto¬
mach, and then to the throat, producing a choking sensation; the
act of swallowing is frequently repeated; the abdomen becomes
distended with wind, loud rumblings and sudden belching take
place; there is much palpitation of the heart, the patient is sad and
sorrowful, and prone to shed tears.
After the paroxysms, these patients commonly void a large
quantity of limpid urine, looking almost like water; and this is
sometimes expelled during the fit.
Almost any part of the nervous system, in women predisposed
to hysteria, is liable to fall into a disordered state of action, pro¬
ducing symptoms closely resembling those of other, and far more
serious forms of disease. There are cases of hysteria that might
very readily be mistaken for peritoneal inflammation. The patient
complains of acute pain in the abdomen, aggravated by the slight¬
est pressure; can scarcely bear to be moved in bed; and probably
she will have a hot skin, quick pulse and furred tongue. The
anxious and ghastly expression of countenance peculiar to perito¬
neal inflammation, does not accompany this form of hysteria.
272
HYSTERIA.
Not dangerous.—Hysteria, however violent the paroxysms, very
rarely proves fatal.
Patients subject to hysteric fits, are apt to feel a tenderness in
some part of the spine when it is pressed upon, which fact has led
some physicians to view hysteria as a disease depending upon ir¬
ritation of the spinal marrow. Other theorists contend that its
seat is in the uterus, whilst others again locate the disease in the
brain. It would be useless in a practical point of view, to attempt
to sustain or refute any of these theories, as the disease, in all
cases, must be treated upon geiaeral principles, applying the reme¬
dies to suit the emergency of the symptoms.
Treatment. — Hysteric fits are generally preceded by extreme
languor, coldness of the hands and feet, and distress at the pit of
the stomach. At this period stimulants should be given,—capsi¬
cum, composition, or spice bitters. No. 6, essence of peppermint,
or lavender brandy, may be also used to expel wind from the
stomach. The feet should be placed in warm water, and volatile
salts applied to the nose.
If the symptoms be not relieved by the above means, an emetic
must be given, and the patient warmly covered, and warm bricks
applied to the feet.
If spasms or fits come on, give the third preparation of lobelia;
or brown lobelia powder in lukewarm water.
Females are sometimes thrown into violent convulsions in con¬
sequence of obstructed menstruation. In such cases the brown
lobelia or third preparation must be given freely, warmth applied
to the feet and injections administered if practicable.
The Vapor Bath. — Warm vapor applied to the surface soothes
nervous agitation, and is signally beneficial in all cases of hysteric
affections. When the system is very cold, a bath preceding an
emetic will materially assist the operation of the latter.
Injections. — Stimulating enemas are scarcely less important,
both as a preventive and curative means, in hysteria. The liquid
of the third preparation of lobelia, or the lobelia powder in No. 6,
is to be administered in warm water, bayberry, composition, or
skullcap tea. When there is a violent determination of blood to
the head, the use of stimulating enemas is particularly called for,
as they prove an efficient means of equalizing the circulation of
the blood, and of sustaining and equalizing the nervous influence.
Mustard plasters applied to the feet and palms of the hands may
have a beneficial influence in soothing nervous agitations.
Antispasmodics.—The third preparation of lobelia is the best
HYSTERIA.
273
anti-spasmodic, and it also answers as an emetic arid stimulant.
, This medicine may be given in teaspoonful doses at any time when
the patient can swallow. Even during hysteric convulsions, the
liquid of the third preparation poured into the sides of the mouth .
when the teeth are firmly closed, will have an influence in shorten¬
ing the paroxysm, even though the medicine should not be swal¬
lowed.
Musk may be employed with benefit in hysterical paroxysms.
The high price of the article, however, together with the circum¬
stance of its being rarely found in the shops free from adultera¬
tion, has occasioned the almost entire abandonment of its use in
practice.
Warm fomentations are useful to relieve, pain in the chest or
abdomen. If the head be hot, cloths wet with cold water, spirits
or vinegar, may be applied, and changed frequently.
" In that variety of paroxysmal hysteria," says Dr. Eberle, " in
which the patient lies in a state of torpor and insensibility distinct
from syncope, I know of no remedy so effectual for dispelling the
attack as an emetic." If the patient cannot be made to swallow,
lobelia administered to the bowels in full doses and retained, will
have the same effect upon the system as when taken into the
stomach. A mustard plaster, or pepper poultice applied to the pit
of the stomach, will aid in exciting vomiting. When mustard is
employed, it should be removed before it blisters the skin.
During violent paroxysms of hysteria it will be useless in many
instances, to attempt to administer medicine until the spasms sub¬
side. As soon as the spasms give way, and the patient can swal¬
low, an emetic should be given with a view to prevent the return
of the convulsions. The best form of emetic in all such cases is,
a large teaspoonful of the liquid of the third preparation of lobelia,
with about an equal quantity of lobelia powder, mixed in a teacup
two-thirds full of bayberry or sumac tea. The emetic to be re¬
peated until vomiting is effected. Acids in the stomach interfere
with the operation of emetics, and whenever the emetic is slow in
its operation, a teaspoonful of the bi-carbonate of soda, or half the
quantity of sal-eratus should be given, dissolved in a teacupful of
lukewarm water.
It has been observed by some Thomsonian practitioners, that in
cases of hysteric convulsions, when the patient complains of pain
in the stomach, the spasms cease—the medicine in restoring the-
power of the stomach to control the nervous influence, equalizes"
the circulation and prevents a return of the convulsions.
Chronic Hysteria.—Unmarried women who either are naturally
of a feeble constitution, or have been debilitated by disease, and in
18
*274
HYSTERIA.
whom the menstrual function is in some way disordei'ed, are pecu¬
liarly liable to hysteric symptoms. " They are always complain-^
ing of some unpleasant or painful sensa'tions ; their temper is
variable, often fretful, sortietimes animated, talkative, and anon
peevish and gloomy ; they pass often rapidly from laughing to cry¬
ing, from gaiety to melancholy, from despondency to hope, and
o ce cersd, from the most trifling causes. They often complain of
various distressing sensations in the abdomen, head, and chest,
flatulency, a rumbling noise in the bowels, severe colic pains, a
sense of weight and bearing down in the region of the uterus, pain
in the neck of the bladder, dysury, a feeling of emptiness or iulness
•and tension at the pit of the stomach, variable appetite, slow diges¬
tion, eructations, occasional spells of great anxiety and alarm,
palpitation of the heart," faintness, a peculiar sensation of weight,
•or of numbness in the top of the head, severe pains in the head,
(breast, or other parts of the body, and sometimes the sensation of
a ball rising in the throat.
Hysterical persons ase especially liable to affections of the
throat. In some there is a sudden loss of the voice, and which
again as suddenly returns; others are affected with what is termed
hysteric cough characterized by a peculiar loud, dry, harsh sound,
more like a bark than a cough. Difficulty of breathing is another
■symptom attending constriction or spasm of the muscles about
the throat in hysteria. Then again there is the " hysteric breast
one of the breasts becomes painful, tender, and enlarges ; and the
patient probably consults a physician, fearing it to be a cancer
forming; but which requires constitutional treatment.
Spitting blood, or saliva streaked with blood, is by no means an
unusual occurrence in hj^teria, unaccompanied with disease of
the lungs.
"Another prank belonging to hysteria" (observes Dr. Watson
in his lectures) " and one which it is very necessary that you
should be on your guard against, is that of mimicking disease of
the bones of the spine. The patient complains of pain and tender¬
ness in her back, and of weakness probably in her lower extremities,
and it is now become notorious that scores of young women have
been unnecessarily confined for months or years to a horizontal
.position, and had their backs seamed with issues, for supposed
■disease of the vertebra, who had really nothing the matter with
them but hysteria, and who would probably have soon ceased to
complain if, instead of being restricted to that unnatural imprison¬
ment and posture, they had taken a daily gallop on horseback."
•" It is curious enough to notice how the mind is apt to become
affected in some of these cases. After the patient has been lying
supine for some weeks, she is unable to stand or walk, simply
ibecause she thinks she is unable."
HYSTERIA.
275
Treatment of Chronic Hysteria.—Hysteric symptoms that have
been of long continuance, can be cured only by restoring the ge¬
neral health of the patient. To accomplish this, an occasional
emetic or course of medicine, stimulants and tonics, are the remedies
chiefly to be employed.
Dr. Dean, of Harrisburg, (Pa.) observes, " in some cases where
the patients had labored under this disease for ten years, and
during that time had, by the advice and directions of respectable
physicians, exhausted, with, at most, but temporary benefit, the
whole class of remedies which are usually prescribed, I have, by
the continued exhibition of vomits, either entirely removed the
complaint or so far removed the habits of diseased action in the
stomach, that anti-spasmodic and tonic medicines would in ge¬
neral complete the cure." (Eberle.) The proper time for giving
an emetic or a course of medicine is when the patient feels more
distress than usual.
Tonics—Gum myrrh is a useful tonic in hysteric complaints,
when the disease is associated with an excessive floyv of the menses
The myrrh should be finely pulverized, and formed into pills, three
or four of which mav be taken after meals; or a decoction made
of it by steeping it in boiling water.
Other tonics, such as columbo, gentian, balmony, unicorn root,
barbary, Virginia snake-root, and prickly ash, may be employed
either simply or in combination.
The precipitated carbonate of iron may be employed with more
benefit than any other tonic in some instances. The dose from
half to a teaspoonful three times a day, taken in mucilage of slip¬
pery elm.
When the patient has a craving for some particular substance
such as acids, chalk, or charcoal, they should be used unless they
are found to disagree with the stomach.
I have in several instances known patients to eat freely of bread
and butter dipped in vinegar, which agreed with the stomach.
Charcoal and white mustard seed are decidedly beneficial where
the bowels are habitually constipated, or when the patient is ha¬
rassed with sour eructations or heartburn.
When the bowels are habitually costive, to use injections of a
decoction of aspen poplar and bayberry bark at bed-time, and re¬
tained until morning, will relieve the bowels and at the same time
increase their strength and tone. Purgative medicines must be
avoided, for notwithstanding they may afford momentary relief,
yet eventually the functions of the bowels will be always weak¬
ened by them. By a proper course of constitutional treatment,
joined with a well-regulated diet and regimen, and an abandonment
of cathartic medicine, the functions of the bowels will finally be
restored.
276
FAINTING.
In those cases of hysteria that imitate disease of the spine, the
patient continuing for months in a lying posture,—it is necessary
that the patient be induced to make the effort to walk, and to be
carried in the open air, and ride out frequently, notwithstanding it
may be much against their inclination to pursue this course.
Prolapsus uteri, and chronic inflammation of the womb, are not
uncommon in this form of hysteria. They may either be the con¬
sequence or the cause of hysteria.
There is a form of hysteria called clavus hystericus, character¬
ized by a severe pain in some point of the head, described by the
patient as like the sensation that would be produced by driving a
nail into the part. The pain is apt to come on regularly at a cer¬
tain hour of the day. Courses of medicine and quinine are the best
remedies for this form of hysteria.
The cold shower bath is highly beneficial in hysteria, more es¬
pecially after a steam bath. The continued employment of the
cold shower bath, and exercise in the open air, give tone and firm¬
ness to the system, and will often bring about a change in the
system that cannot always be effected by medicine alone.
SECTION VII.
FAINTING.
A deficiency of arterial 'blood in the brain is the usual cause of
fainting. Thus, persons bled whilst sitting up will faint mucl
sooner than when lying with the head on a level with the body.
Persons who are very weak from sickness, are liable to faint from
sitting up too long. Some faint at the sight of blood; others from
sudden fright or from any other violent mental emotion.
Symptoms. — These are, sudden loss of sensibility, and of the
power of motion; the breathing and pulse scarcely perceptible,
or entirely suspended, and the countenance and lips pale and
bloodless.
Treatment.—The immediate cause of fainting being a deficiency
of arterial blood in the brain, the most important indication is to
place the head as low or lower than the level of the body, with a
view to favor a supply of blood to the brain. Cold water may be
sprinkled or dashed on the face; all tight dresses loosened; and
salts of hartshorn, cologne, or camphor, applied to the nose
If fainting occur in a close room or crowded assembly, the pa
hypochondriasis.
277
/lent must be taken into the open air, and if the weather be very-
warm, fanning will be of advantage. A person fainting in an as¬
sembly is very apt to be so closely surrounded by the bystanders,
as to intercept the circulation of air. This should be prevented
on all occasions where a patient has fainted.
Very weak patients are liable to faint from sitting up to take a
vapor bath. When they first begin to feel faint, a dash of cold
water in the face, holding the head downward for a few moments;
for instance, resting the head low on a chair, or being held by an
assistant, and applying some volatile stimulant to the nose, usually
revive the patient and enable him to continue in the bath the usual
time required in steaming.
SECTION VIII.
HYPOCHONDRIASIS.
{Dejection of Mind — Low Spirits.)
This unnappy and ill-foreboding state of mind, termed hypo¬
chondriasis, is principally confined to persons in advanced life, and
it is always associated with feeble digestion. There is distress at
the pit of the stomach; flatulency and acid eructations; extreme
coldness of the hands and feet; torpid-bowels; and either a dry,
or cold and clammy state of the skin. Very frequently the coun¬
tenance is sallow; indicating a torpid state of the liver. Lowness
of spirits, however, attends bad health at all and every age; but
it is not hypochondriasis, except when there is a fixed despon¬
dency, the conversation and appearance of the patient manifesting
extreme depression of mind, or perversion of the imagination.
Characteristic Symptoms.—" A disposition to seriousness, sad¬
ness and timidity as to all future events; an apprehension of the
worst and most unhappy state of them, and therefore, on slight
ground, a dread of approaching evil." The patient thinks and
talks about his unhappy condition, and observes every change of
feeling in his body with apprehensions of danger. In some in¬
stances the nervous system will be shocked with the most trifling
noise, causing the patient to startle even at the dropping of a knife
at the table, and occasioning a very unhappy state of mind, some¬
times exciting a revengeful feeling, even against their offspring. I
have known patients laboring under this distressing weakness, to be
278
HYPOCHONDRIASIS.
unable to bear the slightest noise from the innocent mirth and
playfulness of their own children, requiring them to be kept out of
sight and hearing. In other instances the mind sinks into a kind
of sullen gloom, with constant forebodings of coming evil.
Causes.—The immediate cause of this dejected, state of mind
technically called " hypochondriasis," is exhaustion of nervous
■power. Severe mental labor, indolent habits, inveterate dyspepsia,
domestic trouble, debauchery, the excessive use of tobacco, or the
long-continued use of opium, are, in many instances, the remote
cause of that dejected state of mind consequent upon a torpid and
enfeebled condition of nervous energy.
The habit of viewing the dark side, only, of events, and yield¬
ing the imagination to gloomy forebodings, exerts a depressing in¬
fluence upon the brain—weakens the energies, and consequently
impairs the powers of digestion, and thus may be laid a foundation
for continued despondency.
The advice contained in the following lines may be found
apropos to those of a desponding disposition.
" Never look sad—nothing so bad
As getting familiar with sorrow;
Treat him to-day in a cavalier way,
And he'll seek other quarters to-morrow.
" Long you'd not weep, would you but peep
At the bright side of every trial;
Fortune you'll find, is oft most kind,
When chilling your hopes with denial.
" Let each sad day, carry away
Its own heavy burden of sorrow;
Or His likely you'll miss half of the bliss
That comes in the lap of to-morrow.
" When hope is wreck'd, pause and reflect
If error occasioned your sadness ;
If it be so, hereafter you'll know.
How to steer to the harbor of gladness."
Patients advanced in years, however, whose nervous energy is
greatly exhausted, have not the power to prevent desppndencv of
mind, any more than they can prevent a fit of ague at will.—The
general health must be improved, and the nervous influence
aroused from its torpid state before the mind can be raised from its
sunken, dejected condition.
HYPOCHONDRIASIS.
Treatment.—When depression of mind is caused by a disordered
state of the system, the most effectual medical remedies are, courses
of medicine administered at proper intervals, stimulants and tonics,
frictions to the surface, and cold water bathing.
A course of medicine, by cleansing the stomach, and awakening
a new action in the system, will frequently be attended with the
most happy effects upon the mind. In deeply seated cases, how¬
ever, the course of medicine will have to be repeated occasionally
for a period of several months, before the general health can be
thoroughly restored.
Capsicum is the best stimulant, and should be taken at meals or
soon after eating: the powder may be taken in lukewarm or cold
water, or in the form of pills.
When the bowels are constipated as they usually are in this
complaint, the same means may be employed as are recommended
in the treatment under the head of costiveness in a former chapter.
The compound lobelia pills answer as a stimulant, and they will
act efficiently on the secretions, both of the skin and mucous mem¬
brane of the stomach and bowels. A patient whose mind was
greatly depressed from ill health, took from forty to fifty of the
compound lobelia pills daily, besides three or four teaspoonsful of
capsicum, without making any sensible impression on the stomach
and bowels. After taking several courses of medicine, and con¬
tinuing the use of the stimulants above mentioned, a skinny sub¬
stance began to pass from his bowels, and continued to pass from
them for weeks. At the time this skinny substance was passing,
the patient experienced frequent griping pains in the bowels, a
symptom which is complained of under the use of Thomsonian
remedies in seated diseases. The above treatment, together with
the use of bitters, the steam and shower bath, exercise in the open
air, and a light nourishing diet, succeeded in restoring the general
health of the patient, and raised his spirits from a state of extreme
depression and melancholy.
There are cases of loiv spirits in which moral influences are of
more importance in the cure than medical treatment. In two in¬
stances I have known despondency and extreme dejection of spirits
to be occasioned by a retirement from business. In one of these
cases, the patient took several courses of medicine, but still the low
spirits continued until he resumed business, and his former active
habits. In the other case the gentleman also resumed his former
active habits, by which the strength, both of body and mind, was
reinstated.
Absence from home, and residing with strangers, more espe*
280
HYPOCHONDRIASIS.
cially in cheerful society, will sometimes cure despondency of
mind.
When the nervous energy becomes depressed from too close
application of the mind to study or business, exercise in the open
air, travelling, and cheerful society, are important.
Reading entertaining books, and every kind of innocent amuse¬
ment should be indulged in, to divert the mind, and bring new
objects into view, when it is not convenient for the patient to per¬
form a journey.
Various means have been successfully employed for the cure of
the hypo, as it is usually called.
The following is from the Medical Companion, written by James
Ewell:
"Some hypochondriacs have fancied themselves miserably afflicted in
one way, and some in another—some have insisted that they were tea¬
pots, and some that they were town clocks. This that he had a big
belly, another that his legs were glass,—one that he was extremely ill,
another that he was actually dying. But I have never heard of any of
this blue-devil class whose extravagance ever yet came up to the follow¬
ing, which was related to me by my noble-hearted old friend, the late
Dr. Stevenson of Baltimore, whose name sounds in my ears as the sum¬
mary of every manly virtue.
" This hypochondriac, who, by the bye, was a patient of Dr. Steven¬
son's, after ringing the change on every mad conceit that ever torment¬
ed a crazy brain, would have it at last that he was dead, actually dead.
Dr. Stevenson having been sent for one morning in great haste by the
wife of his patient, hastened to his bed-side, where he found him stretched
out at full length, his hands across his breast, his great toes in contact,
his eyes and mouth closely shut, and his look cadaverous.
"'Well, sir, how do you do? how do you do this morning]' asked
Dr. Stevenson, in his blustering, jocular way, approaching his bed-side.
'How do I do!' replied the hypochondriac faintly, 'a pretty question to
ask a dead man!' ' Dead !'replied the doctor. ' Yes sir, quite dead :
I died last night about twelve o'clock.'
"Quick as lightning Dr. Stevenson caught 'his cue, which was to
strike him on the string of his character, on which the Doctor recollect¬
ed he was very tender. Having gently put his hand on the forehead of
the hypochondriac, as if to ascertain whether it was cold, and also hav¬
ing felt his pulse, he exclaimed in a doleful tone, " Yes, the poor man is
dead enough—'tis all over with him, and the sooner he can be buried
the better. Then stepping up to his wife, and whispering her not to be
frightened at the measures he was about to take, he called to the ser¬
vant, 'My boy, your poor master is dead, and the sooner he can be put
under ground the better. Run to Mr. C m, for I know he always
keeps New England coffins by him, ready made, and do you hear, bring
a coffin of the largest size, for your master makes a stout corpse,, and
having died last night, and the weather being warm, he will soon begin
to smell.'
"Away went the servant, and soon returned with a proper coffin.
The wife and family having got their lesson from the Doctor, gathered
around him and howled no little, while they were putiing the body in
the coffin. Presently the pall-bearers, who were quickly provided, and
HYPOCHONDRIASIS.
•281
let into the secret, started with the hypochondriac for the church-yard.
They had not gone far before they were met by one of the towns-people,
who, having been drilled by the facetious Stevenson, cried out, 'Ah,
Doctor! what poor soul have you got there V
'"Poor Mr. B ' sighed the Doctor, 'left us last night.'
"' Great pity he had not left us twenty years ago,' replied the other,
' for he was a bad man.'
" Presently another of the towns-men met them with the same ques¬
tion, 'And what poor soul have you got there, Doctor'?'
"'Poor Mr B ,' answered the Doctor again, 'is dead.'
" ' Ah, indeed !' said the other, ' and so the devil has got his own at
last.'
"'Oh, villain!' exclaimed the man in the coffin, 'if I was not dead,
how I would pay you for that!'
" Soon after this, while the pall-bearers were resting themselves near
the church-yard, another one stepped up with the old question again :
' what poor soul have you got there, Doctor?'
"'Poor Mr. B ,' he replied, 'is gone.'
"'Yes, and to h—11,' said the other, 'for if he has not gone there, I
see not what use there is in such a place.'
" Here the dead man, bursting off the lid of the coffin, which had been
purposely left loose, leaped out exclaiming, ' Oh, you villain ! I am gone
to h—II, am I!—well I have come back again to pay such ungrateful
scoundrels as you are.' A race was immediately commenced between
the dead man and the living, to the petrifying consternation of many of
the spectators, at sight of a corpse bursting from the coffin, and in all
the horror of a winding-sheet, racing through the street. After having
exercised himself into a perspiration by this fantastic chase, the hypo¬
chondriac was brought home by Dr. Stevenson, freed of all his com¬
plaints. And by strengthening food, generous wine, cheerful company,
and moderate exercise, was soon restored to perfect health."
The disordered state of mind exhibited in the above case, doubt¬
less was occasioned by a torpid circulation of blood through the
brain, and from extreme deficiency of nervous energy. Whether
any other means than those resorted to by Dr. Stevenson could
have succeeded in arousing an action in the system sufficient to
cure the disordered imagination of the patient, is a question not
readily answered. ,
" A certain hypochondriac, who for a long time fancied him¬
self dying of a liver complaint, was advised by Dr. Crawford, of
Boston, to make a journey to the state of Ohio. After an excur
sion of three months, he returned home, apparently in good
health, but upon receiving intelligence of the death of a twin bro¬
ther who had actually died of a schirrous liver, he immediately took
the staggers, and falling down, roared out that he was dead, and
had, as he always expected, died of a liver complaint. Dr. Craw¬
ford being sent for, immediately attended, and asked the hypo¬
chondriac how he could be dead, seeing he could talk. But still
he would hare it that he was actually dead. Whereupon the sa¬
gacious Doctor exclaimed, "Oh yes, he is certainly dead, and it
is more than probable his liver was the death of him. However.
282
st. vitus' dance.
to ascertain the fact, I will hasten to cut him open before p .^re¬
faction takes place." And thereupon, getting a carving knife
and whetting it as a butcher would to open a dead call, he stepped
jp to him and began to open his waistcoat, when the hypochon¬
driac, horribly frightened, leaped up with the agility oi a rabbit,
and crying out, "Murder ! Murder!" ran off with a speed that
would have defied a score of doctors to catch him. After running
a considerable distance, until he was almost exhausted, he halted ;
and not' finding the doctor at his heels, soon became composed.
From that period this gentleman was never known to complain of
his liver; nor had he for more than twenty years afterwards any
symptoms of this disease."—EwelVs Medical Companion.
Persons laboring under depression .of spirits from ill-health are
often accused of being " hipped," a term employed to designate a
weakness which the patient could overcome or control at will.
Insinuations of this kind, generally come from persons ignorant of
the controlling influence which a disordered condition of the
digestive organs exerts upon the spirits.
SECTION IX.
ST. VITUS' DANCE.
Symptoms.—It commences with twitching or jerking of the mus¬
cles of some portion of the body, generally first observed in the
face or in one of the limbs. These sudden contractions of the
muscles are usually slight at first, occurring only occasionally, and
more particularly when the mind is grieved or agitated. By de¬
grees these jerking motions increase, until, in many instances,
almost every muscle in the body is affected with spasmodic con¬
tractions. In most instances the contractions are much stronger
on one side of the body, and frequently they are confined almost
exclusively to the left side. The disease occurs in young girls much
oftener than any other persons. If the patient is told to put out
her tongue, she makes sundry attempts to do so before she can
accomplish it; and then the tongue is suddenly thrust out, and as
suddenly withdrawn. The muscles of the face seldom escape
being affected, twisting the features, with all sorts of ridiculous
forms. She jannot keep her hand or arm half a minute in the
same position. When, at meals, she desires to carry her hand to
her mouth, it is arrested midway, and suddenly pulled back again,
or pushed off in some other direction; and it is only after many
deviations and fruitless efforts that she succeeds. " From the im-
st. Vitus' dance.
283
perfect command of the will over the voluntary muscles, the
patient, when she attempts to walk, has a starting, hobbling, and
irregular gait, with an awkward dragging of one of the legs."
Sometimes the arms and legs are thrown into such confused
motions, that the patient will be unable to walk, or even to stand
alone.
" At first the expression of the countenance, in the intervals of
the spasmodic motion, is that of good humor and contentment."
In a later period of the disease, however, the countenance loses its
expression of cheerfulness, the temper is irritable, and sometimes
the intellect is enfeebled. " Slight paralysis occasionally occurs
on one side of the body."
When the patient sleeps, the jerking motion of the muscles is
entirely suspended.
Patients affected with St. Vitus' Dance are generally worse at a
particular time of the day.
The appetite is variable; sometimes voracious—at others fee¬
ble. The tongue is slightly coated, and generally somewhat
contracted. Digestion is more or less impaired ; the bowels are
usually inactive, and the stools seldom have a healthy appear¬
ance.
St. Vitus' aance is usually confined to the period of life which
intervenes from the eighth to the twentieth year.
Causes.—Constitutional disorder, more especially a deranged
condition of the digestive organs, is the chief cause of St. Vitus'
dance. Among the occasional causes of this disease are, violent
mental emotions; sudden fright, or anger; " repelled cutaneons
eruptionssuppression of the menses; and exposure to cold and
damp.
Not Dangerous. — St. Vitus' dance very rarely proves fatal.
The few instances that have been known to terminate fatally, with
" slow irritative fever," have probably been experimented upon by
medicines which have poisoned the stomach, and destroyed the
vital principle.
Duration.—In some instances this disease continues only a few
days; in others it is prolonged to many months, or even years.
When the disease is wholly dependent upon a disordered condi¬
tion of the stomach and bowels, it is more readily cured than when
it has been brought on by sudden alarm or other violent emotions
of the mind. Girls attacked with St. Vitus' dance, about the age of
thirteen or fourteen, are seldom permanently cured until menstrua
tion becomes fully established. The disease is also apt to become
protracted when associated with chronic derangement of the gene
ral health.
284
st. vitus' dance.
Treatment.—--The following plan of treatment I have known tc
succeed in curing several cases of St. Vitus' dance, viz:—In the
first place, give broken doses of lobelia, sufficient to occasion slight
nausea; a course of medicine administered occasionally; a shower
bath every morning, sometimes preceded by a vapor bath ; and as
the tongue begins to clean, or the skin becomes pale, and the
system relaxed, give tonics.
On administering Broken Doses of Lobelia.—Lobelia may be ad¬
ministered in the form of pills, tincture, or the powder mixed in
warm water. In some cases it is necessary to give as much as a
teaspoonful of brown lobelia powder at a time, and this frequently
repeated in order to effect even slight nausea.
In the case of a little girl laboring under St. Vitus' dance, the
brown lobelia powder was given in full doses, and frequently re¬
peated without producing the slightest nausea, or causing any per¬
ceptible degree of relaxation, until several courses of medicine had
been given. At the end of the third week from the commence¬
ment of the treatment, the patient became much distressed and
deathly sick under the influence of lobelia administered after the
vapor bath. She tossed about in every direction, and continued
in this way six or seven hours, the system being much relaxed. After
this operation, the patient began to mend rapidly. The compound
lobelia pills are convenient to take, and may be used writh as much
benefit, probably, as any other form of lobelia. From twelve to
twenty pills should be taken daily.
The Vapor Bath is particularly beneficial in St. Vitus' dance,
especially when the skin is in an unhealthy condition. The bath
may be repeated daily, or every few days, as the circumstances
of the case may indicate. After steaming, the patient must be
showered with cold water, rubbed dry, and the surface bathed
with No. 6, or some kind of stimulating liniment.
Emetics.—These may be given once a week, or at longer or
shorter intervals, as the character of the symptoms may demand.
Brown lobelia powder, infused in strong composition tea, is a pro¬
per form of emetic to administer to children. Lobelia, adminis¬
tered by injection, in warm water, and retained several minutes,
will occasion vomiting and relax the system as effectually as when
swallowed. I have been sent for on several occasions where fa¬
milies have become alarmed by the extreme relaxation occasioned
by lobelia injections, All that is required is to bathe the face,
breast, and hands with spirits, or vinegar and water. It is well,
however, to give occasionally some stimulant, No. 6, capsicum tea,
composition, or even simple herb teas, pennyroyal or mint, toge¬
ther with some light nourishment—milk porridge or chicken tea
st. vitus' dance.
I never knew an instance of St. Vitus' dance in which the disease
did not moderate after the patient was fully relaxed under the in¬
fluence of lobelia. I have on several occasions, however, given
from six to eight teaspoonsful of lobelia powder to patients labor¬
ing under this form of disease, without causing any perceptible
relaxation, or effecting even slight sickness ; and then again, at
another stage of the disease, one teaspoonful, or even half that
quantity, will operate effectually both in cleansing the stomach, and
relaxing the system.
The Cold Shower Bath is much employed in the treatment of
St. Vitus' dance. This remedy is particularly appropriate in the
more advanced stage of the disease, after the stomach has been
thoroughly cleansed. The proper time for administering the cold
shower bath, is in the morning, as soon as the patient is out of bed.
After the bath is administered, the patient must be rubbed dry,
wrapped in a blanket, and put in bed, and remain there half an
hour or longer. If the patient experience a glow of warmth over
the system, after the shower bath, it will be almost certain to prove
beneficial.
Infusion of black snake-root, and Pipsissewa in connexion with
the use of the warm foot bath, and vapor bath, is recommended
by Dr. A. C. Logan, in cases of St. Vitus' dance.
Tonics.—The spice bitters may be used in any period of the dis«
ease. In the more advanced stages of it, stronger tonics will be
required; such as quinine, carbonate of iron, centuary, balmony,
golden seal, or Virginia snake-root. The skull-cap (Scutellaria
laterejlora) may be employed both as a tonic and nervine. It may
be taken singly in decoction, or combined with other tonics.
Injections.—When the bowels are very costive, injections may
be used occasionally, composed of salt, molasses and water, adding
an even teaspoonful of green lobelia to each injection. Lobelia
administered by injection, and retained, will benefit the patient as
much as when taken into the stomach. When the disease has
been of long continuance, however, or the patient feeble and ema¬
ciated, the vomiting will be best effected by the third preparation
of lobelia taken into the stomach.
Astringent, or anti-canker medicine.—In the latter stages of the
'disease, or during any period when the tongue is thickly coated
and manifests a tendency to clean, a strong decoction of bayberry
or sumac, or of the two combined, must be given as often as once
a day. In every case of St. Vitus' dance that I have attended,
there has been a false membrane discharged from the bowels, and
flakes of a similar substance have been thrown off by vomiting
286
LOCKED JAWi
about the time the disease gives way. Indeed I have sometimes
been inclined to believe that a coating of thickened secretions over
the mucous membrane of the stomach and bowels was a principal
cause of the protraction of the disease. The fact that patients
recover soon after such a substance is observed to pass irom the
bowels, furnishes some proof in support of this opinion. May it
not be the presence of a false membrane lining the stomach that
renders this organ so extremely insensible to the impression of
lobelia, observable in many instances in St. Vitus' dance 1
The No. 3 pills will answer in the place of the astringent teas,
and are much more readily taken. From three to six of these pills
may be taken three or four times a day on an empty stomach.
Sea Bathing has been found particularly beneficial in the cure
of St- Vitus' dance.
The Diet must be nourishing, and easy of digestion, such as
boiled milk and toast, stale bread, crackers, fresh beef and mutton,
poultry, eggs, custard, boiled rice, and all wholesome vegetables.
All kinds of confectionery, cakes, hot bread, and pastry, must be
avoided. The supper should always be light.
When St. Vitus' dance is dependent upon, or associated with,
obstructed menstruation, the method of treatment already laid
down will be appropriate to the case. Particular attention, how¬
ever, will be necessary to keep the feet dry and warm, and to use
frequently warm foot baths. When the period arrives at which
the patient should be unwell, stimulating enemas should be admin¬
istered to the bowels, composed of pennyroyal tea, adding a tea-
spoonful of lobelia powder to each ; or of bayberry tea, with the
addition of a teaspoonful of the third preparation of lobelia; the
foot-bath should be used daily, and the patient drink freely of
composition or pennyroyal tea, and if the general health be much
deranged, an emetic should be given. If there be much pain in
the back or loins at this period, the patient should be kept warm
in bed, and bottles of hot water or hot bricks wrapped in damp
cloths be applied to the back and feet.
SECTION X.
TETANUS —LOCKED JAW.
Causes.—Locked jaw is sometimes caused by wounds; in other
instances it is brought on by exposure to cold, when the vital
powers are in an enfeebled condition. Sleeping in the open air is
LOCKED JAW.
287
very commonly an exciting cause of tetanus in hot climates. The
use of narcotic poisons may also occasion tetanus. Veratria, an
article frequently employed in the old school, but more generally in
the Homoeopathic practice, has caused tetanus in several instances
m this city. Wounds of the head, gun-shot wounds, and punctured
wounds in the soles of the feet, and palms of the hands, are the
kinds most apt to occasion locked jaw. " Tetanus is particularly
apt to follow wounds in which a nerve is partly divided or lacer¬
ated, without being completely divided."
Symptoms.—This formidable disease usually comes on in a
gradual manner. At first there are pain and stiffness in the back
of the neck, slight spasms in the muscles of the throat, and distress
at the pit of the stomach. In some instances these symptoms con¬
tinue several days before the jaws become fixed. As the disease
increases, the jaws become stiff and at length immoveable; great
distress is felt at the pit of the stomach; the whole, or a part of
the muscles of the body and limbs become rigidly and permanently
contracted — the head is thrown backward, and the body is bent
either backwards, forwards, or sideways. Sudden paroxysms of
pain, and retraction at the pit of the stomach occur at frequent
intervals, attended with violent spasmodic contraction of the
muscles. "These paroxysms last usually but a few minutes—the
muscles of the trunk and extremities resuming for awhile a com
paratively relaxed state; but those of the jaws remain firmly con¬
tracted during the remissions. In the latter period of the disease,
the spasms remit but slightly and transiently: the patient is in an
almost continued rack of torture; the muscular contractions are
general and extremely violent; the countenance becomes fright¬
fully distorted; copious sweats break out; the pulse is quick and
irregular; the respiration hurried and laborious; the voice grating
and unnatural; the eyes dim and watery, and the jaws immove-
ably locked. Towards the fatal termination of the disease, slight
delirium generally occurs. At this period a severe spasm often
terminates the scene."
" The usual mode of termination in fatal cases is by apoplexy.
In some instances, all the muscles become completely relaxed a
short time before death takes place. The patient seems to have
emerged from his terrible malady. Every part of the body is in
the ordinary state of relaxation. Suddenly, however, extreme
prostration of strength ensues. He becomes insensible and coma¬
tose ; the countenance assumes a cadaverous expression, and death
speedily follows."
Duration.—Locked-jaw usually terminates before the fifth or
sixth dav. Occasionally, however, the disease is protracted for
weeks.
288
LOCKED JAW.
Favorable Symptoms.—The remissions between the paroxysms
becoming complete and of longer duration; a tingling sensation in
the extremities, as if ants were crawling over the parts ; a moist.,
and uniformly warm skin; an increased flow of saliva from the
mouth; " and above all when the patient enjoys sleep," strong
hopes may be entertained of an eventual recovery.
Locked jaw occasioned by causes which operate upon the system
generally, such as sleeping on damp ground, or sudden exposure
to extreme cold, is in general less fatal than when the disease is
caused by wounds.
Preventive means in case of Wounds.—For severe wounds, more
especially gun-shot wounds, especial care should be observed to pre¬
vent the admission of cold or damp air to the wound. This will be
he surest means of protecting the patient from locked jaw. » Warm
timulating poultices must be applied to the parts to favor suppu¬
ration.
When a punctured wound is received in the palm of the hand
or sole of the foot, for instance, from a nail or pin, the wound should
be enlarged a little with the point of a small lancet, bistourie or
penknife, and No. 6, or spirits of turpentine poured in; and this
-epeated several times a day, and a warm stimulating poultice
applied, with a view to favor the action of suppuration; or beat
die part gently with a piece of wood, or the handle of a knife, with
•i view to attract blood to the part and to excite adhesive inflam¬
mation. Locked jaw rarely or never occurs from such wounds
when they discharge matter. " It has been observed," says Dr.
Ewell, " that the less inflammation there is in the injured part, the
greater will be the liability to tetanus. This circumstance has
suggested the propriety of exciting inflammation in the wounded
part by means of irritating applications." In almost every instance
where locked jaw has been brought on from punctured wounds,
as when a nail has penetrated the foot, the disease has not
appeared until after the wound has closed, and the part become
free from inflammation.
If the patient be dyspeptic, or the general health otherwise de¬
ranged, a course of medicine must be given, followed by the free
use of composition or capsicum, with a view to keep a determination
to the surface. " An equable and comfortable temperature, with a
simple diet and rest, are important auxiliaries in preventing this
disease after wounds."
Treatment of Locked jaw.—On the first appearance of symptoms
which indicate the approach of locked jaw, such as slight spasms in *
the throat, a sense of stricture and distress at the pit of the stomach,
and stiffness in the neck and shoulders, a thorough and persevering
course of treatment must be instituted. The means chiefly to be
LOCKED JAW.
289
relied upon, are vapor baths, the third preparation of lobelia, arid
powerfully stimulating injections.
A full course of medicine must be administered without delay;
after which the third preparation must be continued in teaspoonful
doses, in bayberry tea, repeating the dose every hour or two as the
circumstances of the case may require. When the symptoms are
severe, the third preparation may be given in tablespoonful doses,
and repeated as often as every half hour, until the symptoms assume
a more favorable aspect, when the quantity may be lessened accord¬
ingly-
Steaming is highly important in the treatment of locked jaw, arid
in the early stage of the disease, and when the patient can sit up
without difficulty, the vapor bath should be administered two or
three times a day. The patient should be dashed with cold water
at the close of the steaming, and after being rubbed dry, the sur¬
face bathed in No. 6, and when the patient is in bed, hot bricks, or
bottles of hot water, wrapped in damp cloths, applied to the feet.
Injections composed of a teaspoonful, or even a tablespoonful of
the third preparation of lobelia, in bayberry or composition tea,
must be administered at intervals of every two or three hours. The
strictest caution must be observed to protect the patient frotn the
influence of cold air on getting out of bed, when he is in a per¬
spiration. Unless the air in the room be at the summer tempera¬
ture* the patient should continue under the bed-clothes.
When there is great difficulty in swallowing, the injections
retained several minutes, and frequently repeated, will prove nearly,
or quite as beneficial as if the medicine were taken into the stomach.
When the spasms are violent, a tablespoonful of lobelia powder
may be administered occasionally by injection in lukewarm water,
and retained, with a view to relax the muscles. When the third
preparation of lobelia can be retained in the bowels, it should be
used in general, in preference to the simple lobelia powder.
When the symptoms have abated, and the patient is weak and
relaxed, wine-whey may be given freely as nourishment. Large
quantities of wine have been given with benefit.
Quinine is as good a tonic as can be employed. It may be
given in large quantities—from 10 to 20 grains at a time, and this
repeated every few hours. Quinine is best adapted to a late period
in the disease, when the symptoms have assumed a more favor¬
able aspect by the course of treatment as before mentioned.
Local Treatment.—If the disease arise from a gun-shot wound,
or from any injury attended with sloughing, or with symptoms cf
mortification, a poultice should be applied, prepared in the follow¬
ing manner, viz: To a pound of wheat flour, add half a pint of
yeast, and a large tablespoonful of fine ginger, and after mixing
k290
HYDROPHOBIA.
ihom well together, set the mixture by the fire until it begins to
rise, then spread and apply it. The poultice must be kept warm,
and changed morning and evening.
When a punctured wound is the cause of locked jaw, the wound
should be opened with a lancet or other instrument, and every
effort used to excite inflammation and the formation of matter, by
pouring spirits of turpentine or No. 6 in the fresh wound, and ap¬
plying warm stimulating poultices, such as a mixture of slippery
elm and cayenne pepper. If the injury be on the hand or foot, the
part should be steamed occasionally, in order to attract an afflux
of blood to the part, and favor the formation of pus.
Either a mustard plaster or pepper poultice must be kept applied
to the spine, extending from the nape of the neck eight or ten
inches down the back. The mustard should not be allowed to
•cause a blister.
SECTION XI.
HYDROPHOBIA.
Bite of a Mad Dog, or other Rabid Animal.)
This terrific disease is occasioned in the human system by the
'oite of a rabid animal. The poisonous saliva from the mouth of
the animal is conveyed by its teeth into the wound, and when ab¬
sorbed and carried into the system, brings on hydrophobia.
When this dreadful disease becomes firmly seated in the system,
there is scarcely the-possibility of effecting a cure by any medical
treatment. Therefore when an individual is bitten by a mad ani¬
mal. the most prompt measures should be used to prevent the
absorption of the poison which may have been deposited in the
wound. The most important preventive means are cutting out the
parts that are bitten, or burning with a red-hot iron, or with caustic
potash.
Hydrophobia seldom occurs until three or four weeks after the
bite is inflicted. More commonly the disease does not become
leveloped until the sixth or seventh week after the insertion of the
poison. " It is said that the disease comes on much earlier in hot
climates than in temperate latitudes." The disease, however, may
renerally, if not always, be prevented, by cutting out the parts
bitten, or by cauterizing them with a red-hot iron, down deeper
than the wound itself.
When persons are bitten through their clothes, the poisonous
saliva will in general be rubbed from the teeth as they pass through
hydrophobia.
291
the clothing. Thus many who have been bitten by mad animals
have escaped hydrophobia without having the wound either cut
out or cauterized with a red-hot iron, having relied upon some re¬
puted specific, such as elecampane stewed in milk, or other equally
simple preparation, which could have had no possible effect in
preventing the absorption of the poison, if it had been deposited in
the wound. It is doubtful whether hydrophobia was ever pre¬
vented in a single instance by any of these reputed preventives.
The reason why the disease has not come on when no other means
have been used than those falsely called preventives, is simply
because the poison was either rubbed from the teeth of the animal
by the clothing, or from some other cause did not happen to be
deposited in the wound.
A case of hydrophobia occurred not long since in Lancaster
county, Pa. The patient, after being bitten by a mad dog, used
no other means to prevent the disease than a preparation that was
supposed to be a certain preventive to the disease. Poison, how¬
ever, happened to be deposited in the wound, and being allowed to
remain there, it was absorbed, and by contaminating the system,
brought on hydrophobia, of which the patient died.
Means to be employed to prevent Hydrophobia. — Any one, on
being bitten by a mad dog, or other rabid animal, should immedi¬
ately have a cord applied around the limb above the wound, so as
to stop the circulation, the wound washed with cold water, and
then, as soon as possible, have the surrounding flesh pared away,
as deeply as the wound had penetrated, or sear the whole of the
wound with a red-hot iron, or with caustic potash, in order to re¬
move or destroy the poison. The sooner the parts are cut away,
or cauterized, after the bite, the more certainly will it prevent hy¬
drophobia. If this should have been neglected at first, even for
several days after the bite, it should still be done. Doctor Mar¬
shall Hall, on the treatment of hydrophobia, makes the following
observations: " But the most important point in practice is to excise
the part on which the bite has been inflicted, early, nay immedi¬
ately, if possible, but late rather than not at all: indeed it is not
too late if the symptoms have not yet appeared." Some surgeons
recommend the application of a cup after the parts are pared away,
and then cauterize the wound freely.
Besides the local treatment above mentioned, constitutional
treatment should at once be instituted, with a view to assist the
constitution to expel the poison from the system, in case there
should be a portion of it absorbed. A course of medicine must be
administered every few days, and the patient take broken doses of
lobelia; drink skull-cap tea; keep the bowels regular by the use
of injections; have a vapor bath administered every day, and use
light nourishing food. When the above preventive measures are
292 HYDROPHOBIA.
early employed, there would be scarcely the possibility of the oc*
currence of hydrophobia.
Symptoms of Hydrophobia.—" The only symptom w.iich is never
wholly absent in this disease, as it affects the human species, is
the extraordinary dread or horror of liquids—more especially of
water. Patients laboring under rabies, may indeed sometimes
experience a temporary abatement, or even absence of this tor¬
turing symptom, but in all instances it occurs in a greater or less
degree, and generally remains throughout the whole course of the
malady. In general the mere sight of liquids, or the sound of
pouring water from one vessel to another, brings on violent suffo¬
cative spasms; and the attempt to swallow water, or to bring it to
the lips, commonly excites a degree of horror and agitation truly
frightful. Even the sight of polished surfaces, as of a mirror, or the
rustling sound of bed curtains, or of running water, will, in the
more violent grades of the disease, immediately renew the spasms
and feeling of horror. Occasionally, however, this extraordinary
horror is only manifested against water; for patients have been
known to take small quantities of other fluids, as of soups, milk,
and wine, in a lukewarm state. The thirst is always extremely
urgent, and although the suffering from this source is generally
very great, the patient does not attempt to swallow any liquids.
The secretion of saliva is profuse, and from an inability to swallow
it, the patient continually spits it out in every direction, often de¬
siring those around him to stand aside, as conscious that he might
thereby injure them. During the whole course of the disease oc¬
casional remissions occur. Whilst these continue, the patient
often appears calm, talks deliberately about his feelings or his
affairs, and cautions those about him not to approach him too
closely when under the paroxysm of madness, lest he should
injure them. Notwithstanding this partial calm, there is always a
peculiar wildness and appearance of alarm in the expression of the
countenance; the motions are quick and hurried ; the eyes cast
about with an air of suspicion; and if the patient attempt to lie
down and obtain some rest, he usually soon starts up again with
great agitation and anguish of feeling. During the exacerbations,
the expression of the countenance is wild, furious, agitated, and
agonizing; the eyes are blood-shot, sparkling, projecting, and ex¬
pressive of rage and terror; the muscles of the face, throat, and
chest, and sometimes of the extremities, are thrown into spasms ;
respiration is interrupted or convulsive; the arms are throwiii
about; the fists clenched; the teeth violently gnashed ; the mouth
foaming; with an unconquerable disposition to bite everything
that comes within the patient's reach. In violent paroxysms
furious and maniacal ravings occur, attended often with an entire
absence of consciousness. These paroxysms usually last from
about fifteen to thirty minutes."
HYDROPHOBIA.
293
There is seldom any fever in hydrophobia, except sometimes in
tne later period of the disease. The pulse is generally natural,
except towards the termination of the disease, when it becomes
quick, irregular, and weak. The countenance is pale, except
daring the paroxysms,—then the face is turgid and flushed. The
power of generating heat in the system is almost suspended, the
patient being extremely sensitive to cold, and shudders at the
slightest gust of air. The skin is dry and constricted, the bowels
.nactive, " and the blood drawn from a vein is often dissolved and
very fluid."
Duration of the Disease.—Hydrophobia, in most instances, ter¬
minates fatally by the second or third day from its commencement.
It has, however, occasionally been protracted to the fourteenth or
fifteenth day.
Treatment.—When symptoms of approching hydrophobia ap¬
pear, such as spasms in the throat, and a dread of water, prompt
and energetic treatment must at once be instituted. The vapor
bath and preparations of lobelia are the means chiefly to be relied
upon.
Third Preparation of Lobelia.—This must be given in table-
spoonful doses, and frequently repeated. Injections composed of
two or three teaspoonfuls of lobelia powder in lukewarm water
must be administered and retained, with a view to relax the system
and equalize the nervous influence. This form of injection should
be repeated so as to cause the system to be continually relaxed.
A tablespoonful of the third preparation of lobelia may be occa¬
sionally added to the injection, for the purpose of stimulating the
peristaltic action of the bowels, and to aid the curative efforts of
the constitution to resist the disease. When the patient cannot
swallow liquids, injections are to be chiefly relied upon. Especial
care will be necessary to protect the patient from the influence of
cold air.
The Vapor Bath.—From experiments that have been made in
France, the vapor bath promises to be the most effectual means
for the cure of hydrophobia that has ever yet been tried by the
medical profession. A physician in France by the name of Buis-
son, on being attacked with symptoms of hydrophobia, w^nt
into a vapor bath at the temperature of 140°, and after remaining
there some time, all the symptoms of hydrophobia left him, and he
came out of the bath entirely cured. This took place in the first
onset of the disease,—the only time, probably, when this or any
other remedy will prove successful. M. Buisson, in a paper which
he read before the Paris Academy of Arts and Sciences, wherein
294
NEURALGIA.
he details his own case, asserts also that he had, since this exper
ment upon himself, treated eighty cases of persons bitten by mad
dogs, and succeeded, by the use of vapor baths, in curing or pre¬
venting the disease in every case, except that of a child who died
during the treatment.
There cannot be a doubt that the vapor bath is the most effec¬
tual means of removing poison from the blood. The bath should
therefore be early and perseveringly applied, keeping the patient
in as long as it can be borne, which, in some instances, will be se¬
veral hours. The temperature of the bath should be as high as the
patient can bear. About the time the patient is to leave the bath,
a full dose of the third preparation of lobelia should be given. The
bath must be repeated at frequent intervals, say every few hours,
as long as it promises any hope of being successful.
SECTION XII.
NEURALGIA—TIC DOULOUREUX.
Symptoms. — This form of disease is characterized by a succes¬
sion of darting pains, which come on and pass away with the sud¬
denness of an electric shock, shooting along the course of the
affected nerve. "It comes on in sudden paroxysms, with longer or
shorter intervals of more or less complete freedom from suffering.
In general, much pain is experienced throughout the whole course
of the paroxysm, with frequent transitory shocks of darting pain,
so extremely agonizing as often to cause a temporary loss of reason
and consciousness." When the disease is seated about the head
or face, the surrounding parts, during the paroxysms of pain, are
extremely tender, and usually somewhat swollen; the slightest
touch suddenly causing severe darting pain. In other instances
there is no swelling of the parts, and the sensibility not increased.
" In very violent attacks of the disease, we generally find the
neighboring muscles affected with spasms, and occasionally spas¬
modic twitchings occur in the muscles of parts distant from the
place where the pain is located. When the disease occurs in the
nerves about the jaws, the saliva is often secreted very copiously,
and when the nerves about the eye are affected, the tears usually
flow freely.
It frequently happens in recent attacks of the disease, that the
paroxysms come on at a particular hour of the day, preceded b.v
NEURALGIA.
295
coldness of the extremities, and sometimes chilliness; observing
as much regularity with regard to the time of its coming on and
passing away by perspiration, as regular intermittent fever or ague;
the patient, during the interval between the paroxysms, being quite
free from pain.
Of its Location.—Neuralgia is most apt to attack the nerves of
the face, head, and jaws; still, any portion of the nervous system is
liable to be diseased in this way.
The optic nerve has occasionally been affected with neuralgia,
the pain being described by the patient as severe as if a red-hot
needle were passed through the centre of the eve.
The nerves of the extremities, but more particularly those about
the hips, are liable to be affected with neuralgia, the parts generally
remaining free from swelling or inflammation, and the temperature
usually lower than the healthy standard. Sciatica is a term gene¬
rally applied to a neuralgic affection of the sciatic nerve, that
passes near the head of the thigh-bone, and down the leg. Some¬
times the pain darts down the course of the nerve to the knee or
even to the foot.
The nerves about the chest are frequently affected with neural¬
gia, and in these cases there is generally a tender spot in the spine
between the shoulders.
The stomach, kidneys, and uterus are also subject to neuralgia.
Causes. — Neuralgia is in the majority of instances occasioned
by taking cold, or from other causes by which the stomach and
bowels are disordered. Frequently, however, it is produced by
local causes, such as decayed teeth, wounds of the scalp, and injury
of a nerve.
Case. — Mrs. R , of Southwark, struck her forehead about
the middle of the eyebrow, against the corner of a stove door.
Shortly after the accident she was seized with violent pains in the
part, and shooting over that side of the head, which became swol¬
len, and evidently larger than the opposite side. On taking cold,
or when the system became disordered from any cause, the patient
was apt to have violent paroxysms of darting pain in the side of
the head, which were generally relieved by a sweat and emetic.
The disease continued to return at intervals during a period of two
years. A singular circumstance connected with this case, was,
"that the teeth of the upper jaw of the affected side became entirely
encased with tartar, excepting their crowns.
Case.—Miss , of New Jersey, had been subject to frequent
attacks of neuralgia in one side of her face during a period of
eighteen months, accompanied with loss of digestion and continued
296
NEURALGIA.
painful diarrhoea. This patient experienced scarcely any benefit
from medical treatment until she had some decayed teeth extracted
from the upper jaw of the affected side, upon which the pains
ceased, and her general health was restored.
Treatment.—There are few cases of neuralgia in which the sto¬
mach and bowels are not prominently disordered in the first stages
of the disease, requiring the employment of emetics to cleanse the
stomach, and the use of stimulants and external warmth, to pro¬
mote perspiration.
Of the Vapor Bath. — Whether the disease be of recent occur¬
rence, or of long continuance, the use of the vapor bath is particu¬
larly appropriate. There are probably few physicians who have
used the vapor bath extensively in neuralgia that have not some¬
times found it to cure the disease after every other remedy had
failed. In the treatment of neuralgia, it is of the greatest impor¬
tance to bring on perspiration, and favor its continuance by the
application of external warmth, together with the use of pure sti¬
mulants internally.
After a vapor bath, the affected parts should be anointed with
the stimulating liniment, or other stimulating preparations applied:
No. 6, third preparation of lobelia, or Granville's Lotion.
Emetics are peculiarly beneficial in all recent cases; and when¬
ever the disease is occasioned by constitutional disorder, attended
with a feverish state of the system, I have repeatedly observed
immediate and complete relief afforded by the operation of an
emetic.
Even when tic douloureux is produced by local causes, such as
decayed teeth, or injuries of the head, emetics, especially when
preceded by the vapor bath, will prove the most effectual, and
sometimes the only means of relief, until the decayed teeth are
removed.
Injections are beneficial when the disease is fixed about the head,
accompanied with a determination of blood to the head, and cold¬
ness of the feet. Cases of this kind may, very generally, be relieved
by placing the feet in warm water, and employing a stimulating
injection to relieve the bowels, followed by one composed of lobelia
powder and warm water, and retained with a view to relax the
system, and equalize the circulation. In fine, injections are bene¬
ficial in all cases of neuralgia, and particularly so where the
uterus, kidneys, or bladder are affected.
Stimulants.—When the attack is violent and protracted, besides
the use of emetics, and the vapor bath, the patient should take
NEURALGIA.
297
freely of capsicum or composition, together with broken closes of
lobelia.
Compound Lobelia Pills.—When the disease has become deeply
seated, requiring a long course of treatment, the above pills may
be substituted for other stimulants, and the No. 3 pills may be used
as anti-canker medicine.
Salt and Brandy has been used with great benefit in some cases
of neuralgia. It appears to be best suited to chronic cases and
where the system is in a cold and torpid condition. The dose is
a tablespoonful once or twice a day.
Quinine.—After the stomach has been cleaned by an emetic or
course of medicine; and in cases unattended by fever, and more
especially when the neuralgia comes on periodically, like chill
and fever, there is no remedy upon which so much reliance can be
placed as quinine. This remedy has been employed with remarka¬
ble success, of late, in curing many cases of an obstinate character.
It may be given in large doses,—from ten to thirty grains are fre¬
quently given at a time—or it may be given in small doses frequently
repeated. In cases where the system is in a cold, torpid condition,
quinine may be given freely, without any preparatory treatment;
if the neuralgia comes on at a certain time of the day, the quinine
should be taken an hour or two before the time.
Subcarbonate of Iron, given in from ten to twenty grain doses,
twice a day, is highly beneficial in many cases of neuralgia, es¬
pecially those of long standing, and where the blood is deficient in
its proper proportion of red globules, the complexion of the patient
being pale or sallow.
For " ague in the face," which is only another name for neu¬
ralgia, Dr. Thomson recommends a portion of cayenne pepper
wrapped in gauze or book-muslin wet with No. 6, and applied be¬
tween the cheek and the jaw of the affected side. This will cause
the secretions to flow freely, and relieve the pain. I attended a
lady in Southwark, who had a severe attack of neuralgia in the
lower jaw, who experienced relief by keeping a portion of the
liquid of the third preparation of lobelia in the mouth. The great¬
est benefit, however, was derived from the use of stimulating in¬
jections containing a portion of lobelia, together with the vapor
bath, and by the system being kept slightly relaxed by broken
doses of lobelia.
When neuralgia is brought on by decayed teeth, they must be
removed before a permanent cure can be looked for. It is not a
298
NEURALGIA.
proper time to extract teeth during a paroxysm of pain, more espe
cially if the gums be swollen and inflamed.
In sciatica, (neuralgia in the hip,) besides the " course of medi¬
cine," and general constitutional treatment already described,
benefit may be obtained by the internal use of the oil of turpentine.
A teaspoonful may be taken three times a day before meals. It
may be taken mixed with a small portion of honey, 01 rubbed up
with a teaspoonful of sugar, with a little water 'added.
Neuralgia of the Stomach is characterized by severe pain at the
pit of the stomach, which ofren darts into the breast and to the
spine, and is " rather relieved than aggravated by pressure." The
pain is often relieved by taking a full meal, of* a draught of stimu¬
lating drink. The tongue is covered with a white fur; the appe¬
tite variable, sometimes natural, at others craving, and then again
extremely indifferent. There is an abundant flow of saliva; ab¬
sence of thirst; and often repugnance to liquids. The pain which
is relieved by eating, is apt to return in a few hours after meals,
accompanied with a feeling of weight at the stomach, harassing
belchings, and extreme depression of mind. In severe cases " the
patient sometime^ experiences difficulty of breathing, palpitations
of the heart, wandering pains and peculiar sensations of coldness,
especially in the arms, loins, and lower extremities. The sleep
is sometimes good, sometimes agitated, and sometimes the pa¬
tient is unable to sleep at all: yet in the morning he gets up
refreshed', and feels quite well, till breakfast renews the suffer¬
ing.
Many of the symptoms attending neuralgia of the stomach, are
such as frequently accompany ordinary dyspepsia, so that it may
be difficult to determine whether the disease be ordinary dyspepsia,
or neuralgia. The same general plan of treatment, however, will
be suited to each form of disease, varying the remedies to suit the
emergency of the case. When the symptoms are very distressing,
a course of medicine will be proper, more especially when the dis¬
tress comes on after meals. A teaspoonful of the tincture of lobe¬
lia, taken in a tablespoonful of warm water, or mint tea, will sel¬
dom fail of relieving neuralgic pains in the stomach. It may be
necessary, however, to repeat the dose. " I have myself," says
Dr. Eberle, " suffered much from this complaint, (neuralgia of the
stomach,) and have taken opium in large doses; but I have found
another remedy, which is less ruinous in its consequences, and far
more permanent in its good effects, than this narcotic. This re¬
medy is the saturated tincture of lobelia inflata ; a few tablespoon-
fuls of which has never failed to give me speedy relief and to pro¬
cure me long intervals of exemption from the disease. I have
also," says the Doctor, " used it in a case of a gentleman in this
DROPSY.
299
city, with the happiest effect; but further than this my experience
in the use of this article does not go."
Stimulating Liniments, and various volatile lotions, may be ap¬
plied externally with much advantage in cases of neuralgia.
Granville''s Lotion was at one time considered almost a cer¬
tain remedy for neuralgia, applied externally over the part
affected.
"Gum Elastic.—Sheet gum elastic is well adapted to the cure of
neuralgia, when the disease is seated in parts that will admit of the
sheet gum being applied. It may be applied to joints affected with
chronic rheumatism with much benefit.
In sciatica, besides the general constitutional treatment before
mentioned, anoint the hip with stimulating ointment, or third pre¬
paration of lobelia, and apply the sheet gum elastic.
Sea-bathing and travelling, will sometimes cure neuralgia where
medicines have failed to do it
CHAPTER X.
SECTION I.
DROPSY.
Dropsy is an unnatural accumulation of fluid in one or more of
the cavities of the body, or in the cellular tissue.
Dropsy is in all cases an effect of disease which had existed
previously to the occurrence of the dropsical effusion.
Different names are given to dropsy, according to its location.
Thus, when the effusion takes place in the cavity of the abdomen,
it is called Ascites. Dropsy in the chest is termed Hydrothorax.
Water in the brain constitutes Hydrocephalus; when there is
dropsical effusion in the cellular tissue, it receives the name of
Anasarca; and when confined to the scrotum, Hydrocele. In
many instances dropsical effusions take place in various cavities
and in the cellular tissue at the same time, constituting general
dropsy.
300
DROPSY.
General Causes of Dropsy. — These are, "obstructions to the
flow of venous blood," arising from disease of the liver, heart, or
lungs; excessive loss of blood; disease of the kidneys; debility,
especially after scarlet fever and measles ; chronic diarrhoea ; dis¬
ease of the peritoneum; the use of arsenic; purging with drastic
cathartics; or the abuse of mercury. In marshy districts of coun¬
try, dropsy often succeeds imperfectly cured ague. Exposure to
wet and cold frequently causes dropsy in those predisposed to this
form of disease.
In a great majority of cases, dropsy comes on gradually; yet in
some instances the dropsical condition has been experienced vety
suddenly. Professor Chapman mentions the case of a gentleman
from Virginia who, by plunging into a cold bath, the body being
at the same time greatly fatigued, and in a free perspiration from
severe exercise, brought on a dropsical effusion in a few hours
after. Another gentleman from South Carolina went into a very
hot water bath, after a fatiguing ride on horseback one very hot
day, and dropsy supervened soon after. In another instance,
dropsy was suddenly produced by a person lying down on the ice,
when much fatigued by skating. He was seized with cold, which
was followed in a few days by dropsy.
When dropsy is caused by disease of the kidneys, termed Bright's
disease, the urine, by being heated to the boiling point, becomes
clouded and thick like the white of eggs, proving the existence of
albumen in the urine, which is never present in a healthy state. It
often happens that disease of the heart and kidneys exists at the
same time.
The Symptoms of Constitutional Disorder that usually attend
Dropsy, are languor and lassitude; paleness of countenance; a dry
and husky skin, without any tendency to perspiration ; general
coldness and torpor of the system; scanty and high-colored urine;
constipation of the bowels, or the stools of an unnatural appear¬
ance ; and the appetite variable, yet generally impaired.
1. ASCITES DROPSY IN THE BELLY.
Dropsy in the cavity of the abdomen is generally associated with
disease of the liver or spleen, occasioned, in most instances, either
by intemperance, long-continued agues, or inveterate dyspepsia.
Dropsy of the abdomen is usually accompanied with dropsical
effusion in the cellular tissue, especially in the legs, except in cases
where it is caused by disease of the peritoneum alone.
Pregnancy, and tumors in the cavity of the abdomen, have, in
some instances, been mistaken for dropsy. A collection of water
in the cavity of the belly, however, may be very readily distin
guished from pregnancy. One of the surest means for ascertain-
DROPSY.
30!
ing the presence of water, is to place the palm of the hand on one
side of the belly, and with the other hand to tap lightly on the op¬
posite side, which will cause a distinct fluctuation or wave to be
felt by the hand placed on the abdomen, provided there be a col¬
lection of fluid within. In dropsy the swelling is uniform on both
sides of the abdomen, and when the patient lies on the back, the
liquids will press out the sides and flatten the middle; whereas, in
pregnancy or ovarian tumors, there is usually more swelling in
one side, and the form of the swelling is but slightly altered by
lying on the back. A collection of water in the cavity of the
abdomen will occasion difficulty of breathing, from the pressure of
the fluid upon the diaphragm, when the patient lies down with the
hips raised higher than the chest. Dropsy is attended with symp¬
toms of constitutional disorder, which are mostly absent in preg¬
nancy.
Ovarian dropsy is not so readily distinguished from other kinds
of swellings in the abdomen, for in this form of dropsy the swelling
is confined to one side of the belly, and the shape of the tumor will
not be modified, to any extent, by changing the position of the
patient's body. And in ovarian dropsy, the extant of the tissues
between the surface and the fluid, renders it difficult to detect fluc¬
tuation by percussion.
2. Hydrothorax—Dropsy in the Chest.
Dropsy in the chest, like other forms of dropsy, is the conse¬
quence of a disordered condition of the general system, or of organic
disease of the liver, heart and kidneys. In this form of dropsy,
patients seldom experience much inconvenience from it, until the
accumulation of water becomes so great as to interfere with re¬
spiration. The dropsy may take place only in one side of the
chest, yet, more commonly, the effusion occurs in both sides.
Signs of Dropsy in the Chest.—These are, a dull sound produced
by percussion, (tapping on the chest above the diaphragm with the
ends of the fingers,) whilst the patient is in a sitting posture ;
difficulty of breathing produced by pressing firmly upon the abdo¬
men, just below the ribs, which, by forcing up the diaphragm,
causes the water to rise in the chest, and thus it interferes with
respiration. A sense of suffocation on lying down; " starting
during sleep great agitation ; and an habitual cough.
The symptoms above mentioned, however, may attend othei
forms of disease, without there being an accumulation of water in
the chest. Thus asthma and disease of the heart and cellular
dropsy may occasion the same oppression of breathing that occurs
in dropsy of the chest. The same difficulty in lying down attends
302
DROPSY.
asthma as dropsy of the chest. Asthma, however, usually comes
on by paroxysms, whereas in dropsy of the chest the oppression
of breathing and inability to lie with the breast low continue with¬
out intermission. If, together with the symptoms before men¬
tioned, characterizing dropsy of the chest, there be a tendency to
dropsy in other parts, as in the feet, and beneath the skin covering
the chest, sufficient evidence will be afforded to warrant the con¬
clusion that there is water in the chest; and although it may be
difficult to determine whether the disease be dropsy, asthma, or
disease of the heart, it should occasion no embarrassment to the
practitioner in directing the treatment, for the same general plan
will be equally appropriate to each case. Thus the vapor bath,
which will relieve asthma, will prove beneficial in dropsy, wher¬
ever it may be located. Lobelia, which is the most effectual
remedy for asthma, is the article chiefly to be relied upon, both in
dropsy of the chest, and disease of the heart.
In dropsy of the chest or abdomen, a sudden subsidence of the
swelling in the legs and feet, without an increased secretion of
urine, is to be viewed as an unfavorable symptom.
3. An^arca—Dropsy in the Cellular Tissue.
This form of dropsy generally commences in the feet, and the
swelling ascends, and in some cases extends over the whole sur¬
face of the body. Sometimes the swelling will be confined to the
legs and feet; or to the face, hands, and feet.
Pressing a finger firmly against the swelling will leave an in¬
dentation or pit, which will remain a considerable length of time
after the pressure has been removed. This serves to distinguish
cellular dropsy from swellings arising from other causes. Thus
milk-swelling, as it is termed, has the appearance of dropsy, but
pressing a finger upon it will not leave such indentations as
remain after pressure upon dropsical swellings.
General Causes.—Cellular dropsy is peculiarly liable to occur
from exposure to cold after scarlet fever and measles. Females are
liable to dropsy of the lower limbs during the later period of preg¬
nancy, in consequence of pressure upon the veins, thus obstructing
the circulation. Extreme exhaustion from loss of blood ; " ex¬
posure to cold when the system is under the influence of mercury;
the long-continued use of arsenicchronic diarrhoea; repelled
cutaneous eruptions ; great debility and exhaustion; chronic gout;
organic disease of the kidneys, and disease of the heart are the
most common causes of this variety of dropsy.
Treatment of Dropsy in General.—The most important indica¬
tion for the cure of dropsy of every variety, is to correct the dis-
DROPSY.
303
ordered condition that causes it. In many instances, however
dropsy is an effect of an incurable organic disease of some im¬
portant organ.
Of the Course of Medicine.—1st. The Vapor Bath.— This ful¬
fils important indications in the treatment of dropsy. It improves
the condition of the skin—effects a determination to the surface—
excites free perspiration—diffuses a natural warmth through the
system, and by augmenting sensibility, causes the emetic to ope¬
rate more effectually. It is an observation of Dr. Thomson's, that
one emetic after steaming will prove as effectual in removing dis¬
ease, as four emetics given without the bath. A vapor bath in
the evening will enable a patient to rest more comfortably through
the night. Dropsical swellings of the limbs that occur after scar¬
let fever and measles, may be effectually removed in many in¬
stances by the use of vapor baths, giving also a dose of composi¬
tion powder three or four times a day.
2d. The Emetic.—The most decided benefit is derived from the
frequent administration of emetics, more especially in the early
period of dropsy. Cases of dropsy have been cured by spontane¬
ous vomiting. Dr. Eberle mentions a case of dropsy of the abdo¬
men cured by spontaneous protracted vomiting. The relaxation
produced by the lobelia, together with the retching and straining
effort to vomit, will in some instances overcome obstinate obstruc¬
tions in the liver and other organs.
3d. Injections.—If the bowels be costive, an injection should be
administered previous to the bath. Stimulating injections, con¬
taining a portion of lobelia, exert a beneficial influence by arousing
the nervous energy, and thus give an additional impulse to the
circulation of the blood, and an increased action to the absorbent
vessels. The kidneys may also be stimulated to increased action
by injections. To favor the operation of the medicine, the patient
must be kept warm, and take freely of capsicum or composition
tea.
4th. A Vapor Bath, after the emetic, completes the course of
medicine. The patient should be allowed to remain in bed after
the operation of the emetic, as long as he continues in a perspira¬
tion. When perspiration ceases, the second bath may be applied:
and the patient showered with cold water, or washed with spirits,
rubbed dry, and the surface bathed with some stimulant, such as
No. 6, pepper-sauce, or stimulating liniment. After this the pa
tient must be kept warm, either in bed or by being warmly clad
and continue the use of stimulating medicines, to " support the
internal heat," and maintain a determination to the surface
304
DROPSY.
Where perspiration cannot be continued, or an increase ir> the
secretion of urine be induced, the use of the usual stimulants, cap¬
sicum or composition tea, will be required. The medicine must
be given chiefly in the form of pills, or the powders taken dry, or
in a very small quantity of water. The compound lobelia pills
answer both as a stimulant and relaxant, and they should" be taken
in sufficient quantity to occasion a slight and continued nausea.
Compound Lobelia Pills. — There is probably no medicine or
compound that will fulfil so many indications for the cure of dropsy
in general as these pills. From one to four or five pills may be
given every hour or two, regulating the quantity taken by the effect
produced. The free use of these pills, and occasionally a course
of medicine, are the means most to be relied upon in the treatment
of dropsy. If the bowels be very costive, a small portion of bitter
root may be added to the pills. Not in sufficient quantity, how¬
ever, to occasion purging.
The above plan of treatment is adapted to the cure of all forms
of dropsy that arise from constitutional disorder, and will be as
likely to prove successful as any other. Even in cases that are
incurable, an occasional course of medicine will often relieve dis¬
tressing symptoms more promptly and effectually than any other
course of treatment.
Nervines. — Skullcap or valerian tea may be used at night to
promote sleep, or they may be taken with other medicine.
Diuretics.—In certain conditions of the system, the use of diu-.
retic medicine will be beneficial, by increasing the secretion of
urine, which is among the first symptoms indicating a favorable
termination of dropsy. But where the loss of power in the kid¬
neys depends upon constitutional derangement, it will be useless to
rely upon diuretics to cure the dropsy. First resort to general
constitutional treatment, and as the health improves, diuretics will
be beneficial. A great variety of diuretics is employed in the
treatment of dropsy. The following, I am informed, was a favor¬
ite remedy of the late Dr. Parrish:
Take parsley root, English mustard-seed, horse-radish, and bur¬
dock root, bruised or grated, put them into a stone jug with a pro¬
per portion of sound cider; to be taken several times a day. If
this should increase the flow of urine without occasioning unplea¬
sant feelings in the stomach, it should be continued as long as it is
found to be agreeable.
A strong tea of the sumac, more especially of the roots and ber¬
ries, answers in some instances as a diuretic, besides the important
indication which it fulfils of cleansing the stomach and bowels of
" canker."
DROPSY.
305
Haarlcem Oil has been used with surprising effect in some cases
of dropsy. The dose for an adult is twenty drops, taken in a ta-
blespoonful of boiled milk, and repeated three or four times a day.
Scabious (Erigeron Philadelpheum) may be used in decoction
with advantage, in cases accompanied with difficulty of passing
urine.
Wild Lettuce (Pyrola Rotundifolia) is recommended by Samue1
Thomson as a good remedy in mild cases of dropsy. The tops
and roots to be pounded or bruised, and steeped in boiling water,
and the tea drunk freely. It may be sweetened with honey.
Juniper.—The oil of juniper, or a tea of juniper berries, is used
to promote the flow of urine.
It must be borne in mind, however, that diuretics are not to be
relied upon for the cure of dropsy, but to be employed as aux¬
iliary remedies.
Tapping.—In many cases of dropsy of the belly, it becomes ne¬
cessary to drain off the water by tapping. This, though a very
easy and safe operation, requires to be done by one acquainted
with the operation. 1 shall, therefore, not attempt to give direc¬
tions for performing it, but merely observe, that I have found a
thumb lancet the best instrument for tapping in dropsy; a canula
closed at the end and perforated with holes to admit the escape of
the fluid, is to be inserted when the lancet is withdrawn. With a
lancet in good order, the operation of tapping does not occasion
more pain to the patient than is caused by bleeding in the arm.
The trochar (the instrument generally employed for tapping) has
no advantage whatever over the lancet, and with the latter the
operation can be performed with much less difficulty, and with
one-tenth of the pain to the patient that would be caused by the
introduction of the trochar. In some instances the operation of
tapping requires to be several times repeated. There are cases-
recorded where the operation has been performed more than one
hundred times in the same patient. Even in cases where there is
no probability of a cure being effected, the operation of tapping:
will frequentfy be called for as the only means of relief to the
patient.
Puncturing the Legs.—In dropsy of the chest, where the water-
gravitates to the feet and legs, relief may be afforded by having*
the patient sit with his legs hanging down, and when the water-
settles in them, to puncture the skin in many places with the point
of a lancet or needle, and thus allow the water to run off. This;
operation may be repeated as often as required.
306
DROPSY.
Tonics.—When the disease has been of long standing, the
stronger kinds of tonics should be used', more especially after a few
courses of medicine have been administered. A strong tea ot
quassia, wormwood, balmony, or golden seal, may be taken once
or twice a day.
External Applications.—Bandaging the swollen parts, more espe¬
cially the legs and abdoman, will be beneficial; and alter tapping,
the use of a bandage becomes indispensable. Before applying
the bandage, the stimulating liniment, No. 6, or pepper sauce
must be applied to the skin; or the bandage' must be wet with
strong salt water, and dried before it be applied. Frictions of the
surface with a salted towel or flesh-brush will be of more or less
■benefit.
Dr. Thomson in his Narrative makes mention of several cases
'of dropsy, in which he succeeded in effecting a cure, after the
regular practice had failed, and the disease had been considered
;as incurable. He treated them upon his general plan of giving
■freely of the " hot medicine to support internal heat" and to con¬
tinue perspiration, assisted by external warmth, and occasionally
'by a course of medicine. And in dropsy of the abdomen, he drew
•off the water by tapping, in the usual way, after passing the
patient through several courses of medicine, in order to restore a
more healthy action in the system, and thus lessen the liability to a
'return of the dropsy.
The character of the fluid drawn off by tapping varies in different
■cases. Sometimes it will be high-colored like strong coffee, or it
may be thick and ropy; more frequently, however, it resembles
'ordinary urine.
The remedies generally employed in the old school practice in
■dropsy, such as digitalis and hydrogogue cathartics are worse than
useless ; for notwithstanding they may lessen the amount of the
►dropsical fluid, they directly tend to prostrate the digestive func¬
tions. and necessarily weaken the restorative powers of the con¬
stitution. There is probably no case of dropsy cured under the
treatment pursued by the medical profession, but would be more
•eadilv and permanently cured under the Thomsonian treatment.
Elaterium, or the squirting cucumber, is extensively employed
n dropsy as a cathartic by the medical profession; but its
lirect tendency upon the constitution is to prostrate the digestive
functions.
4. Hydrocele — Dropsy of the Scrotum.
When this occurs in infants, as it sometimes does at birth, it is
'nailed congenital hydrocele. It may be distinguished from hernia,
' DROPSV»
307
by the transparency of the parts, and the absence of slight ver-
micular motions. It is generally readily cured in infants and
children, by applying some mild stimulant, the scrotum being
kept in a suspensory bag, by which moderate pressure upon the
parts is maintained.
Hydrocele in adults, frequently demands the operation of tapping
the scrotum. From a tendency to a reaccumulation of the water,
the operation will require to be repeated many times, in some
rases, before a cure takes place. It has been the practice of many
surgeons to inject port-wine or a solution of iodine into the cyst
after drawing off the fluid, to excite inflammation, and cause an
adhesion between the surfaces of the cavity. The late Dr. Physick
relied almost exclusively on tapping for the cure of hydrocele,
repeating the operation until the water ceased to accumulate.
Dr. Harvey has for thirty years successively employed the fol¬
lowing treatment in hydrocele, obtaining a radical cure without
injection; his mode is as follows :—
- " First discharge the fluid with a trochar, or pocket lancet, and
then apply a warm vinegar poultice all over the scrotum, in order
to bring on inflammation, which generally comes on in a few
hours, and becomes painful. When sufficient inflammation has
been excited, remove the vinegar poultice, and apply a bread and
milk poultice. In a short time the pain and inflammation subside*
and the cure is complete."—Braithwaite's Retrospect.
5. Hydrocephalus — Dropsy in the Brain.
Effusion of water in the brain is more liable to occur in chil¬
dren, between two and five years of age, than at any other period
of life.
Symptoms.—Pain in thfe head, especially across the brows, or in
the back of the neck; constant motion of one or both hands; sick¬
ness and efforts to vomit; a disposition to be in a lying posture; a
deranged condition of the bowels; an eruption on the face, resem¬
bling very minute drops of water. Stupor, and sometimes convul¬
sions, attend dropsy of the brain.
The above symptoms usually accompany hydrocephalus. Pre¬
cisely the same group of symptoms occur, however, without there
being any effusion of water on the brain. Dr. Chapman rec'entlv
attended in consultation on a case, where there was every charac¬
teristic symptom of dropsy of the brain, but on examination after
death, there was no appearance of water in that organ.
Causes. — An originally feeble constitution ; exhaustion from
disease; exposure to wet and cold; together with the reducing
plan of treatment practised by the medical profession, constitute the
308
DROPSY.
principal sources of dropsy of the brain. Severe attacks of diar
rhoea or infantile cholera, are frequently attended with eflusion oi
water in the brain; the dropsy being merely a link in the chain of
effects resulting from loss of vital power. Active purging, when
the system is in a state of exhaustion, may occasion symptoms
indicative of hydrocephalus.
Dr. Travers, who in reputation is excelled by few in the profes
sion, advances the opinion, that the depletive treatment pursued
by the profession occasions, in many instances, those symptoms
indicative of dropsy in the brain, so frequently observed in chil¬
dren.
A physician discovers symptoms of inflammation in the head
and adopts a depletive course of treatment, under the false impres¬
sion that the inflammation is the source of danger. A child is
taken, for instance, with cholera morbus, and the purging and
vomiting continuing for some time, the brain consequently becomes
exhausted, and nature sets up her restorative action, occasioning
symptoms of inflammation of the brain. This feverish or inflam¬
matory action is the means which nature employs to restore the
lost vitality of the brain, and to sustain its functions; and these
curative efforts should be aided instead of being prostrated by a
depletive course of treatment. When the pulse is strong, and the
skin hot, the chances of a cure are much greater than when there
is general torpor and a cold skin.
Treatment of Dropsy in the Brain.—The existence of dropsy in
the brain cannot be determined to a certainty, as the symptoms
which attend collections of water in the brain also accompany an
inflammatory action in it. Precisely the same symptoms also arise
from determinations of blood to the head from exhaustion of
strength. The treatment, however, applicable to one case, will be
equally suited to a similar condition of the general system in the
others. The treatment must be directed to assist the efforts of
nature. The means to be employed are, injections, the vapor bath
emetics, the warm foot-bath, volatile stimulants applied to the
head, such as whiskey or vinegar; together with frequent doses
of stimulants, which may be rendered more efficacious by the ad¬
dition of small portions of lobelia. In cases of dropsy of the brain
in the last stage of disease, such as cholera, dysentery, &c., it will,
of course, be of little use to administer medicine with a view of
• curing the dropsy.
, Sometimes an oppressed stomach will occasion symptoms re¬
sembling those arising from inflammation of the brain, and be
entirely relieved by the operation of an emetic. Even though
here should not be foul matter burdening the stomach, still a
lobelia emetic may prove beneficial, more especiallv if there be
fever.
scrofula.
309
Where there is an active determination of blood to the brain,
accompanied by fever, the system must be kept under the influence
of lobelia in broken doses, taken into the stomach, or adminis¬
tered by injection to the bowels, with a view to relax the capillary
vessels, and cause the blood to circulate more equally through the
system. Although an inflammatory action be necessary to the lost
vitality of the brain, still there may be an undue determination of
blood, and concentration of nervous influence to the head, which
may require to be regulated by the means above mentioned, to¬
gether with the use of the vapor bath, foot-bath, pepper poultices
or rryjstard plasters to the feet, and cooling applications to the
head. The strength is to be supported by the use of stimulants
usually employed, and by a light nourishing diet. In fine, inflam¬
mation, dropsy, and all other disorders of the brain, arising from
constitutional disease, are to be treated upon the same general
principles.
Symptoms denoting a recovery from Dropsy of the Brain. — A
heavy sediment in the urine, or if it have a foetid smell, the pulse
softening, and a running from the nose. This last, denoting the
restoration of the secretions of the nose, is to be depended upon
more than any other symptoms, as indicative of a recovery from
dropsy of the brain.
Bad Symptoms. — Blindness or deafness, deep stupor, spasms, a
copious discharge of pale urine, watery discharge from the bowels,
and twitchings of the muscles, are symptoms which indicate an
unfavorable termination of the case.
CHAPTER XI.
SECTION I.
SCROFULA.
The name scrofula is applied to forms of disease differing mate
riallv in their general aspect. Thus, a child affected with sore
eyes is said to be scrofulous; another has an eruption on the skin
which is called scrofula ; a third will have a disease in the hip,
which receives the name of scrofula; a fourth has swellings in
310
SCROFULA.
the glands of the neck, also called scrofula ; another, curvature
of the spine ; another, running from the ears ; and another, white
swelling ; all receive the appellation of scrofula.
Children possessing what is called the scrofulous constitution
are usually of small frame, with pale and delicate skin; the mus¬
cles imperfectly developed, the flesh being soft and flaccid. The
edges of the eye lids are much disposed to become inflamed, and
when the scrofulous tendency is strongly developed, the tarsi (under
edge of the eye lids) " are constantly red and tender." The
digestive powers are feeble, the appetite variable, and the bowels
seldom in a healthy condition. The patient is very sensitive to
cold, and the temper generally irritable.
In female children of scrofulous constitutions, " a leucorrhoeeal
discharge is apt to occur from time to time; and in very young
children, excoriations behind the ears, scabby eruptions about the
head and lips," and sore eyes are frequently observed.
That species of consumption called tubercular consumption, of
which so many die between the age of 14 and 30, is of the same
nature as scrofula, arising from imperfect organization. Scro¬
fulous consumption is a term frequently applied to tubercular con¬
sumption. In many instances the mesenteric glands (glands of
the intestines) become much enlarged and indurated, and some¬
times of a scirrhous or cancerous nature. This is termed inward
scrofula. Both children and adults are liable to swelling of the
glands of the neck, though entirely free from scrofula.
It very often happens that children exhibit a strong tendency to
scrofula, but become healthy without the disease having ever become
further developed, except occasionally by slight swellings in the
glands about the neck. Sometimes the disease breaks out early
in life, and in others it does not appear until after the age of puberty.
In some the disease is of short duration, the patient soon becoming
entirely healthy; in others the constitution sinks under the ravages
of the disease, and the case terminates fatally, not unfrequently by
tubercular consumption. Occasionally the disease breaks out in
childhood, and continues for years, or even during a long life, the
patient enjoying tolerably good health with the exception of swell¬
ing of the glands about the neck, and probably more or less dis¬
charge of matter from those that have suppurated ; or if the disease
be located in the hip, the patient may recover, except from the
lameness and deformity which almost always follows as a conse¬
quence of the hip disease.
Causes.—Scrofula, in all its different forms, consists essentially
in debility, and an imperfect condition of the nutritive functions.
Although the disease is generally the consequence of original weak
constitution, or imperfect organization, still children w7ho have
uiherited good constitutions, may become scrofulous by bad living,
SCROFULA.
311
cruel treatment, confinement in bad air, and such influences as tend
to impair the functions of nutrition. Children who work in cotton
and woollen factories, are peculiarly liable to scrofula. The
disease also prevails among the children of the poor, more espe¬
cially the colored population, when they are badly clothed, sleep
in small close rooms, and live on unwholesome food badly cooked.
Scrofula frequently occurs as a consequence of taking cold after
measles, scarlet fever, or whooping cough.
Preventives.—With children who exhibit marks of a constitutional
tendency to scrofula, a small frame, pale skin, soft and flaccid con¬
dition of the flesh, light, fine and thin hair, long and slender neck,
with a weak and irregular appetite, an unhealthy condition of the
bowels, and* a tendency to eruptions about the head, or to swelling
in the glands of the neck, means should be employed to renovate
and strengthen the constitution, in order to prevent the development
of scrofula. Regular exercise in the open air, waym clothing,
sleeping in a large room, wholesome, nourishing food, shower
baths, or bathing in cold salt water in the morning, and friction to
the surface, are the means chiefly to be relied upon, not only for
renovating the constitution and preventing the development of
scrofula, but as important auxiliaries in the cure of the disease
after it has become manifest. Too close confinement in school
rooms, and close application to study are injurious to delicate
children.
Constitutional Treatment.—In all the different forms of scrofula,
an occasional course of medicine, or simply an emetic, will prove
beneficial. It will not, however, be required to give medicine con¬
stantly to delicate children; for in most instances, it is more im¬
portant to attend to the regulation of their diet, dress and bathing,
and to let them have healthy exercise, than to give medicine. Medi¬
cines, however, are essentially beneficial in many instances of
scrofula, more especially when the stomach and bowels are in an
unhealthy condition, the patient feverish, and restless at night.
The compound lobelia pills may be used with benefit in almost
every case; from one to three given at bed-time.
Tonics are proper in every stage of scrofula, when the patient is
languid and weak. The spice bitters, gentian, Virginia snake-root,
quinine, sub-carbonate of iron, or gai'den bitters, may be em¬
ployed, occasionally changing them, as the fancy of the patient,
or the judgment of others may determine.
The diet must be nourishing and easy of digestion. Boiled milk
and toast, eggs, custards, mutton, the tender part of fresh beef, all
kinds of wild game, stale bread and butter, potatoes, and boiled rice
312
SCROFULA.
are suitable articles of diet in scrofula. Sugar, for instance rock-
candy, affords a kind of nourishment that suits the system remark¬
ably well in cases of long standing.
Fresh air, moderate exercise, cleanliness, salt water baths, fric
tions to the surface with a flesh-brush, or salted towel, are of as much
importance in the cure of scrofula as medical treatment. Close
and crowded school-rooms are improper places for children pre¬
disposed to scrofula. It is equally important for such children to
avoid getting their feet damp. It is not sufficient to wear merely
tight shoes, but the soles should be very thick, to prevent damp¬
ness from penetrating them. It is of little avail, as a preventive
to disease, to clothe the body warm, whilst the feet are unpro¬
tected from cold and dampness.
%
Treatment of scrofulous Swellings.—Scrofulous tumors are more
liable to appear on the neck than on any other part. Where the
swelling is not inflamed nor tender, rubbing with the warm hand
an hour every morning and evening, is the best thing that can be
done.
The glands about the neck are liable to become swollen, when
the constitution of the patient is altogether clear of any scrofu¬
lous tendency, and do not require any attention further than local
treatment.
When a scrofulous tumor becomes painful and inflamed, warm
emollient poultices must be applied with a view to favor suppu¬
ration, and prevent its being converted into an indolent abscess.
Elm, pounded cracker, white pond lily and ginger, combined-
together, and wet with warm water, will form a suitable poultice.
The poultice may require to be wet occasionally with warm water,
to prevent its being hard and dry. If the disease be accompanied
by high fever and severe pain, a course of medicine will be re¬
quired, together with the use of broken doses of lobelia, and once
or twice a day a teacup half-full of strong bay berry tea, or four or
five of the No. 3 pills. If the tumor have been inflamed, throb¬
bing, and at the same time the patient affected with chilliness,
followed by fever, and after the lapse of some days or probably a
week or more, the tumor becomes soft and fluctuates under the
fingers, and a blush of red is observed on the skin, then the tumor
may be opened and the same stimulating poultice applied as long
as the abscess discharges ; after which some kind of salve or
plaster must be applied to protect the part from the influence of
the air. Abscesses along the lower jaw, must always be opened
from inside the mouth.
Of the Indolent Abscess.—It sometimes happens that a scrofu-
lour tumor, after being more or less inflamed for a time, becomes
SCROFULA.
313
soft, and exhibits positive signs of its containing pus, but with no
pain in the part, and the skin over the tumor cool, the patient
clear of fever and the system in a torpid condition. This con¬
dition of things arises as a consequence of the constitutional
strength being too weak to raise or continue the proper degree
of inflammation sufficient to carry on healthy suppuration. The
efforts of nature subside without accomplishing its design, and
the abscess becomes converted into one of an indolent character,
which should not be opened, provided it can be avoided, but sti¬
mulating liniments or strengthening plasters applied, and. the con¬
stitutional energies strengthened by the use of tonics, the vapor
bath, and shower bath ; a course of medicine every few weeks to
cleanse the stomach and bowels; and a cold salt water shower
bath in the morning, provided the patient does not remain chilly
after it. If a glow of warmth comes on in the course of fifteen
minutes or half an hour after the bath, it will be certainly beneficial.
These means, together with fresh air and wholesome food, may
succeed in causing the absorption of the contents of the abscess;
or if it should break, or require to be opened, the constitutional
efforts will be better able to carry on the healing process. In all
cases where a large abscess is either forming, or has discharged
its contents, the most nourishing diet must be allowed the patient,
to supply the system with strength to carry on her healing opera¬
tions. In case of cold or indolent abscess, wine whey forms a
suitable article of diet, when the stomach is too weak to take much
solid food. Under circumstances of this kind, bitters must also be
used freely.
A scrofulous Ulcer is to be known by " its occurring after a sup
purated scrofulous tumor—the peculiar dull red, or purple color
of its edges—'its remaining indolent for a length of time, neither
increasing nor diminishing in size, and its being attended with that
peculiar state of health which invariably prevails in the scrofulous
constitution."
Treatment of scrofulous Sores or Ulcers. — Constitutional treat¬
ment is sometimes as important as local applications in the cure
of this kind of ulcer. The means before mentioned for cleansing
the stomach and bowels, and for improving the health, will be es¬
pecially adapted to this form or stage of scrofula. Stimulating
poultices must be applied to the ulcer, containing a large portion
of astringent—either white pond lily, or bayberry, and the poultice
wet with a strong tea of the same.
Indolent ulcers may be stimulated to a more healthy condition
by filling the n with dry and finely pulverized marsh rosemary,
bayberry, or rhattany root, and then apply a poultice or salve over
the whole, repeating it morning and evening.
314
SCROFULA.
" We have known a sea voyage to heal scrofulous ulcers of bad
character, which had resisted years of medical treatment."—Mar¬
shall Hall.
When a scrofulous abscess, after being evacuated, continues t-
discharge more or less for a great length of time, it should be
syringed with castile soap and water, and in order to stimulate a
more healthy action of the parts, inject into the cavity tincture of
myrrh, diluted with water, or bayberry tea, repeating it every day,
and apply over the surface a stimulating poultice, or strengthening
plaster covered with pepper.
Tincture of myrrh may be used with benefit as a wash, in cases
of indolent ulcers.
Sarsaparilla. — A simple syrup of sarsaparilla, when properly
prepared, may be used with decided benefit in scrofula, more espe¬
cially when the disease has been of long continuance, and the pa¬
tient feeble and emaciated. I have, in some instances, observed
a rapid improvement in patients on taking a syrup of sarsaparilla.
The cases in which I have known the most benefit derived from
using the syrup, have been patients in whom the disease had
apparently become exhausted, and the system left in a languid,
impoverished condition. It is questionable whether more benefit
is not derived from the sugar of which the syrup is composed, than
from the sarsaparilla. On many occasions I have become ac¬
quainted with cases of scrofula in which patients have taken from
twenty to sixty bottles of Swaim's and other preparations uf sar
saparilla, without experiencing any benefit from them. Most of the
cases of remarkable cures effected by Swaim's Panacea, have beer,
of the character above alluded to — the disease having come to a
stop, and the system being in a condition in which a syrup of
sugar afforded the most appropriate kind of nourishment to the
system, as by its use new blood was made more rapidly, furnish¬
ing to the system that nourishment which it required in order to
regain strength and flesh. Probably rock-candy or sugar will be
found as beneficial as Swaim's Panacea; the patient being allowed
to eat of the sugar between meals. It must be recollected, how¬
ever, that it is only in cases of long standing, that sugar will be
likely to prove beneficial. A variety of simple remedies are used
In scrofula, such as pipsissewa, sarsaparilla, yellow dock-root, and
sassafras bark. A decoction of either of these, or a composition
of them sweetened with sugar, will do as well as Swaim s
Panacea.
GOITRE.
315
SECTION II.
GOITRE.
This form of disease, although resembling scrofulous swellings
of the glands, is essentially different from scrofula.
Goitre is an enlargement of the thyroid gland, situated low on
the front part of the neck, and covering a portion of the windpipe.
Scrofula is seated in the lymphatic glands, which occupy a differ¬
ent position from the former. The thyroid gland possesses a low
degree of vitality, and its use has never been ascertained. The
lymphatic glands have a higher degree of vitality, and they are
known to perform important functions. This difference of charac¬
ter between the thyroid and lymphatic glands affords an explana¬
tion of the cause of the difference between goitre and scrofula.
In the first stages of goitre, the tumor is soft and spongy to the
touch. The skin covering it has a natural appearance, " and is
moveable over the enlarged gland." As the disease progresses,
the tumor becomes harder, and after the lapse of many years, it
sometimes becomes very large, and of a gristly or cartilaginous
structure. The usual progress of goitre is very slow, requiring
many years before the tumor acquires much size, and, in many
instances, it never becomes so large as to occasion great inconve¬
nience to the patient. In some, however, the tumor occupies
almost the whole of one side of the neck, extending from the cla¬
vicle (collar-bone) to the ear. Goitre is very seldom attended with
pain or inflammation, and in these particulars, it differs materially
from scrofula in general: yet sometimes goitre is attended with
darting pains, when the tumor is very large and indurated.
The skin and cellular tissue covering the thyroid gland, yielding
readily to pressure, admit the gland to become very large without
pressing upon the windpipe to such a degree as to interfere with
respiration. When the gland becomes greatly enlarged and hard,
it generally occasions some embarrassment in breathing, swallow¬
ing and speaking.
Goitre prevails to a great extent among the inhabitants of some
valleys situated at the base of high mountains. " In no part of the
world is the disease so prevalent, and so distressing in its charac¬
ter, as in some of the valleys of the Alps and Apennines. In
certain districts of Switzerland and Savoy, almost the whole of the
indigenous population are more or less affected with goiirous en¬
largements. In the valley of the Rhone, at Martigny, St. Maurice,
Aigle, Villeneuve, Bourg, Lucerne, and at Dresden, and in the
alleys of Piedmont, this disease is extremely cor imon,"—Eberle.
316
GOITRE.
Some experienced surgeons have mistaken goitre for aneurism
of the carotid artery. It has likewise been mistaken for an en¬
largement of the jugular vein. When only a portion of the gland
becomes enlarged and remains soft, it may be difficult tor even an
experienced surgeon to determine whether the disease be aneurism,
enlargement of the jugular vein, or goitre.
Causes.—Great diversity of opinion prevails among medical men
in relation to the cause of this singular disease, as it prevails epi¬
demically. Whilst some suppose it to be brought on by drinking
water impregnated with lime and other calcareous substances,
others have advanced the opinion that the use of snow-water is
the cause of the disease. Others have contended that goitre is
produced by the use of water entirely devoid of carbonic acid*
and others again have conceived it to depend upon particular
articles of food. A more plausible theory of the origin of the dis¬
ease, is that which attributes it to atmospheric influences—a humid,
dense atmosphere, and the absence of electricity in the air. " In
many deep, damp, and woody valleys, goitre is extremely preva¬
lent; but in proportion as we ascend towards the more elevated
and dry situations, on the sides and tops of the adjacent moun¬
tains, the disease becomes less and less frequent. It is well
known, moreover, that when young persons affected with goitre
remove from the valley in which the disease was contracted, to
high and dry situations, the tumor almost always becomes con¬
siderably diminished in size, and in many instances disappears
altogether."—Edinburg Med. and Surg. Journal.
Dr. J. K. Mitchell of Philadelphia, states that he frequently finds
goitre connected with disease of the heart.
Not dangerous.—Goitre is not a dangerous form of disease, being
very rarely known to prove fatal, except in those situations where
it prevails as an epidemic.
Treatment.—This disease is evidently an obstruction in the gland,
and is to be cured only by removing this obstruction. The means
to be employed for restoring the circulation in the obstructed gland,
are frictions with flannel, or with the warm hand ; and the use of
stimulating liniments and warm fomentations. The application of
the vapor and shower bath, and occasionally a full course of
medicine, are important, more especially in the earlier stages of
the disease, whilst the tumor remains soft.
Patients residing in a district where goitre prevails epidemically,
will derive more benefit by a removal to a more elevated situation,
where the disease does not prevail, than from any medical treat¬
ment.
Washing the tumor with saltwater, and sea-bathing, are said
SUSPENSION OP ANIMATION FROM DROWNING.
317
.0 be beneficial in removing goitre, more especially in its earlier
stages, before the tumor becomes of a cartilaginous or gristly
texture.
Iodine, in the form of ointment, applied to the tumor externally,
is considered by some as an effectual remedy for dispersing such
tumors, especially before they become hard.
CHAPTER XII.
SECTION I.
SUSPENSION OF ANIMATION FROM DROWNING.
When a person is taken out of the water soon after drowning,
" the face exhibits a turgid and livid appearance ; the eyes are open
and staring; the limbs somewhat stiff; the tongue thrust a little
beyond the teeth ; and the epigastrium tense and tumid."
It is questionable with many physicians whether animation can
be restored in drowned persons, after the heart has ceased its
motions. There is sufficient evidence, however, to establish a
belief that, under favorable circumstances, life may possibly be
restored, even after the heart has ceased to act. When a person
is drowned in very cold water, it will be more difficult to restore
animation, in consequence of the heat of the body having been
abstracted by the cold.
It is generally believed that in drowning, water is conveyed into
the lungs; but as long as life remains the glottis is closed, prevent¬
ing the admission of water into the wind-pipe. It is the exclusion
of air from the lungs that occasions death in drowning.
Treatment.—As soon as the patient is rubbed dry, and covered
warm, stimulating injections should be administered. A table-
spoonful of the third preparation of lobelia, or even two or three
ounces, may be administered at once in lukewarm water. No other
means can be employed that are so well calculated to arouse the
nervous influence, and excite the action of respiration, as powerful
stimulants administered by injection to the bowels, or introduced
into the stomach by means of a stomach-pump or gum-elastic
catheter. The injection should be frequently repeated, and the
surface rubbed with the warm hand. In the place of the third
318
SUSPENDED ANIMATION FROM GAS.
preparation of lobelia, pepper tea, No. 6, or any kind of spirits mav
be employed.
Symptoms which accompany returning animation. — Twitchings
of the muscles about the mouth, soon followed by efforts to breathe;
sudden motions of the limbs; " a small and weak pulse, beating
at irregular intervals; and a discharge of frothy fluid from the
mouth."
As soon as the patient can swallow, stimulants such as the third
preparation of lobelia, or pepper tea, must be given in small doses,
and these frequently repeated.
Wine whey and essence of beef should be given as nourish¬
ment, and especial care should be taken to keep the patient com¬
fortably warm. Vomiting is often induced when animation is
being restored, which is always a favorable symptom.
SECTION II.
SUSPENDED ANIMATION FROM CARBONIC ACID GAS.
Carbonic Acid Gas, produced by burning charcoal, when taken
into the lungs undiluted with atmospheric air, will very quickly
destroy life. The gas not only excludes oxygen from the lungs,
which is necessary to life, but it exercises a deadly influence upon
the nervous system, speedily destroying its sensibility.
A person in a tight room where there is a furnace of burning
charcoal, will soon become affected with giddiness and faintness,
followed by stupor and insensibility,, and unless carried into fresh
air, life soon becomes extinct. Many deaths have been occasioned
from sleeping in rooms in which charcoal was burning, and where
there were no means for the escape of the gas.
Carbonic acid gas, being heavier than atmospheric air, settles
next the floor, and fills the room from below upwards. Hence a
person lying on the floor would become affected by it, and sink
into a state of insensibility, whilst another person, occupying a
position near the ceiling, would be very little, if at all, affected.
This affords an explanation why dogs and cats are sooner affected
than men in the same room,—the animals inhaling the gas, whilst
a man would be above it.
Treatment.—In suspended animation from the inhalation of car¬
bonic acid gas, the patient must be removed immediately into a
current of fresh air, and cold water dashed on the face and breast
SUSPENDED ANIMATION PROM LIGHTNING.
319
[f the patient be entirely insensible, the clothing should be stripped
from the body, and cold water dashed on the head and breast, or
the head raised and a stream of cold water poured upon it. Some¬
times the first dash of the cold water will occasion a convulsive
effort to breathe.
A stimulating injection should be administered as early as pos¬
sible, and frequently repeated, with a view to excite the nervous
influence to action, for so long as enervation remains, suspended
animation cannot be restored. The tJiird preparation of lobelia
with lukewarm water, will form the most effectual injection, and
in the absence of this, some other stimulant, as composition, or
pepper tea, wine, or vinegar and water. The surface of the body
and limbs should be rubbed freely, and bathed with whiskey, or
vinegar, and if the patient can swallow, stimulants must be given
in small doses and frequently repeated.
When breathing becomes fully restored, the patient may be
rubbed dry and placed in bed, and should continue to take fre¬
quently of stimulants, such as capsicum, composition, or wine whey,
with carbonate of ammonia. If the patient has not vomited, the
third preparation of lobelia may be given in bayberry tea, and the
dose repeated until vomiting takes place.
In some instances, after vitality is restored, vigorous reaction
ensues: the heart palpitates vehemently; the pulse is full, strong,
and hard ; the vessels of the head turgid, and a disposition to heavy
sleep ensues. Under these circumstances, the third preparation
of lobelia or some other stimulant must be given freely, with a view
to give the stomach power to regulate the circulation. The face
and breast should be bathed with vinegar or spirits; and warmth
apDlied to the feet and around the body.
SECTION III.
SUSPENDED ANIMATION FROM LIGHTNING.
Persons struck by lightning require the same treatment as in
suffocation from gas; to dash buckets full of cold water over the
face and breast, and to administer stimulating injections to the
bowels with a view to restore the nervous influence, for motion
cannot be restored so long as the currents of nervous fluid remain
suspended.
Case.—The following case is reported in the fifth volume of the
Philadelphia Botanic Sentinel, by Dr. Imri Spruill, of North Caro-
320
DISEASE OF THE EYES.
lina: " Mr. Lewis Harrell was called last May to a negro woman
who had been struck by lightning, 'and,' said he, 'when I got
there I saw about twenty men standing around her; she ap¬
peared to be (as it was thought by all) in the agonies of death,
and speechless. Knowing the efficacy of the Thomsonian reme¬
dies, I gave her a large dose of the third preparation of lobelia,
which soon aroused her, and enabled her to speak. On making
an examination, I found that the lightning had struck the back
part of her head, and passed obliquely to the breast, tearing a new
homespun cap up like gun wadding, and taking a strip of skin off
in its way two inches wide, and extending over the breast and
lower part of the abdomen to the groin, leaving a streak from the
groin down to the sole of the foot. Her under garment was split
throughout its entire length with as much precision as though it
had been done with a knife. Two or three courses of medicine
were administered, and she recovered rapidly.'"
During a thunder-shower persons should avoid going under a
tree for shelter; it is safer to be in the open field or road. In a
house the safest place is on a feather-bed ; the bedstead should not
be near the wall. A bed in the middle of a room, with a piece of
glass or sealing-wax under each bed-post, would afford almost sure
protection from any serious injury, even though the house were
struck by lightning. Silk is a non-conductor of electricity, so
that by placing a chair upon an old silk dress, in the middle of the
room, or standing on the silk, protection will also be afforded
against lightning.
CHAPTER XIII.
VARIOUS FORMS OF DISEASE OF THE EYES.
SECTION I.
INFLAMMATION OF THE EYES FROM TAKING COLD.
When the eyes become inflamed by taking cold in them, the in¬
flammation is usually in the membrane that covers the white of
the eyes, and the inner surface of the eye-lids. The direct effect
of cold upon the eye is to weaken and debilitate it; and the inflam¬
mation that ensues is an effort of nature to remove the effects pro
duced by the cold.
DSEASE OF THE EYES.
321
Symptoms.—These are, a redness more or less extended over the
white of the eyes; an appearance of inflammation on the under
surface of the eye-lids; a feeling of sand in the eye; a profuse
secretion of tears, and sometimes a thick matter in the corners of
the eyes and about the eye-lashes, and a strong light is intolerably
painful.
Local Treatment.—In inflammation of the eyes proceeding from
cold, all kinds of cold applications are to be avoided : for although
they may afford temporary relief, they scarcely ever fail of exer¬
cising an injurious influence. It is in inflammation of the eyes,
arising from wounds or bruises, that cold applications are some¬
times found useful. Even physicians of the old school deprecate
the use of cold applications in that variety of inflammation of the
ayes which they term catarrhal ophthalmia.
Moderately stimulating washes and warm poultices may be em¬
ployed with more advantage than cold applications, in all cases of
inflammation of the eyes arising from cold.
Eye Washes.—In the early stages of the inflammation, benefit
may be derived by washing the eyes occasionally with warm cat¬
nip tea, a weak infusion of lobelia, or even with a weak tea of
capsicum. The object of stimulating washes is to increase the
secretions from the inflamed mucous membrane. It is in this way
that stimulants lessen inflammation of the mucous membrane.
The design of the inflammation is to restore the secretions, and
hence the application of pure stimulants operates in harmony with:
the designs of nature.
Astringent washes of every description are improper in the ear¬
lier stages of the inflammation, unless there be a stimulus in the
wash sufficient to overcome the drying effect of the astringent-
Astringent washes are applicable to chronic inflammation of the-
eyes, where the tissues are in a relaxed condition.
Poultices of elm, flaxseed, or Indian mush, adding a small por¬
tion of ginger, applied to the eyes warm, and wet occasionally
with warm catnip tea, or warm water, will prove serviceable if
not continued too long at a time. The constant application of a
poultice for several days, would relax the parts so much that the-
cure might be retarded thereby. The poultice should be covered:
with gauze or book-muslin to prevent its adhering to the eye. A
piece of lean fresh beef .or an oyster bound on the eye, will supply
the place of a poultice.
Constitutional Treatment, in inflammation of the eyes, is, in many"
instances, of greater importance than local applications. Inflam¬
mation of the eyes is generally associated with a disordered state
21
322
DISEASE OF THE EYES.
of the system. The eyes being weakened in consequence of
general debility of the system, the cure will be greatly facilitated
by improving the condition of the general health, either by the use
of pure stimulants—composition, capsicum, or simple herb teas,
together with the use of the warm foot bath, and a careful avoid¬
ance of cold; or by a course of medicine, followed by the use ol
the stimulants above mentioned, with a view to promote perspi¬
ration, and sustain and strengthen the curative efforts ol the
constitution.
If there be violent pain in the head, injections should be used,
containing a portion of lobelia ; the feet kept warm, and broken
doses of lobelia given in combination with the stimulants.
Inflamed or sore eyes from dust, seldom require any other atten-
iion than to wash them with warm mik and water.
SECTION II.
RHEUMATIC INFLAMMATION OF THE EYE.
The globe of the eye, except the transparent portion in front,
•containing the pupil, and an opening on the back part, for the
passage of the optic nerve, is covered by a membrane of a fibrous
structure, similar to the tendons of muscles and ligaments about
the joints. It is inflammation of this fibrous structure that consti¬
tutes rheumatism. When the fibrous membrane of the eye be¬
comes inflamed, it is attended with pain which resembles rheuma¬
tic pains, and hence it is termed rheumatic ophthalmia. The
difference, therefore, between catarrhal ophthalmia and rheumatic
ophthalmia, is the difference in the location of the disease: in the
first, the inflammation is seated in the mucous membrane of the eye
—in the latter, the inflammation is seated in a fibrous membrane,
beneath the mucous membrane.
Symptoms.—These are, violent pain in the ball of the eye, often
-extending to the temples, teeth, lower jaw, and internal ear. The
pain is continuous, with occasional fits of aggravation, and is
almost always much more severe at night than during the day.
The white of the eye is of a yellowish-red tinge, terminating
abruptly at the cornea—which latter (the transparent part of the
centre of the eye-ball) becomes dull, cloudy, and, as the disease
advances, more opaque in the centre than at the circumference.
The flow of tears is at first diminished, but in the course of the
disease, it becomes copious.
DISEASE OF THE EYES.
323
Causes.—Rheumatic inflammation of the eye is generally brought
on by exposure to cold and dampness. More especially is it apt
to occur from exposure to cold when the system is under the in¬
fluence of mercury. '
Treatment.—Constitutional treatment is necessary in most cases
of rheumatic inflammation of the eye. The means to be em¬
ployed are such as will restore the natural warmth of the system,
cleanse the stomach and bowels, promote perspiration and restore
digestion.
First, give stimulants, composition, or capsicum tea, and if the
pain be severe, attended with an undue determination of blood to
the head, the feet must be placed occasionally in warm water,
containing a portion of mustard; and stimulating injections, con¬
taining a portion of lobelia, administered once or twice a day, and k
the patient kept warmly covered to favor perspiration. If this
course of treatment prove insufficient to relieve the pain, a course
of medicine must be given and repeated according to the urgency
of the symptoms.
The compound lobelia pills, if taken in doses of two or three
pills, every hour or two, and continued, will place the system in a
condition that will favor the recuperative efforts of the constitution
to re-establish a healthy condition, not only in the eye, but in
every other diseased part.
When the disease becomes chronic, which means that it be¬
comes protracted and unaccompanied with fever, or other symp¬
toms of reaction, gum guiacum, and bitter tonics, are to be
employed, together with the general course of treatment above
recommended.
Local Applications.—In the early stages of the disease, when the
secretions of the eye are deficient, and the pain severe, moderately
stimulating applications, either in the form of poultices or washes,
are required for the purpose of exciting the secretions of the eye.
A weak infusion or diluted tincture of lobelia, or weak capsicum
tea, may be used for this purpose, and a poultice composed of equ?'
parts of slippery elm, white pond lily powder, and a portion of
ginger, applied. The poultice should be wet with a strong tea
of raspberry leaves, or of some other of the vegetable astringents.
One of the best eye-washes for this form of inflammation of the
eye, is made by dissolving four grains of nitrate of silver in one
ounce of water; one drop of this solution is to be dropped in the
eye every five or six hours.
The diet should be restricted to light kinds of food, such as
gruels, toast and tea, &c., more especially during the earlier stage
of the complaint.
324
DISEASE OF THE EYES.
SECTION III.
SUPPURATIVE INFLAMMATION OF THE EYES.
(Purulent Ophthalmia.)
Symptoms.—This variety of disease of the eyes is marked by a
sudden swelling of the eye-lids, attended with a copious discharge
of a thick white or yellowish matter. In severe cases the eye-lids
become enormously swollen, more especially the upper lid. There
is more or less pain in the eyes, even in the milder form of the
disease, and where the swelling is very great, the attending pain
is usually violent. The mucous membrane covering the eye-ball
becomes also much swollen, rising up like a spongy mass, and
sometimes overlapping the pupil. A copious secretion of pus takes
place soon after the swelling' commences, though sometimes the
matter does not escape as it is formed, in consequence of the swell¬
ing causing the eye-lids to be firmly closed. The pus, being thus
retained, distends the eye-lids in the form of a round fluctuating
tumor, the contents of which, sooner or later, escape from between
the eye-lids. In the severe form of the disease, there is always
considerable constitutional disorder and generally high fever at
night.
Under a proper course of treatment the symptoms, even in this
severe form of the disease, will generally begin to moderate in the
course of a few days, and the eye gradually recover, and become
restored to a'healthy condition. Occasionally, however, the ball
of the eye suppurates, partially or wholly destroying the sight.
Infants are occasionally attacked with sudden swelling and in-
. flammation of the eyes, attended by a free discharge of matter. In
them the disease very rarely injures the eyes permanently.
A very destructive form of disease of the eye prevailed epide¬
mically, and to a great extent, in Egypt, " during the British expe¬
dition under Sir Ralph Abercrombie." This disease received the
name of Egyptian ophthalmia.
Causes.—The Egyptian ophthalmia was supposed to be caused
by a suddenly variable temperature—an atmosphere loaded with
dampness and humidity—by the prevalence of a "hot wind loaded
with fine particles of sand, and a bright and piercing light of the
sun." Another and more frequent cause of the disease in this coun
try is the accidental application of certain poisonous substances to
the eye, more especially the matter from the venereal disease.
DISEASE OP THE EYES.
325
The disease, as it occurs in infants soori after birth, is occasioned
by some morbid secretion being introduced into the eye at flie
time of the infant's birth. On this subject Dr. Eberle observes,
" I have never known a single instance of this disease occurring in
infants soon after birth, when, upon inquiry, I did not learn that
the mother had been affected with leucorrhoea, or some other mor¬
bid vaginal secretion."
Of the consequences of this form of disease.—As it occurred epi¬
demically in Egypt at the time above mentioned, the disease
proved very destructive to the eyes. The introduction of the
matter of the venereal disease into the eye sometimes occasions a
loss of its sight, and this form of disease is always difficult to cure.
When the disease occurs in young infants it is seldom followed by
serious injury of the eye, the matter occasioning the disease being
of a less destructive nature than that of gonorrhceal poison. A
mild form of suppurative inflammation of the eye is sometimes oc¬
casioned by constitutional disorder, and also by ordinary atmo¬
spheric influences, but which seldom or never occasion any serious
injury to the eye.
Treatment. — In all violent attacks of suppurative inflammation
of the eye, a vigorous course of constitutional treatment is impe¬
riously demanded. The patient should have a thorough course of
medicine administered early, and the same repeated daily, until
the disease begins to decline. If it should be inconvenient to
administer a regular course of medicine, the warm foot bath must
be used, and composition or cayenne pepper tea given freely; after
this an emetic must be given, and if the symptoms continue to
be of a violent character, doses of lobelia in composition tea must
be continued every hour or two; stimulating injections adminis¬
tered three or four times a day; hot bricks wrapped in damp
cloths placed at the feet; and the head kept elevated by pillows.
If there be high fever, with violent pain in the head and eyes,
benefit will be derived by administering a small teaspoonful of
lobelia powder in lukewarm water, by injection, and retained.
This will relax the system, and generally cause the patient to
vomit.
When the disease is of a mild form, and also when it is on the
decline, a less energetic treatment will do—merely giving occa¬
sionally composition, ginger, or pennyroyal tea, to favor a determi¬
nation to the surface, and warm applications to the feet. In all
cases, however, when the eyes are very much swollen, the system
must be placed under the influence of lobelia, and continued in a
state of moderate relaxation, more particularly during the early
stages of the disease.
In infants, constitutional treatment is seldom necessary, unless
326
DISEASE OF THE EYES.
the disease of the eyes be brought on bv a disordered condition of
the stomach and bowels.' If the bowels be disordered, injections
must be administered. These may be prepared of simple bayberry
tea, adding half a teaspoonful of the tincture of lobelia to each
injection.
Local Applications.—When the disease occurs in infants, I have
found a weak infusion of lobelia, combined with raspberry tea,
to be an effectual application — the eyes to be washed occasion¬
ally with the above tea, warm. All cold applications are inju¬
rious. It may be necessary, in some instances, even in infants, to
apply a warm emollient poultice. Slippery elm powder, white
pond lily, and crackers rolled fine, with a small portion of ginger,
form a suitable compound for a poultice, which should be wrapped
in gauze.
The same local applications, viz : lobelia and raspberry tea, and
warm poultices, will be proper in the early stages of the same
disease, without regard to the age of the patient, or the cause of
the disorder. The most effectual way to wash the matter from
the eyes is by syringing. The washes above mentioned may be
applied by means of a syringe to far greater advantage than by
any other means. In a later period of the disease, in adults, when
the swelling has subsided, and the eye-lids are in a relaxed con¬
dition, Dr. Thomson's eye-water, simple tincture of myrrh, a tinc¬
ture of myrrh and bayberry, or No. 6, will be suitable applications.
When the disease has been produced by the application of venereal
poison, the eyes should be frequently syringed with a strong infu¬
sion or tincture of lobelia.
A small portion of lard applied along the eye-lids will prevent
their sticking together. Various kinds of salves may be used for
the same purpose, but sweet lard is probably as good as any pre¬
paration of salve.
In all cases where the disease has become protracted, and the
patient is in a feeble condition, tonics, such as quassia, wormwood,
Peruvian bark, Virginia snake-root, gentiai}, &c., must be given,
together with stimulants and nourishing food, in order to excite
and sustain the curative efforts of nature.
disease of the eyes.
327
SECTION IV.
SCROFULOUS SORE EYES.
In this vaiiety of disease of the eyes, the inflammation is mostly
confined to the mar<jjns of the eye-lids, attended with extreme
sensibility to light, a profuse secretion of tears, and a thick matter
exuding from the edges of the eye-lids and the roots of the eye¬
lashes, which glues the lids together during sleep.
This form of disease prevails most 'in childhood, during the
period that intervenes between the time of weaning and the eighth
year of age, occurring in those of delicate constitution. Some¬
times the eyes become diseased from want of cleanliness alone.
In some cases the patient cannot bear the light to come to the
eyes; he keeps them constantly closed, places his hands over them,
and lies with his face downward.
Scrofulous disease of the eye is generally protracted in duration
—in many instances continuing with a greater or less degree of
severity many months, or even years, until, by the aid of medi¬
cine and other means, or by the natural increase of strength,
the constitutional powers are invigorated and the disease thereby
removed.
The intolerance of light is a very prominent symptom of this
disease, and sometimes it is the only symptom that manifests
itself. It is curious that this inability to endure a bright light
bears no regular or definite proportion to the intensity of the other
symptoms. It is not that the eye is painful when protected from
the light; but that the access of the ordinary light of day occasions
extreme suffering; the eye-lids being spasmodically closed, and
the orbicular muscle so affected with strong and apparently involun-
tarynaction, as effectually to resist all attempts at opening them.
Children that are affected with this disease carry it legibly written
in their physiognomy. Although you cannot tell what is the actual
condition of the eye without examining it, you can tell, as soon as
you look at the patient, what is the nature of the inflammation
under which he is suffering. The child's brow is knit and con¬
tracted, while the sides of his nose and his upper lip are drawn up¬
wards ; those muscles of the face (they happen also to be muscles
of expression) are instinctively bent in action, which tends to
exclude the light, without shutting out the perception of external ob¬
jects; producing a peculiar and distinctive grin. In the more severe
cases the child will skulk all day in dark corners; or if in bed will
lie upon his face, or under the clothes; and while the light is thus
kept off he does not appear to suffer. If brought towards a window,
he holds his head down, and passes his hands or arms over his
328
DISEASE OF THE EYES.
eyes. When you attempt to open his eye to examine it, a profuse
discharge of scalding tears takes place: these pass partly into the
nose, and excite fits of sneezing, and partly over the skin, which
they sometimes inflame and excoriate ; and then frequently pustules
arise, and produce a discharge that crusts over the cheek and
extends to the forehead and temples. This is called crusta lacta,
and is very characteristic of the scrofulous habit; it occasionally
spreads over the whole body. q
Treatment.—Scrofulous sore eyes, being a constitutional dis¬
ease depending upon a feeble organization, not only demand
constitutional treatment, but in the great majority of cases, require
a considerable period of time to effect a permanent cure. In
general, much medicine will not be required. Exercise in the
open air, wholesome nourishing food, warm clothing, keeping the
feet dry and warm, cleanliness, a cold shower bath or sponging
the body with salt water in the morning, and frictions of the sur¬
face with the flesh-brush or salted towel, are important means for
improving the general health, and strengthening the constitution.
When the appetite is bad, the breath offensive, or the stools ex¬
hibit an unhealthy appearance, an emetic will be beneficial: this
will operate still more effectually after the administration of a
vapor bath. In recent cases the operation of an emetic will
generally be followed by a manifest improvement in the condition
of the eyes, and sometimes it alone will effect a cure.
The Compound Lobelia Pills may be used with benefit in almost
gvery case of chronic disease, whether it be of a scrofulous charac¬
ter or otherwise. These pills do not affect the bowels in the way
that cathartics operate; they stimulate the peristaltic action, and
excite the secretions of the mucous membrane of the bowels, with¬
out disordering their functions, or weakening the vital powers;
whereas cathartics weaken their functions, and disordei^ the
stomach. The continued use of a cathartic, — for instance,
a small dose of Epsom or Glauber salts, taken daily, or every
few days — by provoking irritation in the bowels, and lessen¬
ing. the determination of blood to the surface, may diminish the
inflammation of the eyes; but the constitutional disorder will be
increased, because digestion must necessarily be impaired by the
action of the salts, which merely change the symptoms of the
disease, without restoring the health. Let a child in good health
be purged with salts every day, and this continued for a week; the
digestive powers at the end of the week will be impaired, the
warmth of the system will be reduced, and the bowels will remain
enfeebled and inactive for several days after. The absurditv of
administering such medicine to one whose constitution is feeble,
and general health deranged, must be apparent to every unpre-
DISEASE OF THE EYES.
329
judiced mind. To change the symptoms of disease by the use of
cathartics, or by administering poisons, is one thing, but to remove
disease from the system is quite a different matter.
Tonics.—The best tonic in cases of scrofulous sore eyes, is qui¬
nine. It may be given in grain doses, three times a day, at any
period of the complaint, but more especially after having the sto¬
mach cleansed by an emetic. A very good plan of treatment is
to give quinine through the day, and from two to four lobelia pills
at night, on going to bed. Other tonics may be substituted for
quinine, but there is no other article equally efficacious in strength¬
ening the nervous system. Dr. Mackenzie, who made extensive
use of quinine in scrofulous sore eyes, declares that it acted like a
charm, abating, commonly, in a few days, the excessive intolerance
of light and profuse flow of acrid secretions, and promptly improv¬
ing the condition of the eyes in every particular.
The tonics to be preferred next to quinine are the precipitated
carbonate of iron, and extract of gentian.
Purified Charcoal may be used with advantage in cases of cos-
tiveness, more particularly when accompanied with an acid condi¬
tion of the stomach. The dose is a teaspoonful two or three times
a day, taken before meals.
Salt and Vinegar. — When patients have an inclination for
acids, such as vinegar, or lemon-juice, as they frequently have in
scrofulous complaints, where digestion is impaired, a mixture of
salt and vinegar will sometimes be found of signal benefit in im¬
proving digestion.
Sarsaparilla.— A simple syrup of this article is an admirable
medicine for scrofula in certain conditions of the system. I have
occasionally observed the most marked benefit from its use in
cases where the disease had apparently come to a crisis, the patient
remaining in a weak and languid condition. But whether the
patient be most benefited by the sarsaparilla or by the syrup of
sugar, is not very easy to decide.
Burdock-root tea has been employed with great advantage in
cases of scrofulous sore eyes, the tea to be drunk freely, and the
eyes wet with it several times a day. The narrow-leafed yellow-
dock root may be used for the same purpose.
Local Treatment.—In scrofulous sore eyes, it will in most cases
be found on examination that some of the eye-lashes are dead, and
thus, operating as foreign bodies to the parts, occasion very disa¬
greeable itching in the eye-lids, and the formation of matter at
their roots. T^e removal of these dead eye-lashes, therefore, is
330
DISEASE OF THE EYES.
important in the cure of the disease. A little observation will
teach one how to distinguish the living from the dead lashes, and
they are very easilv removed, without causing much pain, by a
pair of tweezers. I have, on several occasions, removed, at one
time, over one hundred dead eye-lashes from the eye-lids of a-
patient affected with sore eyes.
If there be a high degree of inflammation in the parts, apply a
piece of fresh lean beef, or a piece of cabbage leaf on the eye, and
continue it until the inflammation is diminished, and then apply
tincture of myrrh to the eye-lids three or four times a day, by means
of a small brush or the end of a feather.
The Diet must be such as is easy of digestion, yet nourishing;
fresh beef and mutton, poultry, wild game in season, eggs, boiled
rice and milk, boiled milk and toast, toast and cream custard,
stale bread and butter, black tea, chocolate, and all wholesome
vegetables may be used, provided they be found to agree with the
stomach.
When scrofulous sore eyes are accompanied with eruptions on
the face, or running sores behind the ears, the treatment should be
the same as already described, observing especial care, when the
vapor bath is administered, to protect the skin surrounding the
affected parts from the irritating secretions which the steam will
cause to be discharged from the eruptions. The secretions from
scrofulous eruptions are sometimes so acrid that they produce an
eruption on the surrounding parts wherever they are touched by
them; and in this way the disease will spread over almost the
whole of the face, and sometimes extend from behind the ears
down to the shoulders, and cover a portion of the back. This may
in general be prevented by bathing the parts surrounding the erup¬
tion with No. 6, or the tincture of lobelia, immediately after the
bath, the parts being also protected at other times wThen the erup¬
tions are discharging. These eruptions require the same plan of
treatment recommended for the cure of scald-head; namely, to
prevent the admission of air to the eruption by the application of
salve or ointment, together with the use of medicines for correcting
the general health.
Case.—A boy seven years old, living in Christian street, was
affected with scrofulous sore eyes, attended with eruptions over
the face and back of the ears; after the disease had continued
more than eighteen months, the patient was placed under Thom-
sonian treatment, which speedily improved the general health;
but the eruptions suppurated freely, causing extensive patches of
raw surface, secreting pus. Necessary care was not taken for
preventing the discharge from affecting the surrounding parts, and
DISEASE OF THE EYES.
331
the eruption consequently commenced spreading considerably,
although the eyes were improving. The parents became dis¬
couraged, and applied again to the old practice. The treatment
next pursued consisted in the continued use of salts, and cooling
applications to the surface.—Under this course of treatment the
determination of blood to the surface was lessened, the system
became cold and inactive, and as the disease left the face, the hip
and knee became affected with scrofula, attended with years of
suffering, and followed by distortion of the limb. The cooling
treatment occasioned the disease to become fixed in the hip, which
would probably have been kept on the surface and eventually
cured under Thomsonian treatment, and the disease prevented
from seating itself in the hip.
Case.—A son of Mr. Laird of Southwark, was under treatment
six months for scrofulous sore eyes, and continued to grow worse
and waste in flesh under the treatment, which consisted of mild
purgatives, and washing the eyes with a solution of nitrate of
silver. The child was placed under Thomsonian treatment, con¬
sisting of an occasional vapor bath and emetic, broken doses of
tincture of lobelia administered daily, a dose of composition two or
three times a day, and injections. The eyes were poulticed with
a mixture of elm, white pond lily and ginger. In six weeks the
patient was well.
SECTION V.
BLINDNESS.
(Total or Partial.)
A total or partial loss of sight may be^ caused by a variety of
forms of disease of the eye; or, more properly, different parts of
the eye are liable to become diseased, occasioning loss of vision.
Thus blindness may be produced by disease of the optic nerve,
which conveys impi'essions to the brain. This form of disease i?
called amaurosis.
A very common cause of blindness is an opacity of the crystal
line lens, or its capsule, designated by the term cataract.
Sometimes a total or partial loss of vision depends upon disease
of the transparent cornea of the eye, which is liable to become
clouded and thickened; and occasionally it becomes very much
swollen, bulging out from the centre of the eye-ball, forming a
332
DISEASE OF THE EYES.
tumor as large as a cherry. The eye is also liable to dropsy
cancer, and to gangrenous ulceration ; which happily, however, are
of very rare occurrence.
Symptoms of Amaurosis—Disease of the Nerve of the Eye.—In
this form of disease, the eye does not present any particular appear¬
ance of disease upon a superficial examination, except that the
expression is vacant; but on a closer inspection we find the pupil
dilated, and on applying a lighted candle near, the contracting
power of the pupil is observed to be either lost, or greatly dimi¬
nished. " There is frequently the sensation as if a cloud were
before the eye," and the pupil often presents a greenish appearance.
The sight is obscure, or the power of seeing is lost.
Causes.—Close and long-continued application of the eyes to
minute objects, more especially by candle-light; paralysis of the
optic nerve, occasioned by an unhealthy condition of the brain, at
the origin of the optic nerve; and constitutional disease, are the
principal sources of amaurosis.
Treatment.—Almost the only hope in cases of amaurosis, is an
early and vigorous course of constitutional treatment, with a view
to restore the circulation of nervous fluid in the diseased nerve.
Frequently, however, the disease depends upon causes that render
all medical means abortive; still, a trial should be made, as by it the
sight may possibly be restored, or at least greatly improved. Many
cases have been cured by the use of emetics.
When amaurosis is connected with manifest derangement of
the general health, there is strong reason to anticipate benefit
from the operation of emetics, but still more from full courses of
medicine.
Besides constitutional treatment, stimulating washes should be
frequently applied to the eye, such as capsicum tea, or Thomson's
eve-water, and the patient continue as much as possible in the light.
The frequent application of volatile salts to the nose, and snuifing
freely of composition or other stimulating powder, may assist in
restoring the function of the optic nerve.
Cases of amaurosis have been cured by the application of elec¬
tricity and galvanism.
Concerning the Treatment of Cataract little need be said here,
as the disease is one, the cure of which requires an operation by
the hands of a surgeon. In the incipient stage of cataract, how
ever, a proper course of constitutional treatment may in som
cases prevent the further progress of the disease, and even cause
the absorption of the cataract. The constitutional treatment foi
cataract does not differ from that recommended in amaurosis.
disease of the eyes.
333
There are occasional instances of congenital opacity of the
cornea,—the eye at birth resembling somewhat the appearance of
ordinary cataract as it occurs in adults. The pupil in some in¬
stances is entirely covered by the cloud, in others only partially.
Usually, in those cases of congenital opacity of the cornea, the cloud
gradually disappears by absorption, and the eye becomes perfect.
The process of absorption may be promoted by the daily applica¬
tion of some kind of stimulant to the eye, for instance salt water,
or tincture of lobelia.
SECTION VI.
IRITIS—INFLAMMATION OF THE IRIS.
The iris is a membrane stretched across the centre of the eye¬
ball, giving to the eye its color. In the centre of the iris is an open¬
ing called the pupil. It is the contraction and dilatation of the
iris that effects the variations in the size of the pupil. The use of
the iris appears to be, to regulate, by its dilatation or contrac¬
tion, the quantity of rays of light necessary for distinct vision.
The iris is placed in a little cavity filled with a thin fluid like
water and lined by a serous membrane. Serous membranes, when
inflamed, throw out lymph, and inflammation of the iris has occa¬
sionally caused blindness, the effusion of lymph causing adhesions
between the iris and the parts around. It is a very rare occur¬
rence, however, for blindness to be produced in this way.
Symptoms.—The symptoms which characterize inflammation ot
the iris, are change in the color of the iris; for instance, a grey
or blue eye becomes yellowish or greenish, and a dark eye pre¬
sents a reddish tinge ; irregularity of the pupil, produced by ad¬
hesions of the iris to the neighboring parts; the edge of the
pupil, instead of being perfectly smooth, is more or less serrated,
small toothlike processes being shot out; the eye becomes dull
and tarnished, as it were, and if the inflammation is confined to
one eye, the difference in the general appearance of the diseased
eye is strikingly different from that of the well one. In some cases,
there may be seen on the iris small rustv-looking spots or freckles.
These spots are portions of effused lymph. " Sometimes, when the
inflammation is very violent, or the disease has been neglected,
actual suppuration takes place. A reddish-yellow prominence
rises from the surface of the iris, and at length breaks and dis¬
charges matter, which sinks down to the bottom of the anterior
334
DISEASE OF THE EVES.
chamber, and presents the appearance that has been called hy¬
popyon."
" Another very common consequence of the effusion of lymph
from and upon the surface of the iris, is its adhesion to the cap¬
sule of the crystalline lens, which lies behind the iris, and very
near it. And the pupil itself is apt to become blocked up by
lymph."
" The motions of the iris are seriously impeded by the mere
effusion of lymph into its texture. At first it moves sluggishly
under variations of light; gradually the pupil contracts, and
becomes fixed and motionless. The adhesion of the iris to the
capsule of the lens, still more decidedly restrains the action of the
part. When it adheres to one or more points of the margin and
remains free elsewhere, the pupil is deformed; loses its circular
shape; becomes angular; and this deformity is the most marked
when the eye is examined either under a weak light, which allows
the pupil to dilate, except at the points where the pupil is tied down
to the lens; or under a very strong light, which forces the free
portions of the margins, and those only, to approach the centre."
"Acute iritis is attended with pain and intolerance of light. To
the latter circumstance is probably owing the contraction of the
pupil during the progress of the inflammation ; and then the lymph
fixes the pupil in that state of smallness and contraction. There
is pain in the eve-ball itself, and in the parts about the eye, the
brow and temple, most severe at night. There is much variety,
however, in regard to the pain. Sometimes it is constant and
severe, but still more aggravated at night. Sometimes, even when
the quantity of mischief that is visible is very great, scarcely any
pain at all has been experienced." Generally acute iritis is at¬
tended with constitutional disorder, causing headach, fever, loss
of appetite, furred tongue, costiveness, &c. In severe cases of
iritis, and under unfavorable circumstances, such as a vitiated state
of the general health, or where the recuperative powers of the
system have been crippled by profuse bloodletting, long-continued
purging, or the system poisoned with such articles as nitre, anti¬
mony or calomel, the disease is liable to result in blindness, either
from suppuration taking place in the iris, or the inflammation
extending to the retina.
Constitutional Treatment.—In inflammation of the iris, consti¬
tutional treatment should be early and perseveringly applied, with
a view to effect a termination of the inflammation, without the
occurrence of suppuration of the iris, and to prevent the disease
extending to the retina. In severe cases, a vapor bath or the hot
air bath, and a lobelia emetic should be administered daily, at
least until there be a manifest improvement in the symptoms.
Resides these the patient should be kept more or less nauseated by
DISEASE OF THE EYES.
335
small doses of lobelia frequently repeated ; and stimulating teas
given to favor perspiration. In the place of purgative medicines,
which always harass the stomach and bowels, employ injections.
The patient should remain in bed with warmth applied to the
feet; and the room should be kept darkened, provided the light be
painful to the eye.
Local Applications.—Either a soft poultice composed of slippery
elm, adding a portion of lobelia powder, or soft muslin cloths wet
with cold water, may be laid on the diseased eye, if agreeable to
the feelings of the patient.
The course of treatment above described is applicable to the
acute form of inflammation of the iris, where the attack is sudden
and severe. In chronic inflammation of the iris,—the most com¬
mon form of the disease, and often connected with a syphilitic
taint of the system, chronic rheumatism and gouty affections,—va¬
riations from the treatment above recommended will be required.
For instance, instead of administering a course of medicine dailyr
once or twice a week will be sufficient, and in the intervals give
tonics, as well as broken doses of lobelia.
When iritis is associated with syphilis, such remedies must be
employed as are best adapted to clear the system of the syphilitic
poison. See Treatment for Secondary Symptoms of Syphilis. Sy¬
philitic iritis is never attended with abscess of the iris.
If inflammation of the iris occur in combination with rheuma¬
tism or gout, the treatment must be regulated to suit the character
of the constitutional symptoms. Thus, if there be strong febrile
symptoms, hot skin, and a strong, quick pulse, the case must be
treated as one of inflammatory rheumatism, or as any other form
of acute disease, relying chiefly upon courses of medicine, and a
continued repetition of broken doses of lobelia and stimulants. If
associated with chronic rheumatism, or long-standing gouty affec¬
tions, the case must be treated accordingly; the grand object always
to be kept in view, being the improvement of the general health.
Thus the same constitutional treatment that would cure a case of
chronic rheumatism, would be adapted to the cure of rheumatic iri¬
tis. And again, where iritis is complicated with gout, the treatment
that would be most successful in restoring the general health,
would be the kind of treatment for curing disease of the eye, pro¬
vided the iritis have been occasioned by the same cause as the
gouty affection.
In chronic iritis, as well as in chronic rheumatism, and other
forms of chronic disease, change of air, especially a residence near
the sea, or travelling in a mountainous country, will often effect
changes in the constitution that cannot be wrought by medical
treatment alone.
336
disease of the eyes.
Case.—A gentleman came to Philadelphia some weeks since,
affected with inflammation of the iris of the right eye. He had
been some weeks under the old school practice, and had been
purged severely with salts and other cathartics, which, together
with cooling applications to the eye, constituted the principal treat¬
ment. The continued purging had caused the blood to recede
from the external capillaries, the skin being cool, dry, and ol a
dirty, pale color; the digestive functions were much impaired; and
general torpor of the system prevailed. The disease of the eye
proceeded from cold, and was unconnected with either syphilis or
rheumatism. The pain in the eye was violent, especially during
a part of the night. This patient, after having been six weeks under
the old school practice, was placed under Thomsonian treatment.
The first vapor bath relieved the pain in the eye almost like a
charm; and by the use of lobelia, emetics, and vapor baths, which
were administered daily for some time, together with injections
and broken doses of lobelia, the patient was relieved from pain, and
could sleep during the whole of the night. His skin became of a
healthy temperature and continued moist; the secretions were
restored ; the stomach recovered its lost tone ; the eye improved in
every way, so that in the course of a week from the time this
patient came to the city, he was so far improved that he returned
to the country, apparently nearly well.
SECTION VII.
STYE.
The formation of a small abscess on the eye-lid, called a stye,
is of very frequent occurrence. It is generally occasioned by a
disordered condition of the stomach. Sometimes it is caused by
the presence of a dead eye-lash, the abscess being formed at the
root of it.
Treatment. — When the stye becomes painful and considerably
inflamed, cooling applications should be made to the eye, frequently
wetting it with cold water, or applying a poultice of slippery
elm, or of flaxseed stewed with Indian meal, until it becomes well
softened. If there be a dead eye-lash in the centre of the stye, it
should be pulled out, which, when done early, will sometimes check
the progress of the abscess. Rubbing the stye, when it first ap¬
pears, with cold metal, as a silver spoon or knife-blade, will, it is
said, in many instances prevent an abscess from being formed.
DISEASE OF THE EYES.
337
SECTION VIII.
FISTULA LACHRYMALIS.
[Obstruction of the duct which conveys the tears from the eye into
the nostril.)
The tears and mucus secreted in the eye are conveyed into the
nostril through a small duct, which is liable to become obstructed
by various causes, and then the tears, instead of passing into the
nose, are obliged to flow over the cheeks, proving a source of
extreme annoyance.
The obstruction may take place at the inner corner of the eye,,
where the duct commences, and may be remedied by the careful
introduction of a fine silver or gold pin through the duct into the
lachrymal sac, which is an enlargement of the duct about a quarter
of an inch from its commencement. If the obstruction be seated
in the duct below this little sac or bag just alluded to, the tears
will pass down into the sac, and being retained there in conse¬
quence of the obstruction below, it becomes swollen into a round
tumor, as large sometimes as a chestnut. The tumor will be
situated a short distance below the eye, near its inner corner. By
pressing upon the tumor, the contents will be forced upwards and
pass out at the eye; or if the obstruction below the tumor be not
complete, the tears contained in the sac may be forced into the
nostril. " The complaint sometimes remains in this state for years,
with little inconvenience, pressure being occasionally made upon
the sac to empty it." Sometimes the tumor suppurates and breaks
externally, and the tears will pass out through this opening, and
flow over the cheek. The sac is now very liable to frequent
attacks of inflammation and suppuration.
Treatment.—In the early stage of this complaint, constitutional
treatment, particularly the vapor bath with an emetic, has, in
some instances, overcome the obstruction and effected a perma¬
nent cure. The disease, however, is seldom curable by constitu¬
tional treatment; the only chance of its success is in the early
stage, and especially when the obstruction is owing to inflamma¬
tion and swelling of the duct. When these exist, the use of the
vapor bath, together with relaxing the system fully by lobelia, and
promoting perspiration and an equal circulation by the use of sti¬
mulants, such as capsicum or composition, may prove successful!
in restoring the duct to a healthy condition.
When the tears flow over the cheek, and the lachrymal sac, jusS
22
338
INSANITY.
below the eye, is not swollen, it affords evidence that the obstruc¬
tion is in the duct, between the eye-lid and the lachrymal sac.
This obstruction may be removed by passing a small silver or gold
pin down the duct into the sac.
Sometimes the lachrymal sac becomes diseased, and secretes
from its surface a thick matter, which does not pass readily through
the duct, and the sac becomes distended, requiring to be pressed
upon in order to force the thick matter up to the corner of the eye,
or down into the nose.
A gentleman not long since told me that he was cured of an
•obstruction in the duct that leads the tears into the nose, by the
operation of a course of medicine. The disease had continued for
many months, the tears passing over the cheek. During the opera¬
tion of the emetic, the tears resumed their natural channel, by the
removal of the obstruction in the duct. It is not to be inferred,
■however, that many cases of this affection can be removed by a
course of medicine. It is only under particular circumstances that
we can reasonably anticipate a cure by constitutional treatment.
A common practice in this complaint is to introduce a gold or
silver tube down the course of the duct, and thus lead the tears
(into the nostrils. In some cases this tube answers a good purpose
-in others it does injury.
CHAPTER XIV.
SECTION I.
INSANITY—MENTAL DERANGEMENT.
Insanity depends upon a diseased condition of the brain, whicn
is the organ of the mind.
" The mind consists of a plurality of innate and independent
faculties, a congregation of separate and primary powers." —
Fowler. Each faculty of the mind has its especial organ, and
when only a part of the brain is diseased, those faculties only will
rbe deranged or destroyed which are located in the diseased part.
Thus phrenology explains the reason why an individual may be
insane on some subjects, and at the same time quite rational on
others.
There is a close and intimate sympathy existing between the
«k
INSANITY.
339
mind and the body, so that a change in the condition of the one
will vary the condition of the other. Who has ever experienced
a flow of good spirits during a fit of ague, or in the commencing
stage of small-pox, or in the early stage of any other form of dis¬
ease, when Ihe brain is deprived of its due supply of blood and
nervous energy? In proportion as the nervous energy of the brain
is enfeebled, and the supply of arterial blood to it lessened, so in
proportion will the mind become enfeebled—it cannot be other¬
wise—yet still the mind may be free from insanity. Cases occur,
however, where the b^ain receives so small a supply of arterial
blood, in consequence probably of long-continued, inveterate dys¬
pepsia, that it does not generate. a sufficient quantity of nervous
fluid to support the mind, and consequently it sinks into a state of
imbecility, and sometimes into insanity. A blow upon the head,
producing concussion of the brain, stops at once the operation of
the mind until the brain recovers from the shock. And again,
sudden impressions made upon the mind exert a powerful influence
upon the brain and digestive organs. Too close attention to study
immediately after dinner, weakens digestion, by causing an afflux
of nervous energy to the brain, and thus, determining it from the
stomach, enfeebles digestion.
A sudden shock of the mind soon after a meal, such as sudden
fright or some distressing news, will suspend the power of diges¬
tion. This intimate connexion existing between the mind and the
body leads us to perceive the cause of mental derangement in the
diseased condition of the organs of the mind.
Causes. — In some families there exists a predisposition to in¬
sanity, so that several members of the same family will be affected
with the disease. Moral influences, by disordering the organs of
the mind, occasion insanity. Thus, by close, long-continued, and
deep study, the blood-vessels of the brain may become diseased,
and so far derange the functions of the brain as to occasion insanity.
A great variety of moral influences,—disappointed love, religious
enthusiasm, fanaticism, excessive joy, jealousy, and long-continued
depression of mind, sometimes produce insanity. The physical
causes are excessive losses of blood, exhaustion from long-conti¬
nued and inveterate dyspepsia, habitual drunkenness, injuries of the
head, abscess in the brain, the inordinate use of mercury, the use
of narcotic poisons, and a diseased condition of the stomach and
bowels. Some of the early writers on medicine have maintained
that mental derangement has its seat generally in the stomach—
the diseased xondition of the functions of the brain being the con¬
sequence of a disordered condition of the stomach.
•
Chances of cure.—Of the cases of insanity that occur, probab/v
less than one-half are cured. The great majority of cures take
340
INSANITY.
place within the first year from the commencement of the disease.
After the disease has continued without intermission over three
years, there is little hope of the patient being restored to perfect
reason; still, recoveries sometimes take place after the fifth or sixth
year from the commencement of the derangement.
It is stated by physicians who have attended in lunatic asylums
that partial insanity and melancholy are more difficult to cure than
a general derangement of the mental faculties, unattended with
melancholy. It is also ascertained that patients who have a distinct
recollection of recent occurrences, "with an oblivion of events
long passed," are more easily cured than those who have a recol¬
lection of events long past, but who cannot remember occurrences
that have recently transpired about them. " In general, acute and
furious mania is much more under the control of remedial manage¬
ment than low, torpid, and fatuous insanity. Mental derangement
from physical causes, generally yields more readily and perma¬
nently than when it arises from moral causes. A recovery of the
general health of the system, without a corresponding melioration
*>f the mental disease, is said to be an unfavorable sign."—Eberle.
1. MANIA GENERAL INSANITY.
Symptoms which characterize general Mental Derangement, or
Mania.—These are, a rapid succession of incoherent ideas, and
violent excitement of the passions, expressed by great agitation,
iOud vociferation, singing, menaces and fury.
Torpor of the bowels ; cold extremities ; variable appetite, fre¬
quently craving; sudden and frequent variations of temper, the
patient often manifesting a vicious disposition ; an inability to sleep
much, and frightful and distressing dreams, are symptoms which
generally precede the occurrence of mania.
" When the disease is once fully developed, the expression of
the countenance is wild, and often furious ; the eyes are prominent,
sparkling, and in constant motion; the patient sings, whistles, vocife¬
rates, shouts, walks to and fro with rapidity, or stands still with
his hands and eyes often raised towards the heavens ; he does not
sleep for many nights, sometimes not for several weeks; he often
manifests great muscular power; the skin is dry, cool, and occasion¬
ally covered with profuse perspiration." It is stated that the exha¬
lation of a peculiar and disagreeable odor from the body and the
excretions is peculiar to maniacs.
" In the violent grades of mania, the mind forms erroneous per¬
ceptions of the impression of external objects on the senses, or the
senses convey erroneous impressions to the mind. In this case
the patient does not recognise the persons and objects around him;
mistakes friends for strangers, and commonly visiters for his rela¬
tions : loses the consciousness of his individuality, and is ignorant
INSANITY. 341
of the place he occupies, of his rank and condition in society, and
of the lapse of time. The imagination is sometimes so powerfully
excited, that its representations prevail over those of the senses.
The patient hears voices, and holds conversations with persons
whom he imagines are present; and in some cases these voices
harass him wherever he goes, by day and by night, in public and
in private. Sometimes the empire of volition seems to be entirely
suspended, and the patient is no longer master of his own determi¬
nations. An irresistible impulse leads him to injure himself, or to
inflict injury upon others; to tear the clothes from his body, run
out naked into the streets, leap out of the windows, and commit
other acts of fury."
2. PARTIAL INSANITY.
In this form of mental derangement, a part only of the organs
of the faculties, or of a single faculty of the mind, is diseased, so
that the patient will be insane upon one subject and entirely rational
on others.
" This is by far the most common form of mental derange¬
ment, and it is always entirely free from delirium or paroxysmal
raving."
In that variety which is usually denominated hypochondriasis,
the hallucinations relate to the patient's own body, or to the cir¬
cumstances which he conceives have an especial sinister influence
upon his own system, fortune, or happiness. The suggestions of
his morbid imagination are taken for realities. He believes him¬
self afflicted with some certain incurable and fatal disease, parti¬
cularly with consumption, cancer, or stone, and, above all, with
impotency and the venereal disease. He fancies that some poison
has been maliciously introduced into his system ; or that he has a
living animal, or some other very injurious substance in his sto¬
mach or bowels. Some patients believe themselves transformed
into inferior animals, and others imagine themselves to be made
of glass, wax, butter, &c.
Some patients are insane on the subject of religion ; others upon
the subject of love, wealth, or ambition. I knew a minister, a mem¬
ber of the society of Friends, who visited England and returned
again entirely insane on the subject of religion, but perfectly sane
on other subjects.
Treatment of Mental Disease.
The medical profession have almost abandoned the use of medi¬
cine in the treatment of insanity, depending almost exclusively upon
moral influences. A removal of the patient from home, and, hind
treatment, are the means chiefly relied upon by those who have
had long experience in treating mental disease.
342
INSANITY.
From the good success that has attended Thomsonian treatment
in several cases of insanity, depending upon a disordered condi¬
tion of the stomach, or upon a diseased state of the system gene¬
rally, there is reason to believe that in many instances a cure may
be effected by this system of practice. The failure of the old
school practice of medicine furnishes no just criterion to judge of
the effects of Thomsonian treatment. A patient may have taken
emetics of tartarized antimony, without being benefited, and yet
be greatly benefited by a Thomsonian course of medicine. Mer¬
curial preparations, cathartics, cupping, leeching, together with
the use of all the remedies which are employed by the medical
profession for reducing what they call morbid excitement, mav fail
of doing good, when an opposite and more rational course of treat¬
ment may prove successful in removing the disease, by aiding
nature.
Case.—During last winter, I attended a patient who had be¬
come insane through religious enthusiasm. She had been in fee¬
ble health for many years. On my first visit I found her under
the bed ; and when brought from her hiding-place, she manifested
a high degree of mental excitement, frequently bursting forth in a
continued and rapid strain of imprecations and curses, until she
became exhausted ; when she would lie down for a time, and some¬
times hide her head under the pillow, or throw her limbs about, as
though suffering bodily distress. In this case I found the most
signal benefit from giving lobelia emetics. Every time she vomit¬
ed freely, and the system became relaxed under the influence of
the lobelia, she became quiet, and would sleep several hours.
This treatment was continued; namely, an emetic given at inter¬
vals of one or two days, and broken doses of lobelia given at in¬
tervals of every two or three hours, as the patient could be per¬
suaded to take them, not resorting at any time to compulsory
means, except when the patient made an attempt to go out of the
room. During the operation of the fourth or fifth emetic, a large
mass of thick dark-green matter was thrown from the stomach ;
the muscular system became fully relaxed, the patient continuing
many hours very sick and much distressed ; after which she be¬
came calm and composed, and had no return of insanity, except
in a very slight degree.
In another Case of Mental Derangement, occurring in a young
man of this city, medicine appeared to have scarcely any appre¬
ciable effect on the disease. The derangement had approached in
a gradual manner, his family and friends having frequently observed
him to be absent-minded, and occasionally disposed to melancholy,
secluding himself from the society of his own family; and then
again to form some scheme for regenerating the world, or to at-
INSANITY.
343
tempt to engage in some wild speculation. This condition of mind
continued several years before he became entirely insane. Although
medical treatment appeared to have scarcely any effect, yet, under
kind treatment from his family, the mental derangement improved
so that he was removed to the family of a friend; and from that
time he began to recover more rapidly, until all the symptoms ol
insanity disappeared.
When the insanity is general, and comes on suddenly, attended
with great excitement and even furious delirium, it is in general
much more under the control of medical treatment than when it
is accompanied with melancholy, and a torpid condition of the
system, or when the case is one of partial insanity.
" One of the first measures in the treatment of mania, should be
to remove the patient from his friends, and to place him in some
quiet and secluded situation. Dr. Rush strongly insists upon the
importance of separation and proper seclusion ; and the most
eminent of the English, German, and French writers, advise the
adoption of this measure." "Let it be observed, however, that in
recommending separation and confinement, it is not intended to
object to regular exercise in the open air, and the enjoyment of
the society of suitable persons during the patient's intervals of
comparative calmness. Whenever the weather is favorable, and
the patient's condition will admit of it, free air and ample exercise
should be allowed. The mutual association of patients similarly
affected, particularly during convalescence, has also a favorable
tendency."
Idleness is unfavorable to the recovery of patients affected with
partial insanity; they should be allowed, and even persuaded, to
engage in amusing exercises, " as playing at quoits, the chase,
shooting; and even chess, checkers, cards, and push-pin should'
be preferred to idleness."—Rush.
The Medical Treatment generally pursued in the different asy¬
lums and hospitals for the insane, is the chief objection to these
institutions. Established for the purposes of benevolence and
philanthropy, and under the government of persons experienced in
the management of the unfortunate insane, and with the advantages
which they afford in relation to discipline, exercise, and amuse¬
ment, these institutions, apart from the medical treatment practised
upon the patients, should receive the sanction and support of every
member of the community.
" In the furious state, insane patients should never be contra¬
dicted, however absurd their opinions and assertions may be, nor
should we by our answers deny their requests, when it is proper to
grant them. In the second stage of the disease, we should divert
them from the subjects upon which they are deranged, and intro-
344
DELIRIUM TREMENS.
duce, as it were accidentally, subjects of another and of an agree¬
able nature. When they are upon the recovery, we may oppose
their opinions and incoherent tales, by reasoning, contradiction
and even ridicule."—Rush.
When insanity is brought on by the sudden suppression of the
catamenia from cold, the treatment must be directed to the removal
of this obstruction. The means to be employed are, the warm
stimulating foot baths, stimulating enemas, the vapor bath, emetics,
and the free use of the compound lobelia pills.
When the patient is in a sunken and depressed condition, a
course of medicine will awaken an action in the system, and in
recent cases it will be certainly beneficial.
Insanity, which sometimes follows child-birth, is generally cura¬
ble by medical treatment. The most important means to be em¬
ployed are stimulating enemas, containing a portion of lobelia;
emetics; the continued use of broken doses of lobelia in composi¬
tion, or pepper tea; warmth applied to the feet, and the vapor bath
and shower bath used when practicable.
In many of the cases of insanity, the patients will have a mor¬
bidly craving appetite, so that they will eat four times as much as
is necessary, and more than the stomach can receive with impunity.
In such cases, therefore, it is necessary to allow the patient as
much food only as will be requisite for his sustenance, and not
permit him to overload and oppress the stomach.
SECTION II.
DELIRIUM TREMENS—MANIA A POTU.
(Craziness from Drinking.)
Tins is a species of mental derangement occasioned by habitual
drunkenness, or by the intemperate use of opium.
Symptoms.—The disease comes on after the excessive drinking
of ardent spirits. The digestive powers are prostrated by the poi¬
sonous effect of the liquor; there is distress at the pit of the stomach,
loss of appetite, nausea, great agitation and distress of mind, and
tremulous motions of the limbs.
As the disease continues, the countenance of the patient becomes
more expressive of alarm and suspicion; there is continual rest¬
lessness, and increased mental agitation. The tremor of the
hands increases, and, in some instances, the whole muscular system
DELIRIUM TREMENS.
345
is agitated as though the patient were laboring under a fit of ague.
" The eyes are cast about with quick and scrutinizing glances, or
often fixed, apparently, upon some object that attracts the atten¬
tion for a moment, and then quickly withdrawn. The patient is
unable to sleep, either by day or night. He fancies that he sees
snakes, cats, mice, and other animals in his room, and disgusting
vermin crawling over the bed and on his clothes; or fancies that
various persons have entered his room, for the purpose of robbing,
killing, or injuring him. To avoid these and other horrid illu¬
sions, he often calls out loudly for assistance; runs to the door to
make his escape, or to the window to leap out; is greatly agitated,
vociferates, threatens, and sometimes raves violently. Sometimes
he fancies that he hears loud and strange noises around him, over¬
head, in an adjoining apartment, or loud and frequent knocking at
the door. His mind and body are in a continued state of action ;
he calculates, projects, walks hurriedly about the roo«n, thinks he
picks up money, runs up to the window, and calls out to some
imaginary person in the street, starts with terror and agitation from
the presence of frightful and disgusting apparitions, insists that he
is well, and confined with some sinister intentions against him, and
requests to be suffered to go out in pursuit of his usual occupation.
If the patient be flatly contradicted, he usually becomes much ex¬
asperated, and insists with vehemence on the correctness of his
notions; but when he is soothingly dealt with, he will now and
then answer questions mildly and even distinctly ; and by judicious
management may, in general, be restrained without any violent
coercive measures." The skin is cool and generally covered with
perspiration.
In some instances the symptoms are slight, and pass off in the
course of two or three days : whilst in others the patient becomes
furiously crazy, does not recognise any one, shouts, or talks con¬
tinually, and is controlled with difficulty.
A form of mental derangement closely resembling mania a potu,
sometimes occurs from overstraining the nervous system. " Long-
continued mental anxiety, that state of mind in which gamblers
and great speculators (who are indeed gamblers) are accustomed
to live, may cause it; any thing by which the mind is overwrought
may produce it."
The Duration of Mania cl Potu varies from two days to several
weeks, and in some instances it has been observed to continue
several months. Under a proper course of treatment, the patient
will in general be restored to reason in less than a week from the
commencement of the delirium. Much depends, however, upon
idmmistering the remedies early in the disease, as, in many in¬
stances, when the disease is fully seated, it is with the greatest dif¬
ficulty that the patient can be persuaded to take sufficient medi
346
DELIRIUM TREMENS.
cine to produce much effect. Mild cases of the disease have fre¬
quently been observed to terminate speedily after spontaneous
vomiting, or the supervention of diarrhoea without having been
induced by a purgative medicine.
Fatality.—Delirium tremens rarely terminates fatally, except
when it occurs in patients affected with extensive disease of the
liver or some other important organ, or when the constitutional
energies are broken down, either by disease or by a long course
of intemperance.
Unfavorable Symptoms.—A rapid and very small pulse ; coldness
of the limbs, the skin covered with cold sweat; constant delirium ;
the pupil of the eyes contracted, and twitching or working of the
muscles of the face, are symptoms indicating danger.
•
Favorable Symptoms.—One of,the most favorable symptoms in
mania a potu is an ability to sleep tranquilly, even though it may
be of but short duration. The practice of giving opium to produce
sleep is often attended with injurious consequences : it prostrates
the power of the stomach, and, in many instances, increases the
wakefulness and aggravates all the symptoms. At most it does
but blunt the sensibility, without removing the cause, or restoring
to the system its lost vitality.
Mania a potu essentially consists in a weakened condition of
the vital principle. The functions of the stomach are prostrated ;
digestion is suspended; the system is not supplied with nourishment;
the temperature of the body is reduced ; the bowels are torpid, or
they may be provoked by the acid state of their contents, occa¬
sioning diarrhoea ; the nervous power is enfeebled ; and the brain
is deprived of its natural healthy stimulus, the morbid effects of
the liquor having previously weakened its functions. Nature,
struggling to regain her lost power, occasions the excited condi¬
tion of the system attending mania a potu.
Treatment.—The remedies and means that have proved most
successful in curing mania & potu, are the vapor bath, emetics of
lobelia, injections, and pure stimulants, such as cayenne and ginger.
The Vapor Bath relieves the symptoms by equalizing the circu¬
lation of the blood and nervous influence; restores for a time the
natural heat of the system, and thus increases the sensibility of the
stomach to the impression of medicines, rendering their operation
more effective; throws deleterious substances out of the blood by
exciting free perspiration and a determination to the surface; in
fine, it aids the efforts of nature, generally, to bring about a crisis,
and cast off the disease. After steaming, when the patient has
DELIRIIM TREMENS.
347
been rubbed dry, the surface may be bathed with No. 6. or stimu¬
lating liniment.
Emetics.—I have invariably observed more benefit derived from
the use of emetics than from any other means. Sometimes mania
a potu is observed to terminate by spontaneous vomiting. Merely
evacuating the stomach is not sufficient, however, except in cases
of a very mild character: the mucous membrane is in most in¬
stances thickly coated with morbid secretions, which require the
continued use of stimulating and anti-canker medicine for two or
three days, besides frequent vomiting, before the stomach will
become cleansed of morbid secretions, and its power of digestion
be restored. The third preparation of lobelia is the best form, yet
it may be taken either in powder, infusion,*or in tincture, given in
sumac or bayberry tea. Alter the operation of an emetic, if the
symptoms be not very much relieved, a teacup half-full of a strong
decoction of bayberry or sumac, adding from a teaspoonful to a
tablespoonful of the'liquid of the third preparation of lobelia, must
be given every hour or two, as the patient can be persuaded to take
it: this supplies the place of all other medicines. Sometimes it
requires considerable management to induce the patient to take
medicine. Some will take medicine in the form of pills; and in
such cases the compound lobelia pills may be employed, as a gen¬
eral medicine, until the disease is overcome. If given freely—say
from three to five pills every hour, they will effect free vomiting
and supply the place of the usual form of emetic previously men¬
tioned. A case of delirium tremens occurred not long since, in
which brown lobelia powder and cayenne were given, mixed with
calves-foot jelly, the patient obstinately refusing to take medicine
in the liquid form. The medicine, after having been given at fre¬
quent intervals during over forty-eight hours, excited free and
copious vomiting; and soon after this, the patient slept three hours,
and awoke perfectly rational.
Some writers advocate the use of alcoholic liquors, as a remedy
in this disease, whilst others oppose its employment on all occasions
I have in a few instances given patients liquor, but have never at,
vet observed any good effects resulting from it; on the contrary,
the symptoms have been almost invariably aggravated by it, except
when given in very small quantities. The disease requires stimu¬
lants, but they should be pure stimulants, and not the same poison¬
ous articles that occasioned the disease. Although mania a potu
seldom occurs whilst the patient continues to drink, the symptoms
first appearing after the drinking is stopped, yet it is the drink that
prostrates the vital powers and occasions the derangement which
essentially constitutes the disease; and the longer the drinking is
continued, the worse it will be for the patient. The long-continued
use of opium will cause mania a potu; and the practice of pr«
348
DELIRIUM TREMENS.
scribing this article as a remedy in the disease, is almost, if not
equally, as absurd as to give a patient brandy to cure a disease
brought on by its use. It is very desirable that the patient be able
to sleep, not, however, by means- of a drug that will deaden the
sensibility of the brain, prostrate the powers of the stomach, and
probably produce serious congestion in the blood-vessels of the
brain, and prolong the disease. In a mild case of the disease, a
dose of opium may sometimes cause the patient to sleep, and not
be materially injured by it; but in those cases a vapor bath and
emetic, followed by broken doses of lobelia, would bring the disease
to a crisis much sooner, and the cure be more complete than bv
the use of opium, or probably by any other means.
During the act of vomiting, if the face be swollen and the ves¬
sels turgid with blood, the patient's head should not be allowed to
be lower than the level of his body; for the action of the blood¬
vessels of the brain being weakened, the blood circulates sluo;gishlv
through them. This requires that the head be kept somewhat
elevated, in order to favor the returning circulation. When the
skin and extremities are cold, an injection should be administered,
and also a vapor bath, before giving an emetic. If these cannot
be accomplished in consequence of the strenuous opposition of the
patient, still the lobelia should be given in-some form. If injections
can be given, the lobelia powder may be administered in this way
in lukewarm water, which, if retained, will occasion vomiting, and
exert even a more beneficial influence upon the system than when
taken into the stomach.
Injections.—Besides the plan just spoken of for placing the sys¬
tem under the influence of lobelia, stimulating injections will prove
of especial service to the patient.
Stimulants.—Cayenne tea is probably the most appropriate sti¬
mulant in all cases of delirium. It may be given freely in any
form and at any stage of the disorder. Composition or ginger may
be used in combination with cayenne.
" In hospital practice," observes Dr. Watson, " it sometimes
becomes necessary to confine the patient to his bed by straps, or
to muffle his limbs in a strait-waistcoat; but this is a most unfor¬
tunate necessity. Physical coercion, whether manual or me¬
chanical, should never be resorted to in delirium tremens, when by
any means it can be avoided. The angry feeling and mental fret
which it produces, and the exhausting bodily struggles to escape
or resist the thraldom, are always highly injurious, and full of
danger to the patient. A couple of strong and good-tempered
attendants will not have much difficulty in persuading and manag¬
ing the sick man, who is seldom either boisterous or obstinate:
*nd if he be intractable by soft words, he will yield more patiently
delirium tremens.
349
to their gentle restraint than to the force of manacles ; while the
appearance of coercion need not be continued a moment after his
acquiescence."
A case of death from mania a potu occurred in this city some
months since. The patient was a strong, robust man, and being
hard to control, he was kept tied down on a bed, but he struggled
violently and continually, until his strength became exhausted, and
he died in twenty hours from the time the coercive means were
resorted to.
Diet.—After free vomiting has been effected, essence of beef or
milk porridge may be given, provided the patient can be persuaded
to take food. This kind of nourishment is more particularly re¬
quired in cases of extreme prostration of strength, and also when
the mental agitation is subsiding.
In many instances of mania a potu, the mental derangement
will continue several days, even under the most appropriate and
well-directed treatment.
Of the efficacy of Thomsonian treatment in reforming drunkards.
Case I.—A man employed in the sheriff's office in this city, had
indulged in the use of strong drink, until he became so much a
slave to it that he was rarely entirely sober. He was sensible that
he was on the high road to ruin, and occasionally he would form
a resolution to quit the degrading practice; but the functions of
his stomach had become so much impaired, that his system was not
furnished with sufficient stimulus from food, to support the energies
of his mind, and in moments of extreme mental depression, he
would again resort to his accustomed drink : as soon as one glass
was taken, his resolution was overcome, and he relapsed back into
his former habits. Speaking to a friend one day of his anxiety to
abandon drinking, and of his unsuccessful attempts to do so, from
the constant hankering for stimulus, his friend advised him to get
some of the Thomsonian composition powder, and, whenever he
felt the want of a stimulus, to take a dose of the composition. He
accordingly obtained the composition, and on taking it as directed,
it furnished an agreeable stimulus, without disordering the brain ;
overcame the desire for liquor, and at the same time restored the
tone of his stomach to a healthy condition; so that, in the course
of a year, he became changed from drunkenness and wretchedness
and enjoyed perfect health and a fine glow of spirits. He is now
actively engaged in the temperance cause; and through his example
and persuasion others have been induced to resort to the use of
the composition powder, with the same happy result
Case II.—A merchant of this city, who had formerly resided ia
350
delirium tremens.
the south, had contracted the habit of excessive drinking, and was
occasionally attacked with mania a potu. Having experienced
good effects from vomiting, he determined on taking a course of
Thomsonian medicine, to have his stomach thoroughly cleansed,
and then to refrain from the use of strong drink altogether. He
stated to me that he had often resolved to quit the injurious prac¬
tice, but that his spirits sometimes became so much depressed, and
his appetite so bad, that his resolution to refrain from liquor gave
way, and he would again take a glass; this was soon succeeded
by another ; and thus he would go on drinking until his stomach
turned against it, when he would be attacked with symptoms of
mania a potu. After this patient had placed himself under Thom¬
sonian treatment, he did not relapse again into his former habits,
except on two or three occasions ; and then a course of medicine
was administered, and the general course of treatment adopted
that is recommended for mania a potu, which shortened the dura¬
tion of the disease; and by the daily use of pure stimulants, the
digestive powers were finally restored, so that the patient was
exempt from that state of mental depression which had so fre¬
quently led him to resort to spirituous liquors. This gentleman
has continued a sober man during the past two years, and doubt¬
less will continue so.
Case III.—During the summer of 1838, a man called at my
office, and gave me the following history of his case. When about
the age of thirty, he became dyspeptic from close attention to busi¬
ness, and experienced at times extreme lowness of spirits, with
trembling of his hands. An acquaintance recommended brandy
and water, which he took and experienced temporary relief: con¬
tinuing to take his glass of brandy and water whenever he felt the
want of a stimulus, he at length found that the dyspepsia was gain¬
ing ground, and that the attacks of nervous weakness were more
frequent, requiring a more frequent repetition of the brandy ; and
finally his nervous energy became so prostrate that he was induced
to fly to his accustomed stimulus, the first thing in the morning
and to continue under its influence during the whole of the day.
It was then sixteen years since he had commenced the use of
brandy, " and," said he, " to speak plainly, I am a confirmed
drunkard." He was willing to submit to any course of treatment
that would restore his digestion, so that he could do without the
brandy, which he was sensible had gained the upper-hand of him.
I told him, if he was anxious to quit the use of brandy, I had no
doubt that he could do it, and be restored to health. He placed
himself under treatment, which consisted in an occasional course
of medicine and the free use of cayenne pepper, more especially
at meals; and when he felt the want of his accustomed stimulus, a
dose of No. 6, or of composition. The result was most happy :
ORDINARY HEADACH.
351
he quitted the use of brandy without much difficulty ; his digestion
was restored, and he now enjoys good health, not having taken
any kind of intoxicating drink during a period of more than two
years.
The above are not the only cases of the kind that have occurred
under my own immediate observation : I could mention several
others of equal interest and importance, where men addicted to
drunkenness have become reformed, partly through the aid of
Thomsonian treatment, which affords a pure stimulus, entirely free
from intoxicating properties, and at the same time has the effect to
correct and strengthen the digestive functions.
CHAPTER XV.
SECTION I.
ORDINARY HEADACH.
Pain in the head is occasioned, in general, by a disordered con¬
dition of the stomach. Sometimes, the only symptom attending a
foul stomach and imperfect digestion, is pain in the head, the
patient being exempt from feelings of pain or distress in the stomach.
Pain in the head is one of the most common symptoms that accom¬
pany constitutional disease. Almost every case of fever and.
catarrh is accompanied with pain in the head; and under these
circumstances it is to be cured by such means as will correct the
constitutional disorder.
Neuralgic pain about the head is a common complaint among
dyspeptics, and especially in those of a nervous temperament.
ordinary headach, the pain is usually described as dull and heavy;
whereas in neuralgia the pain is sudden and darting, coming on
suddenly, like an electric shock, and leaving as suddenly.
Slight attacks of headach may very often be removed by having
the head rubbed freely with the hands, which favors the returning
circulation from the head. Bathing the forehead with some vola¬
tile stimulant, as No. 6, spirits of camphor, or hartshorn, or with
simple vinegar or whiskey, will sometimes remove it. When the
feet are cold, they should be warmed by the foot bath, or by other
means, and the patient take composition or pepper tea. Snuffing
352
sick headache.
composition, or No. 6, up the nose, by stimulating to excitement
the secretions of the mucous glands, will sometimes cure simple
headache.
When the pain is violent, and not relieved by the means already
mentioned, an emetic, or the repetition of three or four stimulating
injections to relieve the bowels and attract the circulation trom the
head, will seldom fail of curing the pain.
There is a form of headache, of a neuralgic character, occasioned
by overstrained mental exertion, in which a free use of quinine and
the vapor bath are the best remedies. It is in cases unaccompa¬
nied by febrile excitement that quinine constitutes the best remedy.
SECTION II.
SICK HEADACHE.
When there is pain in the head, attended by sickness at the sto¬
mach with or without vomiting, it is termed sick headache. It
always arises from a disordered condition of the stomach; patients
almost always experiencing much relief from the pain in the head
/ after free vomiting.
In many instances sick headach occurs periodically; in some
the attacks come on every week, in others at intervals of two 01
three weeks. Persons predisposed to this form of disease are espe¬
cially liable to an attack from some change of habit, for instance,
missing a regular meal, riding in the cold, or sitting some hours
in a crowded assembly. Inaccuracies in diet, fatiguing exercise,
exposure to cold, and getting the feet damp,- frequently occasion
an attack of sick headache.
*
Treatment. — The best remedy for sick headache is an emetic
This, taken in the commencement of the attack, will not only
moderate the symptoms, but, very generally, after the free opera-
tion of an emetic, all the distressing symptoms will be speedily
removed. If the feet be cold, apply the warm foot bath or vapoi
bath, and let the patient take a dose of composition or pepper tea
before the emetic be given.
Injections.—I have known sick headache speedily cured bv the
use of injections alone. Prepared in the usual form of composition
or pennyroyal tea, adding a teaspoonful of lobelia, the injections
SICK HEADACHE.
353
will relieve the pain in the head, and, if applied in the onset of the
attack, will never fail of proving beneficial.
In milder cases, and when the stomach is not very materially
disordered, it may be sufficient that the patient get to bed, drink
some warm tea, and have warm applications to the feet.
Sleep.—When a patient can obtain a few hours' sleep, the head¬
ache is generally cured for the time, whether they have or have not
taken medicine previously. The practice, however, of taking an
emetic in the commencement of sick headache, and repeating it
every time that there are symptoms of an approaching attack, will
not only prove the most effectual means for relieving the symp¬
toms, but, if the practice be persevered in, and medicine be taken
to strengthen digestion, the liability to the attack will be greatly
lessened, and in most cases the patient will be freed altogethei
from it.
Bitter Tonics should be taken once or twice a day, more espe-
ciallv after dinner. Wormwood, centaury, balmony, golden sealr
quassia, or almost any combination of bitters may be employed,.
It is the tonic principle that is needed, and it is not important thai
any one particular article should be employed in preference to
others.
Alkaline Bitters.—Take a handful of wormwood, and a table-
spoonful of hickory asnes, pour on a pint of boiling water ; a wine-
glassful to be taken after meals, cold. This preparation is appli¬
cable in cases of heartburn or sour eructations.
Quinine.—There is strong evidence in favor of the use of quinine
as a preventive and cure for sick headache. It may be employed "
in the place of all other tonics, after the stomach has been cleansed
by an emetic, and the patient is clear of fever. It has been used
recently as a preventive to sick headache with remarkable success.
The proper time for taking it as a preventive is a day or two before
the attack is expected; or, if the patient be not feverish and the
tongue not thickly coated, it may be taken freely in the commence¬
ment of the attack. The dose is from 6 to 20 grains. Quinine
pills in general contain about one grain each.
Salt and Vinegar.—A disordered condition of the stomach will'
in some instances be rectified, and digestion restored, by the use
of salt and vinegar. In these cases patients have an inclination for
acids.
Costiveness almost universally attends sick headache. The ma¬
jority of patients take some kind of purgative medicine to remove
23
SICK HEADACHE.
costiveness, which leaves the bowels in a worse and weaker condi¬
tion than they were before; the costiveness continues, ana more
physic is taken ; and in this way many persons continue for a suc¬
cession of years, until, finally, the- digestive powers become so
much weakened, and the functions of the bowels prostrated to such
a degree, that, without a most careful attention to diet, a natural
passage from the bowels is seldom procured. It is indeed doubtful
which has done the most injury to the human constitution, the use
of purgative medicine or spirituous liquors. Costiveness is occa¬
sioned by a weakened condition of the functions of the bowels ; and
to assist and strengthen their peristaltic action, and excite the se¬
cretions of their mucous membrane, are the essential indications
for the cure of habitual costiveness. In many instances this may
be effected by the daily use of bread made of unbolted wheat flour
•or bv taking every evening for supper a gruel, or mush made of
'the same material, and avoiding the use of cathartics. The bra.<
is supposed to act as a mechanical stimulus. Where costiveness
is attended by heartburn or sour eructations, finely pulverized char¬
coal will be found especially beneficial; purified charcoal should be
used when it can be obtained. The dose is a large teaspoonful taken
in composition or spice bitters tea, or, if preferred, in boiled milk
It should be taken an hour or two before meals.
Capsicum, taken freely at meals or immediately after, will stimu¬
late the action of the bowels, and, in many cases of constipation,
will be sufficient to overcome it.
Injections.—Where the use of purgative medicine has been con¬
tinued for a succession of years, it may be necessary, besides the
means above mentioned, to assist the bowels occasionally by the
use of the syringe. There is probably not a case of obstinate con¬
stipation of the bowels, in which their mucous membrane is not
coated with thickened secretions, forming a complete false mem¬
brane, which occasionally passes off in long pieces, somewhat
resembling an intestine. The removal of this false coating from
the mucous membrane of the bowels is essential to the restoration
of their natural functions. Purgative medicines operate upon the
bowels as a foreign substance,—something not congenial; and
provoke an action—an effort to cast off the offending substance,
causing the mucous surfaces to throw out a coating of thickened
secretions to shield them from the deleterious impression of the
cathartic : therefore cathartics, instead of cleansing the bowels
of" canker." as Dr. Thomson expresses it, give the canker a deeper
hold, and thus add to the difficulty. That which is required for
cleansing the lining membrane of thickened morbid secretions of
canker, is to excite the bowels by pure stimulants, capsicum, com
SICK HEADACHE.
355
position, and compound lobelia pills, and the use of stimulating
and astringent injectiqfas.
Patients subject to attacks of sick headache should use the pre¬
caution to dress very warmly whenever they ride out in cold or
damp weather. With regard to headache being occasioned by
gotting the feet damp, too few persons in the community are fully
sensible of the influence which dampness, applied to the feet,
exerts over the digestive functions, and of the extent of derange¬
ment which it frequently occasions.
Another Variety of Headache.—Severe pain in the forehead and
eye-balls is sometimes occasioned by disease of the frontal sinuses,
which are small cavities in the bones of the skull, immediately
above the eye-brows. These small cavities are lined with a
mucous membrane, which is continuous with the mucous mem¬
brane of the nose. The disease is occasioned by taking cold, and
prevails during the cold and damp weather of spring and autumn.
It is in no wise dangerous, but sometimes continues several days,
and occasionally for weeks before the pain is removed. In the
first place the mucous membrane is weakened by the influence of
cold; inflammation ensues, which terminates in the free secretion
of a thick yellow or greenish matter, which is discharged by the
nostrils, and then the pain usually subsides.
Treatment. — Besides constitutional treatment, such as taking
freely of warm stimulating teas to favor perspiration, benefit wiil
be derived from breathing through the nose the vapor of vinegar
and water, and using the composition powder or cayenne pepper
as a snuff, which will excite the secretions, and in this way afford
relief.
Not unfrequently this form of headache is accompanied with a
deranged condition of the system generally, the affection in the
head being a mere branch of disease, the root of which is in the
stomach and bowels. Hence, in violent cases of headache, accom¬
panied with symptoms indicating a disordered condition of the
stomach and bowels,—a furred tongue, loss of appetite, bad taste
in the mouth, costive bowels, chilliness, and flashes of heat,—the
system must be warmed by the use of stimulants internally, ana
external warmth, applied either by warm bricks placed around the
patient, or a vapor bath administered, followed by an emetic to
cleanse the stomach ; and if the bowels require assistance, let it be
done by enemas. After this the patient may take occasionally of
some stimulant—composition, spice bitters, ginger, or simple herb
teas, and avoid exposure to the cold or dampness.
I have never known a case of headache that was not either cured
or greatly relieved by administering a vapor bath and emetic.
356
TOOTHACHE.
SECTION III.
TOOTHACHE.
The curableness of toothache by local applications depends upon
the condition of the tooth and the cause of the pain. Thus, if the
tooth be hollow, and the pain arise from the presence of acrid
matter in the decayed part, or from exposure of the nerve to cold,
the pain may be greatly relieved by filling the hollow of the tooth
with cotton wet with the third preparation of lobelia, oil of cloves,
spirits of hartshorn, No. 6, or spirits of camphor, together with
warm applications to the cheek, such as bags of hot ashes, salt, or
sand, or a towel folded up and applied as hot as can be borne.
When a dry heat does not answer the purpose, a small bag of hops
or of bitter herbs damped with vinegar, or cloths wrung out of hot
water, may be applied.
Toothache may be cured, in many instances, by placing the feet
in warm water, and taking freely of composition or pepper tea.
In violent cases an emetic should be given, followed by broken
doses of lobelia, stimulating teas, and warm applications to the
feet. A very intelligent and experienced Thomsonian once told
me that he generally prescribed a dose of the third preparation of
lobelia for toothache, and said that it seldom failed of removing the
pain.
It very often happens that an abscess forms at the extremity of
the root of a tooth, which finally swells out the gum, forming what
is commonly called a gum-bile. External applications are seldom
of permanent benefit in such cases, the only certain cure being the
extraction of the tooth. After the abscess discharges, the pain
generally vanishes. When a tooth has become diseased at its
root, it will most probably be a frequent source of annoyance so
long as it remains in the jaw, as plugging will seldom answer any
good purpose in such cases.
Whenever teeth begin to decay externally, they should be
plugged by a dentist well acquainted with the business. Persons
residing in the country are too apt to neglect their teeth when they
begin to decay, and do not apply to a dentist until they experience
the disadvantage of the loss of some of their teeth and the partial
decay of others. A skilful dentist can generally prevent the fur¬
ther decay of a tooth, if timely applied to. Although the teeth
may be preserved by plugging them, they are often injured by too
much filing. Dentistry, like the Thomsonian system, has been
greatly abused by quacks, who have engaged in it without being
acquainted with its principles. A dentist properly acquainted with
TOOTHACHE.
357
his profession, will be very cautious how he uses the file, knowing,
as he does, the importance of preserving the enamel of teeth, and
the liability to a rapid decay of them when a portion of the
enamel is destroyed. I have known individuals to condemn den¬
tistry altogether, because they have observed their teeth to decay
more rapidly after having had them filed. It is quackery in den¬
tistry that should be condemned, and not the principles of the
science. There is scarcely a branch of science, the principles of
which can be more plainly demonstrated than that of dentistry.
Having made allusion to Thomsonian quacks, I will explain
myself,—not meaning to be understood as applying this term to
every one who engages in the practice without having had a re¬
gular medical education : — indeed, some of the most successful
practitioners that I have ever yet known, have been men without
a regular medical education, who have established a correct method
of reasoning upon things in general, and, possessing good common
sense, were able to comprehend the true principles of Thomsonism
by reading the works of its founder, and possessed of sufficient
moral courage to pursue the treatment thoroughly and persever-
ingly, as their mature judgment dictated, uninfluenced by the slan¬
der of gossips, the opposition of the prejudiced, or the timidity of
professed friends. I would apply the term quack to one (whether
he have been educated in a college or on a farm) who, announcing
himself a Thomsonian doctor, and railing against all mineral poi¬
sons, employs mandrake and other vegetable poisons, and delete¬
rious compounds, as improvements on the Thomsonian system;
and who, instead of being governed in his practice by the general
principles of the Thomsonian system, declares his independence
of it, and employs inefficient syrups, and worse than useless cathar¬
tics, in the place of Thomsonian medicines. Such practitioners
may very properly be termed quacks in medicine.
358
earache.
CHAPTER XVI.
DISEASE OF THE EARS.
SECTION I.
EARACHE.
This distressing complaint is of frequent occurrence. It pre
vails most in early life, and in those who have decayed teeth.
Causes.—Pain in the ear is generally a consequence of exposure
to cold and dampness. It frequently attends pain in the face and
jaws caused by the exposure of the nerve of a partially decayed
tooth. Where the nerve of a tooth is exposed, a tender spot will
be detected by probing the hollow in the tooth. Those who are
predisposed to this form of disease, are extremely liable to an
attack by getting their feet damp. Children are peculiarly sub¬
ject to a discharge of matter from the ear, and they generally
suffer more or less pain for several days before the ear begins to
discharge, attended with a flushed countenance and some degree
of fever.
Treatment.—When earache is caused by cold, it may be re¬
lieved by steaming the side of the head and using the warm foot
bath. Steam may be applied to the ear through a funnel placed
over a vessel containing boiling water. If there should not be
sufficient steam, a small hot stone should be put in the water.—
After the steaming, a portion of cotton wet with the tincture of
lobelia, No. 6, or third preparation, should be kept in the ear, 01
dry cotton may be employed. The heart of a roasted onion put
in the ear will sometimes relieve earache : it should be hot, or as
warm as can be borne. If there should be an abscess forming ir.<
the ear, the same course of treatment may be pursued; or a warm
poultice, cloths wrung out of hot water, or a bladder partly filled
with warm water, applied to the ear, with a view to hasten a dis¬
charge of the matter. Syringing the ear with warm soap-suds
will sometimes relieve the pain.
If the pain in the ear be caused by exposure of the nerve of a
tooth, the tooth should be extracted or the nerve destroyed. I
have known of persons subject to frequent attacks of earache for
years, from the exposed condition of the nerve of a tooth, to be
"oermanently cured of it by having the exposed nerve destroyed.
RUNNING OF THE EARS.
If the system be much disordered, an emetic will be beneficial,
after which, broken doses of lobelia may be given, in order to cause
a moderate degree of relaxation of the system, and to equalize the
nervous influence.
In violent cases, more especially if accompanied with fever,
injections should be resorted to, and the system placed under the
influence of lobelia.
The compound lobelia pills may be used in all cases where the
patient can take pills readily. Free vomiting may be effected by
taking freely of these pills.
How to get a Bug or Fly out of the Ear.—When any kind of an
insect gets into the ear, the patient should lay his head down on
its side, with the ear that contains the animal uppermost, and have
oil poured in the ear. The bug will come to the top of the liquid,
and be easily removed.
SECTION II.
RUNNING OF THE EARS.
A discharge of matter from the ears is by no means uncommon
in children. Those of a scrofulous constitution are most liable to
it, but it is often observed in children who are not predisposed to
scrofula.
This disease occasionally injures the hearing, though, more com¬
monly, it is not attended by any permanent injury to it, even
though the discharge continue at intervals during a period of seve¬
ral years.
The running, in many instances, is from the parts immediately
around the bottom of the cavity of the ear. In the first place a
small abscess is formed near the cavity of the ear, which breaks
into it, and is thus discharged. In other instances the disease is
confined to the membrane lining the cavity and drum of the ear.
Treatment.—When a child of a weak and delicate constitution
is affected with running from the ear, a permanent cure is rarely
accomplished until the general health is improved. It is, there¬
fore, of more importance in such cases to use means for improv¬
ing the constitutional health, than to depend upon applications to
the ear.
There are no means so effectual for improving the health as an
occasional emetic, or a full course of medicine. If the tongue be
%
360 RUNNING OF THE EARS.
coated, a strong tea of bayberry must be given once or twice a
day, or, in place of this, use No. 3 pills.
Whenever the patient is suffering pain, or is feverish, give broken
doses of lobelia, either in the form of tincture or pills.
If the running from the ears should stop and the patient com¬
plain of pain, or if it be a young child, and become restless and
feverish, apply a warm poultice to the ear, cleanse the stomach by
giving an emetic, relieve the bowels by injections, and give lobelia
in broken doses.
Pipsissawa.—A strong tea or syrup of pipsissawa may be used
with benefit in this and other forms of disease in children, more
especially in scrofulous constitutions.
Yellow dock, sarsaparitta, and guaiac shavings, combined in equal
portions, simmered an hour, and then strained, sufficient sugar
added to form a syrup, and then simmered again, forms a useful
syrup in all cases of running sores in children, more particularly
in cases where the disease has been of long continuance. The
dose of the syrup is from a tablespoonful to a wineglassful, accord¬
ing to the age of the patient.
Tonics.—When the discharge is profuse, and the patient debi¬
litated, the spice bitters, or some other form of tonic, must be em
ployed, unless the syrup above mentioned be found sufficient.
When the complaint becomes protracted, the constitutiona
health should be aided by allowing the child to be> much in the
open air, and affording healthful exercise. The body should
be bathed in salt water, and wholesome, nourishing diet admi¬
nistered.
Local Applications.—Syringing the ear with castile soap and
water, or with a strong tea of bayberry, will be beneficial. A
strong tea, made by steeping in boiling water a compound of bay¬
berry, aspen, poplar bark, and gum myrrh, will not only serve to
cleanse the parts, but will assist the healing efforts of nature.
Many persons doubt the propriety of syringing the ear with stimu¬
lating teas, supposing that they may be carried into the head. The
drum of the ear, which is not more than an inch and a half from
the external opening, forms a barrier to the passage of substances
beyond it.
"When the discharge has been long continued, No. 6 alone, or
combined with about an equal quantity of bayberry or poplar bark
tea, should be dropped into the ear two or three times a day; or.
if this be very painful, a simple tea or tincture of myrrh may be
used, either of its usual strength or diluted with water, or bayberry
tea
RUNNING OP THE EARS.
361
In some instances the matter discharged is so acrid, that it ex¬
coriates the ear, causing the surface of it and the parts below the
ear to be continually sore and inflamed; the glands back of the
ears and on the side of the neck are apt to be more or less swollen ;
and sometimes an eruption appears over a part of the head and
face, which very often continues for weeks, and sometimes for
months, before it can be entirely cured. Where the external ear
becomes excoriated, or sores break out on the skin, the parts must
be kept from the air by the application of tar ointment, or some
kind of adhesive salve, in order to protect the raw surface from
the atmosphere. Apart from constitutional treatment, there is
nothing of more importance, in the cure of eruptions of the cha¬
racter above mentioned, than to protect the parts from the action
of the air. It does not make much difference what kind of salve
or ointment is used, provided it will effectually exclude the air.
In most instances the parts suppurate and discharge freely soon
after applying a salve or ointment; but by continuing the applica¬
tion, so as to keep off the air, the parts will soon heal, unless the
system be much diseased, and the healing power of the constitution
thereby enfeebled. When the parts suppurate freely, the ointment
or salve will of course require to be removed daily, in order to
cleanse the parts; but the exposure should not be continued
longer than is necessary to dress the sores. Such eruptions should
never be dried up by the application of lead-water, or driven into
the system by the use of salts, or other cooling medicines ; for,
although they might not be followed by immediately bad effects,
yet serious consequences have often resulted from the application
of lead-water, or a solution of corrosive sublimate, to eruptions on
the face and head, and by drawing the determining powers from
the surface by purging. Hence some physicians advise parents to
use no means to cure eruptions about their children's heads, con¬
sidering the eruption as a safeguard against internal disease of
far more serious consequence. I have never known any bad
effects to arise from curing eruptions about the head upon the Thom-
sonian plan. The internal remedies used for curing the disease,
will also prevent it from seating itself in the system.
In children of scrofulous constitution, the bones about the in¬
ternal parts of the ear are occasionally diseased, occasioning an
extremely offensive watery discharge, and the cavity of the ear
sometimes becomes filled up for a time with proud flesh. Such
cases generally prove obstinate of cure under even the most judi¬
cious treatment, the patient being in most instances subject to fre¬
quent spells of violent headache. Nothing will give so much relief
in such cases as thorough vomiting, and keeping the patient re¬
laxed with ! belia.
It is not difficult to discover wax in the ear, when it exists in a
quantity sufficient to injure the hearing, by having the patient to
362 deafness.
hold his head in such a position as to allow the rays of the sun to
strike upon the drum of the ear, the cavity of the ear being made
more straight and open by raising the ear upwards and outwards.
A lighted candle in a dark room will answer to examine the ear.
SECTION III.
DEAFNESS AND DULNESS OF HEARING.
Deafness, or dulness of hearing, may depend upon palsy or
other diseased condition of the nerve of hearing; thickening of the
drum of the ear; or it may proceed from disease of other parts
of the internal apparatus of the ear. Hardness of hearing, very
frequently, depends upon a collection of hardened wax in the drum
of the ear.
Complete deafness is very rarely cured. When hardness of
hearing is occasioned by indurated wax in the ear, it is very easily
remedied by syringing the ear with warm soap-suds, made of
castile or palm soap. A convenient way to syringe the ear, is to
have the warm suds in a basin, with one edge of it placed against
the neck immediately below the ear, and inject the liquid into the
ear, with sufficient force to reach the further extremity- of the
cavity. The syringing should be continued until the wax softens
and is washed out.
Galvanism.—When dulness of hearing is occasioned by obstruc¬
tion in the nervous circulation, the application of the galvanic
battery may prove of utility. A very convenient apparatus has
recently been constructed by a Mr. Code, of this city, called
Code's Patent Graduated Electro-Galvanic Battery. VVith this
machine the galvanic fluid may be applied to any part of the sys¬
tem with perfect safety.
palpitation of the heart.
363
CHAPTER XVII.
SECTION I.
PALPITATION OF THE HEART.
An irregular beating, and fluttering motion of the heart, very
frequently attends dyspepsia, sick headache, neuralgia, asthma, con¬
sumption, hysteria, gout, and constitutional debility; and in per¬
sons of nervous temperament, it is frequently occasioned by any
slight derangement in the system. The use of strong coffee or
tobacco ; an oppressed condition of the stomach from food that is
hard of digestion; grief, anxiety, or any sudden emotion of the
mind, will, in some, occasion irregular throbbing and fluttering
motions of the heart.
Of all the cases of irregular palpitations of the heart, there is
probably, in nine of every ten of them, no disease of the heart; the
irregularity of the motions of the heart being caused by a weak¬
ness and derangement in the nervous system. A disordered state
of the stomach weakens the nervous power, and the weakened
condition of the nervous influence may occasion disorder of the
functions of the heart, constituting what is termed a functional dis¬
ease of the heart. Thus sick headache and palpitation of the heart
are often associated ; both arising from the same cause, a diseased
condition of the stomach.
Treatment. — Palpitation of the heart being in most instances
merely a symptom of disease, the original cause of which is a dis¬
ordered condition of the stomach, it does not demand any especial
treatment, apart from that which is required for correcting the dis¬
ordered condition of the stomach, and restoring digestion. Thus
a patient may have an attack of hysteria, accompanied with vio¬
lent pain in the head, and palpitation of the heart; these being
mere symptoms arising from constitutional disease, the seat of
which is commonly in the stomach, the same course of treatment
will be sufficient to remove all these different symptoms. If ten
thousand persons were to become diseased from one general cause,
there would probably not be two cases in which all the symptoms
of disease would be precisely alike. The membranous sac that
envelopes the heart, called the pericardium, is liable to become
affected with rheumatism, accompanied with palpitation of the
heart; a sense of oppression about the pit of the stomach; a catch
364
PALPITATION OF THE HEART.
in the breathing; a dry cough; an inability or unwillingness on
the part of the patient to lie on the left side; pain in the situation
of the heart, increased by full inspiration ; and stiffness and pain in
and about the left shoulder. This affection seldom occurs in an
acute form, except in connection with general acute rheumatism;
and wherever it occurs, the treatment should be energetic, and the
remedies perseveringly applied, with a view to bring about a
favorable crisis in the inflammation before serious mischief result.
The same general remedies are to be employed that are recom¬
mended in the treatment of acute rheumatism.
Irregular action of the heart often accompanies chlorosis, and
the functional derangement of the heart is to be cured only by im¬
proving the condition of the general health of the patient. Occur¬
ring in connection with hysteria, palpitation of the heart requires
the same remedies to effect a cure that are best adapted to the
cure of hysteria. Nervous persons are frequently affected with
palpitation of the heart, occasioned by a foul stomach, and under
these circumstances emetics are required.
Persons of full habit of body, whose digestive powers are en¬
feebled by a long-continued course of excesses in eating and drink¬
ing, and the inordinate use of tobacco, are very liable in advanced
life to frequent attacks of strong, irregular throbbing, and tremulous
motions of the heart. I knew an instance where a gentleman was
confined to the house several months, laboring under symptoms of
disease of the heart; yet, by adopting a judicious course of diet
and regimen, and making free use of Thomsonian remedies, con¬
sisting chiefly of capsicum, a compound of the astringent or anti-
canker medicines, and bitters, he recovered perfectly from all
symptoms of disease of the heart.
Palpitation of the heart is frequently occasioned by a disordered
condition of the spinal nerves. By applying pressure along the
course of the spine, a tender spot will generally be detected, either
about the nape of the neck or between the shoulder-blades. Here
it will be proper to employ the vapor and shower bath, stimulating
applications to the spine, together with such constitutional treat¬
ment as the condition of the general health may demand ; for in¬
stance, if the patient experience distress at the pit of the stomach,
or be otherwise affected with symptoms of dyspepsia, other means
besides those just named may be required, especially emetics; and
if there be acidity of the stomach and constipation of the bowels,
such remedies must be employed as will prove most effectual in
correcting the secretions of the stomach, and giving strength and
tone to the bowels.
A young lady of Frankford was affected with palpitation of the
heart to such a degree, that for several weeks she could not lie down
at night. Her digestive powers were prostrated, and there was
extreme tenderness in the spine between the shoulders. A course
DISEASE OF THE HEART.
365
of medicine was administered as often as once a week, a pepper
poultice applied to the spine, and tincture of lobelia given in small
doses, frequently repeated. The patient's general health was re¬
stored, and no inconvenience felt from irregular action, or violent
throbbings of the heart.
The motions of the heart are regulated by nervous influence;
and hence it may be inferred, that, in all cases of functional de¬
rangement of the heart, there is a fault in the nervous currents that
govern the heart's movements. Thus the use of strong coffee, and
also the excessive use of tobacco, will occasion, in some persons,
palpitation and fluttering of the heart, in consequence of the mor¬
bid impression they make upon the nervous influence.
SECTION II.
STRUCTURAL DISEASE OF THE HEART.
The preceding section treats of irregularity in the action of the
heart, unaccompanied with disease of structure. The heart is also
subject to structural disease.
The most frequent forms of structural disease of the heart are,
—imperfection in the valve of the foramen ovalie, that sometimes
exists at birth; enlargement of the heart, with thickening of its
walls, termed hypertrophy of the heart; dilatation of the left ven¬
tricle, with unnatural thinness of its walls; ossification of the
valves of the heart; and dilatation of the auricles.
Symptoms of various forms of Heart Disease.—When a child is
born with an imperfection in the septum, or partition between the
right and left ventricles of the heart, the venous blood mixes with
the arterial, and occasions a blue appearance of the face and ex- '
tremities, popularly called the blue disease of infants. In some
cases this blue appearance is continuous, and in others it appears
only when the child cries, or is in some way agitated.
In hypertrophy of the heart, the increased developem^nt of
the muscular fibres renders the contractions of the heart stronger,
and consequently the impulse is more perceptible; but it is slow
.iand more heavy. The patient has a sensation of beating of his
heart which he ought not to have; he feels it and hears it beating
as he lies awake in bed, and at other times when he is at rest. If
it be a case simply of increase of the substance of the heart, the
pulsations will be regular, the breathing will not be affected,
neithei will there be any tendency to dropsy. In the majority of
366
DISEASE OP THE HEART.
cases of hypertrophy of the heart, there is a demand for an in¬
creased developement of muscular fibres, in consequence of the
existence of some mechanical obstruction to the free circulation of
the blood ; and under these circumstances the hypertrophy is really
an effort of nature to overcome the disease.
In dilatation of the heart, if the walls of the ventricles are thin,
the contractions take place very abruptly and. quickly. The
I'esult of this is, that the contraction ceases with the first impulse.
There is a smart jerk with the first impulse, but it is a very short
one, having nothing of the heaving character of hypertrophy.
Those acquainted with the theory of the sounds of the heart,
depend most upon this source, for ascertaining the location, extent,
and character of structural lesions of the heart.
If the heart beat strong, and the impulse be perceptible over a
large space, it will afford evidence of the existence of dilatation
and hypertrophy conjoined.
Disease of the Valves of the Heart.—Many of the symptoms
which attend disease of the valves of the heart, also accompany .
other forms of disease; so that even experienced physicians some¬
times find it difficult to distinguish disease of the heart from mere
sympathetic derangement or functional disorder of this organ.
Asthma is very frequently attended by palpitation of the heart;
and, again, structural disease of the heart is accompanied by diffi¬
cult respiration, resembling asthma. Patients affected with cer¬
tain forms of disease of the heart experience great oppression and
difficulty of breathing on using exercise; the same symptoms attend
on asthma and dropsy of the chest; and even when patients are
extremely feeble, and without being affected either with asthma,
dropsy, or disease of tbe heart, they are liable to experience great
oppression in the chest, difficulty of breathing, and violent palpi¬
tation of the heart from over-exertion. The livid hue of the lips
observed in cases of heart disease, alike accompanies paroxysms
of asthma. The inability to lie down, however, only continues
during a paroxysm of asthma ; whereas, in disease of the heart, it
is generally continued; or at least the patient can seldom lie on the
right side, with the head on a level with the body; the same, how¬
ever, attends hydrothorax. The pulse, which is irregular in
structural disease of the heart, is also intermitting in functional
disease of the heart, and also in other varieties of disease. Alarm¬
ing dreams and sudden startings during sleep, with a distressing
sense of suffocation, which are mentioned among the symptoms
attending disease of the heart, are by no means peculiar to that
form of disease alone. When palpitation of the heart occurs as a
consequence of functional derangement, the patient is sensible of
the irregular action ; whereas, in structural disease of the heart,
the irregular action is often unperceived by the patient.
DISEASE OP THE HEART.
367
" When we find a patient complain of more or less habitual
dyspnoea," (difficulty of breathing,) " greatly aggravated by corpo¬
real exertion; slight oedema" (dropsical swelling) " of the feet: a
puffy and anxious appearance of the countenance, with a livid hue
of the lips; frequent palpitations or tremulous action of the heart
dui'ing the paroxysms of dyspnoea; the occasional sudden occur¬
rence of an elastic, puffy swelling of the lower eye-lids and the
upper lip; an irascible temper; quick and short inspirations; a
deep purple and bloated aspect of the face during the paroxysms
of difficult breathing; with an absence of the peculiar wheezing
and rattling noise in the lungs; and a free secretion of urine:
when these symptoms are noticed, we have strong reasons for pre¬
suming that there exists some disease of the heart."—Eberle.
One acquainted with the sound of the heart's beating in a healthy
state, may, by placing the ear to the chest in the region of the
heart, detect organic or structural disease.
Difficulty of Cure.—The majority of cases of confirmed structu¬
ral disease of the heart are incurable; yet such structural changes
as a mere thickening of the tissues, such as are occasioned by
rheumatism of the heart; slight imperfection in the septum between
the ventricles, that sometimes exists at birth; and even unnatural
thickness or thinness of the walls of the heart, constituting what is
called hypertrophy, and dilatation of the heart, are often cured.
And even in incurable cases, the patient in some instances may,
by a prudent course of living and appropriate treatment, enjoy
pretty good health, and live many years.
p "i
Treatment.—In the blue disease of infants, the child should be
kept lying on the right side, immediately after birth, with the
shoulders somewhat elevated. This position will favor the circu¬
lation of the blood through the heart.
Thickening of the walls of the heart, particularly of the left
ventricle, is not always to be considered as a disease, as, in many
instances, it is designed for a good purpose—to enable the heart,
by the augmented developement of its muscular fibres, to force the
blood through its natural channels, when there is an unnatural
impediment to its free circulation.
Dilatation of the heart usually proceeds from debility, and re¬
quires such treatment as will increase the strength and tone of the
system.
In all cases of disease of the heart, excesses of every kind must
be avoided. Quietness of mind and body, a strict attention to diet
and to keeping the body comfortably warm, and the use of reme¬
dies that tend to sustain a healthy state of the system, are objects
of paramount importance in heart disease. The means to be em-
gloved are, the warm foot bath, the vapor bath, pure stimulants.
368 DISEASE OF THE HEART.
injections, emetics, frictions of the surface, and the continued use
of lobelia in broken doses.
Case. — A young man, by the name of Bullock, was laboring
under disease of the heart of a sevei'e character, the throbbings
being constantly violent and irregular, and his flesh much
wasted. The physician who attended him was a man of con¬
siderable eminence in the profession, and declared the case to
be an incurable disease of the heart. It was proposed to the phy
sician that the patient be taken to the country. He replied that
it would be altogether useless, as the disease was of that character
which afforded no grounds for hope of recovery. Under these
discouraging circumstances, the patient was taken to a Thomso-
nian infirmary, which was under the superintendence of Frederick
Plumer, and there he had a course of medicine administered to
him every few days. Under this treatment he improved so much
that, after the twentieth course of medicine was given, he was
almost free from symptoms of disease of the heart. This gentle¬
man subsequently regained perfect health, engaged in the study of
law, and now resides in one of the southern states.
In another instance, a gentleman past his fiftieth year, who had
been a full liver, was confined to the house several months with
well-marked symptoms of disease of the heart. By a careful
avoidance of all injurious influences, and the continued daily use
of Thomsonian remedies, this patient became entirely free from
symptoms of heart disease, his general health being fully restored.
The above are the only cases of disease of the heart (admitting
them to have been of that character) in which, to my knowledge,
the effects of a persevering and well-applied course of Thomsonian
treatment in this disease have been fully tested. The tendency of
Thomsonian treatment in equalizing the circulation and improving
the general health, and the remarkable influence of lobelia in equal¬
izing nervous energy, even when administered in small doses,
affords sufficient ground to warrant confidence in the practice,
even though the disease may heretofore have baffled the treatment
pursued by the medical profession.
Excesses of every kind to be avoided. — Persons laboring under
disease of the heart cannot observe too much caution in avoid¬
ing of excesses in eating, drinking, and exercise. If the stomach
be oppressed with too much food, or by the food being hard of
digestion, it will more or less disturb the equilibrium of the circula¬
tion of the blood, and thus increase the disturbance in the regular
action of the heart. Much the same effects will be produced by
exposing the feet to dampness, which causes the blood to recede
from the surface and oppress the heart. Too much exercise is apt
to occasion great distress at the heart, with violent palpitations.
disease of the heart.
369
Many persons may question the propriety of administering a
course of medicine to a patient laboring under disease of the heart.
Experience has proved, however, that patients affected with it to
such an extent that they cannot use even the exertion of walking
a short distance without bringing on distressing sensations of op¬
pression in the breast, and difficulty of breathing, will go through
a full course of medicine without occasioning that kind of distress
produced by muscular exertion when the system is not under the
influence of a course of medicine. During the winter of '38 I was
requested to visit a Mr. Kates, who was laboring under a most
severe form of disease of the heart. The case was utterly hopeless
of cure; his legs were dropsical, requiring to be punctured every
few days to drain off the fluid; there was an accumulation of
water in the cavity of the abdomen; he was extremely emaciated,
and the action of the heart continually laboring and irregular, so
that it was with difficulty that he could walk a few steps without
support, and he was compelled to continue night and day in a.
sitting posture. I commenced treating the case with a view only
of affording relief; and after applying the steam bath daily, which;
he bore very we'll, and having given composition tea occasionally
three or four days, I administered a full course of medicine, and
did not perceive any unusual excitement or. increased difficulty of
breathing during the operation; not even immediately after vomit¬
ing ; the means employed equalized the circulation of the blood,
and thus prevented it from crowding upon the heart. Thus a
patient laboring under a paroxysm of asthma, who is unable to
walk across a room, or scarcely to stand erect, will be materially
if not entirely relieved by a thorough emetic, and still more cer¬
tainly by a full course of medicine.
I attended a patient living in Woodbury, N. J., a man in ad¬
vanced life, laboring under a most severe form of asthma, attended
with well-marked symptoms of organic disease of the heart. It
was with difficulty this patient could walk ten feet, and he had not
lain down during a period of twelve months. Every extra effort
would cause violent throbbing and distress at the heart; still this
patient would go through a course of medicine and feel much
relieved during the operation. The course of treatment adopted
in this case, which consisted chiefly of the free use of the third
preparation of lobelia, given in a strong decoction of bayberry and
sumac berries, repeating the dose whenever the symptoms of op¬
pression were more distressing, together with the daily application
of the vapor bath, warmth to the feet, the use of injections, and
stimulating liniment to the surface, not only removed the asthma,
hut so far restored the natural action of the heart, that the patient,-
in a few weeks after the commencement of the treatment, was able
to walk a mile without experiencing much inconvenience from the
exercise.
24
BLEEDING FROM THE LUNGS.
To bleed and give poisonous sedatives, that will destroy the
digestive powers, to lessen the action of the heart, is, to say the
least, irrational.
The same course of treatment that is adapted to the cure of
asthma, is precisely that which will afford the most reliel in disease
of the heart or dropsy of the chest; so that, however difficult it may
be to decide the precise character, form or location of the disease,
the grand object to be attained by treatment, is the promotion of
healthy action in the system.
CHAPTER XVIII.
SECTION I.
BLEEDING FROM THE LUNGS.
Raising blood from the lungs occurs under various conditions of
them, and although it generally occasions alarm, it is not always
attended with danger. Though generally connected with pulmo¬
nary consumption or with a predisposition to that disease, still
frequent instances have occurred where persons have been subject
to bleeding from the lungs for many years, without much incon¬
venience ; and occasionally persons live to an advanced age who
have been subject to frequent discharges of blood in this way.
The opinion so generally prevailing, that bleeding from the lungs
is always caused by the rupture of a blood-vessel, is erroneous.
Still this does occasionally happen in the advanced stage of con¬
sumption, in consequence of ulceration of the vessels. But in the
great majority of instances, the blood oozes through the infinitely
small vessels which terminate on the lining membrane of the air-
passages; these vessels, being in a relaxed, or otherwise diseased
condition, are unable to resist the pressure of blood upon them.
The same occurs in the lining membrane of the nose: the blood
escapes from the mouths of the vessels without their being rup¬
tured. The quantity of blood discharged varies greatly in different
individuals; and also, at different periods, in the same patient.
A free discharge of blood from the lungs is usually preceded bv
coldness of the extremities; a sensation of tightness and oppres¬
sion at the breast; distress at the pit of the stomach ; palpitation
of the heart \ chilliness 5 <i^itcition of* mind 5 cilternsite paleness
BLEEDING FROM THE LUNGS.
371
and flushing of the face ; and often a disagreeable salty or sweetish
taste in the mouth."
To distinguish bleeding from the lungs from bleeding from the
stomach, observe that where blood is vomited, it comes from the
stomach ; and when -raised by hacking or coughing, it is from the
lungs. Clots of blood, however, may collect in the posterior naries,
and be expelled by the same kind of effort as though it were from
the lungs.
Causes.—Bleeding from the lungs may arise from various causes,
such as the presence of tubercles in the lungs; exposure to cold
and dampness; over-exertion; disordered stomach ; the suppres¬
sion of habitual evacuations; and obstructions in the liver or
spleen.
Rarely proves fatal.—Patients seldom die of bleeding from the
lungs; for although the bleeding may be profuse, it is seldom so
great as to destroy life at the time. Frequent copious bleeding
from the lungs, however, may occasion such a degree of debility
that dropsy, consumption, or marasmus will ensue.
f
The Treatment of bleeding from the lungs should be regulated
by the circumstances under which the bleeding occurs. For in¬
stance, if a young woman have a sudden attack of bleeding from
the lungs, in consequence of obstructed menstruation, the warm
stimulating foot bath, stimulating injections, and lobelia emetics
will constitute the remedies most to be relied upon, and, in fact,
will be appropriate remedies in all cases of active hemorrhage from
the lungs, attended with a flushed countenance and active pulse.
But in cases of deep consumption, attended with extreme emacia¬
tion and prostration of strength, the patient should not be subjected
to any kind of treatment that calls for much exertion of muscular
power, but be allowed to remain perfectly quiet, with the breast
elevated by pillows, and warmth applied to the feet and legs, by
means^of hot bricks wrapped in damp cloths, or by bottles of hot
water. One of the best internal remedies is a strong decoction
of some vegetable astringent that contains a large portion of gallic
acid; witch hazel leaves, and the leaves and berries'of upland
sumac, contain gallic acid, and should be preferred to either bay-
berry or any other of the astringents in such cases.
In cases of slight bleeding, placing the feet in water as hot as
can be borne, and drinking freely of hot composition tea, adding
small portions of lobelia to excite perspiration and assist in equal¬
izing the circulation, may be sufficient to check the bleeding. But
where this is not sufficient, a full course of medicine administered
will prove the surest means of equalizing the circulation. I have
never witnessed a case in which bleeding from the lungs continued,
372
BLEEDING FROM THE LUNGS.
after the free operation of an emetic. The lobelia should be given
freely, provided the patient be feverish, with a flushed face ana
hot skin, not only with a view to produce free vomiting, but also
to relax the system. When the system becomes relaxed, the
blood ceases to determine to the lungs in an-undue quantity; ob¬
structions in the capillary vessels are overcome; the nervous
influence is equalized, and the force of the heart's contractions is
moderated. The straining efforts to vomit will not increase the
determination of blood to the lungs except momentarily; and in
many instances an equilibrium in the circulation cannot be effected
without the use of an emetic, especially in cases where the stomach
is foul, and contains a large amount of acid. Stimulating injections
containing lobelia are especially beneficial, by the influence which
they exert in determining the blood from the lungs. The patient
must be kept as quiet as possible, and avoid conversation. After
the bleeding is checked, the warm application to the feet should be
continued, together with an occasional dose of composition to
promote perspiration and maintain an equilibrium in the circula¬
tion ; and if the patient be feverish or restless, add such a portion
of the tincture or powder of lobelia to the composition as will
merely occasion slight nausea. Bayberry and sumac berrie9
steeped in boiling water, making a very strong tea, adding a por¬
tion of cayenne, sweetened, and drunk freely, will be as effectual
a remedy as can be taken, excepting the emetic.
Professor Chapman, in his lectures, relates the circumstance of
his being called to a,ttend a young man who was bleeding freely
from the lungs; as the doctor entered the room, the patient
vomited, in consequence of a large dose of medicine that he had
just taken, and the bleeding immediately ceased. The fact of the
hemorrhage from the lungs ceasing when the patient vomited, to¬
gether with the conviction that it admitted an easy explanation,
induced the doctor to make a trial of emetics in similar cases.
Accordingly, in the next case that came under his care, which was
that of a young woman who was bleeding profusely, and the usual
means, salt, and acetate of lead, having failed, an emetic o£ ipeca¬
cuanha was given, which produced active vomiting, and the bleed¬
ing immediately ceased. The next case of the kind was that of a
young woman who had been subject to raising blood, in conse¬
quence of suppression of menses. The usual remedies having
also failed, the doctor resorted to an emetic, and with entire suc¬
cess : not only did the emetic check the flow of blood from the
lungs, but it removed the obstruction which occasioned the bleed¬
ing. Dr. Chapman declares that more than thirty years' expe¬
rience has convinced him that emetics are the most effectual
means for checking bleeding from the lungs: rarely failing and
no danger attending the operation, when under the direction of a
judicious practitioner.
BLEEDING FROM THE NOSE.
373
Persons not in deep consumption, who are liable to attacks of
raising blood from the lungs, will in almost every instance prevent
bleeding, by taking an emetic or a full course of medicine, as soon
as there are symptoms which indicate approching hemorrhage;
and this will not only prevent hemorrhage at the time, but will
also prove the most effectual means of restoring the general health,
and thus remove the predisposition to raising blood.
Common table salt is a remedy generally resorted to for spitting
blood, which, fogether with placing the feet in warm water, will
sometimes be successful in stopping the bleeding.
There is a popular nostrum, extensively used in England for
stopping spitting of blood, called Ruspini's Styptic. This prepara¬
tion consists of a solution of gallic acid in alcohol, diluted with
rose-water. A strong tea of witch hazel leaves and sumac berries
contains the same properties as the above styptic, excepting the
alcohol, which is probably of no advantage, further than to pre¬
serve the solution from fermentation.
SECTION II.
BLEEDING FROM THE NOSE.
Bleeding from the nose, as it usually Occurs in young and
healthy persons, or where it is caused by slight injuries, does not
require particular attention. Confirmed into a habit, however, it
is liable in weakly constitutions to bring on disease, by draining
the system of blood.
Bleeding from the nose often takes place during the active stage
of fever, and more especially when it is attended with great fulness
in the head.
From the frequent occurrence, also, of bleeding from the nose
about the turn of fever, it is considered by many as a crisis symp¬
tom, and has been cited as an argument in favor of blood-letting
in fever; but it should be recollected that the escape of blood from
the nose is the effect and not the cause of the favorable change in
the disease; the vessels of the mucous membrane of the nose,
being debilitated by disease, are unable to resist the force of the
circulation, when it is restored to these parts by the increase of
vital power.
Bleeding from the nose occurs in a condition of the system the
opposite to that above mentioned; namely, in the sinking stage of
malignant diseases, as typhus and yellow fever: the blood appa-
374
BLEEDING FROM THE NOSE.
rently becoming dissolved and deprived of its tenuity, escapes from
the vessels, they having lost their power of contraction. I his is
an unfavorable occurrence, as it tends to reduce the already enfee¬
bled strength of the patient.
Occasionally bleeding from the nose assumes a serious aspect,
where it occurs in aged persons, and where there exists extensive
derangement in some important organ, as the stomach, liver, spleen,
&c., sometimes proving, under such circumstances^ extremely dif¬
ficult of control.
Enormous quantities of blood are sometimes lost from the nose.
From five to eighteen, and even thirty pounds have, in some in¬
stances, been lost in a few days. The bleeding, it is said, always
ceases when the patient faints.
Treatment. — Persons predisposed to bleeding from the nose,
should be careful to avoid all exciting causes, as exposure to cold,
especially cold, damp feet; heavy lifting, stooping with the head
low, hot stove-rooms, &c.
Pressing the sides of the nose together with the thumb and finger,
opposite the bleeding vessels, will in common cases prove effec¬
tual, provided the pressure be continued a sufficient length of time
to allow the blood to coagulate and block up the vessels.
If the pressure be made below the bleeding vessels, the blood
will pass down the nostrils into the throat.
Holding the left arm up perpendicularly will often stop bleeding
from the nose. The column of blood in the arm pressing upon
the aorta, lessens the determination to the head.
In cases of a more obstinate character, depending upon exten¬
sive derangement of the general health, or where it has become a
confirmed habit, a course of medicine should be repeated at proper
intervals, together with proper intermediate treatment, with injec¬
tions, and the usual means employed by Thomsonians for improv¬
ing the health.
The compound lobelia pills may be used as a general preventive
to habitual bleeding at the nose.
The following is from Dr. Samuel Thomson's narrative.—
"While at Exeter, I had a case of a young man, son of Col. N.
Gilman, who was in a decline. He was about fourteen years old,
and had been troubled with bleeding at the nose. They had made
use of such powerful astringents, with corrosive sublimate snuffed
up the nose, that the blood-vessels in that part seemed to be
shrunk up, and his flesh much wasted away; I carried him through
a course of medicine, which caused an equal circulation of blood
throughout his body, then raised a natural perspiration, and re¬
stored the digestive powers so as to support the body with food
/nstead of medicine. The bleeding from the nose ceased, and in
a short time he recovered his health."
BLEEDING FROM THE NOSE.
375
Children, and young persons, are especially liable to bleeding
from the nose, even when there is no other derangement of the gene¬
ral health except constipation of the bowels. In such cases, from
one to three of the compound lobelia pills, taken after dinner and
at bed-time, and a large teaspoonful of pulverized charcoal, taken
before breakfast, will, if continued daily, regulate the bowels, and
overcome the tendency to bleeding from the nose.
When bleeding from the nose comes on during the early stage
of acute disease, when there is a flushed countenance, hot skin,
and strong pulse, it will seldom require particular attention, as the
loss of a few ounces of blood will be a matter of little account.
If, however, the bleeding should occur too frequently, or become
too profuse, to be borne without detriment to the patient, the head
and face and breast should be bathed with vinegar or whiskey;
lobelia given in doses sufficient to occasion nausea, and clear the
nostril of the clotted blood, and draw into the nostril some astrin¬
gent, either bayberry or any astringent tea; or snuff" bayberry
powder or powdered alum.
Females are occasionally attacked with profuse nose-bleeding,
occasioned by obstructed menstruation. Under such circum¬
stances, the treatment must consist in the employment of such
means as are adapted to the restoration of the uterine secretion
avoiding the application of cold.
The circumstances under which bleeding from the nose becomes
most alarming, are when it occurs in patients much debilitated by
long-continued disease, and when it comes on as a consequence of
an altered condition of the blood, as happens in malignant forms
of disease, and in chronic complaints, such as scrofula, chlorosis,
scurvy, dropsy, &c. The most appropriate remedies for bleeding
from the nose, when it occurs under the circumstances above
mentioned, or when it occurs in low forms of fever, are, injections,
the internal use of vegetable astringent^, and- oil or spirits of tur¬
pentine ; and astringent and stimulating applications to the bleeding
vessels, with a view to cause them to contract, and favour the
coagulation of the blood in the extremities of the bleeding vessels.
The internal use of the spirits of turpentine is probably the best
means of arresting the bleeding. The usual method of preparing
it, is to beat up a tablespoonful of the oil or spirits of turpentine
with the yolk of an egg, and of this give a teaspoonful every fifteen
or twenty minutes, until the bleeding ceases.
Plugging up the nostril with cotton will generally stop nose-
bleeding, provided the plug be applied to the part from whence the
blood escapes.
376
BLEEDING FROM WOUNDS.
SECTION III.
BLEEDING FROM WOUNDS.
W ounds made by smooth, sharp-edged instruments, bleed more
freely than wounds of equal, or even much greater extent, made
by rough-edged instruments. Bruised or lacerated wounds seldom
bleed profusely, except when the vessels cut or torn are large.
Nature's method of arresting the flow of Blood.—When a vessel
is cut or torn, the inner coat of the vessel at the place of injury
commences throwing out a gluey substance, which gradually fills
up the cavity of the vessel, and prevents the further escape of
blood. In this way the cavity of the vessel becomes gradually
filled, so that in the course of half an hour, an artery or vein, the
size of a small crow-quill, may entirely cease to bleed. When a
vessel is torn or bruised, its cavity becomes closed much sooner
than when it is cut with a smooth instrument.
Wounds about the extremities, or in any part where the vessels
are not larger than a crow-quill, seldom require the vessel^ to be
taken up and tied, as they will become plugged up in the manner
above described, without any serious loss of blood, provided ad¬
vantage be taken of position, and the dressing be so applied as to
make a proper degree of pressure upon the part.
Faintness, from loss of blood or from other causes, always dimi¬
nishes the flow of blood from a wound or from mucous surfaces,
as of the nose, stomach, uterus, &c. Sickness, produced by
administering nauseants, has a like tendency, as under either con¬
dition the force of the heart's contraction is abated, and the for¬
mation of a clot or plug in the cut vessel or vessels is favoured
by it.
Position. — In wounds of the extremities, for instance, on the
hand or arm, that bleed freely, the parts should be held above the
head; or if on the foot or leg, the patient should lie down, and
have the limb raised higher than the body.
Pressure. — Much may be done by pressure in arresting bleed¬
ing, more especially where the cut vessel is situated in bony parts,
for here the pressure will be more effectual. Pressure may be
made by a piece of sponge, or a compress of folded cloths, held
or bound firmly upon the parts, until the bleeding ceases. Pressing
the sides of a wound together firmly, will be sufficient to arrest
BLEEDING FROM WOUNDS.
377
the bleeding, except where large vessels are divided; for although
the blood may flow freely at first, it will in a short time cease,
provided the pressure be properly applied. After operations upon
the lip, for instance, cutting out a cancer, all that is required to
arrest the bleeding, is to bring the sides of the wound together by
means of sutures or stitches. The same means should be em¬
ployed in accidental cuts on the lip, or in other parts that bleed
profusely, and where pressure cannot well be applied.
When several small arteries are cut and bleed freely, for in¬
stance, on the hand or foot, the bleeding may be checked very
much by placing a piece of cork over the main arteries, above the
wound; for instance, if the hand be bleeding, apply the cork on
the arteries at the wrist; and if the wound be on the foot, the
pressure must be made upon the arteries of the ankle, binding the
cork on firmly with a bandage.
Dr. Granville S. Woolman, of Rancocus, informs me he has fre¬
quently checked -bleeding after extracting a tooth, by placing a
little roll of cotton wet with spirits of turpentine in the cavity, and
directing the patient to close the jaws; the roll of cotton being
sufficiently large to make firm pressure upon the part.
Relaxing the system with lobelia, will lessen the escape of blood
from a wound, except in cases of malignant disease, where the
blood has become deprived of fibrin, and consequently lost its
tenuity.
To distinguish between an Artery and Vein when cut. — When
an artery is cut, the blood will be thrown out in jets, and its colour
will be red; whereas when a vein is cut, dark blood is discharged.
Even large veins may be checked from bleeding freely, by
applying firm pressure on the vein above and below the wound.
There is more or less danger to be apprehended from tying a vein;
this, therefore, is to be avoided, unless the vein be large, and the
bleeding cannot be checked by other means.
Large arteries that are cut require a ligature, unless the bleed¬
ing should not be very profuse. A person in full health may lose
a large quantity of blood, and soon have this loss restored, if the
digestive functions retain their integrity, and the person be supplied
with a nutritious diet; whereas in disease where the digestive
functions are prostrated, the loss of blood will not be restored for
a much greater length of time.
Vessels on the head seldom require tying, as pressure can be
effectually made upon them, in consequence of the vessel lying
near the bones of the head. Tying the vessels of the scalp is
liable to be followed by erysipelas, especially if the parts have
been bruised.
An artery that is only partly cut off will bleed much longer than
378
vomiting blood.
when it is completely divided. Hence when it is ascertained thai
a vessel is partly divided, it should be entirely severed, which will
enable the ends of the bleeding vessel to contract and retrace
and to become filled up by the lymph which exudes from the inner
coat of the vessel. If an artery or vein be partly divided only, it
will be difficult for the vessel to become filled with lymph, so that
even a small artery that is partly severed, may continue, to bleed
a long time. The only means of ascertaining whether a vessel be
partly divided, is by searching at the bottom of the wound by clear¬
ing away the clotted blood, and then applying a sponge to cleanse
the wound, so as to seize the vessel with a pair of forceps, and if
it be found to be partly cut off, let it be entirely divided.
Some surgeons recommend pinching and twisting the ends of
bleeding vessels with a pair of forceps or tweezers, as it causes
the inner coat of the artery to throw out lymph more rapidly.
Styptics. — Various agents are employed for the purpose of
arresting bleeding. Tar-water, Turlington's balsam, tincture of
myrrh, Thomson's No. 6, tincture of bayberry, puff ball, spider
web, ashes of burned cork, spirits of turpentine, &c. Tar-water,
Turlington's balsam, tincture of myrrh, or No. 6, may be used in
any case, and often prove effectual in staunching the blood, except
when a large vessel is divided or wounded. These articles not
only arrest haemorrhage, but they also favour the healing process,
by stimulating the parts, and by preventing putrefaction of the
effused blood that may remain in the wound. I have known
extensive wounds of the scalp to heal without suppurating, by
keeping the parts wet with tincture of myrrh, and the wound well
protected from the air. Atmospheric air is highly pernicious to
all wounds. In dressing wounds, therefore, especial attention will
be required to prevent the admission of air into the wound, at
least until a reunion has been effected, or suppuration taken place.
A wound that discharges matter, must of course be exposed to the
air when the dressings are changed.
SECTION IV.
BLEEDING FROM THE STOMACH.
(Vomiting Blood.)
When blood is thrown up by vomiting, it comes from the sto¬
mach ; and when it comes from the lungs, it is raised by hawking
or by coughing. The quantity of blood discharged by vomiting
VOMITING BLOOD.
379
in different cases, varies from half a pint to several quarts. Being
mixed with phlegm, and other matters in the stomach, the quantity
of blood usually appears much greater than it really is.
Symptoms.—When blood collects in the stomach to any con¬
siderable amount, it occasions various distressing symptoms, such
as a sense of weight and distress at the pit of the stomach; sour
belching and heart-burn; pain and tenderness in the region of the
stomach; a feeling of faintness; anxiety; chilliness and flushes of
heat; a small, contracted and irritable pulse; palpitation; cold
extremities; a pale and contracted countenance; weakness and
constriction about the breast; the Senses become confused; and
there is great sickness of the stomach. These symptoms are fol¬
lowed by copious vomiting of blood, from which the patient expe¬
riences much relief, though usually remaining extremely debilitated
—requiring the use of the most active diffusible stimulants, such
as wine and brandy, in connection with cayenne, composition, &c.,
together with the use of wine-whey, essence of beef, egg soup, or
milk porridge.
A portion of the blood in the stomach passing into the bowels,
occasions dark, watery, acrid discharges from the bowels, attended
with griping pains.
Causes.—The bleeding does not proceed from a ruptured vessel,
in cases of vomiting blood, but escapes through the mucous mem¬
brane, as it does in ordinary cases of bleeding from the nose.
The majority of cases of vomiting blood is occasioned by ob¬
structed menstruation. It may proceed from an injury or disease
of the stomach ; or from obstruction in the liver or spleen ; or it
may be the consequence of an altered condition of the blood, from
malignant disease, such as typhus and yellow fever. Blood is in
some instances discharged from the liver into the stomach, and
thrown up by vomiting. Cancer of the stomach is one of the rare
causes of vomiting blood.
The last case of vomiting blood that I have seen, occurred in a
female, forty-three years of age, and who had been suffering for a
long time with severe dyspepsia, vomiting her food up every day,
for months together. She became healthy.
Treatment. — The same general course of treatment will be
required in cases of bleeding from the stomach that is recom¬
mended for bleeding from the lungs. The important objects are
to evacuate the stomach by emetics, when oppressed by a mass
of blood, stimulate the vessels of the mucous membrane to
contract, by giving stimulants and astringents, and attract the
blood to the surface and to the extremities by warmth applied
* externally.
380
VOMITING BLOOD.
To most persons, it may appear an improper practice to give an
emetic in cases of bleeding from the stomach; but if the stomach
be oppressed with a mass of blood, there is no other means upon
which any confidence can be placed but prompt emetics.
Professor Chapman, in his lectures, relates a case of a young
woman who was seized with vomiting blood, and when he first
saw her she had thrown up three pints of blood. Astringents and
various other remedies were employed without effect; she became
much exhausted, and continued to throw up blood. An emetic
of ipecacuanha was given, and a large mass of black blood was
thrown from the stomach, after which she revived, the bleeding
ceased, and she did well. But for the emetic, this patient would
doubtless have died from the oppressed condition of the stomach.
Other cases were related by the Professor, where emetics proved
effectual after the usual remedies had failed. In one instance, the
bleeding returned after the operation of the first emetic; a second
was given, and after its operation there was no return of the
bleeding.
Emetics to be employed in bleeding from the stomach, may be
prepared in the usual form. The following will do very well in
any case:—
Put a teaspoonful of the No. 3 preparation, a teaspooniul of
green lobelia, and a teaspoonful of sugar, into a tea-cup;
rub these well, and then fill the tea-cup half or two-thirds
full of strong bayberry tea. To be stirred well, and taken
at once. The dose to be repeated once or twice, at inter¬
vals of fifteen or twenty minutes.
Emetics operate more easily and effectually after a vapor bath;
and when the patient has strength to sit up and take a bath, it is
a good practice to administer one, and also to give an injection
before administering an emetic. The circumstances of the case,
however, must govern the treatment; for instance, if the patient
be very feeble, and suffering great distress and oppression at the
stomach, an emetic should be given at once.
I have employed active emetics in two instances of bleeding
from the stomach, and in both with good success. In one of these
cases, the patient used freely of cayenne tea after the emetic, and
continued using it several weeks after, as a general medicine.
This patient said that she felt more benefit from pepper tea, than
from any other medicine she had taken, excepting the emetics.
In another instance, a third case, the patient became extremely
weak, and the powers of life depressed to such a degree, after two
or three attacks of vomiting blood, that she was thought to be in
a dying state, but was sustained by a free use of wine-whey,
brandy, and essence of beef.
>
BLOODY URINE. 381
Wine-whey and essence of beef are often demanded in cases of
vomiting blood, in consequence of the debility and prostration of
vital energy that attends the complaint. When the functions of
the stomach are depressed, or its power weakened, to the extent
that it often is in bleeding from this organ, the forces of life sink
very low, presenting the appearance of a dying state, demanding
the free use of the most potent stimulants.
Injections should always be employed when the evacuations
from the bowels are dark and of an acrid character, as they fre¬
quently are in bleeding from the stomach. More especially are
injections called for, where there is reason to suspect the cause of
the haemorrhage to be obstructed menstruation. The injections
should be stimulating, and contain a portion of lobelia.
SECTION V.
BLOODY URINE.
Blood discharged with the urine, may proceed either from the
kidneys, ureters, bladder, or urethra. It may be a consequence
of debility in the mucous membrane of the urinary passages; or
t may be caused by the presence of calculus or gravel, either in
.he kidney, ureter, bladder, or urethra; or from the use of power¬
ful diuretics, particularly cantharides. Gouty patients are not
unfrequently attacked with discharges of blood with the urine.
Obstructed menstruation has been known to cause it. Among
the most common of the causes of bloody urine, is ulceration of
the neck of the bladder.
Treatment.—When bloody urine is occasioned by calculus or
gravel, there will be severe pain in the part where the calculus
is situated; and such a case should be treated the same as a case
of gravel, without any discharge of blood, adapting the remedies
to the character of the symptoms. (See Treatment for Gravel.)
Attending extreme prostration of the system, a discharge of
blood from the urinary passage should be treated as a case of
passive haemorrhage, relying chiefly upon the use of oil of turpen¬
tine and astringents, such as the anti-canker pills, and a strong
decoction of sumac leaves. A tea of peach-leaves has been used
with good success in cases of bloody urine.
When the complaint is occasioned by the use of powerful
diuretics, demulcent drinks, such as elm gruel and flaxseed tea,
should be given freely.
382
CANCER.
When gouty patients are attacked with bloody urine, the con¬
stitutional treatment should be adapted to improve the condition
of the general health; and in these kinds of cases, the use ot oil
of turpentine will often prove beneficial in other ways besides
arresting the bleeding.
Ulceration of the neck of the bladder is usually attended with
some discharge of blood; and in these cases, the blood will appear
at the commencement of the passing of water, and will not stain
the urine regularly, as when it proceeds from the kidneys, ureters,
or mucous membrane of the bladder.
Occurring as a consequence of obstructed menstruation, bloody
urine requii'es no treatment apart from that best adapted to the
restoration of the menstrual secretion.
The mere discharge of blood with urine, is in itself of but little
account; the reason why it occasions alarm in those acquainted
with the matter, is that it indicates disease which sometimes is
incurable.
When blood is collected in the urethra, or neck of the bladder,
and not mixed with urine, the urethra may become plugged up
with clotted blood, so as to occasion obstruction to the passage
of urine, requiring the introduction of the catheter, or the wash¬
ing out of the urethra, by means of warm water injections.
CHAPTER XIX.
SECTION I.
CANCER.
Cancer is a malignant disease, generally seated in the glands,
though no portion or tissue of the body is altogether exempt from
the liability to become diseased in this way. Thus the lips, tongue,
skin, stomach, ovaries uterus, and even the bones, are subject to
cancerous growths.
Different Species. — The simplest classification is that which
recognizes but two species; namely, scirrhus or hard cancer; and
soft cancer. Of the latter species, there are two varieties — the
encephaloid or brain-like cancer, and the colloid or gum-like cancer
Besides cancerous growths, there are others of comparatively
harmless character. Such are certain fatty tumours, fibrous
CANCER.
383
tumours, and osseous or bony tumours. Cancer doctors and doc-
tresses apply the term cancer to various kinds of sores and tumours,
probably from inability to distinguish between true cancer and
diseases of a different character. No well informed physician
will profess to cure genuine cancer, except under very favorable
circumstances, and in the early period of the disease, before the
system becomes contaminated with the cancerous poison.
Cancer of the Female Breast.
Symptoms.—When first discovered, a cancerous tumour is usu¬
ally about the size of a marble, and is extremely hard and move¬
able. The disease progresses very slowly, attended now and then
with a sense of uneasiness in the part, but without inflammation
of the skin. " Sometimes the attention is first attracted to the
bosom by a drop of bloody serum having stained the linen oppo¬
site the nipple, it having flowed from one of the lactiferous tubes.
Sometimes a distinct and sharp pricking pain leads to the dis¬
covery of the swelling."
There is rarely much pain felt in the part in the early stage of
cancer, but after a time the patient experiences turns of excessive
darting, or burning pains in the tumour, which are apt to occur at
intervals of about two weeks. As the tumour becomes painful, it
is observed to enlarge; but true cancer rarely ever becomes larger
than two or three inches in diameter, except when the disease
invades the whole gland.
As the disease advances, the paroxysms of pain become more
frequent, and are often intensely severe, as though "the parts were
pierced with a knife, or the nerves of the breast torn out." Prior
to menstruation (about four days), the breast feels fuller, heavier,
and much more painful.
After the tumour has attained a considerable size, which in
some instances requires many months or even years, the nipple is
observed to become shorter, being drawn in by the milk ducts,
which are pushed out of their course by the tumour; " frequently,
also, the nipple becomes red, inflamed, excoriated, and sometimes
ulcerated." A change is also produced in the appearance of the
skin; it is puckered so as to resemble a cicatrix, and this arises
from its adhesion to the surface of the cancer. At this stage of
the disease the parts around the cancer become more firm and
harder than natural, and little tumours are generally perceptible
in the parts surrounding the cancer. During the progress of
cancer, the glands under the arms almost always become more
or less swollen and hard.
Exists for years without destroying Life. — Months, and some¬
times years roll on, and the disease continues in its adhesive
384
CANCEK.
stage: and it may even destroy life without ever suppurating; but
frequently it proceeds to a suppurative inflammation; then the skin
appears of a livid redness; the pain becomes even more severe;
a slight sense of fluctuation, or rather of yielding, is perceived in
the part, which gradually ulcerates and discharges only a bloody
serum; for true pus is not generated. Pus is attempted to be
produced; but it is not formed on a truly malignant surface, but
only upon the surrounding parts, if they be ulcerated.—Cooper.
" Character of the Sore after the Cancer opens.—The surface of
the sore feels "hard, like the original tumor, and is remarkably
insensible to pressure; and you therefore will observe the patient
wipe it, and handle it with a degree of roughness and want of
gentleness, which surprises those who are unaware of its little
sensibility."—Cooper.
Cancerous ulcers are apt to bleed frequently. The bleeding
may be checked by a compress of carded cotton, lint, or soft
muslin cloths, applied to the part, and confined by a bandage, so
as to make moderately firm pressure upon the bleeding vessels.
As the ulceration proceeds, a deep cavity is formed, sometimes
extending to the breast-bone.
Patients affected with cancer are apt to complain of rheumatic
pains in various parts of the body, more particularly in the loins
and thighs.
As the disease extends, the arm upon the diseased side becomes
swollen; there is frequently much difficulty in breathing, the
patient being unable to lie down; a sense of stricture and spasms
at the pit of the stomach is often experienced, and sometimes
attended by vomiting. Finally, the constitutional energies become
exhausted, and the patient sinks under the disease.
It should be recollected, however, that it is not every case of
cancer that destroys life, even when the tumor is not removed.
Sometimes the disease remains stationary for many years.
The female breast is very liable to tumors that do not partake
of the cancerous nature. A cancerous tumor in the breast is
rarely ever observed in females under thirty years of age.
Treatment. — The constitutional treatment for cancer should
consist in the employment of such means as are best adapted to
improve the condition of the general health. There are no spe¬
cific remedies for the cure of cancer. An occasional hot air bath
and an emetic; the use of the No. 3 pills, to prevent the mucous
membranes from coating with unhealthy secretions, taking as
many as 6 or 8 of the pills about the middle of the forenoon and
afternoon; and occasionally from one to three or four of the com¬
pound lobelia pills, constitute the remedies best suited for regu¬
lating the constitutional health.
CANCER.
385
If there be acidity of the stomach, and the bowels costive, pul¬
verised charcoal will be beneficial. It may be taken prepared in
water, composition, or spice bitters tea. The dose of the charcoal
is a large teaspoonful; to be repeated two or three times a day,
before meals.
When a violent paroxysm of pain comes on, it may be mitigated
by the use of the warm foot bath, or of the vapor bath, and the
use of enemas composed of some mild stimulant, such as compo¬
sition or pennyroyal tea, with the addition of from a half to a tea-
spoonful of lobelia, either the powder, tincture or third preparation.
Whatever tends to equalize the circulation of the blood, and of
the nervous power, will relieve pain, no matter where it be
situated. The free use of pure stimulants, cayenne and compo¬
sition, containing small portions of lobelia, will also be useful in
relieving paroxysms of pain.
Difficulty of breathing will be relieved by the treatment above
described. The same remedies are also indicated for the relief
of the dry and harassing cough which often attends cancer, more,
especially in its more advanced stages.
Tonics will be proper with a view to strengthen digestion—such
as spice bitters, balmony, &c.
Diet. — The diet should be nourishing, and easy of digestion.
Some patients feel more comfortable upon an exclusive vegetable
diet, while others require animal food.
Change of Climate. — Every means that strengthens and im¬
proves the system, tends to prevent the progress of cancer; and
a change of atmosphere will often do more towards improving,
health in chronic diseases, than medicine.
Applications to the Tumour before the Skin is broken. — During
the early periods of cancerous tumours, they should be kept warm,
and the skin in a perspiration, by the application of some simple
kind of salve spread on silk oil-cloth, or by wearing a piece of
rabbit skin with the fur side to the breast.
Poultices are to be applied when the tumor softens, and the
skin becomes inflamed. The poultice may be made of elm, ginger,
and cracker, or any soft emollient substance, adding a portion of
lobelia powder, say a tablespoonful. to each poultice.
Local Treatment eor Open Cancer.
Cancer.—Many reputed cures for cancer have been introduced;
into use in form of salves, plasters,, and balsams, but which, upon?
25
386
CANCER.
the whole, have doubtless been of far more injury than benefit.
Powerful caustics and corroding poisons, as preparations ot arse¬
nic, are applied by some cancer doctors to almost every kind of
indolent ulcer they meet with, and if it should heal, it is announced
as a case of cancer cured; whereas in true cancer such applica¬
tions would probably have little effect, other than to irritate the
parts and aggravate the sufferings of the patient, without accom¬
plishing a cure.
Extract of Sheep Sorrel.—The use of this article appears to have
operated very favorably in some cases of cancer. The extract is
obtained by evaporating the juice of the sorrel, in tin or pewter
plates set in-the sun, until it acquires the consistency of tar. This
is spread on thin leather or silk oil-cloth, and applied to the cancer,
renewing it daily. Or apply the extract to the surface of the
'cancer with the point of a knife, and as the parts become deadened
and soft, incisions should be made in various directions, for the
purpose of introducing the extract deeper into the cancerous tumor.
The effect of the sorrel extract is to destroy the vitality of cancer,
and as the surface becomes dead and softens, it may be scraped
off without causing the least pain to the patient.
Extract of Red Clover Blossoms. — This preparation is recom¬
mended by Dr. Thomson as a valuable application in cases of open
cancer. I cannot speak from personal knowledge of the efficacy
of this remedy.
The extract of clover or sorrel will destroy and dissolve cancer,
when it will not injure the healthy flesh, not even causing inflam¬
mation.
The following compound may be used to cover the surface of
open cancer, two or three hours after the application of the extract
of clover or sorrel:—
R. Powdered Marsh rosemary 1 oz.
" Cranesbill (geranium maculatum) . 1 "
" Rosin 1 "
" Blood-root 1 "
" Gunpowder 1 "
These to be combined, and applied dry to the surface of the
cancer, and then cover the parts with a plaster of Castile soap, or
of some simple salve, and keep the parts warm. On the following
day, the powder, with the portion of cancer deadened and softened
by the previous dressing, is to be removed by scraping it off with
a knife-blade, and then put on the extract, and in a few hours apply
the powders, &c.; and continue this treatment until the cancer is
CANCER.
387
entirely removed; and, at the same time, let every means be
employed to improve the patient's general health.
Removal of Cancer by Excision.—This operation, if performed,
should be done in the early stage of the cancer, before the system
becomes contaminated with the cancerous poison.
To Open a Cancer.—The dread of an operation by the knife is
so great with many individuals,* that they will not submit to the
operation, but choose rather to suffer more pain, and have the
cancer removed by escharotics, or cancer plasters.
"The proper plan is first to remove the cuticle over the surface
of the tumor by the vesication of a common fly blister, or a strong
solution of lunar caustic, and afterwards to protect the skin around
by the application of an adhesive plaster, spread upon a circular
piece of leather. A paste or ointment of some slowly acting but
efficient caustic is then applied over the excoriated surface, and
maintained there for several hours by a compress, bound down by
a large adhesive plaster and bandage. Sometimes the application
has to be repeated from time to time, for the purpose of ensuring
a thorough impression, but in superficial growths one full trial of
this kind will prove sufficient. The subsequent and frequently
repeated applications of emollient poultices, combined with nar¬
cotics, will mitigate the pain, and promote suppuration around the
tumor, and a final detachment of it by ulceration. Sometimes .
even large tumors will slough away entirely in this way, and leave
a clean, healthy ulcer, which will afterwards close by a sound
cicatrization. The favorite caustics at present employed by our"
(Allopathian) " practitioners, are the chloride of zinc, mixed in
equal proportions with flour of calcined gypsum." — M'Clellan's
Surgery.
Cancer of the Lip.
A blackish, hard lump or tumour, the size of a duck-shot or
pepper grain, situated in the lip, and attended with a twinging
pain, should be regarded as a cancer, and should be removed by
the knife; and a course of treatment instituted to improve the
general health of the patient.
The Open Cancer of the Lip, or malignant ulcer, which occa¬
sionally is observed in persons long habituated to the excessive
use of the tobacco-pipe, are sometimes cured by the application
of caustic, excluding the air from the ulcer by means of salve and
suitable dressing.
388
CANCER.
Cancer of the Tongue.
The tongue is liable to lumps, or tumors, excrescences, and
ulcers, arising either from bad digestion or decaying teeth, which
often resemble cancer of the tongue, and occasion unnecessary
alarm.
Cancer of the tongue sometime^ appears in the form of a rough,
hard excrescence or wart, situated about the middle of the tongue,
towards the tip, and attended with a lancinating, piercing pain;
and sometimes it commences in the form of a ragged ulcer, filled
with fungus or proud flesh, which bleeds from the slightest irrita¬
tion. The pain attending, is of the same deep-seated, lancinating
character, extending to the throat and to the base of the brain.
Ulcers upon the side of the tongue,'occasioned by carious teeth,
may be converted into a very troublesome sore by allowing the
teeth or tooth to remain, and thus keep the sore irritated for a
length of time.
Treatment of Cancer of the Tongue. — For true cancer of the
tongue there is but one remedy, and that is to remove it by means
of a ligature. This is of course to be done by a surgeon, or by
one acquainted with the proper method of performing the operation.
Lupus. — Cancer of the Skin.
There is a variety of cancer usually termed lupus, which appears
in the form of a small indurated tubercle, or wart-like excrescence,
mostly situated on the face near the corner of the eye, or by the
nose, attended with a twinging or prickling pain. " Sometimes
the first appearance is in the form of a discolored spot or point,
or of a hard, dusky, or warty scale, which repeatedly falls off, or
rather is pulled off, and leaves an elevated raw surface exposed,
in which cancerous ulceration finally supervenes. Occasionally,
ragged warts appear with an induration beneath, which eventually
run into the same malignant ulceration."
Treatment. — The local treatment should consist, of the applica¬
tion of the clover or sorrel extract, until the cancer is destroyed,
and cover the surface once or twice daily with the powder
recommended in a preceding section, and cover the part with an
adhesive plaster.
t
Garden Celandine.—The juice of this herb is a favorite remedy
with some practitioners as a cure for lupus. The juice is to be
applied to the cancer two or three times daily, and the parts pro¬
tected from the air by some kind of adhesive plaster or salve.
SPRAINS.
389
Cleanliness of person, moderate exercise in the open air, a weil-
regulated diet, protection from cold and dampness, warm cloth¬
ing, and cheerful society, are of much importance in all cases of
cancerous disease.
Constitutional Treatment. — Besides the remedies previously
ecommended under the head of constitutional treatment, there
are others which may be employed ; and the same remedies may
be prepared in different ways, to suit the fancy of the patient;—
the syrup of bayberry, for instance, be substituted for the No. 3
pills, and the tincture or syrup of lobelia in the place of the com¬
pound lobelia pills.
A strong decoction or syrup of the following compound is
recommended as a general constitutional medicine in cases of
cancerous diseases:—
E. Yellow dock-root,
Sarsaparilla,
Guiac. shavings,
Mountain ditany,
Pipsissawa,
Elecampane,
> Of each an equal weight.
These to be mixed together, and to about one ounce of this
compound pour a pint of boiling water; let it steep an hour in an
earthen vessel. This quantity to be taken daily; made fresh every
morning, and taken either cold or warm, or with or without sugar,
as the patient may prefer.
The above may be taken in connection with the remedies before
mentioned.
CHAPTER XX.
SECTION I.
SPRAINS.
Sprains are caused by a sudden wrench or twisting of a joint,
by which the tendons or ligaments are either torn or violently
stretched. The wrist and ankle joints are those most liable to
sprains.
Sprains are extremely painful at the time of the injury, and
sometimes continue for hours. Soon after the accident, the paits
390
SPRAINS.
oegin to swell, in consequence of the blood stagnating in the
injured vessels, or from its being effused into the cellular tissue
from the torn vessels.
Immediately after a sprain, the joint can be readily moved;
whereas in dislocations the joint is stiff and rigid. This fact
furnishes a means for distinguishing between a sprain and a dis¬
location.
When inflammation takes place, as becomes necessary, in order
to repair the injury, the parts swell, and there will be extreme
tenderness, so that the slightest motion of the joint will cause pain.
Treatment. — In sprains, the first thing to be attended to is to
prevent blood being effused into the tissues from the ruptured
vessels. This may in a great measure be prevented by pouring a
stream of cold water upon the part soon after the accident, and
keeping the part in an elevated position. The stream of cold
water drives the blood from the parts and contracts the vessels.
It may be continued fifteen or twenty minutes at a time, and re¬
peated two or three times in the course of the first three or four
hours after the injury. By this time, the torn vessels will have
become closed, and the parts then require to be kept warm and
bathed frequently with salt and vinegar, No. 6, or stimulating
liniment.
When inflammation occurs, evaporating lotions, as alcohol, or
whiskey, diluted with water, and warm fomentations, as worm¬
wood stewed in vinegar, must be used. Steaming the part occa¬
sionally, will prove especially beneficial. If it be the wrist joint
that is sprained, the arm must be carried in a sling; or if it be the
ankle joint, it should be placed on a chair whilst the patient is
sitting up, and avoid producing motion in the injured joint.
Application of Splints.—To secure the joint from motion in cases
of severe sprains, splints should be applied. This is more particu¬
larly necessary in injuries of the wrist joint. If motion in the
joint be not prevented whilst the broken tendons or ligaments are
uniting, by means of inflammation, it may break up the new ad¬
hesions, and thus greatly retard the cure. It is not until after the
inflammation has entirely disappeared that motion in the parts
should be allowed.
After the inflammation and extreme soreness have subsided,
should the part remain swollen, the action of the absorbent vessels
must be promoted by rubbing the parts occasionally with the warm
hand, or dry flannel, and then applying stimulating liniments or
embrocations, and bandage the joint as tightly as can be borne
comfortably, always commencing the bandage at the end of the
limb. Steaming will also promote the action of the absorbents.
A joint that has been once badly sprained, will in general
bruises. 391
remain weak a considerable length of time, and be more easily-
sprained than before.
The extreme pain often experienced after a bad sprain, may be
much relieved by nauseating the stomach by lobelia, given in
broken doses.
SECTION II.
BRUISES.
The best kind of dressing for a bruise, is soft muslin folded
several times, wet in cold or lukewarm water, and bound upon
the part bruised. The dressing to be taken off and wet before it
becomes dry, or when it becomes uncomfortably warm.
If the bruise be situated on a part where the circulation is
feeble — for instance, upon the shin of an aged person — oiled silk-
should be applied over the wet dressing, with a view to keep the
parts warm. The wet dressing having been kept on two or three
days, the next dressing should be some kind of salve, spread upon
oiled silk and bound on, with a view to keeping the parts warm,
and favoring the process of absorption.
Bathing a bruised part with a stimulant, either tincture of myrrh,
spirits of camphor, salt and vinegar, brandy, or No. 6, is always
beneficial, and may be done any time the dressing is removed.
Constitutional Treatment. — Slight bruises seldom require con¬
stitutional treatment; but in more severe cases, the hot air or
steam bath should be applied, and warm drinks given to promote
perspiration.
SECTION III.
SEVERE SHOCKS FROM VIOLENT BLOWS OR FALLS.
In all cases of severe blows or falls, the vital powers of the
system will be more or less prostrated. A man receives an injury,
for instance, a severe blow upon the head, falls from a height, or
is thrown from a horse with such violence as to cause concussion
of the brain—he will lay senseless and pale; the pulse weak ; the
breathing feeble, and in some instances scarcely perceptible. The
patient may recover his sensibility in the course of a few minutes.
392
SEVERE BRUISES.
If, however, reaction should not take place, and consciousness in
a measure be not restored, in a few minutes after a severe injury,
means should be taken to bring on reaction. These are, rubbing
the surface with the warm hand or warm flannel, keeping the
head on a level with the body, administering stimulants and the
application of external warmth, either in the form of steam or by
the application of warm bricks; and bathing the surface and ex¬
tremities with stimulants.
Injections. — Stimulating injections constitute the most efficient
means of restoring animation in persons that are seriously stunned
by an injury. Two or three teaspoonsful of the third preparation
of lobelia should be administered in half a pint of lukewarm water;
if this medicine be not at hand, almost any stimulant may be em¬
ployed, such as capsicum or composition tea, No. 6, or even vinegar
and water, or brandy and water.
Emetics.— The operation of a stimulating emetic is decidedly
beneficial in cases of great prostration after severe injuries. If
the system sustain a severe shock, within an hour or two after the
individual has taken a hearty meal, free vomiting will be highly
necessary. A severe shock to the system, suspends at once the
power of digestion, and if there be undigested food in the stomach,
it will oppress the powers of life, and may prevent or greatly
retard the occurrence of reaction. The best form of emetic is the
third preparation of lobelia, given in bayberry tea; or the lobelia
powder may be given, adding a portion of No. 6, or capsicum.
When a person is severely stunned soon after a full meal, render¬
ing it necessary to produce free vomiting, the usual emetic (lobelia)
not being at hand, a tablespoonful of ground mustard given in
warm water, or the patient made to swallow warm salt water
freely, may answer as an emetic. Forcing the feathered end of
a quill far down the throat, is sometimes resorted to, in order to
produce vomiting.
Animation being restored, the use of pure stimulants must be
continued, in small doses, aided by the application of external
warmth, with a view to sustain the circulation, and excite mode¬
rate perspiration.
Steaming is of great service to patients who have been badly
injured. It is always safe to apply the vapor or hot-air bath, the
patient being placed on a couch or mattress, when he is too feeble
to sit up. When there is fever, and the patient restless, it will not
do to apply dry heat externally; and even when a moist heat is
applied during fever, it may be necessary to bathe the face and
surface of the body with cold whiskey and water, or vinegar and
•water.
SEVERE BRUISES.
393
External Treatment. — In those instances where the system has
received a severe shock, the injured part should be bathed with
No. 6 or salt and vinegar, and warm fomentations, poultices, or
the warm water dressing, applied.
When the flesh is both torn and bruised, a poultice must be
applied, and renewed daily until the parts suppurate and cease
to discharge matter freely, when a simple dressing of salve will
answer a better purpose than a poultice. Whatever emollient
substance the poultice be made of, a portion of ginger must be
added, to render it moderately stimulating.
When there is an undue determination of blood to an injured
part, occasioning much swelling and hardness, attended with a
sense of great heat and pain, the parts should be kept wet with
evaporating lotions, as camphor and water, alcohol and water, or
vinegar and water; the patient should be taken through a course
of medicine, if the severity of the symptoms demand it, together
with the continued use of stimulants and broken doses of lobelia,
with a view to promote perspiration, and excite the secretions of
the stomach and bowels, aided by the application of external
warmth.
Severe injuries are in general followed by more or less fever, in
the course of a few days after the injury: the tongue will become
dry and furred, the skin hot and dry, and the pulse increase in
hardness and quickness. In this condition of the system, stimu¬
lants—capsicum, ginger, composition or simple herb tea, must be
given, together with small doses of lobelia, bathing the surface,
when needed, with alcohol and water, or vinegar and water, and
occasionally the administration of a vapor ba||i, followed by an
emetic, if the system be much disordered, or the injury assume an
unfavorable appearance.
Case. — A young man, engaged in a manufactory, had his arm
caught between two large cog-wheels, which tore the flesh from
one-half of the arm, from a few inches above the elbow up to the
shoulder, and split off a portion of the arm bone, which caught in
between the cogs, and stopped the machinery. The shoulder and
part of the back were bruised into a jelly. The physicians of the
village were called, who decided that the arm must be taken off
at the shoulder, and appointed the time for performing the ope¬
ration. The patient, however, requested that his step-father, a
Thomsonian physician, who resided some miles distant, should be
sent for. On his arrival, he applied a poultice over the whole of
the injured parts, carried him through a course of medicine; occa¬
sionally repeated it, and gave freely of stimulants to promote the
curative action of the system, and in six weeks the wounds were
perfectly healed. If the great vessels and veins of the arm had
been broken off, no treatment could have saved the patient's arm;.
394
WOUNDS OF THE SCALP.
but when these are not destroyed, however severe the injury may
be, there is a probability of saving the limb.
Case.—Mr. R was thrown violently upon the pavement by
the overturning of a sulkey, which left him for some time senseless,
and bruised him internally, so that breathing was painful, and he
raised small quantities of blood. After his sensibility was restored
and he conveyed home, two physicians that had seen him shortly
after the injury, called to ascertain how he was, and on being ap¬
prised of the fact that Mr. R. was a Thomsonian, they requested
to know what medicine he was taking; and when some composi¬
tion tea was handed them, and they were informed that this was
the medicine the patient was taking, they manifested great surprise,
and gave it as their judgment that such medicine would throw the
patient into a fever, and endanger his life. Mr. R., however, took
freely of hot medicine, was steamed every day, was taken through
one course of medicine, and recovered rapidly without the occur¬
rence of a bad symptom. Physicians employ bleeding and purg¬
ing to prevent inflammation, and although they may relieve pain
at the time, yet it enfeebles the curative efforts of nature, increas¬
ing the liability to unhealthy inflammation, and doubtless in many
instances destroys the life of the patient. The practice of bleeding
in injuries is so generally adopted by physicians of the old school,
that it is thought by the community to be necessary, and when a
person receives a severe injury, every one is recommending bleed¬
ing as the first and most important remedy, so that sometimes it
requires no small amount of courage to withstand this popular
mania for bleedina»
SECTION IV.
WOUNDS OF THE SCALP.
Wounds of the scalp, more especially when the parts are bruised
and lacerated, require strict attention, such wounds being often
observed to be followed by serious consequences. A simple cut
through the scalp with a sharp instrument, heals in general with¬
out difficulty, except in persons of depraved habits, or in bad
health from other causes. Wounds of the scalp, under the old
school treatment, are particularly liable to be attended with ery¬
sipelas, which sometimes affects the brain so as to endanger life.
Treatment. — In severe injuries of the head, the edges of the
wound must be properly adjusted, the hair shaved off closely
around the edges of the wound, the parts washed with whiskey
WOUNDS OF THE SCALP.
395
and water, or with warm water. Tincture of myrrh or No. 6
poured in the wound, to prevent putrefaction of the disorganized
blood, and to stimulate the injured vessels to carry on the healing
process; then apply dry lint over the wound, to absorb the effused
blood and serum, and bandage it as tightly as the patient can bear
without inconvenience. If the lips of the wound cannot be kept
closed by bandaging, the hair must be shaved off, and strips of
adhesive plaster applied before applying the lint. In bandaging
the head, especial care must be observed to have the hair combed
smooth into its natural position, for if a lock of hair be turned the
wrong way and bound down, it will occasion soreness of the
scalp. Wounds of the scalp must never be stitched.
Removing the Dressing.—It is generally recommended to avoid
removing the first dressing until four or five days have elapsed,
with a view to prevent the admission of air into the wound; but
if the tincture of myrrh be poured into a wound, the dressing may
be taken off in the course of twenty-four hours after, and the lint
containing the effused blood removed, without any risk of air
getting into the wound, for by this time the wound will be filled
with coagulable lymph. Before removing the lint, have it well
saturated with spirits, tincture of myrrh, or No. 6, that it may be
removed without disturbing the wound; and after its removal,
apply some simple cerate or salve, put on dry lint. The second
dressing may either remain on four or five days, or be removed
daily. If the injured part become painful and very hot, the head
must be dampened with whiskey or vinegar, and be kept elevated.
Wetting the dressing over the place of injury with No. 6 occa¬
sionally, so as to fully saturate the dressing with it, will lessen the
tendency to erysipelas, or unhealthy inflammation. Adhesive in¬
flammation is necessary—injuries cannot be repaired without it;
and there is probably no article so well adapted to promote the
healing process of a wound, as the tincture of myrrh, or Thom¬
son's No. 6.
Constitutional treatment should always be employed in wounds
of the scalp. Soon after the wound is inflicted, the patient should
be carried through a course of medicine, more especially if the
wound be severe, and repeated as often as the condition of the
system may require it. If the bowels be costive, they must be
evacuated by the use of the syringe.
Perspiration. — It is important to promote the secretions and
exhalations of the skin by the use of stimulants that neither dis¬
order the brain, nor aggravate inflammation. Capsicum, compo¬
sition, or ginger tea, may be used freely and with safety. Simple
herb teas may be employed for the same purpose. The feet must
396
WOUNDS OF THE SCALP.
be kept warm. When a patient is feverish, a small portion of
lobelia should be added to the stimulants given, and the surface
bathed occasionally with some alcoholic preparation.
Should symptoms occur denoting inflammation of the brain—
pain in the head, flushed countenance, intolerance of light and
sound, and delirium, the system must be placed under the influ¬
ence of lobelia, taken in the usual way, and also administered by
injection. A teaspoonful of brown or green lobelia may be ad¬
ministered by injection in lukewarm water, and retained ; and
occasionally a stimulating one also may be administered — a tea^
spoonful of the third preparation of lobelia in bayberry tea. I
have frequently given the third preparation of lobelia to patients
laboring under symptoms of inflammation of the brain in low forms
of fever, and have invariably observed good effects to result, from
it; in many instarces after vomiting, the delirium has very mate¬
rially moderated, and in some instances disappeared entirely for
a time.
In inflammation of the brain from injury of the scalp, it will be
proper to relax the system by the lobelia enemas, and the appli¬
cation of vapor to the body before giving an emetic of the third
preparation of lobelia. This treatment must be perseveringly
employed, for inflammation of the brain often proves fatal under
any mode of treatment. The hair must be cut short, and the
head raised upon pillows, and cloths applied wet with alcohol, or
vinegar, or if there be erysipelatous inflammation of the scalp,
No. 6, or the third preparation of lobelia, must be used on the
inflamed part, whilst on other parts of the head the first mentioned
articles may be used.
When there is evidence of the existence of matter under the
scalp, an opening should be made with a lancet, to allow the pus
to escape; after which, especial care must be observed to shield
the parts from the air by a stimulating poultice, or plaster, spread
upon oiled silk; and if a poultice be employed, it must be kept
moist with warm water, containing about one-fourth of its quantity
of No. 6. Equal quantities of composition powder and slippery
elm, mixed with lard, form a suitable poultice in erysipelas,
attended with the formation of matter in the parts.
The practice advocated by some physicians and denounced by
others, of prescribing bark and wine to patients laboring under
erysipelas of the scalp, is not much less objectionable, in certain
conditions of the system, as when the secretions are in a great
measure suspended, than the absurd practice of bleeding patients
"almost to death," in inflammation of the brain. In the earlier
stages of erysipelas, the medicines employed should be such as
excite the secretions, both of the skin and of the mucous membrane
of the stomach and bowels. Hence, when the tongue is dry, as
a general plan of treatment, use pepper tea, either alone or com-
WOUNDS OF THE SCALP.
397
bined with simple herb tea, such as pennyroyal, balm, &c., and
broken doses of lobelia, and apply a moist heat to the surface of
the body and feet. A case of erysipelas that would be aggravated
by the use of bark and wine, would be relieved and benefited by
the treatment as above described. In any case of fever in which
the secretions are suspended, bark and wine would prove more or
less deleterious; whereas the treatment above mentioned would
relieve the symptoms and assist nature.
Inflammation of the brain is always attended with danger; and
therefore in injuries of the scalp, or concussion of the brain, treat¬
ment should be early applied to cleanse the stomach, promote the
secretions, and sustain the equilibrium of the circulation, as the
surest means of preventing disorganization of the brain. Even
slight injuries of the scalp should not be neglected, as very small
wounds of the head have frequently been observed to occasion
dangerous symptoms, through neglect or exposure. Wherever
the scalp is the least torn or cut, it must be protected from the air,
otherwise erysipelatous inflammation may be the consequence.
Case. — W. B. S. received a severe blow upon the side of the
head from some machinery in an iron foundry, which left him
senseless a considerable length of time; the scalp was cut to the
bone, the wound being about two inches in length, and lacerated
at the edges. The wound was dressed with strips of adhesive
plaster, (the hair having been previously shaven from the edges of
the sore,) dry lint applied, and the head carefully bandaged. This
patient was placed under a course of Thomsonian treatment, the
vapor bath administered every day, and means used for promoting
perspiration, and also other secretions, such as composition, or
pepper tea, and warm bricks to the feet; and the bowels regulated
by the use of enemas. On removing the dressing from the head,
on the seventh or eighth day, I found the wound healed, by "first
intention," as it is termed, a circumstance rarely occurring in
wounds of this kind. A physician residing near the place where
this accident happened, was sent for immediately after the acci¬
dent, who observed to some of the patient's friends, that if he (the
patient) was not bled, his life would be endangered. The patient,
however, was neither bled nor purged; and although the shock
was very severe, he recovered without the occurrence of an unfa¬
vorable symptom.
Diet. — In all cases of severe injuries the diet should be light.
Gum Arabic mucilage, elm gruel, milk porridge, toast and tea,
custard, and oat meal and Indian gruel, form suitable articles of
diet when the digestive powers are in a prostrated condition. In
a later period, when the injured parts are secreting matter freely,
or the patient is free from any considerable degree of fever, the
398 WOUNDS PRODUCED BY SHARP INSTRUMENTS.
tongue moist, and the patient is disposed to perspiration, then q
more nourishing diet will be required, as chicken soup, beef steak
mutton, eggs, stale wheat bread, &c.
Tonics.—When an injured part or an abscess discharges matter
freely, and the system is in a relaxed condition, bitters must be
taken to strengthen digestion.
SECTION V.
WOUNDS PRODUCED BY SHARP INSTRUMENTS.
Simple cuts made by sharp instruments heal more readily than
any other kind of wound of the same extent.
In treating a simple wound, the first thing to be attended to is to
arrest the bleeding. If an artery be cut, the blood will be of a
bright red color, and come in jets; dark blood comes from veins.
When a blood-vessel is cut or torn, a gluey substance is secreted
by the coats of the injured vessel, which gradually plugs it up and
entirely stops the escape of blood. Arteries the size of a crow-
quill, though they may bleed rapidly at first, will soon become
plugged up by this admirable process of nature.
An intelligent person once related to me the following circum¬
stance, to prove that some persons possessed the power of stopping
the flow of blood without seeing the patient. A young man who
was cut badly continued to bleed profusely, until the family became
alarmed, and sent a messenger off post haste to a Dutchman, who
lived twenty miles distant, who it was thought possessed the
power to stop bleeding. On the messenger arriving at the resi¬
dence of the Dutch doctor, and making known his mission, he was
asked the name and age of the patient; on being informed in these
particulars, he told the messenger to go home now, that the bleed¬
ing would be stopped before he got back; and sure enough the
bleeding had ceased, because nature had been all this time filling
up the vessels, until they had finally become closed. The Dutch¬
man, however, received the credit of stopping the blood, and of
saving the young man's life.
Pressure. — Unless when a large artery be cut the bleeding
may be arrested in a short time by pressing upon the parts with
a sponge, or a compress of folded linen or muslin.
Position. — Bleeding from a cut upon the extremity of a limb,
WOUNDS PRODUCED BY SHARP INSTRUMENTS. 399
may be partly arrested by holding the limb above the level of the
body; aided by pressure upon the part.
Dr. Bellvil, who was a very eccentric, but most distinguished
physician, of Trenton, N. J., was sent for in great haste to assist
another doctor to take up an artery that was bleeding. The mes¬
senger informed the Dr. that the cut was in the ball of the thumb,
and that the doctor who was there had been searching two hours
for the artery, without being able to find it. The doctor was sur¬
prised that a physician should be probing the parts, and keeping
the blood running, by searching for an artery in a part where the
vessel would soon stop bleeding if bound up and left alone, refused
to attend the summons, and told the messenger to go home and
bind up the wound, and cut the doctor's head off.
Cleansing the Parts.—After the bleeding is stopped, or so nearly
so as to admit^of the wound being dressed, the parts should be
cleared of all extraneous substances, and the clotted blood re¬
moved from the surface and edges of the wound.
Placing the injured parts in their proper position is the next
step, and this is one of some importance. In a simple, straight
incision, there is seldom any difficulty in keeping the sides of the
wound in a proper position, unless when the wound is extensive,
and cut across a muscle, — for when a muscle is cut across, the
contraction of the muscular fibres will separate the sides of the
wound, and break up the new adhesions as they are formed by
the healing process.
When a portion of flesh is badly cut, stitches may be required;
the stitches should be made with a fine sewing needle, threaded
with cotton or silk, and should not penetrate beneath the skin.
Adhesive Plaster.—Never cover the whole of a wound with ad¬
hesive plaster, but put it on in strips, leaving sufficient interspaces
to allow the escape of blood and serum from the wound. Lint is
to be applied over the strips, and the part propei'ly bound up.
Bandaging a Limb. — In cases where muscles are cut across,
for instance, a deep cut across the calf of the leg, or across the
thigh, or the fleshy part of the arm, the limb should be bandaged
from its extremity up to the next joint above the injury. Thus if
on the calf of the leg, the limb should be properly bandaged up to
the knee, and kept in a flexed position, and all motion cf the limb
avoided until complete union has taken place.
Evaporating Lotions. — When a wound becomes hoi and pain¬
ful, evaporating lotions, alcohol, or camphor and water, must be
applied, or the dressings wet occasionally with cold water; still
400
LACERATED WOUNDS.
the dressing must not be removed, except so far as to loosen it if
it becomes too tight. A bandage should always be wet before it
is applied, otherwise it will shrink and become too tight.
In large wounds, stitches are generally preferable to adhesive
plaster alone, for the parts require the application of evaporating
lotions, which will render adhesive plaster of but little use.
Where, however, the sides of the wound can be kept in perfect
apposition by bandaging, both the adhesive plaster and stitches
may be dispensed with.
Removing the dressing too soon, may very materially retard the
cure; this should therefore be avoided until two or three days
have elapsed after the occurrence of the injury, unless it becomes
painful or offensive, from the putrefaction of the blood and secre¬
tions confined under the dressing.
#•
Constitutional Treatment.—A simple cut seldom requires consti¬
tutional ^treatment; still slight wounds are sometimes observed to
become converted into very troublesome sores through neglect,
and exposure to cold and dampness. In large cuts, constitutional
treatment will be necessary when the patient is in bad health, or
the wound becomes very painful, or assumes an unhealthy appear¬
ance. The constitutional treatment indicated will not differ from
that already recommended in injuries of the scalp. A single
course of medicine will sometimes cause a wound that presents an
unhealthy appearance to become greatly improved in its general
aspect in the course of a few hours.
SECTION VI.
LACERATED WOUNDS.
Lacerated wounds are those made by rough instruments, which
tear the fibres of the flesh.
Lacerated wounds rarely bleed to any considerable extent;
even large arteries may be torn asunder without occasioning
much loss of blood.
Lacerated wounds are more difficult to heal than a smooth cut;
they seldom unite without the formation of pus. They are also
much more liable to be attended with unhealthy inflammation, and
constitutional disorder, than wounds made by a sharp and smooth-
edged instrument.
The Treatment, both local and constitutional, is the same as
PUNCTURED WOUNDS.
401
described in the preceding section for wounds produced by sharp
instruments, except that lacerated wounds demand more attention,
both in relation to evaporating lotions to the parts, and constitu¬
tional treatment.
Tincture of myrrh is probably the best application that can be
made to a fresh lacerated wound, as it tends effectually to prevent
putrefaction of the effused blood contained in the wound, and at
the same time it promotes the healing actions.
Even extensively lacerated wounds have healed by the first in¬
tention, by filling the wound with tincture of myrrh before dress¬
ing it.
The warm or cold water dressing is to be applied, except when
the injury requires the use of adhesive straps, or is so situated that
the wet dressings cannot be applied. In cases of extensive wounds,
more especially when on the hands or feet, where the circulation
is feebly performed, attention must be paid to keeping the wet
dressings from becoming cold. This is to be prevented by wrap¬
ping several thicknesses of dry flannel over the wet dressing, and
if this be not sufficient, apply oiled silk over the dressing, and the
dry flannel over it.
SECTION VII.
PUNCTURED WOUNDS.
Wounds made by pointed instruments, — dirks, hooks, scissors,,
Tails, &c., are much more liable to be followed by serious conse¬
quences, than cuts made by sharp-edged instruments.
Punctured wounds in tendonous parts, as the palm of the hand
and ball of the foot, are far more dangerous that when they
happen in fleshy parts. The mere wounding or puncturing a
nerve, is much more likely to produce serious consequences, than
when even many nerves are completely divided.
Punctured wounds in the palm of the hand, or in the bottom of
the foot, are apt to close up without the occurrence of adhesive
inflammation, or the discharge of matter. Such wounds, if a
nerve happens to have been punctured, are followed frequently by
much constitutional disorder, and sometimes by locked-jaw.
Treatment. — In punctured wounds, means should be employed
to excite adhesive inflammation, by pouring in the wound No. 6,.
or spirits of turpentine, and then applying a stimulating poultice
to the part. The poultice should contain a portion of cayenne
pepper, so as to attract blood to the part, and establish adhesive
26
402
WOUNDS OP JOINTS.
inflammation and suppuration. It is the deficiency of blood in
tendonous parts, as in the palm of the hand and sole ot the foot,
that occasions punctured wounds in these parts to close without
the occurrence of inflammation, or the formation of pus.
If the hand or foot be pierced by a rusty nail, the wound should
be cleaned out by a probe, or syringe with soap suds, or simple
warm water, and then pour into the wound No. 6, or spirits of
turpentine, and apply the stimulating poultice.
If the stimulating poultice, after continuing on several hours,
should become painful, causing an unnecessary afflux of blood to
the parts, it may be removed and one less stimulating applied.
Constitutional Treatment is highly necessary in cases of severe
punctured wounds, more especially if the wound be about a large
joint, or in the palm of the hand, or ball of the foot. A course of
medicine should be first given, after which the patient should take
•sufficient of composition, pepper tea, or other stimulants, to pro¬
mote a healthy action throughout the system; and broken doses
•of lobelia, to promote the secretions, which is highly important
as a preventive to locked-jaw, or other unfavorable effects from
wounds.
Exposure to cold and dampness, and excesses of every kind,
should be avoided by those who have received a punctured wound.
To remove points of Needles.— Points of needles are sometimes
broken off in the flesh, and particularly in the hands and feet; and
when there is any difficulty in finding a needle point, the best
way is to apply a warm poultice, and keep the part at rest a few
days, or until matter is formed around the needle; and then if it
is not very deeply imbedded, a black speck will be seen, and by
cutting down to it, the needle point can be easily removed by a
pair of small forceps or tweezers.
i
SECTION VIII.
WOUNDS OF JOINTS.
A wound of a large joint, for instance, of the knee, where the
cavity of the joint is cut into so as to allow of the admission of
air, and the escape of the joint-water, is an accident of the most
serious character. When such a wound occurs in an aged per¬
son, or in one of an unhealthy constitution, the patient very rarely
recovers the use ol the joint, and it not unfrequently terminates
WOUNDS OF JOINTS.
403
fatally. Young persons, of vigorous constitution, may in general
recover from such injuries; still there is great danger attending
wounds of the large joints.
Treatment.—In wounds of a joint, the first and by far the most
important point in the treatment, is the closing of the wound im¬
mediately, in order to exclude the air from the cavity of the joint.
When air is admitted into the cavity of a joint, it operates as a
powerfully deleterious agent upon the cerous membrane lining the
cavity of the joint, and requires a high degree of inflammatory
action and much constitutional energy to repair the injury. Dry
dressing must be put on, and as soon as the parts are well secured
from the air, the limb, if it be the knee joint, must be bandaged*
commencing at the foot and carrying it up to the knee; the wound
should be covered with lint, and the knee well bandaged. The
object of applying a dry dressing is to favor the healing of the
parts without the formation of matter, and of excluding the air
from the joint. A poultice must never be applied where joints are
cut into, until after the lapse of several days, and the parts exhibit
marks of suppuration, or the formation of matter—then it will be
proper to apply either a poultice or the warm water dressing.
When the joint is dressed, a splint must be applied, in order to
prevent the possibility of motion in the parts; for if motion be
allowed in the joint, the new adhesions will be broken up, and a
union by the first intention thereby prevented. As the parts swell,
the dressing must be loosened.
Constitutional Treatment must be early applied, unless the sys¬
tem be comparatively clear of disorder. Injuries of large joints,
however, are necessarily attended with much constitutional dis¬
order, and more especially if the wound does not heal without
suppuration occurring. The bowels are to be regulated by the
use of injections; the secretions promoted by giving stimulants,
such as capsicum, composition, or simple herb teas; and when
there is fever, give small doses of lobelia in combination with the
stimulants.
The diet must be light at first, avoiding every thing that is ui>
wholesome, or hard of digestion.
If the wound suppurate, tonics must be given, unless the tongue
be dry and the patient feverish, and even under these circum¬
stances the spice bitters may be used. Wounds of the large joints
require great exertion on the part of the constitution to repair the
injury, creating the necessity for all the support that can be
afforded by stimulants, tonics, and a nutritious diet.
404
BURNS AND SCALDS.
SECTION IX.
BURNS AND SCALDS.
In the treatment of scalds and burns, this one point should
always be considered, namely, to secure the part from the action
of the atmosphere.
For slight burns and scalds, when the skin is not destroyed, the
best application is cold water, either holding the part in a basin of
cold water, or applying linen or muslin cloths or carded cotton on
the parts, kept wet with cold water, or whiskey-and water. This
is to be continued until the smarting ceases; then cover the parts
with an ointment prepared of sweet oil and lime water, or a salve
made by melting together beeswax and mutton suet, or sweet lard,
or bind dry cotton on, or cover the parts with oiled silk.
When blisters are formed, the best way to open them is to pierce
them in several places with a needle, and then cover the parts with
a thick layer of carded cotton, or soft muslin cloths, kept damp
with alcohol and water, or whiskey and water, and this continued
until the parts cease to be painful; or apply either the salve oi
ointment above mentioned.
Avoid, removing the dressing until several hours, or even a day
or more, has elapsed. Removing the dressing too soon, breaks
the tender skin that nature forms on the surface of the burn, and
thus greatly retards the cure. Whatever dressing be applied to a
burn, which is found to relieve the pain, whether it be dry cotton,
cloths wet with evaporating lotions, sweet oil and lime water; or
a poultice of scraped potatoes or carrots, or flour and water, it
should be allowed to remain on at least for several hours, or even
much longer, unless there be a necessity for its being removed.
When the outer skin is removed at the time of a burn or scald.
I mean the skin that raises up where a blister is formed, the parts
should be covered as speedily as possible with an ointment of lime
watei and oil, simple cerate, or some other mild ointment or salve.
Whilst the ointment or salve is being prepared, the part should be
covered with sweet oil, or lamp oil, or sweet lard, or flour and
water, or with something to exclude the air. Wet cloths should
also be applied, provided it does not chill the patient. The oint¬
ment must be spread on linen or muslin, and when applied, cloths
or cotton may be laid on this dressing, kept damp or wet with
cold water, or whiskey and water, to relieve the pain. The under
dressing must not be removed for two or three days; indeed, it is
oetter to let the first dressing remain on until a new skin be formed
BURNS AND SCALDS.
405
on the burned parts, unless the dressing disagree with the sore,
and occasion pain.
When a part is seared, so as to destroy the skin, from live coals
or a red-hot iron, a poultice or plaster must be applied ; for when
the under layer or true skin is disorganized, suppuration will take
place, and instead of a new skin being formed, as there will be,
when only the outer layer of the skin is removed, the parts will
heal by drawing together, and thus form a scar or seam in the
skin. The poultice recommended by Dr. Thomson, which con¬
sists of a compound of slippery elm, white pond lily root, cracker,
and a small portion of ginger, all finely pulverized and wet with a
strong tea made of raspberry leaves, form as good a preparation
probably as can be devised. The poultice will require to be wet
occasionally; and when the parts are suppurating freely, a fresh
one must be applied daily, until the suppuration is completed, when
a salve must be applied to shield the parts from the air, until they
are healed. When granulations shoot up, forming what is termed
proud flesh, they should be covered with burned alum, or finely
powdered marsh rosemary, at each time the dressing is removed.
When there is but little discharge of matter, and in some cases
when there is a free discharge of pus, some simple salve will be
better than a poultice.
Constitutional Treatment. — Severe burns or scalds generally
occasion great prostration of the powers of life, manifested by
chilliness, coldness of the surface, extreme prostration of strength,
a weak pulse, and sometimes stupor or delirium. Under these
circumstances, stimulants and emetics must be given. If an indi¬
vidual receive a severe burn or scald goon after taking a hearty
meal, the food will not be digested, and if not thrown off by vomit¬
ing, it will oppress the vital powers. It is always safe, and gene¬
rally highly necessary, to give an emetic after a severe burn or
scald.
Stimulants. — Stimulants, such as here recommended, given in¬
ternally, will not aggravate a burn or scald on the surface. By
giving stimulants, we aid the constitution in maintaining; the
natural equilibrium of nervous power between the great centres
of the system and the surface of the body, which is an important
point, in the treatment of all forms of disease, whether general or
local. The stimulants to be employed, are capsicum, composition,
or ginger tea. These stimulants may be given at all times; and
when there is fever, broken doses of lobelia should be added to
them, or taken separately; and if the skin be very hot and dry,
bathe it with vinegar and water, or spirits and water, to reduce its
temperature down to the sweating point.
406
BURNS AND SCALDS.
Vapor Bath. — There is no objection to the use of the vapor or
hot air bath in cases of scalds and burns, the parts being kept
covered by a wet dressing during the steaming. When the
patient remains in a torpid or sunken condition, or the burn or
scald becomes very painful after the lapse of a day or two, or at
any subsequent period after the first pain from the injury has sub¬
sided, the vapor bath will prove especially beneficial, not only in
relieving the pain in the parts, but it will aid the healing efforts
of the constitution. I recently attended an old lady who had her
foot badly scalded, and not being treated properly in the first
place — the dressing being frequently removed, the lymph which
was thrown out by the raw surface, designed to form a new skin, *
was taken off by the frequent changing of the dressings, and the
scalded surface assumed an unhealthy appearance; the foot was
extremely painful, which continued for weeks with but little inter¬
mission, except when the parts were wrapt in wet cloths, and cold
water applied. All the applications that were made to the foot,
failed of exciting the healing power, or to make any favorable
change in the part, until the vapor bath was resorted to; the foot
was steamed from a half to three quarters of an hour at a time
without any dressing on, and this repeated daily, until a new skin
was formed over the foot. This patient experienced more benefit
from a general steaming than when it was merely applied to the
foot.
To prevent Deformity.—Great deformities are apt to take place
after severe burns, when the true skin is destroyed. If, for in¬
stance, the palm of the hand and between the fingers be badly
burned, the natural tendency in the parts will be to contract: the
hand to be clenched and the fingers to unite together. This is to
be prevented by binding a splint on the back of the hand, the
splint being sawed at the extremity, so as to furnish a'separate
splint for each finger. The parts must be first dressed, and then
the splint applied. Especial care must be observed to interpose
dressing between the fingers, to prevent their uniting together. I
once witnessed a very painful and bloody operation on a man,
whose arm had grown fast to his side, in consequence of a severe
burn, the proper care not having# been taken to prevent the burned
surfaces from coming together when healing. Severe burns on
the neck are almost necessarily followed by more or less deformity.
I have seen cases where the chin was drawn down to the collar
bone, the patients being unable to raise the chin from the breast.
A severe burn on the inside of the arm at the elbow, would, whilst
healing, naturally tend to bend the arm; and if allowed to heal
in this position, the patient will be unable to straighten the arm.
This deformity is to be prevented by applying a splint to the back
of the arm, so as to keep the limb straight.
CHILBLAINS. TREATMENT OP FROZEN LIMBS- 407
SECTION X.
CHILBLAINS.
Chilblains are most liable to occur on the heel, the toes, and
sides of the foot. The parts affected are somewhat swollen, red,
and at particular seasons of the year, or on warming the feet by
the fire, they itch very much and are sometimes painful.
Causes. — Chilblains are produced by severe coldness in a part,
and being too suddenly warmed by the fire.
Preventive Measures. — When the feet or hands are benumbed
by cold, and great pain is occasioned as they begin to warm, they
should be placed in cold water, and kept there until the parts
cease to be painful, when they are removed from the cold water;
or the parts may be bathed or rubbed with alcohol, whiskey, opo¬
deldoc, or spirits of camphor, and kept away from the fire, or
from a warm room, as long as there is pain experienced.
Treatment. — Chilblains, unless properly treated, may continue
to be occasionally swollen, and prove a source of great annoyance
for years, unless proper means be taken to overcome the debility
of the vessels of the parts. A very good plan of treating chilblains
is to bind on the parts a poultice composed of wheat bran, soft
soap, and fine salt; the poultice to be continued on an hour or
two at a time, and then the parts to be bound up with oiled silk,
and not allowed to be near the fire. Th'e oiled silk to remain on
several days. Another plan of treatment is to rub the parts with
oil of turpentine, and then rub on stimulating ointment on a piece
of bladder, or silk oil-cloth, and bind it on the parts. This appli¬
cation to be repeated every night, until the parts are restored to
their natural condition.
SECTION XI.
TREATMENT OF FROZEN LIMBS.
When a part is benumbed or frozen, the most important part
of the treatment is to regulate the temperature around the frozen
part, carefully guarding against warmth until the vessels recover
408
TREATMENT OF FROZEN IiIMBS.
sufficient strength to carry on the circulation. A frozen part
should never be thawed by the application of external warmth, or
it will be followed by violent inflammation, if not by mortification.
It would seem that the application of warmth to a frozen part,
destroys the natural equilibrium of nervous energy between the
great centres of the system and the surface of the body. In such
cases, the blood which is attracted to the surface by the warmth
is not circulated or returned back, as it should be, a tendency to
putrefaction or disorganization occurs, attended with violent in¬
flammation, followed perhaps by mortification.
A part that is frozen must be kept in cold water, even adding
snow or ice to it, and this continued until the parts are com¬
pletely thawed, and then the temperature around the part should
be increased very gradually, not allowing a sudden change from
cold to warmth. Covering the frozen parts with snow, is a good
practice.
If a person, besides having his limbs frozen, should be greatly
benumbed and chilled throughout the body — nearly frozen to
death—he should not be taken into a warm room, but be laid in a
room without fire. It would be even better that the patient remain
in a bain, than to be placed in a temperature much above that of
the external air. I have heard a case related of a man frozen
severely and stiff, who was restored by being placed in a cask of
pickled cabbage, commonly called sour-crout.
Stimulants must be given to support the living powers. Cayenne
pepper, composition, ginger tea, carbonate. of ammonia, warm
brandy toddy, and No. 6, in warm water, may be employed as
stimulants; and wine-whey, essence of" beef, or chicken tea, may
be given as nourishment, until the powers of digestion are restored,
so that other kinds of food can be digested. Stimulating injec¬
tions will aid in restoring animation.
When a part of a limb is frozen, without the body being very
much benumbed with cold, the patient may remain in a comfort¬
ably warm room, observing the precaution to keep the frozen part
in cold water, or enveloped in snow, until it be thawed ; and then
the parts may be wrapt in cloths kept damp with whiskey, alcohol,
spirits of camphor, or vinegar. A most important point in the
treatment of frozen parts, is to "keep down the outward heat" of
the injured parts, or a stagnation of the blood in the parts will be
the consequence. When, through improper management in the
first place, or from other causes, a part that has been frozen be¬
comes inflamed, threatening mortification, a poultice must be
applied, composed of elm, white pond lily, cracker and ginger;
the poultice to be kept wet with cold water, and the limb elevated.
The yeast poultice mentioned in the materia medica may be em-
iployed. The patient should also be placed under active constitu-
BILES.
409
tional treatment, in order to aid the efforts of nature. A full course
of medicine should be administered, and frequently repeated, in all
cases where mortification is threatened, and stimulants given
freely, to excite the secretions, and increase the power of action
in the enfeebled vessels, thus lessening the tendency to congestion
of blood in the parts. It is common in the old practice to pre¬
scribe bark and wine in cases of mortification; such remedies,
however, when the secretions are suspended, the tongue being dry
and the skin dry and harsh, will necessarily prove injurious. But
if a patient, in the condition above described, be carried through
a course of medicine, and followed by a free use of cayenne or
composition tea, adding small doses of lobelia, the symptoms will
generally assume a more favorable aspect, and certainly never be
aggravated by it.
Tonics. — There is a condition of the system when barks and
wine will prove of great benefit in cases of mortification, or in
cases of recovery from the effects of freezing. When the tongue
is cleaning and moist, and the surfaces of the body inclined to
moisture, tonics may be given freely. Peruvian bark, quassia,
columbo root, Virginia snake root, balmony, golden seal, quinine,
poplar bark, or spice bitters, may be employed either separately
or combined.
Diet.—The diet in mortification should be of the most nourish¬
ing kind, provided the digestive powers be not too far prostrated.
When the tongue is dry and parched, and the patient feverish,
gum Arabic or slippery elm mucilage, essence of beef, barley-
water, &c., will be the most suitable. But when the tongue is
moist and cleaning, the skin warm and relaxed, the patient may
take eggs, beef-steak, mutton, chicken, wild game, custards, milk
boiled, milk porridge, &c. In some cases of extreme debility,
wine-whey and even wine may be given. No. 6, taken in warm
water sweetened, is an excellent tonic and stimulant.
SECTION XII.
BILES.
Treatment. — In the earlier stages of biles, warm fomentations
and poultices are required to soften and relax the parts, and to
favor suppuration. The poultice should consist of powdered slip¬
pery elm, two parts, and green obelia powder, one part. To be
410
carbuncle.
wet with warm water; renewing or wetting the poultice ever}
three or four hours.
The core of a bile consists of dead cellular tissue, and inflam¬
mation is necessary to bring on suppuration or the absorption of
he parts surrounding the dead cellular tissue, in order to separate
t from the living parts. It is therefore better to avoid opening a
Dile too soon, as that may interfere with the operations of nature,
ind retard rather than hasten the cure. There is a time, how¬
ever, when a bile should be opened, and not allowed to break
spontaneously, or it may destroy so much of the skin as to leave
a large scar.
After a bile has broken, or has been opened, the poulticing must
be continued until suppuration has nearly ceased, and the swelling
and inflammation subsided. In all running sores, it is better to
have a poultice spread on oiled silk, or something that will pre¬
vent evaporation. As a general rule, poultices should be made
more stimulating after an abscess or bile is opened than before,
and if the parts be much relaxed and colder than natural, equal
portions of composition powder and slippery elm will form a very
good poultice.
Washing or syringing the cavity of biles that are slow to heal
with a strong tea of bayberry or sumac, adding a portion of
No. 6, is very useful; it promotes granulation and assists the
healing action.
When the matter is discharged, and the swelling in a great de¬
gree disappeared, poultices may be laid aside and salve spread on
soft muslin or linen substituted, and wash the sore occasionally
with the tea above mentioned.
Constitutional Treatment is not required in common cases of
biles, except it may be to lessen pain by relaxing the system, or
with a view to prevent other biles. Biles very often occur after
scarlet fever, measles and small-pox.
SECTION XIIL
CARBUNCLE.
The carbuncle never occurs in a healthy constitution. It may
arise from the same cause that produces biles; but instead of
healthy inflammation observed in case of a bile, terminating in
the formation of what is called healthy or laudable pus, the in¬
flammation in carbuncle is of an unhealthy character, and attended
with a burning pain in the part. The swelling does not assume
CARBUNCLE.
411
the conical shape of a uile, but is flat, and the colour is of a dark
red or livid hue. " The core or slough being broad, it generally
happens that several orifices are formed over it to discharge the
•natter, instead of one; and a long and tedious period of ulcera¬
tion has to be endured, before the parts can granulate." At first,
the tumor is hard, but in general it becomes soft and feels spongy,
and small vesicles or belbes are formed on the skin, as in ery¬
sipelas, and an acrid fluid is discharged from numerous openings
or small ulcers on the parts. The fluid which escapes, resembles
a mixture of flour and water; the small ulcers run together, and
form openings sufficient to allow portions of the dead cellular
tissue to escape, resembling shreds of tow or cotton.
The cheek, neck, and back, are the parts most liable to car¬
buncle.
Carbuncle is not in general dangerous, yet it is slow in its pro¬
gress, and difficult of cure.
Treatment.—The local treatment, in the first place, should con¬
sist of warm fomentations, stimulating and astringent poultices,
and the application of stimulating lotions to the surface, when the
dressings are changed. Experienced surgeons advise the opening
the carbuncle, by making a deep incision entirely across the
tumor, and applying a poultice made of port wine and ground
flax-seed. A poultice of composition and elm, or of yeast and
ginger, may be used in the place of the port wine poultice.
Syringing the cavity with strong bay berry tea, and then pouring
in a portion of No. 6, will be of especial benefit in exciting a more
healthy action in the parts. Local steamings will also aid the
living parts to cast off* the dead cellular tissue.
Constitutional Treatment will be required in all cases of car¬
buncle, employing means to correct the diseased condition of the
general health, and to strengthen and support the constitution.
In the first place, the patient must be carried through a full course
of medicine every few days, and during the intervals use freely
of composition, pepper or spice bitters. As the constitutional
symptoms wear a more favorable aspect, cleaning of the tongue,
a general warmth through the body, with a moist skin, then
tonics, such as bark and wine, quinine, gentian, columbo, and Vir¬
ginia snake-root, must be given freely, and the patient allowed a
nourishing diet,—eggs, milk porridge, custards, beef steak, mutton
chops, boiled chicken, wild game, stale bread, cream toast, &c.
Fresh Air. — When the state of the weather and the condition
of the patient will admit of it, he should ride or walk out, to
receive the benefit of fresh air and exercise, observing especial
care, however, to keep warm.
412 ABSCESS OF TIIE FEMALE BREAST.
SECTION XIV.
ABSCESS OF THE FEMALE BREAST.
Gathered breast, as it is commonly termed, is most liable to
take place during confinement, after childbirth. It is generally
caused by too great an accumulation of milk, exposure to cold, or
from sore nipples. The frequent exposure of the breast to the air,
more especially when the skin is covered with perspiration, is a
common cause of gathered breast.
Treatment. — As soon as the breast begins to feel hard or pain¬
ful, from too great a flow of milk, it should be drawn and bathed
frequently with some evaporating lotion, whiskey, brandy, warm
vinegar or spirits of camphor and water, or cloths applied, and
kept moist with some one of the above articles. Dr. Dewees
recommends the application of cloths wet with w&rm vinegar, as
being the most effectual means of relief in the early stage of
swelled breast. Bathing the breast with the oil of pennyroyal,
has proved highly beneficial in some cases. The desired object
to be attained by the above application, is the lessening the secre¬
tion of milk by evaporation. But if the breast cakes and becomes
painful, and cannot be eased by the means above mentioned, toge¬
ther with frequently drawing the breast, it should be steamed, and
covered with a plaster or poultice, to keep the skin soft and moist,
A hole must be cut in the centre of the plaster to admit the nipple.
When a lump is formed in the breast, from taking cold in the part
or from irritation of the nipple, steaming the breast frequently and
applying a plaster of salve, or a poultice composed of equal parts
of green lobelia and elm, if early applied, will generally prevent
suppuration, easing the pain and scattering the swelling.
If the system be much disordered, an emetic or a course of
medicine will prove beneficial in removing obstructions in the
breast, and lessening the pain. Placing the patient under the in¬
fluence of lobelia, given in broken doses so as to occasion slight
nausea, will also be useful in moderating pain in the breast; and
by the relaxation thus produced, will aid in removing the ob¬
structions.
If the use of the above means fail of discussing the swelling,
and the breast continues to be very painful and throbbing, warm
poultices must be applied, with a view to favor suppuration and
to bring the matter as speedily as possible to the surface. When
suppuration is about to take place, there is usually a severe throb¬
bing pain in the part, and the patient experiences chilliness, and
WHITLOW OR FELON. 413
a blush appears on me skin covering the swelling; which is an
evidence of the existence of pus, or matter.
It is better to delay opening a gathered breast until the matter
approaches near the surface. After the abscess is opened or breaks
spontaneously, a poultice composed of composition and elm or
flax-seed, or of elm, white pond lily, and ginger, must be applied,
and the poulticing continued until the discharge of' matter has
nearly ceased, when the parts may be covered with some kind
of salve, and moderate pressure applied to favor the union of the
sides of the cavity.
SECTION XV.
WHITLOW OR FELON.
Whitlow or felon is an extremely painful swelling, mostly con¬
fined to the fingers, and particularly to the middle or last joint,
Sometimes it is seated under the nail.
This painful affection often becomes protracted in duration, in
consequence of pus or matter being formed beneath the tendons,
or under the membrane that covers the bone, requiring a tedious
and painful process of suppuration to bring the pus to the surface.
Causes. — Felon or whitlow is sometimes caused by a bruise;
in other instances, it is occasioned by a slight wound on the skin:
even the scratch of a pin, if frequently irritated or not protected
from the air, may affect the parts near the bone, and produce a
felon. Occasionally it comes on without any appreciable cause.
Treatment. — In the outset of a felon, wrapping the finger in
cotton, kept wet with spirits of camphor, alcohol, or vinegar, will
sometimes prevent the formation of matter. And even though it
should fail of preventing suppuration, it will mitigate the pain. A
plaster composed of lime and soft soap, is a favorite remedy with
some for whitlow or felon.
If the swelling continue to increase, attended with severe throb¬
bing pain, the above or some other form of poultice must be kept
*on the parts, wetting it occasionally as it becomes too dry; and
when there is evidence of the existence of matter in the part, it
should be opened either with a lancet, or in the way Dr. Thomson
recommends, which is, to burn pieces of spunk, about the size of
a large pea, on the part, until the flesh becomes deadened down to
the matter, and then to open it. When this method is employed,
414
WHITLOW Oil FELON.
the hand and the diseased finger, except the part on which the
spunk is to be burned, should be held in cold water during the
operation. A pair of forceps, or tweezers, may be used in setting
fire to the spunk, and placing it on the finger. Dr. Thomson does
not advise burning spunk upon the part, until there is a purple
appearance in the part, indicating the approach of matter towards
the skin.
Another plan recommended by Dr. Thomson to facilitate the
approach of the matter to the surface, is to slack a small piece of
lime on the finger. In doing this, the hand should be placed on
wet cloths, and a small roll of wet cloths placed at each side of
the finger, to prevent the lime from falling oft'. A piece of un-
slacked lime, about the size of a shellbark nut, is to be laid on,
then wet, and allowed to remain as long as the patient can bear
it, or until it becomes cold. This may be repeated, occasionally,
until there is some appearance of matter, when an opening should
be made.
Before an opening be made, any kind of emollient poultice ma v
be applied to favor suppuration; but after pus begins to be dis¬
charged, a stimulating poultice must be employed. Equal por¬
tions of slippery elm, white pond lily, and ginger, form a suitable
compound for the poultice. Indian mush, flax-seed stewed in
milk, or any other soft substance, may be employed, adding a por¬
tion of cayenne pepper, or ginger.
When the swelling and inflammation has in a great degree dis¬
appeared, poulticing may be omitted, and salve applied.
When matter is discovered under the nail, a portion of the nail
must be cut away, to allow the pus to escape.
When an opening is mode by a lancet in the earlier stages of
a felon, the matter being deeply seated, care must be observed to
avoid cutting open a joint. A lancet may be safely introduced
down to the bone, except immediately at the joint.
Constitutional Treatment. — The pain attending a whitlow, or
felon," may be mitigated by using means to excite perspiration,
and by placing the system under the influence of lobelia, given in
broken doses, to the extent of producing slight nausea.
If the system be much disordered, an emetic, or a full course
of medicine, will be especially beneficial. Patients may some¬
times procure sleep by having the hand raised upon pillows, and
taking tincture or syrup of lobelia in sufficient quantities to cause
slight sickness.
HIP DISEASE.
415
SECTION XVI.
HIP DISEASE.
Disease of the hip joint is of very common occurrence; an<.
although it prevails most among children, still the disease not un
frequently attacks adult persons.
Causes.— Although the hip disease be occasioned in many in¬
stances by a fall, yet it rarely happens, even from severe bruises,
in persons of sound and vigorous constitution. A bruise upon the
hip that occasions scarcely any inconvenience to one of a healthy
constitution, would be liable to cause the hip disease in one of
feeble organization, or who has inherited the scrofulous diathesis.
Symptoms.—In the majority of instances of hip disease, the first
thing of which a patient complains, is a pain in the knee. The
pain is, in some cases, slight at first, in other instances it is severe
from the commencement, preventing the patient from sleeping at
night, except at short intervals. The patient is observed to limp,
and the knee becomes bent. As the disease advances, the patient
complains of severe pain about the hip, or groin, yet in some cases
the pain is almost exclusively confined to the knee during the
whole progress of the disease.
Duration of the Disease.—The hip disease is usually slow in its
progress, seldom terminating its course in less than a year. Occa¬
sionally, under favorable circumstances, and a proper course of
treatment, the diseased parts resume a healthy condition in the
course of a few months, or even in two or three weeks; but, un¬
fortunately, in the great majority of cases, the disease continues
for years, though seldom attended with severe pain, except at
intervals, and more especially in the early stage, and when sup¬
puration is about to take place.
Termination.—Few patients recover from the hip disease, with¬
out more or less distortion of the limb of the affected side. Some¬
times the inflammation of the joint terminates in resolution; still
this is of very rare occurrence, for the parts possess so low a
degree of vitality, that the restorative efforts of nature are insuffi
cient to prevent disorganization of the diseased parts in unhealthy
constitutions. A part of the body that is well supplied with red
blood, will recover from disease much more readily than parts
which receive but a small supply of arterial blood. Hence the
416
HIP DISEASE.
(issues about the joints receiving very little red blood are slow to
recover from disease; most commonly, the inflammation termi¬
nates in suppuration about the joint, "the matter taking different
directions, sometimes pointing to the surface in the region of the
joint; in other instances, the matter travels down into the groin,
forming a fluctuating tumor; or it may pass down the thigh,
sometimes almost to the knee. In most instances, the parts finally
heal, but the joint remains stiff, and the limb shortened. The head
of the thigh bone is sometimes entirely destroyed, leaving the limb
several inches shorter than the sound one. In very feeble consti¬
tutions, the disease sometimes terminates fatally, the powers of
the constitution being worn out by disease.
Treatment of Hip Disease in its early stage. — In the outset of
this disease, the means chiefly to be relied upon, are the vapor
bath, rest, stimulating applications, wet dressings, covered with
oiled silk; occasionally an emetic; broken doses of lobelia, and
warm teas to promote perspiration.
The Vapor Bath may be administered daily during the early
period of the disease. When the patient has been steamed twenty
minutes or half an hour, he may be showered with moderately
cold water, rubbed dry, and bathed with vinegar or spirits. After
the bath, the hip must be bathed with a volatile stimulant; the
third preparation of lobelia, tincture of capsicum, oil of penny¬
royal, or granville lotions; or with salve, to which a portion ot
pepper has been added. The parts should then be covered with
a wet dressing, and over this apply oiled silk, to promote perspira¬
tion and keep the parts warm.
Rest is very important in the early period of the disease. A
splint, carved or moulded to fit the limb in a straight position, or
nearly so, may be applied with benefit in the early stage of the
disease. It will not only favor the cure by keeping the joint at
rest, but may prevent deformity of the limb, provided the disease
terminate without the occurrence of suppuration. After the dis¬
ease becomes permanently fixed, then to confine the patient with
a splint will be useless, or even injurious; he should be allowed
to use crutches, and, when the weather will permit, to have the
benefit of the open air.
Emetics must be given whenever the condition of the patient
demands their employment. It is in the early period of the dis¬
ease, however, that they are more particularly beneficial. The
proper time for giving an emetic, is shortly after a vapor bath has
been administered. If the patient be very feeble and pale, the
emetic of lobelia should be combined with stimulants, as compo-
HIP DISEASE.
417
sition, pepper and bayDerry, or with No. 6 and bayberry. There '
is no period of the disease when an emetic will not prove of benefit,
if the stomach be foul, or when the patient is suffering severe pain.
•
In a more advanced period of the hip disease, it will be useless,
as before mentioned, to keep the parts at perfect rest, or to confine
the patient by the use of a splint. Neither will it be necessary to
give much medicine, except occasionally, as the condition of the
patient demands it. Cleanliness, fresh air, nourishing diet, sail
water bath, or sponging the body with salt water, and friction of
the surface, are chiefly to be relied upon when the disease has be¬
come permanently fixed. When the parts are painful, however,
or the general health disordered, medicine must be employed.
When suppuration takes place, an abscess may be formed at the
hip, or the pus may pass down into the thigh, forming a fluctuating
tumor there. All experienced surgeons now agree that abscesses
about the hip should not be opened until at a late period, or when
the matter comes so near the surface as to threaten the destruction
of a considerable portion of the skin, when it is better to make a
small opening with a sharp lancet, drawing off only a part of the
matter at a time, and then closing the opening with a piece of
adhesive plaster.
Abscesses in the thigh often contain from half a pint to a quart
of pus, which being secreted at the hip joint, passes down between
the muscles, and thus collects in the thigh. Where an abscess is^
formed in a part thus remote from the joint, it may be opened
with safety.
When pus is discharged, either spontaneously or by opening
the abscess, every means should be employed for sustaining the
patient's strength; and the use of tonics, nourishing food, exercise
in the open air, salt water bathing; a change of residence, for in¬
stance, from a city to the country, to the seaboard, or to a moun¬
tainous or pine country, should be resorted to.
Sick children are apt to be indulged in eating sweet cakes and
various kinds of dainties between meals, which impair digestion
and destroy the natural appetite. And although the patient may
have the gratification of eating a sweet cake, he loses not only
the enjoyment but the benefit of a meal. When patients who are'
recovering from sickness, and more especially children, require
food between meals, it should consist of such articles as milk por¬
ridge, toast and milk, crackers, stale bread, custards, or crusts Of
bread.
Pepper Poultice. — In the earlier stages of the hip disease, and
also after an abscess has formed, and where matter has been dis¬
charged, and the parts remain in a pale and flaccid condition, ai
27
418
WHITE SWELLING.
poultice, composed of equal portions of cayenne pepper and slip
pery elm powder, may be employed occasionally with decided
advantage.
Warm Fomentations. — In the earlier stage of hip disease, when
the parts are painful, besides administering vapor baths, bags of
hops, or of bitter herbs, wet with hot vinegar, may be applied to
the hip, and kept warm by hot bricks, or bottles of hot water.
Pressure. — Whenever the hip will bear pressure without occa¬
sioning pain, it must be applied, with a view to support the en¬
feebled and relaxed vessels. This may be done by a bandage of
flannel or of muslin, put around the hip. After pus has formed
and discharged, or the parts are still secreting matter, pressure
should always be applied, in a degree suited to the condition of
the parts.
Children who inherit scrofulous constitutions, are, in general,
'favored with superior intelligence, so that although they may be
physically weak, yet superiority of mental power enables them to
pursue professions which require intellectual rather than muscular
strength. It must be borne in mind, however, that children of
scrofulous constitution will not bear close confinement in crowded
school-rooms, without materially injuring their health. It is better,
in such a case, that their education be neglected in early life, and
that they receive the benefit of the open air, which will prove the
most effectual means of improving the constitutional health.
SECTION XVII.
WHITE SWELLING.
The knee joint is observed to be more frequently affected with
white swelling than any other of the joints. It seldom happens in
others than in those of feeble constitution, and more especially in
the scrofulous. The hip disease, so prevalent among children of
bad constitutions, is a disease of the same character as white
swelling. The hip disease prevails mostly in children under
twelve years of age; whereas, white swelling is most prevalent
in adults.
Causes.—The most frequently exciting cause of white swelling
lis exposure to cold. A. person of a sound constitution may beat
WHITE SWELLING. 419
an exposure to cold, without that inconvenience wnich would
occasion such a degree of debility in one of scrofulous constitution
as to cause white swelling.
When the vitality of a part is reduced below a certain point,
the constitution establishes inflammatory action, with the design
of sustaining the vitality of the part. Thus the membrane that
lines the cavity of the knee joint by the influence of cold, may be
so far deprived of its vitality, as to call upon the* constitution for
an increased supply of blood, in order to prevent the death of the
parts, and to repair the injury already sustained in the affected
parts. A new supply of blood is sent to the knee, an inflammatory
action is established, which, under favorable circumstances, may
terminate in resolution — the parts being restored to a healthy
action. Under circumstances less favorable, the inflammation
may terminate in adhesion—the joint being stiffened, but without
any destruction of the parts. Under circumstances still less
favorable, for instance, where the constitutional health is very
bad, or the vitality of the diseased parts reduced beyond the power
of reparation, then suppuration of the parts will take place, matter
will be discharged, and the disease necessarily become of long
continuance, and extremely painful. Portions of bone are de-
stroyed in many instances by the process of absorption.
Treatment.—The indications for the cure of white swelling, are
to correct and support the general health, and to employ such
local means as will aid in bringing the inflammatory action in the
diseased parts to a favorable termination — either in resolution, or
anchylosis (stiffening of the joint), or if suppuration occur to favor
the occurrence of adhesive inflammation and stiffening of the joint,
which will be the only " safeguard of the patient," after suppura¬
tion has taken place.
An occasional course of medicine should be administered in the
earlier stage of the disease, or at any period when the patient is
suffering severe pain.
Besides the course of medicine, the spice bitters should be taken
two or three times a day, and a dose of composition, or of bay-
berry and pepper, at night. These remedies, however, may be
given in a different form, to suit the fancy of the patient. Thus
the No. 3 pills will supply the place of the bayberry and pepper,
and when the tongue is dry, the compound lobelia pills will be
appropriate.
Injections, moderately stimulating and containing a portion of
lobelia, will be useful not only to assist the action of the bowels,
but by the influence which they exert over the circulation of the
lower extremities. An injection of composition tea, adding a
portion of lobelia powder, retained fifteen or twenty minutes, or
420
WHITE SWELLING.
allowed to remain in the bowels, will seldom fail of mitigating:
pain in the diseased limb, and it will also in many instances cause
free vomiting.
Tonics.—In a later period of the disease, and more particularly
where suppuration has taken place, and the parts are discharging
matter, bitters may be employed, with a view to strengthen the
digestive powers, so as to allow the patient to take nourishing
food, to support the constitution in her curative efforts. In the
earlier stages of the disease, composition, pepper, spice bitters, and
lobelia, are generally required; whereas, in its more advanced
stages, tonics, syrups, generous diet, fresh air, and gentle exercise,
are called for.
Local Treatment. — In the earlier stages of white swelling, and
all affections of this character, steaming and fomentations will be
found beneficial. The steam may be applied for half an hour, or
even an hour, at a time, and after this the stimulating liniment
may be applied to the parts, and then bind them up in oiled silk
or flannel. The limb must be kept warm, and at rest.
Bandages.—Even in the earlier stages of white swelling, mode¬
rate pressure will be beneficial, provided it can be applied without
occasioning too much pain. If the disease be in the knee joint,
the limb must be bandaged from the end of the foot to the knee,
first applying stimulating ointment, No. 6, or pepper sauce.
Dr. Thomson's Poultice for White Swelling.—Take fresh comfrey
root and scrape or grate it fine, until you obtain half a pint. To
this add the white of two or three eggs, well beaten, and a gill
of brandy, or sufficient to make it of a proper consistence for a
poultice; spread this and bind it on the affected parts as firmly as
can be borne, renewing it, or wetting it with brandy, as often as
it becomes dry.
When the parts suppurate, the disease becomes extremely pain¬
ful and protracted—in some cases, to several years' duration. In
severe cases, the constitution may become exhausted, the patient
sinking under the effects of the disease.
In treating this, and every other disease attended by inflamma¬
tion, it should be borne in mind that inflammation is not the first
change in the parts from a healthy condition. Coldness and loss
of vitality in the part is the first change from a healthy state, and
inflammation follows as an effort of the constitution to preserve
the vitality of the parts, and protect the joint from destruction;
and although these efforts are frequently baffled, from want of
constitutional energy, or from great debility of the parts diseased,
ULCERS. 421
still Mie design of the inflammation is the same, and the treatment
should be directed to correct and support the general health, and
to promote the circulation in the diseased joint by the various
means already mentioned.
SECTION XVIIL
ULCERS.
Some medical writers divide ulcers into three classes, namely,
healthy, unhealthy, and specific ulcers. An ulcer is generally of a
healthy character where it occurs in one of a healthy constitution,
and more especially in the young and robust; whereas the aged
and feeble, and especially those of intemperate and dissolute
habits, are subject to ulcers of an unhealthy character, and very
difficult of cure. Syphilitic, cancerous, and scrofulous ulcers, are
generally considered as being of a specific character.
1st. Simple or Healthy Ulcer.
Causes. — Simple ulcer arises from some local injury, a bruise,
cut, or burn; or it may follow abscesses or biles.
Characteristic marks of the healthy Ulcer. — The surface of this
ulcer has a florid appearance, raised above the edges, discharges
a cream-like pus, that has no odour; " and the edges of the sore
are whitish, and nicely adapted to the surface."
Treatment.—The simple healthy ulcer seldom requires any thing
more than to be protected from the air, by the application of some
simple salve.
A healthy ulcer may become converted into one of an unhealthy
character by frequent exposure to the air, or to other injurious
influences. If proud flesh rise up in the sore, finely powdered
marsh rosemary, bayberry, or alum, must be sprinkled upon the
parts, and salve applied; or instead of the powder, apply dry lint
to the proud flesh, cover the edges of the sore with salve, and
apply moderate pressure to the sore.
Carrots boiled and mashed fine, adding a little lard, constitute
a favorite poultice, in cases of sores and ulcers.
A great variety of salves and plasters are employed as a cure
for sore. It is not of much consequence what a salve is made of
for common sores, as the great object is to preserve the sore from
the air.
422
ULCERS.
Cold Water Dressing. — Cloths wet with cold water applied to
sores, promotes the healing action. This kind of dressing is more
particularly applicable to cases attended with heat and inflamma¬
tion. Where the cold water dressing causes unpleasant feelings
in the part, warm water may be substituted.
2d. Unhealthy Ulcers. — Sores of Long Standing.
An unhealthy ulcer may be extremely irritable, inflamed, and
painful; or it may be indolent, and almost devoid of sensibility.
In aged persons, a bruise upon the shin is apt to occasion*an un¬
healthy ulcer, " the parts being too weak to carry on the actions
necessary to its recovery."
A great diversity of appearances is presented by unhealthy
ulcers.
" The Irritable Ulcer is generally characterized," observes Dr.
Gibson, 44 by the following appearances: — The edges of the sore
are ragged, undermined, and sometimes almost serrated. The
parts for some distance beyond the ulcer are red and inflamed,
and often cedematous. Irregular hollows occupy the bottom of
the ulcer, and contain a thick greenish or reddish matter, which
is so extremely acrid as to excoriate the adjoining skin. In place
of granulations, may be found a white or dark red spongy mass,
extremely painful, and shedding blood upon the slightest touch."
"Inflamed Ulcers.—Here you have a serous discharge from the
sore; a bloody ichor, composed of serum and the red particles of
blood; a disposition in many cases'to slough; the surface covered
with a brown incrustation; and the skin and surrounding parts
highly inflamed."—Castle's Manual of Surgery.
" Gangrenous Ulcers.—In ulcers of this kind, the surface is per¬
fectly free from any discharge; the surrounding edges of a livid
appearance, with small vesicles or blistered spots on them; and
the patient suffers much from irritative fever."
Indolent Ulcer.—This is the most common kind of ulcer. The
edges of the sore are raised, and rounded, giving the appearance
ot a deep cavity to the ulcer. The surface of the sore is covered
to a greater or less extent with a slight colored crust, and is ex¬
tremely insensible to the touch. In general, there is a free dis¬
charge of a tenacious matter from the sore, differing essentially
from the healthy pus. This kind of ulcer is in almost every in¬
stance seated on the leg, and the nearer it is to the ankle the more
difficult it is of cure.
ULCERS.
423
Treatment of Unhealthy Ulcers, or Sores of long-standing.
Constitutional Treatment is, in general, necessary in the cure of
unhealthy ulcers, besides its influence in exciting a healthy action
in the vessels of the diseased part; a proper course of constitu¬
tional treatment secures the constitution from the bad consequences
that might otherwise ensue from the healing of long-standing
ulcers. I have known ulcers, of many years' standing, to be en¬
tirely healed in a short time, under Thomsonian treatment, and
the general health of the patient still continue to improve.
Unhealthy ulcers will in many instances be observed to assume
a more healthy appearance, after the patient has been carried
through a course of medicine. In cases of long-standing, the
vapor bath and emetic, or a full course of medicine, will be re¬
quired to be administered as often as every week or two, and
repeated several times, together with the daily use of stimulants,
capsicum, composition, and tonics, and a proper course of local
treatment, before the sore will assume a healthy condition, and
secrete the cream-like pus, observed in healthy ulcers.
In confirmed drunkards, ulcers are often very difficult to heal;
constitutional and local treatment proving ineffectual, so long as
the habit of excessive drinking is continued.
Besides an occasional course of medicine, the following plan of
giving the medicines (first proposed to me by Dr. A. C. Logan,) I
have found well adapted to almost every case of chronic disease,
namely:—A dose of Thomson's anti-canker medicine in the morn¬
ing before breakfast, a dose of the No. 4 bitters before dinner,
and composition at night. If the bowels be costive, from three
to six of the compound lobelia pills should also be taken at bed¬
time.
Dr. Logan's Alterative Syrup.—This syrup is made by combining
equal portions of tincture of lobelia, No. 6, and simple syrup of
sugar. To be taken in doses of from one to two or three tea-
spoonsful, repeating the dose several times a day, but particularly
shortly after, or within an hour or two after meals. The use of
this syrup fulfils many important indications for improving the
general health.
Sarsaparilla Syrup.—In mercurial syphilitic, or scrofulous ulcers,
the simple syrup of sarsaparilla, or a syrup made of a compound
of sarsaparilla, guaiac shavings, and yellow dock-root, will be
found useful. Pipsissawa, bruised and steeped two or three hours,
to make a strong decoction, and this drank freely, will supply the
place of the above syrups.
424
ULCERS.
Local Treatment in Unhealthy Ulcers.—In the first place, stimu¬
lating and astringent poultices must be employed to stimulate and
give tone to the enfeebled vessels; and when the ulcer has begun
to secrete thick yellow or cream-like matter, and healthy granu¬
lations are formed upon the surface of the ulcer, then fresh salve
may be applied. If the ulcer be on the leg, the limb should be
bandaged, commencing at the end of the foot, and extending the
bandage above the ulcer, so as to apply moderate and equable
pressure to the limb. This will, in general, enable the patient to
walk out, or to pursue his daily avocation, the bandage furnish¬
ing support to the blood-vessels, aiding them to carry on the cir¬
culation.
Indolent ulcers may require actively stimulating poultices, such
as a compound of cayenne pepper, bayberry and elm, or of com¬
position powder. Dr. Samuel Thomson informed me that he had
cured indolent ulcers by applying the dry powder of cayenne pep¬
per, brown lobelia and bayberry, and then administering a course
of medicine.
Another plan of treating unhealthy ulcers, is to fill the ulcer
with beeswax and Burgundy pitch melted together, and applied
as warm as the patient can bear. This is to be bound on, and
renewed as often as may be required.
Change of Remedies.—Every one who has treated ulcers of long
standing, must have observed the utility of occasionally changing
the local treatment. An application that will answer well at one
time may prove useless, or even worse than useless, at another.
The bark of the root of wild indigo mashed to a pulp, and com¬
bined with slippery elm so as to form a soft poultice, is a valuable
application in cases of indolent ulcers.
Prepared chalk and linseed oil rubbed together to the consist¬
ency of putty, and applied to old sores, will often effect a cure
where all other general remedies had failed. As the putty be¬
comes too dry, more oil may be applied or fresh putty put on.
Loaf Sugar, finely powdered, is an admirable remedy in cases
of ulcers.
The extract of red clover, (Thomson's cancer balsam,) has been
highly recommended by some practitioners of the old school, as a
valuable remedy in indolent ulcers. The extract of sheep sorrel
may be used for the same purposes.
It must be borne in mind, however, that in cases of long stand¬
ing sores, a course of medicine should be administered, and re¬
peated, if necessary, in order to prevent any bad effects that might
•otherwise arise from the healing up of ulcers.
ULCERS.
435
To prevent a return of Uxers. — When an old sore has healed,
the part should be bound in flannel, wetting it every day with
No. 6. The flannel will not require changing, as the myrrh will
prevent its becoming in the least degree offensive. Benjamin
Thomson, formerly of Boston, showed me a flannel bandage that
he had worn around his shin tw7o years; and by having it wet
occasionally with No. 6, it was entirely devoid of offensiveness,
and afforded a protection against ulcers, to which he had been
many years subject.
Gangrenous Ulcers.—" In ulcers of this kind, the surface is per¬
fectly free from any discharge; the surrounding edges of a livid
appearance, with small vesicles or blistered spots on them; and
the patient suffers much from irritative fever."
Treatment.—When a part is threatened with gangrene or mor¬
tification, the yeast, sassafras, or charcoal poultice, should be ap¬
plied, and be kept wet with cold sassafras tea or whiskey, and the
patient carried through a course of medicine, followed by the free
use of cayenne pepper tea, third preparation of lobelia in bayberry
tea; the compound lobelia pills, ginger or composition tea. For
nourishment, give wine whey, essence of beef, or any other nutri¬
tious food that may suit the condition of the stomach.
If the parts be excessively hot and inflamed, the poultice may
be kept wet with the tincture of lobelia, simple water, or with wild
incjigo root tea.
Varicose Ulcers.
Ulcers arising from diseases of the Veins.—The veins of the leg
are more liable to disease than veins in any other part of the sys¬
tem, giving rise to the formation of ulcers along the course of the
larger veins. The circulation of the blood being impeded or ob¬
structed by the diseased condition of the vein, adhesive inflamma¬
tion is established, forming a small tumor under the skin; the skin
over the tumor is observed first to roughen and peel off, and then
a crust is formed, and finally an ulcer breaks out. These ulcers
may, in most instances, be healed without great difficulty; but
the vein continuing diseased, new ulcers are formed, and in this
way they continue to break out until, by frequent ulceration, the
vein becomes obliterated, when the ulcers will cease to return.
Treatment.—Besides adopting the usual means for restoring the
general health, when it is disordered, the limb upon which the
ulcer or ulcers exist must be accurately bandaged from the foot
to the knee, or a laced stocking worn, for the purpose of support¬
ing the debilitated veins of the leg, and to assist them in carrying
426
ULCERS.
on the circulation, by which the tendency to obstruction will be
lessened.
In the selection of a local application for the ulcer, we must be
governed by the circumstances of the case. If the parts around
the ulcer are swollen and inflamed, poultices, or cold water dress¬
ing must be applied ; or if the ulcer emits an offensive odor, keep
cloths wet with whiskey on until the inflammation subside, when
fresh salve may be substituted, or apply a paste made of prepared
chalk and linseed oil. This hardens and maintains an equable
pressure to the ulcer, supporting the weakened vessels, and pre¬
venting proud flesh. The dressing to be changed daily.
Old ulcers are apt to become spongy, or filled with proud flesh,
and continue to keep sloughing. In such cases, pressure must be
applied, to support the vessels and prevent proud flesh. A mix¬
ture of prepared chalk and linseed oil, formed into the consistence
of dough, may be put in the cavity of the ulcer, and changed as
often as the circumstances of the case may require.
Friction.—Rubbing the limb briskly every morning and evening
may prevent the formation of new ulcers, by removing obstruc¬
tions to the circulation of the blood in the veins.
Rest and Position.—When the ulcer is in an irritable condition,
and the parts surrounding it swollen and inflamed, the patient
should refrain from walking much, but keep at rest, with the
affected limb elevated on a chair while sitting up.
Pressure. — In cases of old sores, and in all cases where an
ulcer is spongy, or contains proud flesh, it is important to apply
pressure, with a view to support the capillary vessels of the .part.
If this is not done, the ulcer will not heal in many instances for
years. We often see ulcers fill up with spongy flesh, but the ves¬
sels being too weak to carry on the circulation in the part, the
blood stagnates and the parts that are spongy slough away; and
in this way many ulcers continue to fill up, and then slough off in
regular succession for even years, which might be cured by ap¬
plying the mixture of prepared chalk and linseed oil, formed to
the consistency of soft paste. This paste is to be spread on linen
or muslin, and bound on, and the dressing changed once a day.
This mixture hardens, and will make the ulcer feel very sore.
If the ulcer becomes more inflamed, or is very offensive, fill it
with lint, apply a bandage, and keep the sore wet with whiskey
several hours, and then apply the paste. This will generally cure
the worst cases of ulcers.
GONORRHOEA.
427
Ulcers under a Nail. *
Ulcers sometimes form at the root of the nail, which may con¬
tinue to prove a source of annoyance for months, or even years,
unless the dead portion of the nail be removed. Sometimes it be¬
comes necessary to remove the whole of the nail before the parts
will heal soundly. If the root of the nail become separated from
the surrounding parts by ulceration, or by an injury, the nail will
operate as a foreign body, keeping up a continual irritation and
ulceration of the parts until it is removed.
CHAPTER XXL
SECTION I.
VENEREAL DISEASE.
The term venereal disease is applied to two foims of disease,
differing essentially in their general aspect. The one, in the male,
consisting of an inflammation in the urethra, attended by a dis¬
charge of thick matter; whilst the other is an ulcer, called chancre,
situated externally.
Gonorrhcea.
Symptoms. — The first symptoms are a burning sensation on
passing water, accompanied with inflammation, and a discharge
of thick matter from the urethra. In the course of a few days,
the burning sensation on passing urine subsides, but the inflamma¬
tion and discharge of matter seldom disappear under eight or ten
clays, and very frequently continue for weeks, and sometimes even
months will elapse before the complaint will be permanently cured.
In the female, the symptoms are much more obscure, and so
closely resemble diseases arising from other causes than venereal
poison, that in many instances it is difficult to form an opinion as
to the true character of the disease.
It should also be borne in mind, that men are liable to disease
of the urethra, resembling gonorrhcea in many particulars, but
arising from causes wholly distinct from that of gonorrhceal poison.
The peace of families has in some instances been destroyed, by a
428
GONORRHOEA.
wife or husband being affected with symptoms resembling those
attending the venereal disease, at the same time the accused party
being entirely innocent. Instances have occurred in which symp¬
toms of gonorrhoea have occurred in men, in consequence of the
ivife being affected with a severe form of fluor albus, or whites,
each party accusing the other of infidelity.
" Women are not so liable to gonorrhoea as men, nor do they
suffer as much from it — owing to the insensibility of the v-agina,
compared with that of the urethra. It is not easy, indeed, i ' every
instance to determine the existence of the disease in a female, so
slight is the pain, and so equivocal the discharge; though I have
met with several cases in which the inflammation ran so high,
and produced such intolerable anguish, that the patients were un¬
able to leave their beds. Gonorrhoea has often been confounded
with fluor albus; but close attention to the symptoms peculiar to
each complaint will be sufficient, in general, to distinguish them."
Of the general course of the disease in the male.—Under proper
treatment, and with great care and attention on the part of the
patient in relation to medicine, diet, rest, &c., the disease will in
many instances disappear in the course of a week or two, or even
in less than a week. It often happens, however, that the disease
is neglected in its first stage, the patient being unwilling to make
his disease known; or he will not lie by without some plausible
excuse for so doing, in order to evade suspicion, by which course
the disease is often aggravated, and becomes protracted to many
weeks, or even months' duration.
Where the general health is much disordered, and the patient
of a scrofulous constitution, want of proper care and treatment,
the use of improper remedies, or when the venereal poison has
been of the more malignant character, the disease is very liable
to become extremely difficult of cure, and may continue even six
months, or longer. The most malignant form of the disease, how¬
ever, will generally run itself out in six months.
"The most observing practitioners have repeatedly decided that
the disease naturally tends to the development of a certain course
or period, during the progress of which nothing can be done,
except in the way of palliating or mitigating the symptoms."—
M'Clellan.
Swelling of the testicle, and swelling of the glands of the groin,
often attend severe cases of gonorrhoea.
Where the disease has been of long continuance, the patient is
in most instances left with what is termed gleet, consisting of a
slight discharge from the urethra of a transparent mucus, resem¬
bling the white of an egg, which is the effect of a weakened con¬
dition of the mucous membrane.
In the female, the disease is much less troublesome; in many
GONORRHOEA..
4'29
instances causing little inconvenience, and is also much more
readily cured.
Treatment in the early stages.—In the first stage of gonorrhoea,
and more especially if there be much inflammation in the urethra,
the stomach should be kept nauseated with lobelia, taken either in
the form of tincture, syrup, pill, or in powder, and the patient
avoid using much exercise. His diet should be restricted to the
lightest kinds of food, such as gruels, stale bread, toast and tea, &c.
A gruel made of elm, or of unbolted wheat flour, is well suited
to the early stage of gonorrhoea. The digestive powers are, in
general, more or less weakened during the early stage of the dis¬
ease, and if food be taken that is hard of digestion, it will retard
the cure. And again, if strong food, such as butter and meat, be
used, the urine will be more acrid and irritating to the inflamed
urethra.
When the disease is of a mild character, it will not be neces¬
sary that the patient confine himself to the house.
Cubebs and Balsam Copaiva. — These are the remedies chiefly
relied upon for the cure of gonorrhoea. These remedies, taken in
the very onset of the disease, will, under favorable circumstances,
cut short the disease—the cure being effected in the course of a
week, or even in less time.
The dose of the cubebs is a teaspoonful, mixed in sweetened
water. To be taken three times a day before meals.
The balsam to be taken three times a day, in doses of from
twenty to thirty drops; or take from four to six of the copaiva
capsules daily.
If these remedies, but more especially the copaiva, when taken
in the early stage of the disease, do not mitigate the symptoms in
the course of three or four days, their use should be discontinued,
at least for some days, until the condition of the system is changed,
and the inflammatory symptoms are abated.
When the general health is in a bad condition, or the patient
feverish, or the skin dry and harsh, a course of medicine will be
particularly serviceable; after which, the patient should take every
hour or two a small dose of lobelia, either in the form of tincture,
syrup, powder, or in pills; drink freely of elm gruel, flax-seed tea,
barley or gum Arabic water; and morning and evening take a
teacupful of a strong decoction of sumac or bayberry. The teas
should be taken warm, with the view to promote perspiration,
which is of much importance 4n the early stage of the disease?
provided the patient remain in the house.
After the inflammatory symptoms have abated, which will
usually be in the course of ten days or two weeks from the first
appearance of tne disease, the cubebs and balsam copaiva should
430
GONORRHCEA..
be used, as before directed, and the compound lobelia pills, or
lobelia in some form, taken in broken doses through the day, and
a quantity taken at bed-time, sufficient to cause nausea.
When the tongue is furred, the skin hot and dry, and the patient
feverish; or when the digestive functions are much weakened by
previous disease, the balsam of copaiva is almost sure to disagree
with the stomach; and when found to disagree, it must be laid
aside, at least for a few days, and general constitutional treatment
instituted — such as the hot air bath and an emetic, and the free
use of No. 3 and compound lobelia pills.
If the bowels be costive, they must be relieved by injections,
composed of composition, bayberry, or pennyroyal tea, adding a
teaspoonful of the tincture or powder of lobelia.
When it is impracticable to have a course of medicine, the com¬
pound lobelia pills may be used as a substitute: from one to three
pills may be taken every hour or two, and these continued during
the whole course of the disease. These pills will be useful in all
cases, and in the great majority of instances, if used freely, will
supply the place of all other medicines, during the inflammatory
stage of the disease, with taking demulcent drinks, such as elm
gruel, gum Arabic water, or flax-seed tea.
External Treatment—Wet Dressings. — From the first appear¬
ance of the disease, the cold water dressings should be kept applied,
and changed as often as twice in twenty-four hours.
Oiled silk may be bound on over the wet dressings, as this will
assist in keeping the parts warm, and will prevent the wet dress¬
ings becoming dry too soon. A bag made of oiled silk, worn over
the wet dressing, will secure the clothing from the discharge.
If the oiled silk should cause the dressing to become uncomfort¬
ably warm, it should be taken oft', and dry muslin or flannel sub¬
stituted to bind on the wet dressing.
The wet dressing should be kept in its place by means of a strip
of muslin or tape, fastened to the dressing, and tied around the
hips or waist.
Injecting the urethra with astringents, such as preparations of
lead-water, with a view to checking the discharge of matter during
the early period of the disease, will be liable to do injury.
In a more advanced stage of the disease. — After the passing of
urine ceases to cause burning sensations, then astringent and sti¬
mulating injections into the urethra will be useful; commencing
with a simple tea of bayberry or sumac, adding a small portion
of the tincture of lobelia. In a still later period of the disease, the
discharge having been for some time profuse, a portion of No. 6
or pepper must be added to the tea, in sufficient quantity to make
gonorrhoea. 431
a sensible impression on the urethra. Undiluted No. 6 has been
used in some chronic cases for injections.
A weak solution of the nitrate of silver may be used for inject¬
ing the urethra with perfect safety, and in man) instances with
more benefit than any other form of injection; commencing with
one grain of the nitrate of silver to the ounce of rose water, and
increasing the strength of the solution to three or four grains to
the ounce of water. A lass syringe must be used for this pre¬
paration.
Chordee, as it is termed, depends upon the deposition or extra¬
vasation 6f lymph in the parts along the course of the urethra,
which feels hard like a cord. This condition occasions severe
pain at times, more especially at night, compelling the patient to
apply cold water to the parts to ease the pain. The local treat¬
ment for chordee consists in the use of fomentations and wet
dressings. In the commencement of chordee, it may often be
cured by steaming the parts an hour or two, by placing a hot
brick in a basin containing a small portion of water, and sitting
over the steam, or wrap a hot brick in damp cloths, and place it
as near the parts as can be borne, in bed. This steaming opera¬
tion may be repeated as often as it proves beneficial, in any stage
of the disease. It is beneficial in any stage of gonorrhoea.
Gum camphor is prescribed as a preventive to chordee. A
piece as large as a large pea, or grain of corn, to be taken at
bed-time. *
Another application for chordee is a strip of oiled silk, covered
with salve, placed along the course of the urethra, and bound on
with a wet or dry dressing.
In some instances, there is swelling of the testicle, generally the
left one; and occasionally the prepuce swells up like a blister, oc¬
casioning unnecessary alarm. Both of these ailments require the
same kind of treatment — to wit, warm fomentations, and wet
dressings covered with oiled silk, and bathing occasionally with a
volatile stimulant.
Gleet, as it is usually called, consists of a discharge of a thick,
and almost transparent mucus from the urethra, caused by tho
weakness resulting from gonorrhoea. This is sometimes a trou¬
blesome affair to get rid of, as it often continues for months, under
any kind of treatment. It is not, however, of much consequence,
as it does not prove particularly injurious to the system. Stimu¬
lating astringent injections, and the use of balsam copaiva and
cubebs, are the chief remedies. Combining powdered cubebs with
powdered prickly ash bark, in equal quantities, is a good form of
medicine. A teaspoonful of this powder to be taken either before,
or an hour or so after, meals.
4-12 SYl'IIILIS.
Syphilitic Sore, or Chancre.
" Chancre, or the true syphilitic sore, usually begins with a
slight redness or inflammation on some part of the genital organs,
attended with pruritis or itching. This itching is soon converted
into pain, and a pimple is in a short time formed, filled with pus,
which upon bursting leaves an excavated ulcer of a circular shape,
with hard and abrupt edges, and a surface covered with a grey
tenacious matter. The base of the ulcer is thickened and indu¬
rated, and the parts surrounding it for some distance converted
into a tumor, so distinct and circumscribed, that it may be elevated
by the fingers, and feels like a hard and movable body beneath
the skin. This description will particularly apply to chancre
when seated on the glans penis; some variation is observable,
however, when the prepuce or frsenum is affected. In such cases,
the inflammation is generally higher, the pain more considerable,
and instead of a regular pimple filled with matter, the chancre
often follows a slight excoriation or abrasion of the surface.
When seated on the common skin of the penis or scrotum, the
matter discharged from the sore soon dries up and forms a scale,
which quickly drops off, and is succeeded by another of a larger
size. Wherever seated, chancre commonly preserves certain
general features that seem to distinguish it from common sores,
the edges of which are usually smooth and shelving—while those
of chancre are jagged and vertical. But, perhaps, the most cha¬
racteristic sign of genuine primary syphilitic ulceration, is the
indurated base; and so long as this continues, even though the
sore may be healed, little doubt will remain of the presence of
the disease."—Gibson.
" Among females, the parts commonly attacked are the labia,
the nymphce, and the entrance of the vagina; though not unfre-
quently very large and virulent chancres appear on the perineum,
the outside of the labia, near the anus, or on the hip. Sometimes
the lips, eyelids, or edges of the nostrils, are covered with
chancres — from the inadvertent application of syphilitic matter
by the fingers. The fingers themselves, if their extremities be
pricked or sore, may suffer from handling chancres, or from de¬
livering infected women."
" The period at which a chancre appears, after the application
of the venereal virus, is very uncertain. Sometimes the disease
follows in twelve or fifteen hours; at other times, several days
elapse; and in a few instances, no ulceration takes place for two
or three months."
When the disease is contracted by persons of intemperate or
depraved habits, and under other unfavorable circumstances, as
where mercury and other poisonous drugs are taken, the syphilitic
SYPHILIS.
433
sore sometimes assumes a highly malignant character, occasion¬
ing extensive sloughings. And if not correctly treated, the system
is liable to become affected with the poison, producing various
symptoms termed secondary symptoms of syphilis. Swelling of
the glands of the groin, termed bubo, is a very common attendant
upon chancre.
Treatment.—The new plan of treating chancre, called the a6or-
tive treatment, consists in destroying the syphilitic virus by cau¬
terizing the pimple or sore with solid lunar caustic in the onset of
the disease; or where the sore is situated on the loose skin, to cut
it away with a pair of sharp scissors. Either of these methods,
if adopted early in the disease, will destroy the syphilitic poison,
and convert the venereal sore into one of a simple character, that
will heal in a few days.
" Whatever form a chancre may assume in its commencement,
it ought to be treated by the abortive method; for there is no
authenticated instance of ulcers, destroyed within five days after
infection, having afterwards given rise to secondary symptoms,
if these ulcers existed alone, and without other actual compli¬
cations."
" If, however, it be acknowledged that chancres ought to be
destroyed as quickly as possible, it is equally clear that the same
means will not be proper in every case; and the indication for
those which have been proposed, as excision, direct and indirect
cauterization, deserves a moment's consideration."
" Hunter, who was of opinion that chancres ought promptly to
be destroyed, says, without regard to the forms they may at first
assume, that cauterization is preferable to extirpation, when they
are situated on the glans, whose less acute sensibility excites less
pain, and exposes less to haemorrhage; whilst excision is better
calculated for those cases where the skin is affected, and where
the whole extent of the disease could hardly be reached by the
caustic."
Mode of applying Caustic. — Whenever, after a suspicious con¬
nection, a sore appears on the parts exposed to the contagion,,
take a piece of lunar caustic, the end pointed, and apply it to
every part of the sore, so as to effectually destroy every particle
of the syphilitic virus. If there be a pustule formed, it must be
cut open, and the whole of the base of the pustule effectually
cauterized.
After the caustic has been applied, wet a small pledget of lint
with tincture of bayberry, or tincture of myrrh and bayberry,.
place it upon the sore, cover it with a piece of oiled silk or adhe¬
sive plaster, and apply the wet dressing, as recommended in the;
28
134 SYPHILIS.
treatment of gonorrhoea. These dressings to be renewed two or
three times daily.
When the sore is situated upon the loose skin externally, 01
upon the inner surface of the prepuce, it may be clipped oil with
a pair of curved scissors, and the same kind of dressing applied
as above recommended.
Not unfrequently, after either of the above operations, the parts
swtell considerably. Wet dressings, covered with oiled silk, by
promoting absorption, will disperse the swelling.
When the chancre has existed too long to be destroyed by
either of the above methods, it should be dressed every four or
five hours with lint, wet with a wash made by adding about half
a.n ounce of bayberry, sumac, or marsh rosemary, to a gill of the
third preparation of lobelia, tincture of myrrh, or No. 6, covering
the lint with a small piece of oiled silk or plaster, and over this
the wet dressing. Before removing the lint, it should be wet, to
:avoid irritating the sore.
Duration. — When not destroyed in its early stage, chancre is
seldom cured in less than two or three weeks, and frequently from
four to six weeks will elapse before the disease is cured.
Formerly, it was believed that mercury was a specific for
syphilis, not because it proved to be a specific, but because high
authority had pronounced it to be such. More recently, however,
this doctrine has been exploded by the highest authority in the
profession, and the use of mercury is not only declared unneces¬
sary in the cure of syphilis, but pernicious in the extreme, unless
given with the greatest caution. Professor Gibson, of this city, in
his work on surgery, recommends the use of mercury in cases of
chancre, but he now honestly declares mercury to be altogether
improper, tending to convert a simple chancre into one of a ma¬
lignant or corroding character. P. Ricord, surgeon to the Vene¬
real Hospital of Paris, in a recent " Treatise on Venereal Dis¬
orders " in the course of his observations on the employment of
mercury in chancre, observes: " By one party it is declared, that
no cure can take place, no repose be enjoyed, no future health
anticipated, unless mercury be used; and by the other, future
disease and death are predicted, if this remedy be employed."
"Again," observes the same writer, "Prejudice attaches us to the
principles in which we are educated, and renders them objects
of affection; and hence the obstinacy with which men cling to
ideas with which they are familiar. The experience of the world
has shown that partisans are sternly adhesive; that truth is more
frequently imagined than perceived; that the value of a reason is
too seldom accurately measured; and that minds satisfied with
partial knowledge, far out-number the warm conscientious lovers
SYPHILIS.
435
of philosophy. We can readily perceive the reason why men
spurned the great principle promulgated by Rose and Thomson.
It was a heavy blow aimed at a favorite and long-cherished
opinion; but the truth will stand fast, despite the efforts of the
boisterous declaimer, or the insidious endeavors of the smiling
sophist. Rose and Thomson demonstrated an important truth;
they incontrovertible proved that mercury is not necessary to the
cure of chancre, as chancre; and this the intelligent ingenuous
mind will acknowledge, however much it may dissent from their
method of applying it."
The ulcer is sometimes so situated that it cannot be reached,
except by injections; for instance, when its seat is on a part
where the skin is drawn over, and swollen to such a degree that
it cannot be drawn back. Under circumstances of this kind, local
steaming and warm fomentations must be employed, and the sore
syringed often with a tincture of myrrh and bayberry; or with a
preparation made by adding a tablespoonful of bayberry powder
to a gill of No. 6.
Constitutional Treatment. — When chancre is destroyed by the
abortive method, internal medicines will not be needed, provided
the system be in a healthy condition, and the sore heals readily.
But where the syphilitic sore has been permitted to take root, so
as to be out of the reach of a speedy cure by caustic or excision,
then it becomes highly necessary to employ means to protect the
system from contamination with the venereal poison. The best
remedies for this, and also to promote the curative process, are
the hot air bath, lobelia, vegetable stimulants and astringents.
Lobelia, in some form, should be taken every two or three
hours; and if the tongue be furred, the No. 3 pills, or bayberry
syrup, should be taken daily until the tongue cleans.
The hot air bath, by warming the blood and inducing free per¬
spiration, proves beneficial in all cases and in all stages of syphilis,
It may be administered daily, if practicable. The most suitable
time for the bath, is just before going to bed.
When the patient is so circumstanced that the hot air bath can¬
not be employed, he must keep his person clean by daily washing
the surface, and he should avoid excesses of every kind.
The Diet should be light, and easy of digestion, avoiding, as a
general rule, salted meats and acids. •
Bubo. — Swelling of the glands in the groin, often attends both
gonorrhoea and chancre. In the former complaint, bubo is seldom
very painful, and rarely suppurates; but when produced, by the
absorption of a venereal poison, from chancre, the inflamed gland
becomes painful, and unless judiciously treated in the early stage
43G
SYPHILIS.
of the swelling, suppuration is apt to take place, confining the
patient to his bed, probably for weeks.
Treatment — Slight swelling in the groin, in cases of simple
gonorrhoea or clap, demands, in general, no particular attention,
further than keeping the parts well protected from cold, and avoid¬
ing fatiguing exercise.
If the swelling increase, and becomes painful, the patient should
keep as quiet as possible, apply a poultice, composed of bitter
herbs stewed in vinegar, and thickened with elm or Indian meal:
or apply wet cloths, and bind them on with dry dressings; and
every time the poultice or wet dressing is removed, bathe the
swelling with opodeldoc or No. 6.
When bubo occurs in one who has a syphilitic ulcer, the poul¬
tice or wet dressing must be applied, using either alcohol and
water, or vinegar and water, to wet the cloths, instead of simple
water; the patient keeping warm in bed, and a hot brick or bottle
of hot water should be kept near the groin, to keep the dressing
or poultice warm.
The patient should also be placed under constitutional treat¬
ment, taking sufficient of lobelia to keep his stomach slightly nau¬
seated, with warm teas to favor perspiration, and occasionally a
course of medicine, and the frequent application of the hot air
'^ath.
Tf the above treatment fails of dispersing the swelling, and the
) become more painful and throbbing, then apply a poultice,
composed of ground slippery elm and green lobelia, wet with
warm water; and continue the poulticing until the bubo either
disappears or suppurates, and the contents discharged either by a
spontaneous or artificial opening. As soon as the pus has escaped,
the cavity of the bubo should be syringed with tincture of bayberry
or with No. 6, to stimulate the surface to granulation ; and when
suppuration has nearly or entirely ceased, the place must be kept
covered with some kind of salve or plaster.
If the bubo assume an indolent character, showing no tendency
to heal, the cavity should be syringed with a weak solution of the
nitrate of silver, beginning with a solution of the strength of two
grains to the ounce of water, and increasing its strength to four
or si* grains to the ounce of water. This will change the con¬
dition of the surface of the cavity, so that granulations will be
formed, and the cavity heal. A portion of lint, wet with tincture
of myrrh, introduced into the cavity every day, will favor the
healing process.
Secondary Symptoms.— Venereal taint of the System. — Under a
correct course of treatment of chancre, there is not much danger
of the system becoming contaminated from, absorption of venereal
SYPHILIS.
437
poison, for Nature, to protect the system, forms a hard base around
the chancre, which prevents the absorption of the syphilitic poison;
but physicians apply mercurial ointment, with a view to soften this
hardened base, and in effecting this object, they expose the patient's
system to the hazard of contamination with the poison; for when
the base of the chancre is softened, the absorbent vessels will take
up the virus, and carry it into the circulation.
When the disease attacks the roof of the mouth, an ulcer is
formed ; and if it be not checked, the bone is made bare and ex¬
foliates, forming an opening between the mouth and the cavity of
the nose, changing the sound of the voice.
If the disease be seated in the tonsil, an ulcer is formed, present¬
ing the character of chancre. When the mucous membrane of
the nose becomes diseased by the syphilitic poison, the patient is
very liable to lose some portion of the bones of the nose.
Sometimes the secondary symptoms of syphilis appear in the
form of copper-colored eruptions on the skin. These eruptions
are slightly raised, scarcely ever painful, but are apt to itch, espe¬
cially in the after part of the day. " There is a greater variety
of character in these venereal eruptions than in any other symp¬
toms of the complaint; not only in appearance, but also in size.
In some, you will find the eruptions of considerable magnitude,
appearing as if a portion of copper-colored skin laid upon the sur¬
face, but unattended with ulceration. In others, you will observe
deep ulcerations, with a ragged edge; in a third, there will be
scaly eruptions, covering very large surfaces in various parts of
the body."
When the disease attacks the periosteum of the bones, " the
patient experiences in the evening a sensation of pain in the bone,
which afterwards becomes the seat of the node. The pain does
not immediately produce a swelling; but in the course of a few
days a painful swelling appears in the evening, which disappears
again on the following morning, and leaves no pain. At this time
the periosteum (membrane that covers the bone) only becomes
affected with inflammation; in a short time a deposit takes place
between it and the surface of the bone; this deposit is, in fhe first
instance, only a serous fluid, but a cartilaginous substance is soon
secreted, which is gradually converted into bone, and is technically
called a node.
In some instances, the bone itself becomes extremely painful,
more especially at night, when the patient is warm in bed. The
pain is felt, as it were, in the marrow of the bone.
Treatment of Venereal taint of the System. — In whatever form
secondary symptoms appear, constitutional treatment will be called
for. The frequent application of the hot air bath, an emetic occa¬
sionally, and the daily use of lobelia in broken doses, with astrin-
438
SYPHILIS.
gents, and a decoction or syrup of sarsaparilla, or of a compound
of sarsaparilla, pipsissawa, yellow dock-roots, and burdock-roots,
are the constitutional remedies adapted to aid the efforts of nature
to get rid of the syphilitic taint.
Local Treatment.—If an ulcer be formed either in the throat or
on the roof of the mouth, it should be touched with the solid
nitrate of silver, to destroy the poison, the same as in primary
ulcer, and the sore wet several times daily with a tincture of
myrrh and bayberry.
The nitrate of silver should be applied to the ulcer every two or
three days, whilst the surface continues white and the ulceration
is going on, observing especial care to avoid touching any part
except where the surface is covered with a white, thick matter.
Where the nose is diseased, the patient should frequently resort
to the breathing of steam through the nostrils, and the parts should
be syringed occasionally with bayberry or sumac tea, adding a
portion of No. 6, or the simple tincture of myrrh. Finely pow¬
dered bayberry and green lobelia, combined in equal portions,
should be snuffed up the nostrils often, in all cases where the nose
is affected.
Syphilitic eruptions are, in general, very readily cured by the
use of the vapor bath, a course or two of medicine, bathing the
eruptions with a preparation made by adding sumac berries to
No. 6, or with the third preparation of lobelia, and then apply the
stimulating ointment, or some kind of salve, to protect the parts
from the air; this last is more particularly needed in case of
ulceration.
Where the membrane that covers the bone becomes diseased,
and there is evidence of the existence of fluid between it and the
bone, attended with throbbing pain and a blush upon the skin, it
should be opened, and the part poulticed until the swelling and in¬
flammation subside, when a strengthening plaster must be applied,
and if the parts be slow in healing, syringe the cavity with tinc¬
ture of myrrh. In many cases the swelling will fluctuate, proving
the existence of a fluid, but unaccompanied with pain, and without
inflammation or a blush of red upon the skin; here it will be im¬
proper to make an opening into the swelling, but steam the limb
daily, apply stimulating embrocations, keep the parts warm and
bandaged, and employ constitutional remedies.
OBSTRUCTED MENSTRUATION.
439
CHAPTER XXII.
SECTION I.
OBSTRUCTED MENSTRUATION.
Derangement in the function of menstruation may be occasioned
by a variety of causes, the most prominent of which is exposure
to cold and wet during the menstrual period, or immediately pre¬
ceding the time of its occurrence.
This function may be either partially or completely suspended.
Some females, during this period, experience pain almost as severe
as labor pains, and which continue in some instances several days,
in others only a few hours.
When menstruation does not come on at the period of life at
which it usually does, it is termed suppressed menstruation. The
symptoms usually attending the complaint, and the treatment indi¬
cated, will be found under the head of chlorosis or green sickness.
An excessive flow of the menses depends upon constitutional
debility or disordered condition of the system, and the same course
of treatment that regulates the secretion when too profuse, may be
found equally applicable when this function is partially or wholly
obstructed.
Various derangements of the system are observed to follow as
a consequence of obstructed menstruation, such as violent pain in
the head, bleeding from the nose, violent fever, delirium, bleeding
from the lungs, violent pain in the side, back or loins, and some¬
times convulsions. The uterus is liable to have its internal surface
coated with a false membrane, obstructing the menstrual secretion.
Treatment.—Whether the obstruction be partial or complete, the
case will require to be treated upon the same general principles.
When the patient is dyspeptic, and the general health much im¬
paired, the treatment should consist in the employment of such
remedies as are adapted to restore the natural warmth of the
body, excite and sustain the capillary circulation, and correct the
disordered condition of the stomach and bowels. The remedies
and means to be employed to fulfil these important purposes, are,
stimulants, the vapor batn, emetics, vegetable astringents, and in¬
jections to the bowels. These remedies to be applied according
to the circumstance o£ the case; when the symptoms are violent,
the remedies must be applied more liberally than in slight de¬
rangements.
440
OBSTRUCTED MENSTRUATION.
There are no other means so effectual in restoring the function
of menstruation as regular courses of medicine, and the free use
of injections to the bowels, containing stimulants and lobelia.
Half a pint of strong pennyroyal tea, adding a teaspoonful ol
No. 6 and as much green lobelia; or of bayberry or sumac tea,
adding a teaspoonful of the third preparation of lobelia; or com¬
position tea, adding a teaspoonful of green lobelia, may be em¬
ployed.
The Thomsonian course of medicine is well adapted to the cure
of every derangement of the menstrual function occasioned by cold
or other constitutional derangement. The same treatment will be
proper where there is obstruction as where there is an excess of
the catamenia.
In some instances, it is only necessary to soak the feet two or
three times a day, to use a few injections, drink freely of warm
pennyroyal tea, and keep covered warmly in bed, with a warm
brick placed at the feet.
In other instances, the case will demand the frequent repetition
of a course of medicine, together with a liberal use of the othei
means already mentioned, more particularly the injections. The
functions of the kidneys, bladder and uterus, may be more imme¬
diately and effectually influenced by means of injections than by
medicine taken into the stomach.
When the derangement has become seated, and depends upon
constitutional debility, the patient should seek the fresh air, use
moderate exercise, sponge the body with cold water in the morn¬
ing, repeating it daily twice or three times a week, apply friction
to the surface with a flesh-brush or salted towel, and take such
medicine as the circumstances of the case may demand, observing
especial care to keep the feet dry.
The use of tonics are indicated when the derangement has been
of long standing, and the patient weak and relaxed. The ladies'
spice bitters, which contain a portion of gum myrrh and unicorn
root, may be employed as a general tonic and stimulant. Tinc¬
ture of guiacum is a good tonic in such cases.
In nine cases out of every ten of the cases of obstructed men¬
struation, the derangement is occasioned by exposure of the feet
to cold and dampness. Standing upon a damp pavement or upon
wet ground, in thin-soled shoes, is very apt to occasion obstruc¬
tions in the system, not always to be removed without consider¬
able difficulty.
When convulsions come on, the treatment must be thorough,
depending chiefly upon the use of the third preparation of lobelia;
or if the patient have been in good health a short time previously
to the fits, and the circulation is active, the*face red and swollen,
the brown lobelia powder may be given in lukewarm water, in
teaspoonful doses, and these repeated frequently until the symptoms
TREATMENT OP FLXJOR ALBUS.
441
abate, or the spasms disappear: there is no objection to the use of
the third preparation of lobelia in any ease, the lobelia powder
being more easily taken, would of course be preferred where it will
do as well. Injections should always be employed, if practicable,
in cases of convulsions arising from obstructed menstruation.
Case.—A robust Irish girl was seized with violent convulsions,
occasioned by obstructed menstruation. An ounce of brown
lobelia was given in teaspoonful doses, before the spasms abated.
When the patient complained of distress at the stomach from the
medicine, and free vomiting occurred, the spasms ceased.
Case.—Miss A , aged 16, was in violent spasms during the
whole of one night, occurring at intervals of every ten or fifteen
minutes. She had been bled, and had taken freely of assafcetida,
and such remedies as are used in the old-school practice, without
any appreciable good effect. The treatment was changed, and
an ounce of brown lobelia powder was given in the space of an
hour, and a stimulating injection. Sensibility was aroused in the
stomach, the patient complaining of pain at the pit of the stomach,
vomited freely? and the spasms ceased. Saleratus water was
given to cause the lobelia to operate.
SECTION II.
TREATMENT OF FLUOR ALBUS, OR WHITES.
When this complaint is attended by general debility, which is
its most common cause, a permanent cure cannot be anticipated
without an improvement in the general health being effected. To
accomplish this, a course or two of medicine will be required, in
most instances, to cleanse the stomach and bowels; after which,
the ladies' spice bitters, or some other form of bitters, should be
taken; and from sixteen to twenty of the No. 3 pills taken daily;
or a teacup two-thirds full of bayberry or sumac tea, adding a
teaspoonful of composition powder or half a teaspoonful of cayenne
pepper to the tea, every night or morning, to keep the stomach
from becoming foul. This dose will sometimes vomit, but never
unless the stomach be disordered, and then it will always be bene
ficial. Half a pint of a strong decoction of equal portions of
sumac, or witch hazel leaves, and poplar bark, administered by
injection to the bowels every night at bed-time, and retained until
morning, will not only improve the condition of the bowels, but it
442
BEE-STINGS.
will also strengthen the uterine organs. Injections with a female
syringe must also be employ 3d. In the early stage ol the com¬
plaint, or when the parts are irritable, a simple decoction of bay-
berry, cranesbill, witch hazel or sumac, may be employed; the
decoction to be made very strong, in order to have the desired
effect. An ounce of bayberry tea to a pint of boiling water, will
form a decoction of the proper strength. When the disorder has
become protracted in duration, the astringent injections must have
stimulants added, such as tincture of myrrh, No. 6, 01* tincture of
guiacum.
Tar Water has become a favorite remedy for fluor albus, used
by injection. It may be used either alone, or in combination
with some astringent.
Sponging the body with salt water in the morning, friction to
the surface, wholesome and nourishing diet, are important means
to improve the general health.
CHAPTER XXIII.
MISCELLANEOUS.
Bee-Stings.
When a person is stung by a honey-bee, wasp, hornet, yellow-
jacket, or humble-bee, a severe pain is felt in the part, soon fol¬
lowed by inflammation and swelling. It is the poison injected
into the wound that causes the pain and inflammation. The
design of the inflammation is to block up the cellular tissue, and
prevent the poison from spreading. Hence inflammation is neces¬
sary, to secure the system from injury by the poison, unless the
poison be neutralized, by applying spirits of hartshorn or salt
water. The early application of either of the above articles to a
sting, will ease the pain, and, by neutralizing the poison, will pre¬
vent inflammation.
Nervousness. — Weak Nerves.
This question is often put to physicians: What shall I do to
strengthen my nerves? It is not at all times that the proper
remedy can be pointed out, without some inquiry into the patient's
NERVOUSNESS. WEAK NERVES.
443
habits, occupation, &c. Thus one of a nervous temperament mav
by the free use of tobacco, either by chewing, smoking, or snuii-
ing, become extremely nervous from its effects. The use of any
of the narcotic poisons debilitates the nervous system. Hence
opium-eaters are apt to have their nervous system shattered, and
consequeutly they suffer extreme depression of mind, except when
the brain is under the immediate influence of the narcotic, which
produces a kind of hallucination of mind, bordering, sometimes,
upon mania. Administering laudanum, and the various prepara¬
tions (called anodynes) containing opium, to infants and children,
often does irreparable injury to the nervous system. There are me¬
dicines so poisonous, that, administered rn the most minute doses,
they will often do irreparable injury to the nervous system. The
intemperate use of alcoholic drinks also weakens the nerves, occa¬
sioning tremulous motions of the hands, and sometimes of the
whole muscular system. Depressing passions, venereal excesses,
too close application to study, more especially in confined and
unwholesome air; dyspepsia, and, in fine, whatever weakens the
system generally, will weaken the nerves; and in persons of ner¬
vous temperament, a disordered state of the nerves frequently
forms a most prominent symptom, and then the patient is said to
be nervous. Attending in a family not long since, a female in
middle life inquired of me if we had not a medicine that would
strengthen the nerves. I perceived that her nerves were extremely
weak, and having ascertained that she was a great smoker, I told
her what I believed to be the chief cause of the nervous weakness,
which, it appeared, had never occurred to her as having such a
tendency. Protracted illness, more especially when poisonous
drugs are used as medicine, is apt to leave the nervous system in
a weak condition, sometimes continuing for many years. An un¬
healthy condition of the uterine organs, and derangement of their
functions, is a very common cause of derangement of the nervous
system in females.
Treatment. — The same means that will restore the general
health, strengthen digestion, and increase the relative amount of
the red globules of blood, will strengthen the nervous system. If
the nerves are weak, in consequence of a disordered condition of
the stomach, the original cause must be removed before the nerves
can be strengthened.
Whenever nervous weakness arises from the use of tobacco, or
from any other bad habit or excesses that over-tax the system, a
restoration cannot be effected whilst the cause of the weakness is
allowed to continue to operate.
The use of the cold shower bath, or sponging the body every
morning with cold saltwater; frictions to the surface with the
flesh-brush, salted towel, or horse-hair mits, together with exercise
444
POLYPUS OP THE NOSE.
in the open air, are important means for invigorating the nervous
system.
The continued use of the No. 3 pills, by improving the condi¬
tion of the mucous membrane of the stomach and bowels, will im¬
prove the condition of the nervous system. From six to eight of
the pills to be taken at a time, and the dose repeated two or three
times daily. These pills may be used with safety in all cases, and
they have in many instances proved more beneficial than any
other form of medicine that had been employed.
Nervines. — Cypripedium humile (Thomson's nerve powder),
scutilaria laterifolia (scull-cap), are chiefly employed as nervines in
the Thomsonian practice. These may be used on many occasions
with much benefit, as a means of promoting sleep, and of quieting
nervous agitation. A collection of acid in the stomach frequently
occasions wakefulness, and an excited condition of the nervous
system, in which case a dose of sal aeratus, or bi-carbonate of soda,
in lukewarm water, is a good remedy.
Lobelia, though not a narcotic, exerts a marked influence in
calming nervous excitement. There is no remedy of equal value
in quieting fretfulness and wakefulness in infants and children, as
lobelia, given in small doses. Although it may not produce sleep
with as much certainty as laudanum, or other preparations of
opium, yet the fact of lobelia being free from any deleterious
quality, gives it the preference to narcotics.
Polypus of the Nose.
Polypus of the nose is seldom observed in others than those of
scrofulous constitution. It is generally brought on in consequence
of repeated catarrh or cold.
During the first stage of catarrh, the mucous membrane of the
nose becomes dry, then a free secretion of thin fluid is produced,
terminating finally in a thick pus-like secretion. This is the
natural course of catarrh, as it passes to a favorable termination.
Whereas, in scrofulous constitutions the mucous membrane, when
diseased by repeated colds, may be too far debilitated to establish
that kind of inflammatory action necessary- to the formation of
those salutary secretions above mentioned, and instead of there
being a thick yellowish secretion, which terminates the disease,
leaving the parts in a natural condition, a tough, semi-transparenl
substance is formed on some portion of the lining membrane of
the nostril, which adheres to the parts and increases in size, until
in some instances it fills one side of the nostril, and frequently be¬
comes extended down the posterior naries, so as to be seen and
CRAMP IN THE LEGS AND FEET.
445
felt in the throat, behind the palate. Polypus is composed of
albumen, and in time becomes in some degree organized, blood¬
vessels being shot through it from the mucous membrane.
A substance similar to polypus of the nose is sometimes formed
on the uvula of the palate, resembling the-soft part of an oyster,
arising from the same cause, though not so generally confined to
those of scrofulous constitutions as the former disorder.
Treatment.— Polypus of the nose, in its early stage, may in
many instances be dispersed by black pepper, composition powder
or finely pulverized blood-root, combined with an equal quantity
of green lobelia powder, snuffled freely up the nostril. If the
polypus be so large as to obstruct the passage of air through the
nostril, the powder should be blown upon the polypus through a
quill.
When the uvula becomes affected in the manner above men¬
tioned, having the appearance of the soft part of an oyster, or of
a blister; gargling the throat frequently with a mixture of black
pepper and whiskey, pepper sauce, or strong bayberrv or sumac
tea and pepper, will in general effect a cure in the course of a few
days. Still more effectual than gargling the throat is the applica¬
tion of dry bayberry powder, composition, or black pepper and
salt, or powdered alum. The powder may be applied by putting
it in a teaspoon, and then carry the spoon under the uvula.
Polypus of the nose cannot in every instance be removed by
the means above mentioned, as in many cases nothing short of a
surgical operation will effect its removal.
Constitutional Treatment. — When the general health is de¬
ranged, constitutional treatment must be instituted, to restore
healthy action in the mucous membrane.
Cramp in the Legs and Feet.
Cramp in the feet and calves of the legs may sometimes be pre-'
vented by the patient rubbing the feet and legs up to the knees
with the stimulating liniment, and wearing woollen or worsted
stockings at night. A bottle of hot water, or a hot brick, placed
at the feet on going to bed, will also prove a preventive to cramp.
Most persons who are attacked with cramp at night, are forced
to jump out of bed before the muscular spasm can be overcome.
In general, cramp is attended with constipation of the bowels.
In such cases, the No. 3 pills, taken to the extent of from fifteen
to thirty pills daily, and the use of unbolted flour gruel at supper,
will, by improving the condition of the bowels, lessen the tendency
to cramps at night.
446
PROLAPSUS ANI.
Prolapsus Ani — Protrusion of the Bowel.
In this complaint, a portion of the intestines protrudes irom the
anus.
Children of feeble constitutions, and more especially those who
have been injured by purgative medicines, are often affected witli
prolapsus ani.
Causes.—Constitutional weakness of the parts: the use of pur¬
gative medicine, especially aloes, and the violent straining at stool,
when the bowels are obstinately constipated, are the principal
causes of the complaint.
Treatment. — The first point to be attended to, when prolapsus
takes place, is to return the protruded intestine. This is generally
easily accomplished, early after the protrusion of the bowel takes
place, by simply pressing upon the parts. In some cases it is best
to introduce the finger, previously oiled, into the intestine, and
pressing gently upon the parts until the bowel is returned into its
proper place.
11 the parts become swollen and inflamed, so that the intestine
cannot be replaced, cloths wrung out of cold water must be applied
to the parts; or, if this does not relieve the swelling, aided by
pressure upon the parts, warm fomentations, or soft cloths wrung
out of warm water, should be substituted, and the patient be kept
nauseated with lobelia until the swelling subsides.
The means to be employed for strengthening the bowel are, in¬
jections of a strong decoction of sumac or witch hazel leaves, and
retained in the bowels several hours, and this repeated daily. An
injection of the kind above mentioned, administered at bed-time,
may in general be retained until morning.
In many cases the intestine does not protrude, except when the
bowels are moved. If tKe prolapsus be liable to occur at other
times, a tight bandage, or a truss made expressly for this com¬
plaint, must be worn until the parts become strengthened.
If the general health be deranged, constitutional treatment will
be required. Washing the body in cold salt water in the morn¬
ing, will prove beneficial in invigorating the system.
'• In infants, a fresh protrusion of the rectum may sometimes be
prevented by making them sit on a high, close stool, with their
feet hanging freely down. Every thing tending to produce either
diarrhoea or costiveness should be avoided."—Castles' Manual of
Surgery.
I
HERNIA, OR RUPTURE.
447
H ernia, or Rupture.
Hernia, in the great majority of instances, commences about
the groin, forming at first a small tumor, but, if neglected, the
protruded intestine is apt to descend gradually along the course
of the spermatic chord, and sometimes forms a large tumor in the
scrotum.
Causes.—The usual exciting causes of hernia are, violent sneez¬
ing, heavy lifting, and hard straining.
In most instances, the protruded intestine forming the tumor is
readily returned into the cavity of the abdomen by slight pressure
upon it. This is called reducible hernia.
In some cases, adhesions take place, preventing the return of
the tumor into the abdomen, forming irreducible hernia.
Occasionally the protruded intestine becomes strangulated, in
consequence of a stricture at the upper part, or neck of the 'tumor,
constituting a most formidable and dangerous form of disease.
From estimates that have been made, it would appear that one
of every ten or twelve of aged persons in the community, are
affected with hernia, or rupture, and still strangulated hernia is of
rare occurrence. The strangulation may be either partial or com¬
plete; and a patient may experience severe pain in the part with¬
out there being any stricture. It is asserted by experienced sur¬
geons, that strangulation is most liable to occur where the hernia
is very small.
Treatment.—In the treatment of reducible hernia, the first point
is to return the protruded intestine into the cavity of the abdomen,
and then apply an appropriate truss. By attending to the rupture
when first discovered, and applying a truss, a permanent cure will
in many instances be effected. The truss must be worn con¬
stantly, except when the person is in bed, and always be put on
again before rising from it. During an effort to laugh or sneeze,
the hand should be pressed against the parts, unless supported by
a truss.
In simple irreducible hernia, the tumor should be supported by
a bag, to prevent its further enlargement.
Strangulated H ERNIA.
When hernia becomes strangulated, violent pain is experienced
in the part and throughout the belly, attended with sickness and
vomiting, and more or less fever. "If the stricture continue with¬
out being relieved, the most distressing symptoms ensue. The
patient continues to retch and vomit, and the contents of the
44S
STRANGULATED HERNIA.
bowels, down to the stricture, are sometimes thrown up; the ex^
tremities are cold; the pulse small, quick, and hard." "After a
time, hiccough comes on, the pulse is hardly perceptible, respira¬
tion weak, and the whole body covered with a cold clammy
sweat. Mortification now takes place, beginning in the protruded
viscera, and extending to the neighboring parts. The patient sud¬
denly becomes easy, the swelling of the belly subsides, and the
tumor of the part diminishes, and the skin covering it sometimes
changes its natural color for a livid hue.'' By pressing the tumor
with the fingers, a crackling or crepitus will be perceived, as
though bubbles of air were bursting under the pressure of the
fingers. " This crepitus is the sure indication of gangrenous mis¬
chief within. In this state it goes up spontaneously, or is returned
with the smallest degree of pressure; a discharge is made by stool,
and the patient fancies himself better. This feeling, however, is
of short duration, hiccough and cold sweats increase, convulsive
symptoms come on, and the patient soon expires." It will be per¬
ceived that the symptoms attending mortification may be mistaken
for a favorable crisis. The cold sweats, hiccough, and unnatural
expression of countenance, continuing after the pain is gone, are
always to be considered alarming.
Treatment of Strangulated Hernia. — The use of the vapor or
warm water bath, and relaxing the system fully by giving the
patient freely of lobelia, and administering it also by injection,
and retained, constitutes the treatment most likely to overcome
the stricture.
After the patient has been in a vapor or warm water bath, he
should be wrapped in a blanket, and kept warm in bed, provided
perspiration continue. If the skin become dry, and the patient
be oppressed with heat, the surface may be bathed with spirits or
vinegar.
The most important means for the cure of strangulated hernia,
is the use of lobelia injections. They may be prepared by adding
lobelia powder to simple warm water. The brown lobelia is to be
preferred, a teaspoonful or even a tablespoonful of which may be
administered at a time, and retained. When the system becomes
relaxed, an attempt should be made to return the protruded gut
into the cavity of the abdomen, not by simple pressure upon the
tumor, but by placing a hand at each side of the tumor, and as
gentle pressure is made by the palms of the hands, the tumor
should be drawn backwards, by which the contents of the intes¬
tine will be more likely to return into the cavity of the abdomen.
Another method is to grasp the tumor with one hand, making
moderate pressure, and with the finger of the other hand, en¬
deavor to push small portions of the intestine through the stricture.
STRANGULATED HERNIA.
<149
This should not be attempted, however, until the system has be¬
come more or less relaxed by the use of lobelia given freely, and
administered by injections; together with the application of the
steam or warm water bath.
In severe cases, it will be proper to give from a teaspoonful to
a tablespoonful of the third preparation of lobelia, in bayberry
tea, every fifteen or twenty minutes, and give injections of brown
lobelia, in warm water, as often as every hour. The third prepa¬
ration will be necessary to be given to support the power of the
internal nervous energy, as well as to answer other important
objects.
A patient who has a strangulated hernia should keep the body
bent forwards, and the knees drawn towards the belly. The
position generally to be preferred, is on the back, with the hips
and shoulders raised, and the thighs drawn up.
When the above treatment fails of removing the stricture, after
being perseveringly employed, the last resort is an operation..
This, however, will require a surgeon. Although few recover
after an operation, still it may save life in some cases. The ope¬
ration itself is not severe, nor dangerous; but it is rarely per¬
formed until mortification is about to take place, which affords
an explanation why the operation is not more generally attended,
with success.
Case.—A lady fell upon a pointed piece of wood, causing a rup¬
ture, about three inches below the umbilicus, without, however,
breaking the external skin. A portion of the omentum or intes¬
tine protruded, inflammation ensued, and the tumor became ex¬
tremely painful. The physician who was called, knowing the
patient to be a Thomsonian, cautioned her against taking any
thing that would be likely to cause sickness or vomiting. Finding
no relief from the remedies used, she determined on using an
injection, containing a portion of lobelia. The injection was
retained in the bowels, occasioning extreme sickness, relaxation,
and vomiting, and during a straining effort to vomit, the protruded
omentum or intestine returned into its proper place; the pain was;
at once relieved,. and the rupture healed in the course of a few
days.
450 EPIDEMIC CHOLERA. ASIATIC CHOLERA.
CHAPTER XXIV.
EPIDEMIC CHOLERA. — ASIATIC CHOLERA.
Where cholera prevails as an epidemic, there will be a general
predisposition to diarrhoea, with other symptoms of impaired diges¬
tion, among the residents of the infected town or district; proving
the existence of a general cause, or combination of influences,
operating deleteriously upon the system—weakening the digestive
functions — effecting changes in the constitution of the blood, and
■of the secretions of the mucous membrane of the alimentary canal,
:so that articles of food not suited to the condition of the stomach
^become a source of oppression to the stomach, and even prove
poisonous, and if not rejected, may occasion death.
In all the cases of recoveries from cholera which have come
•under the immediate notice of the writer, where an opportunity
ihas been afforded of examining the matters ejected from the sto¬
mach, under the operation of the emetics employed, there have
been, invariably, flakes of a membranous appearance mixed with
thickened greyish or brown tenacious secretions, to be observed
floating upon the fluids thrown up.
The existence of a coating of consolidated albuminous secre¬
tions upon the mucous membrane of the stomach, and of the whole
alimentary canal, would necessarily impair the digestive functions;
and whether the presence of such secretions on the mucous sur¬
face constitutes a secondary cause of the loss of power in the sto¬
mach, predisposing the system to cholera, is a question important
in its bearing upon the treatment of cholera.
The immediate or exciting cause. — The general exciting cause
of cholera, as it prevailed in Philadelphia in 183*2 and '49, was
undigested food in the stomach. The enfeebled condition of the
digestive powers, rendered the stomach extremely liable to be-
•cotne oppressed, and even paralyzed, by improper articles Of diet.
In most instances, where the attack was sudden and violent, it
was after food had been taken that proved indigestible, operating
■ as a violent poison to the vital functions. The straining efforts to
vomit, attending the disease, were the struggles of Nature to rid
.the stomach of the offending cause; but frequently these efforts
were ineffectual, when not assisted by appropriate remedies.
Even in cases of cholera, where the prominent symptoms were
watery diarrhoea, unattended with vomiting or sickness at the sto-
•rnach, the administration of the hot air bath, followed by a stimu-
EPIDEMIC CHOLERA. ASIATIC CHOLERA. 45]
lating lobelia emetic, proved the most effectual plan of treatment;
evacuating the stomach of masses of undigested food and acrid
secretions, which had remained in the stomach, but for want of a
proper degree of sensibility in that organ, their presence excited
neither sickness nor vomiting. The late Dr. George McClellan,
in a lecture, stated, that during the prevalence of cholera in 1832,,
finding by post-mortem examinations masses of undigestible cru¬
dities in the stomach, where persons had died of the disease, he
adopted the practice of administering active mustard emetics; and
stated that in some instances undigestible crudities were thrown
from the stomach, such as pieces of boiled beets, cabbage, corned
beef, &c., which evidently, in some instances, had lain a week or
more in the stomach — as the persons had eaten nothing of the
kind during that period of time. The lecturer informed the class,
that the practice was invariably successful, when the mustard
emetic effected a free evacuation of the stomach, before the
patient had sunk deep into a state of collapse.
Symptoms.—A late writer (Watson), in treating of cholera, ob¬
serves : —" The epidemic cholera so far resembled the sporadic
(common cholera morbus), that it was attended by profuse vomit¬
ing and purging, by extreme prostration of strength, and by
cramps. But it differed remarkably in these respects: in the cir¬
cumstances that the matters ejected from the stomach and bowels
contained no bile, (and this alone is a good reason, against calling
the disease cholera); in the early supervention of the symptoms
of collapse; and in the great mortality of the disorder.
" The amount of fluid matters thrown up from the stomach, and
discharged by the bowels, was really in many cases wonderful.
At first, perhaps, the patient would have so copious a stool — a
consistent dejection, it might be, but so large in quantity — as to
lead him to conclude that the whole contents of the bowels had
been evacuated at once. Yet soon afterwards a turbid whitish
liquid would again and again pour from his bowels in streams ;
and be spouted from his mouth, as if from a pump: not, in general,
with much effort, but.easily and abundantly. The matters thus
discharged were thin, and for the most part of a whitish color,
like water in which rice had been boiled; without fecal smell; and
containing white albuminous flakes. There were some varieties
in the evacuations; but the kind I have mentioned, resembling
rice-water, was the most common, and the most characteristic :
and however else their sensible qualities might vary, this circum¬
stance was universal, that they contained no bile.
" With all this, there was early sinking, and collapse, as it was
called. This term, collapse, expressed a general condition, made
up, in the most exquisite cases, of the following particulars: — A
remarkable change took place in the circulation, and a striking
'152 EPIDEMIC CHOLERA. ASIATIC CHOLERA.
alteration in the appearance of the patient. The puise became
frequent, very small and feeble, and at last even for hours some¬
times extinct at the wrists. The surface grew cold; and in most,
or in many instances, blue as well as cold. The lips were purple;
the tongue was the color of lead, and sensibly and unpleasantly
cold, like a frog's belly; and the breath could be felt to be cold.
With this coldness and blueness, there were a manifest shrinking
and diminution of the bulk of the body. The eyes appeared sunk
deep in their sockets; the cheek fallen: in short, the countenance
became as withered and ghastly as a corpse. The cadaverous
aspect that sometimes precedes death in long-standing diseases,
would come on in the course of an hour or two in this complaint.
If the physician left his patient for half an hour, he found him
visibly thinner on his return. The finger-nails became blue; the
hands and fingers shrivelled, white, corrugated, and sodden, like
those of a washerwoman, after a long day's work. The skin was
bathed in a cold sweat. The voice became husky and faint. So
peculiar was this change, that the sound was spoken of as the vox
cholerica. These were the symptoms which the single word col¬
lapse was meant fo express.
44 Another very striking feature of this disorder, was the mus¬
cular cramp; affecting the muscles of the thighs and calves of
the legs, rendering them as hard and rigid as wood; and drawing
up into knots the muscles of the abdomen. These spasmodic
contractions were attended with severe pain, and constituted the
greater part of the patient's suffering. During the continuance
of the symptoms that I have been endeavoring to describe, not a
drop of urine was passed or secreted. One man, who was under
my own observation and care, and who recovered, did not void a
drop of water from Sunday morning till the afternoon of the fol¬
lowing Wednesday.
" Even in the extreme state of collapse, the intellect remained
quite clear; the patients would continue to talk rationally to the
last moments of their lives; and, for the most part, singularly in¬
different and apathetic about their condition.
" In the fatal cases—and a very fearful proportion of the whole
number were fatal — death took place sometimes' in the course of
two or three hours; and it was seldom delayed beyond twelve or
fifteen. In those that recovered, the favorable symptoms were a
cessation of the vomiting, purging, and cramp; the return of the
pulse, and of warmth to the surface; the disappearance of the
blueness of the skin, and of the hippocratic countenance ; the re¬
appearance of bile in the alvine evacuations, and the restoration
of the secretion of urine.
" The course of the symptoms varied a good deal in different
persons. Sometimes the vomiting and purging soon ceased, and
sometimes there was neither sickness nor diarrhoea at all, but
EPIDEMIC CHOLERA. ASIATIC CHOLERA.
453
rapid collapse and sinking. These were thought the most for¬
midable cases. However, the peculiar secretions were poured
jr/rth in some, at least, of the instances in which none of them
were ejected from the body. A patient died of cholera in the Mid¬
dlesex Hospital without any vomiting or purging; but on examin¬
ing the dead body, the intestines were quite full of the rice-water
serous fluid. Sometimes the cramps were not very troublesome.
The cutaneous blueness was not a universal phenomenon. The
patients were in general tormented with thirst; and when attempts
were made to bleed them, the blood was found dark and thick,
like treacle, and scarcely moving, if moving at all, in the veins;
in some cases it could not be made to flow out. Considerable
hurry, and anxiety of breathing, were also symptoms that I
omitted to mention before."
The symptoms attending cholera, as above given, are descrip¬
tive of the disease in its severest forms. It will be noticed, that
the most fatal cases were those where there was neither vomiting
nor purging; yet it would seem that physicians generally regarded
the vomiting and purging as the principal sources of danger, as
their prescriptions have been, in general, designed to check the
vomiting and purging, lihere would be neither vomiting nor
purging, if there were no enemy to life in the stomach and bowels;
and to put to rest, by means of opiates, the efforts of the organiza¬
tion to cast out the offending agents, is to operate against Nature.
In ordinary cases of cholera morbus, the stomach is in most
instances relieved of the offending substances causing the disease,
by spontaneous vomiting; but in epidemic cholera, the powers of
the stomach are too feeble to expel undigested food, and other
offending materials, from its cavity; for although liquids may be
poured out from the stomach in large quantities by spontaneous
vomiting, still there are, in most instances, remaining behind,
masses of undigested food, and other offending materials, de¬
manding for their dislodgemeni the aid of a stimulating lobelia
emetic.
Fatality. — Epidemic cholera has proved an alarmingly fatal
disease, under the various methods of treatment adopted by the
medical profession generally. The results, however, that have
attended a prompt and energetic course of Thomsonian treatment
in this disease, have been such as to warrant the assertion, that
even epidemic cholera is readily cured.
Treatment.—To warm the system, empty the stomach, cleanse
the mucous membrane of the stomach and bowels of morbid
secretions, and sustain the circulation, are the grand objects to be
kept in view in the treatment of all cases of cholera. The means
requisite to obtain these desired results, are the hot air bath, or
454 EPIDEMIC CHOLERA. ASIATIC CHOLERA.
steam bath, stimulating lobelia emetics, vegetable astringents, ac¬
tive stimulants, and external warmth.
When cholera comes on suddenly, and the temperature of the
bod}7 is not reduced much below the healthy standard, an emetic
should be given at once, and the dose repeated until the stomach
is thoroughly evacuated. External warmth must always be ap¬
plied, by means of bottles of hot water, or hot bricks wrapped up
in cloths, placed at the feet and around the patient.
When the attack is more gradual, the circulation feeble, the
surface and extremities cold, the hot air or steam bath must be
administered promptly, to warm the blood, restore capillary cir¬
culation, and relieve internal congestions; and immediately after
the bath give the emetic in full doses.
The Emetic. — The most efficient emetic for cholera is lobelia,
combined with stimulants and an astringent. Either of the fol¬
lowing preparations may be employed. The doses to be repeated
two or three times, or oftener, if necessary, at intervals of from
ten to twenty minutes.
Take of the third preparation of lobelia, two large teaspoons-
ful; mix it with a gill or more of bayberry tea, made by
steeping an ounce of the bayberry in a pint of boiling
water. Sweeten well, and give at once.
Or, — To the above add one teaspoonful of the green lobelia
powder.
Or, — Take of green lobelia powder one large teaspoonful,
.cayenne half a teaspoonful, No. 6 two teaspoonsful, sugar
a large teaspoonful. Rub these well together, and then
add bayberry tea, prepared as above directed.
The above emetic doses are adapted to the treatment of violent
cases of cholera. In cases where the disease is of a milder cha¬
racter, the doses will not be required to be so large.
Repeating the Emetic.— To evacuate the stomach of its foul
contents, is not the only important object to be accomplished by
the emetic doses ; for they are well adapted to sustain the circu¬
lation, and effect a determination to the surface.
In some instances, in cholera, it will be necessary to continue
the doses of the third preparation of lobelia in bayberry tea, at
intervals of from one to two hours, for a day or two, before the
system can be brought into a condition to allow of its discon¬
tinuance.
The writer has had cases of cholera under treatment, when the
stomach rejected at once every thing in the way of diinks or
medicine, excepting teaspoonful doses of the liquid part of the
EPIDEMIC CHOLERA. ASIATIC CHOLERA.
455
third preparation of lobelia, combined with bayberry or sumac
tea; and when the patient did vomit after these aoses, the matters
ejected were such as the stomach had not the power to throw
off previously, although the retching and straining efforts had in
some instances continued, at frequent intervals, for hours or even
days.
Finally, the only effectual way to relieve the retching and vomit¬
ing attendant upon cholera, is to warm the system, cleanse the
stomach, and effect a determination to the surface.
Full doses of the emetic preparation may occasion pain in the
stomach; but the pain soon subsides, and the patient feels at once
that he has been benefited by the medicine. Hot applications to
the pit of the stomach will tend to relieve pain.
The hot air or steam bath is indispensable, in many instances,
to the cure of cholera. When the patient has sunk into a state
of collapse, or is affected with cramps; or when the surface and
extremities are cold, nothing can be done that will afford so much
relief to the patient, and at the same time prove of so much benefit,
as the application of the hot air bath.
The writer has not known of an instance where the application
of the bath has failed of relieving cramps, when the patient was
able to sit in the chair a sufficient length of time to allow the system
to become warmed by the hot air or steam. In many instances,
a remarkable change in the condition of the patient has been
effected by the hot air bath, in the course of twenty or thirty
minutes. Imparting warmth and animation to the whole system,
the cramps soon cease, the circulation is attracted to the surface,
the external capillary circulation is restored, internal congestions
relieved, the pulse rises, the lungs expand more fully and freely,
enabling them to perform their function of decarbonizing and
vitalizing the blood in a more perfect manner; and with all these
good results, the system is placed in a condition more favorable
for the effectual operation of an emetic, and other internal remedies
employed in the treatment.
Directions for administering the hot air and steam bath wiii be
found in a subsequent part of this book. When the patient needs
support to enable him to sit up, a chair, with the back towards
him, should be placed before him, with a pillow on the back of
the chair to rest the head upon. The head should be wet with
spirits or vinegar, and the face be wet frequently with, the same,
or with Cologne and water, or with simple water, as may prove
most agreeable to the patient. When the heat of the bath becomes
oppressive, the surface must be bathed with water; or take a
sponge or towel filled with water, and press about the neck, ao
that the water will pass down over the body.
The application of the bath must be repeated as often ai ihe
circumstances of the case demand it; and when the patient feels.
456
EPIDEMIC CHOLERA. ASIATIC CHOLERA.
comfortable in the bath, it may be continued half an hour or longer
at a time.
Internal medicine must be given during the operation of the
bath; either composition tea, with tincture of ginger or No. 6
added; cayenne tea, with a teaspoonful of spirits of camphor or
spirits of ammonia added; or a tea-cup of bayberry tea, adding
a teaspoonful of cayenne.
When the patient has been in the bath a sufficient length of
time, the surface must be bathed, or showered with cold water,
rubbed dry, and then bathed with some kind of stimulant, such as
whiskey, brandy, tincture of myrrh, vinegar, or No. 6; then cover
the patient warmly in bed, and apply bottles of hot water to the
feet and to the abdomen; or if the patient lies on his back, place
the bottles to his sides.
Of other remedies to be employed.—In the early stage of cholera,
and when the symptoms are of a mild character; and also when
the disorder has been checked by the treatment as above recom¬
mended, one or more of the following remedial agents should be
taken, at intervals of from one to two hours—namely:
Composition powder, No. 6, and sugar, of each a teaspoonful;
rub these together in a tea-cup, and then fill the cup half
full of lukewarm or cold water; stir it well, and take be¬
fore it settles. Or a teaspoonful of the liquid of the third
preparation of lobelia, mixed with a tea-cup half full of
bayberry tea, or with a tablespoonful of bayberry syrup.
Or a teaspoonful of cayenne, mixed with a tea-cup half full
of bayberry tea. Or from eight to ten of the No. 3 pills.
Poulticing. — Equal portions of composition powder, cayenne,
and elm powder, wet with hot water, to a proper consistence for
a poultice, applied over the abdomen, will be found highly advan¬
tageous in the treatment of cholera, and in all analogous com¬
plaints. . The poultice to be wet occasionally, and renewed as
often as once in every twenty-four hours.
Injections.—Stimulating and astringent injections are beneficial
in all cases of cholera; and though not indispensable to the cure
of the disease, still they cannot be employed too frequently, to
answer a good purpose. One of the best preparations for injec¬
tions, is half a pint of bayberry or sumac tea, with from one to
two teaspoonsful of the third preparation of lobelia added.
Drinks. — Cold water may be allowed the patient, provided it
ibe found to agree with the stomach. If the thirst be urgent, weak
EPIDEMIC CHOLERA. ASIATIC CHOLERA.
457
cayenne tea, or ginger tea, or any kind of herb tea that the patient
may fancy, may be taken freelv, even though they be reiected by
the stomach.
Diet. — Essence of beef, egg-soup, chicken-water, wine-whey,
and milk porridge, constitute the kinds of food best adapted to
the enfeebled condition of the digestive functions in cholera.
The following letter from R. M. Pancoast, M. D., who was
called to Winslow, N. J., in the summer of 1849, to treat cholera,
which prevailed in that place to an alarming extent, affords ample
proof of the superior efficacy of thorough Thomsonian treatment
in that disease.
Winslow, N. J., July 30, 1849.
Dear Doctor: — I embrace this, my earliest convenience, to
give you a hasty sketch of what I have witnessed since coming
to this place. The cholera in its most malignant form has visited
this town. For the last two weeks my time has been almost con¬
stantly occupied, night and day, ministering to the sufferers from
this disease.
Nearly all of this sickness has occurred in a place little, if any,
over a mile square, and containing only about four hundred inha¬
bitants. There is scarcely a person in the town whose system
has not been palpably affected by the cause of this disease. What
this cause is, I of course cannot pretend to say, but will give you
a hurried glance at its effects, with which I am now sufficiently
familiar.
Owing to some abnormal, atmospheric, or geological condition,
I know not which, but most probably a concurrence of both; the
mucous lining of the stomach, and in fact of the whole alimentary
canal, becomes more or less weakened, and its secretions corre¬
spondingly deranged ; as is manifested by the appearance of a
peculiar yellowish coating upon the tongue, and by the individual
experiencing a clammy feverish taste in the mouth, with rather
an unusual desire for drinks.
This furred condition of the tongue, thirst, &c., at first slight,
continues to increase for a period of from one day, to a week ;
when looseness of the bowels commences, and progresses with
greater or less rapidity, until the evacuations become either of a
light or yellow color, and watery consistence; which condition
may obtain for a period of from one hour to several days. All
this* time the man eats well, sleeps well, and may tell you that he
feels well—having little or no pain with his diarrhoea (the less
pain the greater the danger always); and although, in many in¬
stances, you cannot persuade him he is in the least danger, yet, in
458 EPIDEMIC CHOLERA. ASIATIC CHOLERA.
reality, he is now almost upon the very verge of the grave; for
he is now liable to be seized at any moment with vomiting and
cramps, when, unless promptly and judiciously attended to, death
X'ill ensue in from one to twelve hours.
So much for this disease when not interfered with. Now for
the treatment. I came here possessed of no great confidence in
the power of any remedial agency to counteract the cause of
cholera; particularly in severe cases. My success, however, has not
only exceeded my expectations, but has been beyond even my most
sanguine hopes. Every case—without one single exception—that
has come under my care previous to the supervention of collapse,
and in which the course recommended has been strictly adhered
to, has recovered, or is now rapidly recovering. And quite a
number have recovered to whom I was called subsequent to the
stage of cramp and collapse, when the extremities were cold and
shrivelled, the surface bluish, and the whole capillary circulation
apparently suspended.
My plan is this. If consulted during the first or second stage
of the disease, I direct a heaping teaspoonlul of composition pow¬
der (or bayberry and cayenne) to be rubbed up with as much
sugar, and taken in a teacup half-full of cold water, — or what is
better, strong bayberry tea,—immediately after every evacuation
from the bowels, until there is but one in the twenty-four hours.
After this, the same dose may be taken about an hour before each
meal, with from four to ten of the No. 3 pills every hour, whilst
awake, until the tongue becomes clean. But this will only answer
in the first and second stages of the disease, when we have plenty
of time. If there be cramp and coldness of the extremities, the
most prompt measures must be had recourse to at once — for in
these cases time is all important — even half an hour's delay may
prove fatal; for with the discharges in cholera, as Prof. Meigs
says of hemorrhage, it is not the first quart, but the last ounce
that kills.
The indications are, first, to relieve the tension upon the muco-
capillary system, by attracting the blood from thence to the sur¬
face and extremities. Secondly, if, as usually occurs, the stomach
be over-distended and oppressed, either by indigestible food, or by
the serous exhalations from its weakened mucous surface, to eva¬
cuate it as speedily as possible. And lastly, to stimulate or arouse
the latter to the proper performance of its function.
The most prompt and efficient means of accomplishing the first
is, the hot-air bath ; in which I place the patient as quickly as
possible, and then administer a teaspoonful of capsicum with one
or two teaspoonfuls of 3d preparation, in about two-thirds of a
teacupful of strong bayberry tea. This is a tremendous charge,
and usually decides the contest. The patient, if no? too far gone,
EPIDEMIC CHOLERA. ASIATIC CHOLERA.
459
soon becomes warm, his pulse returns at the wrist, and he per¬
spires freely. If this be the case, he is safe — the cramps and
discharges being almost immediately arrested. I now have hot
bricks placed in the bed, and the patient removed from the bath
to the bed; direct the above dose to be repeated every fifteen
rnkiutes, until retained on the stomach that length of time ; then
every thirty minutes, until retained that length of time; then every
hour, &c., gradually decreasing the quantity and frequency of the
dose. The most important point is to keep the patient warm. So
long as one perspires he is safe; and anything that will excite per¬
spiration, and restore the action of the mucous lining of the sto¬
mach and bowels, and consequently the power of generating
animal heat, will cure the cholera. But a distinction must be
made between perspiration and the oozing from paralyzed and
relaxed cuticular capillaries.
The greatest apprehension that I have on leaving a patieni, is
that the attendants will allow him to become cold. For I have
noticed that in every instance, and to the same extent that they
are allowed to become cold, do they cease to improve, and grow
worse.
The observation of Cartwright, that " the fluids cannot run in
opposite directions," is gainsayed by facts elicited in every fatal
case of this disease. For in every instance of death from cholera,
is there both internal and external exhalation progressing at the
same time, previous to dissolution.
The functions of the liver and kidneys, in common with those of
the mucous surfaces, are more or less suspended, and by the same
means are they just as certainly restored. The liver secretes no
bile, and the bowels secrete no faeces; in fact, all action is lost in
the muco-capillary system; and the disease, or rather the cause
of death, is one of inaction — of debility. The weakened vessels
relax and allow their contents to flow out, and unless proper
means be. taken to restore their wonted contractility, the system
is drained of "the pabulum of life," and death must and vi'
ensue.
Respectfully yours,
R Montgomery Pan .«■ / (k
460
thomsonian course of medicine.
i
THOMSONIAN COURSE OF MEDICINE.
The following process constitutes a Thomsonian course of medi¬
cine.
1st. A hot-air or vapour bath.
2d. An emetic, prepared and administered according to the di¬
rections hereafter given.
3d. An injection to evacuate the bowels. In some cases it is
better to administer an injection at the commencement, before the
vapour bath, and repeat it after the emetic operates.
4th. After the operation of the emetic, the vapour bath is again
applied, to restore a natural warmth to the system, or, as Dr.
Thomson expresses it, "to set the wheels of life in proper action
5th. Light nourishment is to be given after the emetic operates,
either before or after the last bath, as the inclination of the patient
may dictate. Milk porridge is generally given as nourishment
after a course of medicine, and when the patient inclines to take
it during the operation, it may be given, as it will assist the opera¬
tion of the emetic. In sudden attacks of disease, however, as in
fevers, pleurisy, &c., crust coffee, elm, gruel, barley-water, or gum
arabic water, will be more suitable than milk in any form.
The above process, termed a course of medicine, first instituted
by Samuel Thomson, is the most effectual, consistent and philoso¬
phical plan of treatment ever devised for assisting nature in her
curative efforts, when the system is invaded by disease. By
courses of medicine, together with the usual intermediate treat¬
ment, disease may be cured that has resisted every other plan of
treatment; and even though it fail of effecting a cure, still the
treatment will not injure the constitution — the declarations of
medical men to the contrary notwithstanding. The medical pro¬
fession manifest a degree of prejudice against the Thomsonian
practice that is wholly inexcusable. As guardians of the health
and lives of the community, they should know better than to
make the ridiculous, false and absurd assertions which many of
tiiem do in re at ion to the Thomsonian practice.
TIIOMSuNIAN COURSE OF MEDICINE.
GENERAL DIRECTIONS FOR ADMINISTERING A
COURSE OF MEDICINE.
1st. The Hot-air Bath and, the Steam Bath. — The hot-air or
alcoholic bath may be employed in all cases in place of the steam
bath, as it will effect the same important objects that can be at¬
tained by the steam bath ; and as the former requires much less
labour, and may be administered so much more readily than the
steam bath, it must be regarded as an improvement upon the usual
plan of imparting warmth to the body by the steam bath.
The articles required in the application of the hot-air bath are:
a small-sized teacup, about three inches and three-quarters across-
the top (the cheapest kind of ware is always to be preferred); a
tin wash-basin or common quart bowl; a chair with a solid
wooden seat; a flannel skirt or small blanket, to put on the seat
of the chair; two blankets, or a blanket and quilt, to cover the
patient; and alcohol.
Having the above articles at hand, fill the teacup two-thirds full
of alcohol; place it in the middle of the basin or bowl; pour cold
water into this vessel, but not so much as to float the teacup, and
place these upon the floor, under the centre of the chair. Upon
the seat of the chair place the flannel skirt, allowing it to extend
half-way to the floor, in front of the chair, to protect the thighs
from the heat,—but not to extend over the sides of the chair.
The patient takes his seat upon the chair; then the blankets are
to be thrown loosely over him and the chair, leaving the head un¬
covered. First spread a blanket over the back of the chair, and
pin it under the patient's chin; then a blanket or quilt is to be
placed in front, and pinned at the back of the neck. Now raise
the blanket a foot from the floor at the back of the chair, and
apply a match or lighter to the alcohol.
The patient's feet to rest upon a stool, or upon the round of the
chair upon which he sits.
Observe always to use woollen materials for placing on the
chair and covering the patient; as cotton might take fire by acci¬
dentally coming in contact with the blaze from the burning alco¬
hol. If the blankets covering the patient be not sufficient to retain
the heat, a cotton sheet or light quilt may be spread over the
blankets.
During the operation, the face and head should be wet frequently
with cold water, vinegar, or alcohol and water; and when the
heat becomes oppressive, take a sponge or soft towel, filled with
cold water, and press against the side of the patient's neck, pulling
the cover from the neck, so that the water will run down over the
462
THOMSON I AN COURSE OF MEDICINE.
patient; this is reviving, and may be repeated often, as the shocks
from the cold water are beneficial.
If the teacup in which the alcohol is burned be over three inches
and three-quarters in diameter at the top, there will be too much
heat, probably, for the patient to bear. When the heat is too
high to be borne, the blanket must be raised from the floor a few
inches, at the back of the chair, to admit cold air. It is always
best to admit fresh air into the room, to the patient, when in the
bath.
A dose of composition tea, with a teaspoonful of No. 6 added,
should be taken after the patient has been in the bath a few
minutes.
In applying the hot-air bath, when a patient has fever, or when
the skin is unusually dry and harsh, the surface should be kept
wet with lukewarm water until perspiration comes on. This the
patient can generally do himself, with a wet sponge or towel.
The Steam or Vapour Bath.—Various methods are employed in
the application of the vapour or steam bath; the usual plan, how¬
ever, is to place the patient upon a tight-bottomed chair, throwing
a quilt over him, leaving the head uncovered; a flat-bottomed
basin or dripping-pan is to be placed under the chair; a quart of
hot water poured in, and put into it a red-hot brick or stone.
Bricks that nave been kept in a dry place are much the best;
the fire-brick are the kind to be preferred, if obtainable. If the
brick be entirely red or while hot, it should be set in sidewise at
first, or the steam may be too warm for the patient to bear; in a
few minutes the brick may be placed with the flat side down.
Three and sometimes two bricks will be sufficient, provided they
are thoroughly dry, and red-hot on one side. If the steam be too
hot, the quilt may be raised from the floor so as to admit the cold
air; and when the patient feels oppressed with the heat, the face
and head must be frequently wet with cold water, vinegar and
water, or whiskey, and occasionally the body of the patient should
be washed or sponged with cold or tepid water. During the latter
part, or at the close of the steaming, a shower bath must be used,
or the patient washed in cold water, rubbed dry, and bathed with
vinegar, or with some kind of alcoholic liquor.
The feet may be effectually steamed by placing a stool upon the
chair, the patient sitting upon the stool and resting the heels upon
the edge of the suat of the chair.
A small tin boiler and pipe, for conveying steam either into a
steam closet, or under a chair, is more convenient than hot bricks,
and the steam can be more easily regulated than when bricks are
used.
The patient having got into bed immediately after the bath, and
THOMSONIAN COURSE OF MEDICINE.
463
a bottle of hot water, or a hot brick, placed at the feet, should
take the emefic, whilst the system is in a glow of warmth.
The Emetic.
Lobelia Emetics may be prepared in many different ways.
The plan adopted by Dr. S. Thomson, of combining with lobelia,
stimulants and astringents, for cleansing the stomach, renders the
emetic more efficacious, and, at the same time, easier in its opera¬
tion.
For ordinary cases of disease, the following constitutes an effi¬
cient emetic:
A teaspoonful of the third preparation of lobelia,
A teaspoonful of green or brown lobelia,
And a large teaspoonful of sugar;
•
Rub these well together in a teacup, and then pour on a teacup
two-thirds full of strong bayberry or No. 3 tea, lukewarm. To
be stirred well, and taken before it settles.
A similar dose is to be repeated in the course of twenty minutes
or half an hour. It is seldom necessary to take more than two
doses; still, more may be given if required. I have on many oc¬
casions given two and three ounces of lobelia in administering a
course of medicine.
In violent fever, severe attacks of inflammation,—as in inflam¬
mation of the lungs, pleura, or of the brain; convulsions, accom¬
panied with a hot skin and swollen face; and in all cases where
A is important to relax the system, the emetic should contain a
less proportion of the stimulants; for instance,—
Take a teaspoonful of brown lobelia, pulverized, and half a
teaspoonful of cayenne pepper, and mix them with strong
berry tea, sweeten, and take immediately after being
stirred.
Or, — Take a teaspoonful of brown lobelia, and the same
quantity of vinegar, and pour on scalding hot bayberry or
composition tea. Then, after standing a few minutes,
stirring it frequently, strain, sweeten well, and add as much
cayenne as will lie upon a ten-cent piece.
Or, — Simply mix the lobelia powder in composition tea.
Or, — Give from four to six of the compound lobelia pills
every half hour, until four or five doses are taken, or until
they occasion sickness. They will do no harm, taken in
any quant'ty.
464
TH0MS0NIAN COURSE OF MEDICINE.
When a sufficient quantity of lobelia has been given, the patient
should be allowed to remain quiet, without taking any thing to
force the operation, until an hour or two has elapsed. In some
instances, however, the patient will vomit soon after taking the
emetic; but in very many cases the emetic will remain from two
to four hours before it will operate, provided no means be taken
to force its operation. It is better that the emetic remain on the
stomach at least an hour, as it generally renders the operation
more easy and effectual.
A teaspoonful of the supercarbonate of soda, or half a tea-
spoonful of saleratus, taken, dissolved in a tumbler half or two-
thirds full of lukewarm water, will seldom fail of causing the
emetic to operate in a short time. If this should occasion pain
in the stomach, it will do no harm, and generally subsides very
soon after the patient vomits. A bottle of hot water, or a hot
brick placed over the seat of the pain, will tend to relieve the
distress.
In cases of sfeated disease, where the patient is weak, and the
system relaxed, as in low, protracted fevers, long-standing dys¬
pepsia, chronic diarrhoea, &c., where the condition of the stomach
requires active stimulants and astringents, there can be no better
form of emetic than teaspoonful doses of the third preparation of
lobelia, in a very strong tea of either bayberry or sumac ; or taken
in bayberry syrup. The dose to be repeated as often as may be
deemed requisite. The third preparation of lobelia, to be em¬
ployed, should be freshly made, or such as has been kept well
corked.
Half a teaspoonful of green lobelia powder, added to each dose
of the third preparation, will insure a more effectual operation.
As a substitute for the third preparation, mix two teaspoonsful
of No. 6 with a teaspoonful of green lobelia powder, and half a
teaspoonful of nerve powder.
3d. The Injection. —In some cases it is better that an injection
be administered in the commencement of the course, before the
vapour bath, and another after the operation of the emetic.
The kinds of cases where this course is more particularly
needed, are such as are attended with a determination of blood to
the head, and coldness of the feet; for instance, in erysipelas on
the nead or face; severe neuralgia of the head or face; violent
pain in the head, from any cause; apoplexy, stupor, &c.
A very common form for injections is half a pint of composi¬
tion tea, adding a teaspoonful of nerve powder to the tea whilst
hot, and when lukewarm, a teaspoonful of lobelia powder and as
much No. 6. This answers for common cases. Where there is
canker in the bowels, and in case of dysentery, cholera morbus,
&c., the bayberry or No. 3 tea should be usedr adding the liquid
THOMSON I AN COURSE OF MEDICINE.
465
of the third preparation of lobelia, or two or three teaspoonsful
of No. 6, and a teaspoonful of green lobelia.
Ii the bQwels be much disordered, injections will in general oc¬
casion more or less pain and distress for a short time; the patient,
nevertheless, experiences much relief from the operation. An in¬
jection containing lobelia, if retained in the bowels, will often
cause sickness at the stomach and vomiting, and effectually relax
the system. Recent attacks of disease have in many instances
been broken up by such an operation. Asa general rule, patients
experience the most benefit from injections that occasion the most
distress and pain. Lobelia possesses a propem of arousing the
sensibility of the stomach and bowels, so that if they are diseased,
it causes the patient to feel the disease.
4th. The Second Bath.—The proper time for administering the
ast bath in a course of medicine, as a genera] rule, is, when the
patient ceases to sweat, or becomes restless after the operation of
the emetic. If the patient continue to retch and vomit a long
time, there is nothing so effectual in settling the stomach as a
steaming. When the bath has been continued long enough, the
patient must be showered or washed with cold water, rubbed dry,,
then bathed with alcohol, whiskey, or vinegar, and kept warm.
It is beneficial in many cases to bathe the surface with No. 6,.
pepper sauce, or stimulating liniment, after the last bath, and when
the patient is rubbed dry. This is more especially needed where
the skin is in a relaxed condition, as in chronic rheumatism, bron¬
chitis, asthma, consumption, &c. Sometimes the skin is extremely
sensitive to stimulants, and if applied too freely, will occasion a
severe burning sensation in the skin, which may continue several
hours.
Drinks. — When patients are thirsty during the course, they
should be allowed to drink as much of warm teas, or even of cold
water, as may be desirable to them.
Food. — Some persons, on reading Dr. Thomson's work, under¬
stand him to say that patients, after a course of medicine, may
take almost any kind of food. It is those cases where the appe¬
tite and digestion are restored that Dr. Thomson alludes to, when
he speaks of allowing almost any kind of food that the appetite
may crave. In most cases of disease, the digestive powers are
too* feeble to digest any but the lightest kinds of food, such as
barley water, crust coffee, arrowroot gruel, egg soup, essence of
beef,'toast and tea, and panada. Even milk porridge, which is
generally given after a course of medicine, is not adapted to the
condition of the stomach in cases of fevers, severe pleurisy, in¬
flammation of the lungs, and during the early stages of sudder®
30
4G6
THOMSONIAN COURSE OF MEDICINE.
attacks of disease accompanied by fever. It is far better that a
patient, in the early stage of a severe attack of disease, abstain
from food altogether, than to take such as will oppress the sto¬
mach.
From three to six hours is in general required for a full course
of medicine; and except in urgent cases, it is better, as before
stated, to allow the emetic to remain on the stomach an hour or
two, or at least avoid forcing the patient to drink largely of teas
soon after the emetic has been taken.
A Partial Course of Medicine. — In very many instances of dis¬
ease, a full course of medicine is not required; all that is neces¬
sary is to restore the natural warmth of the body, by meaVis of
the hot-air or vapour bath, and then to give an emetic; dispensing
•with the injection and the second bath.
Emetics without Steaming. — In sudden and violent attacks of
disease, as in croup, fits, colic, sick headach, cholera morbus, and
in fine, all sudden ;• acks of disease, emetics may be given with¬
out the previous administration of a bath.
Hot bricks wrapped in damp cloths, placed around a patient,
may take, in many cases, the place of the vapour bath. Thus, in
cases of low fevers, as they are termed, it often becomes necessary
to vomit a patient every day when he is too weak to sit up. In
rheumatism, when the patient cannot be moved without occasion¬
ing severe pain, it may be better, especially in cold weather, to
give emetics, without moving the patient from the bed.
Preparing the Patient for a Course of Medicine.—In sudden at¬
tacks, and in all cases of acute disease, a course of medicine may
be given, as before stated, without any preparatory medicine;
whereas, in chronic complnints, as in consumption, deep-seated
dyspepsia, and in cases where the system is in a cold and torpid
condition, a course of medicine will prove more effectual by the
patient taking composition several times a day, or from twenty to
thirty of the No. 3 pills, and three or four compound lobelia pills
at night, and continuing the use of these medicines several days
before the course is administered.
Repeating the Course of Medicine. — In the first stages of dis¬
ease, and more especially if the attack be violent, the course of
medicine, or at least a partial course, may be repeated daily until
the symptoms abate. In small-pox, measles, and scarlet fever, the
disease will run its course, and all that we can anticipate from the
operation of medicine in these cases, is to relieve the symptoms,
and aid the constitution to work off the disease in the way which
nature or the God of nature has established. In chronic com-
THOMSONIAN COURSE OF MEDICINE.
467
plaints, as in long-standing dyspepsia, consumption, chronic gout,
and rheumatism, and whenever there is absence of fever, a course
of medicine will seldom become necessary oftener than once in
two or three weeks. In fine, there are many cases of seated dis¬
ease in which more reliance is to be placed upon fresh air, a
change of residence, travelling, sea bathing, and a strict attention
to diet and regimen, than upon medicine.
Emetics for Children and Infants. — A teaspoonful of green
lobelia powder, and a teaspoonful of brown sugar, wet with com¬
position tea, and rubbed with a spoon, to soften the lobelia powder,
and then adding from half a gill to a gill of bayberry tea or com¬
position tea, will form a suitable emetic for children. To be
stirred well, and given before settling.
A child that will swallow pills may be as effectually vomited
by taking from six to ten 'of the compound lobelia pills, fresh
made, as by any other form of emetic.
For Infants, half a teaspoonful of green lobelia powder, pre¬
pared as above directed, will generally prove sufficient for eva¬
cuating the stomach. Or, from half to a teaspoonful of the syrup
or tincture of lobelia, mixed with a tablespoonful of bayberry tea,
sweetened.
No fears need be entertained of giving too much lobelia, even
to infants; although it may cause distress for a time, the result
from the operation will prove beneficial.
The hot-air or steam bath may be administered to children in
the same way as for grown persons, by placing the child in a
small chair, and placing this upon the seat of such a chair as is
used for administering the bath to adults.
Remarks concerning various symptoms that attend, the operation oj
a Course of Medicine.
Some persons have declared that they never felt better than
when going through a course of medicine, excepting during the
sickness and vomiting; and then again, under a different condition
of the system, patients will experience severe pain and distress.
The tendency of the course of medicine is to awaken sensibility,
and to excite the efforts of nature to action to overcome obstruc¬
tions, cast off morbid matter from the stomach, and to restore a
natural circulation throughout the system; and hence, the more
the system is diseased, the more distressed the patient will be
when he is made to feel his real condition.
At one time a patient may vomit by merely taking a dose of
composition tea ; whils* at another, when the stomach is in a dif-
468
THOMSONIAN COURSE OF MEDICINE.
ferent condition, half a dozen doses of composition will not occa
sion the slightest sickness. A patient with a very foul stomach
may become sick from taking a dose of composition, or of bay-
berry and pepper, during the first steamihg in a course of medi¬
cine ; and after the operation of an emetic, and the stomach
becomes settled, a pint of composition may be taken without
causing the slightest sickness. It often happens, however, that
the stomach will not be settled until after the last bath, the patient
vomiting freely on having his system warmed by the steam, and
by taking stimulants; after which, the stomach will not be dis¬
turbed by these medicines, even though they be taken freely.
A vapour bath, when administered previously to an emetic, or
when the emetic has not operated effectually, may occasion sick¬
ness at the stomach, and cause the patient to feel weak and faint
for a time; but is often observed to increase the strength when
the stomach is not foul. I have on many occasions observed a
patient, on taking a course of medicine, to be much stronger after
the last bath, who had felt weak and relaxed from the first, in
consequence of the disordered state of the stomach. Patients
sometimes become sick and feel oppressed soon after they are
placed in the bath, and feel as though they cannot sit up, or bear
it any longer; but by throwing cold water in the face, and allow¬
ing fresh air to come to the patient, the sickness will, in general,
pass off in a short time; and when perspiration becomes free, the
patient will experience no difficulty in sitting in the bath the usual
time required for the operation.
When the stomach is cold and contains acid, a dose of pepper
or composition tea is apt to cause pain in the stomach, more es
pecially during the first bath in a course of medicine. In such
cases, the pain is relieved when the patient belches wind or gas
from the stomach. Some No. 6, or tincture of ginger, in hot
water, taken as hot as the patient can bear it, will relieve these
unpleasant feelings. Essence of peppermint, lavender, or any
thing that is good to expel wind from the stomach, may be em¬
ployed.
Of peculiar symptoms, sometimes observed during the operation oj
a Course of Medicine.
Lobelia, especially the brown lobelia (the seed), taken in emetic
doses, will sometimes, and more particularly in persons of nervous
temperament, and in cases of deeply-seated disease, occasion
symptoms which have been called alarming symptoms; whereas
the term crisis symptoms would be more appropriate; for it has
been universally observed that the occurrence of these symptoms
.is in most instances followed by a manifest improvement in the
condition of the health of the patient;—effecting cures where all
THOMSONIAN COURSE OF MEDICINE.
469
other means had failed. Seemingly, almost miraculous cures
have been brought about by such operations, in long-standing
cases of disease, where probably nothing short of placing the
system fully under the active influence of the hot-air or steam
bath, and brown lobelia, would have answered the purpose.
The following symptoms will sometimes be observed during the
operation of a course of medicine, where the brown lobelia pow¬
der. is employed as an emetic, or administered by injection, to
wit: soon after the emetic is taken, the patient complains of pain
or distress in the stomach, which soon extends to the bowels; he
is continually changing his position; rubs his stomach and bowels,
and complains very much of distressing feelings. The breathing
becomes irregular, respiration being sudden, somewhat like the'
sobbing of a child. The distressing feelings in the bowels subside,
but the patient remains relaxed, the skin sometimes colder than
natural, and contracted; the tnucous membrane of the nose is
dry, inducing the patient to pick or rub his nose frequently; the
tongue and mouth are dry, attended with more or less thirst. The
patient makes efforts to get out of bed; frequently feels like
Slaving a motion from his bowels; talks in an unconnected man¬
ner, and sometimes lies completely relaxed, apparently too weak
to raise his hands, and the countenance is pale and contracted.
During the continuance of the symptoms above described, the
stomach and bowels appear to be in a state of unusual agitation,
as though the vital energies were concentrated in these organs,
(generally the seat of disease,) and carrying on a revolutionary,
health-restoring action; which, after continuing an indefinite
period of time, varying from one to four or six hours, and occa¬
sionally a still longer period, free . vomiting again ensues, after
which the patient goes to sleep, and sleeps calmly and naturally;
the skin becomes moist and warm, and often profuse perspiration
ensues. On awaking, the patient expresses gratification at feeling
so well; appears unconscious of having suffered to any extent
during the operation; has probably a good appetite, and, after
taking light, nourishing food; and then having the course of
medicine completed by the administration of a bath, showered
with cold water, rubbed dry, and bathed with alcohol or vinegar,
realizes a remarkable improvement in his general feeling.
Dr. Thomson, in treating upon the subject of the operation of
lobelia, says, as follows:—
"When this medicine (lobelia) is given to patients that are in
a decline, or are labouring under a disease of long standing, the
symptoms indicating a crisis will not take place until they have
been carried through from three to eight courses of medicine;
and the lower they have been, the more alarming will be the
symptoms. I have seen some who would lay and sob for two
hours like a child that had been famished; not able to speak or to
470 THOMSONIAN COURSE OF MEDICINE.
raise their hand to their head; and the next day be about, and
soon get well. In cases where patients have taken considerable
opium, and a course of medicine is administered, it will, during
the operation, produce the same appearances and symptoms that
are produced by opium when first given; the opium having lain
dormant, is roused into action by the enlivening effects of the
course of medicine, and they will be thrown into a senseless state;
the whole system will be one complete mass of confusion; the
patient tumbling in every direction, will require two or three per¬
sons to hold him in bed; they grow cold, as though dying; re¬
maining in this way from two to eight hours, and then awake like
one from sleep, after a good night's rest, and become entirely calm
and sensible, as though nothing had ailed them. It is seldom that
they have more than one of these turns, as it is the last struggle
of the disease, and they generally begin to recover from that time.
I have been more particular in describing these effects of lobelia
in particular cases, where disease is deeply seated, as they are
very alarming to those unacquainted with them, in order to show
that there is no danger to be apprehended, as it is certain evidence
of a favourable turn of the disease."
Thomsonians are frequently applied to in desperate cases, where
it is impossible to determine whether the disease is curable or not;
and notwithstanding the grave charges so frequently against the
Thomsonian practice when it fails of removing disease, still a trial
should be made, so long as the circumstances of the case furnish
grounds for a reasonable hope of success. Courses of medicine
are sometimes administered with the view only of affording relief
to the patient, the disease being evidently incurable; and yet it
would seem that a portion of the community, and some who ought
to know better, attribute every death that occurs, where, Thom¬
sonian treatment is employed, to the treatment, or to want of skill
in those who have charge of the case. Among the great mass
of desperate cases that come under Thomsonian treatment, deaths
will, in the very nature of things, occasionally happen unexpect¬
edly and under unfavourable circumstances. In the early period
of my practice I was called to attend the wife of Samuel
Wheeler, of Wilmington, Del., and found Mrs. W., as I then
thought, in a condition to be benefited by a course of medicine,
and had determined on having one administered. A dose of com¬
position was prepared, but before it was sufficiently cool to be
taken, she expired. Had I arrived two hours earlier than I did,
doubtless Mrs. W. would have died whilst under the operation of
a course of medicine; and although the medicine might have pro¬
longed the life of the patient a short period, still she could not
have survived many hours longer than she did, as mortification
of the bowels had taken place. Courses of medicine doubtless
have been, and will again be administered to patients on the very
BLOOD-LETTING.
471
verge of dissolution; creating not only an unfavourable impression
in the neighbourhood where it happens, but a highly-coloured and
distorted account of the case is carried by the press to various
parts of the country. The general good success, however, at¬
tending the Thomsonian practice, affords sufficient evidence to
establish the belief that it is based upon correct principles, and
that this system furnishes the means which ihe constitution re¬
quires to overcome disease; for although it does, and must neces¬
sarily fail sometimes of effecting cures, yet what evidence have
we that it will not prove successful, when properly applied, in all
cases that are curable by means of medicine 1
Most patients experience an unusual degree of. weakness and
general distressed feeling about the time a disease is being re¬
moved ; the patient feeling discouraged, under the impression that
the course of medicine, or other treatment, is too hard for his
constitution. In many cases of deeply-seated disease, that I have
treated, and a cure has been effected, the patients were discou¬
raged about the time that the disease was giving way: the system
being relaxed, attended with loss of appetite, disgust for medicine
and frequent pain and distress in the bowels.
BLOOD-LETTING.
The abstraction of blood from the system does not remove the
cause of disease, but, on the contrary, its direct tendency is to
prostrate the curative action of the constitution; and although
patients may experience relief from pain, by the abstraction of
blood, still the cure may be very much retarded by it, and it may
cause the death of the patient. A person in health may lose a
large quantity of blood without experiencing other inconvenience
than debility; for when digestion is carried on with considerable
vigour, the blood is soon replaced. But in disease, where the di¬
gestive powers are greatly impaired or suspended, the loss of
blood cannot be readily supplied; and if the bleeding be carried
to a great extent, the patient will be very apt to remain a long
time in feeble health, and very probably be left with some deeply-
seated chronic disease, dyspepsia, liver complaint, consumption,
or dropsy.
The blood furnishes the organs with power to carry on their
functions, and to resist the causes of disease; and in proportion
to the quantity of blood taken from the body, will the system lose
its power,of resisting disease. An undue accumulation of blood
in a part *is always attended by a deficiency of it in other parts;
472
BLOOD-LETTING.
and we have sufficient evidence to warrant the assertion, that the
Thomsonian practice, if properly applied, will prove more effec¬
tual in equalizing the circulation of the blood than any other plan
of treatment that has ever been pursued.
A patient having a good constitution may, in the early stage of
disease, be bled profusely, and recover his health : not in conse¬
quence of the loss of blood, however, but in spite of the bleeding;
whereas, in a later period of disease, where the vital powers of
the patient are much enfeebled, or in very young or very aged
persons, the loss of even a few ounces of blood would be very
liable to be followed by extreme prostration, and probably cause
the death of the patient. That blood-letting removes pain, lessens
fever, and relieves the head, is no evidence that it cures disease;
for these very symptoms, pain and fever, are, in general, the con¬
sequence of the vital powers resisting disease: and what can be
more absurd than to break down the living power, in order to re¬
lieve pain 1 But blood-letting will not always relieve pain, except
the patient be brought so low by it as to destroy his sensibility;
and very often, in cases where pain is relieved by a copious bleed¬
ing, it will return again in a more aggravated form; the constitu¬
tion having to struggle not only against the cause of disease, but
also against the effects of the loss of blood.
Patients are sometimes bled profusely during the eruptive fever
of small-pox; the physician supposing the disease to be bilious
fever. The consequence of this treatment has been, in some in¬
stances, to sink the vital powers so low, that the eruption has
never been fully developed, and the patient's life made a sacrifice
to legalized quackery.
Formerly, it was the universal opinion that blood-letting was
necessary in cases of severe bruises, to prevent the occurrence
of inflammation. Experience and observation, however, do
not confirm the propriety or necessity of this practice. Look, on
the other hand, and we will find that the most experienced sur¬
geons admit the danger of drawing blood in cases of severe in¬
juries, especially immediately after an injury, before the system
reacts. Dr. M'Clellan, in lecturing upon the subject of severe
injuries, and the prevailing practice of bleeding patients imme¬
diately after their occurrence, said: "By far the greater portion
of deaths which occur in these cases, are occasioned by too fre¬
quent and continued bleedings before the system has had time to
recover from the shock. Thousands and tens of thousands of
lives have been destroyed by this practice."
A physician of the old school told me not long since, that for¬
merly he thought he must bleed whenever he saw evidences of
inflammation, but that within the last few years he had almost
abandoned this practice of bleeding, and found that his patients
now iecovered more speedily and effectually, even from inflam-
BLOOD-LETTING.
473
matory diseases, than when he resorted to its use. The fact is,
in the regular practice there are no general established principles
for treating disease; almost every physician having his favourite
hobby. Thus, one'will prescribe anodynes under the same cir¬
cumstances that another would employ bleeding; while a third
would administer some favourite cathartic, and a fourth depend
exclusively upon counter-irritation, such as cupping, blisters, &c.
A patient is taken with pleurisy, for instance, and his physician
bleeds him and the pain is relieved; on the following day the pain
returns, and the doctor resorts to the same means which relieved
the pain before; and in this way the bleeding is often repeated
until the vital powers are sunk too low to react, and the patient
sinks from loss of blood; or if he recovers, it is generally by very
slow degrees.
Dr. Marshall Hall, in his work on the morbid and curative
effects of the loss of blood, has given a number of cases proving
the fact, that though a blood-letting may relieve pain, it may
cause the death of the patient.
In cases of a severe bruise, the old school doctrine is to bleed
and purge with a view to prevent inflammation. When a patient
is injured, inflammation is necessary, in order to repair the injury.
This is nature's method. — Injuries cannot be repaired without in¬
flammation ; and the more vigorous the general health of the
patient is, the sooner will the injury be repaired, and the less lia¬
bility will there be of the inflammation assuming an unhealthy
character.
An ordinary bilious or remitting fever is often converted into
a disease of a malignant character, by blood-letting. In like
manner, healthy inflammation may assume an unhealthy charac¬
ter, by reducing the vital principle — the restorative power — by
taking blood.
That a patient may experience relief from losing blood, is not
proof that his condition is improved or his situation rendered less
dangerous by it. Taking away blood to relieve pain is as un-
philosophical as to give arsenic or any other violent poison for the
same purpose. The cause of disease is not removed by either
plan. There are poisons which, when administered even in ho-
rncepathic doses, will relieve pain and change the form of disease,
but will not remove the cause; for although patients get well un¬
der such treatment, it is through the efforts of nature in defiance
of the poisonous medicines. Physicians prescribe arsenic in in¬
termitting fever, which will change the symptoms; — there may
be no more ague, but a disease will remain, more difficult to get
clear of than ague.
Pain that would be relieved by an ordinary blood-letting, would
be more effectually removed by a Thomsonian course of medicine,
or even by a vapour bath. Under the bleeding practice, pain is
474
THE HOT-AIR OR VAPOUR BATH.
relieved by prostrating the power of reaction; whereas, undei
Thomsonian treatment the circulation is equalized, and the ob¬
structions removed that cause the pain.
The fact of the matter is just this: under favourable circum¬
stances a patient may lose a large quantity of blood without en¬
dangering his life; but under other circumstances, the loss of a
few ounces would cause the death of the patient. Physicians
learn under what circumstances blood-letting can be best borne
without endangering the life of the patient; but the principle of
this practice is wrong under all circumstances. It will relieve
pain, lessen fever, and reduce inflammation; but an invariable
effect is to impair the digestive and nutritive functions, and to
weaken the power of resisting disease. In all cases of severe
attacks of disease, where blood-letting is deemed a proper prac¬
tice by physicians of the old school, the Thomsonian remedies,
well applied, will not only prove more effectual in relieving pain
and curing the disease, but it is a safe practice.
THE HOT-AIR OR VAPOUR BATH.
Although the use of the vapour bath as a means of curing dis¬
ease, was employed many centuries back, still the principle upon
which it operates in removing disease was not fully explained,
nor its utility in aiding the operation of medicine appreciated be¬
fore the time of Samuel Thomson.
This bath constitutes an important part of the Thomsonian
system of practice, fulfilling several important indications in the
cure of disease. It diffuses warmth through the system, equalizes
the circulation, imparts electricity to the blood, and increases the
sensibilities of the system to the impression of medicine. Warmth
imparted to the body by means of the hot-air or vapour bath, is
as congenial to the human system as light and heat from the sun
is congenial to the vegetable kingdom.
" I had but little knowledge of medicine," says Samuel Thom¬
son, " when through necessity I discovered the use of steaming,
to add heat or life to the decaying spark; and with it I was ena¬
bled, by administering such vegetable medicines as I then had a
knowledge of, to effect a cure in cases where the regular practi¬
tioners had given them over."
" In all cases where the heat of the body is so far exhausted as
not to be rekindled by using the medicine, and being shielded
from the surrounding air by a blanket, or being in bed,"and chills
THE HOT-AIR OR VAPOUR BATH.
475
or stupor attend the patient, then applied heat by steaming be¬
comes indispensably necessary."
We oiten hear persons say that when they were bled the blood
was almost black, and so thick that it would scarcely run; and
they conceive that their blood is bad and had better be taken
away. The blood becomes thick and dark in consequence of its
slow and torpid circulation, for want of heat and nervous energy.
Place a patient, whose blood is in the condition just mentioned, in
a vapour bath at a proper temperature, and in less than twenty
minutes the character of his blood will be changed; so that, in¬
stead of being almost as thick and dark as molasses, as it was
before the steaming, it will be of a more natural colour and con¬
sistency, in consequence of the warmth and electricity imparted
to it, and by giving an increased impetus to its circulation through
the lungs.
There is scarcely a form of disease or a condition of the sys¬
tem in which the vapour bath may not be employed, not only with
safety but benefit. One of the most important objects gained by
the application of the vapour bath, is adding warmth and electri¬
city to the blood. It has been ascertained that in disease even of
the most inflammatory character, the blood contains less electri¬
city than it does when in a healthy condition; and the application
of the vapour or hot-air bath in the early stage of pleurisy and
acute rheumatism, will in some instances arrest the farther pro¬
gress of the disease.
Disease of an inflammatory character generally proceeds from „
cold; and the buffy coat which appears on blood drawn from one
labouring under an inflammatory disease, may be attributed to
the want of a sufficient amount of heat and electricity in the blood.
Dr. Marshall Hall, in his Practice of Medicine, p. 340, observes:
" Some practitioners continue to let blood in most cases of acute
rheumatism ; thinking themselves justified in their mode of prac¬
tice by the sizy appearance of the blood. The same principle
might lead them to empty the whole sanguiferous system; for,
every time blood-letting is repeated, the blood becomes more and
more dense, or sizy. I have further observed," says he, " that
by bleeding repeatedly, the pains, swelling, and febrile symptoms,
were not only aggravated at the time, but often protracted in¬
finitely ; at least, I have seen them continue, under such a mode
of practice, upwards of two months."
The vapour bath may be employed with immense benefit in dis¬
ease of the urinary organs; as stranguary, gravel, retention of
urine, inflammation of the lungs, &c.
In croup, where the disease has continued several hours, the
vapour bath is almost indispensable, in order to restore the natural
warmth of the blood, and assist the operation .of the medicine.
Professor Chapman, in a lecture, said that he had recently beep
476
THE IIOT-AIR OR VAPOUR BATH.
called, in consultation, to a case of croup, where the application
of the vapour bath proved effectual in curing the disease, alter
various other means had been employed three successive days,
without effecting any change for the better. The patient con¬
tinued in the bath three hours at a time. In croup, the blood is
sometimes in a condition which occasions the formation1 of a false
membrane in the windpipe; which, if not arrested, finally fills up
the cavity of the windpipe to such an extent as to cause suffoca¬
tion. In such cases, besides the free use of lobelia and stimulants,
the bath must be perseveringly applied, with a view to restore the
natural warmth of the blood, and thus overcome its plastic condi¬
tion.
In asthma, when the system is in a cold and torpid condition,
medicine will often fail of affording much relief, without the pre¬
vious use of a bath. In this form of disease, the hot-air bath will
in general prove more effectual than the steam or vapour bath.
Ordinary headach is speedily cured by an application of the
bath.
In dysentery, and bowel complaints in general, the use of the
bath is attended by the most signal benefit.
In eruptive diseases, nettle-rash, small-pox, scarlet fever, vario¬
loid, and measles, the vapour bath may be used with benefit at
any stage of the disease. If the eruption be slow to appear, ap¬
plying a vapour bath will bring it out to the surface; or if there
be a tendency to a retrocession or striking in of the eruption, the
vapour bath should be applied; or at least a moist heat should be
• applied around the patient, and powerful stimulants given,—as the
third preparation of lobelia, and stimulating injections. In every
stage of small-pox the vapour bath is grateful to the patient, and
aids the constitution in working off the disease. In the later
period of small-pox, when scabs are forming and the patient much
distressed, the steam bath will afford more relief than any other
means that can be employed; and when the scabs are dry and
falling off, there can be no better means employed for restoring
the natural healthy condition of the skin than steaming. Scarlet
fever and measles are very liable to be followed by dropsy, run¬
ning of the ears, swelling of the glands, &c., arising in part from
an unhealthy condition of the skin, which may be remedied by
steaming the patient two or three times, about the termination of
the eruptive disease.
The duration of erysipelas may be shortened, and the symptoms
mitigated, by the hot-air or steam bath; and in severe cases it
should not be neglected.
The bath may be employed with especial benefit in all cases of
dropsy, except when the disease is incurable.
In violent olds and catarrh, where the breathing is greatly op¬
pressed, or the skin dry and husky, or cold and clammy, and the
THE HOT-AIR OR VAPOUR BATH.
477
patient much distressed, the use of the bath becomes highly neces¬
sary, not only to relieve the distressing symptoms, but to facilitate
the operation of medicine. Thousands of patients die annually
of consumption, that in its early stage is curable' under Thom-
sonian treatment.
" In all cases of falls or bruises, steaming is almost infallible;
and is much better than bleeding, as in the common practice,
which only tends to destroy life, instead of promoting it. If the
person is not able to stand over the steam, it must be done in bed,
as has been described. Give the hottest medicine inside that you
have, and keep the perspiration free until the pain and soreness
abate, and the strength will soon be restored. If the advantages
of this mode of treatment were generally known, bleeding in such
cases, or in any other, to remove disease, would never be resorted
to by the wise and prudent."—Samuel Thomson.
In "peritonitis, which is a very fatal form of disease, the bath
should be promptly and perseveringly applied, besides giving
largely of lobelia and pure stimulants.
In inflammation of the lungs, liver, stomach, bowels, or any
other of the internal organs, the use of the vapour bath will be
found to relieve pain, assist the operation of medicine, and shorten
the course of the disease. ,.
In cholera, the application of the hot-air or steam bath is almost
indispensable to the cure of the disease; more especially when
the surface and extremities are cold, or the patient affected with
cramps. The warmth imparted to the system attracts the blood
to the surface, restores the external capillary circulation, relieves
internal congestion, the nervous energy is increased, the lungs ex¬
pand more fully, and the blood consequently becomes more highly
vitalized, and sensibility awakened; so that medicine will act
more promptly and efficiently.
In "low fevers," as they are called, where the heat and strength
of the patient are far reduced, I have observed marked benefit to
result from the application of steam to the patient. A patient
who is too weak to sit up or even to raise his head, will bear
steaming on a couch or mattrass in majay instances over an hour,
without being debilitated by it,—provided proper attention be paid
,to bathing the face and surface of the body occasionally with
spirits or vinegar, and giving stimulants. The most remarkable
recoveries from " low, malignant fevers," as they are termed, that
I have known, have been where the vapour bath has been admin¬
istered frequently, and the third preparation of lobelia administered
freely, both by injection and to the stomach. In these cases, the
steam was of course applied to the patient in bed or on a settee.
478
THE HOT-AIR OR VAPOUR BATH.
The hot-air or vapour bath forms an important auxiliary in the
treatment of rheumatism, gout, lumbago, palsy, hysteria, chloro¬
sis, neuralgia, consumption, fevers of every variety, scrofula, &c.
— Finally, the application of warmth to the body, in this way,
aids the efforts of nature to overcome disease oi every variety,
that is curable by the aid of medical treatment.
" Some who practise according to my system," observes Dr.
Thomson, " boast of canying their patients through a course of
medicine in a shorter time, without the trouble of steaming: this
is easily accounted for; steaming is the most laborious part of the
practice for those who attend upon the sick, but the most useful
to the patient; as one full course of medicine, in which the patient
is steamed both before the emetic is given, and after it operates,
will in general be more effectual in removing disease than four
emetics without the steaming."
The bath affords a protection to the system against sickness;
and when applied in the early stage of many forms of disease,
will effectually prevent it from becoming seated, by restoring the
lost heat, promoting the secretions, and removing obstructions.
If the efficacy and safety of the hot-air or steam bath in mid¬
wifery were generally known, the practice of bleeding would be¬
come abolished ; for no sensible woman would willingly submit to
be bled, who had a knowledge of the utility of steaming, and
more especially of courses of medicine. By means of the bath
and lobelia, the muscles may be more effectually relaxed than by
bleeding, and at the same time the secretions are promoted and
nature assisted, without the least possible degree of danger to the
patient, from the treatment.
For pain in the back and loins during pregnancy, the bath may
be used with much benefit.
False labour fains may be removed by the application of the
bath; whereas true labour pains will be increased by it. This
fact I have seen tested on many occasions. Not long since, I re¬
ceived a message to attend Mrs. C g, in Currant alley, who,
it was supposed, was in labour. The patient had regular pains
about every fifteen minutes, which had continued over twenty
hours. I directed a dose of composition to be given, and an in¬
jection of composition tea, with a teaspoonful of green lobelia, to
be administered. These had the effect to diminish the frequency
and intensity of the pains. A vapour bath was then, applied,
which dispersed the pains entirely, and Mrs. C g had no more
return of pains until the lapse of two weeks, when they returned,
and the same means were employed as on the previous occasion,
above spoken of; and the pains being true labour pains, they were
strengthened and aided by the same treatment that expelled the
false pains.
THE HOT-AIR OR VAPOUR BATH.
479
The above is only one of many instances in which I have
known false labour pains entirely to disappear under the use of
the bath, lobelia and stimulants; and I have never yet seen this
treatment fail to increase and assist true labour pains. If Mrs.
C g had been under the treatment of the old school practice,
and ergot had been administered, as it very often is under the
same circumstances that attended this case, the uterus would have
been thrown into violent spasmodic contractions, and it is not easy
to say what the consequence might have been. It cannot be
questioned but that in thousands of instances ergot has been given,
and then the forceps resorted to, in cases of premature or false
pains, that would have been dispersed by the use of the vapour
bath, lobelia, and pure stimulants.
Opinion of various writers concerning the Vapour Bath.
" The vapour bath is attended by the very best effects, particu¬
larly in chronic ailments; and there can be no question that its
action is chiefly on the skin, and through that medium on the ner¬
vous system. As a means of determining to the surface, pro¬
moting cutaneous exhalation, and equalizing the circulation, it is
second to no remedy now in use; and, consequently, in a variety
of affections which this process is calculated to relieve, it may be
employed with every prospect of advantage." — Combe's Physi¬
ology.
" To the wars between Napoleon and Russia is western Europe
indebted, if for nothing else, to the introduction of vapour baths.
Prussian soldiers having constructed them in the north of Prussia,
some of the Prussian physicians were induced to observe the ef¬
fects of this new fashion of bathing. They soon found that it
cured various diseases, such as rheumatism and cutaneous affec¬
tions, and were not slow in giving notoriety throughout Germany,
by means of various publications. The king of Prussia caused a
bath to be constructed at his palace; and in 1818, the Princess
Marianne, sister-in-law of this sovereign, was present at the open¬
ing of the first public vapour bath at Berlin, and allowed it to re¬
ceive her name." — Eclectic Journal of Medicine.
" Of all Turkish remedies, the vapour bath is the first and most
fficacious in rheumatism and cutaneous diseases. I have* seen
lem removed in one fourth part of the time in which they are
ommonly cured with us." — Dr. Madden.
" If life be nothing but a brief succession of ideas, the rapidity
/ith which they now pass through the mind would induce one to
elieve, that in'the few short minutes which he has spent in the
bath, he has lived a number of years." — Sir John Sinclair.
" The vapour bath may be used with decided advantage in all
480
THE IIOT-AIR OR VAPOUR BATII.
seasons, as it is in Prussia and in Asiatic countries. It is a vulgar
error, contradicted by general experience, to suppose that vapour,
or warm bathing, is contra-indicated in winter, as disposing those
who bathe to contract colds.'1 — Dr. Schmidt.
" Major Long, who made an expedition to the Rocky Moun¬
tains subsequent to the time of Lewis and Clark, informs us, also,
that the Indian sweating baths, as he terms them, are in high re¬
pute for the cure of many disorders. He remarks, that they are
generally constructed near the edge of a water-course, and formed
of pliant branches of trees, stuck into the ground in a circle, bent
over at the top, and covered in every part with bison robes. Some
of them contain only one person, and others four or five. The
invalid enters with a kettle of water and some heated stones, on
which the water is sprinkled, until the requisite degree of steam
is produced. When it is thought that the perspiration is suffi¬
ciently profuse, the patient is taken out and plunged into the water
—previously breaking the ice, if the stream is frozen. He is not
subjected a second time to the action of the steam, but covers
himself with his robe and returns home." — Mattson's American
Vegetable Practice.
" Lewis and Clark mention a remarkable cure which was per¬
formed with the vapour bath, during their expedition. One of
their men had so great a weakness in his loins, that he could not
walk, nor even sit upright without extreme pain. They exhausted
the resources of their art upon him in vain; and, at length, at the
suggestion of an Indian hunter, and at the request of the patient
himself, they placed him in a vapour bath, with the steam as hot
as it could be borne. In twenty minutes he was taken out,
plunged twice in rapid succession into cold water, and returned
to the bath. During this time he drank freely of horse-mint tea.
At the end of three-quarters of an hour he was again withdrawn,
carefully wrapped, and suffered to cool gradually. The morning
after the operation, he was able to walk, and nearly free from
pain." — Ibid.
" The prevalent fear of catching cold, which deters many from
using the vapour bath, even more than from warm bathing, is
founded on a false analogy between its effects and those of profuse
perspiration from exercise or illness. The latter weakens the
body, and by diminishing the power of reaction, renders it suscep¬
tible of injury from sudden changes of temperature. But the
effects of the vapour bath, properly administered, are very dif¬
ferent. When not too warm, or too long continued, it increases,
instead of exhausting the strength, and, by exciting the vital action
of the skin, gives rise to a power of reaction, which enables it to
resist cold better than before." — Combe's Physiology.
PARTIAL STEAMING.
481
PARTIAL STEAMING.
The plan of applying steam to the lower half of the body was
first introduced by Dr. A. C. Logan. To administer the hip va¬
pour bath, the cover must be fastened around the waist, instead
of the neck. It is particularly applicable to cases of palsy of the
lower extremities, hip disease, white swelling, indolent ulcers on
the limbs, obstructed menstruation, strangulated hernia, swelled
testicles, and dropsy of the legs. Applied in this way to the lower
half of the body, it may be borne without inconvenience for an
hour, or even several hours together; and much credit is due Dr.
Logan for this method of steaming in certain cases.
Toothach, pain in the face, swollen and painful breast, may be
relieved by the application of steam to the affected part.
In cankered sore throat, scarlet fever, quinsy, and in severe
colds, attended with dryness of the throat and oppressed breathing,
benefit may be derived by inhaling the vapour from hot vinegar
and water.
The following is from Constable's Miscellany, as given by the
celebrated Urban Chevreau, Secretary to Christine of Sweden.
Cure of Fevers in Sweden.
" One thing which I saw in Sweden surprised me. The pea¬
sants who have fever, take a quantity of beer, into which they
put ginger, cloves, cinnamon; and having heated it as much as
their mouth and stomach will bear, they drink it off. The prac¬
tice is successful.
" They have also another remedy which would appear a start¬
ling one to inhabitants of our climate. They have dry stoves,
which they call bastou, into which they enter naked; and when
the perspiration is profusely produced on all the body by the heat
of the stove, they immediately come out and lie down among the
snow; or, if they can swim, throw themselves into the water.
Our physicians may judge how far their aphorisms agree with the
experience of these peasants." This was published during the
life of the author, who died in 1701, and may serve to show to
the incredulous faculty, that steaming is no new doctrine; and it
also exhibits a striking analogy to the practice of our North Ame¬
rican tribes, in cases of fever.
31
482
WARM WATER FOOT-BATH. EMETICS.
WARM WATER FOOT-BATH.
The right way of proceeding in the application of the warm
foot-bath, is to have the water at first of an agreeable temperature
— not too hot to be disagreeable to the patient; and then, about
every two minutes, add as much hot water as the patient can bear,
for the space of ten or twelve minutes. Then rub the feet dry,
and bathe them with whiskey.
OF THE UTILITY OF LOBELIA EMETICS IN THE
CURE OF DISEASE IN GENERAL.
Thomsonian emetics constitute the most effectual remedy em¬
ployed in the treatment of disease occasioned by a foul stomach.
There is scarcely a form or variety of disease in which the use
of emetics will not prove beneficial; and in many instances they
are indispensably necessary to the recovery of the'patient.
Previous to the discovery of the medical properties of lobelia,
by Samuel Thomson, poisonous articles were employed almost
exclusively as emetics. Even now, the medical profession con¬
tinue to prescribe the same deleterious articles, notwithstanding
the evidence afforded of the efficacy of lobelia emetics in cleansing
the stomach; and likewise knowing—as they might know if they
would—that it possesses no deleterious qualities.
Sudden attacks of disease,—such as colic, violent headacb, and
various distressing symptoms, occasioned by a foul stomach,—
may, in many instances, be cured at once by an emetic. And
when disease has become more deeply seated, other important
objects beside cleansing the stomach, are obtained by the operation
of emetics. They relax the system, and in this way overcome
obstructions; equalize the circulation of the blood, and of the ner¬
vous influence; invigorate the energies of the stomach, and re¬
move morbid secretions from its mucous surface; restore the
secretions ; and, in fine, assist the constitution in resisting disease,
and thus aid her efforts in restoring health.
Whenever there is a general fever" pervading the body, it is
evidence of a diseased condition of the stomach; and hence, in
fever, the use of emetics is particularly indicated. Whether a
fever arise from undigested food in the stomach, worms in the in¬
testines,— its energies sunken, or its functions prostrated bv the
[ioisonous influence of marsh effluvia, or from previous exposure
1u cold, — Thomsonian emetics may be given with benefit.
EMETICS.
483
In measles, scarlet fever, and small-pox, the disease will be ren¬
dered more mild in its character, less dangerous, and sometimes
of shorter duration, by the early administration of a Thomsonian
emetic.
In diseases of children, emetics constitute by far the most effi¬
cient remedy. Vomiting is nature's method of relieving the
stomach in infancy. We can scarcely do wrong in giving emetics
to sick children, more especially at an early stage of disease.—
In cases of sudden attacks of fever, croup, convulsions, &c., lobe¬
lia should be given freely; either the powder in warm teas, or in
simple warm water, the tincture, or the third preparation.—The
latter is particularly adapted to cases of spasms, and in cases
where the heat of the system is very low, and in the advanced
stages of disease. No danger need be apprehended from vomiting
a child too much in croup, nor in any other violent attack of dis¬
ease; nor of relaxing the system too much with lobelia.
In protracted chills, where the patient is in a stupor, the third
preparation of lobelia should be given freely, with the application
of external warmth and friction to the surface, with a view to
bring on reaction.
"Emetics," observes Professor Chapman, "however beneficial
they may operate as mere evacuants, produce effects not less salu¬
tary in another way. Whatever may be the cause, fever, as has
already been shown, is a result of sympathy; having, for the
most part, the primary link of its ultimately lengthened and com¬
plex chain, in the stomach. To expel, therefore, the offending
cause, or to subvert the nascent impression which may be created,
before it becomes invigorated, diffused and fixed, vomiting is ob¬
viously the remedy.
" Erysipelas of the face, I have benefited, or entirely removed,
by vomiting—and in several instances, have derived scarcely less
advantage from the same remedy, when the brain becoming af¬
fected, stupor has supervened."
Emetics administered in the early period of scarlet fever will
sometimes exert a most signal influence in moderating the vio¬
lence, and in shortening the duration of the disease.
In case of bleeding from the lungs, the effect of the operation
of emetics is to attract blood from the lungs and diffuse it through
the system, by which the bleeding will be checked.—Warm foot¬
baths, or the vapour bath, should be employed, to aid in restoring
the natural equilibrium of the circulation of the blood. "In sup¬
port of this practice, it may be proper to mention, that it appears
on good authority, that the late Dr. Willis, so celebrated for his
skill in the treatment of mania, and especially the cure of George
III. of England, resorted to emetics in all cases of haemoptysis,
(bleeding from the lungs,) and declared that the lengthened expe¬
rience of nearly half a century had taught him to confide in them
484
EMETICS.
above all other means, as well on account of their safety as elli-
cacy."—Chapman's Therapeutics.
In bleeding from the stomach, in which case blood will be raised
by vomiting, the employment of active emetics is indicated; not
only for dislodging accumulations of blood in the stomach, which
may have oppressed its energies, but to cause a distribution of
blood throughout the system, and to strengthen the weakened
capillary vessels of the mucous membrane of the stomach. I
have found the third preparation of lobelia, given freely, together
with the application of the vapour bath, to be successful on several
occasions of bleeding from the stomach; and have never known
it to fail in checking the hemorrhage.
In uterine hemorrhage, the flow of blood may in general be
controlled by active emetics, aided by the use of stimulating
enemas to the bowels.
In severe colds and sore throat, either from inflammation or the
existence of ulcers, emetics are of great utility.
Emetics are more effectual than any other remedy in the cure
of consumption, bronchitis, and other forms of disease of the
chest.
The most severe paroxysms of asthma may be overcome by a
thorough emetic; more especially when the emetic is preceded
by the application of a vapour bath, rendering the system more
sensitive to the impression of medicine.
In pleurisy and inflammation of the lungs, emetics may be em¬
ployed with great advantage; more especially in the early period
of the disease. I have never observed the act of vomiting to be
attended with much pain or difficulty in the most violent cases of
pleurisy and inflammation of the lungs. As a patient sickens, the
system becomes relaxed; which affords an explanation why a
patient may vomit with so little pain or difficulty when there is
active inflammation in the pleura or lungs.
" In their wide and pervading operation, they (emetics) subdue
or have a tendency to subdue vascular action, to remove cuta¬
neous constriction, promote absorption from the lungs, facilitate
expectoration, lessen dyspnoea, cough and sanguineous discharge,
to calm the system by equalizing excitement, and thus re-establish¬
ing that just balance in the distribution of the blood, on which the
restoration and maintenance of health so materially depends."
In whooping cough, more benefit may be derived from the usu
of emetics than •from any other remedy. In violent cases, an
emetic should be given daily, or even two or three times a day.
In those cases when violent paroxysms of coughing are observed
to come on at certain periods, it is a good practice to place the
patient under the influence of lobelia, given even to the amount
necessary to cause free vomiting previously to the time at which
ihe paroxysm of coughing usually comes on.
EMETICS.
485
Emetics form an important part of the treatment for rheuma¬
tism, lumbago, gout, neuralgia, &c. No remedy under my obser¬
vation has produced so much relief in these forms of disease as
active emetics; their efficacy will be greatly enhanced by the
previous application of a vapour bath.
Of the various remedies that have been employed in the treat¬
ment of dyspepsia, emetics have proved the most successful. —
Even in cases where there is extreme tenderness at the pit of the
stomach, an emetic after a vapour bath will afford more relief in
general than any other remedy. In the early stage of dyspepsia,
digestion, in most instances, may be restored by one or two active
emetics, followed by the free use of cayenne pepper at meals.
Sick-headach, depending upon a disordered condition of the
stomach, may be more speedily relieved by a prompt emetic than
by any other remedy. Besides the speedy relief which the opera¬
tion of emetics affords, they sometimes, if taken in the early
period of every attack, will break up the disease altogether; the
patient being freed from subsequent attacks.
Emetics are well adapted to the cure of every variety of colic,
or cramp in the stomach. " To induce general relaxation, and to
excite the biliary secretions, a deficiency or suspension of which,
he considers as an accessary cause of some of the cases of obsti¬
nate constipation in colic, Professor Hosack has given emetics, as
he states, with great success." — Chapman.
In diarrhoea, dysentery, and cholera morbus, digestion is lost,
and the stomach contains more or less foul matter, and its mucous
surface is coated with thickened secretions, oppressing its func¬
tions. Hence, the use of emetics, combined with active stimulants
and astringents, to cleanse the mucous surface, are especially de¬
manded in the treatment of such disorders. Besides relieving the
stomach of foul matters, Thomsonian emetics exert a beneficial
influence upon the secretions, cause a determination to the surface,
restore capillary circulation, and aid the efforts of nature to re¬
store healthy action in the mucous membrane of the bowels.
Many have doubtless died of these complaints, that might have
been cured by prompt emetics.
Epilepsy, or falling sickness, is in many instances occasioned
by an oppressed or otherwise disordered state of the stomach,
demanding the use of emetics. " By exhibiting them just before
the accession of the paroxysm, they will often prevent it, and even
if they fail in this respect, they render it milder and of shorter
duration- Nor is this all which they accomplish. By the strong
and direct impression made on the stomach, the commencement
in that or«;an of the wrong association constituting the disease, is
broken, and afterwards it yields more readily to tonics.
" Nearly the same views, I think, may be taken of hysteria.
Even admitting that the disease is mostly radiated in the uterus,
486
EMETICS.
it does unquestionably often proceed from gastric irritation, and
demands to be treated accordingly- Whatever may have been
the immediate cause of the paroxysm, I have found, when ex¬
ceedingly vehement, no remedy half so effectual as vomiting. It
promptly allays the convulsive agitations of the nervous system,
and produces a state of mental composure which invites to sleep."
— Chapman.
Apoplexy, brought on, as it often is, by a mass of undigested
food in the stomach, calls for the free exhibition of emetics, of
which the third preparation of lobelia is the most appropriate.
Lobelia should also be administered by injection, and allowed to
be retained in the bowels, to assist in exciting vomiting; to relax
the system, and equalize the nervous influence. Even if the seat
of apoplexy be in the brain, and incurable, as it often proves to
be, still the treatment can do no harm.
Mania is generally associated with, and not unfrequently de¬
pendent upon, a disordered condition of the stomach. Many
cases have been cured by free vomiting with stimulating lobelia
emetics.
In long-continued dyspepsia, as in other forms of seated dis¬
ease, the mucous membrane of the stomach becomes more or less
coated with a false membrane; a general torpor then pervades
the system, the nervous energy is prostrated, and the energies of
the mind often greatly depressed. In such cases there is no plan
of medical treatment which promises equal success with that of
the frequent use of the hot-air or steam bath and stimulating eme¬
tics. These means will prove the most effectual in restoring the
secretions, and causing the detachment and removal of the false
membrane lining the stomach. Without effecting this, the func¬
tions of the stomach cannot be restored. I have on many occa¬
sions observed that patients who had been long affected with
dyspepsia, are very liable to experience severe pain under the
operation of an emetic, and often complain of feeling worse about
the time the disease is breaking and a more healthy action taking
olace.
Affections of the head, in general, proceed from derangement
of the stomach; so that not only in sick-headach are emetics in¬
dicated, but the most violent neuralgic pains in the head, accom¬
panied with extreme tenderness of the scalp, will sometimes be
promptly relieved by free vomiting. " Early adopting the notion,"
says Dr. Chapman, " that this complaint proceeds from a morbid
condition of the stomach, the only two cases of it which have
come under my care, I have managed by emetics, and had reason
to be entirely pleased with the result. Even genuine tic-doloureux,
the neuralgia of some writers, has been cured in several instances,
by this same practice, and with such facility as to place it, in my
EMETICS.
487
opinion, decidedly above all other modes of treating this most
painful, and hitherto nearly unmanageable affection."
Diseases of the eye, as amaurosis, and acute inflammation of
this organ, have been more successfully treated by active emetics
than by any other plan. It is only in the early stage of amauro¬
sis, however, that so much reliance is to be placed upon emetics.
The operation of emetics in connection with the use of the va¬
pour bath, is applicable to cases of dropsy. Besides cleansing
the stomach, placing the system under the relaxing influence of
lobelia promotes the action of the absorbent vessels, and conse¬
quently the use of this remedy is particularly well adapted to
cases of dropsy.
Emetics form an important part of the treatment for the cure
of jaundice. I know a case of this form of disease which was
cured by the administration of a vapour bath and an emetic; the
patient having taken freely of composition and compound lobelia
pills a few days preceding the bath and emetic. Cases that are
more deeply seated, however, will require, as do other forms of
seated disease, a repetition of courses of medicine, together with
the appropriate intermediate treatment.
An occasional emetic will be serviceable in every variety of
scrofula.
Persons labouring under the poisonous effects of mercury will
experience benefit from the use of the vapour baths and emetics.
It is asserted by some medical writers that diabetes has been
cured by the operation of emetics. This disease, however, is
often incurable; as in many instances it is the consequence of the
wearing out of the constitution.
Torpor of the Liver, which attends jaundice and bilious fever,
has frequently been removed, and the functions of this important
organ restored, through the influence of vapour baths and active
emetics. To restore the natural temperature of the blood and
impart electricity to it, by the steam bath; to relax the system
with lobelia ; together with the influence of straining efforts to
vomit, constitute the most effectual means of relieving congestion
of the liver, and of restoring its functions. Lobelia administered
by injection, and retained, exerts the same beneficial influence
upon the system as when taken into the stomach.
Whenever the system experiences a severe shock, as by falling
from a height, a violent blow, or by a severe burn or scald, diges¬
tion will be suspended; and if the accident should happen soon
after, or within an hour or two after the patient has taken a hearty
meal, the stomach should be evacuated by an active emetic. This
may save the patient a great deal of suffering, and materially
lessen the danger of the injury.
Thomsonian emetics may be employed with perfect safety dur-
4S8
EMETICS.
ing every stage of pregnancy; and most of the derangements of
the system consequent upon that state, — such as a feeling of ful¬
ness, dizziness, or violent pain in the head; pain and distress in
the back and loins; extreme sickness; water brash; and distress
at the stomach, may be relieved, and frequently entirely removed,
for a time at least, by an active lobelia emetic, preceded by the
use of an enema and a vapour bath. I have known females to be
carried through from three to nine Thomsonian courses of medi¬
cine during the last two weeks preceding their confinement, inva¬
riably deriving benefit, and generally complete relief from distress,
by their operation. A full course of medicine, administered just
before confinement, is incomparably the best plan of treatment
that has ever been adopted for insuring an easy and safe labour.
Child-bed fever, convulsions, and other forms of disease, which
sometimes come on after confinement, doubtless, in the great ma¬
jority of instances may be prevented, or, at least, the system be
placed in a far better condition to resist the influence of the usual
exciting causes of disease, by a course of medicine administered
in the last stage of pregnancy.
The condition of the stomach excites a controlling influence
over local diseases ; such as painful swelling in every part of the
body, swelled breast, and swellings in the groin, neuralgia, local
inflammation, gout, disease of the kidneys, carbuncle, affections
of the spine, abscesses, &c. In the early stage, painful swellings
in the groin and in other glands may, in many instances, be
brought to a crisis, and dispersed without suppuration taking
place, by administering vapour baths and emetics, together with
a proper use of injections, to assist the action of the bowels.
Just so much as the stomach is disordered will local diseases
become generally more difficult of cure. I have known indolent
ulcers, of several years' standing, to be healed in a few weeks,—
chiefly by improving the condition of the system generally, and,
more particularly, that of the stomach, by Thomsonian courses
of medicine, — of which the emetic constitutes, undoubtedly, the
most important part of the treatment.
Even when the seat of disease is located principally in the
brain, emetics may be given, with great advantage, in many
cases.
If a person be injured on the head, or on any part of the body,
and the accident occur soon after the patient has taken a hearty
meal, a prompt emetic should be given, or the patient be made to
vomit freely by some means. If this be neglected, the stomach
will be oppressed by a mass of undigested food, aggravating the
symptoms, and causing the patient much suffering.
When any poisonous substance has been swallowed, an emetic
•should be given promptly. The third preparation of lobelia is
ithe most effectual form of emetic in such cases.
ON THE USE OF CATHARTIC9.
489
When any substance is lodged in the throat, means should at
once be taken to cause vomiting. Where this cannot be effected
by running a finger into the throat, an emetic of lobelia should be
given. It the patient cannot swallow an emetic, vomiting may
be effected by administering one or two teaspoonsful of lobelia
powder in warm water, by injection, and retained in the bowels.
Besides producing vomiting, this treatment will relax the system,
and thus tend to overcome the rigidity of the parts in which the
foreign substance is lodged, and lessening the difficulty of its be¬
ing removed.
Finally, in disease, the stomach is more or less coated with
thickened tenacious secretions, for the removal of which there is
no remedy so effectual as a lobelia emetic, given in combination
with capsicum and a strong decoction of bayberry, or sumac.
The stomach possesses a very low degree of sensibility, so that
its functions may be greatly depressed, or disordered, without the
patient experiencing any symptoms of disease, except in parts re¬
mote from the stomach. One who is subject to a weakness in
any part of the spine, will experience an increase of the disease
by the stomach becoming more disordered than usual. In many
instances, disease of the spine has been cured by the use of the
vapour bath and emetics.
Eruptions of the skin, such as scald head, nettle-rash, and tet¬
ter, are occasioned, in general, by derangement of the digestive
functions; and these eruptions may frequently be more effectually
cured by emetics than by any external applications.
The operation of an emetic, and more especially of a full course
of medicine, is of especial benefit as a means of preparing the
system for surgical operations.
ON THE USE OF CATHARTICS, OR PURGATIVE
MEDICINE.
Every substance which operates upon the bowels as an active
cathartic, whether it be mineral or vegetable, is injurious.—There
is a wide difference between restoring the natural action of the
bowels by aiding nature, and that of provoking an unnatural ac¬
tion in them by means of cathartics. The intestines possess very
little sensibility, excepting that portion called the rectum, which
comprises < uly a few inches of their lower extremity; and it is
not until the contents of the bowels pass down within a few inches
of the anus, that the inclination to evacuate the bowels is felt. It
490
ON THE USE OF CATHARTICS.
is only the lower end of the intestinal canal that is supplied with
true nerves of sensibility. A substance, to be felt in any other
portion of the bowels, must be of an irritating acrid nature. If
there be a superabundance of acid in the bowels, and the person
take freely of cayenne pepper, it will be very likely to occasion
purging, by awakening, in some degree, the sensibility of the
bowels to the impression of the acid. Substances thrown into
the rectum, will stimulate the bowels to evacuate their contents,
when the same substance, taken by the mouth, will never occasion
purging.
We can judge of the injurious tendency of cathartics in a dis¬
eased state of the system, by ascertaining their effect upon the
system when in a healthy condition. Every physician will at
once admit that the use of cathartics is injurious to persons in
health—directly tending to disorder the stomach, impair digestion,
lessen the determination to the surface, weaken the power of gene¬
rating heat, diminish the nervous influence, and ultimately pros¬
trate the functions of the bowels. If a person in health take daily
a dose of purgative medicine, sufficient to produce a free opera¬
tion, and continue the practice a few days, it will disorder the
stomach and weaken the functions of the bowels, so that they
will be left either relaxed and irritated, or constipated.
" In disease, the excretions existing in the alimentary canal are
a matter of little importance, the object being to promote those
actions by which the excretions are formed ; which being restored,
the bowels will be enabled to relieve themselves." — Jackson.
Costiveness is the consequence of the peristaltic action of the
bowels being in a weakened condition. Hence, costiveness is the
effect and not the cause of disease; or, at least, it is merely one
link in the chain of effects arising from loss of vital power, or a
weakened condition of the principle of life. A patient applies to
a physician for advice. He tells the doctor that he has pain in
the head; feels very drowsy and heavy; and has no appetite.
The doctor inquires about the condition of the patient's bowels,
and ascertaining that they are in a constipated condition, disco¬
vers a cause for the headach 'and drowsiness, and he directs a
cathartic, in order to remove the difficulty. But the inquiry should
always be extended further, to ascertain the cause of the costive¬
ness, and " apply the axe to the root of the tree," instead of em¬
ploying means which merely change the symptoms, and interfere
with the curative operations of nature. By tracing disease to its
primary source, we find it to arise from loss of vital power; and
this should always be kept in view in the treatment of disease
Medicines often get the credit of curing disease, even where they
may have had the effect to increase the distress of the patient,
and lengthen the duration of disorder.
It is no easy matter to determine the effects of some medicines
ON THE USE OF CATHARTICS.
491
in sligh* attacks of disease, or in acute disease in general.—Thus
a person, by some inaccuracy in diet, or from exposure to cold
and dampness, feels indisposed to-day, takes a dose of salts, eats
nothing, or at least only something very light, keeps himself
warm, the physic operates, and to-morrow he will be almost well
again,—except that he will be costive a few days, in consequence
of the salts he had taken. The patient attributes the restoration
of his health to the dose of salts; yet doubtless his health would
have been as speedily and more perfectly restored by the absti¬
nence which he had observed, and being kept warm, without the
purging.
Purging, like blood-letting, will modify the symptoms without
removing the cause of disease; ultimately tending to disorder the
system, and prostrate the vital forces. It will be admitted by
every physician, that in a sunken state of the system, or in very
aged persons, the use of purgative medicine is not only hazardous,
but, in many cases, if given to the extent of exciting free purging,
would cause the death of the patient.
It is by the efforts of nature that disease is cured. Medicines
are only serviceable when they aid the efforts of nature. When
the bowels are too inactive, or in any way disordered, the great
object is to aid in restoring the power of heat, and of nervous in¬
fluence ; the only way by which the functions of the bowels can
be restored to a healthy condition. The direct tendency of ca¬
thartics is to lessen the internal heat, and weaken the nervous
power.
Cathartics are agents which do not harmonize with the laws of
life; and when taken into the stomach, the constitution makes an
effort to remove the offending substance by purging. The delete¬
rious influence of cathartics provokes the bowels to action, upon
the same principle that a portion of tainted meat will produce
looseness of the bowels and violent purging.
It is urged by some, that many diseases pass off with a loose¬
ness of the bowels, and that nature sanctions the propriety of
purging. — But it should be borne in mind, that the forced action
from a cathartic is different from the action which results as a
consequence of the bowels recovering their functions at the crisis
of disease. In the first case, the bowels are aggravated and pro¬
voked to action; whereas, in the latter, it is the recovery of their
lost functions.
Some have endeavoured to prove the advantage of using ca¬
thartics, by selecting a few isolated cases, where especial benefit
appeared to result from their employment, the medicine having
been given at a favourable period of the disease. Thus, a patient
may have several courses of medicine administered, which may
brino- the disease almost to a crisis, and just at this time take a
dose°of cathartic medicine, and the next day the disease be broken
492
ON THE USE OF CATHARTICS.
up;—not in consequence of having taken a purge, but because the
disease was forming a crisis when the cathartic was taken; and
although it does more harm than good, still, the disorder being just
at its termination, the patient would improve more rapidly, and
very erroneously suppose that he had received more benefit from
the cathartic than from courses of medicine.
I have known patients relieved of rheumatic pains by being
freely purged with powerful cathartics; but I have never yet seen
a patient really benefited, or the cause of disease removed by such
treatment.
A physician may obtain a large practice, whose course of treat¬
ment may in every instance be detrimental to the recovery of his
patient; — nature still struggling against the disease and the treat¬
ment, health becomes restored, and the doctor receives much
credit for his skill! more especially where a patient recovers who
has been nearly killed by the treatment.
There are thousands of persons in the community who continue
in bad health year after year, in consequence of the habitual use
of purgative medicines. After commencing the use of purgatives,
the bowels being weakened by them, they become more costive:
to overcome this, more physic is taken, which may relieve, but it
weakens digestion, and is followed by increased torpor of the
bowels. —1 have frequently conversed with persons who had been
in the habit of taking a dose of purgative medicine regularly once
a week or oftener, and had continued in this practice from five to
fifteen years; the bowels finally becoming so torpid as scarcely
ever to be moved, except provoked by the irritating effects of a
cathartic; whereas, if no purgatives had been used, many of these
patients might have enjoyed good health.
The exclusion of cathartics constitutes one of the distinguishing
features of the Thomsonian practice of medicine; and no one
can justly claim the title of Thomsonian who is in the habit of
prescribing either mineral or vegetable cathartics. It is incon¬
sistent to denounce all mineral poisons, and at the same time ad¬
minister vegetable poisons, such as mandrake, an article which
has been laid aside by the medical profession generally as too
irritating to be used with safety; and yet many who claim to be
Thomsonian doctors employ mandrake to a great extent in their
practice. Castor oil, which is one of the mildest cathartics, occa¬
sions purging, because it is indigestible and offensive to the sto¬
mach and bowels.
Dr. Samuel Thomson used to say, that the practice of taking
physic (purgatives) was like borrowing from Peter to pay Paul—
which may afford some relief, but does not diminish the debt. In
like manner, a dose of purgative medicine may afford relief, but
it does not remove the cause of disease.
In disease that comes on suddenly, — more especially when at-
ON TIIE USE OP CATHARTICS.
tended by fever, frequent changes in the symptoms and aspects
of the disease take place, which are apt to be attributed to medi¬
cine that has had no other effect than to retard the curative efforts
of the constitution. A professor in Jefferson college being called
out into the country, in consultation, was told by the country phy¬
sician that he found his patients, who had remitting fever, to bear
purging so badly this season (1842), that he had ceased to employ
cathartics altogether, and that some of his patients had gone four¬
teen days without a passage from the bowels. Laying aside ca¬
thartics was certainly correct, but why the doctor did not recom¬
mend enemas, appears somewhat singular.
In treating cases of constipation of the bowels, even of long
standing, I have in many instances been agreeably disappointed
by finding the natural action of the bowels to be in a great mea¬
sure restored in the course of from two to four weeks, under a
course of treatment in which no purgatives were used.
In certain conditions of the stomach and bowels, for instance,
when they contain a portion of acrid secretions, the use of medi¬
cine that possesses no cathartic properties may be followed by
purging. — Thus, cayenne pepper or composition powder, taken
freely when the bowels contain a superabundance of acids, will
increase the sensibilities of the mucous membrane, and may cause
the acid or acrid secretions to operate as a purgative. By con¬
tinuing the use of the same medicines until the acid is removed,
then it may be taken in increased quantities and no cathartic
effect will be produced. In like manner, a dose of purgative
medicine may be made to operate, by giving stimulants to in¬
crease the sensibility of the bowels to the morbid impression of
the cathartic, and stimulating the restorative efforts of nature to
cast off the deleterious substance. — Cayenne does not therefore
possess cathartic properties; its use is never followed by purging,
except there be acrid secretions, or some deleterious substance in
the bowels.
A deficiency of bile, in consequence of want of action in the
liver, is a very common cause of costiveness; and under these
circumstances, cathartics are decidedly injurious.
The object to be kept in view in the treatment of disease is to
aid the efforts of nature; "to husband the resources of the con¬
stitution," in order that lost action may be restored. Nature has
established certain methods for removing disease, and for regain¬
ing her lost power; and the use of medicine, or other employment
of means that do not harmonize with these curative actions,
though they may change the symptoms and procure relief, still
the designs of nature will be frustrated and her energies crippled.
In illustration of what I have here asserted, I will suppose a pa¬
tient who is sick of what is termed bilious fever, to be left entirely
in the hands of nature, except so far as to take simple warm teas
494 ON THE USE OF CATHARTICS.
and be protected from all injurious influences.—Watching the pro*
gress of the case, we find the fever continuing without any abate¬
ment, except at short intervals in the morning; the tongue becomes
even more thickly coated, the bowels remain costive, and all the
symptoms continue, without any perceptible change, for several
days; but finally the tongue begins to clean along the edges, the
fever abates, perspiration ensues, the appetite returns, and the
function of the bowels is restored. Now, under such circum¬
stances, by what method is disease removed 1 It is by the con¬
stitution " husbanding her resources"—retaining the heat by which
these actions are sustained, which resist the influence of the causes
of disease, and by which the secretions and all other functions are
fully restored. Now, suppose such a case be placed under the
treatment of a physician of the old school practice, and active
cathartics given, causing a free operation upon the bowels: would
this restore the lost function of the bowels '? No: it would aggra¬
vate the bowels and drain the system of a portion of its strength.
In this way, by frequent purgation and blood-letting, disease is in
many instances prolonged to four or five weeks' duration, which,
if left in the hands of nature alone, would have found a crisis in
less than two weeks, and the patient subjected to much less suf¬
fering.
There are means, however, by which nature may be assisted,
the duration of disease shortened, pain relieved, and life prolonged.
To Dr. Samuel Thomson are we indebted for the detection and
exposition of the errors of the regular practice of medicine; the
discovery of the true principles of medical science ; and the intro¬
duction of a system of practice which does not clash with nature's
efforts, but operates in harmony with life; and when properly ap¬
plied, will prove a safe and effectual means of restoring lost
health.
It has been urged as an objection to the Thomsonian practice,
that all diseases are treated alike, or that the same remedies are
used in all cases. The fact that Thomsonians treat disease upon
general principles, without regard to the name of disease, is in
reality a strong point in favour of its correctness. A thousand
different forms of disease may be produced by one general cause;
and a course of treatment that will assist nature in one form of
disease will do it in another. Thus, the same form of emetic that
will cleanse the stomach when it has become disordered bv ex¬
posure to cold, will also do the same when disordered through
inaccuracies in diet, dissipation, loss of rest, exposure to foul air,
&c.
ENEMAS. INJECTIONS.
495
ENEMAS. — INJECTIONS.
Many important objects may be accomplished by the use of in¬
jections in cases of sickness; and in many instances they consti¬
tute the most important means for the cure of disease.
In disease, the bowels are generally either constipated or af¬
fected with diarrhoea; and in either case, the use of injections,
though not always necessary, may nevertheless be employed with
advantage. The mere evacuation of the fecal contents of the
bowels, is not of so much importance in the cure of disease as is
generally supposed. To restore healthy action in the bowels is
the great object to be kept in view; and it is better that a patient
submit to some unpleasant feelings from costiveness, than to harass
his stomach and bowels by taking cathartics.
When aliments leave the stomach, they pass quickly through
the small intestines, a distance of about thirty feet, in a liquid
state, and when received into the large intestine are there retained
to undergo a kind of second digestion. Hence, the seat of cos¬
tiveness, in almost every instance, is in the lower bowels, and
within the reach of the influence of injections.
" Whatever is good to cure disease, when taken into the sto¬
mach, is likewise good for the same purpose given by injection;
as the grand object is to warm the bowels and remove canker.
In all cases of dysentery, cold, piles, and other complaints, where
the bowels are badly affected, injections should not be neglected.
They are perfectly safe in all cases; and better that they be used
ten times when not needed, than once neglected when they are.
In many violent cases, particularly where there is danger of mor¬
tification, patients may be relieved by administering medicine
in this way, when all other means would fail."—Dr. Samuel
Thomson.
Lobelia, administered by injection and retained, operates upon
the general system as effectually as when taken into the stomach.
Indeed, a greater degree of relaxation may be effected by the
same quantity of lobelia administered by enemas, than when taken
into the stomach. Often I have observed a most striking change
for the better produced in violent attacks of disease, by a lobelia
injection retained. Obstruction in the system, wherever situated,
appears to be more effectually removed by relaxing the system
with lobelia, than by any other means. Not that we are to de¬
pend, however, upon this treatment, to the exclusion of the use of
stimulants, the vapour bath and emetics. There is probably no
medicine so effectual in arousing the sensibility of the bowels as
lobelia—causing the patient to feel his diseased condition ; and by
496
ENEMAS. INJECTIONS.
exciting the disease-expelling power into action, distress in the
bowels will be experienced; followed, however, in all curable
cases, by a manifest and frequently remarkable change for the
better.
Of the various methods of preparing Injections; together icith
further remarks in relation to their practical application.
Half a pint of warm composition tea, adding a teaspoonful of
green lobelia powder, forms a suitable injection for ordinary cases
of disease, where the symptoms are not of a dangerous or violent
character, nor the bowels badly disordered.
Where there is reason to believe that the bowels are " cankered,"
or coated with thickened tenacious secretions or a false membrane,
as they are in dysentery, diarrhoea, and in obstinate cases of dis¬
ease of every description, tfie following form of injection will
prove more effectual than the one before mentioned, namely:
Half a pint of bayberry or No. 3 tea, made very strong, and
after it is strained or settled and poured off, add a large teaspoon¬
ful of the liquid of the third preparation of lobelia, or a tea-
spoonful of No. 6, and a teaspoonful of either brown or green
lobelia powder.
In violent cases, the quantity of third preparation, or of the
pepper and lobelia, must be increased to double or treble, or even
to ten times the quantity above mentioned. Thus, in malignant
forms of disease, as in what are termed typhus or congestive
fevers, I have generally found it necessary to administer a large
tablespoonful of the third preparation of lobelia at a time by in¬
jection, and have it repeated every two or three hours for several
days in succession, in order to sustain vital action and prevent
mortification. I have known patients to recover from malignant
forms of disease chiefly, I believe, through the influence of ac¬
tively stimulating injections, administered every hour or two, and
in this way continued from one to four or five days. In some of
these cases, the sensibility of the bowels was so low, that from
four to six injections would be retained before an operation was
effected, or the bowels made sensible to their impression.
The daily use of stimulating injections during "confinement"
after child-birth, will prove an effective preventive against puer¬
peral or child-bed fever, as it promotes the contractile power of
the uterus and prevents stagnation of blood in the uterine vessels
—a frequent cause of puerperal fever. It may be asked, will not
lobelia injections relax the uterus ? If there should be spasmodic
contraction of the uterus, the use of lobelia will overcome the
spasmodic contraction, but at the same time will promote the
power of healthy contraction; just as in a case of spasm of the
ENEMAS. INJECTIONS.
497
neck of the bladder, lobelia injections, while they relax the spasm,
increase the expelling power of the bladder.
By observing the character of the evacuations from the bowels
during the course of disease, we perceive that about the time that
a favourable crisis takes place, there will be more or less of a
skinny-like substance escaping from the bowels, and which had
previously coated their mucous membrane. To remove this sub¬
stance from the lower bowels, (where it is chiefly situated,) the
use of injections is particularly demanded. Thus, long-standing
cases of dyspepsia are cured by the removal of a false membrane
from the stomach and bowels, by means of courses of medicine
and taking freely of composition powder, or of bayberry and
pepper, together with the daily use of an enema. Powerful pur¬
gative medicines, though they may sometimes bring away false
membrane, when not too firmly adherent, yet as they neither re¬
store the lost functions of the bowels, nor tend to improve the
condition of the blood, nor of the secretions, the patient, instead
of being benefited, will be left in a worse condition, from the ef¬
fects of the medicine; whereas, under the Thomsonian practice,,
the course of treatment that cleanses the mucous membranes re¬
stores their functions.
In cases of obstinate costiveness, and where the chief object is
merely the evacuation of the bowels, the following will be found
sometimes to answer a better purpose than those already men¬
tioned.
A tablespoonful of salt,
Do. do. molasses,
And a pint of warm water.
This may be rendered more effectual by the addition of a tea-
spoonful of the third preparation of lobelia, or of the lobelia powder.. „
Simple Astringent Injections. — In bad cases of piles, the pow¬
erful stimulating injections should not be employed except under
some peculiar circumstances, for instance, in paralysis of the
lower extremities, or of the bladder, or rectum, suspended anima¬
tion, or in cases of extreme prostration, from illness. When a.
patient is affected with piles, and ordinary injections are found to
make the piles worse, I have never found any plan of treatment
more effectual than a strong tea of witch-hazel, sumac berries,,
bayberry, and poplar bark, used by injection at bed-time, and re¬
tained until morning. This diminishes the piles, relieves the sore¬
ness of the parts, and generally procures a motion from the
bowels in the morning.
Simple Lobelia Injections. — Immense benefit may very oftem
be derived by placing the system under the influence of lobelia,,
32
498
ENEMAS. INJECTIONS.
administered by injection, and retained ten or fifteen minutes; and
indeed, no harm will arise from it, even though it should remain
in the bowels many hours. In all violent attacks of disease, one
of the most important indications is to relax the system by lobelia,
either taken into the stomach, or administered by injection, in
lukewarm water. If stimulants are employed in the injection, the
lobelia will pass off before the system will be effectually influenced
by it. In violent cases of croup, besides giving lobelia by the
mouth, half a teaspoonful of the powder in a tea-cup of lukewarm
water should be administered by injection, and this repeated if the
case prove obstinate of cure. In severe cases of scarlet fever,
attended with an undue determination of blood to the head, and,
in fine, whenever there is vehement fever, attended by a hard and
tense pulse, injections of lobelia powder in lukewarm water, by
.relaxing the system, will very greatly assist the efforts of the con¬
stitution to overcome obstructions, and restore the functions of the
bowels.
In administering lobelia to infants and children, by injection, the
■quantity used must vary, to suit the age of the patient and the
violence of the disease. Thus, for children under one year old,
:as much lobelia powder as will lay on a five-cent piece; or even
,less than this will be sufficient in ordinary cases. But when the
.symptoms are violent, as in severe croup, fits, &c., a much larger
quantity may be required.
The practice of placing the system under the influence of lobe¬
lia, administered by injection and retained, is not to be confined
exclusively to cases in which there is a high fever. Disease thai
has become seated, whether accompanied with fever or not, has
often been removed by means of lobelia injections.
Case.— Some months since, a little girl was attacked with a
very severe form of canker sore mouth; and various kinds of re¬
medies, together with the use of the steam bath, and the usual
stimulating injections, having failed to effect a favourable change
in the symptoms, and the disease having continued nearly two
weeks, a lobelia injection was administered and retained, which
relaxed the system very much, aroused a new action in the
bowels, occasioning considerable pain and distress for a time; but
the symptoms of the sore mouth at once assumed a more favour¬
able aspect, and in a short time it was well.
Case. — A young lady of nervous temperament was thrown
■into convulsions by being hit upon the neck with a nut-shell. Dr.
Harris, ol Newtown, Bucks county, was sent for, who prescribed
the third preparation of lobelia. Ascertaining, however, that she
could not swallow, and appeared insensible to the impression of
the medicine when put in her mouth, and the spasms continuing.
ENEMAS. INJECTIONS. 499
She doctor desired the females present to administer an injection,
consisting of a tablespoonful of the third preparation of lobelia,
in some warm water. This was accomplished with considerable
difficulty. The injection was retained; and appearing to lessen
the violence of the convulsions, a second injection, similar to the
first, was given; and this soon occasioned free vomiting, followed
by a cessation of the convulsions, and a return of consciousness.
After the lapse of a few hours, however, symptoms of returning
convulsions came on; but the patient being then able to swallow
the third preparation, it was given every time that the symptoms
became manifest, and convulsions prevented.
Lobelia, retained in the bowels, will always produce for a time
more or less pain and distress, by greatly increasing the sensibility
of the parts, and, as it were, attracting the nervous influence to
he bowels, removing obstructions, and restoring the internal
capillary circulation necessary to carry on the functions of the
jowels in a healthy manner. Patients may be effectually vomited
oy lobelia, administered in the manner just described; the vomit¬
ing and relaxation of the system even continuing longer than
when an emetic is taken in the usual way.
In all cases of obstinate obstructions in a part, attended with
violent pain and strong pulse,—as in severe pleurisy, inflammation
of the brain, inflammation of the lungs, croup, &c., — lobelia
should be used freely: either given by the mouth, or administered
by injection and retained. In some instances it will be necessary
to repeat the injections at intervals of every four or five hours,
with a view to overcome obstructions, if there be seated inflam¬
mation ; to equalize the circulation of the blood and of nervous
power. In this way we obtain all the benefits that can possibly
result from relaxing the system by blood-letting, and without any
danger of the serious consequences which not unfrequently result
from the loss of blood.
Lobelia, administered by injection, exerts a more prompt and
effective influence upon the kidneys, bladder, and uterus, than
when taken into the stomach. Hence, in all cases of disease of
any of these organs, or in parts within the vicinity of the lower
bowels, the use of injections will constitute a very essential part
of the treatment. Flooding after child-birth can be more effect¬
ually and promptly checked by stimulating injections, containing
lobelia, administered to the bowels, than by any other means.
Violent inflammation of the kidneys, strangulated hernia, in¬
flammation of the neck of the bladder, retention of urine, painful
stricture of the urethra, and inflammation of the uterus, demand
the prompt employment of lobelia injections, besides the usual
constitutional treatment proper to be employed in such cases.
Habitual costiveness is rarely cured bv the use of ordinary in-
500
ENEMa.3. INJECTIONS.
jections alone; other means must be employed, as the circum
stances of the case require. (See article on Constipation.) Some¬
times a free use of cayenne pepper at meals will restore the natu¬
ral action of the bowels.
In administering a course of medicine in deeply-seated disease,
no matter by what name it may be called, it is a good practice to
administer a stimulating injection previously to the steaming, and
after the bath, repeat the injection, — composed simply of half a
teaspoonful of lobelia powder in warm water, so that it may be
retained, — and then give the emetic of the third preparation of
lobelia, or some other preparation of lobelia, combined with stim¬
ulants, in bay berry tea.
It would appear that most persons, and even physicians, regard
constipation of the bowels as more injurious to the system than
the frequent use of purgative medicines. This is one of the pop¬
ular errors, — introduced and established by false theory. The
homoepathic physicians use neither purgatives nor injections ; al¬
lowing their patients to continue eight, ten, and even twenty days,
without a motion from the bowels; and their success in the treat¬
ment of disease is equal, if not more than equal to that of the
alopathic practice.
A lady at Moorestown, N. J., continued nine days without any
motion from the bowels, notwithstanding injections were admin¬
istered daily. She experienced no apparent inconvenience from
the constipation of the bowels; and being in a state of extreme
prostration, this patient would probably not have recovered, if her
stomach and bowels had been aggravated by cathartics, or even
by laxatives ; the mere stimulus of distention, arising from the pre¬
sence of faecal matter in the bowels, assisting in supporting the
strength of the patient.
Turpentine, administered by injections, has frequently proved
successful in removing pain in cases of bilious colic. Take a
tablespoonful of oil, or spirits of turpentine, and the yolks of two
eggs; beat them well together, and then add a pint of warm
water. This may be all administered at a time, and repeated if
necessary.
Tonic Injections. — A decoction of Peruvian bark, rose willow,
poplar, or of any of the vegetable tonics, administered by injection
and retained, will exert the same influence upon the system as
when taken into the stomach. Tonics may be administered in
this way in cases where the stomach is too irritable to retain tonic
medicines.
THOMSONIAN MATERIA MEDICA:
CONTAINING
A GENERAL DESCRIPTION •
OF THE
MEDICAL PROPERTIES AND USES
OF THE
VARIOUS MEDICINES AND COMPOUNDS
EMPLOYED IN THE
, THOMSONIAN PRACTICE.
LOBELIA INFLATA —EMETIC HERB.
There are several species of lobelia; none of which, however(
except the inflata, appear to possess medical properties of suffi¬
cient importance to entitle them to a place in the materia medica.
The lobelia inflata presents several peculiarities by which it may
very readily be distinguished from every other plant. It grows
in every kind of soil, but is to be found most plentifully in old
pasture fields, and in fields that have been in grass a year or
longer. Lobelia does not come to maturity the first year of its
growth. It is a biennial plant; rising but very little above the
surface of the ground during the first summer, and on the following
one it blossoms and seeds. " The young plant may be seen in the
latter part of summer, and during the autumn, with its leaves flat
upon the ground, spreading out in the form of a star; and it re¬
mains in this situation through the winter, resisting the effects of
the frost and snow, and arrives at maturity the ensuing year. By
cultivation, however, lobelia becomes an annual; that is, if the
seeds be deposited in the ground early in the spring, and the sea¬
son is favourable, they will sprout and shoot up stems; and by
the expiration of the autumn, the plant will have passed through
the various stages of its growth." Lobelia does not grow in
England, nor is it probable that the climate of that country would
(501)
502
MATERIA 3IEDICA.
admit of its cultivation, excepting in gardens or hot-houses.
Europe, according to botanical works, affords only three species
of lobelia, neither of which is the " injlata
No one, except Dr. Samuel Thomson, has any just claims to
the discovery of the medical virtues of lobelia. This, like many
of the most useful discoveries that have been made, was the result
of accident. Thomson, during a period of twenty years, com¬
mencing with early boyhood, had often observed the singular
effect of lobelia upon persons, by chewing a small portion of the
plant, before it occurred to him that it possessed any valuable
medical properties. The small quantity taken, and the probable
healthy condition of those who were induced to take it, affords
an explanation, why the knowledge of its peculiarly valuable
medical qualities so long escaped the discriminating mind of
Thomson.
The idea of lobelia being useful as medicine, originated with
Thomson from observing its powerful and beneficial effects upon
a man in bad health, who had swallowed some, through motives
of mere curiosity. The man became very much relaxed, vQmited
freely, sweat profusely, and in a short time after ate a hearty
dinner, and declared that he never had any thing to do him so
much good. — This circumstance induced Thomson to make a
trial of it for cleansing the stomach, which resulted in the convic¬
tion that it possessed important medical properties — that it was
powerful in removing disease, and harmless to the system.
" In giving a description of this valuable herb," says Dr. Thom¬
son, " I shall be more particular, because it is the most important
article made use of in my system of practice;—without which it
would be incomplete, and the medical virtues of which, and the
administering of it in cases of disease, I claim as my own dis¬
covery. The first knowledge I ever had of it was obtained by
accident, more than forty years ago; and I never had any in¬
formation whatever concerning it, except what I have gained by
my own experience. A great deal has been said of late about
this plant, both in favour and against its utility as a medicine; but
all that the Faculty have said or published concerning it, only
shows their ignorance on the subject; for there is very little truth
in what they have stated concerning its medical properties, except
wherein they have admitted it to be a cure for the asthma."
The extraordinary influence exerted upon the system by lobelia,
has doubtless induced many to believe that it is poisonous. The
assertion, however, that lobelia is a poison, is not true; "but, on
the contrary," as Dr. Thomson observes, " there is no vegetable
that the earth produces more harmless in its effects on the human
system, and none more powerful in removing disease and promot¬
ing health."
The great majority of medical men have set their faces against
MATERIA MEDICA.
503
lobelia, and the Thomsonian practice, in general, with a degree*
of prejudice and stubbornness, which reflects no credit upon the
profession. At the trial of Dr. Frost, of New York, and on other
occasions, where regular physicians have given testimony before
"coiTts of justice," in relation to the properties of lobelia inflata,
theii evidence has been based upon the information they had ob¬
tained from medical authors who knew as little as themselves of
its properties from experimental observation.
Some of the regular profession, who have written upon the sub¬
ject of the medical qualities of lobelia, have ventured to speak
favourably of the article. The following extracts are selected
from different authors.
"I am confident," observes Professor Tully, of Yale College,
" the old women's stories in the books to the contrary notwith¬
standing, that lobelia is a valuable, a safe, and a sufficiently gentle
article of medicine; and I think the time will come when it will
be much better appreciated. Little, however, of its value can be
specified within the compass of a single sheet of paper."
Dr. Eberle, in his Practice of Medicine, says: "The lobelia
inflata has proved an excellent remedy in my hands in hooping
cough. It not only mitigates the violence of the cough, but it has
appeared to me unequivocally to shorten the course of the disease
in several- cases." The same author, in his Materia Medica, ob¬
serves: " I have had several striking examples of the good effects
of lobelia in asthma. Its operation is, indeed, often surprisingly
prompt and effectual. I have known the most frightful paroxysms
completely allayed in less than fifteen minutes. Even where the
disease depended on organic affections of the heart, it has speedily
as a general rule, mitigated the distressing difficulty of breathing.
As an emetic, I have employed it in several cases of croup, with
very great benefit."
" It has been my misfortune," observes Dr. Cutler, " to be an
asthmatic for about ten years. I have made trial of a great
variety of the usual remedies, with very little benefit. The last
summer, I had the severest attack I had ever experienced. It
commenced early in August, and continued eight weeks. Dr.
Drury, of Marblehead, also an asthmatic, made use of the tinc¬
ture by the advice of a friend, in a severe paroxysm, early in the
spring. It gave him immediate relief, and he has been entirely
free from the complaint since that time. In a paroxysm which,
perhaps, was as severe as any I ever experienced, and the diffi¬
culty of breathing extreme, I took a tablespoonful of the tincture
made of the fresh plant.. In three or four minutes, my breathing
was as free as it ever was, but I felt no nausea at the stomach.
In ten minutes, I took another spoonful, which occasioned sick¬
ness. After ten minutes, I took the.third, which produced sensible
effects upon the coats of the stomach, and a very little vomiting,.
504
MATERIA MEDICA.
with a kind of prickly sensation through the whole system, even
to the extremities of the fingers and toes. The urinary passage
was perceptibly affected, by producing a smarting sensation in pass¬
ing urine; but all these symptoms very soon subsided, and a
vigour seemed to be restored to the constitution, which I had not
experienced for years. Besides the violent attacks, I had scarcely
passed a night without more or less of it; and often so as not to
be able to lie in bed. Since that time, I have enjoyed as good
health as, perhaps, before the first attack."
Dr. Waterhouse, for many years a professor'in the medical de¬
partment of Harvard University, observes: " I have had ample
proof of the efficacy and safety of lobelia in a number of cases,
and have reason to value it as equal to any article in our materia
medica. I not only give it to my patients, but take it myself,
whenever I have any occasion for an emetic."
Medical Properties. — The result of experiments made by Mr.
William Proctor, a chemist of Philadelphia, proves the active prin¬
ciple of lobelia to be a volatile alkaline substance. It has been
named lobelina. Mr. Proctor having obtained some lobelina, ad¬
ministered a large dose of it to a cat. The animal became sick,
very much relaxed, and remained so several hours. After the in¬
fluence of the medicine passed off, the animal was well, and ate
as usual.
The medical virtues of lobelia are destroyed by boiling, unless
a portion of acid be present.
Uses. — Combined with astringents and stimulants, lobelia may
be regarded as the best emetic known.
The accumulated experience of thousands of observing and in¬
telligent persons, for half a century, fully sustains the views of Dr.
S. Thomson, in relation to the medical virtues of lobelia. Taken
in emetic doses, it awakens sensibility in the stomach ; the patient
feels his diseased condition; an internal reaction is established;
" the disease-expelling power of the organization is stimulated to
action," and more benefit realized, in many instances, from one
full operation of this kind, than can be obtained from any other
course of treatment.
The general complaints that prevail during infancy and child¬
hood frequently depend upon a foul stomach, and the facility
with which the stomach may be evacuated by a lobelia emetic,
and the relief almost sure to follow the operation, places within
the reach of parents a safe and effectual means of relieving.-the
distress accompanying the diseases of children.
Taken in broken doses, lobelia is probably superior in efficacy
to any other article, as an expectorant, in cases of asthma, ca¬
tarrh, recent cough, pleurisy, inflammation of the lungs, &c.
MATERIA MEDICA.
505
Pills, composed of equal quantities of brown lobelia and cay¬
enne, may be used as a general medicine in all cases of disease,
with almost certain benefit in curable cases, and without injury in
any case.
The green lobelia, used as snuff, either alone or mixed with bay-
berry powder, has cured cases of polypus of the nose. It may
be used in this way for catarrh in the head, and all complaints
affecting the mucous membrane of the nose.
Lobelia powder, with an equal .quantity of slippery elm, wet
with warm water, constitutes the most efficient form of poultice
that can be applied in local inflammation, such as attends biles,
felons, &c.
Preparations of Lobelia.
Green Lobelia Powder. — To prepare green lobelia powder, the
herb should be gathered when in blossom; dry it in the shade,
and as soon as it is thoroughly dried, strip or beat off the leaves
and pods, reduce it to a fine powder, and keep it secluded from
the air, dampness, and from light. This forms the green lobelia
powder. This preparation of lobelia is generally employed as an
emetic in ordinary cases of disease, and for children in general.
It is usually given in strong composition tea, or in a strong de¬
coction of bayberry or sumac, adding a portion of cayenne or of
No. 6.
Tincture of Lobelia.—To prepare a tincture of lobelia, take the
freshly-dried herb in any stage of its growth, before the leaves
become yellow, and put it in diluted alcohol, whiskey, or in ma¬
deira or sherry wine.—Tinctured in vinegar it is a worthless pre¬
paration. The tincture is a convenient form of administering
lobelia to children, as an expectorant in whooping cough, and
affections of the breast in general. Ordinary attacks of croup
may be cured by giving promptly and freely of the tincture of
lobelia. As an emetic, the lobelia powder or the third prepara¬
tion is to be preferred to the tincture; but when it is desired to
place the system under the influence of lobelia in a moderate way,
as in cases of tight cough, disease of the chest in general, dys¬
pepsia, palpitation of the heart, scrofula, and, in fine, in a great
variety of cases of disease, the use of the tincture of lobelia lorms
a very convenient and useful preparation, given to an extent to
produce a slight degree of nausea. I have observed the use of
the tincture of lobelia, taken in doses of from half to a teaspoonful
every hour < r two, to be attended with very great benefit in very
many cases of dyspepsia, consumption, and in diseases of the
breast in general.
506
MATERIA MEDICA.
Tincture of lobelia forms a substitute for the various kinds of
anodynes in general use, such as Godfrey's Cordial, paregoric,
and other preparations containing opium. Given to infants and
children in small doses, varying from five to twenty drops, it
quiets restlessness, and disposes to sleep. Administered in this
way, lobelia has a soothing influence upon the system. Lobelia
is not narcotic — it possesses no such properties.
Taken in small doses, by those who are attending upon the
sick, the tincture of lobelia will be useful in protecting the system
from disease.
j*
Syrup of Lobelia.
To make a Syrup of Lobelia. — Take half a pound of either the
brown or green lobelia, a gallon of water, and half a pint of vine¬
gar; boil or steep half an hour, and pass it through a displacer;
then add eight pounds of sugar, and steep it another half hour;
and when it cools, add a quart of the alcoholic tincture of lobelia.
This may be used as a substitute for the tincture of lobelia in
all cases.
Lobelia Seed. — To obtain lobelia seed, the herb should be col¬
lected when the pods have turned yellow. If left until the cap¬
sules are fully ripe and dried, the pods being open at the top, the
seed will fall out, unless great care be taken in gathering. — To
prepare the seed for use, they must be finely pulverized in a mor¬
tar or by grinding.
The lobelia seed exerts a much more powerful influence upon
the system than the green powder, or the tincture. The alarming
symptoms, as they are called, are seldom produced by the use
of any other preparation of lobelia than the seed. The brown
lobelia, administered in full doses, will rarely fail of relaxing the
system ; and this is a point of great importance in the cure of
disease attended with high fever or violent pain; for instance,
cases of strangulated hernia, peritoneal -inflammation, strangury,
inflammatory rheumatism, and violent fevers, such as often at¬
tend scarlet fever and small-pox; — the brown lobelia will prove
more efficient in such cases, and should be employed in preference
to the green.
Third Preparation of Lobelia.
Directions for Preparing. — Take an ounce of lobelia seed pul¬
verized; an ounce of cayenne pepper; and an even tablespoonful
of nerve powder. Mix them together, and add between half a
pint and a pint of No. 6. To be kept in vials or bottles tightly
MATERIA MEDICA.
507
corked, and not allowed to remain in a hot place. This prepara¬
tion, given in strong bayberry or No. 3 tea, forms an efficient
emetic. It is a powerful agent for assisting nature to overcome
disease, and may be used with perfect safety. The dose is from
a teaspoonful to a tablespoonful; to be repeated as the circum¬
stances of the case may demand. I knew an instance where a
child, but nine months old, took three ounces of the third prepa¬
ration of lobelia during one afternoon. It was a case of croup,
which had continued two or three days, before this thorough
treatment was adopted. The patient recovered through the
agency of the treatment.
The third preparation of lobelia is particularly adapted to vio¬
lent attacks of disease, as in fits, bilious colic, cholera morbus,
epidemic cholera, locked jaw, poisons taken into the stomach,
suspended animation from drowning, lightning, or from inhaling ■
carbonic acid gas; difficult cases of croup and asthma; gout,
palsy, and in all cases of violent pain.
In preparing emetics for adults, I generally combine the third
preparation and lobelia powder. In all cases where the strength
of the system is in a sunken condition, in protracted fevers, ma¬
lignant small-pox, measles and scarlet fever, where the eruption
is slow in appearing, for want of vital action; or where there is
a tendency to a retrocession or striking in of the eruption, the use
of the third preparation of lobelia is particularly called for.
In many cases, for instance, in fevers, where the patient is very
low, the third preparation of lobelia may be taken in teaspoonful
doses, repeated every hour or two, and continued a day or even
longer, without occasioning vomiting. If it should not cause
vomiting, however, it need not occasion the least degree of
anxiety, as it can do no harm under any circumstances.
To sustain vital action, and prevent mortification in malignant
forms of disease, — for instance, in the advanced stages of what
are called fevers, — there are no means more effectual than the
free use of the third preparation of lobelia in the stomach and
administered by injection. The quantity to be used must be regu¬
lated by the effect produced. In some instances I have found it
necessary to use a tablespoonful or more in an injection; and this
repeated every two or three hours, and continued several days
and nights in succession, and with the most happy effects, espe¬
cially in low forms of fever.
In treating of the third preparation of lobelia, Dr. Thomson
observes: — "This preparation is for the most violent attacks
of disease, such as locked jaw, bite of a mad dog, drowning,
fits, spasms, and in all cases of suspended animation, where the
vital spark is nearly extinct. It will go through the system like
electricity, giving heat and life to every part. In cases where the
spasms are so violent that the patient is stiff, and the jaws become \
MATERIA MEDICA.
set, by pouring some of this liquid into the mouth, between the
cheek and teeth, as soon as it reaches the glands at the root of the
tongue, the spasms will relax, and the jaws will become loosened,
so that they will open; then give a dose of it, and as soon as the
spasms abate repeat it, and afterwards give a tea ot No. 3, as
prepared for canker.—This course I never knew to fail of giving
relief. It is good in less violent cases, to bring out the measles
and small-pox. * * * * * I have cured three dogs with
this preparation, who were under the most violent symptoms of
hydrophobia; and one of my agents cured a man with it who
had been bitten by a mad dog; and I have not the least, doubt of
its being a specific for that disease." — Dr. S. Thomson.
I have never known of a patient being suffocated by having the
third preparation of lobelia poured into the mouth, even where
the patient was in a state of unconsciousness at the time.
In giving the third preparation as an emetic, and on ordinary
occasions, it should be given in bayberry or No. 3 tea, made very
strong.
Externally applied, the third preparation of lobelia will prove
beneficial in cases of rheumatism, lumbago, palsy, erysipelas,
asthma, weakness of the spine, pain in the side, dropsical swell¬
ings, chronic pleurisy, chilblains, some species of tetter, and in
tic-doloureux.
Compound Lobelia Pills.
Directions for malting. — Mix equal portions of pulverized lobe¬
lia seed and cayenne pepper, and add sufficient mucilage of gum
arabic, or liquorice dissolved in water to the consistence of mo¬
lasses, to render the mass of a proper texture for working into
pills.
The compound lobelia pills may be used as a general medicine,
where patients prefer taking medicine in the form of pills. They
are particularly adapted to cases of dropsy; as the desired im¬
pression may be made by medicine, without the use of liquids.
Where a disease has become seated, as in dyspepsia, rheumatism,
gout, asthma, tetter, scald-head, consumption, costiveness, jaun¬
dice, St. Vitus's dance, piles, palsy, neuralgia, scrofula, &c., these
pills may be employed in the place of the stimulating teas; and
as intermediate medicine, where courses of medicine are given.
The use of these pills will in many instances occasion more or
less uneasiness and pain in the bowels, until, by their use, a more
natural warmth and action are restored to the bowels; and then
they will cease to produce pain, unless taken in large quan¬
tities.
MATERIA MEDICA.
509
The use of these pills promotes the natural action of the
bowels. They possess no cathartic properties. If there be an
accumulation of acid in the bowels, a free use of these pills ma)
cause the acid to be more sensibly felt, and in this way occasion
purging. But when the acid is removed from the bowels, the pills
will not occasion purging.
Finally, the compound lobelia pills maybe employed as a gene¬
ral medicine in all kinds of complaints, until the disease forms a
crisis, and the condition of the patient requires the use of tonics.
They occasionally excite free vomiting; — more especially when
the patient's stomach is very foul. They can do no injury under
any circumstances.
Children, subject to what are usually called worm symptoms,—
such as irregular appetite, costiveness, distention of the belly,
itching of the nose, restlessness at night, &c., may often be cured
by giving them two compound lobelia pills after each meal, and
at bed-time, and continuing their use for some days.
Dose. — In case of rheumatism, diopsy, &c., when it is proper
to place the system under the continued influence of medicine,
from two to four pills may be taken about every hour or two. In
ordinary cases of dyspepsia and costiveness, where the patient is
not confined to the house, from two to four or five of the pills
may be taken at bed-time. Emetics of lobelia may be adminis¬
tered in the form of pills; the patient taking freely of bayberry
tea when sickness comes on.
Emetic Doses. — From three to five of the lobelia pills, taken
at intervals of from twenty to thirty minutes, until four or five
doses are taken, will in general prove an effectual emetic, provided
the patient be in a condition favourable to their operating: —
covered warmly in bed, and composition tea taken to aid their
opeiation.
MATERIA MEDICA.
STIMULANTS
Which raise and sustain vital action, and assist the efforts of
nature to remove disease.
CAPSICUM — CAYENNE PEPPER.
"Numerous species of capsicum, inhabiting the East Indies and
tropical America, are enumerated by botanists, the fruit of which,
differing simply in the degree of pungency, may be indiscrimi¬
nately employed. The capsicum baccatum or bird pepper, and
the capsicum frutescens, are said to yield most of the cayenne
pepper brought from the West Indies and South America; and
Ainslie informs us that the latter is chiefly used in the East Indies.
The species most extensively cultivated in Europe and this coun¬
try, is that recognised as officinal by the pharmacopoeias, name¬
ly: the capsicum annuum. The first two are shrubby plants; the
last is annual and herbaceous." — U. S. Dispensatorij.
Capsicum is a pure and permanent stimulant; its direct effect
upon the system, when taken, is to raise and support vital action;
it restores a natural warmth to the system, increases the power
of generating nervous influence, by which the secretions are in¬
creased, a determination to the surface is produced, and the cir¬
culation of the blood equalized. Cayenne pepper, therefore, is an
important agent in the treatment of disease; always assisting
nature and operating against disease, whether it be attended by
chilliness or fever. It is congenial to the living principle in man
as certainly as that the sun is congenial to the life of the vegetable
kingdom.
The greater part of the cayenne pepper sold by grocers ana
apothecaries, contains very little strength, and therefore should
not be used as medicine.
The American pepper, though inferior in strength to the im¬
ported, will answer in ordinary cases of disease, provided it be
properly dried and prepared. The African pepper, however, is
always to be preferred, when it can be obtained pure.
Large quantities of damaged capsicum are landed in our sea¬
port towns, so that the greatest degree of circumspection is neces¬
sary in purchasing the article. Those who deal largely in
Thomsonian medicines should either purchase the article in the
MATERIA MEDICA.
511
pod, so that they may know its qualities, and have it ground under
their own inspection, or purchase it of those who are judges of
the article, and have it ground in mills where no poisonous drugs
are allowed to enter.
" I shall not," says Dr. Thomson, " undertake to dispute but
that cayenne had been used for medical purposes long before I
had any knowledge of it; but it is equally true that the medical
faculty never considered it of much value, and the people had no
knowledge of it as a medicine, till I introduced it, by making use
of it in my practice. That this is one of the safest and best ar¬
ticles ever discovered for the removal of disease, I know to be a
fact from long experience. Mention is made of cayenne, in the
Edinburgh Dispensatory, as chiefly employed for culinary pur¬
poses, but that of late it has been employed in the practice of
medicine. The author says, ' There can be little doubt that it
furnishes one of the purest and strongest stimulants which can be
introduced into the stomach; while at the same time it has nothing
of the narcotic effects of ardent spirits. It is said to have been
used with success in curing some cases of disease that had re¬
sisted all other remedies.' All this," continues Thomson, " I am
satisfied is true; for if given as a medicine, it will always be
found useful; but all the knowledge they had of it seems to have
been derived from a few experiments that had been made, without
fixing upon any particular manner of preparing or administering
it. * * * * * When I first began to use this article, it
caused much talk among the people of Portsmouth and the ad¬
joining towns ; the doctors tried to frighten them, by telling them
that 1 made use of cayenne pepper as a medicine, and that it
would burn up the stomach and lungs as bad as vitriol. The
people generally, however, became convinced, by using it, that all
that the doctors said about it was false; and thus proved their
ignorance of its medical virtues, and that in making these asser¬
tions they were influenced by a feeling of malice toward me. It
soon came into general use, and the knowledge of its being useful
in curing disease was spread all through the country. I have
made use of cayenne in all kinds of disease, and have given it to
patients of all ages and under every circumstance that has come
under my practice; and can assure the public that it is perfectly
harmless,— never having known it to produce any bad effects
whatever. It is doubtless the most powerful stimulant known; it
is congenial with nature, having a direct tendency to raise and
maintain the natural heat of the system, upon which life and
health so materially depend. It is extremely pungent, and when
taken, sets the mouth, as it were, on fire; this lasts, however, but
a few minutes, and I consider it essentially a benefit, in many
cases, as it causes a free flow of saliva from the glands of the
mouth and throat."
512
MATERIA MEDICA.
To one not fully acquainted with the effects of cayenne peppe.
upon the system, it may appear a strange practice to give the ar¬
ticle in cases of fever. Singular as it may seem, it is nevertheless
true, that excepting lobelia there is no other article of equal value
with cayenne pepper in the cure of fevers in general. As to the
declarations of physicians, that the use of cayenne internally will
aggravate fever, or that it will increase inflammation in the sto¬
mach and bowels, given even in large quantities, this is contra¬
dicted by the experience and observation of thousands of persons,
possessed of as much common sense, and as capable of appre¬
ciating the effects of medicine as the medical profession.
Experience has proved that cayenne pepper is one of the best
remedies known for inflammation of the throat; and where is the
proof that it has not the same curative effect in inflammation of
the stomach and bowels? Cayenne relieves inflammation of the
stomach and bowels by exciting the secretions.
In ordinary cases of colds, catarrh, mild cases of fever, recent
attacks of dyspepsia, or almost any kind of ailment, not too deeply
seated, the free use of cayenne pepper tea, together with particu¬
lar attention to diet, and avoiding exposure, will prove effectual in
restoring a healthy state of the system.
The efficacy of a free use of cayenne pepper in promoting di¬
gestion no one will pretend to deny. Its use will be found bene¬
ficial even in those cases of indigestion or dyspepsia attended by
extreme tenderness at the pit of the stomach. The best time to
take cayenne, in cases of dyspepsia, is with food, or shortly aftei
meals.
In dysentery, where most medical men, influenced by the doc¬
trines of the schools, consider the use of active stimulants very
improper, yet, even in the most inflammatory form of the disease,
cayenne pepper may be used not only with safety, but with espe¬
cial benefit. The use of cayenne pepper is particularly indicated
in cases of dropsy, jaundice, long-standing cases of tetter, cos-
tiveness, flatulency, rheumatism, and gout. In fine, it may be
used with perfect safety in all cases of disease.
The utility of cayenne for the cure of scarlet fever and malig¬
nant sore throat, is admitted even by the medical profession; and
would the)7 but try its efficacy in all other forms of fever, they
would find it as beneficial as in scarlet fever, notwithstanding its
use is contra-indicated by the popular, though false doctrines pro¬
pagated in the schools of medicine. I once heard Professor
Revere, of Jefferson college, observe, that almost every one knew
cayenne pepper to be one of the best remedies for an inflamed
throat; " and it is impossible," said he, "for us to explain why it
is not equally beneficial in inflammation of the stomach or
bowels."
Cayenne pepper, applied to the skin, will produce redness, in-
materia medic a.
513
crease the heat of the part, and aggravate acute inflammation on
the surface of the body; but when applied to a secreting surface,
as the mucous membrane of the stomach or bowels, it promotes
the secretions from these surfaces, and in this way relieves inflam¬
mation, and assists in bringing about a favourable termination to
disease. Cases of chronic diarrhoea of long standing have been
cured by using freely of cayenne pepper.
The usual dose of cayenne is from a half to a teaspoonful. It
is usually taken in the form of tea, made by pouring boiling water
upon the powder, and then sweetening. Another way to take
pepper, is to mix the powder in lukewarm or cold water. Thus
prepared, it is less pungent, and it is equally as efficacious as the
tea.
In certain conditions of the stomach, and more especially when
it is empty, taking a dose of cayenne will occasion pain for a few
minutes. The pain appears to rise in ccnsequence of a sudden
development or generation of gas or wind in the stomach, — th«;
pain subsiding as soon as wind is expelled. No harm is to be ap¬
prehended, however, from pain occasioned in this way; but, om
the contrary, we often find that patients experience a remarkable
change for the better, immediately after experiencing a severe
spell of pain from taking a dose of cayenne pepper. About foui
years ago, I prescribed medicine to a man who had been dyspep¬
tic, and otherwise in feeble health for twenty years; and on taking
the first dose of Thomsonian medicine, which consisted of a tea¬
cup half full of strong bayberry tea, and a large teaspoonful of
cayenne pepper, (instead of half a teaspoonful, as I had directed,)
he was suddenly seized with violent pain in the stomach, a cold
sweat broke out, and for some time he was helpless. After the
pain had subsided, he fell asleep, slept several hours, and when he
awoke declared that he had not felt so well at any time for many
years. The patient continued the use of the medicine, and his
health was soon restored.
When patients experience severe pain in the stomach, aftei
taking a dose of pepper, warm applications — a hot brick, or flan
nel wrung out of hot Water—applied to the pit of the stomach,,
will generally relieve the pain. Taking pepper tea in very small
quantities, frequently repeated, will seldom occasion pain, even on
an empty stomach.
Combining other stimulants with cayenne,—as ginger or black-
pepper, — will render it less liable to cause pain in the sto¬
mach.
As a gargle in recent attacks of sore throat, and in cases of
ulceration of the throat in scarlet fever, there is no remedy, in
point of efficacy, equal to cayenne pepper. A preparation of
vinegar, salt, and cayenne pepper, has been a long time in high
33
514
MATERIA MEDICA.
repute in some southern countries, as a remedy for malignant sore
throat and scarlet fever.
Tonics and other medicines are rendered more active and effi¬
cient, by being combined with a portion of cayenne.
Cayenne pepper, applied externally, is very useful in many
cases, as in rheumatism, dropsy, and in all cases where the use of
external stimulants are called for. Poultices of pepper may be
employed with advantage in a great variety of cases, — as in
chronic rheumatism, cold abscess, white swellings, hip disease,
indolent ulcers, disease of the spine, and in all cases when it is
necessary to stimulate the vessels of a part, by the direct applica¬
tion of a stimulant.
THOMSON'S COMPOSITION POWDER.
To make Composition Poivder. — Take three pounds of finely-
■ground bayberry-root bark, one and a half pounds of best ginger,
three ounces of cayenne, and three ounces of cloves; all finely
pulverized, thoroughly mixed, and passed through a sieve.
A variety of formulas for preparing composition powder have
been published as an improvement upon that of Thomson's.—
Some recommend the addition of butterfly root (asclepias tube-
rosa); others, sassafras root; either of which, however, are
•comparatively useless articles, and when added to Thomson's
composition powder, they occupy the place of more efficient arti¬
cles.
The composition powder, besides its stimulating qualities, con¬
tains astringent and detergent properties. It may be used with
safety in all cases of disease, and it is more employed by Thom¬
son ians as a general medicine, than any other article or com¬
pound.
Dose. — The usual dose of composition powder is a teaspoonful
scalded in a teacup, half or two-thirds full of boiling water, sweet¬
ened, and drunk warm. This is the proper mode of preparing the
composition, when the patient is confined to the house, or when
it is taken on going to bed ; and also when it is desired to produce
perspiration.
The following is a better way of preparing the composition for
persons exposed to the weather, namely: Take of composition
powder and sugar, each, a teaspoonful; rub them together, damp¬
ened with a little water; then add a teacup half full of lukewarm
or cold water; stir it together well, and take before it settles.
A dose of composition, by increasing the sensibility of the sto¬
mach, will sometimes cause pain, frequently nausea,*and even in
MATERIA MEDICA*
515
some instances occasion vomiting, followed almost invariably
with benefit to the patient—never to the injury of the system.
In preparing composition, even for children, it should be made
strong and well sweetened; — a wineglassful of composition tea,
made strong, will, in genera], prove more beneficial to the patient
than three times the quantity, if made weak.
BLACK PEPPER.
Black pepper may be used with advantage in cases of execs*
sive vomiting, intermitting fevers, cholera morbus, flatulency, and
as a substitute for the capsicum, when the latter cannot be ob¬
tained. Some practitioners combine it with Peruvian bark, in
cases of ague, or intermitting fever. A strong tea of black
pepper is very useful as a gargle in common sore throat. Mixed
with whiskey or vinegar, it constitutes a useful gargle in elonga¬
tion of the uvula, (falling of the palate.)
Black pepper forms one of the important ingredients in the
celebrated remedy for piles, called Ward's paste.
The dose of black pepper is from half to a teaspoonful of the
powder, or the grains may be swallowed whole.
Black pepper gives to boiled milk an agreeable flavour, and
may be given in this way to children, with especial benefit, when
the system is in a weakened condition, requiring stimulants.
GINGER.
The ginger plant " is a native of Hindostan, and is cultivated
in all parts of India. It is also cultivated in the West Indies,
whither it was transplanted from the east."— U, S. Dis-pensatory.
The common ginger of the shops is obtained almost exclusively
from Calcutta. The best ginger comes from Jamaica, and is
usually termed Jamaica ginger, or white ginger. The superiority
of the Jamaica ginger arises from the manner in which it is
dried. The best roots are selected, and the skin taken off"; they
are then dried separately in the sun. The common ginger, as
sold by storekeepers and apothecaries, is often deprived of almost
all its strength by long keeping, and altogether unfit for medical
purposes. In making composition powder, the Jamaica, or white
ginger, should be used, unless the common ginger can be obtained
fresh and of good quality.
Medical Properties. — Ginger is a pure, mild stimulant, and, as
such, it may be employed in all cases of disease; its use can in-
%
516
MATERIA MEDICA.
jure no one. Ginger tea forms a valuable medicine for infants
and children. In fine, it may be employed as a mild stimulant in
all cases of disease.
Ginger tea is much employed as a remedy for colic in infants.
Its use promotes digestion and lessens the liability to colic.
In mild cases of measles, scarlet fever, small-pox, and varioloid,
ginger tea may be employed as a general stimulant.
Combining ginger and cayenne in about equal portions, forms
a sufficiently active stimulus for general use in the treatment of
disease. Tonics may be rendered more efficient and less unplea¬
sant to the taste, by the addition of a portion of ginger.
Ginger Porridge. — In England and other European countries,
ginger tea is frequently used in the place of simple water, in
making porridge and oatmeal gruel. It is not only made use of
in this way for the sick, but the flavour of the food is so much
improved by the ginger, that it is preferred on this account.
Tincture of Ginger.—To make tincture of ginger of a superior
quality, put half a pound of bruised (not ground) Jamaica ginger
to a quart of pure alcohol (not diluted); let it macerate a few
days, and then filter it through paper.
The usual dose of the tincture of ginger is a teaspoonful. It
may be taken in water sweetened, or added to other kinds of me¬
dicines.
" Ginger is a grateful stimulant and carminative; and is often
given in dyspepsia, flatulent colic, and the feeble state of the ali¬
mentary canal, attendant upon atonic gout. It is an excellent
addition to bitter infusions and tonic powders; imparting to them
an agreeable warming and cordial operation upon the stomach."
U. S. Dispensatory.
I
MATERIA MEDICA.
517
ASTRINGENTS.
THOMSON'S NUMBER THREE.
(" Medicine for Canker.'''')
Some of the vegetable astringents are adapted to accomplish
important purposes in the practice of medicine. To cleanse the
mucous membranes, correct morbid secretions, and give increased
tone and energy to the system, are important results effected by
the use of this class of medicines.
Bayberry-root bark, and the leaves and berries of the upland
sumac, are those chiefly employed as internal remedies, in the
Thomsonian practice. They are free from any deleterious pro¬
perties, and may be used without risk of injury in any case of
disease. During the early stage of fever, when the tongue is dry,
a portion of cayenne or ginger should be added to the astringent
medicines.
Formerly, the astringent medicines were taken either in decoc¬
tion, or the powder mixed with water. Of late, the extract of
bayberry, combined with cayenne, and formed into pills, has been
substituted in Philadelphia and other places; evidently increasing
the medicinal powers of this medicine.
BAYBERRY.
(Myrica Cirefera.)
Of the articles mentioned under the head of astringents, the
bark of bayberry root is the best adapted to general use as an in¬
ternal remedy.
Bayberry-root bark should be collected in the fall after the com¬
mencement of frost, or early in the spring, before the leaves put
forth. Bayberry is a very important article in the Thomsonian
practice, and great care should be taken to obtain that which is
good. There are large quantities of bayberry sold that have been
collected in an improper season, mixed with other bark, and
mouldy, and consequently it possesses but little, if any medical
518
MATERIA MEDICA.
virtue. Composition powder, made of such bayberry, as above
mentioned, old and worm-eaten ginger root, and damaged pepper,
would prove a useless medicine; whereas, when prepared oi good
materials, it constitutes one of the most valuable medicines ever
compounded.
The storehouses of wholesale druggists often contain large
quantities of bayberry bark wholly unfit for medicine,—being col¬
lected at an improper season, mixed with trash of various kinds,
and much of the bark itself in the first stage of decay.
The best bayberry is found in a sandy soil, and near the sea.
The principal Thomsonian store in Philadelphia is supplied with
bayberry from the coast of New Jersey, where it is collected in
the proper season.
To prepare for taking. — Bayberry may be taken either in de¬
coction, or the powder finely pulverized, mixed with sugar and
water, or the extract formed into pills. Bayberry tea, to be
effectual, should be made strong, by steeping the bark, either pul¬
verized or unpulverized, in boiling water. Two large teaspoonsful
of pulverized bayberry powder to a teacup two-thirds full of boil¬
ing water, will form a tea of the proper strength to answer the
purpose for which it is generally given.
Astringent teas should never be made in an iron vessel.
A strong tea of bayberry, adding a portion of cayenne, consti¬
tutes a valuable medicine in the cure of disease in general. This
preparation, though not so much used as the composition powder,
is yet more effectual in cleansing the stomach and bowels of
" canker," or unhealthy secretions. A teacupful of strong bay¬
berry tea, taken when the stomach is foul, will sometimes cause
vomiting; but never unless the stomach be disordered.
As a preventive to disease, in general, there is probably nothing
better that can be taken, than an occasional dose of bayberry and
cayenne, or the No. 3 pills, taken in doses of from eight to ten
pills, once or twice daily.
A very strong decoction of either bayberry or sumac should be
used with lobelia, when administered as an emetic. Prepared in
this way, an emetic will operate more effectually in cleansing the
stomach and correcting the secretions; and at the same time oc¬
casion less sickness and retching than when given in pennyroyal
tea or lukewarm water, as recommended in various works on the
Botanic practice.
Syrup of Bayberry
To make Syrup of Bayberry. — Take two pounds of coarsely-
ground bayberry; add a gallon of diluted alcohol, and let it mace-
MATERIA MEDICA.
519
rate two or three days; then separate the tincture from the pow¬
der with a displacer, and place it in a porcelain-lined vessel, ovei
a slow fire, until one-fourth part has evaporated. Then add one
pound of sugar to each pint of the medicine, and place it over
the fire again, until the sugar is dissolved. When cool, bottle it;
and if the weather be warm, keep it in a cool place.
The syrup of bayberry may be used as a substitute for bavberrv
tea, as a general medicine; and also to prepare lobelia in, for
emetics.
The dose is a tablespoonful; for a child, a teaspoonful, either
alone, or mixed with an equal quantity of water. The syrup of
bayberry is well adapted, as a general medicine, to the cure ot
bowel complaints.
Extract of Bayberry.
The extract of bayberry is obtained by evaporating either an
alcoholic tincture, or a simple decoction of bayberry, down to the
consistence of thick molasses. The most suitable kind of vessel
for this purpose is a porcelain-lined kettle or new tin boiler. The
evaporation to be kept up by a slow fire, or by means of a hot-
water bath. Neither iron, brass, or copper vessels, should be used
in preparing vegetable asttingent medicines of any kind. The
extract of bayberry, with an equal quantity of cayenne, formed
into pills,-constitutes a medicine susceptible of as wide and diver¬
sified application as anv other form or compound of medicine.
Extract of Bayberry Pills.
To make these pills, (also called No. 3, or anti-canker pills,")
take about equal quantities of cayenne and extract of bayberry;
work the cayenne into the extract until thoroughly and equally
combined, and then form into pills. By keeping the mixture
warm, it may be more easily worked.
Medical Properties and Uses. — The ingredients composing
these pills possess valuable medical qualities, and, excepting lobelia
inflata and its preparations, constitute the most important medi¬
cines employed in the Thomsonian practice; — furnishing a pure
stimulant, congenial with the health-restoring .power of the con¬
stitution ; an effectual detergent for cleansing the mucous mem¬
brane of the stomach and bowels; antiseptic properties opposed
to putrefaction ; and tonic properties adapted to promote digestion,
and to give increased tone and energy to the system.
520
MATERIA MEDICA.
The No. 3 pills, possessed of medical qualities capable of ac¬
complishing so many important purposes, constitute a medicine
invariably tending to promote a healthy action in the system, and
are consequently adapted to the treatment of all kinds ol disease.
Quantity to be taken. — To obtain the full benefit from the pills,
requires from twenty-five to thirty of them to be taken daily.
They should be taken-between meals—not on a full stomach.
Taken daily, in doses of from eight to ten pills, three times a day,
they will prove an excellent remedy, not only for slight derange¬
ments of the system, but will cure many cases of chronic disease,
by cleansing the mucous membranes of morbid secretions that
coat these surfaces, in seated complaints.
In all cases of disease, when the patient prefers taking medi¬
cine in the form of pills, the No. 3 pills may be used either as a
substitute for composition or bayberry and cayenne, or taken with
these medicines. They have been given in doses of from four to
six or eight pills every two hours, as a general medicine, with
signal benefit, in various acute diseases — pleurisy, dysentery,
small-pox, measles, scarlet fever, and in fevers in general.
In bowel complaints, these pills have been found a valuable me¬
dicine; operating as a detergent—cleansing the lining membrane
of the stomach and bowels, and restoring digestion. They may
be used in all cases of the kind.
The No. 3 pills have proved successful in the treatment of dys¬
pepsia, when taken regularly, for two or three weeks.
In nervous complaints, these pills have proved eminently suc¬
cessful.
The distressed sickness often attending pregnancy is readily
relieved by the patient taking from twenty-five to thirty pills
daily.
The No. 3 pills, taken in connection with the compound lobelia
pills, — say from twenty to thirty of the No. 3 through the day.
and from three to five of the compound lobelia at bed-time, — to¬
gether with a proper attention to diet, exercise, &c., have cured
tnany cases of disease of even long standing.
In numerous instances where these pills hare been taken as a
general medicine, a skinny substance has been observed to pass
from the bowels, and then the patient begins to improve in health
rapidly. This fact has been noticed in different varieties of dis¬
ease, and is invariably followed by an improvement in the health
of the patient.
To strengthen the muscular motions of the bowels, and thereby
overcome costiveness, the No. 3 pills are admirably well adapted.
By their continued use, and avoiding cathartics, long-standinq
cases of constipation have been cured.
As a general regulator of the system, or to correct slight de-
materia medica.
52.
rangements of the stomach and bowels, a dose of pills—say from
eight to ten, once a day—may answer the purpose.
The No. 3 pills are equally well adapted to the complaints ol
children ; and when they can be taken more readily than medicine
in another form, may be relied upon as a general medicine. Chil¬
dren may be induced to swallow pills, by softening them in watei,
and then mixing with them some finely-pulverized elm, made into
a pulp.
UPLAND SUMAC.
(Rhus Glabrum.)
The bark, leaves, and berries of sumac are employed for me¬
dical purposes, and, next to bayberry, may be regarded as the
best astringent for cleansing the mucous membrane of the stomach
and bowels. There are three species of the sumac, each of which
possesses similar properties, and may be used for the same pur¬
poses. The species above named is most used. One species
(rhus copallinum) is called dwarf sumac, scarcely ever reaching
the height of six feet, and is found in dry, rocky ground. A
strong decoction of the bark of the root of the dwarf sumac is
employed as a sovereign remedy for venereal diseases, by the
Chippewa Indians.
The leaves of the sumac should be collected in the autumn, be¬
fore they are bitten by the frost, and when fully dried, should be
packed away and kept secluded from the air.
Sumac berries should be collected soon after the first hard frost.
The dust or powder that coats the berry is the part employed for
medical purposes. Dr. A. C. Logan, who has collected and pre¬
pared large quantities of this article, has the berries thoroughly
dried in an oven, and then rubbed over a sieve; by which process
the powder is rubbed off and separated from the seed. This
powder,—generally called sumac dust,—is used for cankered sore
mouth, and when combined with bayberry powder, in the propor¬
tion of one ounce of the sumac to four ounces of bayberry, forms
a better anti-canker medicine than the bayberry alone. This
compound I have used of latter years as a substitute for the com¬
pound which Dr. Thomson calls No. 3. The powder from sumac
berries and No. 6, mixed together, form a valuable remedy for
tetter and ringworm; and also a wash, in cases of indolent ulcers
and cankered sore mouth.
/
522
MATERIA MEDICA.
Sumac bark should be collected when the leaves are off", or after
they have commenced falling. A strong decoction, made of the
bark, or of the bark, leaves and berries combined, may be used
with advantage in affections of the kidneys, and in all cases ot
weakness of the uterine organs.
" The gum which exudes from the bark on being punctured,
during the summer, is beneficial in gleets and obstruction of the
urine." — Malison's American Vegetable Practice.
WHITE POND-LILY.
(JVymphia Odorata.)
White pond-lily grows in ponds and ditches, and is readily dis¬
tinguished by its beautiful white flower. The root of the pond-
lily possesses astringent qualities, and may be employed in com¬
bination with, or as a substitute for, bayberry and sumac, when
the latter cannot be obtained. The dilficulty of collecting and
preserving this root, and the fact of its being inferior to bayberry
or sumac, in point of medical virtue, has occasioned it to be al¬
most abandoned, except in making poultices.
The pond-lily roots should be collected in autumn or very early
in the spring, washed clean, cut into strips, and strung upon thread
to dry.
WILD RED RASPBERRY.
ft
{Rubus Strigosis.)
This shrub grows in great abundance in New England, and
also in some southern sections of this country.
The leaf, which is the only part employed for medical pur¬
poses, is a mild astringent, and so agreeable to the taste, that
many families use it as a substitute for imported tea.
A strong tea of raspberry leaves is a useful remedy for ordinary
bowel complaints of infants and children. To be efficient, how¬
ever, it should be made strong. In treating of this article, Dr.
Thomson observes^ " It is the best thing for women in travail, of
any article I know of." He recommends a strong tea of it to be
given, sweetened, adding a portion of cayenne. A tea of rasp¬
berry leaf, adding milk and sugar, is good for infants; and D»~
Thomson asserts that it will prevent sore mouth.
materia medica.
523
WITCH HAZEL.
(Hamamelis Virginica.)
The leaver of the witch hazel furnish an active astringent, and
a strong decoction of this article may be used with much benefit
as an injection in piles, fluor albus or whites, and chronic diar¬
rhoea.
The leaves should be collected in the autumn, before they are
injured by the frost, dried out of the sunshine, and as soon as dry
they should be either pulverized or packed in a box and secured
from the air.
GALLiE (GALLS).
Galls are round bodies which form on the bark and leaves -of
the oak. They are produced by the sap escaping through a
puncture made by an insect resembling a common gnat. The
sap becomes inspissated, and gradually hardens, forming these
knotty substances, which possess the astringent properties in an
eminent degree.
An ointment, made with two parts of finely-powdered galls and
three parts of lard, may be used with especial benefit in piles and
prolapsus ani.
EVAN ROOT.
(Geum Rivale.)
This plant is peculiar to low, marshy ground, and has received
a variety of names, viz.: chocolate root, water avens, throat root,
and purple avens. It possesses slightly astringent and tonic pro¬
perties, and may be used with benefit in diarrhcEa, dysentery, and
in bowel complaints in general.
MARSH ROSEMARY.
(iStatia Limonium)
This plant, the root of which is used for medical purposes, is
found only in salt marshes.
524
materia medic a.
The root of marsh rosemary is a powerful astringent, and is
chiefly employed as a remedy for ulcerated sores in the mouth
and throat. The powdered root has a good effect upon old sores,
the powder being put dry into the sore, and a poultice or salve
applied. In long-standing cases of piles, where the rectum is in a
very relaxed condition, or in fluor albus or whites, when a power¬
ful astringent is required, a portion of marsh rosemary, added to
writch hazel or sumac, will form a better injection than either of
the latter articles alone.
DEWBERRY.
(Rubus Procumbens.)
The root of the dewberry, and also that of the blackberry
plant, may be used as a substitute for bayberry or sumac, in dys¬
entery and in bowel complaints in general.
" To the declining stages of dysentery, after the symptoms of
inflammation are removed, they (the deivberry and blackberry root)
are well suited; though I have given them, I think, with greater
advantage, under nearly similar circumstances, in cholera in¬
fantum. To check the inordinate evacuations in the protracted
stages of this disease, no remedy has ever done so much in my
practice. They, moreover, are useful in all excessive purgings,
from whatever cause proceeding, especially in the diarrhoea of
old people, and when it occurs at the close of disease.
" My experience is limited pretty much to the cases which I
have mentioned. But I cannot help believing that they will here¬
after be found susceptible of a more diversified application; and,
perhaps, under all circumstances where an agreeable bitter tonic
or astringent is demanded. As an anti-lithic, and, indeed, as a
corrective of all the depraved states of the stomach, caused by
debility, I am persuaded that they will display valuable powers.
" Of the comparative utility of the dew and black berry, I am
hardly entitled to decide very confidently. My impression, how¬
ever, from what I have observed of their effects, is that the former
is the superior medicine. Certain it is, that it is more pleasant to
the taste.
"Every part of the plant is actively astringent — as the root,
the leaves, the bark, the fruit — and ail may be employed. But
the root is to be preferred. The mode in which I have used it is
in decoction — taking about an ounce, bruised, to a pint of water.
Thus prepared, we have a beautiful claret-coloured liquor, having
its bitterness, which is not very great, tempered by a pleasant,
aromatic flavour." — Chapman's Therapeutics.
materia medica.
525
CROW-FOOT —CRANE'S BILL.
^ (Geranium Maculatum.)
This plant maybe found in many sections of this country. The
root possesses actively-astringent qualities. A decoction of this
root has been used by injection with benefit, in chronic gonorrhoea,
gleet, and fluor albus. The root, boiled in milk, is a good remedy
in bowej complaints of children; more especially when the dis¬
ease is of a mild character, requiring only astringent medicine.
A strong infusion of cranes-bill root, sumac leaves, and black-
birch bark, combined, is recommended by Dr. Logan, in cases
of cholera morbus and diarrhoea.
BEACH-DROP.
(Orbanche Virginiana.)
A decoction of the root of the beach-drop may be employed
for the same purposes as that of the crow-foot. The powdered
root is a good application in cases of open cancer and indolent
ulcers.
The powdered root of the beach-drop, crow-foot, or marsh
rosemary, stewed in fresh tallow, may be employed as an oint
ment for external piles and eruptions on the skin.
ALUM-ROOT.
(Heuchera Americana.)
" The root is a strong and powerful astringent, and con!ain9
more tannin than the geranium maculatum, detergent, styptic, an¬
tiseptic, and vulnerary. If the root be used in powder, as an
external remedy in wounds, sores, and old, foul, indolent ulcers, it
will deterge, and soon prepare for the formation of healthy granu¬
lations." — Dr. A. C. Logan.
526
MATERIA MEDICA.
TONICS —BITTERS.
%
To strengthen the System and promote Digestion.
GENERAL REMARKS.
Bitters are particularly suited to the latter stages of acute dis¬
ease, when fever has subsided and the tongue is cleaning; and in
all cases where the system is left in a relaxed condition, with
feeble digestion. In the suppurative stage of small-pox, and in
cases of large abscesses that are secreting matter freely, bitters
should be employed, in combination with pure stimulants, with a
view to promote digestion, and furnish the system with the neces¬
sary strength to carry on her healing operations. In chronic dis¬
ease in general, bitters may be employed indiscriminately, — pro¬
vided the patient be clear of fever.
The vegetable kingdom furnishes a great variety of bitter
tonics, of which those mentioned under this head are believed to
be the best, and sufficient to fulfil the indications for which tonics
are employed.
The chief objection to the use of bitters during the active stage
of disease, is on account of their tendency, under these circum¬
stances, to arrest the secretions.
As a general rule, it is better to take all bitter teas cold. Bone-
set tea, taken cold, produces a tonic effect; but, taken warm,
occasions nausea and vomiting. Thomson's spiced bitters, de¬
signed to supply the place of a stimulant and tonic, are generally
taken warm.
PERUVIAN BARK.
(Cinchona Officinalis.)
The genuine Peruvian bark is one of the most effectual tonics
ever employed for the cure of intermitting fever or ague. It may
be used as a general tonic in all cases where the use of this class
of medicines is demanded. As a general rule, powerful tonics
should not be employed in the first stage of disease, attended with
MATERIA MEDICA.
527
fever and a dry, coated tongue. Under these circumstances,
bitters, unless combined with a large portion of cayenne, would
repress rather than promote the secretions, and aggravate the dis¬
ease. When, by the free use of cayenne and other appropriate
remedies, the secretions are restored, the tongue cleaning, and the
skin warm and disposed to perspiration, then Peruvian bark or
other tonics may be employed with advantage.
Peruvian bark is rendered more efficient as a tonic, by com¬
bining with it Virginia snake-root, cloves, and cayenne pepper. I
frequently mix equal parts of Peruvian bark and spiced bitters,
and have always found it a good preparation.
A tea, made of equal parts of Peruvian bark and liquorice-root,
is a good remedy for colic in infants; more especially where the
spells of colic are observed to come on periodically.
The name Jesuit's bark has been applied to the Peruvian bark,
from the circumstance of the Jesuits having had the chief control
of the sale of the article during its first introduction into use in
Europe, about the year 1640.
There are three species of Peruvian bark imported to this
country: the pale, yellow, and red. At one time the red bark was
esteemed the most valuable. This induced druggists to convert
other species into red bark, by adulterations, which so materially
lessened the efficacy of the bark, that at one period the red bark
was little used. — Each species of bark above mentioned is effi¬
cient as a tonic, provided it be free from adulterations.
Peruvian bark is most active when taken in substance, mixed
with some liquid; as a tea of spice bitters, Virginia snake-root, a
solution of liquorice, or simply with water. The unpleasant taste
of the bark will scarcely be perceived when it is taken in a solu¬
tion of liquorice.
When the bark cannot be taken in substance, its virtues may
be extracted by boiling water, and taken in decoction, cold. A
small portion of orange-peel, liquorice-root, or spice, added, will
improve the flavour of the tea; and where there is acidity of the
stomach, a portion of the supercarbonate of soda, or salreratus,
should be added.
Peruvian bark is often taken in wine, and with the most happy
effects in many instances, as in recovery from disease, where the
strength of the patient is much exhausted.
Dose. — The quantity of bark taken at a time varies from that
of a teaspoonful to an ounce. Whilst some recommend it in
small doses, repeated every hour or two, others direct an ounce
to be taken at once. More especially is it recommended to be
taken in large doses, in cases of intermitting fever, where, by a
proper course of treatment, the system is placed in a condition
that warrants the free use of tonics.
528
materia medica.
When Peruvian bark or quinine is used, all astringent medi¬
cines, viz.: bayberry, sumac, No. 3, pills, &c., must be laid aside
at the time; as the tannin and gallic acid in the astringents, form
an insoluble compound with the active principle of the bark, ren¬
dering it inert. Astringents may be used in the forenoon and
barks in the afternoon, or vice versa.
Three important indications in the treatment of disease are:
1st. To restore the natural warmth of the system. 2d. To cleanse
the stomach and bowels of " canker," or morbid secretions; and,
3d. To restore digestion. The first requires the use of pure sti¬
mulants, and sometimes the application of the vapour bath; the
second, the use of astringents and detergents; and the third
tonics. Hence, the general indication for the use of tonics i«
when the secretions are restored, and the stomach and bowel*
cleansed of " canker."
Injections of a decoction of barks, retained, will prove almost
if not quite as beneficial as when swallowed, and may be employee
in this way in children, and in cases where the stomach rejects it
or when patients prefer it administered in this way.
QUININE.
Quinine is the active principle of Peruvian bark, and may be
used as a substitute for the bark. Quinine has sometimes been
discovered to be adulterated with starch, stearine, sulphate of
lime, and sugar. There *are means, however, of detecting adulte¬
rations in quinine; for knowledge of which, the reader is referred
to the U. S. Dispensatory.
Quinine is usually taken in the form of pills. Eight quinine
pills, of the usual size, are supposed to be equivalent to an ounce
of Peruvian bark. A pill, to contain a grain of quinine, (equal to
a drachm of bark,) must be considerably larger than pills are
generally made.
It is believed that quinine is rendered more active by the addi¬
tion of cayenne pepper.
As a cure for intermittent and other forms of fever, when the
condition of the system is favourable for the exhibition of tonics,
there is probably no remedy of equal value with quinine. This
medicine, however, is so easily taken, that it may be used too in¬
discriminately. It may be continued until large (quantities have
been taken, — the system, at the same time, not being in a condi¬
tion to be benefited by its use.
Quinine has been employed, with great success, in cases of
neuralgia, or tic-doloureux; more especially, where the attacks
of pain are intermittent, like ague fits. It is not to be employed
MATERIA MEDICA.
529
when the tongue is thickly coatea, or the patient is labouring under
high fever.
There are cases of periodical sick-headach, in which more
benefit may be derived from the use of quinine than from any
other remedy. As a preventive, from ten to twenty grains should
be taken a day or two before the time at which the attack is ex¬
pected. It is in these cases, where there is no fever, and the
tongue not thickly coated, nor too high-coloured, that quinine may
be used without previously preparing the system by other reme¬
dies.
In fevers, as a gen ral rule, quinine is better adapted to the
treatment of cases that occur in spring, winter, and autumn, than
in midsummer.
WHITE ASPEN AND BLACK ASPEN POPLAR.
(Populus Tremuloides and Populus Grandidenlata.)
The bark of these species of poplar possesses valuable tonic
properties. Poplar bark constitutes an important part of the spice-
bitters. A very strong decoction of poplar bark may be employed
as a tonic in any case where a tonic is needed.
The white aspen is not so bitter as the other species, and may
be very readily given to children. Jt is well adapted to cases
when the bowels are left in a weak and relaxed condition, after
dysentery, diarrhoea, &c.
In treating of the poplar, Dr. Thomson-says: "The inner bark,,
made into tea, is one of the best articles to regulate the bile and
restore the digestive powers, of any thing I have ever used. The
bark may be taken from the body of the tree, or from the limbs,,
or the roots, and the outside shaved off; preserving the inner bark,
which should be dried and carefully preserved for use."
Poplar growing in low ground is said to have stronger qualities-
than that which grows on dry soil.
BALMONY.
( Chelone Glabra.)
This herb, commonly called snake-head, is found in low,,
marshy ground, and along the sides of brooks and ponds.
Balmony is a strong bitter, and may be employed as a general
tonic, either singly or in combination with other bitters. The-
leaves, stems, and flowers, are the parts employed. The herb
should be collected when in blossom.
530 MATERIA MEDICA.
BARBERRY.
(Berberies Vulgaris.)
The bark of every portion of this shrub possesses tonic powers,
and it is a good article to restore digestion. Barberry, balmony,
and poplar bark, finely pulverized and mixed together in equal
proportions, constitute Dr. Thomson's No. 4 bitters. — This is a
valuable compound, and may be employed in all cases where a
strong tonic is required.
GOLDEN SEAL.
(Hydrastis Canadensis.)
This plant, which has received it variety of names, — as Ohio
fcerkuma, yellow poccoon, and turmeric root,—is highly esteemed
as a tonic, by some Thomsonians. The root is the part used,
which should be collected in the fall, well dried, and reduced to
ipowder.
Golden seal is found in great abundance in Ohio and Indiana,
■and it is from thence that the principal supply is obtained.
The usual dose is a teaspoonful of the powder, taken in warm
water, or steeped in boiling water, and the tea only used.
Dr. Thomson recommends the use of the golden seal for dis¬
tress, occasioned by indigestion after meals.
VIRGINIA SNAKE-ROOT.
(Serpentaria Virginiana.)
This plant, the root of which contains both tonic and stimulant
properties, grows plentifully in many sections of the United States,
and it is said to be a native of this country exclusively.
The Virginia snake-root may be employed with benefit in fevers,
and in a variety of forms of disease, when the usual bitter tonics
iii ritate the stomach.
The usual dose of the powdered root is a teaspoonful. To
•make the infusion, pour a pint of boiling water on half an ounce
■of the root, and let it steep in a covered vessel;—boiling the root
dissipates its medicinal properties. It may be drunk freely in all
stages of disease; — either cold or warm, as the patient may
prefer.
materia medica.
53!
CENTUARY.
( Chironia Angularis.)
*• Of the centuary we have the above species, which is not in¬
ferior to the European. It is a beautiful annual plant, growing
abundantly in the Middle and Southern States, and every part of
it is medicinal, though the flowers possess the most efficacy. It
is a pure bitter, with some little aromatic flavour, neither unplea¬
sant to the taste nor offensive to the stomach; and is resorted to
by every description of practitioners, regular and irregular, in our
intermittent and remittent fevers. Like some other articles, it has
an advantage over the Peruvian bark, of being susceptible of em¬
ployment in every stage of these diseases. The usual mode of
prescribing it is by strong infusion, which is directed to be taken
without much limitation." — Chapman.
RED DOGWOOD —RED WILLOW.
(Cornus Sericea.)
This species of cornus is usually six or eight feet in height,
with numerous erect stems, which are covered with a shining,
reddish bark, and send out opposite spreading branches. The
leaves are opposite, petiolate, ovate, pointed, entire, and on the
under surface covered with soft, brownish hairs. The flowers are
small, white, and disposed in terminal cymes, which are depressed
and woolly. The fruit consists of globular, berry-formed drupes,
of a cerulean blue colour, and collected in bunches." — U. S.
Dispensatory.
The red dogwood is found growing in low, wet lands, and
along streams in almost every section of the United States. The
bark of this shrub contains valuable tonic properties, and many
experienced practitioners assert it to be equal in efficacy to the
Peruvian bark, and it may be employed as a substitute for the
latter article. Growing in our own country, it can be obtained
genuine; whereas a great portion of bark imported as Peruvian,
is a spurious article, containing little or none of the medical pro¬
perties of Peruvian bark.
GENTIAN.
Yellow gentian root, much employed as a tonic, is imported
from Germany. It grows among the Appenines, the Alps, and
other mountainous regions of Europe. There are several species
532 MATERIA MEDIC A.
of gentian; all possessing the same properties, and used for tfie
same purposes.
Gentian is an invaluable tonic, and may be safely employed in
any case where a tonic is wanted. It may be administered in the
form of tinctui'e, infusion, or extract, or in combination with other
tonics.
Extract of gentian, made into pills, is a convenient form of
tonic. With some, it is a favourite remedy for worms.
Gentian is well adapted, as a tonic, to cases of female com¬
plaints where tonics are demanded.
WILD CHERRY.
(Prunus Virginiana.)
The bark of this tree has tonic and astringent properties. As
a tonic, it is inferior in efficacy to either the red dogwood, or
Peruvian bark. It is adapted to cases of consumption, hectic
fever, and scrofula, and in chronic bowel complaints. It yields
its properties to alcohol, and to hot and cold water. Boiling the
bark destroys its medicinal powers. The proper plan is to have
the bark cut into strips, or pulverized and put into cold water.
QUASSIA.
This tree, the wood of which contains the bitter principle, as it
were, in a concentrated form, is a native of Surinam, Jamaica,
and the Caribbean islands.
This medicine was first introduced into use by a West India
negro, named Quassia, who employed it as a secret remedy,
which proved successful in the cure of the malignant fevers of
that country. The secret was " disclosed to a Mr. Rolander, a
Swede. Specimens were taken to Stockholm by this gentleman,
in the year 1756, and the medicine soon became popular in
Europe. The name of the negro has been perpetuated in the
generic title of the plant."
Quassia may be employed as a tonic in cases of general de¬
bility. It is usually prepared in infusion, in combination with
other tonics,—columba, gentian, Virginia snake-root, and orange-
peel.
Tonics are found to be more effectual, by occasionally substi¬
tuting one article for another, or by frequently changing the com¬
pound.
materia medica. 533
TULIP POPLAR.
(Liriodendren Tulipifera.)
The bark of this tree may be employed as a tonic; — the bark
f the root is probably as powerful a tonic as the aspen poplar.
COLUMBA.
Columba root possesses considerable power as a tonic, and as
such, may be used either alone, or in combination with other
tonics.
THOROUGH WORT — BONESET.
(Eupatofium Perfoliatum.)
A warm infusion or a decoction of this plant will operate as a
nauseant and emetic; when taken cold, it acts as a tonic only.
Boneset has been extensively employed, of late years, in the
treatment of intermittent and remittent fevers. It is employed as
a diaphoretic, emetic, and tonic.
A cold infusion of boneset is an excellent general tonic, useful
in cases of dyspepsia, fevers, &c.
YELLOW ROOT.
(Xanthorhiza Apufolia.)
" The bark of the root of this plant is equal, if not superior to
the golden seal." — Dr. A. C. Logan.
CHAMOMILE.
(Anthemis JVobilis.)
Chamomile furnishes an agreeable and valuable tonic. It has
been a long time employed as a medicine. A warm infusion of
chamomile is often employed in domestic practice, to excite per¬
spiration in case of colds. A strong tea of chamomile, drunk
warm, will sometimes operate as an emetic. As a tonic or sto¬
machic, the cold infusion is usually employed.
534
MATERIA MEDICA.
MYRRH.
Gum myrrh exudes from the body of a small tree growing in
Arabia Felix and Abyssinia, called balsamodendron myrrha. As
the juice exudes, it hardens and adheres to the bark.
" Two varieties of myrrh are distinguished in the market—the
India and the Turkey myrrh—the former imported from the East
Indies, the latter from the Levant. It is said that the India myrrh
is collected in Abyssinia, and thence taken to the ports of Hindos-
tan; while that which goes under the name of Turkey myrrh is
brought from Arabia by the route of Egypt." — U. S. Dispen¬
satory.
There is a great difference in the quality of myrrh. That
which comes from Turkey is of a brighter colour, and more free
from impurities than the East India myrrh. " When of good
quality it is reddish-yellow, and translucent; of a strong, peculiar,
and somewhat fragrant odour, and a bitter, aromatic taste. It is
brittle and pulverizable; presenting, when broken, a shining sur
face, which in the larger masses is very irregular."
Myrrh is actively tonic, somewhat stimulant, and possesses, in
a high degree, antiseptic properties. It constitutes the most es¬
sential ingredient in Thomson's No. 6, or rheumatic drops.
Myrrh has been employed internally, with much benefit, in
chronic diarrhoea, and diseases of the lungs or chest, attended
with a free expectoration and general debility. Its use is also
well adapted to the cure of some complaints peculiar to females,
— especially amenorrh&a (deficient or difficult menstruation),—
and, in fine, in all cases of derangement of the menstrual function,
when accompanied with general debility and a relaxed condition
of the muscular tissues.
Myrrh may be taken in the form of pills, infusion, tincture, or
the powder may be taken suspended in a liquid.
To make Myrrh Pills. — Take a tablespoonful of finely-pul¬
verized myrrh, and of pulverized gum Arabic and loaf-sugar,
each, a large teaspoonful. Rub these up with a quantity of water,
sufficient to form a paste, and make into pills.
To make an Infusion of Myrrh. — Steep an even teaspoonful of
pulverized myrrh in a teacup of boiling water, and add a large
teaspoonful of sugar, and a small portion of cinnamon.
To make a Tincture of Myrrh.—Put three ounces of powdered
myrrh, and a quart of alcohol or fourth-proof brandy, into a stone
MATERIA MEDICA.
535
jug, and boil half an hour in a kettle of water, or let it macerate
several days in a warm place.
Tc prepare the Poicderfor taking. — Rub together half a tea-
spoonful of myrrh and a teaspoonful of sugar, then add a teacup
half full of lukewarm water, or a tea of cinnamon or liquorice
root, stir the mixture, and take before it settles.
When myrrh is taken in the form of pills or powder, care
should be observed to select that of the best quality.
Medical Qualities and Uses of Myrrh. — Myrrh, prepared in
either of the forms above mentioned, is applicable to cases of
general debility, accompanied by a relaxed condition of the
bowels, and an absence of fever. Dr. S. Thomson informs us,
that he has discovered it to be a valuable remedy in what are
called worm complaints, in children, for a child that can swallow
pills.
The efficacy of Thomson's No. 6, and third preparation of lobe¬
lia, in preventing mortification in disease of a malignant or putrid
tendency, may be partly, at least, attributed to the myrrh con¬
tained in these preparations.
Applied to fresh wounds, the tincture of myrrh excites the
healing action, and lessens the liability to the occurrence of un¬
healthy inflammation. It is also a useful application in old sores,
ulcerated sore throat, running from the ears, aphthous sore mouth,
spongy gums, sore nipples, &c. The tincture of myrrh is also
employed to promote the exfoliation of bones. In sinuous ulcers,
and cavities that continue to discharge matter, in consequence of
a debilitated state of the vessels of the part, tincture of myrrh,
combined with an equal quantity of tincture of bayberry, or bay-
berry powder put in tincture of myrrh, injected into the cavity,
and repeated daily, will seldom fail of establishing the inflamma¬
tory action necessary to the production of granulations, and a
union of the sides of the'cavity. Where the parts are too sensi¬
tive to admit the tincture to be used undiluted, it may be combined
with water or bayberry tea. In cases of scrofulous ulcers, white
swellings, hip disease, and wherever there is a free discharge of
matter from a part, and the system is in a relaxed condition, the
internal use of myrrh will generally prove beneficial. The most
convenient way of taking myrrh is in the form of pills.
THOMSON'S NO. SIX. OR RHEUMATIC DROPS.
To this compound a variety of additions have been made by
different individuals, as improvements upon Dr. Thomson's prepa¬
ration. The value of this preparation as a medicine 'epends.
536
MATERIA MEDIG'A.
chiefly upon the myrrh which it contains; and no article can be
substituted that will prove more beneficial than myrrh, for the
purposes to which the No. 6 is generally applied.
To prepare No. 6. — Take an ounce of African pepper, one
pound of powdered myrrh, and a gallon of fourth-proot brandy.
Put these into a stone jug, and boil it half an hour in a kettle of
water — the jug to be uncorked.
This preparation is employed as a general family medicine by
Thomsonians. It is an excellent tonic, and, taken soon after
meals, will remove or prevent flatulency, and relieve oppression
of the stomach. Ordinary colic may be speedily cured by taking
freely of No. 6. It is an effectual cure for ordinary colds, pro¬
vided the patient avoid exposure, and improper articles of diet.
Sickness at the stomach, and even severe spells of sick-headach,
may be relieved and frequently cured by a free use of No. 6, to¬
gether with warm applications to the feet, to favour perspiration.
It also constitutes a valuable remedy for bowel complaints in
general. Taken after meals, it will prove a preventive against
the summer complaint.
In deeply-seated colds, attended by a free expectoration of a
thick, yellowish secretion, the use of No. 6 will be found bene¬
ficial. In the latter stages of disease, No. 6 may be employed as
a restorative; and when there is a tendency to putrefaction, its
use is almost indispensable to the recovery of the patient.
As an external application, No. 6 has been found useful in rheu¬
matism, neuralgia, night-sweats, dropsy, consumption, and in all
cases when the skin is in a relaxed condition. It may also be
employed to great advantage in sprains, bruises, fresh cuts, indo¬
lent ulcers, putrid sore throat, sloughing ulcers, gangrene, and as
a preventive to mortification, both internally and externally.
No. FIVE SYRUP, OR RESTORATIVE CORDIAL.
Take of white and black aspen poplar, each, half a pound,
bark of the root of bayberry, one pound, and boil them a few
minutes in two gallons of water; then strain, and add seven
pounds of good sugar, and simmer until the sugar is dissolved ;
then skim it, and add half a pound of finely-powdered peach-
meats, and three quarts of good brandy.
Dose. — From half to a wineglassful, three or four times a day.
This syrup is useful in cases of recovery from sickness, attended '
with a weak and relaxed condition of the bowels.
MATERIA MEDICA.
537
Another method of preparing a restorative cordial, is to employ
the tincture of myrrh in place of the brandy.
An objection to syrups in general, except when recently pre¬
pared, is their tendency to fermentation. The above syrup, how¬
ever, may be kept good for years.
UNICORN.
( Helonias Dioicia.)
This plant, the roof of which possesses tonic properties, is
iound plentifully in most of the Middle, and in several of the
Western States. It has received a variety of names : blazing
star, devil's bit, and blazing star-wort. The root is, in general,
about an inch and a quarter in length, from a quarter to three-
eighths of an inch in diameter, and its lower extremity terminating
abruptly, as though it had been broken off. " The root leaves
continue green all winter, and spread upon the ground in the form
of a star. They are four or five inches long, narrow at the base,
and terminated by a somewhat tapering point. The stem of the
male plant is a foot or more in height, and terminates in a long,
drooping, and very graceful spike of flowers, which are of a dirty
white colour. They remain in bloom from June to July. The
stem of the female plant is erect, much taller than the other, and
is furnished with flowers of a larger size." — Mattson's American
Vegetable Practice.
The author above quoted observes: " The aletris farinosa, or
star-grass, which has also received the name of unicorn, is often
mistaken for this plant. It is similar in growth and appearance,
but may be identified by its sharply-pointed leaves, and brittle,
scaly-looking root. It possesses tonic properties, but it is also
narcotic and purgative, which renders its use objectionable, and
sometimes hazardous." This plant, the aletris farinosa, has been
introduced into Dr. Hersev's work on Midwifery, and also Dr.
John Thomson's Materia Medica, as the true " unicorn root," used
by Thomsonians.
The root of the helonias dioicia is spoken of by some in
terms of the highest praise, as a remedy particularly adapted to
complaints peculiar to females, yet it is very doubtful whether it
possesses any specific properties apart from those of a general
tonic.
538
MATERIA MED1CA.
BITTER ALMONDS, PEACH-MEATS, AND CHERRY¬
STONE MEATS.
All these articles contain valuable tonic properties. The es¬
sential oil obtained from bitter almonds and peach-meats by dis¬
tillation, and supposed to contain prussic acid, does not exist in
the almond in its natural state, but is the result of chemical ac¬
tion, which takes place during the process of distillation.
Dr. S. Thomson has, of late years, in preparing No. 6,. employed
liquor in which pounded cherry-stones have been kept for some
time, which he calls " cherry spiritThis is an improvement on
the old method.
WINE BITTERS.
Vegetable bitters, tinctured in wine, may be used with benefit
in many cases of chronic disease, and in cases of recovery from
sickness; but the simple decoction or infusion of bitters is to be
preferred to wine bitters, in most cases.
A variety of formulas for wine bitters might be given; the fol¬
lowing, however, is probably as good as any other:—
Take of best Peruvian bark, 1 ounce,
" " gentian bark, 1 "
" " columbo, 1 "
" " Virginia snake-root, ^ "
add a portion of orange-peel, and to this compound put two quarts
of good Madeira or sherry wine.
Dose. — A wineglassful, two or three times a day.
Dr. Thomson employed sweet Malaga wine for making bitters,
and used the same compound as the spice bitters, omitting the
sugar, and adding a portion of prickly-ash berries.
SPICE BITTERS.
The spice bitters are variously compounded by different indi¬
viduals. Sometimes I have met with spice bitters that were ac¬
tively cathartic; and, on other occasions, containing so much of
cloves and cinnamon, as to prove decidedly binding to the bowels.
The following is a good formula : Take of black and white as¬
pen poplar bark, finely powdered, each, three pounds; of ginger,
two pounds; golden seal, two pounds; cinnamon, one pound;
MATERIA MEDICA. 539
cloves, one pound ; prickly-ash bark, half a pound ; cayenne, half
a pound; and eight or nine pounds of white sugar. These are
all to be fineiy pulverized, thoroughly mixed together, and then
run through a sieve.
Next to composition and No. 6, the spice bitters are more em¬
ployed than any medicine or compound in the Thomsonian ma¬
teria medica. The usual dose is a teaspoonful, prepared in decoc¬
tion, with boiling water, or the powder may be taken with a small
portion of lukewarm or cold water. The spice bitters, prepared
according to the above formula, afford a mild stimulant and tonic,
which may be used with great benefit in many cases, and with
safety under all circumstances. As a tonic, in intermitting and
remitting fever, and in cases of extreme debility and obstinate
dyspepsia, the spice bitters are not to be relied upon, as stronger
tonics will here be demanded.
LADIES' SPICE BITTERS.
Adding finely-powdered myrrh and unicorn root to the common
spice bitters, in equal quantity with the cloves, constitutes what
are termed "Ladies' Spice Bitters, or Woman's Friend."
This preparation is well adapted to cases of general debility,
and especially in complaints peculiar to females.
CONSERVE OF HOLLYHOCK.
Directions for making.—Take of poplar bark, bayberry, golden
seal, cloves, cinnamon, and American valerian, each, an ounce ;
and half an ounce of cayenne, — all finely pulverized; mix them
well together, and pass the compound through a sieve. Incorpo¬
rate this powder and half an ounce of the oil of pennyroyal tho¬
roughly with one pound of hollyhock blossoms, previously pounded
into a jellv, and form it into balls of the size of a large marble,
and dry them; or put it into jars, to preserve it in a moist state.
The conserve of hollyhock possesses the same properties as the
spice bitters, but is rather more active, both as a stimulant and
tonic. It may be used on all occasions, to promote digestion, to
warm the stomach and bowels, and also as a preventive to dis¬
ease. It is a convenient medicine for persons while travelling.
540
MATERIA MEDICA.
WORMWOOD.
This garden shrub possesses the bitter principle in a high de¬
gree, and is suited to cases of general debility and feeble digestion.
It should be prepared by steeping in hot water; — boiling it, im¬
pairs its tonic powers.
An infusion,—made by steeping wormwood and hickory ashes,
in about equal proportions,—is often used to strengthen digestion,
and to correct acidity of the stomach.
Wormwood is applied externally, by way of fomentation,
steeped in vinegar. Swelled and painful breast, sprains, bruises,
&c., are the kinds of ailments to which this application is suited.
BITTER-ROOT — INDIAN HEMP — WANDERING
MILKWEED.
(Apocynum Androsemifolium.)
Although Dr. Samuel Thomson recommends bitter-root as a
medicine, in his original guide, he abandoned the use of it in his
own practice many years before his death. It is an active cathar¬
tic, and extremely liable, if taken in purgative doses, to prove in¬
jurious. If used at all, it should be given in small doses; not
sufficient to purge. It is employed in the regular practice, for
dropsy of the brain in children. Dr. Logan recommends the
addition of a small portion of bitter-root to the No. 4 bitters, for
cases of obstinate costiveness. It may prove beneficial in some
chronic cases, given in this way. Combined with other articles,
it may be given in jaundice, rheumatism, dropsy, and dyspepsia.
MATERIA MEDICA.
541
NERVINES.
To quiet Restlessness, calm Nervous Agitation, and promote Sleep
AMERICAN VALERIAN.
Several Species. — Cypripedium humile, pubescens, parviflorum,
condidum, and spectabile.
Common Names. — Moccasin flower, Noah's ark, wild lady-
slipper, umbil, and valerian.
Each of the above-named species of valerian possesses the
same medical properties. The root is the part employed for me¬
dical purposes. The root of the American valerian, dried and
pulverized, constitutes the powder known among Thomsonians by
the name of nerve powder. This powder is usually combined
with emetics, in giving a course of medicine. It is more parti¬
cularly needed when the patient is of a nervous temperament.
From half to a full teaspoonful may be added to each dose of
emetic. The powder may also be taken in hot water, sweetened,
or it may be added to any of the medicines, when the condition
of the patient requires it. The root should be collected in the
autumn, washed clean, carefully dried, and kept from the air.
SCULLCAP.
(Scutellaria Lateriflora.)
This herb has recently been introduced into use as a nervine.
It is found growing in meadows and along streams of water.
• There is a species of scullcap found upon upland, particularly in
stubble fields; whereas the species employed for medical purposes
'is found only in low and marshy land.
I have not made a sufficient trial of the scullcap to form an
opinion as to its medicinal powers. It certainly possesses tonic
properties; and it may be that its powers of quieting nervous
agitation, and tranquillizing nervous excitement, depend simply
upon its tonic properties. New remedies are apt to be overrated
54*2
MATERIA MEDICA.
when first introduced; more especially by those who claim the
honour of introducing them. Still, from testimony adduced in
favour of the Scutellaria, I do not doubt that its introduction into
our materia medica may be a valuable acquisition.
The top of the plant is the part employed; which should be
collected when the plant is in blossom, carefully dried, and pre¬
served from the air. It may be taken prepared in the same man¬
ner and for the same purposes as Thomson's nerve powders.
HOPS.
Hop tea may be used with benefit as a means of quieting ner¬
vous agitation and promoting sleep. Hops are most employed in
protracted fever and delirium tremens (craziness from drink).
The yellow powder, which may very readily be obtained from
hops by rubbing and sifting them, contains the active principle of
hops. This powder (called lupulin), by being rubbed up in a
warm mortar, will form a paste, which may be made into pills,
and taken for the purposes above mentioned.
Pills, composed of equal parts of lupuline and quinine, consti¬
tute an efficient tonic for the cure of intermittent fever.
r
Dose. — From fifteen to twenty pills of the ordinary size may
be taken in the space of two hours, previous to the time at which
the chill comes on.
GARLIC.
This article affords an agreeable and useful stimulant to the
nervous system, in many cases of nervous debility; especially in
gouty persons, and when the system has become debilitated by
intemperance. "To stomachs enfeebled by excess of stimulation,
garlic proves exceedingly cordial; and it may be remarked, that
drunkards recur to it, as it were, instinctively."
Nervines alone are not to be relied upon as a cure for nervous
complaints. •
The complaints popularly called " nervous affections,"—such as
hysteria, in its different varieties, St. Vitus's dance, nervous agita¬
tion, depression of spirits, &c.,—are frequently caused by impaired
digestion, and an unhealthy condition of the mucous membrane
of the stomach and bowels; and are curable only by a course of
treatment that will restore the digestion, enrich the blood, and in
this way improve the condition of the nervous system.
MATERIA MEDICA.
543
The Extract of Bayberry Pills, taken in quantities sufficient to
produce their full effect,—say from twenty to thirty pills daily,—
has proved eminently effectual in relieving various derangements
of the nervous system, in cases where the ordinary nervines an I
anodynes had entirely failed of affording relief to any extent.
The articles and compounds treated of in the -preceding pages
of the Materia Medica, comprise the most essential and effectual
medical agents employed in the Thomsonian practice.
Those hereafter treated of may be used as auxiliary remedies,
and adapted, as such, to effect important purposes in the treatment
of particular cases of disease, and in certain conditions of the
system.
CARBONATE OP AMMONIA.
" Carbonate of ammonia, recently prepared, is in white, mode¬
rately hard, translucent masses, of a striated and crystalline ap¬
pearance, of a pungent smell, and a sharp, penetrating taste." —
U. S. Dispensatory.
Exposed to the air, carbonate of ammonia soon becomes
changed to a white appearance, and in its texture resembles
chalk; when it is no longer fit for use as medicine. Carbonate
of ammonia should be preserved from the air, by being kept in a
glass jar, entirely air-tight; or wrapped in tinfoil. By adopting
the latter method, it may be preserved for months in a condition
suited to medical purposes.
Medical Properties and Uses. — Carbonate of ammonia is a
diffusive stimulant, and powerfully anti-acid. Its use is adapted
to exhausted states of the system, as in congestive and typhus
fever, and wherever extreme debility prevails.
The dose is from five to ten grains, or about as much of the
powdered ammonia as will lie on a ten-cent piece. It may be
taken dissolved either in water, wine-whey, pepper or Virginia
snake-root tea, or it may be taken in the form of pills. The dose
to be repeated every hour or two, as the circumstances of the
case demand.
The unpleasant taste of the ammonia may be disguised by dis¬
solving it in gum Arabic water sweetened with loaf-sugar, and
adding to each dose four or five drops of the oil of cinnamon.
Dr. Eberle states that carbonate of ammonia has been employed
with good success in nervous headach.
Either the aqua ammonia, or the spirits of hartshorne, applied
544
MATERIA MEDICA.
to a part stung by a bee, will neutralize the poison — relieving the
pain at once, and preventing swelling.
Aqua ammonia is regarded as an antidote to the poison from
the bites of rattlesnakes and other venomous reptiles. It is to be
kept applied to the wound, and given internally.
CAMPHOR.
Camphor is obtained chiefly from Japan, where it is found in
distinct grains, interspersed throughout the roots and wood of the
laurus camphora, a forest tree of that country. Camphor exists
in small quantities in some native trees and plants of this country
— the common sassafras, and in rosemary, sage, peppermint
thyme, starwort, and lavender.
Medical Properties and Uses.—Camphor is a volatile stimulant
and actively antiseptic. " In its primary operation it also allays
nervous irritation, quiets restlessness, and produces a general pla¬
cidity of feeling, which renders it highly useful in certain forms
of disease, attended with derangement of the nervous functions.
It is used in colic, fainting, sick stomach, &c.
" By its moderately-stimulating powers, its diaphoretic ten
dency, and its influence over the nervous system, it is admirably
adapted to the treatment of all diseases of a typhoid character,
which combine with the enfeebled condition of the system, a fre¬
quent, irritated pulse, a dry skin, and much nervous derangement;
indicated by restlessness, watchfulness, tremors, subsultus, and
low, muttered delirium. * * * * * jn a great number of
spasmodic and nervous disorders, and complaints of irritation,
camphor has been very extensively employed. The cases of this
nature to which experience has proved it the best adapted, are
dysmenorrhoea, puerperal convulsions, and other nervous affections
of the puerperal state; and in certain forms of mania, — particu¬
larly nymphomania, and that arising from the abuse of spirituous
liquors.
"It is much used externally, as a local anodyne, — generally
dissolved in alcohol, oil, or acetic acid, and frequently combined
with laudanum. The ardor urinae of gonorrhoea may be alle¬
viated by injecting an oleaginous solution of camphor into the
urethra; and the tenesmus of ascarides (worms) and dysentery,
by administering the same solution in the form of enema. A
scruple, or half a drachm of camphor, in substance, added to a
poultice, and applied to the perinseum, allays the chordee which is
a painful attendant upon gonorrhoea."
The dose of camphor is from five to ten grains, or a piece of
MATERTA MEDICA.
545
the size of a large grain of corn, rubbed up with loaf-sugar, gum
arabic, and water, or with milk. The dose to be repeated every
two or three hours, or at longer or shorter intervals, as the cir¬
cumstances of the case require.
Camphor tea is made by pouring boiling water upon camphor;
but as a portion only of the camphor will dissolve in this way, it
forms a weaker preparation than the above. Combining cayenne
with the camphor, we have an efficient stimulant. For instance,
take a lump of camphor, as large as a chesnut; a teaspoonful of
cayenne; pour on half a pint of boiling water, and sweeten it
or employ ginger root in the place of cayenne.
Camphorated Julep. — Take of gum camphor, one drachm ;
finely-powdered myrrh, thirty grains; sugar, two drachms ; water,
four ounces. Saturate the camphor with alcohol, or some kind
of spirit; then rub the ingredients until thoroughly combined, and
add the water. The dose is a tablespoonful for an adult, and a
teaspoonful for a child; to be repeated every hour or two, as the
nature of the case may require. This preparation, combined
with cayenne tea, is particularly well adapted to the treatment of
cases of disease, attended with extreme debility;—as in cases of
typhoid and putrid fever; malignant scarlet fever; confluent small
pox, &c.
Spirits of Camphor. — To make the tincture or spirits of cam¬
phor, put four ounces of camphor to a quart of alcohol.
The dose of spirits of camphor is from ten drops to a teaspoon¬
ful. To prepare for taking, it should first be poured on sugar,,
afterwards adding warm water.
Camphor, dissolved in oil of turpentine, constitutes a remedy-
in high repute for toothach, when the tooth is partly decayed.
Wet a portion of lint or cotton with the drops, and place it in the
cavity of the tooth.
OIL OF TURPENTINE.
The oil of turpentine is obtained from common turpentine by
the process of distillation. Internally, it may sometimes be used
with benefit in children affected with worms; and also as an ad¬
juvant remedy in low forms of fever. " There is a particular
state of fever, usually attended with much danger, in which we
have found this remedy uniformly successful. The condition of
things alluded to, is one which occurs in the latter stages of
35
546
MATERIA MEDIC A.
typhoid fever or lingering remittents; in which the tongue having
begun to throw off its load of fur in patches, has suddenly ceased
to clean itself, and becomes dry and brownish: the skin is at the
same time dry, the bowels torpid and distended with flatus, and
the patient sometimes affected with slight delirium. Under the
use of small doses of the oil of turpentine, frequently repeated,
the tongue becomes moist and less coated, the tympanitic state of
the bowels disappears, and the patient goes on to recover, as in a
favourable case of fever. We are disposed to ascribe the effect
to a healthy change, produced by the oil in the ulcerated surface
of the intestines." — U. S. Dispensatory.
The oil of turpentine, given internally, has been found useful in
cases of lumbago and sciatica. It has also been employed, with
general good success, in severe cases of colic, cramp, and gout in
the stomach. A tablespoonful of the oil of turpentine, beat up
with the yolk of an egg, and half a pint of warm water added,
may be employed with benefit as an injection, in severe cases of
bilious colic.
Next to the third preparation of lobelia, the oil of turpentine is
probably the best remedy, used by injection, in cases of tym¬
panites (a swollen condition of the abdomen), which often occurs
in malignant forms of disease, and in peritoneal inflammation.
A tablespoonful of oil of turpentine, beat up with the yolk of an
egg, and a teaspoonful of the mixture taken at a time, and occa¬
sionally repeated, is said to have generally proved effectual in
checking bleeding from the nose, in typhoid fever.
Oil of turpentine has been much extolled as a remedy for tape¬
worm, and is one of the most popular medicines for worms in
children. It has also been found useful in neuralgia, locked jaw,
malignant and chronic dysentery, and in long-standing weakness
of the urinary organs. It is not, however, to be considered as a
specific for any disease; but, in certain conditions of the system,
it may be employed with benefit.
The dose is from thirty drops to a teaspoonful. It may be taken
dropped on sugar, or combined with mucilage of elm, or gum
Arabic and sugar, or simply mixed with water.
The oil of turpentine may also be taken in the shape of pills,
by mixing it with powdered liquorice root.
As an external application, it may be usefully employed in com¬
bination with Thomson's No. 6, in low forms of fevers, when the
skin is colder than natural. This compound also forms a useful
application in case of rheumatism and palsy. It is a good appli¬
cation in chilblains, and also in the cure of various species of
eruptions.
MATERIA MEDICA.
547
WHITE TURPENTINE.
White turpentine is chiefly obtained from the Southern States;
more especially from North Carolina and Virginia. It is useful
for making strengthening plasters, and may also be taken inter¬
nally, in the shape of pills, for worms, chronic catarrh, lumbago,
and sciatica, and also as a preventive to attacks of bilious colic.
OIL OF AMBER.
" Amber is a kind of fossil resin of vegetable origin, occurring
generally in small detached masses, in alluvial deposites, in dif¬
ferent parts of the world. It is found chiefly in Prussia, either on
the sea-shore, where it is thrown up by the Baltic, or underneath
the surface, in the alluvial formations along the coast." — U.S.
Dispensatory.
Amber has also been found in Maryland and New Jersey.
Oil of amber is obtained by putting a quantity of powdered
amber and an equal weight of sand, into a glass retort, and then
applying a gradual heat, by means of a sand-bath; an oil exudes,
which is separated from the other matters, and should be kept in
tightly-corked bottles. The oil of amber, thus obtained, is sub¬
jected to a process of distillation with water, when it is ready for
medicinal purposes.
Medical Properties and Uses. — Rectified oil of amber is an
anti-spasmodic and stimulant, useful in hysteria, violent colic, hic¬
cough, and in water-brash, attended with cramps or spasms.
As an external application, it is useful in palsy and chronic
rheumatism.
It may also be used with benefit in whooping cough — applied
along the course of the spine, morning and evening.
A dose of the oil of amber is from five to fifteen drops, rubbed
up with a portion of gum Arabic, or slippery elm and sugar, and
a portion of water added.
OIL OF HORSEMINT.
Oil of horsemint may be used internally, in cases of colic,
heartburn, water-brash, and in gout or spasms in the stomach.
The dose is from two to five drops, mixed with sugar and water.
The oil of horsemint, applied to the skin, produces a very sudden
rubefacient effect, — causing redness of the skin, and even blis¬
tering.
548
MATERIA MEDICA.
OIL OF JUNIPER.
Oil of juniper is obtained from juniper berries. It is frequently
adulterated with turpentine.
Oil of juniper promotes the secretion of urine, and may be em¬
ployed with advantage in many cases of dropsy. It has been
found useful in other complaints, as in chronic bronchitis, chronic
disease of the kidneys, gleet, and fluor albus.
There is a form of dyspepsia in which the oil of juniper has
proved highly successful. It is especially adapted to cases of
chronic inflammation of the mucous membrane of the stomach,
where there is constant tenderness to pressure at the pit of the
stomach.
OIL OF PEPPERMINT.
The oil of peppermint is used to relieve colic, overcome nausea,
and check vomiting. The dose of the oil is from one to three
drops, — first rubbed up with sugar, and then water added.
The Essence of Peppermint is made by combining two ounces
of the oil with a pint of alcohol. The dose of the essence is from
ten to twenty drops.
OIL OF ANISE-SEED.
The oil obtained from anise-seed is well adapted to colic pains
in infants, on account of its mildness. The dose is from three to
fifteen drops, rubbed with a small quantity of loaf-sugar, adding
a teaspoonful or tablespoonful of hot water.
OIL OF CARAWAY.
Oil of caraway is chiefly employed to disguise the taste of
medicine, and is much employed by nostrum venders, to give an
agreeable flavour to syrups and pills.
MATERIA MEDICA.
549
VEGETABLE BALSAMS.
BALSAM COPAIVA.
Balsam copaiva is obtained from the copaifera officinalis. This
tree is a " native of Venezuela, and grows in the province of Car-
thagena, mingled with the trees which afford the balsam tolu. It
grows also in the West India Islands, particularly Trinidad and
Martinique, where it is said to be naturalized. The juice is ob¬
tained by wounding the tree; and the operation is said to be per¬
formed several times in the same season. As it flows from the
wound, it is clear, colourless, and runs thin, but soon acquires a
thicker consistence and a yellowish tinge."
Balsam copaiva has long been employed as a remedy in gonor¬
rhoea, fluor albus, and in chronic affections of all mucous mem¬
branes, when attended with a profuse secretion, — particularly
chronic bronchitis, and chronic diarrhcea. In a favourable condi¬
tion of the stomach, the use of balsam copaiva is particularly
beneficial in the above-named complaints.
The dose of copaiva is from fifteen to thirty drops, repeated
three or four times a day. It is usually taken rubbed up with
powdered gum Arabic, or powdered elm and sugar, adding a drop
or two of the oil of peppermint or cinnamon, to which add a suf¬
ficient quantity of water to form it into a consistency convenient
to be taken. Another method recommended for taking this medi¬
cine is, to drop the copaiva .in a wineglass half full of wrater, and
immediately drop on it a few drops of a bitter tincture; the co¬
paiva is collected in a globule, and may be swallowed without
imparting its peculiar taste to the mouth. Recently, however, the
balsam copaiva is taken enclosed in capsules, by which both the
taste and odour of the article are completely disguised.
BALSAM TOLU.
Balsam tolu is obtained from a tree growing near Carthagena.
It is obtained by making incisions into the trunk of the tree, from
which a juice exudes, which is allowed to concrete. On keeping,
the balsam becomes hard and brittle, like resin.
550
MATERIA MEDICA.
The dose is from half to an even teaspoonful of the powdered
balsam. " The best form of administration is that of emulsion;
made by triturating the balsam with mucilage of gum Arabic and
loaf-sugar, and afterwards with water. It may also be taken in
the form of tincture; of which the dose is a common-sized tea-
spoonful, mixed in some sweetened water, or mucilage. When
mixed with water, it immediately becomes white, like milk.
Another way of taking this medicine is, by mixing it with con¬
serve of hollyhock.
Balsam tolu is found beneficial as a remedy in long-standing
cough, chronic catarrh, and bronchitis.
FIR BALSAM —CANADA BALSAM.
The tree which furnishes this balsam grows in Maine and
Canada. The balsam collects in blisters on the body of the tree
these blisters are pierced, and the liquid received into vessels.
Uses. — Balsam of fir is employed for the same purposes for
which balsam copaiva is used. The fir balsam is inferior to the
balsam copaiva in point of medicinal powers. The usual dose is
about twenty drops. It may be taken rubbed up with a portion
of sugar or gum Arabic.
MISCELLANEOUS MEDICINES.
PENNYROYAL.
Pennyroyal tea, drunk warm, promotes perspiration, and may
be employed with safetv in all cases of sickness. It is much used,
even in the old practice, to promote the menstrual secretion.
DITANY.
This herb possesses properties similar to those of the penny¬
royal, and may be used for the same purposes. Hot ditany tea,
taken at bed-time, is good for common colds.
MATERIA MEDICA.
551
CATNIP.
Catnip tea is used successfully as a remedy for colic and flatu¬
lency in infants. A few drops of tincture of lobelia added to each
dose of the tea, improves its medicinal qualities.
HOARHOUND.
Hoarhound is used chiefly in colds and catarrhal affections. It
is slightly tonic, and promotes expectoration.
SCABIOUS.
(Errigeron Philadelphicum and Errigeron Canadense.)
Each of the above species of the errigeron grows plentifully in
the fields in the vicinity of Philadelphia. By some, the errigeron
is called Jleabane.
A tea of the scabious is an important remedy in cases of gravel,
and inflammation of the neck of the bladder; and may be used
freely in complaints of the kidneys and bladder.
The errigeron Canadense is a very effective diuretic, sudorific,
emmenagogue, tonic, and pectoral; it is very efficient in uterine
disease, almost always agrees with the stomach, and is very bene
ficial in cases of gout and gravel." — Dr. A. C. Logan.
HONEY.
Honey'is highly nutritious, and is very useful in many cases oi
sickness; more especially in complaints of the urinary organs,
attended with stoppage of urine, or strangury. In these cases, it
may be employed to sweeten teas with, — such as composition,
sumac, pipsissewa, scabious, burdock, or any other article that
may be employed in those complaints. Some experienced phy¬
sicians state, that they have found more benefit from the use of
honey, than from any other article, in some cases of strangury
and gravel.
Honey disagrees with many persons, taken as food; occasion¬
ing severe colic pains. Eating it with milk, however, will prevent
any unpleasant effects
552
MATERIA MEDICA.
PIPSISSEWA.
(Pyrola Umbellata.)
This evergreen, of which the tops and roots are both used,
possesses some valuable medical properties. A decoction of this
plant may be used with benefit as a common drink in scrofulous
eruptions, rheumatism, dropsy, and in complaints of the urinary
organs in general. Sweetened with honey, and drunk freely, it
will, in general, promote the discharge of urine, relieve stran¬
gury, and assist expectoration.
In order to obtain the full strength of the pipsissewa in decoc¬
tion, it should be boiled half an hour, in an earthen vessel.
CLEAVERS.
There are several species of the cleavers, all of which possess
similar properties. A strong decoction is said to be useful in
urinary obstructions, and in inflammation of the urethra or neck
of the bladder.
BURDOCK.
The root of burdock, cut into thin slices and put into sound
cider, adding a small portion of mustard-seed and horse-radish,
furnishes a wholesome drink; and in certain conditions of the
stomach, where the patient has a desire for cider, as is often the
case after fevers, this preparation may be found not only grateful,
but it will also strengthen the digestive functions. In dropsy, after
the stomach has been cleansed, and the patient has passed through
a course of general constitutional treatment, this cider preparation
will generally prove beneficial, — giving tone to the stomach, and
promoting the secretion of urine. Burdock root, steeped in boiling
water, and the tea drunk freely, is good in cases of scrofulous
humours. Severe cases of scrofulous sore eyes have been cured
by the free use of this tea, taken internally, and using the tea as
a wash to the parts affected.
CUBEBS.
Cubeb berries are the fruit of a running plant, growing in the
East Indies.
"Cubebs are gently stimulant, with a special direction to the
urinary organs." In Java, this medicine has acquired a high
MATERIA MEDICA. 553
reputation as a cure for gonorrhoea, gleet, fluor albus, &c. The
dose of the powder is from twenty to forty grains; or from half
to a teaspoonful, taken in warm water, and repeated three or four
times a day.
PRICKLY ASH.
{Xanthoxylum Fraxineum.)
The prickly ash is a bush growing in wet and shady places,
and seldom exceeds in height ten feet. " The leaves are alternate
and pinnate, consisting of four or five pairs of leaflets, and an odd
erminal one, with a common footstalk, which is sometimes prickly
on the back, sometimes unarmed. The leaflets are nearly sessile,
ovate, acute, slightly serrate, and somewhat downy on their under
surface." " The flowers are small and of a yellow colour, grow¬
ing in little clusters close to the branches. They appear in May,
in advance of the leaves. The seed-vessels have the appearance
of berries; and, during the summer, change from a green to a
red; in the autumn they assume a brownish colour, and open by
three valves: exhibiting a black, polished seed in the centre." —
Mattson.
" Dr. Bigelow informs us that the aralia spinosa, or angelica
tree, which grows in the Southern States, is occasionally con¬
founded with the xanthoxylum fraxineum; in consequence, partly,
of being sometimes called, like the latter, prickly ash. Its bark,
however, in appearance and flavour, is entirely different from the
xanthoxylum." — Wood and Bache.
The bark and leaves of prickly ash are extremely pungent
when chewed. The pulverized bark, seed, and capsules, added to
sther tonics, constitute a good medicine in cases of rheumatism,
where a tonic is wanting. A decoction of these articles alone, or
combined with cayenne or composition, may be used in any stage
of rheumatism. It is stated that a decoction of the prickly-ash
bark is a useful remedy in venereal complaints, fluor albus, and in
general weakness of the urinary organs. The berries may be
used to impart an agreeable flavour to wine bitters.
SARSAPARILLA.
There are various species of sarsaparilla, only a few of which,
according to the observation of some travellers, possess any valu¬
able medical properties. The American sarsaparilla appears to
be entirely inert. Indeed, the most of that which is imported
is of little value; from which circumstance, no doubt, it has lost
its reputation with many as a medicine. " The only criterion of
554
MATERIA MEDICA.
good sarsaparilla which can be relied upon, is its taste. If it have
a decidedly acrid impression in the mouth, after having been
chewed for a short time, it may be considered efficient; ii other¬
wise, it is probably inert."
To prepare a simple Decoction of Sarsaparilla. — Bruise tho¬
roughly the roots of good sarsaparilla, Sift out the dirt, pour on
boiling water, and let it steep two or three hours by a fire, in a
covered vessel: strain, and sweeten with sugar or honey.
To make Sarsaparilla Beer.—Take of sarsaparilla root, bruised,
one pound; guiac shavings, anise-seed, and liquorice root, each,
two ounces; good molasses, one pound; and half a dozen bruised
cloves; pour upon these, two gallons of boiling water, and shake
the vessel several times a day. After fermentation takes place, it
is fit for use.
Compound Decoction of Sarsaparilla. — Take half a pound of
bruised sarsaparilla; and of bark of the*root of sassafras, sliced;
guiacum-wood, rasped; and liquorice-root, bruised; each, an
ounce; pour on these ingredients, half a gallon of boiling water,
and let it boil a quarter of an hour, and strain.
Excepting the omission of one article, this decoction is an imi¬
tation of the celebrated Lisbon diet drink.
The decoction may be sweetened with rock candy, sugar, or
honey.
Syrup of Sarsaparilla. — Take of good sarsaparilla, bruised,
two pounds; guiac shavings, three ounces; red-rose leaves, and
liquorice-root, bruised, each, two ounces; add to these ingredients,
five quarts of diluted alcohol, and let them macerate fourteen days;
then strain through thick muslin. Evaporate the tincture, by
means of a water-bath, to four pints and a half; then add eight
pounds of refined sugar, and simmer until it forms a syrup; then
take a teacup half-full of the syrup, and add to it a teaspoonful of
the oil of wintergreen; mix them thoroughly, and stir it into the
whole of the syrup.
Uses.—Sarsaparilla, either in decoction or syrup, is often found
beneficial in scrofula, where the patient is in an emaciated and
feeble condition; in mercurial disease; secondary syphilis; va¬
rious eruptive diseases; and in a great variety of complaints ot
long standing, attended with emaciation and debilitv.
MATERIA MEDICA.
555
PURPLE ARCH ANGLE.
(Lycopiis Virginicus.)
The auh angle grows plentifully in meadow lands and along
the margin of brooks. The purple arch angle, which is readily
recognised by the purple colour of the under side of the leaf, is
highly esteemed by Dr. A. C. Logan, as a remedy in disease of
the heart, fevers, &c. The infusion may be drunk freely, in any
case of sickness. Dr. Logan says " it will reduce inordinate
action of the pulse rapidly, more so than digitalis, and without any
of the bad effects always to be feared from the use of digitalis."
GUAIACUM WOOD.
Guaiacum wood is imported to the United States from the West
Indies, in the form of logs or billets. It is commonly called lignum
vitce. It is possessed of some medicinal properties, and is em¬
ployed in cases of chronic rheumatism, cutaneous eruptions, and
scrofula. The wood is kept by apothecaries in the form of rasp¬
ings or shavings. The wood yields the greater part of its proper¬
ties to boiling water. It is seldom, however, administered alone,
being mostly combined with other articles, particularly sarsapa-
rilla. The concrete juice of the guaiacum tree, commonly called
gum guaiac, is employed for the same purposes for which the
decoction of the wood is given. It may be taken either finely
powdered and mixed with molasses or syrup, or in the shape of
emulsion with powdered slippery elm, sugar and water, or in tinc¬
ture.
The dose of the powder is from half to a teaspoon, even full.
Guaiac is sometimes added to Thomson's No. 6, and administered
internally in cases of rheumatism, gout, female weakness, mer¬
curial disease and syphilitic taint of the system.
PRECIPITATED CARBONATE OF IRON.
This preparation is much employed in the old school practice,
in chronic diseases—dyspepsia, chlorosis, amenorrhoea, hysteria,
and neuralgia, where there is absence of fever, the skin pale, and
the system relaxed. It is quite harmless, " always having been
regarded as one of the metallic substances friendly to the living
system." " It increases the activity and volume of the pulse,
corrects the state of the blood and secretions, and invigorates the
whole system."
556
MATERIA MEDICA.
The dose of the precipitated carbonate of iron is from five to
sixty grains; mixed with mucilage of elm or gum Arabic; or, it
may be mixed with honey and formed into pills. As a general
rule, a teaspoonful, repeated three or four times a day, is the pro¬
per quantity for an adult. To be taken after meals. Patients,
while using this preparation, should avoid acids and astringents.
TANSY.
Tansy is used both as a tonic and vermifuge. For children
supposed to be affected with worms, the leaves, either in the green
or dried state, are boiled in milk, and a wineglass full given three
or four times a day. It is particularly adapted to a feeble and
relaxed state of the system where the use of tonics is indicated.
SLIPPERY ELM BARK.
(Ulmus Fulva.)
Slippery Elm Bark is employed as a demulcent, by stirring the
finely ground bark into hot water, or by pouring hot water upon
the bark unground, and allowing it to steep. The tnucilage of
slippery elm bark is very nutritious, and it may be employed as
an article of diet in fever, pleurisy, inflammation of the lungs,
scarlet fever, diarrhoea, dysentery, and in any other form or va¬
riety of disease, especially when accompanied with fever, for the
stomach is very rarely in a condition to digest food when it is so
much disordered as to occasion fever, except the food be of the
lightest kind, such as elm gruel, barley water, and gum Arabic
water. A mucilage of slippery elm sweetened with loaf-sugar or
rock candy, adding a portion of lemon juice, is a good remedy
for cough when attended by fever and a dryness of the tongue.
To form an emollient poultice, there is no article superior to
finely powdered slippery elm bark.
YELLOW DOCK.
The root of the narrow-leafed yellow dock is useful in tetter,
itch, and in other cases of eruptions of the skin. A tea of the
root should be drunk, and an ointment or tincture of the root
applied to the eruptions.
Two ounces of the dried root pounded, to a pint of vinegar, is
a good application for tetter.
MATERIA MEDICA.
557
STRENGTHENING SYRUP.
Take four ounces comfrey root dried; two ounces elecampane;
and one ounce hoarhound. Boil in three quarts water down to
three pints. Strain, and while warm add half an ounce of beth
root pulverized, a pint of brandy and a pound of loaf-sugar.
Dose, a small wineglass full three or four times a day. Con¬
sidered useful in cases of female weakness in general.
ACIDS.
VINEGAR.
The use of vinegar on food promotes digestion in particular
conditions of the stomach. With the addition of salt and cayenne
pepper, it constitutes pepper sauce. This preparation is useful as
an internal remedy in many cases of disease, and particularly so
in some cases of fever, where the patient desires or craves acids.
There are families who depend almost exclusively upon the inter¬
nal use of a mixture of salt and vinegar in all cases of dysentery
and bowel complaints. Although this is undoubtedly a valuable
remedy, yet certainly not one to be relied upon exclusively, in
diarrhoea or dysentery. Pepper sauce forms one of the best appli¬
cations for the cure of ulcerated sore throat, so often attendant
upon scarlet fever. The throat must be swabbed with the mixture
and a dose occasionally administered. On many occasions, when
patients have expressed a desire for acid, I have directed them to
take stale wheat bread dipped in vinegar, and it has agreed well
with the stomach in every case where I have recommended it.
Within the past month, a patient of mine ate freely of bread
soaked in vinegar and continued to take it three or four days, not
only without receiving any injury from it, but, on the contrary, it
was evidently of especial benefit as a medicine. This patient was
affected with a form of disease which would have been termed
congestive fever by medical men in general.
Some dyspeptics find nothing to set so well on the stomach as
bread and butter dipped in vinegar. Even in cases of sour sto-
558
MATERIA MEDICA.
mach, vinegar or lemon juice has been found in some instances to
suit the stomach better than alkalies.
Vinegar, applied after caustic potash, will neutralize the caustic
and prevent it penetrating deeper into the flesh
Lemon juice may be used for the same purposes as vinegar in
cases of sickness. Very often we find that a mixture of lemon
juice and sugar, in the form of syrup, suits the stomach remarka¬
bly well in cases of disease, particularly in fever.
ELIXIR OF VITRIOL.
This preparation consists of sulphuric acid, alcohol, and the
essential oil of ginger and cinnamon.
I have employed elixir of vitriol with especial benefit in some
cases of disease, and though not used in the Thomsonian practice,
still there can be no reasonable objection to its employment in the
diluted state in which it is given. It may be employed to mode¬
rate night sweats, and as a tonic in intermitting fever or ague,
particularly when the system is brought into a condition to admit
of their use. In hectic fever and in consumption attended with
urgent thirst, a few drops of the elixir of vitriol, added to a glass
of water, will prove grateful to the taste, and tends to check
thirst.
The dose of elixir of vitriol is from ten to thirty drops taken in
a wineglass full of water, or in ginger or bitter tea. It is often
given, combined with a decoction of Peruvian bark, in cases of
remitting fever.
ALKALIES—ANTI-ACIDS.
Super-Carbonale of Soda—Bi-Carbonate of Soda.
Soda is obtained from the ashes of sea-weeds. It is subjected
to certain processes by which it becomes purified and well adapted
to general use as an anti-acid, in the form of the sup. carbonate,
or bi-carbonate of soda.
It is a stronger anti-acid than pearlash, and is preferable to the
latter on account of not being as liable to impurities as pearlash
is on exposure to the air, or from long keeping.
Soda is preferable to sal seratus for neutralizing acid, and in
assisting the operation of emetics.
Sup. carbonate of soda will generally overcome heartburn, and
affords great relief in case of acidity and distress at the stomach
after eating. It is a favourite medicine with epicures.
MATERIA MEDICA
559
SAL iERATUS.
Sal .eratus, as it is commonly called, is the bi-carbonate of
potassa. It is employed in the place of pearlash, being less liable
to impurities than the latter. It is used for the same medical pur¬
poses as the sup. carbonate of soda. It is more used by Thom-
sonians than the sup. carb. soda, but it is not so strong an alkali
as soda, and it is more unpleasant to take.
A solution of sal seratus in whiskey (for instance, take half a
pint of whiskey and put into it as much sal asratus as it will dis¬
solve,) is a favourite wash with some practitioners for the cure of
scaly eruptions on the surface, constituting one species of tetter.
A solution of sal seratus in water has proved effectual, as stated
by Dr. Anderson of Ohio, in curing cholera in children, even when
the symptoms were violent and the case dangerous. In these
cases, the sal seratus water was given freely? so as effectually to
neutralize the acid existing in the stomach and bowels.
HICKORY ASHES,
A tea made by pouring boiling water on hickory ashes, may be
employed as an anti-acid when bi-carbonate of soda or sal seratus
cannot be ^obtained. A tea of hickory ashes has been used with
much benefit in some cases of dyspepsia attended with a supera¬
bundance of acid in the stomach.
The following was a favourite remedy for dyspepsia with the
late Dr. Physick •:
"A quart of hickory ashes, a teacupful of soot, and a gallon
of boiling water."
Dose.—A wineglass full of the tea immediately after meals.
CHARCOAL.
The charcoal employed for medical purposes, is generally ob¬
tained from those who manufacture gunpowder. In their estab¬
lishments, the charcoal is burned in iron cylinders, by which it is
freed from all impurities; then being finely pulverized for the pur¬
pose of powder-making, it is well adapted also for medical pur¬
poses. Common charcoal is rarely entirely clear of impurities,
and consequently it is not so well adapted to medical purposes as
that prepared by the powder-makers. There are processes, how¬
ever, for purifying the common charcoal and fitting :t for medical
560
MATERIA MEDIC A.
purposes, as follows: — Fill a crucible with ordinary charcoal
reduced to fine powder, and lute on a perforated cover. Then
expose the whole to a strong red heat, and continue the ignition as
long as a blue flame issues from the aperture in the cover; when
this ceases, allow the charcoal to cool, and transfer it immediately
to bottles, which must be kept well stopped.
Another method.—" Take any quantity of thoroughly-burnt char¬
coal, very light, sonorous and pure, made from the wood of the
linden tree, willow, poplar, or some other of the lighter woods,
and moisten it with water. Reduce it to powder in an iron mor¬
tar, or by means of a mill; and having mixed it with water to
form a thin fluid mass, let it stand for a few days; after which
place it in linen cloths to drain. Make up the paste into round
cakes, and expose them to the jays of the sun until they are tho¬
roughly dried. By this process of insulation, the charcoal, it is
stated in the codex, is deprived of all adventitious colour and
smell, and is singularly improved in efficiency."—U. S. Dyspen.
Chemical properties and uses.—Charcoal is absorbent and pow¬
erfully antiseptic. Fresh meat may be preserved for months by
being enclosed in a box of charcoal. Tainted meat may be
sweetened by placing it in powdered charcoal.
The kinds of cases to which charcoal appears to be best suited,
are dyspepsia, accompanied with heartburn and sour eructations,
and fevers attended with sour taste in the mouth; constipation of
the bowels; periodical sick-headache; and in dysentery and other
forms of disease where there is a putrid tendency—the stools very
offensive.
The dose of charcoal is from a teaspoonful to a tablespoonful,
to be repeated from one to three or four times a day. To prepare
the powder for taking, it should first be made into the form of a
paste with a little sugar and water, and then it will combine rea¬
dily with liquids. By preparing it in spice-bitters, composition, or
pepper tea, the patient will obtain the benefit of two medicines in
one dose. For children, it may be mixed with boiled milk. It is
stated by some persons who have travelled through the sickly dis¬
tricts of the western and southern States, that by using charcoal
freely, even strangers unaccustomed to the climate may reside in
those districts without being attacked with disease.
Charcoal is often combined with other powders, such as cayenne,
ginger, or spice-bitters, and taken in this way instead of the char¬
coal alone.
Animal Charcoal.—Charcoal made by burning strips of sole-
leather in closed vessels, is said to be more efficient than the vege-
MATERIA MEDICA.
561
table charcoal as an absorbent, and to correct the putrefactive
tendency that often exists in bowel complaints of children, and in
cases of malignant diseases.
Administered in large doses, animal charcoal proves a powerful
antidote to all the vegetable poisons.
LIMEWATER.
To prepare Limewater.—Take of fresh burnt lime two ounces,
put it in an earthen vessel and pour on half a gallon of cold water:
stir it occasionally with a piece of wood, and in the course of three
hours put it into glass vessels and keep them corked. Pour off
the clear part only for use.
Limewater is good to neutralize acidity in the stomach, to cor¬
rect offensive breath, and overcome putrid eructations. A lady
of this city informs me that for several years her diet consisted of
boiled milk with the addition of about one-fourth its quantity of
limewater; almost every other kind of food soured in the stomach,,
causing distress and vomiting. Persons subject to offensive eruc¬
tations, which they say taste like rotten eggs, will find especial
benefit from the use of limewater. Chronic eruptions in children
are generally attended with acidity of the stomach, which may be
relieved by the use of limewater. It may be employed with
benefit in children who have worms, having the effect, as it is
asserted, to dissolve the tenacious mucus in the stomach and bow¬
els which supports worms. It is also useful in ordinary bowel
complaints of children.
The dose of limewater, for an adult, is from two to four ounces.
It should be combined with about an equal portion of milk. The
dose to be repeated three or four times a day.
PREPARED CHALK.
Prepared chalk is obtained by rubbing a portion of common
chalk in an iron or earthen mortar, with a small portion of water;
and when rubbed very fine it is put into a larger vessel, and a con¬
siderable quantity of water added; then it is to be thoroughly
stirred, so that the fine particles of chalk will be suspended in the
water, and the impurities, sand, &c., will remain in the bottom of
the vessel, or soon settle. This water containing the fine chalk is-
to be poured into another vessel, and when the chalk settles, the
clear water is to be poured off, and the chalk dried.
Medical Properties and Uses.—Prepared chalk is anti-acid and
absorbent, and as such it may be employed with benefit in diseases
36
562
MATERIA MEDICA.
attended with a superabundance of acids in the stomach and
bowels. A teaspoonful of prepared chalk mixed with a teacup
half full of strong bayberry or composition tea, sweetened, forms
a useful preparation in bowel complaints of children. In severe
cases, the use of the vapour bath, emetics, and injections, must be
chiefly relied upon; prepared chalk is to be employed merely as
an auxiliary remedy.
Prepared chalk is beneficial in cases of sore mouth, inflamed
and swollen gums, and ulcerated throat. In scarlet fever, more
especially when the disease becomes protracted, the throat swol¬
len, and the patient feverish, the prepared chalk will also prove
beneficial. It may likewise be used with advantage as an adju¬
vant remedy in other forms of fever, particularly where there is a
tendency to putrescency, as is very common in the fevers that
prevail in warm climates, and during the hot summer months of
■our own climate.
There are a great variety of stimulating liniments, but that
which is frequently alluded to in the practical part of this work,
is prepared by my brother, A. Comfort. The basis of this liniment,
is gum elastic. It is an imitation of Col. Jewett's liniment, which
has been proved beneficial as an external application. It contains
a large portion of essential oils and the liquid of the 3d prepara¬
tion of lobelia. This liniment is one of the best external applica¬
tions I have ever employed. This liniment is well adapted to
neuralgia, rheumatism, and chronic eruptions. It has also been
found especially beneficial, applied to the surface after a vapour
bath, in cases of asthma, chronic bronchitis, chronic pleurisy,
night-sweats, marasmus, St. Vitus' dance, cholera infantum, and
dropsy; and wherever the skin is in a cold or relaxed condition.
Spread upon oiled silk or soft leather, it forms a useful plaster ir
cases of pain in the side, 'disease of the chest, swollen joints, con
sumption, &c., &c.
STIMULATING LINIMENT.
WARD'S PASTE.
Take of black pepper, ground, 8 I
" dried elecampane root, ground, 8
" fennel seed, powdered,
" honey,
*' loaf-sugar,
8 ounces,
8' "
4 "
1 pound,
1 "
MATERIA MEDICA.
563
mix these in a mortar to the consistence of paste, and it is ready
for use.
Dose.—A piece as large as . a shellbark, every morning, or a
piece as large as a chestnut four or five times a-day.
The above preparation has long been a celebrated remedy for
piles. It is designed to'regulate the bowels and to strengthen the
vessels of the parts affected with piles. This preparation may be
used to overcome costiveness in general.
OF COUGH MIXTURES.
A great diversity of compounds and syrups may be employed
with benefit in cases of cough, yet none of them are to be relied
upon further than as a means of relief: the general Thomsonian
treatment constitutes the surest means of curing cough. A course
of medicine will often relieve a cough, when all other means have
failed.
Dr. S. Thomson, in treating of cough, observes, " The general
opinion is, that cough is an enemy to health, and ought to be
treated as such; but this I hold to be altogether an error, for
cough is the effect and not the cause of disease. When the lungs
are diseased, there will be a collection of matter, which must be
thrown off; and the cough is like the pump of a ship, which dis¬
charges the water, and prevents her from sinking: so also the
cough throws off what collects in the lungs, which, if suffered to
remain, would soon putrefy and cause death."
The correct way to cure a cough is to remove the cause and
not to deaden the sensibilities by the use of anodynes; for though
these may afford relief for a time, they directly tend to impair the
functions of the stomach and bowels. There are circumstances,
however, under which it may be proper to administer anodynes;
for instance, in cases of deep consumption, where the cough is so
extremely harassing, as to prevent the patient from sleeping at
night.
Ordinary cough, caused by cold, may be cured by taking com¬
position, or pepper tea; whereas, in cases of seated disease of the
lungs, courses of medicine will be needed. A variety of cough
mixtures, however, of a mild character, may be employed, with
more or less benefit, in cases of hard cough, or difficult expecto¬
ration.
The most effectual cough medicine that I have employed, apart
from Thomsonian courses of medicine, is lobelia, given in broken
doses, either in the form of tincture, or in powder.
MATERIA MEDICA.
COUGH POWDER.
Equal portions of lobelia powder, powdered liquorice root, finely
pulverized skunk cabbage root, recently dried, and sugar, all well
mixed, and taken in small teaspoonful doses, is a very good cough
medicine.
In recent cough from ordinary colds, demulcents: gum Arabic,
slippery elm, flax-seed, and Irish moss mucilage, may be useful,
more especially if the patient be feverish and inclined to drink;
whereas, in coughs that have been of long standing, or have be¬
come deeply seated, they will seldom prove of essential benefit.
Mucilages may be rendered more agreeable to the taste, and their
medicinal properties improved by the addition of lemon-juice and
sweetened with rock-candy, loaf-sugar, or honey.
In cough of long standing; syrup of garlic, or onions, and the
vegetable balsams, will be found the most beneficial kind of cough
mixtures.
Garlic Syrup.—To make Garlic Syrup, mash the garlic, add
warm water, and allow it to stand half an hour, but not heated;
then squeeze through a cloth and add sugar.
Onion syrup may be made in the same way as the garlic
syrup.
These syrups are well adapted to cases of long-continued cough
in children, hystericky females, chronic bronchitis, whooping-
cough, and in consumption.
Oxymel of Garlic is made by digesting garlic in vinegar, and
then boiling the liquid with a portion of honey. This preparation
is considered by Dr. Chapman to be superior to the simple syrup
of garlic, as an expectorant.
The following preparation is often employed as a cough medi¬
cine :—
Take a tablespoonful of powdered liquorice root, add a pint of
boiling water, then strain and sweeten with a tablespoonful of
honey, and add the juice of half a lemon. To a wineglass full
of this mixture, add half a teaspoonful of the tincture of lobelia.
Repeat the dose every two or three hours, as the circumstances
of the case may demand.
Thomsonian pepper candy and conserve of hollyhock are much
used for cough, and they are generally found to answer a good
purpose.
Several other cough mixtures are mentioned in the treatment
of colds and bronchitis, which it is unnecessary to describe here.
MATERIA MEDICA.
565
VOLATILE LOTIONS AND LINIMENTS.
Take of aqua ammonia 5 tablespoonsful,
Spirits of rosemary, 4 ditto.
Spirits of camphor, 1 ditto.
This compound forms the celebrated GranviWs Lotion, at one
ime considered as almost a certain cure for neuralgia, or tic-dou-
loureux, and acute rheumatism. The mode of applying it is to
wet a piece of cotton with it, and lay it on the part affected. It
must not be rubbed, or it will blister the part.
AMMONIA LINIMENT.
Take of water of ammonia one tablespoonful, of sweet oil six
tablespoonsful, and mix them thoroughly.
This liniment is chiefly employed in inflammatory rheumatism,
sprains, and bruises.
CAMPHOR LINIMENT.
Camphor liniment is prepared by dissolving half an ounce of
gum-camphor in four fluid ounces of sweet oil. This preparation
may be used in cases of bruises, sprains, acute rheumatism, &c.
SOAP LINIMENT—OPODELDOC.
Opodeldoc is made by dissolving an ounce of camphor, and oil
of rosemary and oil of origanum, each a fluid drachm, in a pint
of alcohol; then add three ounces of castile soap, and keep it
several days in a warm place. fc
The above compound forms an article extensively employed
as an external application in cases of inflammation, swellings,
bruises, &c.
SIMPLE CERATE.
Melt together one ounce of spermaceti and three ounces of white
wax; and then add six ounces of olive oil.
Simple cerate may be employed as a salve to protect raw sur¬
faces from the air. It contains no irritating properties, provided
it be made of good articles.
566
MATERIA MEDICA.
BASILICON OINTMENT.
Basilicon ointment is prepared by melting together five ounces%
of resin, eight ounces of lard, and two ounces of yellow bees-wax.
This ointment is employed as a salve in cases of ulcers, burns,
scalds, and chilblains.
GUM-ELASTIC.
The sheet gum-elastic may be applied with marked benefit in
many cases of chronic rheumatism, swollen joints, and neuralgia,
more especially in neuralgia of the hip, commonly called sciatica.
The gum should be washed with warm soapsuds before it is ap¬
plied, and also every time it is removed. In some cases, the gum
cannot be kept on more than twenty-four hours without occasion¬
ing a great deal of irritation. As a general rule, the sheet should
be taken off and washed as often as once a-day.
TAR OINTMENT.
Mix a pound of tar with a pint of melted tallow, and stir the
mixture until cold.
This ointment is especially well adapted to the cure of scald
head and some species of tetter.
TAR-WATER.
To prepare tar-water—"Take of tar two pints; water, a gal¬
lon. Mix, stirring with a wooden rod for fifteen minutes; then,
after the tar shall have subsided, strain the liquor, and keep it in
well-stopped bottles."
As an internal remedy, tar-water may be used in cases of chro¬
nic cough, chronic catarrh, piles, and in affections of the kidneys
and urinary organs. One or two pints may be taken daily.
Tar-water has been used with marked benefit as an injection in
cases of fluor albus, and piles. A mixture of equal quantities of
tar-water and a decoction of sumac and witch-hazel is better than
the simple tar-water.
Tar-water and a strong decoction of marsh rosemary, mixed
in equal quantities, is a good preparation for washing parts that
are chafed in children, ringworm, and scaly eruptions on the face.
Tar-water has of late been successfully used as a styptic—to
arrest the flow of blood from wounds.
MATERIA MEDICA.
567
thomson's salve.
Take of bees-wax and fresh butter, each one pound; of tui-
pentine, one and a half pounds; and three-quarters of a pound of
balsam of fir. Simmer by the fire until all the wax is melted, and
then strain.
This preparation, commonly called Thomson's healing salve,
may be employed to protect injured parts from the action of the
air, and in this way assist the healing efforts of nature. This and
the basilicon ointment may be used for the same purpose.
astringent ointment.
Take a pound of sheep suet, melt it, and add two ounces of
witch-hazel or sumac leaves that have been collected in the pro¬
per season and well dried. Simmer these half an hour or more,
and strain whilst warm. This ointment may be used with benefit
in cases of piles, chafing, chopped hands, sore nipples, &c.
persimmon ointment.
Take green persimmons, mash them, and stew them in lard ;
then strain. This ointment has been highly spoken of by sur¬
geons as a cure for piles.
PITCH PLASTER.
Take of Burgundy pitch and Venice turpentine, each one pound
melt them together, and add an ounce of cayenne pepper, and
when it cools, if it be found too hard, melt it over, and add a por¬
tion of sweet oil.
This may be employed as a general strengthening plaster.
TURPENTINE PLASTER.
Venice Turpentine, melted with a portion of bees-wax, to give
it a proper consistence, forms as good a strengthening plaster
probably as any other compound.
GUM HEMLOCK PLASTER.
i
Gtw Hemlock, obtained from the bark of the hemlock spruce,
contains the resinous principle, the same as Venice turpentine, and
5G8 MATERIA MEDICA.
is equally as good for strengthening plasters. It may be melted
with a portion of bees-wax and balsam-fir to make it more adhe¬
sive, softer, and less brittle.
/
MUSTARD PLASTER.
A simple mustard plaster may be prepared by mixing ground
mustard and warm water to form a proper consistency for a
plaster. If it is desired to weaken the plaster, wheat or rye flour
may be added.
A very common form of preparing mustard plaster, is to take
equal quantities of ground mustard and wheat or rye flour, and
moisten them with vinegar. •
Mustard plasters are often found serviceable when not left on so
long as to occasion a blister.
POULTICES.
The composition of poultices requires to be varied to suit the
different conditions of the parts upon which they are to be ap¬
plied. Thus, in the early stage of acute inflammation, as in biles,
felons, sudden swellings of glands; and in bruises and lacerated
wounds; emollient poultices are required, such as the elm, flax¬
seed, or mallows poultice; but in chronic inflammation, and after
a bile or abscess has discharged, stimulating and astringent poul¬
tices will be called for; and in cases of gangrene and mortifica¬
tion, the poultice should possess antiseptic properties.
There are particular forms of disease when poultices do not
answer a good purpose: for instance, erysipelas, venereal chancre,
some forms of tetter, and chafing in infants and children.
The following formulas describe poultices suited to the various
conditions of parts attending the different stages and varieties of
the complaints to which they are adapted as a curative agent.
Recently, the warm water and cold water dressings have been
substituted for poultices.
EMOLLIENT AND SLIGHTLY STIMULATING
POULTICES.
Take of slippery elm powder two parts, white pond lily root,
pulverized, one part, green lobelia powder, half as much as of the
•white pond lily; mix with warm water.
MATERIA MEDICA. 569
This poultice may be used in all cases of biles and tumours
attended with inflammation, and in cases of injuries when the flesh
is lacerated. It also forms a suitable poultice for acute inflamma¬
tion of the eyes, and when a part is burned with a red-hot iron or
live coals, so as to sear the flesh.
STIMULATING AND ASTRINGENT POULTICES
Take of composition powder and slippery elm, pulverized, equal
quantities, wet them with warm water, and then add a portion of
sweet lard.
This poultice is well adapted to all cases of bile or abscesses
when the matter has discharged, and in old sores that require
cleansing and stimulating, and in chronic inflammation.
MALLOWS POULTICE.
Take of mallows, either in a green or dried state, steep them in
milk and thicken with elm powder, ground flax-seed or fine Indian
meal, and, when spread, put a portion of green lobelia powder
over the surface.
This forms a useful poultice in the early stage of biles, felons,
whitlows, &c. After a bile or abscess breaks, or is opened, a
stimulating and astringent poultice should be applied.
CATNIP POULTICE.
Catnip leaves, steeped in vinegar and water, and thickened
with slippery elm, ground flax-seed, or fine Indian meal, form a
poultice that may be applied with especial benefit in cases of ear¬
ache, face-ache, and swollen and painful breasts.
CHARCOAL POULTICE.
Take of purified charcoal three parts, ginger, one part, bayberry,
one part, slippery elm, two parts; mix them in warm water.
This poultice is adapted to the treatment of putrid and offensive
ulcers, and also gangrene and mortification.
YEAST POULTICE.
Take a quantity of yeast and thicken with a mixture made of
equal portions of ginger and rye or wheat flour. Set it in a warm
place until it begins to rise.
The yeast poultice may be employed in all cases of gangrene,
mortification, &c., sloughing and offensive ulcers.
570
MATERIA MEDICA.
MYRRH POULTICE.
Equal quantities of the dregs of No. 6 and slippery elm pow¬
der, moistened with water, may be employed with especial advan¬
tage in cases of indolent ulcers, carbuncle and long standing
inflammation. This form of poultice requires to*be moistened
occasionally, more particularly when it is applied to a part in
which there is an unnatural degree of heat.
WILD INDIGO POULTICE.
The bark of the root of wild indigo pounded fine, and applied
to indolent ulcers as a poultice, will soon change the ulcer to a
more healthy character; so say those who have tried it.
GUM ARABIC.
Gum Arabic exudes spontaneously from the bark of a tree that
grows abundantly in many parts of the continent of Africa. " Cal¬
culated by nature for a dry and sandy soil," the tree that furnishes
this gum " flourishes in deserts where no other trees will grow,
and even the date-tree perishes. We are told that the camels
attached to the caravans derive from it their chief sustenance in
many of those desolate regions in which Africa abounds."
Uses.—Gum Arabic, dissolved, is employed as an article of diet
in sickness. The mucilage of it is well adapted to cases of dis¬
ease where the stomach and bowels are extremely irritable, and
where other articles of diet disagree. It is useful as a demulcent,
as well as affording nourishment in catarrhal affections, pleurisy,
inflammation of the lungs, and in inflammation of the urinary
organs. * A very good mode of preparing it is to dissolve it in
composition, pepper, or ginger tea. Prepared in stimulating tea,
I have found it to agree well with patients affected with diarrhoea
and .dysentery, and particularly in bowel complaints of infants
and children. It is not to be exclusively relied upon, however, as
a cure in those forms of disease, but to supply the system with
nourishment, and being combined with a stimulant, another im¬
portant object is obtained. It is asserted that six ounces of gum
Arabic taken daily is sufficient to sustain life in a healthy adult.
The Moors and Negroes who collect this gum, depend almost ex¬
clusively upon it for sustenance whilst they are engaged in collect¬
ing and conveying it to market.
MATERIA MEDICA. 571
*
CIDER.
Sound cider, more especially old bottled cider, has been used 011
many occasions of recovery from sickness, with the best effects,
especially ii^ cases where patients had expressed a desire for it.
The best time for taking it is at, or after dinner and supper.
A pound of the green, or half a pound of the dry burdock root,
and a small root of horseradish, all cut up fine and put to a gallon
of good cider, is a very healthy drink for those whom cider agrees
with, and it is said to prove a powerful preventive to pestilential
diseases.
The roots of burdock, parsley, and horseradish; and mustard-
seed simmered in good cider an hour or more, is a good remedy
in some cases of dropsy. Iron wire put into sound cider forms a
tonic that may be given with especial benefit in many cases of
debility attended with extreme paleness of the countenance, evinc¬
ing deficiency of red blood.
ARROW-ROOT.
Arrow-root is obtained from the root of a plant which is a na¬
tive of South America and of the West Indies.
The greater part of the article kept in the shops called arrow¬
root, is largely adulterated with potato-starch finely prepared. It
is believed by some, however, that potato-starch is equal to arrow¬
root in every particular, except that the former is not so agreeable
to the taste.
Uses.—Arrow-root is employed as an article of diet in fevers,
and in bowel complaints of infants and children.
To make Arrow-root Gruel.—Mix a tablespoonful of the powder
in cold water, to the consistence of paste, and then pour this gra¬
dually into a pint of boiling water, stirring the water as the paste
is poured in. Sweetened with loaf-sugar. For infants and chil¬
dren, arrow-root is usually prepared with boiled milk.
BARLEY WATER.
To make Barley Water.—Take two tablespoonsful of pearl bar¬
ley, wash it in cold water, and then put it into a sauce-pan, adding
a "quart of cold water, place it over the fire and let it boil slowly
until the water is reduced nearly one-half. Barley water may be
rendered more palatable by having a small handful of stoned rai-
572
MATERIA MEDICA.
sins, or some pieces of liquorice root, stewed with it. When
done, it is to be strained. The addition of ginger not only im¬
proves the taste but aflords a mild and pure stimulant, and pro¬
motes digestion.
Barley is mentioned in the earliest records of history as an
article of diet in sickness. It is extensively used in cases of ge¬
neral fever, and in inflammatory affections, when th^condition of
the stomach will not admit of food, except it be in the form of a
demulcent.
To make Milk Porridge.—Take of wheat flour a tablespoonful,
mix it with cold water to the consistency of paste, pour it into a
pint and a half of boiling water, and after boiling fifteen or twenty
minutes, add half a pint of milk. As soon as it begins to boil
again, after the milk is added, it will be fit for use. It must be
salted to suit the taste, and, when patients prefer it, loaf-sugar may
be added.
Milk porridge is much improved in flavour, and suits the sto¬
mach better, by allowing it to become cold before taken. It may
be warmed again if preferred.
Another method.—Take a portion of wheat flour, say a pint or
more, tie it in a bag, and put into boiling water; let it boil four or
five hours. The inside will be hard and dry and thoroughly
baked. The dry part to be grated fine, made into gruel, and a
portion of milk added and made to commence boiling, and then
it is done. Add a portion of salt. This is well adapted to cases
of bowel complaints, both in children and adults. In making gruel
or porridge, ginger tea may be employed in place of water.
Milk porridge, properly made, is an agreeable and nourishing
article of diet, and the one mostly taken during and after a course
of medicine, except in the early stages of violent forms of disease,
as in violent fever, inflammation of the lungs, &c., when the
digestive powers are too feeble for such food.
Cayenne, or black pepper, put into milk porridge, furnishes a
stimulant congenial to the stomach, and promotes digestion.
The folio/wing preparation of food is especially well suited to
infants and children when digestion is very feeble.
Take of boiled milk half a pint, ginger tea, half a gill, lime-
water, half a gill, and slippery elm powder, a heaping teaspoonful.
To make Oat Meal Gruel.—Take of coarsely ground oat meal
three tablespoonsful, and put it in a pint of boiling water; let it
boil gently half an hour, stirring it occasionally. Then strain and
add a little nutmeg, wine, and butter.
MATERIA MEDICA.
573
When the oat meal is finely ground, it should be sifted and
mixed with cold water to the consistence of batter, and then
poured into boiling water, allowing it to boil gently, and to be
stirred frequently.
To obtain the Essence of Beef.—Take from one to two pounds
of fresh lean beef, cut it into small pieces, sprinkle it with a little
salt, and put it into a dry and perfectly clean porter bottle, and
cork it lightly, or into a stone jar, placing a cover on the jar. Set
the bottle or jar into a kettle of water, and boil the water an hour
or more, and then remove it from the fire before the bottle is taken
out, it may otherwise be broken by the sudden change of tempera¬
ture. Essence of beef is highly nutritious and very easy of diges¬
tion, and consequently forms an important article of diet in disease
attended with extreme debility, as in the advanced stages of fevers,
pleurisy, small-pox, dysentery, &c.
Dried Beef Tea.—Boiling water poured upon chipped dried
beef, not smoked, forms a nutritious drink, that agrees well with
the sick.
French Method of making Beef Tea.—Take two pounds and a
half of fresh lean beef, cut it into small pieces, put it into an
earthen pipkin with three pints of water; let this simmer, but
never boil, until the liquor is reduced about half in quantity; then
strain, and add salt if the patient should prefer it salted. This
may be drank either warm or cold.
/
Chicken Tea may be made in the same manner as above de
scribed, and employed for the same purposes.
To make Crust Coffee.—Take some of the crust and thin slices
of stale wheaten bread, toast it thoroughly, so that there shall be
no part of it unbrowned; pour on boiling water, and, after steep¬
ing ten or fifteen minutes, it will be ready for use. It may be
sweetened, and a portion of milk or cream added if the patient
prefer it so. Crust coffee is nourishing, and generally agrees well
with the sick. To be taken cold or warm, as the patient may
fancy.
To make Panada.—Take some slices of stale wheaten bread,
pare off the crusts, and boil them in water four or five minutes,
then take out the bread, and a little of the water it was boiled in,
beat it fine, and add sugar and nutmeg, and if proper, a little fresh
butter and some wine.
574
MATERIA MEDICA.
To make Mutton Broth.—Take two pounds of the lean part of
mutton, and boil it slowly two or three hours in two quarts of
water, adding a proper quantity of salt and some parsley. The
fat must be skimmed off.
By cutting mutton into thin slices and pounding it, half an hour's
boiling will be sufficient.
Chicken broth maybe made in the same way. The chicken to
be cut up before it is boiled. A small portion of rice, or pearl
barley may be boiled with the chicken.
To make Wine-Whey.—Put a pint of new milk into a sauce-pan
that will hold at least two quarts; set it over the fire, and when it
is in full boiling and raised to the top of the vessel, dash in it a
large wineglassful of Madeira or Sherry wine; set the sauce-pan
off, and do not stir it for four or five minutes; then pour the clear
whey from the curd into a bowl, and sweeten it with loaf-sugar.
When it is desired to have the whey more stimulating, use more
wine. Good currant wine may be used when neither the Ma¬
deira nor Sherry can be obtained.
Wine-whey contains a large amount of nourishment, which is
readily absorbed without undergoing the usual process of digestion
in the stomach. It operates, also, as a diffusive stimulant, and
hence it is an important article in the treatment of typhus fever,
and other forms of disease where the vital energies are much
enfeebled.
The chief objection to the use of wine-whey is its tendency to
become acid in the stomach. This, however, may, in a great
degree, be prevented, by adding to each dose of the whey from
five to ten grains of the carbonate of ammonia.
Egg Soup.—Beat up the yolk of a fresh egg and pour on half a
pint of boiling water. A little wine, salt, and sugar, may be added.
This is highly nutritious, and generally sets easy on the stomach.
Another Method.—Take the yolk of a hard-boiled egg, mash it
in a bowl with a silver spoon; then add sufficient of boiling water
to make it thin enough to be drank. It may be seasoned to suit
the taste of the patient.
SUGAR.
Sugar disagrees with many persons in consequence of its ten¬
dency to form acid in the stomach. There are conditions of the
system, however, where sugar is a very important article, both as
food and medicine, especially in long-standing cases of scrofula,
where the system is weak and emaciated. In these cases, it will
often prove highly beneficial by producing better chile, and richer
MATERIA MEDICA. 575
blood than can be produced by other kinds of food. It may be
taken in the form of syrup, rock-candy, or loaf-sugar, and eaten
between the regular meals, provided the patient find it to relish
well, and occasion no unpleasant feelings.
DRYING ROOTS AND HERBS.
The more speedily roots, barks, and herbs are dried after being
collected, the better will their medical properties be retained.
Bayberry root bark, white pond lily root, and other astringent
articles, may be dried either in the sun or in an oven. White
pond lily root cannot be dried properly without either being strung
on a string and hung up, or placed in an oven. Much of the bay-
berry root bark in the market has been so long in drying, that it is
often moulded and in a state of decay. Bayberry root bark should
"be dried in an oven of a moderate heat, and then all its medical
properties will be retained in a state of purity.
Small fibrous roots, such as Virginia snake-root, and American
valerian, may be very readily dried in a warm room, or in the sun.
Medical herbs retain most of their natural flavour and medical
properties by being dried quickly in an oven, at a moderate tem¬
perature, soon after they are collected. When thoroughly dried,
they should be pounded and put into air-tight vessels, or packed
111 boxes and secured from the air and from dampness.
POISONS AND THEIR ANTIDOTES.
The term poison is applied to all substances which, when intro¬
duced into the animal economy, either by cutaneous absorption,
respiration, or the digestive canal, act in a noxious manner on the
vital properties or the texture of an organ. Poisons exist in three
kingdoms of nature, but those which proceed from animals are
often called venoms, as the venom of the viper, scorpion, tarantula,
&c., whilst those that are the products of disease have the name
virus. In common parlance, therefore, poison is restricted to dele¬
terious articles furnished by the mineral and vegetable kingdoms.
Orfila has divided poisons into four classes.
1. "Acrid, Irritating, Corrosive, or Escharotic—such as the
concentrated acids and alkalies; mercurial, arsenical, cupreous,
and antimonial compounds, cantharides, &c.
576
\
POISONS AND ANTIDOTES
2. "Narcotic;—those that act particularly upon the brain; as
opium, hyoscyamus, &c., but without inflaming the organ with
which they come in contact.
3. " Narcotico-Acrid, or Acronarcotic ; — those that act on
the brain, but, at the same time, inflame the parts to which they
are applied; as, aconite, belladonna, &c.
4. "Septic, or Putrescent; — those furnished by the animal
kingdom. See Venom and Virus.
"Various classifications, of a similar character, have been
recommended by different toxicologists; but they are liable to the
objection, that they throw substances together, whose physiological
action on the system is very different. It is, indeed, difficult to
avoid unnatural compression of matters into places not properly
belonging to them, in all such arrangements."—Dunglison's Med
Die.
CONCENTRATED ACIDS.
Nitric and Oxalic Acids.—Antidotes—" Carbonates of magne¬
sia and lime."
Muriatic and Sulphuric Acids.—The antidotes are "the car¬
bonates of soda, potassa, lime, and magnesia; calcined magnesia
also." " In the case of sulphuric acid, water should not be drunk,
on account of the great heat which is produced by their mix¬
ture."
After an antidote has been given, an emetic should be taken
and alkaline injections administered. A heaping teaspoonful of
supercarbonate of soda, or a large teaspoonful of calcined mag¬
nesia, or of sal a3ratus, to half a pint of warm water, may be ad¬
ministered by injection, and repeated as often as it may be deemed
necessary.
Prussic Acid.—" Ammonia is an antidote; but it should not be
employed in a very concentrated form. The cold douche to the
head has been recommended."
CONCENTRATED ALKALIES.
Caustic Potash, Caustic Soda, pure Volatile Alkali, and Quick¬
lime.—Antidotes—The vegetable acids, such as vinegar, lemon-
juice, citric and tartaric acid, in solution, are antidotes to the alka¬
lies and their carbonates. The fixed oils, such as castor, linseed,
%
poisons and antidotes. 577
almond, and olive, form soaps with the free alkalies, and therefore
destroy their caustic effects.
Two tablespoonsful or more of vinegar or lemon-juice should
be added to a glass of water, and the patient continue to drink it
freely; and, as soon as possible, give a lobelia emetic. In difficult
cases the hot air or steam-bath should be employed in the treat¬
ment.
Creosote.—The antidote to creosote is albumen—the white of
eggs-
Corrosive Sublimate.—This preparation of mercury is a deadly
poison; from one to three grains taken into the stomach is suffi¬
cient to produce death.
This poison is decomposed and rendered inert by mixing it with
the whites of eggs. When corrosive sublimate has been taken
into the stomach, the whites of eggs, beaten up in a little water,
should be given as soon as possible, even to the amount of a dozen
eggs or more, and commence at the same time taking freely of
lobelia, either the powder in warm water, or in the form of the
tincture, or third preparation. If eggs are not at hand, let the
patient drink largely of milk in the place of the eggs. No time
should be lost to have something upon the stomach and to excite
vomiting, and whilst other remedies are in preparation, the patient
should drink warm water, and endeavour to excite vomiting by
putting a finger or a feather in his throat. When the system is
poisoned by the external application of corrosive sublimate, the*
same course of treatment will be required as above described.
Arsenic.—The hydrated peroxide of iron diffused through wa¬
ter; or the precipitated carbonate of iron, are the antidotes to
arsenic. Either one should be taken freely until relief is ob¬
tained.
When arsenic has been swallowed, and the antidotes not at
hand, vomiting should be effected as soon as possible. The best
plan of treatment is to mix lobelia, in any form, in warm water
sweetened, and give it freely. Lime-water or animal charcoal
should also be given if at hand. A piece of unslacked lime
thrown into some warm or cold water, will form lime-water in a
few minutes. It should be strained through linen or muslin, as
there will not be time to allow it to settle. To assist in exciting
vomiting, run a finger or feather in the throat. After free vomit¬
ing is produced, the patient should be steamed, kept warm, and
take freely of pure stimulants, as pepper, ginger, or composition
tea, and occasionally a dose of lime-water.
A large dose of arsenic will in general cause vomiting, and,.
37
578 POISONS AND ANTIDOTES.
therefore, is not so dangerous as a smaller one. A large dose of
this poison taken into the stomach and not shortly thrown off by
vomiting, will destroy life in a few hours.
Arsenic is prescribed both by the homcepathic and old school
physicians, in homcepathic doses, as a cure for intermitting fever
and various other complaints: an unreasonable and injurious prac¬
tice, for it only removes one form of disease by establishing an¬
other. The long-continued and distressing dyspepsia which almost
always follows the use of arsenic, is, in nine cases out of ten,
more harassing to the patient and harder to cure than the com¬
plaints for which this poison is prescribed. The best plan of treat¬
ment in cases of dyspepsia occasioned by the use of Fowler's
solution and other preparations of arsenic, is an occasional course
■of medicine, a free use of cayenne pepper with food, or taken
shortly after meals; and a tablespoonful of either animal or vege¬
table charcoal every morning, fasting.
Antimony.—Preparations of this poison, especially the tartarized
.antimony, and antimonial wine, are extensively used in the old
school practice of medicine, to excite vomiting, and in smaller
doses to occasion nausea. These and other preparations of anti¬
mony occasion vomiting upon the same principle that arsenic
causes it. Tartar emetic, when taken in ordinary emetic doses,
if it do not cause vomiting, is apt to produce active purging,
attended by severely griping pain, followed by general prostration
of the digestive powers, and loss of tone in the bowels.
The best antidote for the antimonial preparations is lobelia, given
' in bayberry, sumac, or raspberry leaf tea; or, it may be taken in
strong table tea. After free vomiting is produced, the patient
should continue to drink strong table tea, and stimulants. If the
patient be cold and chilled, a vapour bath must be administered to
aid the operation of the medicine, and to throw the poison out of
the blood, provided any should have been absorbed. In cases
when the vital powers are greatly prostrated by the poison, the
liquid of the third preparation of lobelia should be given as an
emetic, administered in strong bayberry or table tea, or by injec¬
tion.
Copper.—The acetate of copper (verdigris) and the sulphate of
copper (blue vitriol) are actively poisonous. The best antidote is
the wnite of eggs, of which the patient should take freely, and of
some preparation of lobelia, until free vomiting is produced. If
neither eggs nor lobelia be at hand, the patient should drink largely
of warm or cold water, and run his finger or a feather in the
throat to excite vomiting.
poisons and antidotes.
579
Copper vessels should never be used for culinary purposes, un¬
less they be coated inside with a metal not liable to form poisons
with acids. Pickles greened in a copper kettle, contain more or
less poison. Apples stewed in a copper or brass kettle, will taste
of the copper. Iron, earthen, or tin vessels should always be em¬
ployed for making apple butter.
Lunar Caustic—Nitrate of Silver.—The best antidote for
lunar caustic, when swallowed, is common salt dissolved in
water. This should be swallowed freely, and an emetic of lobelia
given.
Nitre—Saltpetre.—Nitre, though often prescribed in the regu¬
lar practice of medicine, is, observes Orfila, " venomous both to
man and to animals, even where applied to wounds."
The direct effect of nitre upon the system, when taken inter¬
nally, is to weaken and destroy vital power. Hence it is called a
sedative, and medical men, governed in their practice by a false
theory of treating disease, employ this article in fever with a view
to lessen arterial excitement. The necessary result of such treat¬
ment is to weaken the restorative actions—to saddle nature with
a greater burden, and, at the same time, cripple her energies.
Nitre has sometimes been taken in doses of from half an ounce
to an ounce, in mistake for Epsom salts. Taken in this quantity,
it is apt to cause violent vomiting, purging of blood, convulsions
and sometimes death.
When a large dose of nitre has been swallowed, the patient
should drink largely of mucilaginous drinks, as flax-seed tea, or
mucilage of slippery elm, and take freely of lobelia until copious
vomiting be produced. If the system be in a cold and torpid con¬
dition, the vapour bath must be employed, and a moderate and
continued warmth applied to the patient in bed, and he should
take freely of pure stimulants, such as cayenne and ginger tea.
This kind of treatment will increase the pow.er of the depurative
functions in working poisons out of the system.
Dr. Samuel Thomson was the first to call attention to the im¬
propriety of employing saltpetre in curing meat. It hardens the
fibres of meat and renders it more difficult of digestion. There
is as much necessity for employing arsenic in curing meat, as
there is for using saltpetre for this purpose. It is probable that
scurvv on shipboard is occasioned by the saltpetre used for curing
the meat used on sea voyages.
Alcohol.—When alcoholic drinks have been taken to the ex¬
tent to induce deep intoxication and insensibility, free vomiting
should be induced, either by means of an active lobelia emetic, or
580
POISONS AND ANTIDOTES.
irritating the fauces with a feather. When the extremities and
surface are cold, external warmth must be applied.
Poisoning from the Fumes of Lead.—This subject is treated of
under the head of painters' colic.
Poisoning- from Swamp Sumac (Rhus Vernix), and from Poison
Vine, and Poison Oak.—The poisonous effects of the above named
articles are usually limited to the surface of the body, and rarely
or never attended by serious consequences. The best external
application is tincture of lobelia, or salt and vinegar. In severe
cases, vapour baths should be administered and an emetic given,
Jhe patient continuing to take broken doses of lobelia in combina¬
tion with composition, pepper, or ginger tea.
Opium.—This poisonous drug is generally taken in the form of
laudanum. Notwithstanding the poisonous nature of this article,
it is one of the general medicines employed in the old school prac¬
tice. It eases pain by occasioning a partial stagnation of blood
in the brain, and in this way blunts the sensibilities—smothering
disease without removing the cause.
When an over-dose of laudanum has been taken, the patient
should be made to vomit as speedily as possible. Lobelia, in any
form, may be given freely, and the patient should be made to drink
of bayberry tea or strong coffee. If the patient be in a stupor,
the liquid of the third preparation should be poured down the
throat, and a tablespoonful of the third preparation administered
by injection, followed by an injection of brown lobelia powder in
warm water, with a view to aid the operation of the emetic.
Mothers would be very cautious how they gave laudahum and
other preparations containing opium, to make their children sleep,
if they were acquainted with the principle of its operation, and
were fully sensible of the injurious consequences which such a
practice is liable to produce, not only upon the physical, but also
upon the mental powers of infants and children.
Belladonna—Deadly Nightshade.—This powerfully narcotic
poison is chiefly found about old buildings, and along walls in
shady places. The plant grows to the height of from two to
ihree feet, and bears a round berry, which is at first green, then
red, and finally they assume a deep purple colour and not very
unlike a cherry in appearance.—Children, allured by the inviting
appearance of the berries, are not unfrequently induced to eal.
Them, and become poisoned.
The symptoms which follow an over-dose of the deadly night-
POISONS AND ANTIDOTES. 581
*
shade are, dryness in the throat, dizziness and a swimming sensa¬
tion in the head, partial blindness, and difficulty of swallowing.
Belladonna is employed to a considerable extent by homcepathic
practitioners, particularly in the treatment of scarlet fever. Strong
poisons, given even in very minute doses, may change the symp¬
toms of a disease; but, instead of aiding the constitution to cast
off disease in the way which nature has provided, the recupera¬
tive actions of the system are weakened, and the designs of na¬
ture frustrated. 'Tis true that patients recover under this treat¬
ment, and probably better than under the old school practice, but
where is the evidence that those patients who get well under such
treatment would not have recovered even more perfectly without
the medicine? Nature does a great deal which medicine gets the
credit of.
The treatment for poisoning from this article should consist in
giving an active lobelia emetic, followed by the use of stimulating
teas.
Strychnia—Nux Vomica.—Strychnia is one of the most active
poisons employed in the old school practice. "With the excep¬
tion of prussic acid, it is perhaps the most violent poison with
which we are acquainted, and should therefore be administered
with great caution."—U. S. Dispensatory.
Administered even in homcepathic doses, it is capable of pro¬
ducing the most distressing symptoms. Professor Chapman, of
the University of Pennsylvania, asserted that he had been called
to two cases of Tetanus produced by strychnia, prescribed by a
homoepathic physician.
The injurious effects of strycnnia are believed to arise from the
poison being absorbed and carried into the circulation.
Treatment.—To clear the system of this poison, give active
stimulants, and apply the hot air bath, or vapour bath. The most
efficient stimulant is the third preparation of lobelia.
Datura Stramonium—Gympson Weed.—This plant, commonly
called Gympson or Jamestown weed, grows about hog-pens, and
in other places where the soil is very strong. The leaves and
seeds of this weed contain a narcotic poisonous principle. Children
' are sometimes poisoned by eating the seeds of this plant. " When
taken in quantities sufficient to affect the system moderately, it
produces more or less cerebral disturbance, indicated by vertigo
headach, dimness or perversion of vision, and confusion of thought,
sometimes amounting to slight delirium, or a species of intoxica
tion."
582 POISONS AND ANTIDOTES.
*
The treatment should consist of emetics and injections followed
by the use of composition and other stimulating teas, and when
the heat of the system is far reduced, the vapour bath will prove
beneficial.
Purified Animal Charcoal an Antidote to all Vegetable Poisons.
By recent numerous experiments, made by Dr. Garrod of Lon¬
don, it has been ascertained that purified animal charcoal is an
antidote to all vegetable, and some of the mineral and animal
poisons.
Dose.—For an adult, a tablespoonful should be taken at once,
and the dose repeated at short intervals until six or eight or more
doses have been taken.
THE END.
INDEX.
A.
Abscess in the Thigh 417
Abscess of the Female Breast 450
Acids 557
Action required to remove diseases, xliii
Ague 55
Alum-Root . 525
Alcohol 579
Alkalies 558
Amaurosis 332
American Valerian 541
Ammonia. Carbonate of. 543
Ammonia Liniment 565
Anasarca 302
Antidotes to Poisons 575
Concentrated Acids 576
Alcohol 579
Antimony 578
Arsenic 577
Belladonna 580
Blue Vitriol 578
Caustic Potash 576
Caustic Soda 576
Copper 578
Creasote 577
Corrosive Sublimate 577
Datura Stramonium 581
Deadly Nightshade 581
Gympson Weed 581
Laudanum 580
Lead Fumes 580
Nux Vomica 581
Opium 580
Nitrate of Silver 579
Poison Vine 580
Swamp Sumac 580
Strychnia 581
Stramonium 581
Saltpetre 579
Verdigris 578
Anthemis Nobilis 533
Anti-Acids 558
Anti-Canker Pills 519
Antimony 578
Animal Charcoal 560
Aiiimal heat, how produced xl
Apocynum Androsemifolium 540
Apoplexy 249
Aphthous Sore Mouth 156
Arsenic, antidote to 577
Arrow-root 571
Ascites 300
Asiatic Cholera 450
Asthma 133
Astringent Poultices 569
Astringent Ointment 567
B.
Bayberry Syrup 518
Bayberry Extract 519
Bayberry (Myrica Cerifera) 517
Balmony (Chelone Glabra) 529
Balsam "Copaiva 549
Fir 550
Tolu 549
Barberry (Berberis Vulgaris) 530
Basilicon Ointment 566
Barley Water .. 571
Barks, Peruvian 526
Extract of. 519
Syrup of. 518
Beach-Drop 525
BeeStings 442
Beef Essence 573
Beef Tea 573
Belladonna 580
Bicarbonate of Soda 558
Biles 408
Bilious Coli c 169
Fever 61
Bite of Mad Dog 290
Bitter Almonds 538
Bitters 526
Bitter Root 540
Bitters No. 4 539
Spiced 538
Ladies 539
Wine 538
Bleeding from the Lungs 370
Nose 370
Stomach 378
Wounds 376
Blindness 331
Bloodletting 471
Bloody Unae 381 ^
Boneset..., 533
Bronchi*. Saasiu®#- 128
(583)
584
INDEX.
Bronchitis, Acute 118
Chronic 122
Bruises 391
Bubo 435
Burdock 552
Burns 404
Broth, Mutton 547
C.
Camphor 544
Liniment 565
Tea 545
Camphorated Julep 545
Camphor, Spirits of. 545
Toothache Drops 545
Caloric xxxix
Canada Balsam 550
Cancer 382
Cancer of the Female Breast 383
Lip 387
Skin 388
Tongue 388
Canker, Thompson's Theory of. liv
Capsicum—Cayenne Pepper 510
Carbonate of Ammonia 543
of Iron 555
Carbuncle 410
Cataract 332
Catarrhal Affections 144
Cathartics, use of. 489
Catnip 551
Catnip Poultice 569
Centaury (Chironia angularis) 531
Caustic, Lunar 579
Chafing in Children 117
Chalk, Prepared 561
Chamomile 533
Chancre 432
Charcoal Poultice 569
Animal 582
Cherry Stone Meats 538
Chicken Pox 92
Chicken Tea : 573
Chilblains 407
Chlorosis 267
Cholera, Asiatic 451
Epidemic 450
Morbus 159
Cider 571
Chordee 431
Cinchona Officinalis 526
Cleavers 552
Colds 143
Colic 158
Bilious 169
Flatulent 158
Painter's 172
Cholica Pictonum 172
Columba 533
Composition Powder 514
Compound Lobelia Pills 508
Constipation 184
Consumption 125
Bronchial 128
Throat 129
Tubercular 126
Conserve of Hollyhock 539
Continued Fever 68
Convulsion Fits 261
Convulsions in Infants 264
Copaiva Balsam 549
Copper, Poisoning by 578
Cornus Cericea 531
Costiveness 184
Cough Powder 564
Cough Mixtures 563
Course of Medicine 460
Course of Medicine, general direc¬
tions for administering 461
Course of Medicine, general direc¬
tions for administering the
hot air bath 461
Course of Medicine, general direc- *
tions for administering the
Steam bath..... .' 462
Course of Medicine, general direc¬
tions for administering the
Emetic 463
Course of Medicine, general direc¬
tions for administering the
Injection 464
Course of Medicine, general direc¬
tions for administering the
second bath 465
Course of Medicine, general direc¬
tions for administering Drinks 465
Course of Medicine, general direc¬
tions for administering Food 465
A Partial Course of Medicine 466
Emetics without steaming 466
Preparing a Patient for a Course 466
Repeating the Course 466
Various symptoms manifested.. 467
Peculiar symptoms produced... 468
Cramp in the Legs and Feet 445
Croup 146
Spasmodic 147
Crow-foot Crane's Bill 525
Cubebs 552
Craziness from Drinking 344
Crust Coffee 573
D.
Datura Stramonium 581
Deafness 362
Deadly Nightshade 580
Decoction of Sarsaparilla 554
Delirium Tremens 344
Derangement of the Mind 338
Dewberry 524
Diabetes 228
Disease defined xlvi
INDEX.
585
Diarrhoea ... 1 78
!?tany 550
Dropsy 299
in the Belly 300
Brain 307
Chest 301
Cellular Tissue 302
Of the Scrotum 306
Drying Roots and Herbs 575
Dried Beef Tea 573
Dulness of Hearing 362
Dysentery 174
Dyspepsia 187
E.
Earache 358
Elixir of Vitriol 558
Egg Soup 574
Emollient Poultices 568
Emetics 463
For Children 467
General utility of. 482
Enemas 495
Enlargement of the Uvula 157
Epilepsy 261
Erigeron Philadelphicum 551
Canadense 551
Essence of Beef. 573
Eupatorium perfoliatum 533
Evan-root 522
Extract of Bayberry .' 519
Bayberry pills 519
Sheep Sorrel 386
Clover 386
Eyes, Inflammation of from cold.... 320
Rheumatic inflammation of.... 322
Scrofulous inflammation of 327
Suppurative inflammation of... 324
F.
Fainting .' 276
Falling of the Palate 157
Sickness 261
False Labour Pains 478
Membrane
Felon 413
Fever 55
Continued 68
Congestive * 68
Intermittent - 55
Nervous 68
Putrid 68
Remittent 61
Scarlet 96
Typhoid 68
Typhus 68
Yellow 68
Fir Balsam. 550
Fistula Lachrym.ilis 337
Fits, Convulsii■.i 261
Hysteric 270
in Infants 264
Fluor Albus 441
Frozen Limbs 407
G.
Garlic 542
Syrup 564
Oxymel of 564
Galls (Gall®) 523
General Insanity 340
Geranium Maculatum 525
Gentian 531
Geum Rivale 523
Ginger 515
Porridge 516
Tincture of. 516
Gleet 431
Goitre 315
Golden Seal 530
Gonorrhoea 427
Gout 215
Chronic 217
in the Stomach or Kidneys 219
Green Sickness 267
Grippe 143
Gum-elastic 566
Gurn Hemlock Plaster 567
Guaiacum Wood 555
H.
Hamamelis Virginiana 523
Headache, ordinary 351
Sick 351
Another variety 355
Heart, Palpitation of. 363
Structural Disease of. 365
Helonias Dioicia 537
Hsematemesis 378
Hemiplegia 255
Hemlock Plaster 567
Hemorrhage from the Lungs 370
Nose 370
Wounds 376
Hernia, or Rupture 449
Strangulated 449
Heuchera Americana .< 525
Hickory Ashes 559
Hip Disease 415
Hives 104, 146
Horehound 551
Honey 551
Hops 542
Hot Air Bath 474
Hydrastis Canadensis 530
Hydrocephalus 307
Hydrocele 306
Hydrophobia 290
Hydrothorax 301
Hypochondriasis 277
Hypopyon 334
, Hysteria 270
I Hysteric Fits 270
586
INDEX.
I.
Incontinence of Urine 236
Indian Hemp 540
Indigestion 187
Infantile Convulsions 264
Infant's Sore Mouth 156
Inflammation a Curative Action 1
of the Bladder 224
of the Eyes from Cold 320
Rheumatic 322
Scrofulous 322
Suppurative 323
of the Iris 333
of the Kidneys 220
of the Liver 240
of the Liver, Chronic 242
of the Peritoneum 180
Inflammatory Sore Throat 150
Influenza 143
Injections 495
Simple Astringent 497
Simple Lobelia 497
of Turpentine 500
Tonic 500
Insanity 338
General 340
Partial 341
Intermittent Fever 55
Iritis 333
Itch 115
J.
Jaundice 266
K.
Kidneys, Chronic Disease of 223
Inflammation of. 220
Kine Pox 87
L.
Lacerated Wounds 400
Lachrymal Fistula 337
Ladies' Spiced Bitters 539
Laryngitis, Acute 154
Chronic 155
Lemon Juice 558
Lime Water 561
Life xxxix
Lobelia Inflata 501
Brown 505
Green 505
Syrup of. 505
Third Preparation of 506
Tincture of. 505
Pills 508
Locked Jaw 286
Low Spirits 277
Lunar Caustic 579
Lumbago 214
Lupus 388
Lycopus Virgi licus 555
M.
Mallows Poultice 569
Mania 340
Mania-a-Potu 344
Materia Medica i 501
Measles 93
Medicines for Canker 117
Mental Derangement 338
Menstruation, Obstruction of. 439
Milk Porridge 572
Mustard Plaster 568
Muriatic Acid 576
Mumps 152
Myrica Ccrifera 517
Myrrh 535
Poultice 570
Tincture 534
Pills 534
N.
Narcotic Poisons 576
Nature the real Physician xlii
Nervous Fluid governs Motion xlii
Nervousness 442
Nervines 541
Nerve Powder 541
Nettle Rash 104
No. 5 Syrup 536
No. 3 Anti-Canker Pills 519
No. 6 535
Nitrate of Silver 579
Nitre 579
Nux Vomica 581
Nutrition, the Basis, Life, Action ... xli
Nymphia odorata 522
O.
Oatmeal Gruel 572
Obstructed Menstruation 439
Oil of Amber 547
Anise-seed 548
Caraway 548
Horsemint 547
Juniper 548
Peppermint 548
Turpentine 545
Opium 580
Opodeldoc 565
Ophthalmia 320
Purulent 323
Scrofulous 327
Oxalic Acid 576
Oxymel of Garlic 564
P.
Palpitation of the Heart 363
Palsy of one side 255
of the lower half of the body 255
Panada 573
Paralysis 254
Paraplegia 255
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