| tBRAPtY OF CWGRESS. || 
 
 ; TATESOFAJ[EJUCA.l 
 
AN 
 
 EPITOME 
 
 OF THE 
 
 AMERICAN ECLECTIC 
 
 PRACTICE OF MEDICINE: 
 
 EMBRACING 
 
 PATHOLOGY, SYMPTOMATOLOGY, DIAGNOSIS, 
 PROGNOSIS, AND TREATMENT. 
 
 CONTAINING, ALSO, 
 
 A COMPLETE LIST OF THE REMEDIES USED BY 
 
 ALLOPATHISTS, HOMCEOPATHISTS, AND 
 
 HYDROPATHISTS, AND AN ECLECTIC 
 
 PHARMACY AND GLOSSARY. 
 
 DESIGNED FOR 
 
 PHYSICIANS, THE STUDENT OF MEDICINE, AND AS A 
 DOMESTIC PEACTICE FOR FAMILIES. 
 
 BY 
 
 WILLIAM PAINE, M.D., 
 
 PROFESSOR OF THE PRINCIPLES AND PRACTICE OF MEDICINE AND PATHOLOGY 
 IN THE ECLECTIC MEDICAL COLLEGE OF PENNSYLVANIA, PIHLA. 
 
 51 
 
 EETH^ 
 185T 
 

 Entered, according to Act of Congress, in the year 1857, by 
 
 WILLIAM PAINE, 
 
 in the Clerk's Office of the District Court of the United States for the Eastern 
 District of Pennsylvania. 
 
 STEREOTYPED DY J. FAOAX, PHILADELPHIA. 
 
 PRINTED BY BMITH»4 PETEBS, 
 
 Franklin Buildings, Sixth Street, below Arch, 
 
 Philadelphia. 
 
TO MY COLLEAGUES, 
 
 PROFESSORS CHASE, SITES, HOLLIMBAU, CALKINS, AND HOLLAND, 
 
 IX CONSIDERATION OF THEIR 
 
 EARNEST EFFORTS IX THE CAUSE OF 
 
 MEDICAL PROGRESS, 
 
 THIS WORK 
 
 £s ^vcs^cctxullD E-nacvifoefi bv 
 
 THE AUTHOR. 
 
 (iii) 
 
LIST OF SOME OF THE PRINCIPAL AUTHORS 
 REFERRED TO IN THE PREPARATION OF 
 THIS WORK. 
 
 TriE American Eclectic Practice of Medicine, by Jones and 
 Morrow; The Eclectic Practice of Medicine, by Newton and 
 Powel; Newton and Calkins' Work on Thoracic Diseases; Ameri- 
 can Eclectic Dispensatory, by John King, M. D. ; The Eclectic 
 Medical Journal; Middle States' Medical Reformer ; The College 
 Journal of Medical Science ; The Worcester Journal of Medi- 
 cine ; The Syracuse Medical and Surgical Journal ; Massie's 
 Eclectic Practice ; Fondey on Tuberculous and Scrofulous Dis- 
 eases ; Dickson on Chronothermalism ; Eberle's Practice of 
 Medicine ; Clymer on Fevers ; Boisseau on Fevers ; Craigie on 
 Pathology ; Andral on the Abdomen ; Taylor's Medical Juris- 
 prudence ; Dunglison on New Remedies ; Mcintosh's Practice 
 of Medicine ; Lehmann's Chemical Physiology ; Simon's Che- 
 mistry of Man ; Renouard's History of Medicine ; Jahr and 
 Grnner's Homoeopathic Pharmacopoeia; Hull and Laurie's 
 Homoeopathic Practice ; Pulte's Homoeopathic Practice ; Jahr's 
 Manual of Homoeopathy ; Hydropathic Encyclopedia, by Dr. 
 Trail ; Walsh on Diseases of the Lungs and Heart ; American 
 Eclectic Obstetrics, by John King, M. D. ; American Journal 
 of Medical Science ; Carpenter's Physiology ; Family Medical 
 Library, by William Buchan. 
 
 (iv) 
 
PREFACE. 
 
 This volume presents an Epitome of the Ameri- 
 can Eclectic Practice of Medicixe. It is designed 
 as a note-book for the profession, in which, is re- 
 corded many valuable facts relative to the prin- 
 ciples and practice of medicine, and as an assistant 
 to the student in his medical acquirements; also, 
 as a guide to domestic practice for families. My 
 object, in the preparation of this work, has been to 
 record, in a condensed form, what I conceive to be 
 true relative to the present condition of practical 
 medicine, and to give the American Eclectic Treat- 
 ment of disease, which has proved so signally suc- 
 cessful in my hands. Also to enable the public to 
 judge more correctly of the respective merits of 
 the different systems of medicine. 
 
 To accomplish this, I have referred to standard 
 works of Allopathy, Homoeopathy, and Hydro- 
 pathy ; and, in each case, have given the author's 
 own words. The object of this was to allow each 
 1* (v) 
 
VI PREFACE. 
 
 medical system to explain its own position. I 
 have also given, in a condensed form, the character- 
 istic symptoms of most of the diseases peculiar to 
 this country, as manifested during their progress. 
 The practical part of the work has been prepared 
 with especial care, that it might serve as a safe 
 and efficient guide, to the profession and the public, 
 for the speedy removal of disease; and if this 
 volume contributes, in any essential degree, to 
 alleviate human suffering, and to advance the 
 cause of true medical science, I shall feel myself 
 measurably compensated for the arduous task of 
 preparing it. 
 
 THE AUTHOR. 
 
PEACTICAL PEINCIPLES 
 
 AMERICAN ECLECTIC SYSTEM OF MEDICINE. 
 
 In endeavoring to lay down some of the principles "which 
 form a basis to the American Eclectic System of Medicine, it 
 would be presumption, in me, to attempt to do more here than 
 give an outline of what we consider to be the true principles 
 which govern the great American movement for reforming the 
 medical profession. Before entering upon a discussion of these 
 principles, however, I cannot refrain from stating what I con- 
 ceive to be true relative to the present condition of the healing 
 art. 
 
 1st. That a large majority of cases treated by all classes of 
 physicians, are cured by nature and not by medicine. 
 
 2d. That in many cases nature removes the disease in spite 
 of medicine. 
 
 3d. That many fatal cases would have recovered, were it not 
 for medical interference. 
 
 4th. That the Allopathic practice of treating cases by mer- 
 cury, blisters, antimony, blood-letting, &c, is so far from saving 
 life as to be absolutely a prolific source of disease and death. 
 
 5th. That the homoeopathic practice of saturating the system 
 with small doses of arsenic, mercury, dog-button, antimony, 
 lachesis, &c, although the effects are not as immediate as when 
 taken in large doses, yet in their tendency to derange the blood, 
 and lay the foundation for scrofula, consumption, dropsy, dis- 
 ease of the stomach, liver, and uterus, with other diseases of a 
 fatal character, makes this practice equally disastrous to health 
 and life. 
 
 (<; 
 
8 PRACTICAL PRINCIPLES. 
 
 6th. That, although hydropathy is frequently a valuable 
 auxiliary in the treatment of disease, yet, when unskilfully 
 and untimely applied, it becomes an additional cause of sick- 
 ness and death. 
 
 7th. That the entire catalogue of patent medicines are pro- 
 ductive of an immense amount of disease, suffering and death. 
 
 8th. That advertising physicians, such as Analytic, Uriscopian, 
 cancer doctors, &c, together with the entire herd of nostrum 
 venders, are only so many professional knaves, who defraud the 
 people of their money, their health, and their lives. 
 
 9th. That although the American Eclectic System has for its 
 object and aim the correction of the abuses of the profession, 
 as well as the determinate purpose to prevent the administration 
 of medicines fraught with evil tendencies to life or health, yet 
 from ignorance, or other cause, the medicines may be improperly 
 administered, and thereby lessen the chances of recovery. 
 
 In making these statements, I do not wish to be understood to 
 deny the power of medicine over disease when properly admin- 
 istered, neither would I say that Allopathy, Homoeopathy, &c, 
 are never employed with benefit to the afflicted. But as prac- 
 tised by a large majority of that class of physicians, who are 
 ignorant of the true nature of disease, as well as the correct 
 principles of cure, they are infinitely more injurious than 
 beneficial. 
 
 This class of practitioners, to shield their ignorance, attack, 
 in the most vehement manner, every improvement in the pro- 
 fession which in the least conflicts with their narrow and 
 illiberal views. It is this class of the profession who have 
 contributed so largely, to the persecution of every attempted 
 improvement in the practice, and unfortunately they have 
 always been sufficiently numerous to control, in a great measure, 
 its destiny. Thus while every other branch of physical science 
 has made gigantic strides, the progress of medical science has 
 been comparatively slow. While Geology has explored the 
 earth from centre to circumference, and reads, from every tablet, 
 the mighty creative power of Him who has thus wonderfully con- 
 structed it; while Astronomy not only encircles this solar 
 system, but gazes beyond, upon millions of suns and adaman- 
 tine spheres that wheel unshaken through the immensity of space; 
 
PRACTICAL PRINCIPLES. 9 
 
 while Chemistry has analyzed and explained nearly every 
 animal, vegetable, and mineral substance; while Zoology and 
 Botany give unmistakable evidence of uninterrupted progress ; 
 while, by the endless variety of labor-saving machinery, the 
 improved method of printing, the transmission of thought with 
 lightning speed to earth's extreme, the iron horse which break- 
 fasts in the valley of the Mississippi, dines upon the rocky 
 Alle^hanies, and sups on the borders of the Atlantic, with other 
 innumerable inventions, show that the arts, in progress and 
 improvement, keep pace with the march of time ; while the 
 powerful engines of Christian fidelity have burst the bonds of 
 Catholicism, and unfurled the banner of religious liberty, which, 
 for more than three centuries, has floated high in the pure breeze 
 of Christian freedom ; while also the improvement in the moral 
 condition of mankind is seen in the glorious works of reforma- 
 tion, which are so zealously carried on ; while such extensive 
 progress has been made to the perfection of art and every other 
 department of science, it will be seen by reference to fact, that 
 every attempt to improve the healing art, has met such bitter 
 opposition ; that, comparatively, its progress has been slow, and 
 it is far from occupying that advanced position in the ranks of 
 science which its importance demands. 
 
 Harvey, who discovered the circulation of the blood, was called 
 the circulator, in derision. He was deprived of the right to practise 
 his profession in his own country; was threatened with banish- 
 ment, and finally was compelled to leave his native land, to 
 escape the obloquy that was heaped upon him, and died with- 
 out realizing the benefit of his labors. 
 
 In 1522, Ambrose Pare first introduced the ligature, and tied 
 the artery, instead of plunging the limb into boiling tar, as was 
 practised by his cotemporaries. He was denounced, with the 
 most reckless violence, for daring to suspend the life of a man 
 upon a mere thread. In 1638, the Countess of Cinchon, wife of 
 the ex-king of Peru, was laboring under a fever, from which 
 she was unable to obtain relief. The Governor of Loxa, having 
 learned from the natives the curative powers of the Cinchona, 
 advised her to employ it. After much hesitation, she resolved 
 to try it, and was by its use restored to health. Ten years 
 afterwards, a Jesuit of Rome endeavored to introduce the Peru- 
 
10 PRACTICAL PRINCIPLES. 
 
 vian Bark into Europe ; but his efforts were unsuccessful. The 
 profession proclaimed at once that it was a Papish remedy, and 
 proceeded from Quacks, who created all manner of disease. 
 Protestant England called it a Papish remedy, saying that it 
 proceeded from the father of all Papists, the Devil. It was not, 
 until in spite of all opposition, its utility was demonstrated, 
 that physicians availed themselves of its curative powers. 
 
 Lady Mary Wortley Montague, while in Turkey, observing 
 the wonderful effect of inoculation for small-pox, to mitigate the 
 severity of that much dreaded disease, determined to introduce 
 the practice into her native country. But no sooner did she make 
 known her purpose, than the medical faculty arose at once and 
 predicted the most disastrous consequences. The clergy de- 
 scanted from the pulpit on thus seeking to take events from the 
 hand of Providence. In order to satisfy the profession and the 
 people of the great utility of inoculation, she resolved to experi- 
 ment upon her own daughter, and government appointed four 
 of the best medical men to observe its progress. Lady Montague 
 states, that they not only manifested the greatest incredulity as 
 to its success, but also such an unwillingness to have it succeed, 
 that she was absolutely afraid to leave her daughter in their 
 hands, lest she should suffer from their interference. 
 
 In 1790, Dr. Jenner, of Gloucester, remarked that the disease 
 known in the western part of England as cow-pox, communi- 
 cated to those who milked the cows, precluded those who became 
 thus affected from being infected with small-pox. This strange 
 fact suggested to him the idea of inoculating children with 
 virus directly from the udder of the cow, which he accord- 
 ingly did, and in the course of four or five days he saw pustules 
 developed at all points where the skin had been punctured, 
 similar to those of cow-pox ; when the pustule broke, the pus 
 dried, forming a thin scale or crust, which, falling off, left a 
 cicatrice. There was little or no fever, the children continuing 
 to eat and play as usual. After repeated experiments of this 
 kind, Dr. Jenner became satisfied of its being a preventive of 
 small-pox, as not a single child thus inoculated was attacked 
 with it. But how was the discovery received by the illiberal 
 and dogmatical portion of the profession ? With ridicule and 
 contempt, like every other proposed improvement. Jenner was 
 
PRACTICAL PRINCIPLES. 11 
 
 persecuted, oppressed, and driven from his country ; even re* 
 ligion and the Bible were made engines of attack against him 
 and his invention. Errhman, of Frankfort, attempted to prove 
 from Scripture that vaccination was the anti-Christ. At that 
 time small-pox was the scourge of the human family, and, but 
 for the discovery of Jenner, would have remained such until the 
 present time. 
 
 In 1315, Mondini dissected two human bodies, and shortly 
 after published his Epitome of Anatomy, illustrated with wood- 
 cuts. At this time, and for a long time afterward, it was cus- 
 tomary to demonstrate anatomy upon the hog and other animals. 
 The act of Mondini was considered heresy. The persecution 
 of Mondini, together with the prejudice existing upon the sub- 
 ject at the time, prevented any other dissection of a human 
 subject for more than a century ; and Mondini, in his experi- 
 ments, dared not open the dead for fear of committing a mortal 
 sin. It was not until the commencement of the sixteenth 
 century that dissections for anatomical purposes were made, 
 and then they were performed by the authority of the Pope, and 
 not at the instigation of the medical profession. 
 
 The natives of Brazil first taught the medicinal qualities of 
 ipecac; but, owing to the opposition with which it was met by 
 the medical profession, it was more than a quarter of a century 
 before its virtues were appreciated. A Mexican soldier, more 
 than half a century ago, demonstrated the styptic properties of 
 the Matico, and its entire control over the bleeding vessels of 
 the body ; but such is the tendency to oppose every new remedy 
 that, as yet, it is never employed by the mass of the profession. 
 Dr. Samuel Thomson discovered and proved the valuable 
 medical properties of Lobelia; but on modestly making known 
 his discovery to the profession, it was not only denounced, but 
 he was persecuted and imprisoned. At this time we find 
 medical men using it in disguise, and at the same time denounc- 
 ing its discoverer. In 1823, an association of scientific medical 
 men, from different parts of the country, met in New York city, 
 and made preparation for organizing a reform medical college ; 
 when, by the indomitable energy of Dr. Beach, the first reform 
 medical college in the world was organized. 
 
 The object of this organization was to break the shackles of 
 
12 PRACTICAL PRINCIPLES. 
 
 Hunkerism ; to open the science of medicine to all bold and 
 thorough investigators ; to enlarge and improve the materia 
 medica ; to investigate more fully and clearly the nature and 
 character of disease peculiar to the country and climate, and 
 to place the entire profession upon a more liberal and scientific 
 basis. But no sooner was the object and aim of this institution 
 announced, than a majority of the profession commenced an 
 attack upon it, denouncing, violently, all who were indentified 
 with this philanthropic movement. Dr. Beach, its founder, 
 although, a man of learning, and a graduate of one of the first 
 allopathic colleges in the country, was assailed with terms of 
 insolence and reproach, and all those who had the courage to 
 participate in the work shared the same fate. To all who are 
 in any considerable degree acquainted with the history of 
 medicine, it is obvious that this conservatism, which has long 
 been a characteristic of the professon, has had a most disastrous 
 influence upon its progress. 
 
 The conservative, always ready to apologize and explain the 
 reasons for his ungenerous course, with all complacency affirms 
 that to talk of improvement is but a dream ; that the fathers of 
 the profession have left us their knowledge as a choice legacy, 
 which we should keep in grateful remembrance ; that the pro- 
 fession has already attained a position which entitles it to the 
 highest respect. 
 
 Yet the positive uncertainty of medicines is manifested in a 
 striking degree, as we trace the history of particular remedies, 
 recommended by those who are reverenced as almost divine 
 authority by the conservative. What differences of opinion — 
 what an array of alleged facts directly at variance with each 
 other — what opposite results of like experience — what ups and 
 downs, glorifications and degradation, confidence and despair — 
 arose in treating the same disease with the same remedies. To 
 be satisfied upon this point we ne§d only refer to the history of 
 one or two prominent diseases, viz : pneumonia and syphilis. 
 Mercury, antimony and blood-letting have been regarded as 
 specifics in these diseases by many authors, while others of equal 
 pedantry and learning have rejected them as useless and injuri- 
 ous. Such has been the uncertainty of practical medicine, that 
 even the conservative portion of the profession, if they become 
 
PRACTICAL PRINCIPLES. 13 
 
 in the least enlightened, omit the heroic and adopt the expect- 
 ant or tentative mode of practice. The foregoing facts disclose 
 a lamentable state of things, but not a state to be despaired of; 
 *fruch less is it one to be concealed. It is our duty as guardians 
 of the lives and health of our fellow-beings, to unmask, not only 
 the virtues, but the faults of the profession. The course of our 
 subject "will now lead us to attempt to disclose in what the de- 
 fects of the allopathic system of practice mainly consist ; the 
 cause of these, and the means which seem best calculated to 
 remove them. Also the principles which govern the Young 
 American Physic. In order to fully understand why the allo- 
 pathic system of practice is not more successful in removing 
 disease, it will be necessary to enter more fully into its princi- 
 ples of cure and therapeutic resources. For the investigation of 
 these, it will be necessary to enter somewhat into the history of 
 medicine. Pliny states that, if there exist any nation in which 
 at any epoch of its history physicians were not found, there 
 is none in which traces of medicine were not visible. It is pro- 
 bable that medicine has existed, either as an art or science, 
 from tha earliest period ; and that the practice of medicine had 
 its existence in the natural tendency of the soul to resist death, 
 together with benevolent impulses towards the sufferings of 
 others. 
 
 The earliest and most authentic account we have of the 
 practice of medicine, is that given of Centaur Chiron, a prince 
 of Thessaly, who went out in the expedition against Troy. From 
 all accounts we have of his practice, it was exceedingly empirical, 
 and consisted in the external application of a few remedies to 
 wounds, &c, together with incantations and ceremonies to affect 
 the imagination. Chiron transmitted his profession, according 
 to custom, to his son iEsculapius, and iEsculapius to his two 
 sons, Machaon and Podalirius. 
 
 Fifty years after the destruction of Troy, a temple was 
 erected at Titan as, a city of the Peloponnesus, in honor of 
 iEsculapius, who was worshipped as a god. The worship of this 
 god very soon spread throughout Greece and passed into Asia, 
 Africa, and Italy. Multitudes of temples were consecrated to 
 him, among which those at Epidaurus in the Peloponnesus, at 
 Pergamos in Asia, on the island of Cos, and at Cyrene, a city 
 
14 PRACTICAL PRINCIPLES. 
 
 of Libya, were particularly famous. In the temple at Epidaumus 
 there was a statue of colossal size representing the god of 
 medicine, under the figure of an old man, seated on a throne, 
 holding in one hand a sceptre, and resting the other on the head 
 of a large serpent ; a dog, the emblem of vigilance, rested at his 
 feet. The statue was of gold and ivory, and was the workman- 
 ship of Grasymedus. Socrates, it is said, in his last discourse 
 with his friends, requested them to offer for him a cock, as a 
 sacrifice to iEsculapius ; whence we infer that this bird was 
 sacred to the god of medicine. 
 
 The priests attached to this worship were named Asclepiades, 
 or descendants of iEsculapius. They regarded all the knowledge, 
 relative to disease and medicine, as sacred, their laws forbidding 
 it to be revealed to the non-elect, lest their god should be angry ; 
 strangers were not admitted to this knowledge until they had 
 been subjected to certain ceremonies called the tests of initia- 
 tion. 
 
 These temples were erected in the midst of the most delight- 
 ful scenery ; no pains were spared to furnish them with the 
 most agreeable and healthful diversions ; they breathed a pure 
 air, were subjected to a wholesome regimen, and every possible 
 means was used to affect the mind and imagination agreeably ; 
 thus exercising a healthful and happy influence upon the con- 
 stitution. Fasting and prayer were strictly enjoined upon the 
 patients, also abstinence and sacrifices, before they were admitted 
 to receive the response of the oracle. Those who were benefited 
 went to their homes blessing the author of their recovery, and 
 those who were not benefited redoubled their efforts to propitiate 
 the god in their favor. Besides these means, remedies were used, 
 not unlike those now in vogue, consisting in bleeding, purga- 
 tives, vomiting, friction, mineral water, &c. 
 
 There existed in the country, about Epidaurus, serpents of a 
 yellowish brown color, whose bite was not poisonous, and which 
 were easily tamed. 
 
 These were employed by these priest-doctors to more effectually 
 impress the minds of their patients with wonder and astonish- 
 ment at their supposed power, which, from all accounts, had the 
 desired effect. Aurelins Victor relates, that during the year 
 350 of the foundation of Rome, that city was scourged by a terrible 
 
PRACTICAL PRINCIPLES. 15 
 
 pestilence ; the Senate sent six deputies to consult the oracle at 
 Epidaurus. 
 
 On arriving at the temple, suddenly an enormous serpent 
 issued from beneath the pedestal. The sight of it filled every 
 mind with veneration more than with terror. He moved tran- 
 quilly through the crowd and entered the vase of the Romans 
 in the chamber of Ogulnius, the chief of the ambassadors. The 
 serpent was sacredly borne away, and when the ambassador 
 was approaching the city of Romulus it sprang into the waves 
 and swam to an island in the Tiber, where a temple was imme- 
 diately erected to iEsculapius, and the pestilence ceased. 
 
 It can hardly be doubted that the priest-doctors of these 
 temples were endowed with strong natural powers of mind ; that 
 they understood the influence of mind over matter; and that a 
 strong belief in their ability to cure, contributed in a very con- 
 siderable degree to their success. The teachings in these 
 temples were confined to the family of JEsculapius for some 
 eight or nine hundred years. After a time they became more 
 general, assuming more of the character of the medical colleges 
 of the present day. Their means of teaching was confined 
 mostly to tablets hung upon the walls and columns of the 
 temples, showing the name of the patient, the disease, and the 
 manner in which it was treated. One of these tablets, found on 
 the island in the Tiber, the site of the ancien^ iEsculapian 
 temple, bears the following inscription in Greek characters : — 
 Lately a certain Caius, who was blind, came to consult the 
 oracle. The god required that he approach the sacred altar to 
 perform certain adorations ; at once he passed from the right to 
 the left, and having rested his fingers on the altar, he raised his 
 hands and applied them to his eyes, whereupon he recovered 
 his sight immediately in the sight of all the people, who 
 rejoiced to see such marvels performed in the reign of our 
 august Antoninus. Upon the same tablet is the account of one 
 Julin, who had pleurisy, and the gods ordered that the ashes of 
 the altar be put into wine and applied to his side, which being 
 done, he was immediately cured. Another man, Valerius Aper, 
 was blind, and the gods ordered an ointment of the blood of a 
 white cock and honey to be applied to his eyes, which was done, 
 and his sight restored. The only principle which guides these 
 
16 PRACTICAL PRINCIPLES. 
 
 priest-doctors in the administration of medicine for the cure of 
 disease, was, that remedies, which have once cured, will cure 
 again under similar circumstances. 
 
 The practice of medicine, in the temples, was continued until 
 about the commencement of the Christian era. Pythagoras, who 
 was born in the year 500, B. C, at Samos, one of the most 
 flourishing islands in the iEgean sea, having one day heard a 
 lecture on the immortality of the soul by Pherecydes, was so 
 charmed that he renounced every other occupation to devote 
 himself to philosophy. He travelled among the most enlight- 
 ened nations, obtaining extensive knowledge in every art and 
 science cultivated at that early period, and that of medicine 
 among others. It was Pythagoras who first introduced the 
 practice of visiting patients in their own houses ; he also 
 rejected all theories in medicine, and contended that experience 
 was the only safe guide to a successful medical practice. Hip- 
 pocrates, who was born on the isle of Cos, 460 B. C, was one 
 of the first reformers in medicine we have any account of. He 
 was one of the direct descendants of JEsculapius, and received 
 his education at Cos, which contained a temple dedicated to 
 iEsculapius, and a medical school ; thus his advantages for 
 acquiring a medical education were very favorable. He was 
 not satisfied, however, with this instruction, and extended his 
 researches into the principal Greek cities of Europe and Asia, 
 taking a survey of the art of medicine as it then existed, which 
 was in a state sadly deficient and imperfect ; the ideas of dis- 
 ease, and principles of cure, being of an exceedingly vague and 
 uncertain character. He consequently commenced a- series of 
 experimental investigations into nearly every department of 
 medicine. 
 
 He opened an earnest warfare upon the superstitious cere- 
 monies of the JEsculapian priests, and advocated the custom, 
 introduced by Pythagoras, of visiting patients at their own 
 houses. He also classified and arranged diseases and remedies 
 in a much more systematic manner than had hitherto existed, 
 and introduced a variety of new remedies, which proved exceed- 
 ingly valuable in the treatment of disease. His system of 
 Therapeutics was, however, similar to his predecessor; depending 
 in his choice of remedies upon those which experimental observ- 
 
PRACTICAL PRINCIPLES. 1*1 
 
 ation had proved beneficial in removing disease. To show the 
 reader how slightly the treatment of disease, twenty-two centuries 
 ago, differed from that of a class of practitioners at the present 
 time, I will here introduce the treatment for pleurisy, given by 
 Hippocrates, as translated by Renouard. 
 
 "It is necessary to examine, in the following manner, the 
 peripneumonic and pleuritic affections; if the fever is acute ; if 
 there is pain in one or both sides of the chest ; if the patient 
 suffers during expiration ; if he coughs, and the expectoration 
 is rusty or livid, or thin and frothy, or of a blood-red — if, in 
 fine, it differs at all from that which is natural, the following 
 course must be pursued : the pain extending above and towards 
 the clavicle, or towards the vein and the arm, the internal vein 
 of the arm on that side should be opened. The quantity of 
 blood drawn should be proportional to the constitution of the 
 body, the season of the year, the age and color of the patient ; 
 and if the pain is acute, the bleeding should be boldly pushed to 
 syncope ; afterward an injection is to be administered. 
 
 " If the pain occupies the inferior region of the chest, and is 
 very great, you should prescribe for pleuritics a mild purgation ; 
 but the patient must taste nothing else whilst the medicine is 
 operating. After the purgation they should have an oxymel.* 
 The purgation should not be administered until the fourth day ; 
 during the first three days injections should be employed ; but 
 if they are not sufficient, the purge should be given, as above 
 said. He must be watched until the fever ceases, and the 
 seventh day is attained ; after that, if he appears out of danger, 
 he may take a little barley-water, sweetened with honey. If the 
 convalescence progresses and the respiration is good, the tisane f 
 may be given twice a day, and be gradually increased in quan- 
 tity and strength ; but if the convalescence is slow the drink 
 must be lessened, and a small quantity of weak tisane, for 
 nourishment, once a day. It should be given when the patient 
 is in the best condition, as may be known by the appearance of 
 the urine. 
 
 " To those who approach the close of the disease, it is not 
 necessary to give the tisane before you see the coction manifested 
 in the urine or expectoration ; nevertheless, if, when purged, the 
 
 * Decoction of barley. f Oxymel, honey and vinegar syrup. 
 
 2* 
 
18 PRACTICAL PRINCIPLES. 
 
 patient has abundant evacuations, it is necessary to give the 
 tisane, but in less quantities and weaker, otherwise the empti- 
 ness of the vessels would allow him neither to sleep, nor to 
 digest, nor to await the crisis. With this exception, the crude 
 humors should be liquefied, and whatever has been the obstacle 
 should be ejected : then nothing prevents alimentation. The 
 expectoration is perfectly concocted when it appears like pus : 
 the urine, also, when it has a red sediment like brick-dust. 
 
 " As to the pain in the side, nothing contra-indicates the uso 
 of fomentations and wax-plasters. The legs and arms should 
 be rubbed with warm oil and then anointed with fat. The 
 hypochondria should be covered as high as the breast with a flax- 
 seed poultice. When the peripneumonia has reached its height, 
 nothing can be accomplished without purgation : it is bad if the 
 patient has dyspnoea, or if the urine be thin and acid, or there 
 be sweats around the neck and head. These sweats indicate 
 danger in proportion to the violence of the disease, which is 
 known by the suffocation and rattling, which increases and 
 produces death, unless there supervene an abundant flow of 
 viscid urine, or of concocted sputa. Whichever of these two 
 phenomena supervenes, it indicates resolution. 
 
 "An eclegma is prescribed for peripneumonia, with galbanum 
 and grains of pine seed, in Attic-honey. Other expectorants are 
 employed, such as worm-wood (Artemisia dbrotanum, Lin.), and 
 pepper in oxymel ; purgatives — boil black hellebore (Helleborus 
 orientalis, Lin.), and give it as a drink to pleuritics at the com- 
 mencement and while the pain is felt A useful remedy in 
 affections of the liver, and in pains proceeding from the 
 diaphragm, is a drink of opoponax (Pastinacce ojpoponax, Lin.), 
 boiled in oxymel and strained. In general, a remedy that is to 
 act on the stools, or urine, should be given in wine and in hone^ ; 
 if to act on the stools alone, it should be given in a much larg<r 
 quantity of diluted oxymel." 
 
 It will be seen, by comparing the treatment of Hippocrates 
 with that of Dr. Eberle, given in another part of this work, that 
 there is no essential difference. The bleeding and purgative 
 plan is still adhered to. 
 
 At the death of Hippocrates, which occured when he was 
 about one hundred years of age, his two sons, Thassalius and 
 
PRACTICAL PRINCIPLES. 19 
 
 Draco, together with his son-in-law Potybius, cultivated the art 
 of medicine, and transmitted the knowledge of their father by 
 teaching in a public manner his doctrines. Hippocrates and his 
 sons were the first authors of any note upon the subject of medi- 
 cine. 
 
 The foundation of the Alexandrian Library, about the year 
 320 B. C, had a happy effect upon some departments of medicine, 
 as Anatomy, Physiology, &c. 
 
 But from the statement of Galen, who had examined all the 
 contents of this library relative to medicine, it appears that the 
 only knowledge it evinced of therapeutics was merely experi- 
 mental. The Alexandrian Library is said to have contained 
 about 600,000 volumes or rolls, which were equal to about 
 200,000 modern bound volumes. This library contained all the 
 valuable information of those times in every department of 
 science and art. It was burnt by Caliph Omar, A. D., 640, who 
 gave as his reasons that, if the books agreed with the Koran, they 
 were of no use, and if they disagreed they contained heresy, 
 and should be burnt. Thus far in the history of medicine, the 
 only therapeutic axiom was this : "When a treatment was suc- 
 cessful in one case, it was always employed in analogous cases 
 without inquiry whether it acted upon one principle or another ; 
 although Hippocrates and his disciples suggested some diseases 
 were cured by their opposites, and others by similars ; while 
 again diseases have been cured by remedies which appear to be 
 neither similar nor contrary to the nature of the disease. 
 
 It is not my purpose to enter in any considerable degree into 
 the consideration of the theories which prevailed in those ancient 
 times relative to disease, yet I can hardly present to the reader 
 any thing like an idea of the comparative condition of medicine, 
 without noticing in a brief manner some of the more prominent 
 notions relating to it. The xlsclepiades, of the isle of Cos, regarded 
 disease as a series of phenomena, resulting from the efforts of 
 nature to remove the cause of the disease. They regarded nature 
 as competent to accomplish her purpose in many instances, but in 
 others medical interference become necessary. They also 
 regarded disease as having critical days and a certain duration. 
 Pythagoras states that the number of days which bring about 
 the cure or death of a patient, regulates the crisis, of fevers. In 
 
20 PRACTICAL PRINCIPLES. 
 
 remarking upon the observation of these critical periods and 
 daily phenomena of disease, he says that a physician who 
 neglects nothing that may contribute to the patient's health, 
 must observe carefully what passes each day. 
 
 Among those days of even numbers the most important are 
 the fourteenth, the twenty-eighth, and the forty-second. Who- 
 ever carefully observes the phenomena of disease, as described 
 by these ancient authorities, will see an aphorism of Prof. J. J. 
 Jones verified: That all diseases are more or less periodic. 
 Following the doctrine of crisis is that of the four elements, 
 Heat, Cold, Dryness and Moisture ; and the four cardinal humors, 
 blood, bile, atra-bile, and phlegm. 
 
 Empedocles was the first to introduce this doctrine of the 
 elements. He says the human body is composed of blood, 
 phlegm, and two sorts of bile — yellow and black; and that 
 their condition determines the state of health ; that perfect 
 health consists in a due proportion of each ; that disease is 
 caused by an excess of any one of these, or if any one lacks its 
 due proportion, or is evacuated without being properly mixed — 
 for when it is thus evacuated, they claim that not only the 
 region where the admixture took place must be affected, but the 
 organ, through which it passed off, must suffer and become dis- 
 eased. Another theory of those times was, that all disease was 
 caused by cold, which they explained as follows : — Colds cause 
 the condensation of the tissues and veins of the head ; if the 
 cold strikes them when they are heated, they contract, and the 
 humors contained in them are expelled. All the tissues are 
 obliged to pour out their fluids when they contract. 
 
 Fluxions are also caused by the tissues becoming heated, 
 which rarefies them, enlarges their pores ; the humors they con- 
 tain are attenuated, so that it flows easily when compressed. 
 This theory of fluxions is regarded as being anterior to Hippo- 
 crates. For a long time after Hippocrates, we have no writings 
 from which we can learn any progress in the practical resources 
 of the profession. From all we can gather, it would seem that 
 little, if any, progress was made in the principles or practice of 
 medicine for many centuries. Herophilus is mentioned by some 
 as a reformer in medicine, and as having introduced quite a 
 large number of medicines ; but what they were, history fails 
 
PRACTICAL PRINCIPLES. 21 
 
 to tell us. Dioscorides states that the medicines used by him 
 had the power to dissolve stone in the bladder ; to consume the 
 spleen ; to prevent conception in females ; of making children 
 black-eyed, &c. ; also, that they would prevent the various mani- 
 festations of mental emotions and passions. The modus 
 operandi of medicines, as explained by the ancients, was that 
 they acted upon the system- according to the degree of heat or 
 cold, dryness or moisture, of the system. A principle not very 
 dissimilar to that advocated by the modern Samuel Thomson, 
 which was that heat was life, and cold was death ; and that 
 medicines acted beneficially or otherwise, according to the degree 
 of heat they contained. 
 
 iEtius, who lived at the commencement of the sixth century, 
 and was the first physician of eminence who embraced the 
 Christian religion, dispensed with most of the ceremonies, magic 
 and incantations, that originated in the iEsculapian school; but 
 instituted others almost equally superstitious. In his directions 
 to use certain medicines, he recommended that the following 
 words be repeated in a low voice : May the God of Abraham, 
 the God of Isaac, the God of Jacob, deign to bestow upon this 
 medicine the necessary virtues, &c. In extracting a foreign 
 substance from any part of the system, he recommends, in con- 
 nection with proper means used, the following words : As Jesus 
 Christ caused Lazarus to come forth from the sepulchre, as 
 Jonah came out of the whale's belly, come thou out. In his 
 practice he made free use of the cautery, and introduced a 
 number of new ointments. He also claimed to have introduced 
 to the materia medica several new remedies, but did not tell us 
 what they were. His principles of practice were the same as 
 his predecessors. 
 
 Rhazes, an Arabian physician, although a strict imitator of 
 the Greek practice, offered one or two suggestions worthy of 
 remembrance. Among other considerations, he says: "studv 
 carefully the antecedents of the man to whose care you propose 
 to confide all you hold most dear in the world — that is to say, 
 your life and health, and the life and health of your wife and 
 children. If the man is dissipating his time in frivolous plea- 
 sures ; if he cultivates with too much zeal the arts that are fo- 
 reign to the profession, such as music and poetry ; still more if he 
 
22 PRACTICAL PRINCIPLES. 
 
 is addicted to debauchery, refrain from committing into his 
 hands a trust so precious." 
 
 Hally-Abas, Avicenna, and Albucasis, were also Arabian physi- 
 cians of some note, and lived in the eleventh and twelfth centuries. 
 They added to the resources of the Greeks several articles of 
 some value, such as cassia, senna, and manna. They also added 
 several ointments and syrups to the pharmacy. In the princi- 
 ples of treating diseases, however, they made but little, if any, 
 advancement. 
 
 On examining the progress in the principles and practice of 
 medicine, from its commencement to the close of the seventeenth 
 century, we find that the principal improvements were made by 
 the descendants of iEsculapius, Hippocrates and Galen ; that the 
 Arabians, Turks, and Jews, did little, if any thing, more than 
 teach it as it had been taught by Hippocrates. Even after the 
 discovery of the art of printing by Guttenberg and others, in 
 1424. physicians appeared to be entirely satisfied in translating 
 the writings of ancient authors, and in commenting upon what, 
 it would appear, they thought a fixed science. 
 
 In the year 1700, John Fernel, who wrote quite extensively 
 upon the materia medica, re-examined the therapeutic axiom of 
 Hippocrates, that, all diseases are cured by contraries. He 
 stated that every disease must be cured by contraries : for, says 
 he, " a remedy is that which can drive out a disease, and that 
 which drives acts violently. That which uses violence is in 
 opposition, therefore the remedy is always opposed to the dis- 
 ease, and no healing can take place except in virtue of the law 
 of contraries. We call contraries not only those things which 
 are endowed with opposite elementary qualities, heat and cold, 
 dry and wet, but also things which differ among themselves in 
 any way, as to quantity, number, quality, &c. Thus the hard 
 and the soft, the dense and the diffuse, the great and the small, 
 that which is in excess and that which is deficient ; the high and 
 the low, the pure and the impure, are all examples of contraries. 
 These are the views of Fernel relative to the therapeutic action 
 of medicine, although he carried them further than Hippocrates 
 and Galen, and entirely rejected their experimental knowledge 
 of therapeutics, and claims the law of contraries to be impos- 
 sible. 
 
PRACTICAL PRINCIPLES. 23 
 
 Paracelsus, a native of Einsiedeln, a village of Switzer- 
 land, lived in the latter part of the sixteenth century, and 
 although a man of neither integrity of purpose, nor stability of 
 character, obtained almost universal sway over the medical pro- 
 fession. He claimed to have made great discoveries in thera- 
 peutics and pathology. He stated that the human body, like the 
 great world of which it is an image, is composed of four elements, 
 fire, air, earth and water. The fire in man is the soul ; the earth 
 is represented by the dry parts ; the water by the liquids ; the air 
 by the vacuum. These four elements cause disease. But if we 
 leave this high analysis to get at the more immediate elements, 
 the body of man is composed of mercury, the liquor of sulphur 
 and salt. And now we see how this is demonstrated by alchymy. 
 There are, in the first place, in the body liquids ; these are the 
 mercury; then the solids, which may be burnt; the portion 
 which burns is sulphur, while the residue or the ashes is salt. 
 It can hardly be imagined how a man can embody, in so few 
 words, such an amount of ignorance, and, what is still more 
 wonderful, is, that a system, thus founded in the grossest igno- 
 rance, should exert such an influence on the medical profession. 
 The additional element of mercury, which he added to the four 
 elements of the ancients, enabled him to found a new system of 
 therapeutics, and in a measure to introduce new principles of 
 cure. Mercury, he tells us, being in close relation to ordinary 
 quicksilver, produces, by its volatility, many affections of 
 the ligaments, as tremblings, &c. If it becomes excessive, or if it 
 be joined to acrimony, mania, phrenzy and madness occur. On 
 the contrary, if the mercury is chilled, it causes trembling of 
 the hands and feet, lethargy, erosions of the mouth, &o. Sul- 
 phur causes various kinds of fevers, jaundice, &c. Salt causes 
 gravel, gout, sciatica, and, when it becomes dissolved, it causes 
 diarrhoea; if it coagulates, constipation; if it volatizes too soon, 
 it causes ulcers, itch, erysipelas, cancers, herpes, &c. .For the 
 purpose of removing all these diseases, he introduced into the 
 system antimony, gold, mercury, copper, and some other metals. 
 He discarded many of the remedies of Hippocrates as being in- 
 effectual and unable to control the elements of the body, and 
 pretended the principle upon which mercury removed disease 
 from the body was a profound secret, peculiar to himself. It 
 
24 PRACTICAL PRINCIPLES. 
 
 was a combination of these metals which composed what he 
 called his elixir vitce, or universal remedy for all diseases. One 
 attempt which he made to explain the modus operandi of his 
 medicines, will suffice to show his Entire ignorance upon the 
 subject. It was as follows : — "As antimony purges gold only, 
 and consumes all other metals, it is the proper agent to purge 
 the human body, and no other ; for in regard to perfection and 
 forces, man has a great similitude to gold ; whence it follows, 
 that antimony brings man and gold to a supreme degree of per- 
 fection and purity, while it destroys, consumes and exempts 
 every thing else. The nature of antimony is a purgative, though 
 it does not produce evacuation of faeces and other excrements ; 
 but, above all other remedies, which act insensibly, it drives out 
 that which renders man impure, and having purged the cause 
 of disease, brings him to a supreme degree of health." It will 
 readily be perceived from the above quotation, that in the adminis- 
 tration of medicine, he was guided for less by correct principles 
 than his predecessors in the profession. Paracelsus was the 
 first physician who used mercury and the other violent mineral 
 poisons. Andrew Libanius, a physician, chemist and director 
 of the gymnasium at Cobourg, and cotemporary of Paracelsus, 
 informs us that the latter cured very few of his patients ; that he 
 killed a great many, and that many others were horribly tor- 
 tured by the use of his medicaments. As ignorant and unskillful 
 as was Paracelsus, he is the founder of the present system of 
 Allopathy ; and the very remedies of which he composed his 
 quack elixir, are still insisted upon as being the almost universal 
 panacea for bodily ills. It is true that men, eminent in the pro- 
 fession, have labored for a more rational system of practice ; have 
 minutely investigated the cause and nature of disease, and have 
 very materially improved the condition of pathology. But not- 
 withstanding all this, it must be acknowledged that their thera- 
 peutic resources are essentially the same as those of Hippocrates 
 and Paracelsus. By referring to the compendium of Dr. Eberle's 
 Practice, in another part of this work, we can learn what the 
 resources of the Allopathic portion of the profession are. I* 
 be sure, every article is not there enumerated which has been 
 recommended by that branch of the profession • but, he being a 
 late author, and having enjoyed the confidence of the profes- 
 
PRACTICAL PRINCIPLES. 25 
 
 sion as such for nearly a quarter of a century, it is probable he 
 as fairly represents his party in medicine as any author I could 
 select. According to all their authors, bleeding, blistering, 
 mercury, antimony, &c, are their principal therapeutic re- 
 sources. With these are they successful in accomplishing the 
 only purpose for which medicine is cultivated? — that of healing 
 disease. The first of these resources, in order, is bleeding. Is 
 bleeding of service in the treatment of disease ? Is it produc- 
 tive of more good than evil ? These are questions which should 
 be solved before venturing upon so active a measure in changing 
 the normal condition of the human organism. 
 
 To assist us in the solution of this question, we may first in- 
 quire, what are the purposes of the blood ? what part does it 
 perform in the economy of human life. Scripture tells us that 
 the blood is the life of the flesh. Physiology tells us that the 
 blood is the histogenic material, out of which all the organs of the 
 body are formed, and by which they maintain their normal 
 integrity. Pathology, still further, informs us that a large 
 majority of all disease that afflicts the human family is depen- 
 dent upon, or is caused by, a deficiency in the whole, or in certain 
 constituents of the blood. Physiological pathology informs us 
 that the blood is a medium through which all the disintegrated 
 or waste portions of the old tissue are removed from the body ; 
 that it watches diligently over every tissue, and carefully supplies 
 every deficiency. Still the question is, does it remove disease t 
 What are the facts? The following remarks o£ Dr. Samuel 
 Dickson, formerly an officer of the British staff, now of London, 
 will show some facts upon the utility of blood-letting in the 
 treatment of disease. "A medical officer of one of her majesty's 
 regiments, serving in India, couched a woman for cataract. 
 The next day the eye having become inflamed, according to 
 received practice, he bled the patient; but scarcely had he 
 bound up her arm, when she fell as if she had been shot, and 
 lay, to all appearance, dead ; with the greatest difficulty he 
 succeeded in recovering her from this state : but it was not till 
 four long hours had passed that he felt he could safely leave her 
 with attendants ; for during the greater part of that time, when 
 he ceased to chafe her temples, or otherwise call up the attention 
 of the brain, by the application of stimulants to the nose, mouth, 
 3 
 
26 PRACTICAL PRINCIPLES. 
 
 &c, she relapsed into a death-like swoon. More than once he 
 was obliged to inflate her lungs to keep her from dying. But 
 in this ease, gentlemen, blood-letting did not cure the inflamma- 
 tion ; for the next day the eye was more painful and inflamed 
 than ever, and the poor woman, after all the blood she had lost, 
 — and who will sa.y that she was not bled? — did not recover 
 her sight. It is now many years since that case came under 
 my sight, and it made an impression on my mind I shall never 
 forget. Had the woman died, would not every one have said 
 that the gentleman who bled her had killed her? and very 
 justly, too." 
 
 " Religion Freedom, Vengeance, what you will, 
 A word's enough to raise mankind, to kill — 
 Some party-phrase by cunning caught, and spread, 
 That Guilt may reign, and Wolves, and worms be fed." 
 
 " The first resource of the surgeon is the lancet — the first 
 thing he thinks of when called to an accident, is, how he can 
 most quickly open the flood-gates of the heart, to pour out the 
 stream of an already enfeebled existence. Does a man fall from 
 his horse, or a height, is he not instantly bled? has he been 
 stunned by a blow, is not the lancet in requisition? Nay, has 
 an individual fainted from over-exertion or exhaustion is it not 
 a case of fits — and what so proper as venesection ? You can- 
 not have forgotten the fate of Malibran — the inimitable Mali- 
 bran ; she who so often, by her varied and admirable perform- 
 ances, moved,, you to tears and smiles, by turns. She was playing 
 her part upon the stage ; she entered into it with the whole of 
 her soul, riveting the audience to the spot by the very intensity 
 of her acting. Just as she had taxed the powers of her too 
 delicate frame to the utmost, she fainted and fell ; fell from very 
 weakness. Instantly a medical man leapt upon the stage, — to 
 administer a cordial ? No, to bleed her! to bleed a weak, worn, 
 and exhausted woman ! and the result? She never rallied from 
 that unfortunate hour. But, gentlemen, Malibran was not the 
 only intellectual person of the thousands and tens of thousands 
 who have prematurely perished by the lancet. Byron and Scott, 
 those master-spirits of their age — those great men, who, like 
 Ariosto and Shakspeare, not only excited the admiration of 
 cotemporary millions, but whose genius must continue, for gen- 
 
PRACTICAL PRINCIPLES. 27 
 
 erations jet unborn, to delight the land that produced them — 
 they, too, fell victims to the lancet — they, too, were destroyed 
 by the hands, -which, however friendly and well-intentioned, 
 most undoubtedly dealt them their death-blow. Is not this a 
 subject for deep reflection ? To the cases of these great men we 
 shall recur in the course of this lecture; but, for the present, 
 we must turn to other matters — to events that have just passed 
 before our eyes. The affair of Newport, in Wales, is still the 
 topic of the hour. You must therefore remember it to its min- 
 utest detail — the attack of the rioters upon the town; the 
 gallant and successful stand made by Capt. Gray and his little 
 detachment of the 35th regiment — the prisoners captured and 
 the investigation which took place afterwards. In the course 
 of that examination a prisoner, who was under examination, 
 fainted. What was done with him ? he was carried out of 
 court and immediately bled. On his return an extraordinary 
 change had come over his countenance : from being a man of 
 robust appearance, he had becnme so wan and haggard, so 
 altered in every lineament, the spectators could scarcely recog- 
 nize him as the same prisoner. Yet, strange to say, not one of 
 the many journals that reported this case, spoke a word in con- 
 demnation of the uncalled-for measure which brought the man 
 to such a state ; so much has custom blunted the sense of the 
 public to this, the most dangerous of all medical appliances. 
 Gentlemen, a coroner's inquest was held on a person who died 
 
 suddenly. Mr. , surgeon, stated that he was called upon to 
 
 attend deceased, and found him at the point of death. He 
 attempted to bleed him, but ineffectually, and in less than a 
 minute from witness' arrival, deceased expired. "Witness not 
 being able to give any opinion as to the cause of death from the 
 symptoms that then exhibited themselves, he afterwards, with the 
 assistance of Dr. Ridge, 37 Cavendish Square, made a post-mortem 
 examination, and found that a large tumour, attached to a large 
 vessel of the heart, containing blood, had bursted, and that was 
 the cause of his death. So that, while the man was actuallv dvinn- 
 of inanition from internal bleeding, the surgeon, utterly igno- 
 rant, according to his own confession, of the nature of the 
 disease, proceeded to open a vein. How happens it that the 
 lancet should be so invariably the first resort of ignorance. 
 
28 PRACTICAL PRINCIPLES. 
 
 " In every case of stun or faint, the employment of this instru- 
 ment must be a superadded injury; in all, there is a positive 
 enfeeblement of the whole frame, evidenced by the cold surface 
 and weak but imperceptible pulse ; there is an exhaustion, which 
 loss of blood, so far from relieving, too often converts into a state 
 of utter prostration. True, men recover when treated in this 
 manner — but these are not cures, they are escapes. How few the 
 diseases which loss of blood may not of itself produce ! if it 
 cannot cause the eruptions of small-pox, nor the glandular 
 swellings of plague, it has given rise to disorders more immedi- 
 ately fatal than either. What think you of cholera asphyxia — ■ 
 Asiatic cholera? Gentlemen, the symptoms of that disease are 
 the symptoms of a person bleeding slowly away from life. The 
 vomiting, the cramps, the sighing, the long gasp for breath, the 
 leaden and 'livid countenance which the painter gives to the 
 dying in his battle-pieces ; these are equally the symptoms of 
 cholera and loss of blood. Among the numerous diseases which 
 it can produce, Darwin says, ' a paroxysm of gout is liable to 
 recur on bleeding.' John Hunter mentions ' lock-jaw and 
 dropsy' among its injurious effects — Travers, 'blindness and 
 palsy ' — Marshall Hall, ' mania ' — Blundell, ' dysentery * — 
 Broussais, 'fever and convulsions.' 'When an animal loses a 
 considerable quantity of blood/ says John Hunter, ' the heart 
 increases in its frequency of strokes, as also in its violence/ 
 Yet these are the indications for which professors tell you to 
 bleed. You must bleed in every inflammation, they tell you. 
 Yet is not inflammation the daily effect of the loss of blood ? 
 Magendie mentions pneumonia as having been produced by it, 
 completely confirming the evidence of Dr. Hume upon that 
 point. He further tells us, that he has witnessed among its 
 effects the entire trains of what people are pleased to call in- 
 flammatory phenomena ; and mark, he says, the extraordinary 
 fact, that this inflammation will have been produced by the very 
 agent that is daily used to combat it! What a long dream of 
 false security have mankind been dreaming ! they have laid 
 themselves down on the laps of their Mentors, — they have slept 
 a long sleep ; while these, like the fabled vampire of the poets, 
 taking advantage of a dark night of barbarism and ignorance, 
 have thought it no-sin to rob them of their life's blood during 
 
PRACTICAL PRINCIPLES. 29 
 
 the profoundness of their slumber! Gentlemen, the long shiver 
 of the severest ague, the burning fever, the severest lock-jaws, 
 the vomiting, cramps, and asphyxia of cholera, the spasm of 
 asthma and epilepsy, the pains of rheumatism, the palpitating 
 and tumultuous heart, the most settled melancholy and madness, 
 dysentery, consumption, every species of palsy, the faint that 
 becomes death, these — all these — have I traced to the loss of 
 blood ! 
 
 " Lord Byron called medicine the destructive art of healing. 
 How truly it proved to be so in his own case, you shall see when 
 I give you the details of his last illness: — 'Of all his preju- 
 dices/ says Mr. Moore, ' he declared the strongest was that 
 against bleeding. His mother had obtained from him a promise 
 never to consent to be bled ; and, whatever arguments might be 
 produced, his aversion, he said, was stronger than reason. Be- 
 sides, is it not, he asked, asserted by Dr. Reid, that less slaughter 
 is effected by the lance than by the lancet — that minute instru- 
 ment of mighty mischief!' On Mr. Millingen observing that 
 this remark related to the treatment of the nervous, but not of 
 inflammatory complaints, he rejoined, in an angry tone, 'Who 
 is nervous if I am not? and do not those other words of his (Dr. 
 Reid's) apply to my case, where he says that drawing blood 
 from a nervous patient, is like loosening the cords of a musical 
 instrument — whose tones already fail for want of sufficient 
 tension ! Even before this illness, you yourself knew how weak 
 and irritable I had become ; and bleeding, by increasing this 
 state, will inevitably kill me. Do with me what else you like, 
 but bleed me you shall not. I have had several inflammatory 
 fevers in my life, and at an age when robust and plethoric ; yet 
 I got through them without bleeding. This time, also, will I take 
 my chance/ After much reasoning and repeated entreaties, 
 Mr, Millingen succeeded in obtaining from him a promise, that 
 should he feel his fever increase at night, he would allow Dr. 
 Bruno to bleed him. On revisiting the patient early next morn- 
 ing, Mr. Millingen learned from him that, having passed on the 
 whole, as he thought, a better night, he had not thought it 
 necessary to ask Dr. Bruno to bleed him. What followed I shall, 
 in justice to Mr. Millingen, give in his own words: 'I thought 
 it my duty now to put aside all consideration of his feelings, 
 
30 PRACTICAL PRINCIPLES. 
 
 and to declare, solemnly, to him how deeply I lamented to see 
 him trifle thus with his life, and show so little resolution. His 
 pertinacious refusal had already, I said, caused much precious 
 time to be lost; "but few hours of hope now remained ; and, un- 
 less he submitted immediately to be bled, we could not answer 
 for the consequences. It was true he cared not for life, but who 
 could assure him that, unless he changed his resolution, the un- 
 controlled disease might operate such disorganization in his 
 system as utterly and forever deprive him of reason ! I had 
 now hit at last on the sensible chord ; and partly annoyed 
 by our importunities, partly persuaded, he cast at us both the 
 fiercest glance of vexation, and throwing out his arm said, in 
 the angriest tone, ' There you are, I see, a d — d set of butchers, 
 take away as much blood as you like, but have done with it P 
 We seized the moment (adds Mr. Millingen), and drew about 
 twenty ounces. On coagulation, it presented a strong buffy coat, 
 yet the relief obtained did not correspond to the hopes we had 
 formed, and during the night the fever became stronger than it 
 had been hitherto, the restlessness and agitation increased, and 
 the patient spoke several times in an incoherent manner. Surely 
 this was sufficient to convince the most school-bound of the 
 worse than inoperative nature of the measure. Far from it. On 
 the following morning, the 17th of April, the bleeding was re- 
 peated twice, and it was thought right also to apply blisters to 
 the soles of his feet ! Well might Mr. Moore exclaim, ' It is 
 painful to dwell on such details/ For our present purpose it is 
 sufficient to state, that although the rheumatic symptoms had 
 been completely removed, it was at the expense of the patient's 
 life. His death took place upon the 19th, that is, three days 
 after he was first bled. 
 
 " M. Capeman, in 1845, gives the statistics of the bleeding and 
 non-bleeding practice in apoplexy. * In 1836, when I first re 
 pudiated the lancet in this disease, the statistics were all on one 
 side, the only cases of the non-bleeding side of the argument 
 being my own/ The following is from Mr. Capeman's table : 
 
 Number bled 120 Cured 51 Died 78 
 
 Number not bled 26 Cured 18 Died 8 
 
 Showing that, in the cases where bleeding was practised, nearly 
 
PRACTICAL PRINCIPLES. 31 
 
 two out of three died ; whereas, in the cases treated without 
 blood-letting, more than two out of three recovered ! What is 
 the worth of general assertions in the face of such evidence? 
 
 " In the army hospitals I had an opportunity of studying dis- 
 ease both at home and abroad. There I saw the fine tall soldier 
 bled, for relief of a symptom, to fainting ; and what is fainting ? 
 A loss of every organic perception — a death-like state, only 
 differing from death in the possibility of a recall. Prolong it to 
 permanency and it is death. Primary symptoms were, of course, 
 got over by such measures ; but once having entered the hospital 
 walls, I found that soldier become familiar to me ; seldom did 
 his pale countenance recover its former healthy character. He 
 became the victim of consumption, dropsy, or dysentery. His 
 constitution was broken by the first depletory measures to 
 which he had been subjected." 
 
 In connection with these cases, reported by Dr. Dickson, we 
 might mention that of our own Washington, who, after escaping 
 the perils of war with its engines of death, fell a victim to the 
 lancet. He was attacked with quinsy — bled to an enormous 
 extent, three times within a few .days, and died with all the 
 characteristic symptoms of fatal hemorrhage. 
 
 Andral recently reported one hundred cases of pneumonia 
 treated by blood-letting ; one hundred treated by antimony and 
 mercury, and one hundred by diet and rest. Of the cases 
 treated by blood-letting, 27 died ; of those treated by antimony 
 and mercury, 21 died ; by diet and rest, 7 died. 
 
 To the candid and impartial observer of facts, the general 
 fatality accompanying this practice is conclusive on this point. 
 Within my own experience I could enumerate hundreds who, 
 while in the bloom of health, upon some trifling ailment have 
 submitted themselves to be bled, and thus offered up their lives 
 upon the altar of this murderous practice. These are a few 
 among the many facts which lead us to condemn the use of the 
 lancet. Another therapeutic agent in the allopathic materia 
 medica which we reject, is mercury with all its preparations : 
 for ample experience has shown, that the allopathic axiom, that 
 medicines which will produce one train of morbid phenomena, 
 will remove an already existing disease, is not successful in 
 combating disease ; but, on the contrary, has greatly enlarged 
 
32 PRACTICAL PRINCIPLES. 
 
 the bills of mortality, and increased the amount of human suf- 
 fering. It is not true that two diseases will not manifest them- 
 selves in the human organism at the same time, as common 
 observation will show. It is true that while patients are laboring 
 under the specific influence of mercury, they, at the same time, 
 suffer from the ravages of other morbid influences equally 
 disastrous to the life and health of the patient. Nothing is 
 more common than to see patients die of idiopathic fevers, s 
 83'philis, small-pox., phthisis, pneumonia, pleurisy, inflammation 
 of the brain, stomach, bowels, &c, while under the specific 
 influences of mercury. Statistics show that a much larger por- 
 tion die, when thus treated, than when left to the unaided efforts 
 of nature. This fact was fully appreciated by Lord Byron after 
 recovering from a very severe attack of fever. He stated that 
 after a week of half delirium, burning skin, hot headache, hor- 
 rible sensations, and no sleep, by the blessing of barley-water, 
 and refusing to see his physician, he recovered. 
 
 Lord Byron was not the only one who realized the inefficiency 
 of the allopathic method of treating disease. A large majority 
 of the most intelligent people have felt, for the last two-thirds 
 of a century, the importance of an entire revolution in our 
 therapeutic resources. The following are the preparations of 
 mercury most in use : 
 
 The blue-pill, which is a preparation of quicksilver, rose-leaves 
 and honey. 
 
 Bichloride of mercury, or corrosive sublimate. 
 
 Chloride of mercury, or Calomel. 
 
 Ammonio-chloride of mercury, or White Precipitate. 
 
 Red Oxide of mercury, or Red Precipitate. 
 
 Bicyanide of mercury. 
 
 Sub-sulphate of Peroxide of mercury. 
 
 Nitrates of mercury. 
 
 Iodide of mercury. 
 
 The symptoms of large doses of Bichloride of mercury, as 
 described by Taylor in his Medical Jurisprudence, page 87, are 
 nausea, with vomiting of long stringy masses of white mucus, 
 mixed with blood, followed by profuse purging. 
 
 The pulse is small, frequent, and irregular, being scarcely 
 perceptible as the disease advances. The tongue is white and 
 
PRACTICAL PRINCIPLES, 33 
 
 shriveled, the skin is cold and clammy, the respiration difficult, 
 and death is commonly preceded by fainting, convulsions, and 
 insensibility. The mouth is swollen and the urine is suppressed. 
 The symptoms produced by corrosive sublimate, in the first in- 
 stance, resemble cholera. The quantity necessary to destroy life, 
 according to Taylor, is from three to five grains. 
 
 Chloride of mercury, or calomel, is poisonous in doses similar 
 to corrosive sublimate. A case is reported in the Medical 
 Gazette (18 vol., p. 484), in which a boy, aged fourteen, was 
 killed by one dose of six grains of calomel. 
 
 It is stated, by Mr. Taylor, that no salivation was produced in 
 this case. Pereira mentions a ease of a lady who was killed by 
 a dose of twenty grains of calomel. Sobernheim states that a 
 girl, aged eleven, took eight grains of calomel in twenty-four 
 hours, for croup, and died in eight days from inflammation and 
 ulceration of the mouth and fauces. 
 
 Dr. Taylor mentions a case, which occured at Lesser, where 
 fifteen grains of calomel produced similar effects, and the patient 
 died in eight days. Dr. Christian mentions a case in which two 
 grains of calomel destroyed life by the severe salivation induced, 
 as well as by the ulceration of the throat. Taylor, in his Medi- 
 cal Jurisprudence, page 80, mentions a case, where two-thirds 
 of a grain of calomel was given to a boy, aged eight years, pro- 
 ducing violent salivation and necrosis of the bones. 
 
 In another instance, a little girl, aged five, took daily, for three 
 daysj three grains of mercury and chalk-powder. Her mouth 
 was severely affected ; sloughing ensued, and she died in eight 
 days. In a third case, a boy, aged eleven years, took throe 
 doses of this powder — one of six grains on the 14th, a similar 
 dose on the 17th, and four grains on the 20th, making altogether 
 sixteen grains. The most profuse salivation ensued, sloughin^ 
 commenced in both cheeks and rapidly extended through them. 
 The boy died in four days. Previously to the exhibition of the 
 mercury he had recovered from an attack of fever. In a fourth 
 case, three grains of blue pill, given twice a day, for three days, 
 making eighteen grains,, were ordered for a girl, aged nineteen, 
 who complained of a slight pain in her abdomen. Severe sali- 
 vation supervened, the teeth separated, and she died in twelve 
 days. Dr. Craigie says the great objection to the employment 
 
34 PRACTICAL PRINCIPLES. 
 
 of any preparation of quicksilver in the cure of renal disease, 
 consists in the fact, that the use of the mineral is known to 
 render the urine albuminous, to increase the inflammatory state 
 of the system, and to induce the disease, the effects of which, it 
 is expected, to remove. Another evil is that, in persons laboring 
 under symptoms of granular kidney, a very small quantity of 
 mercury induces salivation, and renders the mouth tender and 
 most painful. (Practice of Physic, ii., 1148.) 
 
 Prof. Z. Freeman reports a case, in the August number of the 
 Eclectic Medical Journal, 1854, p. 345, of a girl who took calo- 
 mel and jalap for a cathartic. It was followed by severe saliva- 
 tion, gangrene and necrosis of the jaw bone. He states, that 
 himself and Dr. Newton took from the jaw four pieces of bone, 
 each over an inch in length and three-fourths of an inch in 
 thickness, including a number of teeth. The jaw was anchy- 
 losqd and the mercurial bone foetor was very offensive in this 
 case. He mentions another case which came before him while 
 he was lecturing in Memphis, in which the jaw was necrosed, 
 and the features horribly mutilated, as the effects of mercury. 
 I knew a case of a lady, treated by a homcepathic physician for 
 remittent fever, who took corrosive sublimate, as admitted by 
 the physician, one grain a day, for three days, producing violent 
 salivation and ulceration of the mouth, w T ith a strong tendency 
 to gangrene, followed by persistent vomiting, prostration, and 
 death in the course of five or six w r eeks. Upon making a post- 
 mortem examination, the mucous membrane of the stomach, and 
 upper portion of the bowels, were found entirely disorganized by 
 the effects of the mercury. 
 
 Dr. Norris, surgeon in the Pennsylvania Hospital, stated, in 
 a recent clinic, that he had not prescribed mercury in cases of 
 syphilis for the last twenty years, and that patients did much 
 better than before. Dr. Dick, of Calcutta, states, in a letter to 
 Dr. Sanders, that chronic liver attacks frequently follow the 
 long continued use of mercury. Dr. Nichols, surgeon in the 
 British army in India, states that most of the soldiers, who were 
 treated for venereal disease with mercury, were exceedingly liable 
 to inflammation of the liver. Dr. M. Dessuelles, that from his 
 experience in the treatment of one thousand three hundred and 
 twelve cases of primitive and secondary syphilis without mer- 
 
PRACTICAL PRINCIPLES. 35 
 
 cury, that the average duration of the disease was only thirty- 
 two days, while those treated with mercury were not only 
 subject to a much longer period of the disease, but a far less 
 number recovered. Prof. J. G. Jones stated, in his lectures, that 
 he had not used a grain of mercury for twenty years. And it 
 is well known that he treated every variety of disease with 
 almost uniform success. 
 
 Dr. Pulte, in his Homoepathie Domestic Physician, states that 
 mercury causes the following diseases and symptoms. Hence 
 he recommends it to cure the same, upon the principle described 
 by Shakspeare. 
 
 "Tut, man ! one fire burns out, another's burning; 
 
 One pain is lessened by another's anguish : 
 
 Turn giddy and be helped by backward turning ; 
 
 One desperate grief cures with another's languish ; 
 Take thou some new infection to thine e}*e, 
 And the rank poison of the old will die." 
 
 Swelling and inflammation of the glands ; inflammatory fevers, 
 with disposition to perspire profusely ; rheumatic, or catarrhal 
 headache ; scrofulous rheumatic ophthalmia ; syphilitic ophthal- 
 mia; rheumatic prosopalgia and tooth-ache; dysentery; mucous 
 or bilious diarrhoea ; influenza. 
 
 Symptoms: — Enlargement, inflammation, and ulceration of 
 the glands, with pulsative and shooting pains. 
 
 Copious and colliquative sweats. 
 
 Vertigo, principally On getting up. 
 
 Itching, tickling and burning in the eyes. 
 
 Tearing, stinging and drawing pains in the ears. 
 
 Bloatedness and swelling of the face. 
 
 Tearing, stinging, or pulsative pains in the carious teeth. 
 
 Putrid smell from the mouth. 
 
 Stinging pains in the throat and tonsils, principally when 
 swallowing. 
 
 Acid and mucous taste ; dislike to all food. 
 
 Violent empty eructations ; excessive tenderness of the stomach 
 and precordial region. ■ 
 
 Loose and dysenteric evacuations. 
 
 Frequent, copious emissions of urine, like diabetes. 
 
 Catarrh, with febrile shivering. 
 
36 PRACTICAL PRINCIPLES. 
 
 Difficulty of respiration, with attacks of suffocation at night. 
 
 Obstructions and inflammatory swellings of the glands of the 
 neck. 
 
 Sharp pains in the shoulders and arms. 
 
 Sharp and piercing pains in the hip-joints. 
 
 We have given some of the~reasons why we reject the use of 
 mercury and all its preparations in the treatment of disease. 
 We urge the same objections against the medicinal use of copper, 
 antimony, arsenic, lead, zinc, tin, in short, against all minerals 
 not found as a component part of the organic structure of the 
 human body. And if our limits would permit, we could produce an 
 array of facts, proving, beyond a reasonable doubt, that the use 
 of all these mineral substances is absolutely disastrous to health 
 and life. The mineral substances, which are constituents of the 
 human organism, and can be used with benefit in the treatment 
 of disease, are the following : * 
 
 Lime, or its base, calcium, is combined with the carbonic or 
 phosphoric acid, in the bones and teeth. 
 
 Magnesia, in the sebaceous matter of the skin. 
 
 Alumina, in the enamel of the teeth. 
 
 And iron in the black pigment of the various parts, and in the 
 blood. 
 
 Metallic bases of earth : — Calcium, magnesium, silicium, 
 aluminum. 
 
 Phosphorus, sulphur, chlorine, and fluorine. 
 
 Metals ; iron, manganese, titanium. 
 
 Water, found universally, composed of hydrogen and oxygen. 
 
 Carbonic acid, found in urine, blood, and sweat. 
 
 Carbonates, or salts of carbonic acid and a base. 
 
 Carbonate of soda, in serum, bile, mucus, sweat, saliva, tears. 
 cartilage, &c. 
 
 Carbonate of lime, in cartilage, bone and teeth. 
 
 Carbonate of magnesia, in the sebaceous matter of the skin. 
 
 Phosphate of soda, in serum, saliva, in sweat, bones, mus- 
 cles, &c. 
 
 Phosphate of lime, in bones, teeth, cartilage, and the sandy 
 concretions of the pineal gland. 
 
 * Wilson's Histology. 
 
PRACTICAL PRINCIPLES. 37 
 
 Phosphate of soda and ammonia, in urine and blood ; but 
 probably only for the purpose of being excreted or thrown off 
 as unfit to constitute a part of the animal body. 
 
 Phosphate of iron, in blood, gastric juice, and urine. 
 
 Chlorine and its compounds : — 
 
 Hydrochloric acid, in gastric juice and in the fluid of the 
 caecum. 
 
 Chloride of sodium, in blood, brain, bone, muscle, cartilage, 
 pigment, and gastric juice. 
 
 Chloride of potassium, in blood, gastric juice, milk and saliva. 
 
 Chloride of ammonium, in sweat and gastric juice. 
 
 Chloride of calcium, in gastric juice. 
 
 Sulphuric acid and its compounds : — 
 
 Sulphate of potassa, in urine, gastric juice, and cartilage. 
 
 Sulphate of soda, in sweat, bile, and cartilage. 
 
 Sulphate of lime, in bile, hair, and cuticle. 
 
 Sulpho-cyanide of potassium, in the saliva. 
 
 Fluoride of calcium, in the enamel of the teeth. 
 
 Silica and oxide of manganese, in the hair. 
 
 Alumina, in the enamel of the teeth. 
 
 Oxide of iron, in blood, black pigment, lens and hair. , 
 
 Oxide of titanium, in the capsulse renales. 
 
 The above minerals, and their compounds, being constituents 
 of the animal organism, necessarily play an important part in 
 the great drama of organic life ; and disease of any of the 
 tissues may, and frequently does occur, from a deficiency of 
 some of the elements of the parts. The blood may become dis- 
 eased from a deficiency of iron, sodium, or potassium ; in this 
 case a proper administration of these articles may be beneficial. 
 A lack of sulphur and soda in the system may cause a defi- 
 ciency of bile; in which case a supply of them may restore the 
 liver to its normal condition, and the bile to its natural quantity. 
 Thus while all minerals, which constitute a part of the organic - 
 structure, not only become assimilated and assist in restoring 
 the abnormal conditions of the system to a healthy state — all 
 minerals which do not enter into the organization of any of the 
 various tissues, when introduced into the system, act as foreign 
 agents, and prove a constant source of irritation, disease and 
 death. Having hinted at what we conceive to be some of the 
 4 
 
38 PRACTICAL PRINCIPLES. 
 
 facts relative to the past and present condition of Medicine, we 
 now proceed more directly to consider some of the principles 
 which guide the great American movement for the reform of the 
 medical profession. 
 
 1st. A determined effort to ascertain more precisely than has 
 been done hitherto the natural cause and events of diseases. 
 Or, in other words, the fatality of disease when left to the 
 unaided efforts of nature. 
 
 2nd. A determination to understand more fully the modus 
 operandi of medicines, and to ascertain their real curative 
 powers. 
 
 3rd. To continue our researches in the vegetable, mineral and 
 animal kingdoms for the purpose of developing resources for the 
 removal of disease. 
 
 4th. To introduce into the profession a spirit of liberality and 
 progression ; to dispense with all creeds and cliques, and to 
 overcome all party prejudice among the different members of the 
 profession. 
 
 5th. That it is the duty of every physician to investigate each 
 system of medicine, and make its valuable resources available 
 for the relief of the sick. 
 
 6th. That both science and experience have demonstrated that 
 the use of mercury, lead, zinc, arsenic, and the entire catalogue 
 of minerals, incompatible with the organic tissues, is a fruitful 
 source of disease, and dangerous to life. 
 
 7th. That blood-letting is one of those dangerous practices, 
 which experience has found to be positively injurious in all 
 cases. 
 
 8th. That the pharmaceutical method of compounding a great 
 variety of medicines into syrups, powders, pills, &c, not only 
 prevents the physician from ascertaining their real curative 
 powers, but the action of each is frequently neutralized, and the 
 object defeated for which it was given. 
 
 9th. That it is far better to leave the disease to the unaided 
 efforts of nature, than attempt to remove it with medicine, un- 
 less its indications are demonstrated by observation and science. 
 
 10th. That investigation and research into the nature and 
 cause of disease should be encouraged, and all new facts rela- 
 tive to medical science should receive due attention. 
 
PRACTICAL PRINCIPLES. 39 
 
 11th. That neither Allopathy, Homoeopathy, nor Hydropathy, 
 as an exclusive system of medicine, has arrived at any consider- 
 able degree of perfection, as shown by the fact that neither very 
 materially lessens the natural fatality of disease ; although, 
 occasionally, each of these may prove successful, as shown by 
 the power of cold water to allay inflammation, which is Hydro- 
 pathy ; by nitrate of silver for aphthae of the mouth, which 
 is Allopathy; or by rhubarb for diarrhoea, which is Homoeopathy. 
 Each of these systems of medication being occasionally appli- 
 cable in removing disease, they should be understood by the 
 physician, and adopted as indicated. 
 
 12th. To discourage, by every honorable means, the baneful 
 practice of constant drugging for all trifling diseases. 
 
 13th. To investigate and adopt the physiological and hygienic 
 methods of curing and preventing disease by a proper regulation 
 of the diet, temperature and purity of the air, by bathing, 
 friction, proper clothing, occupation, mental and physical train- 
 ing, &c. 
 
 14th. That the practice of physicians, of spending their time 
 in idle conversation, electioneering. and otherwise, in pursuits 
 foreign to the profession, disqualifies them for practice; and that, 
 to be a skilful physician, the whole energies of body and mind 
 should be devoted to the profession. 
 
 15th. To avoid adopting any set of dogmas in medicine as 
 infallible ; bearing in mind, that a constant change of opinion 
 relative to the fundamental practical principles of the art, shows 
 that what men supposed to be true at one time, have been proved 
 to be entirely erroneous at another, and that the only means of 
 advancing medicine to the rank of an exact science, is by the 
 constant rejection of old errors and the reception of new and well- 
 attested truths. 
 
 16th. To combine the two extremes of the profession — the 
 ultra-conservative and the fanatical reformer. As conservatives, 
 we would pay due respect to the labors and discoveries of our pre- 
 decessors in the profession, and adhere with commendable zeal 
 and dignity to those doctrines which long usage, and extensive ex- 
 perience and science have demonstrated to be true. As reformers, 
 we would extend cur researches in every direction which promises 
 accession to the already existing stock of medical knowledge, 
 
40 PRACTICAL PRINCIPLES. 
 
 paying no homage to the aristocracy and learned pedantry of 
 the profession, only so far as it has contributed to the advance- 
 ment of science. Finally, that we adopt and adhere to the facts 
 of the conservative, and enter into the labors of the reformer, 
 with equal cordiality. 
 
 17th. To use every practical means to inform the public upon 
 the subject of medicine in all its departments, that they may 
 understand the true merits of the different systems of medicine, 
 and be prevented from trusting their lives and health in the 
 hands of men ignorant of the principles and practice of the 
 profession. 
 
 18th. To cultivate the spirit of true Eclecticism, liberality and 
 progression ; and to show the positive necessity that every phy- 
 sician or student of medicine, who would acquit himself with 
 honor and with fidelity to his practice, should not only pass 
 through the ordinary and preliminary course of study, but that 
 his whole time and attention should be devoted to the investiga- 
 tion of all the therapeutic resources of every school of the pro- 
 fession, selecting from each that which science and experience 
 has proved beneficial in the treatment of disease. 
 
 It will be seen from the foregoing, that the principles laid 
 down as the basis of the American Medical Reform, cover every 
 department of the science. That they propose to annihilate the 
 boundaries of party limits ; to break the shackles which bind 
 the conservative to his dogma ; to reinvestigate existing symptoms 
 of medicine, and study anew all the laws of life and health ; to 
 ascertain to what extent health may be promoted and disease 
 prevented. This is the work which has been commenced by 
 American Medical Reformers, and to the completion of which, 
 they will consecrate their future labors. They desire to esta- 
 blish a practice based upon scientific principles and inductive 
 experience. They claim that, as a man is composed of the com- 
 mon elements of matter, that to understand his organism in its 
 physiological, pathological and therapeutical relations, is to 
 understand his material structure and forms, with their various 
 movements and forces, and cause of forces, which necessarily 
 includes an intimate knowledge of the great branches of Physi- 
 cal Science, vegetable, animal, and mineral, with all the laws 
 and forces which control them, as electrical, magnetical, chemi- 
 
PRACTICAL PRINCIPLES. 41 
 
 cal, dynamical, and physiological or organical. The fallacies 
 of all former doctrines in medicine have, in a great measure, 
 arisen from a want of this important knowledge. The 
 allopathist, in establishing his system of medication, that all 
 diseases are cured by medicines that alter or change the struc- 
 ture or physiological forces of diseased parts, entirely omitted 
 the chemical, organic and vital dependencies of matter, as the 
 very disease which he intends to remove, by altering the organic 
 tissue, may depend upon deficiency of carbon, nitrogen, hydro- 
 gen or oxygen. As these substances alone possess the power of 
 combining and forming the basis of all the elementary tissues, 
 a deficiency of either of these elements may give rise to a series 
 of pathological changes that no allopathic alterative could over- 
 come, the only remedy being to introduce into the diseased organ- 
 ism its original elements. 
 
 Suppose the gastric fluid to be imperfect, as it frequently is, 
 owing to a deficiency of oxygen to unite with the chyle and 
 blood, out of which it is formed. Any attempt to re-establish the 
 normal quantity by alteratives would prove as effectual as an 
 attempt to reorganize water, after. the oxygen is set free, by 
 adding alteratives. A deficiency of the carbonates may cause a 
 disease of the liver, lungs, cartilage, bones or muscles. It is a 
 fact that carbon, united with soda, constitutes a large portion of 
 bile ; that, combined with lime, it forms one of the elements of 
 the teeth, bone, &c; that it unites with oxygen in the lungs to 
 maintain animal temperature. Let us inquire, of the allopathist, 
 how many doses of mercury, how much alterative influence, 
 from bleeding and blistering, will compensate for this deficiency. 
 It must be borne in mind that the human system is an extensive 
 organic chemical laboratory, in which is manufactured germ- 
 cells, epithelium, mucus, muscle, nerves, brain, gastric juice, 
 saliva, chyme, chyle, blood, lymph, tears, hair, nails, cuticle, 
 cartilage, bone, &c. The object of this extensive manufactory 
 is to furnish material for the constant demand made by the 
 human body, that it may maintain its integrity and perpetuity. 
 This constant demand arises from the fact, that not only all the 
 inorganic, but the organic elements, which come in contact with 
 the human organism, tend to unite with it and form new com- 
 pounds, structures and forces, thereby disturbing the natural 
 4* 
 
42 PRACTICAL PRINCIPLES. 
 
 relations and dependencies of the human organism upon its 
 organic elements, causing disintegration and destruction of the 
 old tissue, which is supplied by these newly-manufactured pro- 
 ducts. Any excess or deficiency in the supply is disease. And 
 the only philosophical method of curing or removing such 
 abnormal conditions is to supply elementary deficiencies, pre- 
 vent excesses, and maintain the natural relation of elementary 
 principles to the human organism. What is true of Allopathy 
 is equally true of Homoeopathy. Who, after a moment's reflec- 
 tion, would suppose that chlorosis, which every pathologist 
 admits is dependent upon a deficiency of iron in the blood, 
 could be removed by infinitessimal doses of charcoal, oyster- 
 shell, mercury and arsenic. Or who would suppose that the 
 same remedies would remove disease of the bones, caused by a 
 deficiency of lime and carbon in the system. But, what is still 
 more ridiculous and absurd, in this hair-brain theory of Hahne- 
 mann and his followers, is, that their remedies, as mercury, 
 arsenic, belladonna, &c, are capable of causing, and consequently 
 of curing, fifty or sixty diseases each. Jahr, in his Manual of 
 Homoeopathy, vol. i., p. 563, states that sulphur will both cause 
 and cure the feeling of despair of eternal salvation. Lachesis 
 (p. 310, Jahr's Manual) produces, and hence should cure 
 absence of religious feeling and fear of approaching death ; a 
 small dose of gold, taken internally, produces excessive scruples 
 of conscience, and despair of one's self and others ; veratrum 
 produces extraordinary taciturnity, with oaths on the slightest 
 provocation, and raving about religious matters. Aconite (p. 3) 
 produces an irresistible desire to blaspheme and swear, and a 
 sensation as if the mind was separated from the body. Ana- 
 cardium (p. 33) produces the same swearing symptoms and 
 absence of all moral and religious feelings; (vol. ii., p. 155) a 
 dose of common colocynth (an ingredient in allopathic pills 
 which most people have repeatedly swallowed) produces (says 
 Jahr, p. 189) want of all religious feeling, &c, &c, &c. 
 Lycopodium (club-moss) possesses the same power (p. 319) as 
 sulphur, i. e. the feeling of despair of eternal salvation. Pulsa- 
 tilla causes, and will cure, despair of eternal happiness, with 
 continued prayer and devout aspects (Jahr, p. 468). 
 
 Thus, while Homoeopathy is equally unphilosophical in its 
 
PRACTICAL PRINCIPLES. 43 
 
 general principles, it has advanced some of the most extravagant 
 notions relative to the action of medicine ever advocated by any 
 sect in the profession since the magic incantations of the fol- 
 lowers of iEsculapius. If it were true that these remedies 
 would produce such terrible conditions of body and mind, the 
 effects would be still more disastrous. 
 
 In this case, a patient, who was curing, himself for itch with 
 sulphur, would be seized with despair of eternal salvation ; also, 
 according to Pulte's Homoeopathic Domestic Practice, p. 516, he 
 would contract periodical and intermittent head-ache ; obstruc- 
 tion of the ears, with humming and redness ; inflammation and 
 ulceration of the nose; profuse perspiration day and night; con- 
 gestion of blood in the head ; heat in the face ; tooth-ache ; sore 
 mouth ; dislike for sweets ; pain in the abdomen ; constipation 
 and piles. We can readily conceive how a person, who was 
 suffering under the influence of the above disease, would be will- 
 ing to endure many inconveniences to obtain relief, but, that he 
 would exchange it for such a catalogue of ills is quite doubtful; 
 and yet, if the homoeopathic doctrine be true, and their notions 
 of the action of remedies correct, such would be the case ; and 
 while one morbid condition of the human organism was being 
 corrected, several hundred others would make their appearance. 
 It is frequently claimed, by the disciples of this system, that 
 although the law of similia similibus curaniiir cannot be esta- 
 blished by appeal to the philosophy of medicine, still experience 
 teaches it to be true in practice, and they have observed cases to 
 recover while under its influence. This may be true, and yet it 
 may not follow that the medication contributed in the least to 
 the result ; as it is now a well-attested fact that, without medical 
 interference, the average mortality of all disease in this country 
 does not exceed seven per cent. Hence, to ascertain the useful- 
 ness of any system of medicine, it is necessary not only to 
 observe that some recover, but also how many the profession 
 loses: if above seven per cent., it may be inferred that medica- 
 tion increases the mortality of disease. The limits of this work 
 will not permit me to enter into a full investigation of these 
 different systems of medicine, and show what I conceive to be 
 true relative to all their principles. But in accordance with the 
 principles of American Eclecticism, while we would reject every 
 
44 PRACTICAL PRINCIPLES. 
 
 hypothesis not founded upon science, we would gladly adopt 
 whatever Homoeopathy, Hydropathy or Allopathy contributes to 
 the real advancement of medicine. 
 
 The therapeutic principles which guide us, then, are neither 
 exclusively Homoeopathic, Allopathic, Hydropathic, Antipathic, 
 Physiological, nor Hygienic ; but, by an intimate knowledge of 
 the laws of life and organic elements of the different tissues, 
 with a correct view of all the causes and influences brought to 
 bear upon the human organism, together with a knowledge of 
 all the physiological and pathological changes connected with 
 disease, we are enabled to adopt such principles of cure as the 
 nature of the case may indicate. In the choice of our remedial 
 agents, we claim equal independence and liberality, selecting 
 from all systems such as science and enlightened experience 
 prove to be beneficial to the afflicted, having formed no definite 
 "boundary to our researches ; for, as yet, no theory of medicine, 
 as an independent system, has been able to stand the test of 
 scientific analysis and experience. The following remarks of 
 Thomas Jefferson, in a letter to Dr. Worcester, are to this point. 
 He says: — " I have lived, myself, to see the disciples of Boer- 
 haave, Cullen, Stahl, and Brown, succeed each other like the 
 shifting figures of the magic lantern," and the practice predicated 
 thereon, of course as evanescent and as changing as its sister 
 theory ; and we, of the present time, have, most of us, witnessed 
 one entire revolution in theory and practice of disease ; while 
 we are at this very moment, on the last quarter of the full moon 
 glory of a fast fading system. Where is the practitioner so 
 wedded to the past, so tenacious of early practice, and so un- 
 compromising of change as to risk his reputation or the lives 
 of his patients, on the practice of twenty years ago ? It is more 
 than probable that before another half century has passed, the 
 present system of Hydropathy, Homoeopathy and Allopathy, 
 like -the systems of Hoffman, Boerhaave, Cullen, Stahl, and 
 Brown, will be remembered only as a relic of the past. The 
 well-attested truths of each will, no doubt, be treasured up by 
 the American democratic or Eclectic cultivator of medical 
 science, to contribute to that perfection in medicine, which will 
 enable it to take rank with Chemistry, Geology, or Mathematics. 
 To accomplish this is the object of American Eclecticism. 
 
ANTIDOTES TO POISONS. 45 
 
 For further consideration of this subject, the reader is referred 
 to my large work on the American Practice of Physic, now in 
 course of preparation. 
 
 ANTIDOTES TO POISONS. 
 
 The term antidote had, formerly, a much wider signification, 
 and was applied to the remedies for diseases occurring from 
 natural causes, as well as to the remedies for the derangement 
 of the functions, arising from the direct introduction into the 
 system of a known and material poison. 
 
 The selection of appropriate means to counteract the effects of 
 poisons must be determined by a knowledge of the manner in 
 which each particular poison acts ; but as our limits will not 
 permit us to enumerate or specify these, some general rules, 
 only, will be given. 
 
 The first indication is to remove the poisonous substance ; the 
 second, is to prevent or limit its local effects ; the third, to 
 obviate the effects on remote organs,- supporting their action by 
 appropriate measures, till the injurious impression has subsided. 
 The first of these is to be accomplished mostly by mechanical 
 means. If the poison has been applied to any external part, as 
 by the bite of a viper or rattle-snake, a cupping-glass, or what 
 will answer as well, a wine-glass, tumbler or cup of any kind, 
 from which a part of the air has been expelled, by holding within 
 it a lighted candle for a second of time, should be applied 
 immediately. 
 
 If poison has been taken into the stomach, and is not of a 
 kind to arrest instantly the action of the heart, its removal is to 
 be attempted by the stomach-pump, or by exciting vomiting. 
 The stomach-pump cannot well be used without introducing into 
 the stomach a considerable quantity of water, which, by diluting 
 the poison, lessens its violence, in all cases, except that of oxalic 
 acid. But should a stomach-pump not be at hand, we must 
 attempt to produce vomiting by every means in our power. For 
 this purpose, a tablespoonful of flour of mustard, which is 
 mostly to be found in every house, may be put into a tumbler of 
 warm water, and given to the patient ; or twenty grains of Sul- 
 
46 ANTIDOTES TO POISONS. 
 
 phate of Zinc (white vitriol), dissolved in a pint of -warm water, 
 and the disposition to vomit encouraged by tickling the throat 
 with a feather, and pressing on the pit of the stomach. Neither 
 Ipecac, nor Tartar Emetic should be given, as their action is 
 always preceded by much nausea, during which the absorption 
 of the poison is often facilitated. 
 
 When the poison is of a corrosive or irritant nature, instead 
 of losing time in seeking the means of causing vomiting, it is in 
 general advisable to adopt the second rule, and attempt to pre- 
 vent or limit its local, and thereby its remote, effects. To accom- 
 plish this we must ascertain what the poisonous substance was 
 from which the patient is suffering, and must also know how it 
 acts, as upon this depends the success of our treatment. The 
 objects we should have in view are either to dilute, and so weaken 
 it ; to supply from an external source the particular principle 
 which the poison would abstract from the coats of the stomach ; 
 or, by adding something to it, so change its nature as to render 
 it comparatively or altogether harmless, which last will always 
 be effected if we can succeed in forming an insoluble compound. 
 The first may be done by giving plenty of warm water; and 
 when we know the particular poison, if the warm water can be 
 made the vehicle of an antidote, the second or third object will 
 also be ensured. Suppose Sulphuric Acid (oil of vitriol) has 
 been swallowed ; add to the water, chalk, magnesia, soda, sale- 
 ratus or soap ; the acid will form with these substances purgative 
 salts, and will, by their action on the bowels, assist in lessening 
 the inflammation caused by the poison before its being neutralized. 
 So when Sugar of Lead (acetate of lead) is swallowed, by giving 
 Epsom Salts (sulphate of magnesia) we form an insoluble sul- 
 phate of lead, which will be discharged by the bowels, operated 
 upon by the magnesia, which has been freed from the sulphuric 
 acid. Corrosive Sublimate (bichloride of mercury) abstracts 
 from the coats of the stomach the albumen which they contain, 
 by which it is converted into proto-chloride, or calomel ; now 
 if, by giving white of egg, which is pure albumen, we supply it 
 with the principle which it would otherwise obtain from the 
 coats of the stomach, we shall preserve these entire. 
 
 Such means, then, are antidotes properly speaking ; for the 
 
ANTIDOTES TO POISONS. 47 
 
 means by which the secondary or remote effects are to be com- 
 bated, deserved rather to be termed counter-poisons. The 
 counter-poisons are of no small value in cases of poisoning by 
 the corrosive or irritant, while they are of the utmost importance 
 in the treatment of the sedative and narcotic poisons. To 
 administer these appropriately, we must know which of the vital 
 organs the poison most speedily affects. "When it affects the 
 heart, the s}^mptoms greatly resemble S3 T ncope (or fainting), and 
 as such poisons are the most dangerous, agents, which act as 
 rapidly as the poisons, are alone to be trusted to : such agents 
 are to be found among the diffusible stimuli, ammonia, or its 
 carbonate, i. e. smelling-salts, applied to the nostrils, or dissolved 
 in water and taken into the stomach, warm brandy and water, 
 &c. Where it chiefly affects the spinal marrow, there occur 
 spasms and difficulty of breathing; when the brain, there is a 
 partial or complete insensibility (coma), often with, at first, full 
 pulse, flushed face, and laborious breathing, resembling apoplexy. 
 In such a state of affairs, artificial respiration, with the admin- 
 istration of coffee and vinegar, greatly contribute to save the 
 patient. 
 
 Antidotes to Vegetable Alkaloids, 
 
 In poisoning by opium, salts of morphia, hemlock, aconite, 
 belladonna, strychnine, colchicum, &c, take iodine, gr. iij ; 
 iodide of potassium, gr. vj ; water, 16 ounces. The stomach 
 having been emptied, the mixture is to be given by glassfulls, 
 still encouraging the vomiting; and to be followed (in the case 
 of narcotics) by strong infusion of coffee. Purified animal 
 charcoal absorbs and renders inert the active principles of many 
 vegetable poisons, given in doses of an ounce or more, diffused 
 in warm water. 
 
 Antidotes to Metallic Poisons. 
 
 The salts of mercury, copper and lead, are decomposed by 
 the hydrated proto-sulphuret and per-sulphuret of iron, and the 
 compounds produced are comparatively inert. The antidote for 
 poisoning by arsenic is the hydrated sesquioxide of iron. It 
 
48 ANTIDOTES TO POISONS. 
 
 may be made by adding carbonate of soda to the muriate of 
 iron. It should be given in the moist state, mixed with water — 
 after being once dried, it loses much of its power. 
 
 When given in time, magnesia and chalk is an antidote for the 
 mineral acids and oxalic acid ; albumen (white of egg) for cor- 
 rosive sublimate and verdigris ; bark, for tartar emetic ; common 
 salt for lunar caustic ; sulphate of soda or magnesia for sugar 
 of lead and muriate of baryta; vinegar and oil for the fixed 
 alkalis. These substances act either by neutralizing the 
 corrosive power of the poison, or by forming with it an insoluble 
 compound. 
 
 From what has been said upon this subject, the necessity of 
 an acquaintance with it must be sufficiently clear, not only to 
 ensure our doing right, but to prevent us from doing wrong. By 
 administering an ill-timed antidote, we may often hasten the 
 fatal event ; as where vinegar is given when opium has been 
 swallowed, before it has been ejected from the stomach ; and by 
 throwing tobacco smoke into the bowels of a person apparently 
 drowned, we extinguish the feeble spark of life, which might 
 have sufficed to reanimate him, but for such injudicious inter- 
 ference. 
 
AN EPITOME 
 
 OF THE 
 
 AMERICAN ECLECTIC PRACTICE OF MEDICINE. 
 
 EPHEMERA. 
 
 Ephemera is a fever which lasts but one day. Its 
 symptoms are chilliness and anorexia or indifference to 
 food, followed by a hot skin, flushed face, with hard and 
 frequent pulse. In the course of from sixteen to twenty- 
 four hours, these symptoms yield to a gentle perspiration, 
 which lasts one or two hours, leaving no trace of fever 
 save slight debility. It is mostly confined to children, 
 and may be considered the simplest form of fever, requiring 
 only mild treatment. 
 
 TREATMENT. 
 
 Give a warm bath by immersing the patient in warm 
 water, or by sponging the surface frequently in warm sal- 
 eratus water. If the head is hot, apply a towel wrung out 
 of cold water, and change often. 
 
 If the fever is persistent, add ten drops of the Tinct. of 
 Aconite to ten tablespoonfuls of pure water, and give one 
 teaspoonful every half hour until the fever subsides. If 
 the bowels are confined, give a warm water injection. 
 Warm or cold packs may be resorted to in case of local 
 congestion. 
 
 5 (49) 
 
50 INTERMITTENT FEVER. 
 
 INTERMITTENT FEVER, OR AGUE. 
 
 SYMPTOMS. 
 
 Febrile paroxysms occurring at regular intervals of 
 longer or shorter duration. But mostly recurring every 
 twenty - four, forty - eight, or seventy - two hours. The 
 twenty-four hour type is the Quotidian, the forty-eight 
 hour the Tertian, and the seventy-two hour the Quartan. 
 The interval between the paroxysms is called the Apyrexia. 
 The period from the commencement of one paroxysm to 
 the end of the next is called the revolution. Either type 
 of this fever may appear in a double form. Thus, Quo- 
 tidian frequently occurs twice a day, producing double 
 Quotidian. The Tertian and Quartan, when occurring in 
 a double form, produce a double paroxysm every second 
 and third day. The double daily paroxysms have some- 
 times been ascribed to the double Tertian. And their 
 occurrence at different hours on alternate days, together 
 with the difference in the severity of the paroxysms, have 
 been described by Prof. Jones as diagnostic symptoms of 
 double Tertian. But having frequently observed the Ter- 
 tian type manifesting itself in double paroxysms every 
 other day, with a perfect immunity from the disease on the 
 Apyrexial day, I am led to infer that the double daily 
 paroxysm, ascribed to the double Tertian, is only one 
 modification of double Quotidian. This fever is generally 
 preceded by languor, pain in the bones, irregular bowels, 
 and alternate changes in the urine, which characterize the 
 type of the approaching disease by occurring at the same 
 regular intervals, and lasting the same length of time. 
 These changes in the urine are from a light limpid to a 
 dark yellow appearance. The tongue becomes covered 
 with a white thin coat, and from one to two hours before 
 the chill, the spleen yields a peculiar elastic resonance, 
 
INTERMITTENT FEVER. 51 
 
 and becomes considerably increased in size. About this 
 time distinct rigors or chills are felt, passing up the back 
 and down the legs ; the teeth chatter, the nails become 
 purple, the skin has the appearance of goose-flesh (cutis 
 anserina) with Horripilations. If the chill lasts for any 
 considerable length of time, there will -be oppressed breath- 
 ing, with precordial pressure. 
 
 In the course of from fifteen to thirty minutes these 
 symptoms gradually subside, and at first a mild fever suc- 
 ceeds, which continues to increase until the skin becomes 
 dry and hot. The pulse increases in fulness and frequency, 
 beating from 100 to 120 per minute. There is violent 
 throbbing of the carotid artery, severe pain in the head, 
 with dryness of the secretions, producing thirst, and scanty 
 and high-colored urine. There is also much restlessness 
 and uneasiness throughout the entire Pyrexia. 
 
 These symptoms, modified in different individuals and 
 localities, last from one to six hours, when they become 
 mild, and terminate in the sweating stage. The skin now 
 becomes covered with a profuse perspiration, the pulse 
 becomes soft and natural, the respiration easy, and the 
 patient feels as if almost restored to a state of health. 
 
 TREATMENT. 
 
 On the approach of the cold stage, the feet should be 
 placed in warm water, and the patient caused to drink 
 freely of some warm tea. After which he should be 
 placed in bed, with covering of hot flannel, and jugs of 
 hot water to the feet. As soon as the fever appears, the 
 extra covering should be removed, and from one to ten 
 drops of the Tinct. of Veratrum Yiride should be given 
 every half hour until the fever subsides. Cold packs 
 should be applied to the head, and hot sinapisms to the 
 feet. The body should be frequently sponged in warm 
 broke water, to which may be added a little whiskey. 
 
52 INTERMITTENT FEVER. 
 
 During the Apyrexia, the following compound may be 
 given for the purpose of interrupting and preventing the 
 return of the paroxysm : 
 
 R Eupatorin gr. xx. 
 
 Cornine gr. xx. 
 
 Citrate of Iron gr. x. 
 
 Mix, divide into six powders, and give one every three 
 hours, or oftener if it is necessary, in order to have them 
 all taken before the return of the paroxysms. 
 
 If the paroxysms return, the same treatment may be 
 pursued as at first, during the cold and hot stages. 
 After which, give the following compound : 
 
 U Viburine.... gr. x. 
 
 Rhusine .. gr. x. 
 
 Salicin gr. xxx. 
 
 Mix, divide into six powders, and give one every three 
 hours, or oftener as the case may require. 
 
 Or, 
 
 R Bebeerine gr. xx. 
 
 Quinine gr. x. 
 
 Phosphate of Iron gr. x. 
 
 Mix, divide into six powders, and give as above. 
 Or, 
 
 R Quinine.... gr. xx. 
 
 Bitartrate of Potassa gr. xxx. 
 
 Mix, divide into six powders, and give one every three 
 hours. 
 
 Or, 
 
 U Chinoidin gr. xx. 
 
 Capsicum gr. xx. 
 
 Santonine gr. xx. 
 
 Make ten pills, and give one every two hours. 
 
REMITTENT FEVER. 53 
 
 Or, 
 
 R Syrup of Bone Set , Oss. 
 
 Chloride of Sodium (Common Salt) §j. 
 
 Mix, dose 1 oz. every hour during the revolution. 
 
 Z] of pulverized Sassafras Bark, taken at intervals of 
 one or two hours during the revolution where the stomach 
 will tolerate it, is generally sufficient to interrupt the pa- 
 roxysms. Also a strong infusion of Strawberry root, 
 taken freely during the interval, will generally effect a 
 complete intermission. 
 
 After the paroxysms have been entirely interrupted, a 
 radical cure should be attempted by giving the patient a 
 mild alterative, such as Euonymine, one or two grains, 
 three or four times a day. If the bowels are costive, and 
 do not yield readily to the Euonymine, add ^ or ^ of a 
 grain of Podophyllin, and give sufficiently often to main- 
 tain them in a soluble state. 
 
 If the spleen continues permanently enlarged, Diuretics 
 of Marshmallow and Cream of Tartar should be drunk 
 freely. 
 
 On the seventh, fourteenth, twenty-first, and twenty- 
 eighth days succeeding the last paroxysm, one of the anti- 
 periodic compounds should be given as at first. 
 
 If the patient resides in an ague district, daily baths of 
 warm lye water, together with a free use of Cream of 
 Tartar and Marshmallow, will have a tendency to prevent 
 a recurrence of the disease. 
 
 REMITTEXT FEVEE. 
 
 Eemittent Fever, like Intermittent, is generally pre- 
 ceded by lassitude and yawning, with soreness and stiffness 
 of the muscles, especially those of the neck and calves of 
 the legs. The tongue is covered with a light yellow coat. 
 5 * 
 
54 REMITTENT FEVER. 
 
 The countenance is shrunken, pale, and of a leaden hue. 
 The conjunctiva presents a congested appearance. The 
 urine is thick and of a dark yellow color. The bowel? 
 are costive. The liver is congested, and yields flatness on 
 percussion. 
 
 There is sense of weight in the Hypochondric and Epi- 
 gastric regions. Creeping sensations of cold are suc- 
 ceeded by flushes of heat, the taste in the mouth is me- 
 tallic, the skin is sallow, and sleep is disturbed by alarming 
 dreams. These symptoms increase in intensity, until the 
 attack of the disease is established. As the hot stage be- 
 comes developed, much of the pain about the legs and 
 back frequently abates, although it often returns at the 
 next exacerbation. Frequently, there is a sensation of 
 chilliness, lasting from ten minutes to one hour, during 
 which there is excessive thirst, nausea, and vomiting, 
 mostly rejecting the fluids and medicine taken. There is 
 intense fever with much tenderness of the Epigastrium 
 and right Hypochondrium, which becomes painful upon 
 pressure. The countenance is flushed, the eye has a wild 
 expression, with a violent pain in the head, and in some 
 cases delirium. The pulse is frequent, beating during the 
 fever from 120 to 130 per minute. It is sometimes small 
 and irregular, at others full and forcible. The tongue is 
 mostly brown, with a dry streak through the middle. The 
 bowels are costive, but, when acted upon, the discharges 
 are black or yellow. The urine is scanty and muddy. 
 These symptoms usually continue from six to ten hours. 
 
 The febrile paroxysm is superseded by a gentle perspi- 
 ration on the head and shoulders, rarely extending over 
 the entire body. There is now a mitigation of all the 
 paroxysmal symptoms ; yet there is by no means a perfect 
 A pyrexia. The pulse is still quick and irritable, with 
 Tinnitus Aurium, lassitude and much debility. This state 
 is called the remission, and lasts from one to three hours, 
 
REMITTENT FEVER, 55 
 
 when the febrile symptoms recur, and gradually increase, 
 until they acquire their former intensity, and do not sub- 
 side until after a period longer than that occupied by the 
 first paroxysm. In the subsequent exacerbations, the 
 symptoms all become aggravated, except the chill, which 
 generally becomes less marked each succeeding paroxysm, 
 These exacerbations generally occur in a double Quotidian 
 form, although I have frequently observed them, both of 
 single and double Tertian, and Quartan. 
 
 TREATMENT. 
 
 This fever, if timely treated, yields with much readiness 
 to mild antiperiodic, and alterative remedies. As for 
 instance, in the forming stage, combine thirty or forty 
 grains of Cornine with equal parts of Euonymine divided 
 into six powders, and give one every two or three hours, 
 until a full antiperiodic and alterative impression is pro- 
 duced. This, with rest, and free bathing, will generally 
 arrest the disease. 
 
 During the cold stage the patient should be placed in 
 bed, and a hot pack be applied to the bowels, and also to 
 the regions of the liver and spleen. Hot sinapisms should 
 be placed along the spine and the calves of the legs, ex- 
 tending to the ankles and feet. As soon as the fever 
 makes its appearance, the sinapisms should be removed, 
 and the packs changed to tepid ones. The body should 
 be freely sponged in warm lye water, every hour or two, 
 as long as the fever lasts. The head should be packed in 
 towels wrung out of cold water, and from ten to twenty 
 of the Intermittent drops be administered every half hour. 
 
 These drops are composed of equal parts of fluid Ext, 
 of Lobelia, Cypripedin and Scutellaria. 
 
 If the stomach will not tolerate them, from one to ten 
 drops of the Tinct. Teratrum Viride may be given every 
 fifteen or twenty minutes, until the same effect is produced, 
 
56 REMITTENT FEVER. 
 
 After the remission is fully established, the following 
 antiperiodic compound may be given. 
 
 R Quinine gr. xx. 
 
 Phosphate of Iron gr. x. 
 
 Ferrocyanide of Potassium gr. j. 
 
 Mix, divide into six powders, and give one every two 
 hours. 
 
 Or, 
 
 U Bebeerine gr. xx. 
 
 Salicine * gr. xx. 
 
 Viburin gr. xij. 
 
 Mix, divide into six powders, and give one every three 
 hours. If the exacerbation comes on before the pow T ders 
 are all taken, give one eighth of a grain of Veratrine with 
 each alternate powder, till the remission becomes distinct. 
 Or give Tinct. of Yeratrum in quantity sufficient to sub- 
 due the fever. If this antiperiodic should not completely 
 arrest the disease, before repeating it, the bowels should 
 be moved by giving one gr. of Jalapin, one half gr. of 
 Phytolacca mixed with thirty grains of sugar, and given 
 in three doses at intervals of one hour. If this should fail 
 to produce Catharsis, give one teaspoonful of the fluid 
 extract of Antibilious physic every half hour, accompanied 
 with warm water injection until the bowels move freely. 
 After which, give one of the above antiperiodic com- 
 pounds as before. Or if the stomach become irritable, 
 
 U Quinine * gr. xx. 
 
 Cream of Tartar , gr. xxx. 
 
 Simple Syrup gij. 
 
 Mix, and give one teaspoonful every hour until all is taken. 
 If the stomach still continues irritable, thirty drops of the 
 Tinct. of Gelseminum, and one grain of Morphine, may be 
 added to the above mixture. 
 
 When the paroxysms are very severe, and accompanied 
 
CONGESTIVE EEVER. 5T 
 
 by congestion of some of the vital organs, and the natural 
 increased intensity of the next exacerbation would prove 
 disastrous to the patient, a large and full dose of some 
 antiperiodic, in connection with an intermittent, should be 
 administered at once. As for instance, 
 
 U Quinine gr. xx. 
 
 Scutellarine ,. gr. x. 
 
 Cypripedin gr. x. 
 
 Mix, divide into three powders, and give one every hour 
 until all are taken. Or if the approaching exacerbation 
 is near at hand, they may be given at still shorter intervals. 
 
 When the paroxysmal form of the fever is removed, 
 little remains to be done, save to repair the local and con- 
 stitutional injuries produced by the disease. To restore 
 the deranged functions of the liver, one or two grains of 
 Euonymine may be given night and morning. 
 
 The tone of the stomach may be restored by adding 
 fifteen grains of Hydrastin to one half pint of Simple 
 Syrup, and one eighth of a pint of gin, of which one or two 
 teaspoonfuls may be given before each meal. If there is 
 a tendency to relapse, or if the disease assumes an inter- 
 mittent form, as it frequently does, the antiperiodic altera- 
 tive, and tonic course, should be pursued until the parox- 
 ysms are arrested, and the causes removed. 
 
 CONGESTIVE OR TYPHUS FEVER. 
 
 Much diversity of opinion exists relative to this disease. 
 Some regarding it as a Continued Fever, of a highly con- 
 tagious character, while others consider it as one of the 
 modifications of malarial fever, belonging to the intermit- 
 tent family. 
 
 The limits of this work not being sufficient to admit of a 
 thorough investigation of this subject, the reader is re- 
 
58 CONGESTIVE FEVER. 
 
 ferred to the American Eclectic Practice, by Jones and 
 Morrow, for a more minute description of this disease. 
 
 SYMPTOMS. 
 
 It is preceded by languor, headache, disturbed sleep, 
 loss of appetite, followed by chilliness, swollen tongue, and 
 great debility. The bowels are costive, the urine scanty 
 and high-colored, the countenance is dingy and heavy, the 
 eyes watery, with congestion of the conjunctiva, which 
 often extends to the nasal fossa and larynx. There is 
 ringing in the ears, with Epistaxis, and sense of fulness in 
 the Epigastrium. 
 
 These symptoms continue for two or three days, wheir 
 the teeth become covered with dark sordes, the pulse 
 becomes compressible, and the countenance is of a flushed 
 appearance. 
 
 The debility becomes more marked from the tenth to the 
 twentieth day, and the symptoms are all more aggravated. 
 
 There is incoherent talking, and delirium ; the tongue 
 becomes dark and dry, with tremor of the hands, and 
 Subsultus Tendinum. The evacuations become involun- 
 tary, with retention of the urine, and interrupted breath- 
 ing. The surface is covered with cold sweat, and the 
 patient expires. 
 
 This fever lasts from ten to thirty days. It is frequently 
 confounded with Typhoid Fever, from which, however, it 
 may be distinguished, by the absence of petechia?, the 
 costive state of the bowels, and swollen condition of the 
 tongue. Also, it usually assumes a more intermittent or 
 remittent type. 
 
 Where congestive fever is about to terminate favorably, 
 the symptoms are much milder than those described above, 
 and from the tenth to the twentieth day there is a diminu- 
 tion in the severity. 
 
 
CONGESTIVE FEVER. 59 
 
 TREATMENT. 
 
 There is generally more local congestion in this than 
 any of the previous forms of fever, with almost a complete 
 suspension of the assimilating functions. To remove the 
 congestion, and restore the assimilatiug functions, is the 
 prominent indication to be fulfilled. In the early treat- 
 ment of this disease, hot packs should be applied to all 
 parts of the body involved in the local congestion, except 
 the head, which should be kept cool. For the purpose of 
 restoring the assimilating functions of the stomach, pro- 
 ducing intermission, and interrupting the paroxysmal cha- 
 racter of the disease, the treatment should consist of those 
 remedies possessing intermittent, antiperiodic, and stimu- 
 lating powers, such as the following compounds : 
 
 No. 1. R Quinine gr. xx. 
 
 T. Xanthoxylin , gr. xx. 
 
 Capsicum gr. x. 
 
 Mix, divide into six powders, give one every three hours. 
 Alternate each powder with ten or fifteen intermittent 
 drops. 
 
 Or, 
 
 No. 2. R Quinine gr. xx. 
 
 Capsicum gr. xx. 
 
 Veratrin gr. ij. 
 
 White Sugar gr. xx. 
 
 Mix, and divide into ten powders, and give one every two 
 or three hours. 
 Or, 
 
 No. 3. E Camphor gr. v. 
 
 Quinine gr. xx. 
 
 Viburine gr. x. 
 
 White Sugar ; gr. xx. 
 
 Mix, and divide into twenty powders, and give one every 
 two or three hours. 
 
60 CONGESTIVE FEVER. 
 
 Or, 
 
 No. 4. j£ Eupatorine gr. xx. 
 
 Ainuin .... , gr. xx. 
 
 Aconitine gr. Iss. 
 
 White Sugar gr. xx. 
 
 Mix, divide into six powders, and give one every two 01 
 three hours. 
 
 Or, 
 
 No. 5. R Scutellarine gr. xx. 
 
 Chinoidin gr. xx. 
 
 Oil Capsicum gutt. iij. 
 
 White Sugar gr. xx. 
 
 Mix, divide into eight powders, and give one every two 
 or three hours. 
 
 To act as an alterative after the fever is broken : 
 
 R Euonymine gr. xx. 
 
 Podophyllin gr. ij. 
 
 White Sugar gr. xx. 
 
 Mix, divide into ten powders, and give one every three 
 hours. 
 
 The bowels should be kept open, during the treatment of 
 this disease, by giving small doses of neutralizing mixture 
 and Euonymine, and the body should be freely sponged 
 with lye water and whiskey. In cases where there is evi- 
 dent derangement of the stomach, with costive state of the 
 bowels, an emetic and cathartic should be given, previous 
 to the administration of the antiperiodic powders. A 
 teaspoonful of common emetic acetic Tinct. in warm 
 ginger tea, may be given every ten or fifteen minutes, until 
 the stomach is thoroughly evacuated. This should be 
 followed by small doses of Podophyllin and neutralizing 
 mixture, until free catharsis is produced. In cases where 
 there are severe paroxysms, and the local congestion is 
 likely to prove disastrous to the patient, the antiperiodic 
 
CONGESTIVE FEVER. 61 
 
 should be administered first, and the emetic and cathartic 
 should follow. 
 
 But, whether the emetic and cathartic, or the powders 
 be given first, if they fail to arrest the paroxysms, there 
 should be a repetition of the antiperiodic powders after 
 two or three days. During the interval, the patient 
 should drink freely of some mucilaginous preparation, as 
 marshmallow, flaxseed, or slippery elm. At the same 
 time, if the skin be dry, from five to ten drops of Tinct. 
 of Veratrum may be given to produce moisture. If, after 
 pursuing the above course of treatment a week or ten 
 days, the fever still proves persistent, the following com- 
 pound may be given : 
 
 U Ferri Ferrocyanide gr. xx. 
 
 Quinine gr. xx. 
 
 Piperine , gr. x. 
 
 Gelsemin. '. gr. ij. 
 
 White Sugar , gr. xxx. 
 
 Mix, triturate, divide into ten powders, and give one 
 every two or three hours. 
 
 If, during the progress of the disease, there is trouble- 
 some Epistaxis, a snuff of Matico leaves may be used, or 
 an infusion of them may be injected into the nostrils. If 
 there is much restlessness and inability to sleep, one-eighth 
 of a grain of Hyosciamin, with Cypripedin and Scutel- 
 larin, each one grain, given two or three times a day, will 
 control the symptoms. Where there is tendency to syn- 
 cope : 
 
 R Carbonate of Ammonia gr. v. 
 
 Gruni Camphor gr. v. 
 
 Capsicum gr. x. 
 
 Pulverized Acacia gr. xxx. 
 
 Triturate, mix, and give one as often as indicated. 
 During the treatment of this disease, the patient's strength 
 should be maintained by a free use of beef tea, boiled 
 
TYPHOID FEVER. 
 
 rice, and such other nutritious food as the stomach will 
 tolerate. During the convalescence, a mild alterative and 
 tonic course should be pursued. 
 
 Thus far we have been treating of fevers which are ad- 
 mitted to have their origin in marsh misasm, or are pro- 
 duced by exposure to damp atmosphere contaminated by 
 noxious gases, and decomposing vegetable matter, mostly 
 affecting the spleen, producing Intermittent ; or, the spleen 
 and liver, producing Remittent ; or, the spleen, liver and 
 nervous system, producing Typhus or Congestive fever. 
 But we now come to the treatment of a disease which is 
 supposed to have its origin in both animal and vegetable 
 miasm. And to confine its morbid influence mostly to the 
 small glands of the bowels, producing more or less exten- 
 sive ulcerations. This is called 
 
 TYPHOID FEVER. 
 
 This is a fever which has received quite a number of 
 names. Such as Enteric fever, Continued fever, Bilious 
 fever, Bilious Continued fever, and Nervous fever. But 
 the name by which it is most commonly known is that of 
 Typhoid Fever. 
 
 SYMPTOMS. 
 
 Few diseases are so remarkably insidious, in their ap- 
 proach, as this fever; its commencement being almost 
 imperceptible. Its incubation generally lasts from three 
 or four days to as many weeks. The patient feels at first 
 slight debility, with a dull and heavy feeling in the head, 
 which continues to increase, terminating in violent frontal 
 headache. By the time the disease becomes fully de- 
 veloped, the limbs are weak, with lameness, and in some 
 cases, rheumatic pains. The bowels are at first slightly 
 constipated; but in the course of a few days, there is a 
 strong tendency to diarrhsea. The pulse is accelerated, 
 
TYPHOID FEVER. 63 
 
 and a creeping chilly sensation is felt, commencing in the 
 back, and passing over the entire body. The chilliness is 
 soon followed by a slight increase of all the symptoms, 
 together with a dry and warm state of the skin. These 
 partial paroxysms, frequently follow each other in rapid 
 succession ; but sometimes there is an interval of several 
 hours. The tongue is but slightly coated, and the appetite 
 remains nearly natural until the disease becomes fully de- 
 veloped. Indeed, in a large number of cases which have 
 come under my observation, there is no anorexia during 
 the entire progress of well-marked cases of this disease. 
 
 About this time, there may be observed a number of 
 small white vesicles or sudaminaB, at first mostly confined 
 to the abdomen, but afterwards extending over the entire 
 body. These sudaminae, although frequently appearing in 
 other fevers, are more generally present in this. These 
 vesicles, unless carefully observed, will escape notice, as 
 they are frequently so small as to be scarcely perceptible 
 to the naked eye ; being seldom larger than half the head 
 of a pin. To the casual observer, they might easily be 
 mistaken for partial, detached, dermoid scales. But when 
 pricked with the point of a needle, a small quantity of a 
 thin white fluid may be seen to escape. On the fifth day 
 from the appearance of the sudaminaB, another eruption 
 appears which is diagnostic of this disease. It is small, 
 red, or purple spots or eruption, resembling flea-bites. 
 
 At first they are very small, so small that without the 
 aid of some magnifying power the larger portion of them 
 cannot be seen. They are at first perceptible just above 
 the ileo-caacal valve, or about one and one half inches 
 above the crest of the ileum, and extend over all parts of 
 the body* but are mostly confined to small patches of 
 skin corresponding to the ulcerated parts of the bowels. 
 These spots are called petechice. They are small circum- 
 scribed red spots when fully developed. They may be 
 
64 TYPHOID FEVER. 
 
 distinguished from most other forms of eruption, by dis- 
 appearing on pressure, but returning again the moment 
 the pressure is removed. They come and go, appearing 
 and disappearing ; but their presence or absence during 
 the active stage of the disease, is a sure index to the state 
 of the bowels. As when the bowel symptoms are aggra- 
 vated, the petechias disappear ; but when they become 
 ameliorated, are again visible. This leads me to infer 
 that Typhoid Fever, like Scarletina, is an eruptive disease, 
 and that to maintain the eruption on the surface, is a very 
 important indication to be fulfilled in its treatment. When 
 the disease becomes fully developed, and in some cases, in 
 the forming stage, the bowels yield a marked tympanitic 
 resonance on percussion. 
 
 On inspection, a bloated or tympanitic condition of the 
 bowels may be observed, and most marked, beneath the 
 patches of petechias. 
 
 About this stage of the disease, the nervous symptoms 
 become aggravated, amounting in many cases to delirium, 
 and in others producing great pain in different parts of 
 the body, as the knees, hips, abdomen, side and head. 
 These pains are mostly transitory, or appear in the form 
 of paroxysms. In a few cases the patient inclines to 
 stupor, but generally the opposite is the case, the patient 
 being restless and wakeful. There is a buzzing noise in 
 the head, very much like that caused by full doses of 
 Quinine. 
 
 The tongue, by this time, mostly assumes a red appear- 
 ance, especially upon the tip and edges, and the papillae 
 become elevated. When it is protruded it may be seen to 
 tremble, and in some cases it is protruded with much diffi- 
 culty. The pulse increases in frequency, but diminishes in 
 fulness ; and in the latter part of the disease it becomes 
 very compressible. The eyes have a watery appearance, 
 
TYPHOID FEVER. 65 
 
 and when the bowels become extensively ulcerated, they 
 have a vacant stare and remain partly open during sleep. 
 
 The breathing is laborious, the mouth is half open, and 
 sordes accumulate upon the teeth. The urine, which was 
 somewhat scanty, now becomes nearly suppressed, having 
 a dark red appearance, generally containing a large per 
 cent, of albumen. The bowels continue to bloat, the 
 evacuations are frequent, sometimes watery and frothy, at 
 other times dark and offensive, and mixed with blood : or, 
 the entire discharge may consist of blood amounting to 
 active hemorrhage ; being mostly of a dark venous charac- 
 ter, although I have seen it of a bright red color, or of 
 the appearance of fresh arterial blood. This symptom, 
 although alarming and dangerous if persistent, is fre- 
 quently followed by speedy recovery. The skin is not 
 as dry and hot as in many fevers, yet it is frequently 
 pungent, and has a husky feeling. The pulmonary organs 
 generally sympathize with affections of the bowels, and 
 especially is it the case in this disease. Hence we find 
 Crepitant Rhonchus, and frequently a slight cough. If 
 the disease is about to terminate fatally, the symptoms 
 will continue to increase in severity, the patient will 
 become stupid with low muttering delirium, subsultus ten- 
 dinuin, picking at the bed-clothes, coma, and death. Or 
 frequently the ulceration of the bowels may terminate 
 in perforation, followed by a discharge of the contents 
 into the cavity of the abdomen, producing at first much 
 pain, but soon subsiding, the patient becomes covered 
 with a cold clammy sweat, the pulse ceases at the wrist, 
 the bowels evacuate involuntarily, and the patient sinks 
 into the arms of Death. 
 
 Or what is more frequently the case, where mischievous 
 
 medication has been avoided, the symptoms will continue 
 
 in a somewhat modified form from fourteen to twenty-one 
 
 days, when they gradually become ameliorated, and the 
 
 G* 
 
66 TYPHOID FEVER. 
 
 patient recovers. The average mortality of this disease 
 is only about 10 per cent, or from 15 to 20 per cent, less 
 than it is under Allopathic treatment. 
 
 TREATMENT. 
 
 In no disease is there more mischief done by an im- 
 proper course of medicine than in this. 
 
 The practice of giving active purgative medicine in th( 
 commencement of a fever, with the notion of puking and 
 purging it from the system, has increased the mortality to 
 an alarming extent. For after a drastic purgative, it is 
 almost impossible to cure Typhoid Fever, no matter how 
 prudent your after course may be. First, in the treatment 
 of this disease, the skin should be thoroughly bathed in 
 warm lye water and whiskey. The patient should then be 
 placed in bed, when, if the bowels are costive, they should 
 be moved by warm water injections. If the stomach con- 
 tains indigestible food, or if there should be a marked in- 
 dication for an emetic, one-eighth of a grain of Lobelin 
 may be given in a wine-glass of warm ginger tea every ten 
 or fifteen minutes, until the stomach is thoroughly evacua- 
 ted. After this the patient should drink freely of beef tea 
 and rice gruel. When the stomach becomes settled, or the 
 effect of the emetic has passed off, give from one to five 
 drops of the Tinct. of Aconite in a tablespoonful of water 
 every half hour, until the pulse becomes less frequent and 
 the skin moist. At the same time apply warm lye poul- 
 tices to the bowels, made by adding one teaspoonful of 
 mustard-seed to ten tablespoonfuls. of slippery elm, wet 
 with strong saleratus water. These poultices should be 
 changed as often as three or four times a-day, and con- 
 tinued as long as the bowel symptoms prove troublesome. 
 
 When the pulse becomes controlled by the Aconite, the 
 next thing is to interrupt the periodicity of the disease, by 
 giving the following antiperiodic. 
 
TYPHOID FEVER. 6t 
 
 U Quinine gr. xx. 
 
 Hydrastin .., gr. xx. 
 
 White Sugar gr. xxxx. 
 
 Mix, divide into six powders, and give one every three 
 hours until all are taken. 
 
 At the same time, give freely of mucilage, such as a 
 cold infusion of pulverized marshmallow, acacia, or flax- 
 seed. Also apply water to the head. If the patient is 
 of a bilious temperament, and full habit, the water should 
 be cold. If of a nervous temperament, with low vitality, 
 the water should be tepid, and mixed with a little whiskey. 
 The feet should be kept warm, and the patient remain 
 quiet in bed. At the same time give a sufficient quantity 
 of Aconite to control the fever, and to maintain the 
 petechia upon the surface. If there should be diarrhoea, 
 small doses of equal parts of Erigeron and Rhusine should 
 be given two or three times a-day. If the patient be rest- 
 less and unable to sleep, from the sixteenth to an eighth 
 of a grain of Morphine may be mixed with one or two 
 grains of Cypripedin, and given at bed-time. If the 
 diarrhea proves persistent, in addition to the Khusine and 
 Erigeron, injections should be given two or three times a- 
 clay, composed of from four to six ounces of starch-water, 
 half a grain of Morphine, and from five to ten grains of 
 Tannin. If the Aconite fail to maintain the petechias 
 upon the surface, one half grain of Macrotin should be 
 given in connection with it. If, after pursuing the above 
 treatment for six or seven days, the disease should not be 
 arrested, the antiperiodic should be repeated by giving the 
 following compound : 
 
 U Phosphate of Iron gr. x. 
 
 ,Quinine gr. xx. 
 
 PJmsine gr. xx. 
 
 White Sugar gr. xxxx. 
 
 Triturate, mix, and divide into six powders, and give one 
 every three hours until all are taken. 
 
68 TYPHOID FEVER. 
 
 At the same time, the Aconite and anti-diarrhaea medi- 
 cines should be given if indicated. If the bowels should 
 become persistently tympanitic, with extensive ulceration, 
 the Tinct. Bryonia should be substituted for the Aconite, 
 and the patient prohibited from assuming the upright pos- 
 ture, as in all such cases there is great danger of perfora- 
 tion. Where there is much debility, a permanent tonic 
 may be given in connection with Chalybeates, such as the 
 following compound : 
 
 R Iron per Hydrogen gr. xx. 
 
 Hydrastin gr. xx. 
 
 White Sugar gr. xxx. 
 
 Triturate and mix, divide into ten powders, and give one 
 every two or three hours, during the interval between the 
 antiperiodic medicine. 
 
 During the entire course the patient's strength should 
 be maintained by a free use of the Essence of Beef, made 
 by adding one pound of beef to one quart of water and one 
 half pint of vinegar. Boil the beef till the liquid is one 
 half evaporated. Then strain ; add one pound of White 
 Sugar and eight ounces of rice flour, boil fifteen minutes, 
 strain again, add one half pint of best Old Whiskey, one 
 tablespopnful of salt, and bottle for use. Give the patient 
 from one half to one wine glass full four or five times a-day. 
 Also Porter or Scotch Ale, toast, or broiled beef may be 
 allowed when the stomach will tolerate it. In the event 
 that the medicine already prescribed fails to maintain the 
 petechias upon the surface, the Tinct. of Scrophularia may 
 be given to the amount of twelve drops three or four times 
 a day. If necessary to restore the eruption, hot brandy 
 toddy may be given in connection with the above. If 
 symptoms of softening of the brain appear, from one to 
 five drops of Tinct. Phosphorus may be given two or three 
 times a-day in a large quantity of mucilage. If dangerous 
 hemorrhage from the bowels occur : 
 
YELLOW FEVER. 69 
 
 R Nitrate of Silver gr. x. 
 
 Pulverized Acacia gr. xxx. 
 
 Pulverize, mix, make sixteen pills, and give one every 
 hour until all are taken, or until the hemorrhage is con- 
 trolled. Or give from ten to fifteen grains of Matico every 
 three or four hours. If an alterative is indicated, small 
 doses of Leptandrin may be given three or four times a clay. 
 Where the disease is firmly established, much care must be 
 observed relative to the administration of medicine, never 
 giving any, unless some marked indication demands it ; 
 frequently all the medicine necessary is a few drops of 
 Aconite two or three times a-day, with a liberal quantity 
 of mucilaginous drinks, one or two courses of antiperiodics, 
 and a liberal supply of food. Yet where there is a 
 decided indication for treatment, it should be met with 
 promptness. During convalescence, small doses of Hy- 
 drastin, in connection with Chalybeates, should be ad- 
 ministered. 
 
 YELLOW FEVER, OR TYPHUS 
 ICTERODES. 
 
 This disease prevails endemically in tropical climates, 
 but only appearing at the North as an epidemic. It is 
 generally supposed to have a compound origin arising 
 from the effects of animal and vegetable miasm. 
 
 SYMPTOMS. 
 
 The premonitory symptoms very much resemble those 
 of Typhoid Fever, except that they are more rapid in their 
 course. The skin is hot and dry, the face flushed, the 
 respiration hurried, the eyes are red and watery, and there 
 is nausea and vomiting. As the disease advances, these 
 symptoms all become aggravated, and the diagnostic 
 symptoms make their appearance. 
 
10 YELLOW FEVER. 
 
 The countenance assumes a peculiar cadaverous expres- 
 sion, and is of a bright saffron color. The tongue is soft 
 and swollen, and there is pain in the Epigastrium. During 
 the progress of the disease, the symptoms are variable in 
 different individuals and localities, sometimes running an 
 exceedingly mild course, with little more severity than ordi- 
 nary Remittent Fever, while in other cases the disease is 
 marked with great prostration. In the first stage the pulse 
 sinks, there is nausea, and vomiting of a dark frothy fluid ; 
 the respiration is exceedingly difficult and hurried. There 
 is also low muttering delirium. The alvine evacuations 
 are large and dark, the patient rapidly sinks, and death 
 soon relieves him, unless the disease is arrested by timely 
 treatment. 
 
 TREATMENT. 
 
 The first thing to be done in the early stage of the dis- 
 ease is to give a stimulating emetic : 
 
 U Pulverized Lobelia gr. x. 
 
 " Bloodroot gr. xij. 
 
 " Capsicum gr. xx. 
 
 Mix, add one gill of warm water, steep fifteen or twenty 
 minutes, and after giving the patient three or four wine- 
 glasses full of warm ginger tea, give one teaspoonful of the 
 mixture, and repeat until a thorough evacuation of the 
 stomach is produced. 
 
 Immediately after the emetic, give a spirit vapor-bath 
 by placing a blanket about the patient and chair, and burn- 
 ing a cup of alcohol beneath it, to produce a copious per- 
 spiration : at the same time give the patient freely of 
 weak salt and water to drink. After the sweat, a thorough 
 bathing and rubbing will prepare the patient for bed. The 
 following compound may then be given : 
 
 R Quinine gr. xx. 
 
 Chloride of Sodium gr. xxx. 
 
 Capsicum ., gr. x. 
 
YELLOW FEVER. Tl 
 
 Mix, divide into eight powders, and give one every three 
 hours until all are taken. At the same time, warm poul- 
 tices should be applied to the abdomen and stomach, and 
 hot sinapisms to the feet and calves of the legs, and a 
 warming plaster along the spine. 
 
 When the antiperiodic mixture has been taken, the fever 
 and circulation should be controlled by the use of Aconite, 
 and rest should be induced by giving Cypripedin and Scu- 
 tellaria or by small doses of Morphine. The bowels should 
 be moved by the following alterative : 
 
 R Euonymin gr. x. 
 
 Jalapin „ gr. ij. 
 
 Xanthoxylin gr. x. 
 
 White Sugar , gr. xxx. 
 
 Triturate, mix, divide into six powders, and give one every 
 two or three hours. 
 
 If there is much nausea and vomiting, the following 
 compound may be given : 
 
 B Vinegar . Oss. 
 
 Common Salt gj. 
 
 Capsicum gr. xx. 
 
 Mix, and give one teaspoonful every ten or fifteen minutes, 
 as the symptoms may indicate. If the disease should not 
 yield to the above treatment, within the course of three or 
 four days, the following antiperiodic should be adminis- 
 tered : 
 
 B Salicine gr. xxx. 
 
 Quinine , gr. xv. 
 
 Iron by Hydrogen gr. xx. 
 
 Capsicum gr. x. 
 
 Mix, divide into six powders, and give one every three 
 hours. At the same time give the patient freely of Ess. 
 of Beef as directed under Typhoid Fever. Once or twice 
 a day the patient should be bathed with warm lye water, 
 and allowed to drink of porter or good ale, whenever 
 
12 INFLAMMATION. 
 
 the active fever does not contra-indicate. Local congestion 
 or inflammation should be relieved by hot or cold packing, 
 as the case may require. During the convalescence, altera- 
 tive doses of Podophyllin, with Hydrastin as a tonic, may 
 be given once or twice a day, together with a free and 
 generous diet. If there should be symptoms of a relapse, 
 the antiperiodic remedies should be repeated. 
 
 INFLAMMATION. 
 
 Inflammation is always located in the capillary vessels. 
 Hence, tissues destitute of these vessels are never capable 
 of taking it on, as the hair, nails, cuticle, and enamel. 
 
 Filamentous tissues, on the other hand, as the liver, 
 lungs, and mucous and serous membranes, are very liable 
 to inflammation. The first step towards the inflammatory 
 process is an accumulation of blood, which is congestion. 
 This accumulation may occur either from too slow venous 
 or too rapid arterial circulation. Or it may arise from 
 debility of the capillary vessels, or from all these causes 
 combined. The congestion may disappear by a diminu- 
 tion in the afflux, together with a restoration of the normal 
 functions of the capillaries. Or it may terminate in inflam- 
 mation by the blood beginning to oscillate in the vessels, 
 adhering at different points until finally it stagnates. 
 
 The blood failing to be converted into venous blood, its 
 coagulability is increased so that the globules coalesce and 
 form minute clots. New vessels or canals are formed by 
 globules of blood bursting the vessels and passing into the 
 adjacent parenchyma, reaching another vessel, thus form- 
 ing new passages through the areolar tissue, which ulti- 
 mately become capillary tissue. Or the corpuscles may 
 remain in the adjacent parenchyma, producing swelling by 
 effusion. In active congestion, the contractile powers of 
 the vessels are lost by over-distension, the blood stagnates, 
 
INFLAMMATION. T3 
 
 the coats of the capillaries become diseased and ruptured, 
 resulting in extravasation or effusion of blood, coagulable 
 lymph, and serous or ruuco-purulent fluid. 
 
 THE SYMPTOMS 
 
 Are redness, swelling, pain, and increased heat. The 
 redness is owing to an increased accumulation of blood in 
 the part. The swelling to infiltration, to accumulation of 
 blood and pus, and to oedema of the lymphatics. The 
 pain is produced by the tension, and the pressure made on 
 the nerves of the parts, with the increased sensibility. The 
 heat is caused by oxydation of effete matter and adipose 
 tissue, and retention of natural animal heat. 
 
 The termination of inflammation is 1st, resolution ; 2d, 
 suppuration ; 3d, mortification. 
 
 Resolution may be preceded by Metastasis, as in mumps 
 or rheumatism. The symptoms which precede resolution 
 are increased perspiration, diarrhaea, changes in the urine, 
 and hemorrhage. In effusion, we have formation of false 
 membrane, as in croup. Suppuration is the conversion of 
 coagulable lymph into pus. Mortification, Gangrene, or 
 Sphacelus, is the complete death of the part. 
 
 TREATMENT. 
 
 The first indication to be fulfilled in the treatment of 
 inflammation, is to equalize the circulation, and restore 
 the lost functions of the capillaries. 
 
 Veratrum, Aconite, and Gelseminum, with the ligature, 
 will enable us to control the circulation. While Podo- 
 phyllin, Jaolapin, with Bitartrate of Potassa, will relieve 
 the vessels of the plethora, if that should be a cause of the 
 disease. 
 
 But as the treatment of inflammation depends in a great 
 measure upon its locality, the remedies will be given under 
 the head of inflammation of the different tissues. 
 t 
 
74 PURE NIT IS. 
 
 PHRENITIS, OR ENCEPHALITIS, AND 
 MENINGITIS; 
 
 (OR INFLAMMATION OF THE BRAIN AND ITS MEMBRANES.) 
 SYMPTOMS. 
 
 A vague uneasiness of the mind, defective appetite, 
 dizziness with vertigo. The pulse is hard and bounding, 
 the eyes have a wild and anxious expression. The patient 
 complains of great debility, and a sense of numbness in 
 one side of the body ; the numbness being on the opposite 
 side from the location of the disease, and the patient lies 
 mostly on the back. There is ringing in the ears, which 
 very much increases as the disease advances. In the early 
 stage of the disease, the pupil of the eye is preternaturally 
 contracted ; but in the latter stage, the pupil is much 
 dilated, and light becomes intolerable. 
 
 As the disease advances, there are convulsive muscular 
 movements, with more or less delirium. The respiration 
 is irregular, the skin hot, there is nausea and vomiting, 
 the bowels are confined, and in most cases there is obsti- 
 nate costiveness. These symptoms may all become aggra- 
 vated, terminating in subsultus, picking at the bed-clothes, 
 stupor, coma, suppression of the urine, colliquative sweat, 
 stertorous respiration, and death. 
 
 Or the symptoms may all become ameliorated, and the 
 patient recover. 
 
 CAUSES. 
 
 1. Accidents. 2. Intemperance in eating and drinking. 
 3. Metastasis of inflammation from other parts. 4. 
 Mental excitement. 5. Exposure to atmospheric vicissi- 
 tudes. 6. Animal and vegetable misasim 
 
PHRENITIS. ?5 
 
 TREATMENT. 
 
 After due attention to the cause of the disease, the 
 bowels should be thoroughly evacuated, by giving the 
 following compound : 
 
 U Podophyllin gr. ij. 
 
 Jalapin gr. j. 
 
 White Sugar gr. xx. 
 
 Mix, divide into eight powders, and give one every hour 
 until they act as a liberal purgative. At the same time 
 apply ligatures to the legs and arms by placing a bandage 
 around them sufficiently tight to prevent the return of the 
 blood by the veins, but allowing it to pass into the limbs 
 through the arteries. Care should be taken not to pro- 
 duce complete syncope ; but'the ligatures should be used 
 sufficiently to deplete the brain and thereby relieve the 
 distended capillaries. The ligatures should be tightened 
 or loosened according to the emergency of the case and 
 the indication to be fulfilled. In removing them, much 
 care should be taken to loosen them one at a time, and at 
 sufficient intervals to allow the blood to return to the body 
 by degrees. At the same time cold packs should be ap- 
 plied to the head, and changed sufficiently often to keep 
 them cool. A warm sinapism should be placed along the 
 spine, and the patient caused to take Aconite until a free 
 diaphoresis is produced. The surface should be freely 
 bathed in strong lye water two or three times a day, to- 
 gether with hot foot-baths. 
 
 If the disease does not yield to the above treatment, the 
 purgative should be repeated. 
 
 After wmich the following compound should be given : 
 
 R Digitalin , gr. j. 
 
 Sanguinarin gr. ij. 
 
 White Sugar gr. xx. 
 
 Mix, divide into eight pow T ders ; and give one every two 
 
76 THRUSH. 
 
 or three hours. If there be periodicity connected with 
 the inflammation, give the following compound : 
 R Quinine , gr. x. 
 
 Phosphate of Iron gr. xx. 
 
 Veratrine gr. j. 
 
 White Sugar , gr. xx. 
 
 Mix, triturate, divide into ten powders, give one every 
 two or three hours as may be indicated. During the 
 treatment, the patient should be kept quiet, and in bed, 
 and recourse should be had to the ligature, when the 
 determination of the blood to the head should indicate it. 
 The diet should be principally fluid, and of easy digestion, 
 
 THRUSH, INFANTILE SORE MOUTH. 
 
 This disease mostly occurs in children from one to three 
 months old. 
 
 CAUSES. 
 
 Unhealthy milk and an accumulation of effete matter 
 and lactic acid, which comes in contact with the mucous 
 surface of the child's mouth, while nursing, producing 
 abrasion. 
 
 SYMPTOMS. 
 
 Small white specks appearing, either single or in clusters, 
 having a dark and inflamed base, which continues to spread 
 and coalesce until the entire mucous surface is involved in 
 the disease. 
 
 TREATMENT. 
 
 Remove the cause. Bathe the breast frequently in weak 
 lye water, and thoroughly cleanse the nipple each time 
 before the child nurses, and give the following compound : 
 
 R Hydrastin gr. x. 
 
 Rhusine gr. x. 
 
 Neutralizing Mixture Jij. 
 
FOLLICULAR STOMATITIS. TT 
 
 Give the child from fifteen to twenty drops two or three 
 times a day ; also wash the mouth in a weak solution of 
 Hydrastin. 
 
 FOLLICULAR STOMATITIS, OR 
 NURSING SORE MOUTH. 
 
 Symptoms are transparent whitish vesicles on elevated 
 salivary glands. The vesicles break, and the fluid denudes 
 the mucous surface of the Epithelium, causing inflammation 
 and ulceration, the ulcers often extending over the entire 
 mouth, and in some instances to the (Esophagus and 
 stomach, producing general constitutional disturbance. 
 
 TREATMENT. 
 
 U Neutralizing Mixture. gij. 
 
 Salicine gr. xxx. 
 
 Rhusine gr. xx. 
 
 Mix, give one teaspoonful every. two or three hours during 
 the day. The mouth should be washed in a strong solution 
 of Hydrastin both before and after each meal. 
 
 If the disease does not yield to the above treatment, the 
 following antiperiodic and tonic should be given : 
 
 R Myricin ? gr. xx. 
 
 Cornine gr. x. 
 
 Iron by Hydrogen gr. x. 
 
 White Sugar , gr. xxx. 
 
 Mix, divide into ten powders, and give one every three 
 hours ; after which give the following mixture : 
 U Neutralizing Mixture giij. 
 
 Myricin gr. x. 
 
 Helonin gr. xx. 
 
 Mix, give one teaspoonful three times a day. 
 
 If there is debility, give the gin bitters of the American 
 Eclectic Dispensatory in quantities indicated. 
 7* 
 
78 QUINSY. 
 
 The surface should be bathed every day in warm lye 
 water. The diet should consist of animal broths ; broiled 
 beef, rice, bread and milk, &c. 
 
 QUINSY— CYNANCHE TONSILLARIS. 
 
 SYMPTOMS. 
 
 The parts involved in this disease are the tonsils and 
 adjacent mucous surface. They appear red and swollen. 
 The patient complains of great pain and difficulty in swal- 
 lowing. The pulse becomes quick and hard, and the 
 breathing nasal and laborious. 
 
 These symptoms are generally preceded by rigors or 
 chills, alternated with flashes of heat. The tongue is 
 covered with a light coat, the bowels are confined, the 
 eyes are suffused and red, and the face swollen. As the 
 disease advances the swelling increases, and the patient 
 expectorates a thin viscid mucus. The throat, ears and 
 eyes become painful, the breathing and deglutition more 
 difficult, and the patient is compelled to assume the erect 
 position on account of the great dyspnoea. 
 
 TREATMENT. 
 
 The patient's feet should be placed in hot water, and, in 
 the early stage of the disease, a sufficient quantity of the 
 acetic emetic Tinct. should be given to produce free emesis. 
 After which the surface should be thoroughly bathed i n 
 warm saleratus water, and the patient placed in bed, with 
 jugs of warm water to the feet, and an onion poultice to 
 the throat. If there is much fever, from three to five 
 drops of the Tinct. of Yeratrum should be given from 
 every half hour to an hour; until the fever subsides. 
 
 At the same time the throat should be thoroughly 
 washed by means of a probang, with a weak solution of 
 
OTITIS. 19 
 
 nitrate of silver and Hydrastin. The bowels should be 
 opened by small doses of Podophyllin and antibilious 
 physic. If the swelling produces dangerous dyspnoea, the 
 tonsils should be freely scarified with a sharp-pointed bis- 
 toury, and a strong solution of sulphate of zinc applied by 
 means of the probang. Also apply to the throat, before 
 the application of each onion poultice, a liniment com- 
 posed of equal parts of Acetic Tet. of Beef's Gall, Gelse- 
 minum and Camphor. The patient should be kept quiet, 
 and during convalescence the diet should be light and 
 nutritious. 
 
 OTITIS, OR INFLAMMATION OP 
 THE EAR. 
 
 CAUSES. 
 
 Local injuries, Scarlet Fever or inflammation of the 
 Eustachian Tubes. 
 
 SYMPTOMS. 
 
 Pain, ringing in the ears, &c. Diagnosis is easily made 
 with the Speculum. 
 
 . TREATMENT. 
 
 Remove the cause, after which apply hot packs to the 
 ear, and introduce lint, saturated with equal parts of Tinct. 
 of Lobelia and Aconite. If there are constitutional symp- 
 toms, give a mild purgative of Euonymine and neutralizing 
 mixture. If there is fever, give Eupatorin one or two 
 grains three or four times a-day ; also from five to ten 
 drops of the Tinct. of Gelseminum every two or three 
 hours until the fever abates. If there is ulceration, use a 
 mild zinc wash ; Compound Syrup of Stillingia, given in 
 quantities sufficient to act as a mild alterative, will 
 generally be adequate to a cure. 
 
80 GASTRITIS. 
 
 GASTRITIS, OR INFLAMMATION OP 
 THE STOMACH. 
 
 SYMPTOMS. 
 
 Vomiting, great thirst, precordial distress, a quick and 
 hurried pulse, tenderness in the Epigastrium, with the 
 tongue mostly dry and hard and the papillae elevated. The 
 skin is hot and dry, the urine scanty, and the bowels con- 
 stipated. As the disease advances, the patient is restless 
 and peevish, the countenance has a distressed, shivered and 
 anxious appearance. 
 
 The nausea becomes constant, and every substance taken 
 into the stomach is immediately rejected. The appearance 
 of the rejected contents of the stomach is at first a greenish 
 mucus, mixed with the ingesta ; but if the disease is 
 about to terminate in mortification, and death, they will 
 become dark, and will finally have the appearance of coffee 
 grounds. 
 
 CAUSES. 
 
 Worms, irritating substances taken into the stomach, or 
 as is more frequently the case, it is one of the local symp- 
 toms of idiopathic fever. 
 
 TREATMENT. 
 
 After giving due attention to the cause of the disease, 
 the feet should be placed in warm water, and the entire 
 surface of the body thoroughly bathed in broke water and 
 whiskey. After which, from one to ten drops of the Tinct. 
 of Aconite should be given every fifteen or thirty minutes 
 until a gentle perspiration is produced. 
 
 At the same time, the bowels should be evacuated by 
 means of stimulating injections, and warm sinapisms 
 applied to the Epigastrium. 
 
 After continuing the above treatment for five or six 
 
DYSPEPSIA, 81 
 
 hours, if the symptoms do not yield, the Tinct. of Bryonia 
 may be substituted for the Aconite, and the patient caused 
 to drink freely of mucilage, as Gum Arabic, Slippery Elm, 
 Flaxseed, &c. 
 
 The sinapisms should be removed after having caused 
 irritation, and hot packs applied in their place. 
 
 If, after pursuing the above treatment for ten or twelve 
 hours, the inflammation still proves persistent, and the 
 cause of the disease has been removed, a thorough spirit- 
 sweat should be given, and the hot packs continued, and 
 warm sinapisms applied to the feet. Also from one to five 
 drops of the Tinct. Rhus Radicans given every hour until 
 the disease becomes mitigated. 
 
 If it assumes an intermittent form, some of the anti- 
 periodic compounds should be administered by means of 
 starch-water injections, sufficiently to arrest the disease. 
 
 The diet should be fluid, but nutritious. 
 
 DYSPEPSIA, OR INDIGESTIOX, 
 
 CAUSE. 
 
 Debility of the stomach, and whatever prevents a normal 
 secretion of gastric fluid. 
 
 SYMPTOMS. 
 
 Pain in the stomach after eating, palpitation of the 
 heart, sharp and pinched features, furred tongue, irritable 
 temper, wakefulness, a costive condition of the bowels, 
 dry and husky skin, and debility. 
 
 TREATMENT. 
 
 B Populin gr. xx. 
 
 Sangumarin , , gr. x. 
 
 "White Sugar. gr. xxx. 
 
82 ENTERITIS. 
 
 Triturate, mix, divide into sixteen powders, and give one 
 four times a day. After which, 
 
 R Hydrastin gr. xxx. 
 
 Syrup of Sugar , Oss. 
 
 Muriated Tinct. of Iron gj. 
 
 Mix, and take one teaspoonful three times a day before 
 meals. 
 
 If the above prescriptions do not give relief, the follow- 
 ing compound may be administered : 
 
 U Neutralizing Mixture , Oss. 
 
 Aletrin gr. x. 
 
 Chloride of Sodium gss. 
 
 Mix, and give one teaspoonful three times a day. 
 
 A mixture of animal and vegetable diet should be taken 
 at regular intervals, and thoroughly masticated. 
 
 A free state of the bowels should be maintained by the 
 use of bran-water, salt and water, ripe fruit, etc. ; and the 
 surface should be sponged several times a week in cold 
 or warm water, as circumstances indicate. 
 
 ENTERITIS, OR INFLAMMATION OP THE 
 SMALL INTESTINES. 
 
 In simple Enteritis, there is deep-seated pain in the 
 umbilical region, and sometimes in other parts of the intes- 
 tinal tubes. The pain is more or less constant, yet it is 
 subject to paroxysmal aggravations, and is increased by 
 pressure. The patient manifests restlessness by constant 
 motion of the arms and legs. As the disease advances, 
 the pulse becomes hard and wiry, the skin dry, and some- 
 times pungent, the tongue is covered with a dark brown 
 coat ; and in later stages, there is diarrhea and a bloated 
 condition of the bowels. 
 
DYSENTERY. 83 
 
 TREATMENT. 
 
 The stomach should be thoroughly evacuated by Lobelia 
 and Sanguinaria, in quantities sufficient to produce active 
 emesis. As soon as this is effected, give a spirit vapor- 
 bath, and wash the patient in strong saleratus water. A 
 sinapism should be placed over the bowels, and Aconite 
 administered in one or two-drop doses every ten or fifteen 
 minutes until free diaphoresis is produced. If the symp- 
 toms should not become mitigated in ten or fifteen hours, 
 the following antiperiodic should be given : 
 
 R Gelsemin gr. i. 
 
 Sanguinaria gr. x. 
 
 • White Sugar gr. xxx. 
 
 Triturate, mix, divide into ten' powders, and give one every 
 two or three hours. At the same time, if the fever prove 
 obstinate, one or two drops of the Tinct. of Bryonia may 
 be given between each powder. 
 
 When the sinapism has produced free counter-irritation, 
 warm packs may be applied to the bowels. 
 
 If the disease assumes a periodic character, some of the 
 antiperiodic mixtures should be given. The convalescence 
 should be carefully watched, and the diet well regulated. 
 
 DYSENTERY, OR COLITIS, (AN INFLAMMA- 
 TION OF THE COLON). 
 
 SYMPTOMS. 
 
 Acute dysentery commences with uneasiness, soreness, 
 and sense of weight in the lower part of the bowels, and a 
 constant desire to go to stool. 
 
 In the course of from five to twenty-four hours, the 
 diarrhoea is changed to mucus mixed with blood. As 
 the pain and tenesmus "increase, the skin becomes hot and 
 dry, the urine red and scanty, and not unfrequently there 
 is much pain in micturition. 
 
84 DYSENTERY. 
 
 The tongue is covered at first with a light coat, which 
 soon becomes heavy and of a dark brown color. The 
 pulse varies in frequency and fulness according to the seve- 
 rity of the case. In children, there are more or less brain 
 symptoms, which not unfrequentiy prove the most obstinate 
 feature of the case. 
 
 CAUSES. 
 
 In children the disease is not unfrequentiy caused by 
 ascaricles in the lower portion of the rectum. Also by 
 anything which tends to obstruct the portal circulation, 
 and causes a sudden determination of the blood from the 
 superficial capillaries to the deep capillaries of the bowels. 
 
 TREATMENT. 
 
 To ascertain the cause, and as far as possible to remove 
 it, are the first things to be done in the treatment of this 
 disease, as well as all others. 
 
 If the tongue is coated, and the stomach in a condition 
 to indicate it, an emetic of Emetine or Lobelia may be 
 given. During the operation, the patient should drink 
 freely of some warm aromatic tea. 
 
 As soon as the effect of the emetic has passed off, the 
 spirit vapor-bath should be given ; after which the surface 
 should be thoroughly bathed in warm lye water, and the 
 patient placed in a recumbent position in bed. 
 
 If there is obstruction of the portal circulation from con- 
 gestion of the liver or otherwise, the following purgative 
 should be given : 
 
 R Podophyllin , , gr. x. 
 
 Neutralizing mixture giij. 
 
 Pulv. Acacia gr. x. 
 
 Mix, and give one teaspoonful every half hour until free 
 catharsis is produced. Afterward give the following anti- 
 periodic : 
 
DYSENTERY. 85 
 
 R Chloride of Sodium ^j 
 
 Quinine gr. x. 
 
 Oil of Gaultheriae gutt. vi. 
 
 Triturate, divide into ten powders, and give one every two 
 or three hours until all are taken. 
 
 During the administration of the powders, if there is 
 much tenesmus, injections of starch-water, to which are 
 added two or three grains of Tannin, and from one-fourth 
 to one-half a grain of Morphine, should be given every five 
 or six hours. 
 
 If there is frequent pulse, connected with fever, Aconite 
 or Veratrum should be given in sufficient quantities to 
 maintain a gentle moisture of the skin. 
 
 If, after giving the antiperiodic, the passages should 
 still be frequent and painful, the following compound may 
 be given : 
 
 U Neutralizing Mixture §ij. 
 
 Myricin and Rhusin ; aagr. x. 
 
 Morphine gr. ij. 
 
 Ess. of Anise gi. 
 
 Mix, and give from one-half teaspoonful to a teaspoonful 
 every two or three hours, as the case may indicate. 
 
 Also apply the following liniment to the abdomen : 
 
 R Chloroform gjss 
 
 Tct. of Camphor gij. 
 
 Oil of Olives giij. 
 
 Mix, and apply to the bowels four or five times a day, 
 followed by the application of hot dry flannel. 
 
 If the passages should be large and consist principally 
 of blood, from five to ten drops of the oil of Erigeron 
 should be given every two or three hours, in connection 
 with the above treatment. 
 
 Where brain symptoms prove troublesome, the bowels 
 should be kept open, and a free use made of Capsicum, 
 8 
 
86 ACUTE PERITONITIS. 
 
 and diuretics, in connection with the other remedies. If 
 there is heat in the head, cold packs should be applied, 
 also sinapisms to the back of the neck. 
 
 The diet should consist of beef tea, boiled rice, soft 
 ripe fruit, and such other articles of food as the condition 
 of the patient may indicate. The convalescence should 
 be watched with great care, as regards both diet and 
 exercise. 
 
 ACUTE PERITONITIS, OR INFLAM- 
 MATION OF THE PERITONEUM. 
 
 SYMPTOMS. 
 
 There is a sharp pain in the abdomen over the region 
 of the part inflamed. Soon after the first attack, there is 
 generally more or less of a chill, followed by a decided 
 -reaction and fever. The pulse soon becomes quick, wiry, 
 and weak, and the tongue is covered with a light brown 
 coat. The abdomen is tympanitic, and frequently there is 
 nausea and vomiting. The patient assumes a recumbent 
 position, as pressure causes much pain. The skin is 
 hot and dry, the urine generally scanty and high-colored. 
 As the disease advances, the extremities become cold, the 
 eyes have a peculiar anxious expression, the body is 
 covered with a cold clammy sweat, and the patient ex- 
 pires. Or these symptoms may all become ameliorated, 
 and result in gradual recovery. 
 
 TREATMENT. 
 
 U Podophyllin gr. i. 
 
 Ext. of Anti-Bilious Physic gi. 
 
 Mix, and give one teaspoonful every fifteen minutes, until 
 it operates as a cathartic. After which, give the following 
 antiperiodic : 
 
PNEUMONIA. 8Y 
 
 U Quinine « gr. xx. 
 
 Gelsemin gr. i. 
 
 Capsicum gr. xx. 
 
 Mix, divide into six powders, and give one every three 
 hours, until all are taken. At the same time, if there is 
 fever, give Aconite sufficient to control it. Also apply a 
 poultice to the abdomen, made of one pint of oil meal, 
 and one tablespoonful of mustard, wet with warm water, 
 and change as often as becomes necessary, to keep up a 
 gentle irritation of the surface. 
 
 If, after the antiperiodic has been given, the symptoms 
 still prove persistent, the cathartic should be repeated, 
 followed by the Muriated Tinct. of Iron, from five to ten 
 drops every two or three hours until the symptoms abate. 
 
 The above treatment, together with frequent bathing of 
 the surface, is generally sufficient to control the disease. 
 
 PNEUMONIA, OR INFLAMMATION OF 
 THE LUNGS. 
 
 SYMPTOMS. 
 
 The most prominent is a cough, with difficulty of 
 breathing, followed by a hot skin, and increased fulness 
 and frequency of the pulse. 
 
 In the second stage the cough becomes loose, and the 
 expectoration free and copious, having a rusty appearance 
 and being at times mixed with blood. 
 
 In the third stage, the Sputa assumes more of a purulent 
 appearance, and the respiration is sufficiently hurried to 
 produce more or less Dyspnoea. 
 
 The physical signs are Crepitant Rhonchus in the first 
 stage, Tabular or Bronchial Rhonchus in the second stage, 
 and when there is Hepatization in the third stage, there 
 will be either blowing tubular, sniffling metallic, or 
 
88 PNEUMONIA. 
 
 Crepitant Bhonchus, also dulness on percussion. If there 
 is pulmonary abscess, there will be amphoric tubular, or 
 crack-metal rhonchus. The vocal resonance will be either 
 bronchophonous or pectoriloquous. 
 
 The varieties of pneumonia are numerous. At one 
 time, it is marked by highly inflammatory symptoms ; at 
 another, it assumes more of a Typhoid character, and 
 being connected with great debility, the entire phenomena 
 of the disease resembles that of incipient Phthisis. 
 
 The prognosis of pneumonia, is altogether dependent 
 upon the treatment. The mortality under Allopathic 
 treatment being from fifteen to thirty per cent., while 
 under a judicious Eclectic course, it scarcely amounts to 
 one half of one per cent. 
 
 TREATMENT. 
 
 The prescriptions for simple sthenic pneumonia, are 
 easily indicated ; very few medicines being required. 
 
 The patient should be put upon the Tinct. of Veratrum 
 Viride, in quantities sufficient to control the inflammatory 
 action. In adults of full and plethoric habit, from five to 
 ten drops may be given every half hour, until the inflam- 
 matory stage has passed. 
 
 A large cold pack may also be applied to the chest. 
 When the inflammation has subsided, expectoration may 
 be facilitated by giving equal parts of the Syrup of Lo- 
 belia and Sanguinarin, every two or three hours. 
 
 If there is periodicity to the disease, after the active 
 stage has passed, Ceracine and Cornine may be given in 
 sufficient quantities to produce an antiperiodic effect. At 
 the same time, continue the syrup. If the disease should 
 assume a Typhoid form, Capsicum, in connection with 
 small doses of Carbonate of Ammonia, should be given. 
 Beef tea, and small quantities of wine, may be adminis- 
 tered, to maintain the integrity of the constitution, and 
 
colic. 89 
 
 the patient's strength. If there should be bronchial 
 symptoms, with a persistent cough, twenty or thirty drops 
 of the Syrup of Stillingia should be given three or foui 
 times a day. 
 
 Where there is Hepatization of any portion of the lungs, 
 small doses of Sanguinarin and Iodide of Potassium may 
 be given. For further consideration of this subject, the 
 reader is referred to Xewton and Calkins on Thoracic 
 diseases. 
 
 COLIC, SPASMODIC, OR BILIOUS 
 COLIC. 
 
 SYMPTOMS. 
 
 It commences with very acute pain about the region of 
 the navel. The patient complains of great thirst, and is 
 generally costive. He vomits a hot, bitter, and mostly a 
 yellow bile, which at first seems to afford some relief, but 
 is quickly followed by the same violent pain as before. As 
 the disease advances there is an increased propensity to 
 vomit, which becomes almost continual. The natural 
 motion of the intestines is so far inverted as to render an 
 evacuation almost impossible. If the patient is young and 
 plethoric, the pulse will be hard and resisting, the surface 
 will be covered with a cold clammy sweat during the 
 paroxysm of pain. The vomiting will also prove very 
 persistent. 
 
 This disease may be distinguished from inflammation of 
 the bowels by pressure upon the abdomen, which in bilious 
 colic always affords relief; but, on the contrary, in 
 inflammation of the bowels it increases the pain and 
 aggravates all the symptoms. 
 
90 LEAD OLIO. 
 
 CAUSES. 
 
 The causes of this disease may be various, but the effect 
 is a spasmodic contraction of the muscles of the bowels. 
 
 TREATMENT. 
 
 U Dioscorine gr. x. 
 
 Pulv. Camphor gr. iij. 
 
 White Sugar . gr. xx. 
 
 Mix, divide into ten powders, and give one every fifteen 
 minutes until the patient is relieved. After which, 
 R Gelsemin ,. gr. ij. 
 
 Podophyllin gr. ij. 
 
 Capsicum gr. vi. 
 
 White Sugar gr. xx. 
 
 Mix, divide into five powders, and give one every hour, in 
 a teaspoonful of Neutralizing Mixture, till it operates as a 
 cathartic. 
 
 If the bowels resist the action of the cathartics, they 
 should be injected with warm water, and small quantities 
 of Lobelia Tea. Also apply a poultice to the bowels made 
 of oil meal and mustard ; say ten tablespoonfuls of oil 
 meal to one of mustard. The patient should be kept warm 
 and in bed. During the convalescence the diet should be 
 of easy digestion and nutritious. 
 
 LEAD COLIC. 
 
 SYMPTOMS. 
 
 This disease is preceded by languor, pallor, general 
 debility, pain in the .Epigastrium, and a twisting griping 
 pain in the region of the umbilicus. 
 
SCARLATINA, 91 
 
 TREATMENT. 
 
 U Sulphuric Acid gutt. xxx. 
 
 Pure Water " §i. 
 
 Give from ten to twenty drops five or six times a day 
 for several days. During the time, a Lobelia emetic, vapor 
 baths and mil$ purgatives should be given. 
 
 When the active stage of the disease has passed off, 
 vegetable tonics, wine, porter, and a nutritious diet, are all 
 that will be required to restore the patient to health. 
 
 SCARLATINA. 
 
 Scarlatina is divided into three varieties, indicating the 
 different degrees of severity of the disease, viz : Scarlatina 
 Simplex, Scarlatina Anginosa, Scarlatina Maligna. 
 
 SYMPTOMS. 
 
 The mild form of this disease is preceded by coldness 
 and shivering, to which succeed febrile heat, thirst, and an 
 accelerated pulse. About the fourth day the face swells, 
 and irregular patches of a florid red color make their ap- 
 pearance on different parts of the body. In the course of 
 four or five days, the eruption disappears, and the cuticle 
 falls off in branny scales. 
 
 The second variety is marked by previous lassitude, 
 dejection of mind, pain in the head, soreness, and pain in 
 the muscles of the neck and shoulders, shivering and fever. 
 To these succeed nausea, vomiting, difficulty of swallowing, 
 a hurried respiration, and frequent sighing. There is a 
 quick, weak, and sometimes a hard pulse ; the skin is red, 
 hot, and dry ; the tongue is dry, and florid along the 
 edges ; and there is great thirst. 
 
 About the third day the redness about the face, neck, 
 
92 SCARLATINA. 
 
 and chest, becomes more intense, and the glands of the 
 lower jaw are painful to the touch. In a few hours the 
 redness becomes diffused over the entire body. About the 
 fifth day the redness abates, and a brown color succeeds, 
 the skin becomes rough, and falls off in large scales. 
 
 In the third variety, in addition to the common symp- 
 toms, there is great prostration, the surface has a dark 
 livid appearance ; there is nausea and vomiting, a quick 
 and feeble pulse, and laborious breathing. There are also 
 ulcerations on the tonsils and adjoining parts, covered with 
 dark sloughs, and surrounded by a livid base. The efflo- 
 rescence appears about the third day, but without relief. 
 It assumes a dark purple appearance. Delirium, a debili- 
 tating diarrhoea, and hemoiThage, ensue, and in a great 
 majority of cases under Allopathic treatment, death closes 
 the scene. 
 
 TREATMENT. 
 
 But little treatment is necessary in simple Scarlatina. 
 The patient should be kept in bed, and warm. The skin 
 should be thoroughly bathed in warm lye water, and the 
 surface anointed, after each bath, with sweet oil. A warm 
 bread poultice should be applied to the neck, and from one 
 to three drops of the Tinct. of Belladonna given five or six 
 times a day. 
 
 In the Anginose form a more active treatment is indi- 
 cated. A hot onion poultice should be applied to the 
 throat, and changed every four or five hours. Every time 
 the poultice is changed, the neck should be bathed with a 
 liniment composed of the following ingredients : 
 
 R Oil of Stillingia , gss. 
 
 Tinct. of Capsicum gij. 
 
 Oil Origanum gj, 
 
 Mix. ( 
 
 Bathe the entire body, as in the simple form, with lye 
 "water, but add to every ounce of the sweet oil one-half 
 
SCARLATINA. 93 
 
 ounce of pyroligneous acid, and anoint the surface as 
 before. Add twenty grains of triturated Belladonna to 
 half a tumbler of soft water, and give one teaspoonful every 
 half hour. Also, give the following compound : 
 
 R Capsicum gr. xx. 
 
 Trit. Hydrastin gr. xx. 
 
 Mix, divide into ten powders, and give one every three 
 hours in a teaspoonful of sweet cream. These medicines 
 should be continued until the disease abates. At the same 
 time keep the bowels in a soluble condition by the use of 
 warm water injections. 
 
 There is always extensive capillary congestion in the 
 malignant form, not only in the glands of the throat, but 
 through the entire system. To remove this capillary con- 
 gestion, and bring about a reaction, is the first indication 
 to be fulfilled in this form of the disease. For this purpose 
 the following compound may be given : 
 
 R Xanthoxylin gr. xx. 
 
 Capsicum *». gr. x. 
 
 Hydrastin gr. xx. 
 
 Mix, divide into ten powders, and give one every half 
 hour. If practicable, put the patient in a warm bath ; 
 otherwise, apply hot packs to the bowels, back, and extre- 
 mities ; also, apply sinapisms to the feet and calves of the 
 legs. If these measures fail to produce the desired effect 
 in a few hours, hot rum toddy may be given in connection 
 with them in sufficient quantities to produce the wished-for 
 result. When the reaction is fully established, the patient 
 should be placed upon Belladonna, as in other forms of 
 the fever. Also, give the following antiperiodic : 
 
 U Quinine gr. xx. 
 
 Baptism gr. v. 
 
 Hydrastin gr, xxi. 
 
 White Sugar , gr. xxx. 
 
94 PERTUSSIS. 
 
 Triturate, mix, divide into ten powders, and give one 
 every two hours until all are taken. The onion poultice 
 should be applied to the neck, as in the other forms of the 
 disease ; also, the oil and acid to the surface. The throat 
 should be frequently bathed in a strong solution of Hydras- 
 tin and Bayberry, and the diet should be highly stimulat- 
 ing and nutritious. 
 
 PERTUSSIS, OR HOOPING COUGH. 
 
 The Hooping Cough is usually described as a disease 
 of childhood ; occurring but once in the same individual, 
 usually at some age before puberty, and propagated by 
 specific contagion. It mostly prevails as an epidemic ; 
 hence, a large number of individuals are attacked at about 
 the same time. The diagnosis of Hooping Cough is, a 
 suffocating convulsive cough, returning in regular parox- 
 ysms, and terminating in an excretion of thick, glary 
 mucus. The cough is marked by a prolonged stridulous 
 convulsive inspiration, attended by a peculiar tracheal 
 rattle, and followed by short efforts of inspiration in rapid 
 succession. The long Hooping inspiration is almost im- 
 mediately repeated, and thus the paroxysm continues often 
 for some minutes, until there is a discharge of slippery 
 mucus, either by expectoration or vomiting, when the 
 respiration becomes comparatively easy. 
 
 During the paroxysm, the face becomes much injected 
 and red, the eyes suffused, and there is violent spasmodic 
 action of all the muscles of the respiratory organs. 
 
 Hooping cough is not unfrequently combined with 
 bronchial inflammation, and in these cases, there is more 
 or less cough between the paroxysms. 
 
 The latent stage of the disease, is from eight to fifteen 
 days. The cause of the spasmodic symptoms, is a closure 
 of the glottis. When the disease is unaccompanied by 
 
ERYSIPELAS. 95 
 
 severe bronchial affections, and is not connected with 
 Pneumonia, Trachietis, or inflammation of the brain, it is 
 seldom attended with danger. When it is thus compli- 
 cated, each disease should be treated separately. 
 
 TREATMENT. 
 
 For the primary disease, take of oil of Skunk Cabbage 
 berries, from one to three drops, four or five times a day. 
 Or, 
 
 U Pulv. Alum gr. xx. 
 
 Cochineal gr. x, 
 
 Syrup of Stillingia giss. 
 
 Mix, and give one half teaspoonful three or four times a 
 day. 
 
 Or, * 
 
 U Triturated Belladonna gr. xxx. 
 
 " Sanguinarin gr. xx. 
 
 " Eupatorin .» gr. xx. 
 
 Mix, divide into fifteen powders, and give one three times 
 a day. Once in five or six days, give from ten to fifteen 
 grains of Sulphate of Cinchonin, divided into six parts, 
 and taken at intervals of three hours. 
 
 ERYSIPELAS — ST. ANTHONY'S FIRE. 
 
 S Y M P T M S . 
 
 Shivering, thirst, pain in the back, limbs, and head, loss 
 of strength, restlessness, quick pulse, nausea, and some- 
 times vomiting. In the course of a few hours, a red spot 
 appears upon some part of the face, which tumefies and 
 spreads rapidly. It may confine itself to the skin, or dip 
 deep into the adjacent areolar and cellular tissues, pro- 
 ducing Phlegmonous Erysipelas. There is general fever, 
 a hard and full pulse, and coated tongue. The inflamed 
 parts become of a dark purple appearance, terminating in 
 large and extensive abscess, or in gangrene and death. 
 
96 ERYSIPELAS. 
 
 This form of the disease often assumes a periodic cha- 
 racter, spreading with great rapidity for a few hours, pro- 
 ducing dangerous constitutional disturbance, then subsiding 
 for from twelve to twenty -four hours, when it renews its 
 attack with more than former violence. 
 
 The prognosis of Erysipelas is always favorable, under 
 Eclectic treatment, with good constitutions. 
 
 TREATMENT. 
 
 The first thing to be done in the treatment of this dis- 
 ease, is to give a thorough cathartic of Juglandin and 
 Menispermin. 
 
 R Juglandin gr. x. 
 
 Menispermin g£ x. 
 
 Hyociamin , gr. j. 
 
 White Sugar... gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one 
 every hour, until it operates as a cathartic. 
 
 At the same time, the patient should take a vapor bath, 
 and the inflamed part should be thoroughly covered with 
 Collodion. After the operation of the cathartic, the fol- 
 lowing compound should be given : 
 
 J£ Cinchonin , gr. xx. 
 
 Quinine gr. x. 
 
 Capsicum gr. x. 
 
 Gelsemin gr. j. 
 
 Mix, divide into eight powders, and give one every three 
 hours, until all are taken. After which, give from five to 
 ten drops of Muriated Tct. of Iron, every two or three 
 hours. The diet should be nutritious, and the surface 
 frequently sponged with warm lye water. If there is 
 fever, Veratrum or Aconite should be given to control it. 
 The inflamed parts should be constantly protected by 
 repeated use of the Collodion. 
 
PLEURITIS. 97 
 
 PLEURITIS.* 
 
 SYMPTOMS. 
 
 Acute sthenic pleuritis usually commences with a chill, 
 soon succeeded by an acute lancinating pain in the side, 
 cough, short and quick breathing, and fever. 
 
 Each of these will receive particular notice. 
 
 The pain may come on either before, at the same time, 
 or a short time after the chill. In character it is severe, 
 as if resulting from the thrust of an instrument, and hence 
 it is often called a stitch in the side. Usually it is felt 
 somewhere in the mammary region ; but sometimes, else- 
 where ; sometimes near the lower margin of the chest, in 
 which case it is, probably, the result of inflammation of 
 that part of the pleura which covers the diaphragm. In 
 most cases it is confined to one place ; but it may be dif-^ 
 fused over the surface of the chest, when it is sudden, very 
 sharp and severe. 
 
 It is so nearly simulated by the nervous pains in hysteria, 
 that it may lead to error in diagnosis. By inspiration, 
 cough and motion, it is increased. Generally lying on the 
 affected side, and pressure over the intercostal spaces, 
 aggravate it. There is, a day or two after the occurrence 
 of the most severe pain, a greater degree of soreness ex- 
 ternally, than when early in the disease the pain is most 
 acute. As the effusion increases, the pain decreases in 
 consequence of the separation of the inflamed membranes 
 by the fluid, and the prevention of friction. It is, in some 
 cases, almost entirely wanting, being perceptible only as 
 soreness on pressure. 
 
 The cough is usually short and dry, attended with but 
 little expectoration of mucus or frothy matter. Sometimes 
 a more copious expectoration is present. When the 
 
 * Newton and Calkins. 
 
98 PLEURITIS. 
 
 pleuritis is complicated with a degree of bronchitis, it is 
 occasionally somewhat bloody. Severe pain often attends 
 it, to avoid which, the patient tries to suppress the cough, 
 and to a certain extent he succeeds by the effort. In some 
 cases, however, this is wanting. When such is the fact, 
 and there is at the same time no pain, the disease, by some 
 authors, is called latent pleurisy. 
 
 The breathing, in most cases, is more or less difficult. 
 The pain has the effect of preventing a full, deep inspiration. 
 The patient is said to have a catch in his breath. In 
 consequence of this, less air is taken into the lung when 
 the pleura is affected, and the frequency of respiration is 
 therefore increased, inversely, as the quantity of inspired 
 air at each inspiration decreases. The dyspnoea, unlike 
 the pain, increases as the disease advances. The effused 
 fluid filling up the space usually occupied by the lung, 
 causes this symptom. 
 
 The function of one lung is more or less suspended, and 
 the action of the other is increased beyond its normal 
 degree, so that the breathing of the patient becomes pain- 
 ful and difficult. This is more particularly the case when 
 the effusion is both sudden and copious. When gradual, 
 the system accustoms itself to the abnormal condition of 
 the respiratory organs. In the latter stage it is most 
 severe. 
 
 The decubitus has been considered as a pathognomonic 
 sign of the disease. Yet there is much variance among 
 observers in respect to this symptom. „ This results from 
 the variation of the decubitus in the different stages of 
 pleuritis. At first the patient cannot lie upon the affected 
 side, on account of the increase of pain which that position 
 produces. At a later stage, when the effusion separates 
 the inflamed surfaces, the pain resulting from the position 
 of the two portions of the pleura becomes less, and some- 
 times is entirely wanting. When the decubitus is on the 
 
PLEURITIS. 99 
 
 sound lung, the weight of the effused fluid, pressing on 
 the mediastinum, and forcing this beyond the median line, 
 preventing the ingress of air into the sound lung, causes 
 pain from dyspnoea. And, consequently, at this period of 
 the disease, the decubitus is most free from unpleasant 
 sensations on the affected side. 
 
 The fever is usually considerable, and attended with the 
 most common phenomena of febrile affections. The pulse 
 is quick, sometimes rising to over a hundred beats in a 
 minute, hard, full and tense. The skin is dry and hot, 
 particularly over the chest, or the seat of the disease. 
 
 The tongue is parched, the urine scanty and high-colored, 
 and occasionally there are cerebral symptoms. 
 
 Of the fever there are often daily remissions and exacer- 
 bations, the former coming on in the morning, the latter 
 in the afternoon or evening. In four or five days it 
 moderates considerably. 
 
 TREATMENT. 
 
 In strong and plethoric individuals, where there is a 
 marked case of sthenic pleuritis, the stomach should be 
 thoroughly evacuated by a Lobelia and Boneset emetic, 
 followed by an active cathartic of Jalapin and Cream of 
 Tartar. The affected side should be packed with cold 
 water, and the patient caused to take from five to ten 
 drops of the Tinct. of Yeratrum Yiride every half hour, 
 until the symptoms of the disease abate. After which, the 
 following compound should be given : 
 
 R Asclepin , gr. xx. 
 
 GelsemiiK gr. ij. 
 
 White Sugar, gr. xxx, 
 
 Triturate, divide into ten powders, and give one every 
 three hours. The patient should drink freely of some 
 diuretic mucilage, such as marshmallow or flaxseed. 
 
 If the case be one of asthenic pleuritis, the emetic and 
 
100 PLEURITIS. 
 
 cathartic should be omitted, and hot packs applied to the 
 side or sides, and the Tinct. of Aconite given to control 
 the inflammatory action, say from one to five drops every 
 one or two hours. Also give the following compound : 
 
 U Asclepin . gr. xx. 
 
 Sanguinarin gr. x. 
 
 Quinine , gr. x. 
 
 White Sugar gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one every 
 two or three hours. If the disease is not subdued, the 
 following compound may be given : 
 
 U Eupatorin gr. xx. 
 
 Sanguinarin „.. gr. x. 
 
 Apocynin.. ........ gr. x. 
 
 White Sugar.... gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one 
 every three hours. If there should be extensive effusion, 
 
 R Syrup of Marshmallow- §iij. 
 
 Iodide of Potassium gr. xxx. 
 
 Mix, and give one teaspoonful four or five times a day. 
 Where there is much debility, beef tea, wine, porter, in 
 connection with Iron by Hydrogen, should be freely given. 
 The surface should be thoroughly bathed, and the patient 
 caused to remain quiet in bed. If expectoration is 
 difficult, small doses of Lobelia may be given three or 
 four times a day. Where there is a tendency of the 
 disease to assume a chronic form, an irritating plaster 
 should be placed over the seat of the disease, and allowed 
 to remain until a free discharge ensues. The patient's 
 strength should be supported by vegetable tonics and 
 chalybeates. 
 
CHRONIC PLEURITIS. 101 
 
 CHRONIC PLEURITIS. 
 
 This disease being so well described by my colleague, 
 Prof. Calkins, in his work on thoracic diseases, I shall 
 offer no apology for transferring it to these pages. 
 
 "Chronic Pleuritis," says Prof. Calkins, " yaries 
 greatly, both in seyerity and duration. It may be acute, 
 in respect to the degree of suffering and the rapidity of 
 its progress ; it may be latent in its character, and slow 
 in the progress of the successive changes attending and 
 consequent upon it. Between these extremes, the inter- 
 mediate grades of morbid action are almost innumerable. 
 The term chronic, then, when applied to pleuritis, seems 
 to be more of a conyentional term than in respect to other 
 diseases. In pleuritis, the transition of the acute to the 
 chronic state is so indefinite, and the symptoms of the 
 recent disease sometimes haye so little of an acute cha- 
 racter, while that of a long duration occasionally manifests 
 so much greater an intensity of irritation, that the terms, 
 acute and chronic, would seem to be less applicable to 
 pleuritis than to other diseases. This difficulty arises 
 from the anatomical relations of the pleura. Being a shut 
 sac, its acute inflammation is liable to be made chronic by 
 the retention of inflammatory products ; and the chronic 
 is liable to be changed into the acute by the irritation of 
 effused fluids 
 
 "But, notwithstanding these difficulties, there seems 
 to be no impropriety in ascribing to the disease, when 
 highly inflammatory, and until the inflammatory symptoms 
 seem to arrive at an acme, the term acute. If, after that 
 period, lingering fever continues, evidently excited by the 
 products of previous inflammatory action, then the term 
 chronic may, with as much propriety, be applied to the 
 disease after, as acute to the disease before the acme. In 
 some cases, however, such an acme seems never to exist ; 
 9 * 
 
102 CHRONIC PLEURITIS. 
 
 and to these the name sub-acute may with propriety be 
 applied. n 
 
 Pathology. — The anatomical appearances caused by 
 chronic pleuritis, are very similar to the acute form of the 
 disease. Of course, the influence of time would tend to 
 produce certain modifications. 
 
 In general, we find the membranes thicker, often com- 
 posed of several adherent layers, the earliest deposits 
 being harder than those subsequently formed. The cha- 
 racter of the liquid, too, is subject to various changes in 
 the onward progress of the disease. It is less limpid, 
 more prone to become turbid with flocculi of a fibrinous 
 character. In some cases, it even appears in consistence 
 like jelly. The quantity is greater, and consequently, the 
 displacement of adjacent viscera is much more apparent. 
 Here and there, adhesions are often formed between the 
 pleura and lungs, which, in some cases, enclose little sacs 
 of fluid. 
 
 Under the best treatment, the disease, when uncompli- 
 cated, will generally advance to a favorable termination. 
 
 But it often is the case, that the morbid products cannot 
 be absorbed, and, consequently, they remain and pass 
 through a series of pathological changes, sometimes ending 
 in gangren-e. Cartilaginous laminae, bony plates, abscesses, 
 tubercles, and hemorrhagic effusions, are among the succes- 
 sive steps in the progress of chronic pleuritis. 
 
 " Sometimes/' says Dr. Wood, "the walls of the chest 
 are forced inward contrary to their elasticity, so that, when 
 si puncture is made from without, the air rushes in to sup- 
 ply the vacuity produced by their resilience. In some 
 cases, secretion goes on as rapidly as absorption, and the 
 liquid accumulation remains for a great length of time. 
 This is especially the case in empyema, or collection of pus 
 in the cavity of the pleura. Sometimes the pus makes its 
 way into the substance of the lung, and a fistulous commu- 
 
CHRONIC PLEURITIS. 103 
 
 nicatioE is formed between the bronchi and the pleural 
 .cavity through which pus is discharged and air admitted. 
 
 " In other instances the liquid takes an external direction, 
 and by means of ulceration escapes into the cellular tissue 
 without the chest, and, travelling occasionally for a consi- 
 derable distance, produces sub-cutaneous abscesses in va- 
 rious parts of the chest, which ultimately open, unless life 
 is previously worn out. In thus travelling, the pus has 
 been known to occasion caries of the ribs and vertebra?. 
 Sometimes the purulent collection is found to be connected 
 with a tuberculous vomica." 
 
 It is sometimes difficult to determine the causes which 
 change ordinary acute pleuritis into the chronic form. 
 Evidently, in many cases, too much depletion, the too fre- 
 quent use of mercury, and other articles making up the 
 antiphlogistic regimen, tend to the production of chronic 
 pleuritis. Often, when a case seems to be cured by such 
 means, the impoverished state of the blood, caused by the 
 use of the lancet, thus rendering the system more liable to 
 be affected by low grades of inflammation, developes a new 
 and unwelcome train of symptoms, admonishing the physi- 
 cian that the supposed cure was, after all, delusive. 
 
 Dr. Gallup, defining chronic rheumatism, says that it is 
 acute rheumatism half cured. So, it may be said with 
 equal propriety, that chronic pleuritis is the acute variety 
 half cured. 
 
 Diagnosis. — The general inflammatory symptoms of 
 acute pleuritis may gradually disappear ; but, unless the 
 morbid products of the diseased action are removed from 
 the pleural sac, the fever will recur, and change its type, 
 now very closely resembling hectic, now becoming identical 
 with it. This recurring fever is one of the most trouble- 
 some and alarming symptoms of chronic pleuritis ; for in 
 other respects the patient does not suffer in proportion to 
 the extent or duration of the effusion. 
 
104 CHRONIC PL EURITIS. 
 
 Dr. Gerhard observes: "I once saw a patient who had 
 performed the full duties of a sailor, going aloft with an 
 enormous pleuritic effusion. When he returned from sea, 
 it amounted to two or three gallons. This is an excep- 
 tional case ; but it is very common to find patients who 
 can perform many laborious occupations without much in- 
 convenience. This is generally the case if the dyspnoea is 
 not severe ; and we find that some patients complain of 
 little difficulty of breathing, with an extent of pectoral dis- 
 ease, which will give rise to great distress in other indi- 
 viduals. The symptoms which so frequently characterize 
 chronic organic diseases, are extremely variable in this va- 
 riety of pleurisy. These are emaciation, loss of the firm- 
 ness of the muscles, harshness and dryness of the skin, and 
 slight oedema of the legs. Sometimes they are nearly as 
 well marked as in tuberculous disease of the lungs; — in 
 other cases they are very slight ; hence they constitute a 
 diagnostic sign of the disease ; and if we find them well 
 characterized, we will do right to regard the case as one 
 probably complicated with tubercles. If our impression 
 be erroneous, we will soon rectify it as the symptoms will 
 gradually become more decided in the latter case, and 
 slowly disappear if the pleurisy be followed by recovery. " 
 
 The diagnosis of chronic pleuritis, without the aid of 
 the physical signs, is often very difficult.* Its general 
 symptoms simulate those of phthisis. But the physical 
 signs are far more reliable. When these are present, there 
 is no difficulty in ascertaining the true character of the dis- 
 ease. If it is complicated with tuberculous deposition, the 
 case should be regarded with much anxiety : for the diag- 
 nosis then becomes much more obscure, and the prognosis 
 more " unfavorable. " 
 
 * See Empyema. 
 
CHRONIC PLETJRITIS. 105 
 
 PROGNOSIS. 
 
 The prognosis of this disease depends much upon the 
 extent of the effusion, the condition of the constitution, and 
 the tendency to hereditary disease. Also, upon the skill 
 with which the disease is treated. If the integrity of the 
 constitution is not too much impaired, and there is not a 
 marked tuberculous tendency, under a judicious treatment 
 our prognosis will be favorable. 
 
 TREATMENT. 
 
 The treatment of this disease depends upon the constitu- 
 tion of the patient. If there is still an inflammatory pro- 
 cess going on, Aconite, in connection with Veratrum and 
 Gelsemin, should be used until it is controlled. As for 
 instance, if the skin is hot and dry, the pulse quick, the 
 urine scanty, with more or less dyspnoea, and alternate 
 pyrexia, the following compound may be given : 
 
 R Gelsemin gr. j. 
 
 Quinine ♦ gr. xx. 
 
 Asclepin , gr. x 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, divide into ten powders, and give one every 
 two or three hours until all are taken. 
 
 If the symptoms should not subside under this prescrip- 
 tion, the irritating plaster should be applied over the 
 entire surface of the affected side, and a thorough spirit- 
 sweat be given ; after which, the following mixture : 
 
 R Syrup of Tolu... giij. 
 
 " Sanguinarin gij. 
 
 " Iodide of Iron gij. 
 
 Mix, dose one teaspoonful every three hours. 
 
 If there are febrile symptoms, from one to three drops 
 of the Tct. of Aconite should be given every three hours, 
 in connection with the above mixture. 
 
10G CHRONIC PLEURITTS. 
 
 The diet should be nutritious and stimulating, and if 
 there is much debility, a small quantity of Porter or Scotch 
 Ale should be taken four or five times a day. If there is 
 much effusion, an attempt should be made to produce ab- 
 sorption by the following mixture : 
 
 R Syrup of Iodide of Potassium !|j. 
 
 " Apocynin gij. 
 
 " Stillingia giij. 
 
 Mix, dose one teaspoonful three or four times a day. At 
 the same time drink freely three limes a day of a tea made 
 of equal parts of Eupatorium, Purpureum and Pipsissewa. 
 Tf the strength of the patient will bear it, one eighth of a 
 grain of Phytolaccin and five grains of Cream of Tartar 
 should be given. 
 
 The irritating plaster should not be removed until a free 
 discharge ensues, which should be maintained by the 
 occasional use of the vegetable caustic, and a constant 
 application of slippery elm poultice. If the absorbents 
 should prove too debilitating to the patient, they should 
 be discontinued for a few days, and the following tonic be 
 given : 
 
 U Hydrastin gr. x. 
 
 Phosphate of Iron gr. xx. 
 
 Prunin gr. x. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, and divide into ten powders, and give one 
 every three hours. 
 
 If there are periodical symptoms in connection with 
 debility, and the above prescription should fail to give 
 relief, five drops of the muriated Tct. of Iron, and two grains 
 of Quinine, should be given four times a day. Also a 
 liberal supply of beef tea, prepared as directed in treat- 
 ment of Typhoid Fever. After recruiting the patient's 
 strength for some days, the diuretics and absorbents should 
 again be resumed, and persisted in for the purpose of pro- 
 
EMPYEMA. 10? 
 
 during absorption of the effused fluid. If the above treat- 
 ment should prove unsuccessful, and the Empyema likely 
 to prove disastrous to the patient, the operation of 
 Paracentesis Thoracis should be performed as directed 
 under the head of Empyema." 
 
 EMPYEMA 
 
 Is a collection of fluid in some part of the body, par- 
 ticularly in that of the pleura. It -consists mostly of a 
 purulent, sero-purulent or serous fluid, within the cavity of 
 the pleura, and is dependent upon chronic pleurisy. When 
 inflammation attacks a serous or diaphanous membrane, it 
 loses its transparency, becoming dull, and in some instances 
 dry. These changes may be observed not only in the 
 Pleura, Pericardium and Peritoneum, but in the arachnoid 
 membrane, in which it is distinct when other traces of 
 inflammation cannot be recognized. At the same time, 
 red vessels appear in isolated spots over a considerable 
 extent. They are arborescent, and consist of minute red 
 lines radiating from star-like points. These vessels, though 
 placed in the substance of the membrane, gradually ap- 
 proach the surface as the process advances. They are not 
 newly developed, but are the colorless capillaries of the 
 sound part, injected with red blood. After existing for a 
 longer or shorter time, these changes are succeeded by 
 others, which are regarded as their effects. The first and 
 most important of these is, the formation of a new fluid at 
 the free and inadherent surface of the membrane. 
 
 The nature of the fluid varies according to the stage of 
 the inflammation. In the commencement of the inflamma- 
 tion, the capillaries begin to deposit a semi-transparent 
 fluid, in small quantities, w T hich becomes more abundant as 
 the disease advances. It is straw-colored, of a hornoge- 
 
108 EMPYEMA. 
 
 neous character, and, as it is effused, undergoes sponta- 
 neous coagulation. This consists in part of the fluid 
 attaining a solid form like a jelly in layers of variable 
 thickness, with a honey-comb surface, and thready fila- 
 ments coalescing and quite consistent. A small quantity 
 of a thin fluid is found in the interstices of these filaments, 
 oozing from the surface of the coagulated part, and lodging 
 in the most dependent part of the cavity. This process 
 may continue until a large amount of fluid is accumulated, 
 or the entire product of the inflamed surface may be defi- 
 cient in albumen, producing an extensive accumulation of 
 sero-purulent fluid. 
 
 Baillie and other observers state "that this fluid has 
 been supposed to be derived immediately from the blood ; 
 but that this is not correct, as it is the serous or watery 
 portion of the morbid exudations, from the surface and 
 interstices of which it may be seen trickling. 
 
 The red or brown tint is derived from the blood issuing 
 from the newly-formed capillaries. Shreds of lymph are 
 found floating in it when the accumulation occurs in the 
 pleural cavity. The sero-purulent is often connected with 
 albuminous fluid, from w T hich it is separated during the 
 process of coagulation. It consists mostly of serous fluid, 
 with minute granules of albuminous matter, which precipi- 
 tate to the bottom, leaving a chalk-like liquid, which con- 
 stitutes the majority of the effused fluid in the cavity. In 
 this fluid may be seen small particles of lymph afloat. The 
 puriform fluid of serous membranes consists of serous fluid 
 w T ith small granules of opaque matter, not coagulable, and 
 is considered as an abortive effort to produce albuminous 
 exudation. The puriform deposit mostly occurs in the 
 peritoneum. It is a white or cream-colored opaque fluid. 
 It occurs mostly in chronic pleurisy and peritonitis. It has 
 been supposed that genuine purulent matter was not formed 
 unless there had been previous ulceration of the part. But 
 
EMPYEMA. 109 
 
 the researches of Baillie, Black, Hunter, and Millin, have 
 amply shown that purulent fluid may either be secreted by 
 the inflamed membrane, or from the organized layers of 
 lymph, or from both. In the first, the fluid is secreted 
 directly from the capillaries of the inflamed membrane. In 
 the second, it is derived from the organized false mem- 
 branes which take on the suppurative action. In the third, 
 both sets of vessels are concerned. 
 
 S Y M P T M S . 
 
 The patient either lies on his back diagonally, or on the 
 diseased side with the head slightly bent forward. The 
 voice is weak, and there is a persistent cough, with more 
 or less expectoration of mucus or muco-purulent matter. 
 The face is buffy, and semi-transparent ; the lips tumid and 
 livid. The pulse is habitually quick and small, and febrile 
 attacks are frequent, and often connected with chills. In 
 recent empyema, the diagnosis may be confounded with that 
 of pneumonic solidification. But in empyema, vocal fre- 
 mitus disappears. In hepatization of the lung, it is main- 
 tained, and frequently above the average of health. 
 
 In empyema there is no crepitant rhonchus, nor is there 
 true tubular sniffling, metallic respiration ; vocal resonance 
 is well or weakly bronchophonic. There is dulness on per- 
 cussion over the entire pleural sac, and not unfrequently 
 effusion becomes so extensive as to force the lung towards 
 the mediastinum and spine, compressing it in so small a 
 bulk that it appears to be destroyed. Its vessels are 
 crushed together ; its bronchial tubes and vessels closed, 
 and the whole organ is rendered unfit for respiration. 
 Unless much care is taken in diagnosis, this condition will 
 be mistaken for atrophy of the lungs. In other cases the 
 heart and mediastinum are carried over to the right side, 
 and the heart will be found beating on the right side of the 
 sternum between the third and fourth ribs. 
 10 
 
110 EMPYEMA. 
 
 A case of this kind occurred in my practice, where the 
 effusion, following latent pleuritis, was so extensive that it 
 not only carried the lung forward and backward towards 
 the mediastinum, and against the spine, compressing it so 
 completely, as to prevent the ingress of air ; but, the 
 heart and mediastinum were carried forward, and beneath 
 the sternum, so as to encroach materially upon the right 
 lung. In this case, the symptoms at first were those of 
 latent pleuritis, followed by a persistent cough, with 
 expectoration of muco-purulent fluid, great dyspnoea, and 
 inability to lie on the affected side. There was great dul- 
 ness on percussion, which extended an inch over the right 
 of the sternum. 
 
 The only physical signs which were diagnostic of the 
 disease, were the absence of respiratory murmur on the left 
 side, and the deviation of the area of dulness upon percus- 
 sion ; on changing the position of the patient, the dysp- 
 noea and the increased diameter of the left half of the 
 chest, which was three and one-half inches greater than 
 the right. In this case, absorbents, diuretics, and tonics, 
 only gave temporary relief. And in the course of two 
 and one half years, an opening made its appearance in 
 the base of the pleura and diaphragm, where it had previ- 
 ously become attached, and the fluid made its escape into 
 the cavity of the abdomen, producing peritonitis and 
 death. The patient refused to submit to the operation of 
 Paracentesis. Dr. Hughes reports a case of thoracic dis- 
 ease, where the patient became much debilitated, with 
 quick pulse, dyspnoea, and every physical sign of effusion 
 into the right pleura. There was no bulging of the inter- 
 costal space ; but a fiat fluctuating tumor was observed, 
 which dilated upon coughing. A small trochar was intro- 
 duced, and twenty-four ounces of turbid serum were 
 drawn off. Iodide of Potassium and Sarsaparilla were 
 taken, which afforded partial relief, — yet, he states that he 
 
EMPYEMA. Ill 
 
 operated again, .in two weeks, and drew off thirty-six 
 ounces more. Xo inconvenience followed, and the patient 
 appeared much improved. Some two months afterward, 
 the tapping was again repeated, and twelve ounces of 
 fluid were drawn off. In two months more his health ap- 
 peared good ; but there seeming to be an increase of fluid, 
 tapping was again performed, and thirty-six ounces of 
 fluid evacuated. He was tapped again on the eighteenth 
 and twenty-sixth of November successively, which was 
 also again performed on the twenty-first of December. 
 Finding that repetition of the operation must still be con- 
 tinued, the patient learned to perform it himself, and 
 actually did so twice. The prognosis was subsequently 
 favorable, and after fifteen tappings his restoration was 
 complete. 
 
 TREATMENT. 
 
 The first efforts of the physician should be to produce 
 absorption, which can be accomplished, in most cases, 
 where the walls of the sac are in a normal condition. But, 
 unfortunately, in many instances the albuminous exudation 
 forms a complete false membrane to the internal walls of 
 the sac, which entirely precludes the action of the absorb- 
 ents upon the effused fluid. In this event but little can 
 be expected from the use of remedies, until the fluid is 
 evacuated by means of the trochar. 
 
 The operation of Paracentesis Thoracis is performed in 
 this manner. The patient should be propped up in bed, 
 and inclined a little to the sound side, so as to separate the 
 ribs, as much as possible, on the diseased side. The skin 
 is to be divided to the extent of one and a half inches, in 
 a direction parallel with the superior edge of the lower rib, 
 on the intercostal space that is selected for the puncture. 
 After dividing the superficial fascia, and any portion of a 
 muscle of the chest that may intervene, as well as the 
 external and internal intercostal muscles, the pleura will 
 
112 EMPYEMA. 
 
 be seen to bulge into the wound. After being distinctly 
 felt by the finger, so as to establish the fact that only fluid 
 is behind it, a trochar, armed with a canula, should be 
 introduced through the sac ; the trochar should be with- 
 drawn, and the canula allowed to remain until the fluid is 
 discharged. Or the pleura may be punctured by means of 
 a sharp-pointed bistoury. On making an incision through 
 the integument, the skin should be drawn up from an inch 
 to an inch and a half above the intercostal space intended 
 for the internal opening, so that after the evacuation of 
 fluid, the integument, by passing down over the internal 
 wound, may exclude the air from the pleural cavity, which 
 is one of the most essential conditions to be observed in 
 this operation. 
 
 If there is a probability that the fluid may be absorbed, 
 an attempt should be made, by the use of the following : 
 U Corydalin gr. x. 
 
 Phytolaccin , gr. ij. 
 
 Iodide of Potassium gr. xxx. 
 
 Syrup of Marshmallow giij. 
 
 Triturate, and mix well together ; give from one half to 
 one dram three times a day. 
 
 At the same time apply the irritating plaster to the 
 affected side, until a free discharge ensues. 
 
 The strength of the patient should be maintained by the 
 use of porter, wine, beef tea, and such articles of food as 
 are easy of digestion. When the above remedy has been 
 used for two or three weeks, a change may be made to the 
 following : 
 
 U Quinine gr. xx. 
 
 Digitalin gr. ij. 
 
 Bitartrate of Potassa gij. 
 
 Syrup of Stillingia and Syrup of Iodide 
 
 of Iron., aa gij. 
 
 Mix, and give one half teaspoonful three times a day. 
 
PHTHISIS. 113 
 
 The skin should be thoroughly bathed in lye water two or 
 three times a week, and every effort should be made to 
 preserve the patient's strength. 
 
 If, after the above treatment, and such other remedies 
 as seem to be indicated, the patient is not materially 
 relieved, tapping should be resorted to at once. In per- 
 forming this operation, much care is required to prevent 
 the ingress of air into the cavity of the chest. Other- 
 wise empyema would be removed only by substituting 
 emphysema. After the operation, a general diuretic, altera- 
 tive, and tonic treatment should be pursued, for the pur- 
 pose of preventing a re-accumulation of the fluid. If 
 empyema is connected with organic disease of the lungs, 
 or general tuberculosis, much relief may be obtained 
 from the operation of Paracentesis. Although it may not 
 effect a cure, still it will very materially assist your 
 constitutional treatment. 
 
 PHTHISIS.* 
 
 " The essential character of pulmonary consumption 
 consists in the deposit of tubercles in the tissues of the 
 lungs. This deposit may begin with local mischief, or 
 may evidently be the sequel of constitutional disorder. 
 In both varieties the general disease is present, although 
 it may exist in a latent form. Of this the formation of 
 tuberculous matter is a proof. It is evident, however, 
 that the presence of tubercles does not alone constitute 
 the disease. One step back, along the chain of causation, 
 is a morbid condition, of which tubercles are but the 
 effect. This morbid condition, whatever is its nature, may 
 exist a long time before the formation of tubercle begins. 
 
 * Newton and Calkins. 
 10* 
 
114 PHTHISIS. 
 
 That a change takes place in the blood, which causes or 
 precedes the deposit and development of tubercles, is well 
 established. The corpuscles are diminished, and the 
 albumen increased in quantity. The fibrin is below, rather 
 than above the normal amount, and, it may be inferred, 
 that it is also defective in its nature. Eisner, and some 
 other analysts, have found the fatty principles diminished. 
 
 Dr. Fricke's analyses indicate an increase above the 
 standard of health, in the lime, and a decrease in the 
 phosphates ; while l'Heritier states, that in scrofula the 
 earthy salts are diminished. Hence, the blood may be 
 stated generally to be degraded in quality, and endowed 
 with a low degree of vitality. Whether these be the real 
 changes in the blood is not certainly determined. Physio- 
 logists and pathologists are not fully agreed as to the 
 nature of all the changes which the blood undergoes in 
 the scrofulous diathesis. Andral showed that in phthisis 
 pulmonalis, the fibrin was augmented. The probability 
 is, that this increase of fibrin is most frequent, when inter- 
 current pneumonitis is associated with tubercular disease. 
 To attain to accuracy in this matter is very difficult, on 
 account of the variable state of the blood, arising from 
 exercise, diet, time of the day, and other changing circum- 
 stances. 
 
 The conclusions to which we may logically come, are 
 the following: 1. That from the earliest invasion, the 
 sum of the vital force is either below the standard of 
 health, or it is relatively low as respects the structure and 
 organization of the individual. 2. That this diminution 
 in the sum of the vital force, is dependent on the imperfect 
 blastema of the diseased blood, causing perversion of the 
 tissues. 3. That as tuberculosis advances, the sum of the 
 vital force for the whole system, continues to diminish. 
 4. That the nutritive powers of the blood, .as respects the* 
 nervous tissue, frequently remains undiminished ; this 
 
PHTHISIS. 115 
 
 tissue not requiring for its nutrition, compound principles 
 identical with it to be introduced into the blood with the 
 food, and having a nutrition peculiar to itself, differing 
 from that of the cellular and muscular structures. The 
 fatal disease tuberculosis may be traced to a primary error 
 or defect in the blood-making process. Vitiated air, or 
 air stagnating or insufficiently renewed within the chest ; 
 and probably other anti-hygienic influences, as a vitiated 
 or defective diet, acting singly, coetaneously, or as re- 
 spects each other, ancillary, produces slowly under ordi- 
 nary circumstances, but occasionally with great rapidity, 
 some unknown change in a portion of the proteiniform 
 principle of recently formed liquor sanguinis ; this change 
 may consist in hyper-oxydation ; but whether so or not, 
 it deteriorates its properties, rendering it, more or less, 
 altogether unsuitable as a material for organization. 
 
 At the same time, the oily principle of nutrition circu- 
 lating with a diminished number of real corpuscles, is in 
 part converted into a fatty substance of a lower degree of 
 oxydation. These modified proteiniform and oleaginous 
 principles are exuded in the blastema, and are either em- 
 ployed in the assimilating -processes, deranging the nutri- 
 tion of the organic structures, and giving the tuberculous 
 or scrofulous character to various pathological processes ; 
 or, in the more advanced stages of the morbid process, 
 they are deposited in particular tissues, and accumulate 
 generally in the form of tubercle, but sometimes both as 
 tubercle and morbid fat, substances for the most part inca- 
 pable of organization. 
 
 In the present state of pathological science, confining 
 ourselves to its legitimate object, the study of phenomena, 
 apart from any metaphysical views of final causes relative 
 to the pqmers of nature, this appears to be the most accu- 
 rate definition that can be given of the most essential na- 
 ture of tuberculosis. — (Dr. Ancell.) 
 
116 PHTHISIS. 
 
 But in what manner does tne deposit take place ? We 
 possess sufficient evidence that it is derived from the blood ; 
 that it transudes from the capillary vessels of the part in 
 which we find it; and that after being deposited, it is liable 
 to undergo certain further changes. On the examination 
 of incipient tubercular deposit, we may always note that 
 there is congestion in the tissues immediately surrounding 
 it. In the pia mater of the sylvian fissure, we see an in- 
 creased redness, in which a few vessels are more promi- 
 nent than usual ; in the pulmonary parenchyma we may 
 especially, by the use of the microscope, discover the en- 
 gorgement of the interlobular capillaries investing the air- 
 vesicle into which the tubercle is being secreted. In the 
 mucous membrane of the intestines we see the exquisite 
 arborescent arrangement of the congested vessels, tending 
 from the mesenteric attachment to the point where we 
 observe the deposit, shining through the mucous surface 
 from the submucous tissue, where it has collected. The 
 first elimination of the morbid products acts like a mag- 
 netic point of attraction, and generally serves as a centre 
 around which the deposit progressively enlarges by eccen- 
 tric deposition. 
 
 Tubercles exist in various forms ; in fine points, grey 
 and yellow granulations, miliary tubercles, and grey or 
 yellow tubercular masses, softened and cretaceous. Each 
 of these modifications requires a more particular notice. 
 
 1. Pulmonary Granulations — Grey Granulations — 
 Miliary Tubercles. — These various names have been used 
 by authors to describe round, small, translucent, shining, 
 homogeneous bodies, often not larger than a millet-seed, 
 but varying from this to the size of a pea, which appears 
 to be the primitive state of tubercles. Usually they are 
 of a greyish, but often they are of a reddish or of a brown- 
 ish color, and in some cases they are nearly colorless. 
 Sometimes they are isolated, sometimes clustered in small 
 
PHTHISIS. lit 
 
 bunches, or in aggregate masses. In the latter state they 
 are most often found in the upper portion of the lung. 
 But in the isolated form they are scattered sometimes 
 thickly through the whole or greater portion of the pulmo- 
 nary tissue ; not unfrequently they are found situated be- 
 neath the pleura, producing an irregularity perceptible to 
 the touch. This is more often the case in children than 
 adults. 
 
 2. Grey Tubercular InfittraHoh. — Laennec defines this 
 as the same kind of matter which forms the granules above 
 described, deposited in the cellular tissue of the lungs in 
 irregular masses, sometimes one, two, or even three inches 
 in cubic dimensions without definite boundaries, or limited 
 only by the extent of the lobules. It is hard, homogeneous, 
 translucent, and of a greyish color, sometimes darkened by 
 the black matter of the lungs, portions of which become 
 enveloped in the masses as they are formed. In some 
 cases no traces of pulmonary tissue can be detected in the 
 masses : in others they present remains of blood-vessels, 
 bronchial tubes, and cellular membrane ; and occasionally 
 they are partially penetrated by the air in respiration. 
 
 3. Crude Tubercle and Yellow Tuberculous Infiltra- 
 tion. — The grey translucent matter constituting the first 
 two deposits above noticed, appears to undergo a gradual 
 conversion into what has usually been considered the pro- 
 per tuberculous substance. In the miliary granulations, 
 the transformation commences in a small yellowish, white 
 spot, which most commonly appears at or near the centre, 
 and gradually enlarges until the whole granule assumes 
 that character. 
 
 In this altered state, the little bodies are now called 
 crude tubercles. In the aggregated granules, the change 
 commences at several points, each probably answering to a 
 distinct granule, and considerable masses of yellow opaque 
 
118 PHTHISIS. 
 
 matter result from the extension and ultimate coalescence 
 of these central spots. 
 
 The same transformation takes place in the infiltrated 
 translucent matter, beginning in like manner with isolated 
 opaque spots, and spreading until it involves the whole 
 deposit, which, when thus altered, receives the name of 
 yellow tuberculous infiltration. This may be distinguished 
 from the crude tubercle by an irregular and angular, in- 
 stead of roundish form, and by a less regular line of 
 division between it and the pulmonary tissue. There is no 
 doubt that both the crude tubercle and yellow infiltration 
 are often originally deposited in this state, without the 
 preliminary formation of the translucent matter. 
 
 The next important change in tubercle is that of soften- 
 ing. This, in many authors, is said to begin in the centre, 
 and to gradually advance to the circumference. Concern- 
 ing the truth of this, there is, however, some doubt. The 
 reasons as given by Mr. Carswell upon which such a doubt 
 is based, are the following: — Tubercular matter, accord- 
 ing to his theory L is contained in the air-cells and bronchi. 
 If, therefore, this morbid product is confined to the surface 
 of either,, or has accumulated to such a degree as to leave 
 only a limited central portion of their cavities unoccupied, 
 it is obvious that when they are divided transversely, the 
 following appearances will be observed : — 1. A bronchial 
 tube will resemble a tubercle having a central depression, 
 or soft central point, in consequence of the centre of the 
 bronchus not being, or never having been occupied by the 
 tuberculous matter, and of its containing at the same time 
 a small quantity of mucus or other secreted fluids : — 2. The 
 air-cells will exhibit a number of similar appearances, or 
 rings of tuberculous matter joined together, and containing 
 in their centres a quantity of the same kind of fluids. 
 "When the bronchi or air-cells are completely filled with 
 tuberculous matter, no such appearances as those we have 
 
PHTHISIS. 119 
 
 just described are observed, and hence the reason why 
 tubercle, in such circumstances, has been said to be still in 
 a state of crudity, or in that state which is believed to 
 precede the softening process. 
 
 As the softening process advances, the whole tubercle 
 becomes converted into a soft, pultaceous, yellowish mass, 
 in appearance resembling pus. The infiltrated mass, like- 
 wise, undergoes a similar change. Sometimes the entire 
 tuberculous deposit seems throughout its whole mass, to 
 become suddenly softened, and, in this manner, large por- 
 tions of the lung are quickly destroyed. The pressure of 
 the growing tubercle upon the circumjacent lung, at first 
 makes it less vascular ; but reaction at length takes place, 
 inflammation succeeds, and congestion, ulceration and 
 suppuration follow. In some cases the tubercular disease 
 passes through its various stages without giving rise to 
 marked inflammation. In the majority of cases, however, 
 the bronchi, air-cells and cellular tissue, are more or less 
 affected by the inflammatory process. The succeeding 
 ulceration gives rise to the formation of cavities. Fre- 
 quently one large vomica is made up of several smaller 
 ones, which, in the parietes of the large cavity, make 
 excavations of irregular shape, now winding and now 
 crossed by bands of tissue. The size of the cavity varies 
 from that of a pea to that of an orange. Its contents 
 consist of a mixture of pus and bloody matter, and por- 
 tions of pulmonary tissue. Sometimes they are inodorous, 
 sometimes fetid. In children the vomica are less common 
 than in adults. As the disease advances, a false mem- 
 brane begins to form around the decaying tubercle, at first 
 thin and delicate, and in appearance resembling mucoua 
 membrane. Large abscesses are sometimes seen, between 
 which and the bronchi there is no communication. 
 
 Cicatrization of Tuberculous Cavities. — That this it 
 not a very rare occurrence, Laennec proved in his early 
 
120 PHTHISIS. 
 
 researches into the termination of tuberculous disease. 
 Indeed, from this we learn that phthisis sometimes termi- 
 nates favorably. This happens when the deposit is limited 
 in extent. 
 
 But, sometimes at the apex of the lung, we find an old 
 adhesion, sometimes a crust of fibro-cartilaginous deposit, 
 or even a fibrous band passing from the lung to the ribs. 
 Adjacent to this pathological change, the lung is puckered 
 and drawn inward. To the touch, it feels firm and con- 
 solidated ; to the eye, it appears dark, from an abundant 
 deposit of black pigment. On making an incision, we 
 find a cavity lined by grey fibrous membrane, semi-trans- 
 parent, or thick, whitish, and fibro-cartilaginous, or soft 
 and pliable, like the mucous membrane. 
 
 [In the winter of 1855, my colleague, Prof. Hollem- 
 back, and myself, made a post-mortem examination of a 
 female, who had been laboring under phthisis for the last 
 twelve years. In her case the right lung had been entirely 
 destroyed, save a very small portion, just below bifurca- 
 tion of the bronchi, which was completely injected with 
 tuberculous matter. This portion was about the size of a 
 hen's egg 7 and completely impervious to air. A fibrous 
 band passed from this bunch to the lower portion of the 
 pulmonary cavity, and was attached to the pleura costalis. 
 The cavity was filled with sero-purulent fluid; but the 
 woman had enjoyed a respite from the urgent symptoms 
 of the disease, save periodical attacks of dyspnoea, in one 
 of which she died. — The Author. ] 
 
 Adhesions are almost always present in phthisis. In 
 112 cases examined by Louis, there was only one in which 
 no adhesion was found. To some extent, their location 
 corresponds to that of tubercles. In rare cases, the entire 
 surface of the lung is bound down to the costal pleura, 
 and to that of the diaphragm. These have the effect to 
 prevent pneumothorax. The trachea and bronchial tubes 
 
PHTHISIS. 121 
 
 often are the seat of extensive lesion. Those are most 
 often affected which form a way of exit to vomica. Their 
 posterior, more often than their anterior, internal surfaces 
 are affected. The larynx and epiglottis, are sometimes 
 the location of tuberculous disease. Among other lesions 
 attending phthisis, are partial emphysema- of the lung, 
 dilatation of the bronchi, and enlargement of the bronchial 
 glands. This latter effect is most common in children. 
 
 Appearances in oilier parts of the body. — The origin 
 of tubercles being in the blood, their distribution through- 
 out the entire system is a necessary result. But according 
 to Louis, this general law is established, that when tuber- 
 culous deposit exists in other organs, it always exists in 
 the lungs. The converse of this, is far from being true ; 
 and the law itself is occasionally subject to exceptions, 
 the occurrence of which is most frequent in children. 
 Without the lungs, the tuberculous depositions are most 
 often composed of the yellow opaque tubercle. Grey 
 granulations or miliary tubercles, have also been observed 
 in various parts of the body. From some form of tu- 
 bercle, scarcely an organ of the body is wholly exempt. 
 They are found in the liver, intestines, mesentery, prostate 
 gland, testicles, heart, bladder, uterus, spleen, and kid- 
 neys, and in the membranes and substances of the brain. 
 It was the conclusion of Louis, that, of all the cases of 
 tubercles, occurring in persons over the age of fifteen 
 years, one-third had them in the small intestines, one fourth 
 in the mesenteric glands, one-ninth in the large intestines, 
 one-tenth in the cervical glands, one-twelfth in the lumbar 
 glands, and one-fourteenth in the spleen. The stomach 
 becomes larger than natural, more thin, and is subject to 
 chronic inflammation of its mucous surface. The glands 
 of Peyer — those near the ccecum — become the seat of 
 tubercles. The mucous glands of the small- intestines, 
 sometimes ulcerate, causing perforation, and the admission 
 11 
 
122 PHTHISIS. 
 
 of the fecal secretions into the cavities of the peritoneum. 
 A similar diseased state of the large intestines sometimes 
 occurs. The mesenteric glands are very much enlarged. 
 In the brain, tubercular deposition gives rise to hydroce- 
 phalus. 
 
 GENERAL SYMPTOMS AND COURSE OF PHTHISIS. 
 
 Since the discovery of the physical signs by Laennec, 
 the tendency of some minds has been to disregard the 
 general symptoms in the formation of a diagnosis. Among 
 such, an unnecessary delay is often caused in the applica- 
 tion of remedial agents ; for the general symptoms very 
 frequently are the first indications of approaching disease. 
 A diagnosis should not then be wholly dependent upon 
 the physical signs in the first stage ; for these are seldom 
 manifest, until the disease has so far progressed as to 
 make a prognosis unfavorable. Certain general symptoms 
 are grouped together, and said to be indicative of the 
 scrofulous diathesis, or tuberculous cachexia. What 
 this condition of the system is, or what it* influence, in 
 the development of phthisis, it may be difficult to accu- 
 rately ascertain ; and yet the description of some of its 
 more important symptoms, may be of utility in detecting 
 that first pathological change in which phthisis begins. 
 
 Among the more important symptoms are, a pale, pasty 
 appearance of the countenance, large upper lip aud alce- 
 nasi. In persons of dark complexion, the skin is sallow ; 
 in those of fair complexion it is unnaturally white, resem- 
 bling blanched wax rather than a healthy countenance. 
 The veins are large and conspicuous, the pupils of the eyes 
 are large, eyelashes long, with a fair, florid complexion. 
 In persons of a bilious temperament the skin is coarse, its 
 color dingy. The form of the body is often destitute of 
 symmetry. The trunk is small, the head large, abdomen 
 tumid, limbs unshapely, the growth of the body is irregular, 
 
PHTHISIS. 123 
 
 the functions of nutrition are feeble and deranged. The 
 intellect is often very active ; there is great sensibility to 
 impressions and acuteness of mind. 
 
 Stages. — For convenience in description, phthisis has 
 been divided into three stages. Between these no line of 
 demarkation is accurately drawn. The first stage begins 
 with the onset of the disease, and ends when the softening 
 of the tubercle has commenced. 
 
 General Symptoms. — The pulse is accelerated, espe- 
 cially after eating, towards evening, or by slight exercise. 
 A burning sensation is felt in the palms of the hands and 
 soles of the feet. Towards evening a slight chilliness 
 comes on ; towards morning, perspiration supervenes. 
 The febrile paroxysm is sometimes very slight, scarcely 
 attracting notice ; sometimes severe, causing unpleasant 
 sensations, and exciting alarm. Sleep ceases to refresh, 
 food to give strength and vigor. The aspect of the patient 
 changes ; the countenance is pale, expressive of languor, or 
 red with the hectic flush. The" skin is less elastic ; the 
 muscles less firm ; menstruation is tardy or entirely want- 
 ing ; emaciation becomes evident. If these symptoms have 
 appeared in the spring-time, by the use of proper remedies, 
 and regimen, they are almost entirely removed, until the 
 returning autumn and winter bring them on with increasing 
 severity. Occasionally they seem to arise from bronchitis, 
 pleuritis, pneumonitis, or some febrile disease. When 
 they succeed to measles or scarlet fever, they frequently 
 progress with unbounded rapidity. The rational symp- 
 toms are subject to much variation. In most cases, how- 
 ever, a short, dry cough is one of -the first symptoms that 
 excites alarm. Often very slight, a mere hacking in the 
 morning, it steadily increases, and at length is accompa- 
 nied with a frothy expectoration of transparent mucus, and 
 afterwards of yellow, opaque matter. Slight dyspnoea 
 occurs when the patient exercises. About the sides and 
 
124 PHTHISIS. 
 
 shoulders there are fugitive pains. Slight hemorrhage 
 from the lungs occurs ; at times it may be somewhat co- 
 pious, but often in small quantity. As the disease pro- 
 gresses, the cough increases, preventing sleep, and some- 
 times occurring in paroxysms. The expectoration is cor- 
 respondingly increased, becoming thicker, more yellowish, 
 or greenish and purulent. The other symptoms usually 
 advance with equal pace. Sometimes the disease is very 
 insidious in its approach. Suddenly, without any premo- 
 nition, a violent attack of haemoptysis occurs, immediately 
 succeeded by all the appearances of confirmed phthisis. 
 These rational symptoms are intimately connected with the 
 tubercular deposition. The tubercles are in a state of cru- 
 dity. Softening has not yet commenced. They are in the 
 form of small, roundish, homogeneous bodies, collected in 
 clusters, or more widely disseminated through the lungs 
 in the form of miliary tubercles. Sometimes they are more 
 or less firm, of a greyish color, or translucent. 
 
 Physical Signs. — In the nascent state of phthisis, we 
 cannot derive positive information from physical explora- 
 tion. In order to produce abnormal sounds on percussion 
 and auscultation, the deposit of tubercles must be conside- 
 rable ; or there must be in some one part of the lungs, be 
 it ever so limited, a deposit sufficiently great to interfere 
 with the pulmonary functions. 
 
 If the tubercles are small and scattered, the physical 
 signs will not be so sure to detect the morbid changes. If, 
 on the contrary, they are large and clustered together, 
 abnormal sounds are more readily developed ; so that it is 
 evident that the physical signs cannot determine the accu- 
 rate amount of tuberculous deposition ; since the arrange- 
 ment of tubercles, as well as their number, has a modify- 
 ing influence. Shall we therefore conclude that the phy- 
 sical signs are of no practical utility? As well might we 
 deny the usefulness of the telescope, because it does not 
 
PHTHISIS. 125 
 
 reveal all the minute phenomena of the heavens. Because 
 no one of the physical signs is absolutely pathognomic, we 
 should not conclude that their evidence, added to that 
 afforded by the general symptoms, is not of great value. 
 These signs, found at the point most subject to tubercular 
 disease, the comparative rarity of any other lesions capable 
 of producing the same physical phenomena, enable us to 
 arrive at a degree of probability which is almost equiva- 
 lent to certainty. The existence of the twofold evidence 
 given by the general symptoms and the physical signs, 
 makes the diagnosis far more sure than it could be when 
 founded only on one class of symptoms. 
 
 Inspection is often a valuable means of diagnosis. 
 Prominence of the clavicles, contraction of the intercostal 
 spaces, a flatness of the chest in front, an unequal height 
 of the shoulders, a, depression of the ribs, — all these, when 
 present in a tuberculous patient, indicate the presence of 
 phthisis. 
 
 Percussion is usually somewhat dull under the clavicles. 
 An inequality in its degree on opposite sides of the chest, 
 and at points equally distant from the median line, adds 
 much more significance to this physical sign, and especially 
 if the dulness is greater on the left side. In emphysema 
 and pneumo-thorax a similar inequality of sound may 
 exist. 
 
 In these instances the diseased side is most sonorous ; 
 but the respiration is most feeble where the resonance is 
 greatest, a circumstance which distinguishes this condition 
 from phthisis. An emphysematous condition of the lung 
 occurring adjacent to the location of solidification from 
 tubercles, may cause the percussion to remain nearly nor- 
 mal. Were this coincidence common, it would certainly 
 diminish the value of percussion in diagnosis. But it is of 
 very rare occurrence. The signs derived from percussion 
 should be sought about the clavicular and acromial regions. 
 11* 
 
126 PHTHISIS. 
 
 Obscurity of resonance being detected beneath one or 
 both clavicles, or at any point of the chest near to the 
 apices of the lungs, what conclusion should be formed as 
 to the nature of the disease ? To this question Chomel 
 replies: — "Obscurity of sound, and feeble respiration 
 under one of the clavicles, give strong reason to suppose 
 the existence of tubercles, for partial effusions take place 
 in the immense majority of cases at the inferior and pos- 
 terior parts of the chest, and it is almost never that chronic 
 pneumonia is primitive and without the presence of 
 tubercles. 
 
 In the early stage, the slightest difference of note or 
 pitch on opposite sides of the chest, if confined to the 
 clavicular and acromial regions, should excite suspicion. 
 Although the dulness may be confined to a small locality 
 over the top of the shoulders and the scaleni muscles, yet 
 if it be clearly perceptible it is a very sure indication of 
 the existence of phthisis. 
 
 Auscultation, in the first stage, reveals a feebleness of 
 respiratory murmur in the sub-clavicular region. This 
 occurs where percussion is dull, and at the same time the 
 resonance of the voice is greater than normal. While in 
 one part of the lung these signs are heard, in another the 
 respiration is blowing. A slight difference of sound in 
 relative situations on both sides, does not necessarily 
 indicate phthisis. The anatomical relations of the lungs 
 have a modifying effect. A sound in the right lung of a 
 phthisical patient should not be considered as indicative 
 of tubercles, unless it is decidedly blowing. But if the 
 respiration is more blowing at the apex of the left than at 
 that of the right lung, there can be but little doubt that 
 tuberculous disease is present. With the advance of the 
 disease, the respiration becomes somewhat rough, or even 
 bronchial, with a prolongation of the expiratory sound, 
 which is one of the most striking characteristics of tuber- 
 
PHTHISIS, 12t 
 
 culous deposition. Inspiration is at times somewhat jerk- 
 ing. The cardiac pulsations are more audible than nsual. 
 Bronchial respiration and bronchophony are heard out of 
 their natural locality, thus becoming indications of pulmo- 
 nary lesions. 
 
 Second Stage of phthisis may be considered as beginning 
 with the softening of tubercles, and terminating when 
 cavities are fully formed, and all the physical effects arising 
 from them fully developed. In other words, it is the 
 forming stage of vomicae. 
 
 General Symptoms. — Of the general symptoms collec- 
 tively, I remark that they are more severe. The evening 
 chills are more constant and troublesome ; the succeeding 
 heat is more intense and more general, the morning sweats 
 more regular and copious. Hectic is more constant, and, 
 to use the words of another, " hangs out upon the cheek 
 the red flag of death;' 7 the pulse is more frequent, the 
 respiration quick and laborious, even when the patient is 
 at rest. Languor and weakness increase, emaciation is 
 rapid, the muscles are soft and flabby, and the patient 
 can no longer endure his wonted amount of physical or 
 mental exertion. Paleness of the countenance frequently 
 remains through the early part of the day. Sometimes 
 there is a greater tendency to chills shown by an increased 
 sensibility to cold, and the evening exacerbation brings on 
 an increased heat of the palms of the hands and the soles 
 of the feet. The countenance, under the influence of the 
 morbid excitement, is for a while more animated, the eye 
 brightens, and the red blush of hectic gives to the features 
 new beauty and loveliness. When speaking, the lips of 
 the patient slightly quiver, there is breathlessness which 
 interrupts him in the middle of a sentence. Sleep is more 
 disturbed. Xot unfrequently the mind, even in this stage 
 of the disease, is buoyant and hopeful. The least or most 
 temporary amendment in his symptoms, or the delusive 
 
128 PHTHISIS. 
 
 promises and boasts of quacks, inspire him with, the joy of 
 hope. The Physical Signs in this stage are more marked. 
 As the disease advances, the tubercles soften and become 
 diluted with a morbid secretion from the pulmonary 
 tissues. Particles of curdy or cheesy matter pass from 
 their locality, in the parenchyma of the lungs, into the 
 bronchial tubes, and are expectorated. The exit of this 
 matter from the lungs gives rise to little vacuities called 
 caverns, cavities, vomicae or excavations. A careful ex- 
 amination of the chest, at this time, affords positive evi- 
 dence of the internal mischief. The upper parts are less 
 freely raised during respiration than in the healthy state ; 
 this phenomenon frequently being more evident on one 
 side than on the other. The sub-clavicular regions on 
 both sides, give a dull sound on percussion. To the 
 mind, the ear, or stethoscope, when applied to those 
 portions of the chest situated where percussion is dull, 
 reveals a slight crackling noise — the crepitating rhonchus. 
 After vomicae are formed, the cavernous rale or the 
 gurgling is heard, when the cavity is partly filled with 
 liquid. Resonance of the voice and cough, and at length 
 pectoriloquy follow. If a solidified portion of lung, en- 
 closing a considerable bronchus, comes near to the surface 
 of the chest, then bronchial breathing and bronchophony 
 are heard. Percussion, too, will give the same sound, 
 whether the lung be hepatized or blocked up by tubercular 
 matter. This condition of the lungs may be present in 
 one part, while cavities exist in another, and therefore, 
 different parts of the chest will exhibit different physical 
 signs ; I have said that the gurgling sound is heard in 
 case the vomicae contains liquid. But does this sound 
 necessarily prove in all cases the existence of cavities ? 
 Dr. Watson remarks, "that where we hear, during inspira- 
 tion, the gurgling rale — called by Laennec, gargouillement 
 — we may conclude, that there exists a cavity. But the 
 
PHTHISIS. 129 
 
 cavity will not necessarily be a vomica. In ninety-nine 
 cases out of a hundred, it will be so ; but in the hun- 
 dredth, perhaps it will not." 
 
 Dilatation of the bronchi, sometimes produces a con- 
 siderable globular expansion. In case these cavities, 
 formed by such an expansion, were filled with a liquid, the 
 same sound would be produced, as that caused by tuber- 
 cular vomicoe. 
 
 Third Stage. — The third stage is that period, which 
 commences when cavities are already formed, and con- 
 tinues until the termination of the disease. This has 
 been called the colliquative stage, from the copious per- 
 spiration, the frequent attacks of diarrhea, and the abun- 
 dant expectoration with which it is attended. The feet 
 and ankles become (edematous ; the vital powers gradually 
 decrease, one after another ; the functions of life fail ; the 
 body, by a facilis descensus, falls to the earth, and the 
 soul rises to eternity, 
 
 General Symptoms. — The most important of these are, 
 the colliquative sweat, diarrhaea, extreme emaciation, 
 anasarcous swelling of the lower limbs, and high febrile 
 excitement, A sure indication of approaching dissolu- 
 tion, is an aphthous condition of the mouth. This usually 
 comes on during the last weeks, or days of existence. 
 The mental faculties, at this period of phthisis, are more 
 or less deranged. Keason remains ; but it is not the 
 reason of health. Slight delirium sometimes occurs ; the 
 patient becomes indifferent to what is passing around him, 
 and to his own state, when a little while before his atten- 
 tion was aroused by every unfavorable symptom. 
 
 Special Symptoms. — The expectoration is very copious, 
 consisting of a heterogeneous mass of mucus, pus, soft- 
 ened and occasionally solid tubercle, blood, shreds of 
 lymph, rarely portions of pulmonary tissue, sometimes 
 very fetid. The cough and dyspnoea increase. The 
 
130 PHTHISIS. 
 
 shoulders are raised and brought forward ; the chest is 
 narrow and flat. During respiration, the clavicular 
 regions are less moveable than natural, and when the 
 patient attempts to make a full inspiration, the upper part 
 of the thorax, instead of expanding with the appearance 
 of spontaneous ease, peculiar to the healthy state of the 
 lungs, seems to be forcibly dragged up at each respiratory 
 effort. 
 
 Physical Signs. — The physical signs in the third stage, 
 are similar to those in the second. The gurgling rale, the 
 increased resonance of voice, bronchophony, and pecto- 
 riloquy, amphoric resonance, and metallic tinkling, may 
 be present in different cases and at different times. Some 
 of these signs are more frequently heard than others. 
 The metallic tinkling is oftener present in a large than in 
 a small cavity ; and since large cavities are formed in the 
 third stage, this symptom is observed only when the dis- 
 ease is far advanced. 
 
 Haemoptysis. — This is the most important rational 
 symptom that occurs in phthisis. In other diseases and 
 conditions of the lungs, it is so rare that it very certainly 
 indicates the nature of the case. Haemoptysis, to be sure, 
 may be produced by other causes — by certain forms of 
 heart disease, by cancer, by cirrhosis of the lungs ; and, in 
 females, by vicarious menstruation. But these latter con- 
 ditions of the lungs are very rare, and therefore haemoptysis 
 should be considered a strong evidence of phthisis. 
 
 Emaciation. — This is one of the cardinal symptoms of 
 phthisis. Frequently it precedes the other symptoms. 
 Between the ages of forty and fifty, Dr. James Clark found 
 it one of the earliest symptoms of this disease. Indiges- 
 tion is regarded by the patient and his friends as one of the 
 principal causes of this atrophy. It is frequently associated 
 with anaemia. There is many times a peculiar physiog- 
 nomy ; the cheek is pale and thin, and the eye bright. 
 
PHTHISIS. 131 
 
 Every organ in the body, except the liver and the heart, even 
 the blood itself, emaciates. And this is often the first 
 symptom noticed. At length slight disturbance is mani- 
 fest — a little dyspnoea, a little chilliness towards evening, 
 and a tendency to cough. This symptom, emaciation, is 
 not always progressive. The patient may gain flesh, but 
 he soon loses it again ; then perhaps gains awhile in 
 weight ; and so on alternately. This, however, is observ- 
 able : he seldom gains as much as he loses. There is a 
 gradual though not a continuous descent. It is true also, 
 that while there is an increase of weight, the tuberculai 
 disease advances ; and while the patient and friends are 
 elated with hope by the apparent amendment, a fatal ter- 
 mination steadily approaches. Loss of appetite and 
 diarrhsea very much increase the emaciation. 
 
 Diarrhcea. — The rapidity of the progress of consump- 
 tion very much depends upon this. With the number of 
 evacuations Louis found that the loss of strength corre- 
 sponded. This fact should militate against the employ-" 
 ment of cathartics in phthisis. "A tablespoonful of castor 
 oil," says Dr. James Clark, "I have seen throw a phthi- 
 sical patient into an alarming state of debility." In those 
 who have in health a costive state of the bowels, incipient 
 phthisis produces regularity of action. DiarrKsea is usually 
 confine-d to the advanced stage of the disease. In one- 
 eighth of- the cases treated by Louis, diarrhaea commenced 
 with the disease, and continued until its termination ; in 
 the majority it occurred in the later stages ; in others 
 during the last days of life ; and in four out of one hun- 
 dred and twelve cases, it never appeared. The distress 
 attending this symptom is often severe ; before each 
 evacuation the pain is often intense, and immediately after 
 it there is a deadly sensation of sinking. It has an effect 
 upon the cough and expectoration. 
 
 The severity of these symptoms is usually in an inverse 
 
42 PHTHISIS. 
 
 >atio to that of the diarrhaea. As a diagnostic sign it is 
 T,,ot of great value. The nature of the disease is known by 
 $tber means, before this becomes fully developed. The 
 cause of the diarrhaea is the softening of the tuberculous 
 matter deposited among the coats of the intestines. After 
 death we find ulceration of the mucous membrane, tubercu- 
 lous deposits thickening and softening, and enlarged mu- 
 cous follicles, especially near the termination of the ileum 
 and in the colon. 
 
 (Edema. — This is an invariable attendant of the last 
 stage of phthisis. In young delicate females it may super- 
 vene in the earlier stages. Generally it shows itself first 
 in the lower extremities, and is confined to them. In the 
 morning there is sometimes an cedematous appearance in 
 the face. For the diagnosis this is of no value ; but it is 
 a prognostic of approaching death. Is the suppression of 
 the menses the cause of the tuberculous disease ? Some 
 have thought it might lead to tubercles in the lungs. The 
 menstrual suppression is for the most part the effect of that 
 general debility, that deficiency of the nutritive properties 
 of the blood which precedes the deposition of tubercles. 
 If this theory is true, then the treatment, instead of being 
 wholly directed to the restoration of the uterine functions, 
 should be directed to remedy that deficient nutrition 
 and its consequent debility, which cause the menstrual 
 suppression, §nd the tuberculous deposition. The cessa- 
 tion of the menses is sometimes one of the first, if not the, 
 first, prominent symptom of phthisis ; and a careful exami- 
 nation of the case will often discover this to be the fact. 
 Attendant upon this symptom there are, in most cases, a 
 slight cough, a little chilliness and fever, and some of the 
 physical signs of incipient phthisis. In general this func- 
 tion continues, but decreases in quantity, during the early 
 stage of the disease. From a gTeat variety of causes, this 
 
PHTHISIS. 133 
 
 function is so liable to derangement, that as a diagnostic 
 sign it is not of much value. 
 
 Duration of Phthisis. — Tuberculous phthisis is essen- 
 tially a chronic disease, the range of its duration being 
 considerable. Cases have been recorded which have ter- 
 minated in eleven days, while others have lingered for 
 twenty or even forty years. These, however, are extreme 
 cases ; the majority terminate in one or two years, the 
 average duration being eighteen months. 
 
 Phthisis in Infancy and Childhood. — Phthisis is more 
 common in infancy and childhood than was once supposed. 
 Dr. G-uersent, one of the physicians to the Hospital des 
 Enfans Malades, an institution appropriated to the treat- 
 ment of patients between the age of one and sixteen years, 
 gives, as the result of his observations, that five-sixths of 
 those who die in that hospital are more or less tuberculous. 
 Early in life, its existence is manifested by symptoms 
 somewhat different from those, of adults. The cough 
 occurs in paroxysms ; hectic expectoration and hemor- 
 rhage from the lungs are not so apparent. The tuberculous 
 cachexia, rapid pulse and breathing, emaciation and 
 derangement of the digestive organs, tumid abdomen and 
 irregular action of the bowels, at one time constipated, at 
 another affected with diarrhoea, and the pale unnatural 
 color of the evacuations, point out the nature of the disease. 
 In children the mesenteric glands are more subject to 
 disease than in adults. But the most frequent seat of 
 tuberculous affections is the bronchial glands, and the next 
 in frequency is the lungs. The relative frequency of 
 tubercles in the bronchial glands of children, compared 
 with the lungs, is not less than five to four, which is 
 . reversed after the age of puberty. 
 
 12 
 
134 PHTHISIS. 
 
 CAUSES OF PHTHISIS. 
 
 Among the causes of phthisis, hereditary predisposition 
 occupies the most important place. And yet this heredi- 
 tary tendency explains nothing in relation to the real cause 
 of the disease. It is the name of a fact, not a cause, which 
 is sure to produce specific results. We must, therefore, 
 in order to arrive at anything definite or practical, seek to 
 find that in which the fact has its origin — whether it is a 
 peculiar state of the blood, or a want of functional power, 
 — in the digestive organs, or in the respiratory apparatus. 
 Vitality is the effect of so many conditional causes, each 
 liable to vary in intensity, and by that variation to influence 
 the result — the degree of vitality, — that it is difficult to 
 tell in what ultimate change phthisis has its origin. But 
 the nearer we can ascend to the sources of knowledge, the 
 more general and conditional that obtained knowledge 
 becomes, for all other knowledge relates to it as species 
 to genera. Accordingly, it is evident that if chemistry 
 or optics could detect that condition of the blood, whatever 
 it is, which is most prevalent in the progeny of tuberculous 
 parents, before deposition of tuberculous matter takes 
 place, a general fact would be obtained of more value than 
 many particulars often spoken of by medical writers. From 
 pathology or from chemistry we gain no evidence that 
 those who are predisposed to phthisis have blood essen- 
 tially differing from that of others. And the existence of 
 the hereditary tendency has been questioned by some recent 
 observers. But because of the non-appearance of an ab- 
 normal change in the constituents of the blood, except in 
 rare cases, or because the existence of that tendency is 
 denied, we should' not therefore conclude that hereditary 
 influence does not exist, It may exist, but not as an 
 ultimate cause, ever producing a certain result. 
 
 Occupations of Life. — Concerning the causes of phthisis, 
 
PHTHISIS. 135 
 
 Lombard, of Geneva, has given us some valuable statistical 
 information. The result of his researches is thus stated : — 
 The circumstances which increase the tendency to phthisis 
 are poverty, sedentary habits, violent exercise of the chest, 
 an habitually bent position of the body, impure air in 
 workshops, the inhalation of certain mineral and vegetable 
 vapors, or air loaded with a coarse or impalpable dust, or 
 with light, thready, elastic substances. 
 
 The conditions which seem to exert a favorable pre- 
 servative influence, are easy circumstances, an active life in 
 the open air, regular general exercise, the inhalation, of 
 watery vapor, and animal and vegetable emanations. 
 Sedentary habits are prone to produce phthisis. The 
 habit of sitting with the body inclined forward, thus pre- 
 venting the free expansion of the lungs, and the action of 
 the stomach, and other abdominal viscera, is one cause of 
 the injurious tendency of a studious life. Among shoe- 
 makers and tailors, the proportion of phthisical patients is 
 very large. 
 
 Dyspepsia. • — In dyspeptic diseases, many authors have 
 placed one prominent cause of phthisis ; and with good 
 reason they have done so. For since tubercles depend for 
 their development upon a want of nutrition in the blood, and 
 since dyspeptic diseases deprive the blood of its nutritive 
 properties, there is every reason to believe, that in this 
 source tubercles have their origin. 
 
 There are other causes of phthisis, seldom described in 
 medical works. Of these, one is masturbation, which, by 
 its debilitating effects upon the general constitution, tends 
 in an eminent degree to favor the development of tubercles. 
 Another cause is the use of such remedial agents in the 
 cure of disease, as leave after their primary effects have 
 subsided, secondary ones, which in the end prove worse 
 than the original disease. If this be so, and the history 
 of thousands of individuals corroborates its truth, then 
 
136 PHTHISIS. 
 
 why may not its action upon the system- directly induce 
 tuberculous disease ? Indirectly, if not directly, by debili- 
 tating the system deteriorating the red blood, and inducing 
 emaciation, it so influences the mass of the fluids, as to 
 predispose the system to the ingress of phthisis ; it leaves 
 the territory unguarded by any vital force, even by that 
 mysterious one, "the vis medicatrix naturce." A patient, 
 somewhat predisposed to phthisis, takes a severe cold in 
 the autumn. Febrile symptoms supervene. There is, ac- 
 cording to the opinion of some, an exalted condition of 
 vital action ; and consequently, all the instruments of the 
 antiphlogistic regimen and treatment, are immediately 
 used to subdue the inflammation. After a number of 
 weeks, the patient may slowly recover. But his digestive 
 organs do not seem to be healthy. Strength does not 
 return ; a slight cough begins, and in from six months to 
 a year, phthisical symptoms are fully developed. Such 
 cases often occur, and so often, that the more judicious 
 physicians of all creeds, even those standing on the con- 
 servative platform, now begin to abandon the use of de- 
 pressing remedies ; not because as some often pretend, dis- 
 eases are now so different in their nature, as not to require 
 the same treatment, but because the application of science 
 to the study of medicine, has exploded the idea that it is 
 necessary to hazard life, by the use of deleterious agents, 
 in order to produce a speedy and complete cure. 
 
 Prognosis. — In those cases where the disease is far 
 advanced, the prognosis is always very unfavorable. So 
 small is the chance of recovery, that the physician has no 
 good reason to encourage either patient or friends. 
 
 But morbid anatomy has demonstrated, that even in the 
 last stages, recoveries do take place ; the cavities are filled 
 with chalky concretions, their parietes contract, and cica- 
 trices are produced. What else than the cure of phthisis 
 do such facts teach ? On this subject, Dr. Swett remarks, 
 
PHTHISIS. 137 
 
 "I never shall entirely despair of the life of a patient, 
 when I recollect what I once witnessed in this Hospital. 
 A patient was admitted with phthisis. The disease was 
 perfectly well characterized, and in its roost advanced 
 stage ; a large and well-marked abscess existed under the 
 right clavicle. Indeed the signs of this lesion were so 
 distinct, that I was in the habit of calling the attention, 
 of students in attendance, to them, as perfect in their cha- 
 racter. On one occasion, as I approached the bed for this 
 purpose, I found the patient, who had been gradually 
 sinking, in such a state that it seemed to me improper to 
 disturb him. He was bolstered up in bed, with his head 
 falling upon his shoulder, breathing with great difficulty, 
 bathed in perspiration, and with a rapid and feeble pulse. 
 The next day my attendance ceased, and after two months 
 was again commenced. On entering the ward, the house 
 physician called my attention to a man, dressed, and walk- 
 ing about the ward, apparently stout and well, although 
 somewhat pale. To my great" astonishment, it was the 
 patient I had left two months before, apparently dying. " 
 The same author testifies that he has known a number of 
 cases of patients, who have had all the evidences of 
 phthisis, and yet have recovered. 
 
 TREATMENT. 
 
 11 The indications to be fulfilled in the treatment of this 
 disease," says Prof. Calkins in his very excellent work on 
 thoracic diseases, "are, first, to prevent the farther depo- 
 sition and development of tubercles ; and, secondly, to pre- 
 vent and to protect, as far as possible, the lungs and other 
 organs from their injurious results. The means both pro- 
 phylactic and remedial, which can be of any utility for this 
 purpose, must be directed to the attainment of this result : 
 the production of that state of the solids and fluids which 
 is most adverse to the development of tubercles." Prof. 
 12 * 
 
138 PHTHISIS. 
 
 J. G. Jones says : " The leading indications to be fulfilled 
 in the treatment of this disease are twofold, to wit : 1. To 
 change the condition of the blood, and restore the qualities 
 pertaining to its healthy state. 2. To prevent the further 
 deposition and development of tubercles, give tone and 
 vigor to the whole system, and in a measure change its dia- 
 thesis. " Profs. Newton and Powel, in a work on the 
 treatment of diseases, make the following remarks : "In 
 the treatment of this disease, little else can be done than 
 to make use of means which will enrich the fibrinous por- 
 tions of the blood, strengthen the nervous and muscular 
 system of the patient, and relieve troublesome and danger- 
 ous symptoms as they may appear." Dr. Walshe gives the 
 results which he obtained in the Consumption Hospital as 
 follows: "1. Of a given mass of patients entering the 
 hospital in all stages of the disease, and in every variety 
 of general condition — between the actual moribund state 
 and that of but slight constitutional suffering— the number 
 leaving it, on the one hand, improved or unadvanced was 
 more than double that, on the other hand, leaving it in a 
 worse state or dying within its walls (the exact ratio is 
 61*84: 32*16). If the cases in which death was actually 
 imminent at the period of admission, were excluded, the 
 result would be very materially more favorable than this. 
 2. In 4 26 per cent, of the cases, complete restoration to 
 health, not only as regards apparent disturbance of the 
 functions generally, but as regards local evidence of actual 
 pulmonary disease, was effected. 3. Complete removal 
 of symptoms was more frequently effected in the male than 
 in the female ; but, on the other hand, the results were on 
 the whole slightly more favorable in the latter than in the 
 former sex. 4. All patients who grew worse while they 
 were in the hospital had reached the stage of excavation 
 on admission; and all patients whose tubercles were yet 
 unsoftened on admission, left the hospital either improved, 
 
PHTHISIS. 139 
 
 or having bad a statu quo condition kept up. Improve- 
 ment is more probable than the reverse, even where exca- 
 vation exists on admission. 5. In a given mass of cases, 
 the chances of favorable influence from sojourn in the 
 hospital will be greater in a certain (undetermined) ratio 
 as the duration of the disease previous to admission has 
 been greater ; in other terms, natural tendency to a slow 
 course is a more important element of success in the treat- 
 ment of the disease, than the fact of that treatment having 
 been undertaken at an early period. 6. The mean length 
 of stay in the. hospital, in the most favorable class of cases, 
 nearly doubled that in the least favorable. 7. The chances 
 of benefit are most in favor of those whose trades are pur- 
 sued out of doors (wholly or partially) than of those who 
 work wholly within doors. 8. The results did not appear 
 to be influenced by the laborious or non-laborious charac- 
 ter of the trade individuals might have pursued. 9. The 
 age of the sufferers did not appear to exercise any very 
 material influence on the character of the results. 10. 
 Patients coming from the country have, on an average, a 
 slightly stronger chance of improvement than the residents 
 of London and its suburbs. 11. Patients admitted during 
 the warmer half of the year, benefit by a sojourn at Bromp- 
 ton, to a slight extent, more than those received during the 
 six colder months. " 
 
 From the above facts, together with the experience of 
 every intelligent Eclectic physician, it appears that pulmo- 
 nary consumption is occasionally cured, and sometimes 
 terminates favorably without medical aid ; and perhaps I 
 might state, in spite of medicinal treatment. But when 
 we consider the irrational treatment which has been relied 
 upon for the cure of this disease, we can hardly be sur- 
 prised at its fatality. Xor that not only the medical fra- 
 ternity, but the community generally, have been led to be- 
 lieve that it is incurable. So much so is this the case, that 
 
140 PHTHISIS. 
 
 a large number of physicians deem it a sufficient apology 
 for losing a patient in the prime of life, to state that he 
 died of pulmonary consumption. I do not expect in this 
 article to lay down a course of treatment that will always 
 oure, irrespective of age, condition of the patient, and 
 stage of the disease ; but, I do expect to explain such 
 a course, as will, if properly applied, cure a large pro- 
 portion, and materially relieve such as cannot be entirely 
 restored. 
 
 When a person exhibits premonitory symptoms of 
 phthisis, every exciting cause of the disease should be 
 removed. The patient should exercise freely in the open 
 air, and be placed upon a full and nutritious diet, such 
 as beef-steak rare cooked, &c. He should also take a 
 reasonable quantity of some stimulant, as brandy toddy, or 
 some malt liquors, before each meal. If this does not 
 remove those early symptoms, chalybeates, in connection 
 with sugar, may be given as follows : 
 
 U Precipitated Carbonate of Iron spj. 
 
 White Sugar gvij. 
 
 Mix and triturate, take one teaspoonful three or four times 
 a day. Should the beef, and other articles of food, not be 
 well digested, on account of a dyspeptic habit which fre- 
 quently precedes this disease, slightly cooked eggs and rich 
 animal soups may take their place. This course has been 
 efficient in my hands in a large number of cases, where the 
 early symptoms of phthisis were developed. But where 
 the disease is farther advanced, with more or less anemia, 
 cough and expectoration, with depression beneath the 
 clavicle, feeble respiratory murmur, and dulness on per- 
 cussion, and especially if there is connected with this a 
 tubercular diathesis, then much effort will be required to 
 prevent a disastrous encroachment of the disease. In this 
 condition and stage of symptoms, the following treatment 
 should be instituted. 
 
PHTHISIS. 141 
 
 A large double flannel cloth, within which has been 
 quilted a liberal quantity of coarse suit, should be placed 
 over the chest and back in such a manner as to protect 
 both the anterior and posterior portions of both lungs. 
 This salt pack should be changed from time to time, but 
 should be worn until the disease is removed. And for 
 supplying those deficiencies of the blood, which are such a 
 prolific cause of pulmonary consumption, give the following 
 compound : 
 
 R The white ot eggs xij. 
 
 Iron by Hydrogen gr. xx. 
 
 Phosphate of Lime gij. 
 
 Chloride of Sodium giij. 
 
 Mix with one pint of best brandy, one pound of sugar, and 
 one pint of water ; dose one tablespoonful three or four 
 times a day. In connection with this, the patient should 
 exercise freely in the open air, and should make a liberal 
 use of warm or cold baths, as the case may seem to indi- 
 cate. If there are chilis, 
 
 U Quinine , gr. xx. 
 
 Phosphate of Iron ., gr. x. 
 
 Morphine , gr. jss. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, divide into fifteen powders, and take one 
 every three hours. If the first fifteen powders fail to 
 interrupt the chills, they should be repeated from time to 
 time, until they cease entirely. If there is troublesome 
 cough, with dyspnoea, give the following mixture : 
 
 U Simple Syrup of Stillingia giij. 
 
 Syrup of Tolu gij. 
 
 Morphine , gr. ij. 
 
 Mix; dose, one teaspoonful three times a day, and oftener 
 if required. If there appears to be bronchial irritation, 
 from one-eighth to one-half a grain of Gelsemin should be 
 taken at bed-time. If the salt pack should be removed 
 
142 PHTHISIS. 
 
 at any time during the treatment, the chest should be well 
 protected by oil silk or flannel. In nearly all cases of 
 pulmonary consumption, there is a deficiency of the natural 
 covering, the hair. In fact, so general is this the case, 
 that I have come to regard a deficiency of hair on the 
 chest as one of the indications of a tuberculous diathesis. 
 For the hair is not simply an ornament, but it serves 
 to separate certain proportions of carbon, silica, sulphur 
 and other materials from the blood. As the disease 
 advances to the latter part of the second stage, other 
 symptoms make their appearance, as diarrhoea, and a 
 muco-purulent matter or pus, constituting the sputa, indi- 
 cating a breaking down of the tuberculous deposit, with 
 more or less affection of the glands of the bowels. To 
 control the diarrhsea, no medicine is more effectual than 
 the following : 
 
 U Sub-nitrate of Bismuth gr. xx. 
 
 Quinine gr. xvj. 
 
 Pulverized Gum Arabic gr. xxx. 
 
 Mix, triturate, divide into twenty powders, and give one 
 every five or six hours until that symptom is controlled. 
 
 The method of treating this disease by introducing 
 medicine into the system by inhalation, having received 
 much attention of late, I will quote the remarks of Dr. 
 Turnbull upon the subject, as they appear to embrace most 
 of the facts essential to it. 
 
 " Dr. Snow has shown, in a paper on the inhalation of 
 various medicinal substances, that some must be inhaled by 
 the aid of heat, such as opium, morphia, extract of stramo- 
 nium, and the gum resins ; others with heated vapor, such as 
 iodine, camphor and creosote, and a third class of sub- 
 stances, such as hydrocyanic acid, ammonia and chlorine, 
 at the ordinary temperature. Mead, in his day, recom- 
 mended fumigations with the balsams in phthisical cases, 
 
PHTHISIS. 143 
 
 and Dr. A. T. Thomson (Cyclopedia of Medicine, Art. 
 Expectorants) has stated that he has seen much benefit 
 derived from them, when inhaled in spasmodic asthma, in 
 shortening the paroxysm, and promoting expectoration. 
 Dr. Snow found that ammoniacum gives off a fragrant, 
 rather pungent odor, which can be inhaled very well by 
 most persons. He also found inhalation of the watery 
 extract of opium serviceable in relieving the cough ; but 
 that morphia was the most pleasant and suitable prepara- 
 tion of opium for inhalation. Extract of stramonium 
 afforded more or less relief in five or six cases of asthma. 
 
 He tried iodine in eighteen cases of consumption at 
 Brompton Hospital ; in ten of them it was continued for 
 more than a month ; and the conclusion to which he came, 
 was that no benefit could be observed to follow its use. 
 Oil of turpentine appeared to relieve the cough in a few 
 cases, and likewise camphor. He used the volatile alka- 
 loid conia in the quantity of one minim, diluted with 
 nine of spirit ; the cough was usually relieved, and in two 
 or three cases the breathing also. It would seem, there- 
 fore, from its volatility at the ordinary temperature, to be 
 a remedy peculiarly suitable for inhalation, if it could be 
 obtained more easily. Dr. 'Snow also found great relief 
 in a few cases of bronchitis with difficult expectoration, 
 from inhaling ammonia, twenty drops of the strong solu- 
 tion being mixed with two ounces of water in a Woulfe's 
 bottle. Chlorine has been used for inhalation ; it was 
 introduced for this purpose in France, and there is good 
 reason to believe that it has proved of material service in 
 cases of chronic bronchitis, and even in some of phthisis. 
 
 With reference to its use in this latter disease, Dr. 
 James Clark has observed, "We have tried it in many 
 instances, and it has in several, apparently suspended the 
 progress of the disease. ' r He also states that it relieved 
 dyspnoea and cough in some cases, though in the majority 
 
144 PHTHISIS. 
 
 it procured no amelioration. Dr. A. T. Thomson has 
 likewise stated, that in cases of asthma, the relief it pro- 
 duced was very striking, and that in phthisis, he had 
 observed the hectic symptoms abate. 
 
 Of the various remedies now mentioned, it is probable 
 that gum resins and balsams, camphor, conia, and chlo- 
 rine, are the most suitable and useful for inhalation ; but it 
 does not appear that by inhalation of opium, or morphias, 
 very decided advantage has been gained over the ordinary 
 mode of exhibiting them. 
 
 The vapor of tar was formerly recommended for inhala- 
 tion, and few medicines have been more used for this 
 purpose than creosote. Sir Alexander Crichton, in 1828, 
 strongly recommended tar vapor in consumption ; but 
 Dr. Forbes, in a report of cases in which he had tried it, 
 published in the Medical and Physical Journal, stated 
 that he found it injurious in this disease, though of service 
 in some cases of chronic bronchitis. He appears, how- 
 ever, to have used it in cases so far advanced, that no 
 benefit could reasonably have been expected from its 
 employment. Creosote has now superseded the use of 
 tar vapor, which does not, from its irritating properties, 
 seem well suited for inhalation, though there can be very 
 little doubt, when we consider the healing power it has in 
 external application, that it must exert a similar effect 
 upon the lungs, if it could be used in such a form as to 
 obtain its beneficial influence apart from its irritating pro- 
 perties. Creosote is perhaps more generally used by the 
 profession for the purpose of inhalation, than any other 
 remedy ; and I believe that when sufficiently diluted with 
 vapor of water, it is one of the most useful. I have 
 found that it has a sedative influence, relieving cough and 
 promoting expectoration, whilst it at the same time not 
 unfrequently lessens the quantity of this secretion, both in 
 consumption and bronchitis. I have already observed 
 
PHTHISIS. 145 
 
 that the pyrogenic bodies act upon the mucous and cu- 
 taneous surfaces ; and my attention has been directed to 
 other bodies of this class, by the fact that many of them 
 have remarkable healing properties, when applied to 
 ulcers and chronic cutaneous eruptions, a fact which leads 
 me to expect that this class of bodies may, when fully 
 investigated, furnish a suitable remedy for promoting the 
 healing of pulmonary ulcers, and thus supply the deside- 
 ratum to which I have previously alluded. Many of the 
 pyrogenic bodies possess such healing properties in cu- 
 taneous diseases, in a greater or less degree. From my 
 own experience, I know that ointments, made with tar, 
 creosote, spirit of tar, juniper tar oil, and naphthaline, 
 have such properties, and are valuable remedies in the 
 treatment of skin diseases. 
 
 The inference drawn from these facts, has led me to use 
 for inhalation, some other pyrogenic bodies, viz : spirits 
 of tar, juniper tar oil, Persian naphtha, and enpione, The 
 spirit of tar possesses the healing virtues of tar without 
 its irritating effects ; so much so, that I think it might 
 advantageously supersede the crude substance as an 
 external remedy. It is more readily volatilized than creo- 
 sote ; and when inhaled, it produces generally a mild, 
 stimulating, and often rather a soothing effect upon the 
 lungs. In some instances, however, it has appeared to 
 increase the cough and expectoration, and it is not, there- 
 fore, suited for bronchitis, until inflammatory action has 
 been subdued completely ; or for cases of consumption, 
 until progress has been made in arresting the disease. 
 Without wishing to speak confidently of the remedy, I 
 may state that it has appeared useful in some cases of the 
 latter disease, in conjunction with other treatment. Juniper 
 tar oil (oleum codinum), which is a valuable remedy in 
 skin diseases, and much used on the Continent, is less 
 volatile than spirits of tar, and is less irtitating when 
 13 
 
146 PHTHISIS. 
 
 inhaled. Persian naphtha and eupione possess decided 
 anaesthetic properties ; the former, when inhaled along 
 with the vapor of water, has in some instances relieved 
 difficulty of breathing in a very remarkable and decided 
 manner ; and ttiis fact renders it worthy of trial in spas- 
 modic asthma. Eupione has decided sedative properties : 
 it has relieved cough and difficult breathing, and patients 
 have slept well after using it ; but it is not a pleasant 
 remedy to inhale, and it has not unfrequently produced 
 sickness afterwards, so that I should not recommend it to 
 be used for this purpose. 
 
 I have used several of the essential oils for the purpose 
 of inhalation. Many of them possess decidedly anti- 
 spasmodic properties, and I have found that they have a 
 remarkably strong power over difficulty of breathing, a 
 property which renders them peculiarly suitable for reliev- 
 ing spasmodic asthma. The oil should be dissolved in 
 spirit, and inhaled with the vapor of water, so as to dilute 
 its stimulating properties. The oils of cubebs and copaiva, 
 which are hydro -carbons, are mild in their action, and - 
 produce very little stimulating effect. The oxygenated 
 oils which I have used appeared to be more stimulating in 
 their action on the air-tubes, and some of them have 
 stronger anti-spasmodic and expectorant properties. The 
 oils of anise and peppermint are very stimulating, and in 
 general cause too much irritation. Oil of spearmint is 
 milder and antispasmodic, relieving difficulty of breathing 
 in asthma, and even in phthisis. Oil of fennel is also 
 mild. The oil of origanum is moderately stimulating and 
 expectorant. I have also used the oils of rosemary and 
 pimento, which have similar properties. The hydruret 
 of benzyle, which is the oil of bitter almonds deprived of 
 its prussic acid, is very irritating and much too stimulating 
 for inhalation. Chloroform is a remedy which has been 
 much used by some medical men for the purpose of inha- 
 
PHTHISIS. 147 
 
 lation, not only in asthma, but, in a small quantity, in 
 consumption, in order to relieve irritable cough. In some 
 cases I have dissolved the essential oils in chloroform, and 
 used them in this way for inhalation, their volatility being 
 thus so much increased that they may be given on a hand- 
 kerchief, as chloroform is usually administered. 
 
 In addition to the remedies spoken of by Dr. Turnbuli, 
 Carbonate of Ammonia, Nitrate of Silver, Sanguinaria 
 and Veratrum Viride have been quite extensively used by 
 different physicians, and in some cases to much advantage. 
 The oil of Erigeron, spoken of by Dr. Turnbuli, I have 
 used quite successfully in several cases of haemoptysis, con- 
 nected with phthisis, but whether it acts more efficiently in 
 this way than when introduced into the stomach, I am not 
 prepared to say. If the inhalation of medicine be resorted 
 to, the introduction of medicine into the stomach should 
 not be neglected. We can readily conceive how ineffectual 
 a treatment exclusively by inhalation must prove, since the 
 well established pathology of this disease shows the local 
 affection of the lungs to be only one of the unhealthy pro- 
 ducts of the constitution. In this stage of the disease, 
 much benefit will be derived from the use of diuretics to 
 relieve the blood from the excess of uric, and other acids, 
 with which it becomes overcharged, and also of the dis- 
 integrated tissue which accumulates in the system, owing 
 to imperfect respiration. Among the best diuretics to 
 accomplish this object is the following : 
 
 R Pipsissewa , , gj. 
 
 Indian Hemp 3J SS « 
 
 Marshmallow gj. 
 
 Bruise all together, and make one quart of syrup with 
 white sugar, and add one half pint of best gin, and let the 
 patient take from one half to one wine glass full four or five 
 times a day. 
 
148 PHTHISIS. 
 
 For the purpose of procuring rest at night, 
 
 R Quinine gr. x. 
 
 Scutellarin gr. xv. 
 
 Gelsemin . , gr. ij. 
 
 Iron by Hydrogen gr. xij. 
 
 Mix, divide into ten powders, and give one every night at 
 bed-time. 
 
 Where there is great emaciation and debility in this 
 stage, for supplying material for combustion, and for 
 increasing the quality and quantity of blood : 
 
 II Cod Liver Oil ." Of. 
 
 Good Brandy Oss. 
 
 Chloride of Sodium gij. 
 
 Phosphate of Iron 5Jss. 
 
 Mix, and shake well before using. Dose, one tablespoon- 
 ful three or four times a day. If there is much bronchial 
 irritation in connection with tuberculous affection, 
 
 R Syrup of Stillingia gij. 
 
 Tct. of Veratrum Viride gss. 
 
 Mix, and give thirty drops three or four times a day. 
 
 For the purpose of promoting absorption of the already 
 existing tuberculous deposit, Prof. John Fondey, Emeritus 
 Prof, of Theory and Practice of Medicine in the Eclectic 
 Medical College of Pennsylvania, who has had great ex- 
 perience in the treatment of this class of diseases, places 
 much reliance on the use of electricity. 
 
 In his treatise upon this subject, p. 68, he thus remarks : 
 " The electro-magnetic machine constitutes one of the 
 most powerful means that we possess, to accomplish the 
 results so desirable in the treatment of this disease. What 
 we want in the remedies which we employ, is some power 
 that will excite the contractility of the coats of the vessels, 
 of the enlarged absorbent glands, as well as of the lymphatic 
 vessels ; give strength to the magnetic organization of the 
 
HAEMOPTYSIS. 149 
 
 part, and promote the absorption of the deposits that may 
 have occurred in and around these glands and vessels." 
 
 Dr. Cartwright, of New Orleans, who has published 
 several very interesting articles upon the nature and treat- 
 ment of tuberculous affections of the lungs, cites quite a 
 number of cases where absorption of the tuberculous depo- 
 sition was effected by the inhalation of the vapor of sugar. 
 
 I have generally obtained the most satisfactory results 
 in promoting the absorption of tuberculous deposits by the 
 use of Iodide of Potassium, in connection with mucilage 
 The mucilage prevents the irritating effects of the Iodide 
 of Potassium on the bowels. The chest should be 
 thoroughly bathed twice a day with a liniment made as 
 follows : 
 
 R Oil of Stillingia §j. 
 
 White of three eggs. 
 
 Oil of Turpentine .; gij. 
 
 Chloride of Sodium gij. 
 
 Mix, and shake well together. During the entire treat- 
 ment of this disease, the strictest attention should be given 
 to bathing, diet, and exercise in the open air. Every 
 means should be resorted to which has a tendency to im- 
 prove the general health of the patient. Where the disease 
 assumes a periodic character, the greatest benefit will be 
 derived from administering a liberal quantity of Quinine 
 and Iron every seven or eight days. When the disease is 
 complicated with other local difficulties, such as leucorrhsea, 
 spermatorrhea, &c, they should receive especial attention. 
 
 HAEMOPTYSIS. 
 
 By haemoptysis we understand expectoration of blood. 
 
 It may occur from the mucous surface of the bronchial tubes ; 
 
 by extravasation of blood into the pulmonary tissue, &c, 
 
 or from the corrosion of a blood-vessel on the wall of a tuber- 
 
 13* 
 
150 HEMOPTYSIS. 
 
 culous vomica. It is also said to occur from the granula- 
 ted surfaces in phthisis. The most common cause of the 
 disease in females, when it occurs from the mucous surface 
 of the bronchi, is vicarious menstruation, which takes 
 place about the period of the catamenia. In these cases, 
 for some time previous to the attack, there will be observed 
 a diminution in the catamenial flow, accompanied by anae- 
 mia. Indeed, we have reason to suspect that, in connec- 
 tion with the catamenial derangement, there is tuberculous 
 affection of the lungs. I do not recollect, out of a large 
 number of cases, a single exception, and in quite a num- 
 ber of cases, it has terminated in acute phthisis. When 
 the blood eseapes from the bronchial mucous surface, it 
 may be detected by the bubbling liquid rhonchus in the 
 bronchi. The discharge is generally preceded by more or 
 less constitutional disturbance, such as constipated bow- 
 els, furred tongue, and cough, which is often persistent, 
 and accompanied with great dyspnoea. Where it occurs 
 from the rupture of corroded blood-vessels, the premoni- 
 tory symptoms are quite obscure, and the discharge of 
 blood is very sudden, with violent cough and dyspnoea. 
 The physical sign is the mucous rale. When it occurs 
 from the granulated surface of the pulmonary tissue, or 
 from pulmonary apoplexy, a correct diagnosis of the case 
 may be made from its previous history, together with the ra- 
 tional and physical signs. The general symptoms of hae- 
 moptysis are dulness, cold extremities, followed by flushes 
 of heat, and red cheeks. The discharge from the lungs is 
 attended with dyspnoea, pain, and oppression of the prse- 
 cordia, a sense of rawness in the throat, and a sweetish 
 taste in the mouth. The expectoration consists of bright, 
 frothy, or black and clotted blood, sometimes mixed with 
 mucus. 8&ys Laennec : " When the hemorrhage is very 
 great, it comes on with a moderate degree of cough, and is 
 accompanied with a convulsive elevation of the diaphragm 
 
HEMOPTYSIS. 151 
 
 like that which takes place in vomiting. Auscultation fur- 
 nishes us with two signs of pulmonary apoplexy, absence 
 of the natural respiratory sound over a circumscribed space 
 and crepitant rale around this space. 
 
 TREATMENT. 
 
 • 
 
 Where this disease is dependent upon derangement of 
 the catamenia, the feet should be placed in warm water, 
 and hot sinapisms applied to the back and lower portions 
 of the bowels, and from five to ten grains of pulverized 
 matico given every fifteen or twenty minutes until the 
 hemorrhage ceases. Or, put one drachm of the oil of Eri- 
 geron in a pint bottle, fill it with hot water, and cause 
 the patient to inhale the vapor. Either of these remedies 
 will arrest the hemorrhage. Or, in the absence of other 
 remedies, a teaspoonful of a strong solution of salt and 
 water taken every five or ten minutes, will frequently prove 
 effectual. As soon as this symptom is removed, the patient 
 should be put upon a treatment as directed under the head 
 of irregularities of the catamenia. Where hemorrhage 
 occurs from the rupture of large vessels, ligatures should be 
 applied to the legs and arms, and the patient caused to 
 inhale a strong vapor of the oil of Erigeron, and at the 
 same time from five to ten grains of the matico should be 
 given every fifteen or twenty minutes, until it is arrested. 
 During the active hemorrhage, the ligatures should be so 
 adjusted as to retain the main volume of blood in the 
 extremities, w 7 hich should only be allowed to return by 
 degrees after the bleeding has ceased. 
 
 As this form of haemoptysis is always connected with 
 phthisis, the patient should be treated accordingly. If it 
 arises from pulmonary apoplexy, the ligatures should be 
 used as in the other case. A hot sinapism should also be 
 applied to the chest, and the surface should be thoroughly 
 bathed in hot whiskey and capsicum, for the purpose of 
 
152 BRONCHITIS. 
 
 diverting the blood from the deep capillaries of the lungs 
 to the superficial capillaries. Also, administer the matico 
 with small doses of Lobelia and capsicum every fifteen or 
 twenty minutes. The bowels should be moved by a stimu- 
 lating injection, and the patient allowed to hold ice in his 
 mouth. 
 
 As soon as the hemorrhage ceases, the circulation should 
 be controlled by the use of Aconite. As this form of hae- 
 moptysis is connected not only with phthisis, but also with 
 pneumonia and scurvy, the primary cause of the affection 
 should be treated according to the nature of the case, and 
 the condition of the patient. 
 
 BRONCHITIS. 
 
 Inflammation of the mucous membrane of the bronchi 
 is one of the most common forms of pulmonary disease. It 
 may be either acute or chronic. In the acute form, coryza, 
 sore throat, hoarseness, and slight rigors, are the first 
 symptoms. There is also lassitude with more or less pain 
 in the limbs. As the disease advances there is a sensation 
 of heat and soreness or rawness of the bronchial surface, 
 accompanied by pain on coughing, and oppressed breath- 
 ing. There is a persistent cough, with an expectoration 
 of frothy mucus of a saline taste. In a more severe form 
 of the disease, the small capillary tubes, as well as those 
 of a medium and large size, are implicated. In this form 
 of the disease the pulse is extremely frequent ; there is 
 great dyspnoea, a cyanotic appearance of the countenance, 
 coldness of the body, difficult respiration, and a marked 
 tendency to asphyxia. In these cases the vital powers 
 rapidly become exhausted, and unless relieved by timely 
 treatment, delirium with fatal coma terminates the patient's 
 existence. 
 
BRONCHITIS. 153 
 
 Physical Signs. — In certain cases slight dulness on per- 
 cussion will be detected. In protracted cases, a conside- 
 rable amount of dulness may be* observed at the base of 
 the lung, owing to the gravitation of the excreted fluid. 
 On auscultating the chest, the respiratory murmur will be 
 found weakened, and in some instances entirely sup- 
 pressed. There is sonorous, sibilant, and mucous rhonchus 
 in various combinations. The sonorous and sibilant 
 rhonchus is most marked in the early stage of the disease ; 
 the mucous in the second. But both are frequently com- 
 bined in the second stage. In capillary bronchitis, in 
 addition to the above signs, there is sub-crepitant rhonchus 
 at both bases, posteriorly, with a fine mucous rale higher up. 
 If the fine mucous rale is predominant, it most positively 
 indicates inflammation of the capillary bronchial tubes. 
 
 TREATMENT. 
 
 The surface should be thoroughly bathed in hot lye 
 water, and the patient placed in bed with a warming poul- 
 tice applied over each lung. From five to ten drops of 
 the Tinct. of Yeratrum Yiride should be given every half 
 hour until the active symptoms of the disease disappear. 
 As soon as this occurs — 
 
 R Quinine gr. xv. 
 
 Gelsemin gr. jss. 
 
 Iron by Hydrogen gr. x. 
 
 Pulverized Acacia gr. xx. 
 
 Mix, and triturate ; divide into eight powders, and give 
 one every two hours. After which, if there are any linger- 
 ing symptoms, small doses of the Tinct, of Aconite 
 should be given. To relieve the cough, if any should 
 remain, the acetic Syrup of Sanguinaria should be used 
 as indicated. The patient's strength may be maintained 
 by the use of chalybeates, vegetable tonics, and a nutritious 
 diet. 
 
154 CHRONIC BRONCHITIS. 
 
 CHRONIC BRONCHITIS. 
 
 This, like other forms of chronic inflammation, fre- 
 quently succeeds the acute form, although it may occur in 
 a slow and insidious manner, without being preceded by 
 an acute form of -the disease. 
 
 It attacks individuals of all ages ; but is most frequently 
 met with in the aged, and those who are much exposed to 
 the inhalation of dust. When the disease succeeds to 
 acute bronchitis, the febrile symptoms disappear ; but the 
 pulse still remains frequent, and the cough and difficulty 
 of breathing prove persistent, although these symptoms 
 are materially relieved by free expectoration. There are 
 still nightly exacerbations, and irregular sleep. The ex- 
 pectoration is copious, opaque, and in some instances, 
 puriform. Night sweats are frequent, occasioning great 
 debility. If the disease should not be relieved, the cough 
 will become croupy, the expectoration more copious, the 
 dyspnoea increases, there is diarrhea, and death soon 
 follows. 
 
 Physical Signs. — These are sub-crepitant, mucous, sibi- 
 lant, and sonorous rales. It is said by Laennec, that we 
 frequently have all the sounds in chronic bronchitis quickly 
 following each other, which he calls, lt cantus omnium 
 avium?' 1 (the song of all the birds). If the disease is 
 mostly confined to the extreme ramifications of the bronchi, 
 the sub-crepitant rale will be predominant ; if the larger 
 tubes, the sibilant. If the larger tubes are the seat of the 
 disease, the sonorous rale will indicate it. 
 
 TREATMENT. 
 
 In the early stage of chronic bronchitis : 
 
 R Compound Syrup of Stillingia Oss. 
 
 Iodide of Potassa , gj. 
 
EMPHYSEMA. 155 
 
 Mix, and take one teaspoonful every five or six hours. A 
 salt pack should be applied to the chest, and occasionally 
 moistened with equal parts of the Tinct. of Iodine and 
 Aconite. If there are night sweats, and periodical exa- 
 cerbations : 
 
 R Quinine gr. xx. 
 
 Iron by Hydrogen gr. x. 
 
 Cream of Tartar gr. xxx. 
 
 Mix, triturate, divide into eight powders, and give one 
 every four or five hours. If there is much debility, a 
 liberal use should be made of porter, ale, or brandy, to- 
 gether with a nutritious animal diet. Where there is much 
 irritation of the upper part of the bronchi, benefit is 
 sometimes derived from the use of astringent gargles. 
 Also by inhaling the vapor of Aconite or Lobelia. 
 
 If the cough is troublesome at night, a small dose of 
 Lupuline, Morphine, and Prunin, may be taken at bed- 
 time. When the disease assumes a tuberculous character, 
 it should be treated as in phthisis. 
 
 EMPHYSEMA. 
 
 This term applies to air in the cellular tissue, all por- 
 tions of which are liable to the affection. The sub-cu- 
 taneous is the most so ; but all the prolongations of this 
 tissue through the body communicate with it by the 
 areolar structure. Thus the air when effused into the 
 cellular tissue may pervade nearly every tissue of the body. 
 
 There are three ways by which air may make its ingress 
 into the cellular tissue. 1. By a wound of the integu- 
 ment. This is termed traumatic emphysema. 2. By the 
 development of gas within its cells. 3. By a fistulous 
 opening through the lung, communicating with the pleural 
 cavity. 
 
156 NEPHRITIS. 
 
 The diagnosis of emphysema is seldom difficult. As 
 when air accumulates in the cavity of the pleura, it will 
 readily be distinguished from empyema, by the resonance 
 on percussion. And when it accumulates in the cellular 
 tissue, the swelling is uniform and light, and yields a 
 peculiar crepitant sound upon pressure, caused by the 
 removal of the. air from one cell to the other. 
 
 The prognosis will depend upon the cause of the emphy- 
 sema and the state of the respiratory organs. 
 
 TREATMENT. 
 
 In the treatment of this disease the object should be to 
 arrest its progress by preventing a further accumulation of 
 air in the cellular tissue, and to remove that already accu- 
 mulated. In spontaneous emphysema the only effectual 
 method of arresting the disease is to correct the morbid 
 state of the system, which gives rise to it. When it pro- 
 ceeds from asthemic and typhoid disease, Quinine and Iron 
 with a liberal diet will generally arrest its progress. By 
 scarification, the air which has previously accumulated, 
 will make its escape. In emphysema arising from wounds, 
 by enlarging the wound so as to give free exit to the air, 
 the difficulty may be relieved. Where it occurs as the 
 effect of a fistulous opening into the pleura, the inhalation 
 of the vapor of nitrate of silver, together with astringents, 
 will generally effect a cure. If there is tuberculous affec- 
 tion of the lungs, it should be treated as directed under 
 that head. 
 
 NEPHRITIS, OR INFLAMMATION OP THE 
 KIDNEYS. 
 
 SYMPTOMS. 
 
 There is an acute pain in the region of the kidneys, with 
 some fever, and a dull pain in the thigh of the affected 
 side= The urine is at first clear, but soon becomes of a 
 
CYSTITIS. 15*7 
 
 dark red color. The patient feels great uneasiness when 
 he attempts to walk or sit upright. He lies easiest on the 
 affected side. The pulse is, at first, hard and full, but in 
 the course of a few days, it becomes small, weak, and quick. 
 The skin is hot, and the tongue covered with a dark brown 
 coat. 
 
 TREATMENT. 
 
 Apply hot wet packs over the region of the kidneys, and 
 give freely of the syrup of Marshmallow, Oliver tea, &c. 
 Also, give the following compound : 
 
 U Sweet Spirits of Nitre §j 
 
 Tinct. of Aconite gutt. xxx. 
 
 fjelseminuoi .... gii. 
 
 Mix, and give fifteen drops every two or three hours as the 
 case may indicate. If the disease should prove obstinate, 
 a mild alterative of Euonymine should be given at bed- 
 time, and Digitalis and Cream of Tartar should be substi- 
 tuted for the Aconite and Gelsenihmm. The patient should 
 keep quiet, and in bed, and the diet should be of a light 
 vegetable character. 
 
 CYSTITIS, OR INFLAMMATION OP THE 
 BLADDER. 
 
 Inflammation of the bladder very much resembles that 
 of the kidneys in its symptoms. But there may be acute 
 pain and tension at the lower part of the bowels, and diffi- 
 culty of urinating, with constant inclination to do so, and 
 also to go to stool. 
 
 TREATMENT. 
 
 The bowels should be thoroughly evacuated by Jalapin 
 
 and Neutralizing mixture. The patient should be placed 
 
 in bed, and hot packs should be applied over the region 
 
 of the bladder. The bladder should be injected with a 
 
 14 
 
158 HEPATITIS. 
 
 luke-wann mucilage of slippery elm, and the patient caused 
 to drink of Marshmallow, flaxseed, slippery elm, &c. If 
 the inflammation is not thus controlled, give the following 
 compound : 
 
 R Pulverized Acacia gr. xx. 
 
 Soft Water gii. 
 
 Sweet Spirits of Nitre gss. 
 
 Tinct. Veratrum Viride gutt. xx. 
 
 Mix, give one half teaspoonful every half hour until the 
 symptoms are controlled. Continue the mucilage until the 
 patient is completely free from the disease. 
 
 HEPATITIS, OE, INFLAMMATION OF THE 
 LITER. 
 
 SYMPTOMS. 
 
 The diagnostic symptoms of this disease are tension of 
 the right side, under the false ribs, attended with fever, 
 difficulty of breathing, anorexia, thirst, and a pale and 
 yellow appearance of the skin and eyes. When the inflam- 
 mation is extensive, the pulse becomes quick and hard, and 
 sometimes irregular. The patient is troubled with a dry, 
 hacking cough, and a constipated condition of the bowels ; 
 although, in the latter stage of the disease, and in warm 
 climates, there is sometimes a diarrhaea with bilious vomit- 
 ing, great tenderness in the hypochondrium, and dulness 
 on percussion. 
 
 TREATMENT. 
 
 A hot sinapism should be placed over the region of the 
 liver. The surface should be bathed in warm lye water, 
 and the following compound be given : 
 
 U Euonymin gr. xx. 
 
 Sanguinarin gr. x. 
 
 Bitartrate of Potassa gr. xxx. 
 
ASTHMA. 159 
 
 Triturate, mix ; divide into ten powders, and give one 
 every three hours. At the same time, if there is fever, give 
 from ten to twenty drops of the Tinct. of Gelseminum so 
 often as to maintain a gentle moisture of the skin. 
 
 When the sinapism has produced irritation of the sur- 
 face, it should be removed and hot packs applied instead. 
 If the disease should still prove persistent, the following 
 compound must be substituted for the first : 
 
 U Muriate of Ammonia gr. xx. 
 
 Irisin gr. x. 
 
 Gelsemin gr. j. 
 
 Triturate, mix, divide into ten powders, and give one every 
 two hours until all are taken, or until the disease is re- 
 moved. If the disease should assume a chronic form, a 
 pill of the extract of Dandelion and Capsicum should be 
 given two or three times a day. If the bowels should 
 become constipated from a deficient secretion of bile, give 
 the following compound : 
 
 U Syrup of Boneset Oss. 
 
 Common Salt gi. 
 
 Sulphur gr. xxx. 
 
 Mix, and give one teaspoonful three times a day, and let 
 the diet be free and nutritious. 
 
 ASTHMA. 
 
 SYMPTOMS. * 
 
 The symptoms indicating asthma are various. Some 
 of them are premonitory, and, by those who are accustomed 
 to the affection, are understood as warnings of an ap- 
 proaching attack. Among these are loss of appetite, 
 flatulence, eructation, languor, irritability, drowsiness, 
 oppression and chilliness. Perhaps he retires at night 
 with a sense of uncomfortableness. 
 * Calkins. 
 
160 ASTHMA. 
 
 It is very common for an attack actually to commence 
 sometime after midnight, or about 2 or 3 o'clock in the 
 morning, and the general signs are much like the follow- 
 ing : 
 
 Often the person is aroused from sleep by a feeling of 
 constriction. across his chest, or inability properly to ex- 
 pand it. He raises himself in bed, and sits bowing for- 
 ward, perhaps with his elbows resting on his knees, drawn 
 up before him. His breathing is labored, and attended 
 with a wheezing noise, often so loud as to be audible in 
 another apartment, or at a distance. 
 
 He asks for more air to be admitted into the room, and 
 makes a strong voluntary effort to expand his chest in 
 inspiration, and to contract it in expiration ; or, if able, 
 he rises from his bed, and hastens to a door or window, at 
 which, however cold the weather, he often long remains. 
 The labor of respiration gives warmth to his body, and he 
 often perspires freely. His extremities, however, are 
 liable to become cold, and his countenance is generally 
 distressed, pale and haggard, though sometimes it is red 
 and turgid. Often the pulse is small, feeble and irregular, 
 though sometimes it is scarcely disturbed. Sometimes the 
 heart palpitates, and flatulency becomes troublesome ; the 
 urine becomes copious and pale, and even the fasces are 
 passed with the impatient hurry of spasmodic action. The 
 speech of the sufferer is interrupted and difficult, and there 
 is a propensity to cough, which he sometimes favors with 
 the hope of forcing away the impediment to his breathing.* 
 
 TREATMENT. 
 
 In the treatment of this disease, the first thing to be 
 attained is the relief of the excessive dyspnoea. For this 
 purpose, give the following mixture : 
 
 * Calkins on Thoracic Diseases. 
 
CHOLERA MORBUS. 161 
 
 R Tinct. of Gelseminum < ... gj. 
 
 " Lobelia... gss. 
 
 Mix, and give fifteen or twenty drops every ten or fifteen 
 minutes, till the paroxysm passes off. After which, give 
 the following compound : 
 
 R Quinine gij. 
 
 Cornine . ^iij. 
 
 Compound Syrup of Stillingia Oj. 
 
 Phosphate of Lime gj. 
 
 Mix, and give from one half to one teaspoouful three times 
 a day, during the interval between the paroxysms of 
 dyspnoea. Whenever the paroxysms return, the Gelsemi- 
 num and Lobelia should be repeated. But as soon as 
 relief is obtained, the alterative and antiperiodic should be 
 resumed. Other medicines, such as Chalybeates and vege- 
 table tonics, if required to maintain the integrity of the 
 constitution, should be given. The above course, if per- 
 sisted in, will seldom fail to remove this very troublesome 
 disease. 
 
 CHOLERA MORBUS. 
 
 Cholera Morbus is a violent purging and vomiting, with 
 griping, sickness, and a constant desire to go to stool. 
 
 It is occasioned by a redundancy of bile, by the fermen- 
 tation of food on the stomach, such as cucumbers, melons, 
 sweet-meats, cherries, and all unripe fruit. Also exposure 
 to damp night atmosphere. 
 
 SYMPTOMS. 
 
 It is generally preceded by Cardialgia, sour stomach, 
 flatulency, and pain in the bowels. As the disease 
 advances, the pulse becomes very feeble, and the surface 
 cold and clammy. The urine is scanty, and there is almost 
 constant vomiting and purging. 
 1-4* 
 
162 CHOLERA. 
 
 TREATMENT. 
 
 JJ Neutralizing Mixture §ij. 
 
 Tinct. of Prickly Ash Berries gj. 
 
 Mix, and give from 30 to 60 drops every fifteen or twenty 
 minutes, till the vomiting and purging cease. Apply a 
 hot sinapism over the region of the stomach and bowels, 
 and place jugs of hot water about the patient. If the use 
 of the above mixture for a proper time does not afford relief, 
 give the following : 
 
 U Pulverized Camphor gr. x. 
 
 " Capsicum gr. xv. 
 
 Oil of Peppermint gutt, iij. 
 
 Morphine gr. j. 
 
 Triturate, mix, divide into ten powders, and give one 
 every half hour. At the same time, give the patient freely 
 of rice coffee, made by scorching the rice and preparing it as 
 common coffee. If the. disease assumes a periodic charac- 
 ter, some of the antiperiodic compounds should be given 
 for the purpose of interrupting its periodicity. After the 
 vomiting and purging cease, mild alteratives should be 
 given, as Euonymine, Hydrastin, &c. The diet should 
 consist of rice, dropped eggs, broiled beef, &c. The 
 patient should avoid exposure to the sun, and violent 
 exercise, until completely recovered. 
 
 CHOLERA, EPIDEMIC OR CHOLERA 
 ASPHYXIA. 
 
 This disease began to excite general attention in 1811. 
 It commenced in Bengal in India, from which place it has 
 scarcely been absent since. In 1818 it passed on to the 
 Coromandel coast, and in the same year to Malabar, the 
 Burmese Empire, Sumatra and Ceylon. In 1820 it spread 
 
CHOLERA. 163 
 
 to China, and successively throughout the larger portion 
 of Eastern Asia, and to the islands of the Mediterranean, 
 to Arabia, Mesopotamia and Syria. In 1821 and in 1822 
 to Persia. In 1831 it appeared in Prussia and in Austria. 
 In June of the same year it appeared in St. Petersburg, 
 in October at Hamburg and London. On the eighth of 
 June, 1832, it first made its appearance on the American 
 Continent in Quebec, and in a few days at Montreal. On 
 the 24th of June in New York, on the 3d of July in 
 Albany, on the 5th of July in Philadelphia, on the 30th of 
 September in Cincinnati, from whence it spread to Madi- 
 son, Louisville, St. Louis, Maysville, Wheeling, and made 
 its way to most of the important towns in the United 
 States. 
 
 It reappeared in America in 1848, where it has pre- 
 vailed as an epidemic or in a sporadic form ever since. 
 Its fearful ravages and well-known fatality, have elicited 
 on the part of the medical profession, the most anxious 
 inquiries, in regard to its cause and pathology. 
 
 SYMPTOMS. 
 
 Malignant cholera, like most other epidemic diseases, 
 presents a great diversity of symptoms. Its attack is 
 usually violent and sudden, but mostly preceded by certain 
 premonitory symptoms, such as a furred tongue, diarrhea, 
 with a complete loss of the digestive powers, and some- 
 times with headache and ringing in the ears. After these 
 symptoms have continued for a longer or shorter time, 
 the patient is attacked with violent Cardialgia or heart- 
 burn, soon followed by nausea and vomiting, with a pro- 
 fuse colliquative diarrhsea. The discharges from the 
 stomach and bowels resemble rice water. These symp- 
 toms are soon followed by great weakness and sense of 
 exhaustion. 
 
 The powers of locomotion are speedily arrested, and 
 
1G4 CHOLERA. 
 
 spasms affecting the whole of the muscles of voluntary 
 motion, but particularly those of the arms and legs, come 
 on. The pulse becomes small, weak, and accelerated, the 
 respiration labored, the tongue flat, white, and moist. 
 These symptoms are soon followed by a sense of pain, and 
 burning heat in the stomach, and great desire for cold 
 drinks. The skin becomes cold, corrugated, and covered 
 with a clammy sweat. The lips, limbs, and at times the 
 entire body, have a peculiar livid hue. 
 
 The pulse decreases until it is no longer felt at the 
 wrist, the respiration is slow and feeble, the breath is cold, 
 the eyes are sunken, and surrounded by a livid circle. At 
 this stage there is no secretion of the bile and urine, and 
 the vomiting, purging, and spasms abate. The powers 
 of the mind seem unimpaired, for the patient continues to 
 answer questions freely ; but he frequently expires in this 
 stage suddenly and without a straggle. 
 
 The limits of this work will not permit me to enter into 
 the details of the different varieties of this disease ; but 
 suffice it to say, it often runs an entire course to a fatal 
 termination, without vomiting or cramp, but characterized 
 by the peculiar diarrhea. Again the diarrhgea may be 
 absent, and the vomiting be the principal symptom, The 
 rice water evacuations, together with the excessive pros- 
 tration, are sufficient to distinguish it from cholera morbus. 
 
 TREATMENT. 
 
 The indications to be fulfilled in the treatment of 
 Cholera, are to arrest the diarrhaea and vomiting, and to 
 produce reaction, or to equalize the circulation, by 
 inducing the blood from the deep-seated, to the superficial 
 capillary vessels. For the purpose of arresting the 
 vomiting and diarrhoea, small doses of Camphor, Capsi- 
 cum, and Morphine, should be given every ten or fifteen 
 minutes, in a small quantity of Neutralizing Mixture : say, 
 
CHOLERA. 165 
 
 R Pulv. Camphor , gr. v. 
 
 Capsicum .... gr. x. 
 
 Morphine gr. j. 
 
 Triturate, mix, divide into ten powders, and give one 
 every fifteen or twenty minutes in one half to one tea- 
 spoonful of Neutralizing Mixture, until the nausea and 
 vomiting cease. At the same time the patient should be 
 placed in bed in a recumbent posture, which should be 
 maintained during the entire active stage of the disease. 
 Tire body should be thoroughly bathed in equal parts of 
 lye water, and Tinct. of Capsicum. Also apply sinapisms 
 along the spine, calves of the legs, abdomen and arms. 
 They should be applied hot, made up of good ground 
 mustard, and wet with hot vinegar. If there is thirst, 
 hot rice coffee should be freely given. Also toast water 
 and ftsence of beef, prepared as directed in the treatment 
 of typhoid fever. If the nausea., vomiting, and diarrhoea, 
 do not yield to the above treatment, the following com- 
 pound may be given : 
 
 R Tinct. of Prickly Ash Berries giij. 
 
 Neutralizing Mixture giij. 
 
 Tinct. of Capsicum giij. 
 
 Mix, and give one teaspoonful in hot peppermint sling 
 every five or ten minutes. Also inject the bowels with the 
 following mixture : 
 
 R Starch Water Oss. 
 
 Tinct. of Xanthoxylin Berries gij. 
 
 Morphine giij. 
 
 Mix, and give six ounces as an injection after each pas- 
 sage from the bowels. If reaction, should not follow 
 these measures, hot brandy toddy may be given in con- 
 nection with them every half hour. If there should be 
 cramp with the vomiting and diarrhaea : 
 
166 CHOLERA. 
 
 R Gelsemin , gr. ij. 
 
 Hyosciamin gr. j. 
 
 Pulv. Camphor , ... gr. ij. 
 
 White Sugar gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one 
 every half hour, or oftener, as the case seems to indicate. 
 
 If the discharges continue, and the patient be pros- 
 trated, the following compound will often be successful : 
 
 U Rhusin * gr. xij. 
 
 Quinine gr. x. 
 
 Piperine gr. xx. 
 
 Hydrocyanic acid gutt. iij. 
 
 White Sugar -. gr. xxx. 
 
 Mix, triturate, divide into twenty powders, and give one 
 every thirty minutes. If the sinapisms produce too strong 
 counter-irritation, they should be taken off, and lar^ hot 
 packs applied in their place. If the reaction should be 
 followed by fever, Aconite should be given in quantities 
 sufficient to control the circulation, and maintain mois- 
 ture of the surface. 
 
 Where the patient has passed into the collapsed state, 
 the following compound is valuable : 
 
 U Xanthoxylin gr. xx. 
 
 Piperine gr. x. 
 
 Oil of Capsicum gutt. x. 
 
 White Sugar gr. xxx. 
 
 Mix, divide into ten powders, and give as often as the 
 symptoms indicate the necessity. 
 
 Shocks of electricity, passed through the stomach and 
 liver, have been reputed of much value. Also highly 
 stimulating diuretics, such as oil of Turpentine, Hemlock, 
 Wintergreen, &c. 
 
 The following compound was used with much success 
 by my colleague, the late Dr. Hotchkiss : 
 
SMALL-POX. 167 
 
 R Chloroform £ii. 
 
 Tinct. of Camphor gii. 
 
 Tinct. of Opium ^i. 
 
 Mix, and give from ten to twenty drops every twenty or 
 thirty minutes, as the case may be. As soon as the active 
 stage has passed off, the patient should take freely of fluid 
 nutriment containing the elements of the blood, for the 
 purpose of restoring its exhausted condition. Also, he 
 should remain quiet and in bed, and avoid both mental 
 and physical exertions. 
 
 SMALL-POX, OR VARIOLA. 
 
 SYMPTOMS. 
 
 The premonitory symptoms of this disease do not vary 
 much from those of ordinary bilious fever. 
 
 It is generally preceded by -more or less languor, ano- 
 rexia, headache, and constipation of the bowels. When 
 these symptoms have continued for two or three days, the 
 patient is seized with violent pain in the back, increased 
 pain in the head and limbs, great restlessness ; the pulse 
 becomes accelerated, and the skin is hot and pungent. 
 The eyes are suffused, and in some cases the fever is alter- 
 nated with rigors or chills. On the fourth or fifth day of 
 the disease, small red spots make their appearance on the 
 face and neck, which gradually diffuse themselves over the 
 entire body. 
 
 The eruption is at first pustular, but in the course of 
 eight or ten days becomes vesicular at the apex, yet still 
 remaining pustular at the base. The vesicular portion of 
 the pustule has a cupped appearance, while the base re- 
 mains white and opaque. Maturation commences from 
 the tenth to the fifteenth day, at which time the pustules 
 become covered with a mahogany-colored scab, terminat- 
 ing in desiccation and desquamation, and leaving a deep 
 
168 SMALL-POX. 
 
 pit. At this stage the patient generally has a fresh attack 
 of fever, called the secondary fever. When the pustules 
 are very numerous, and run into each other, the disease is 
 called confluent small-pox. This is decidedly more violent 
 than the simple form. 
 
 There is extensive oedema of the face and lower extremi- 
 ties, and inflammation of the fauces, lungs, and in some 
 instances, the brain ; and the disease not unfrequently 
 terminates in consumption, blindness, and ulceration of the 
 intestines. 
 
 TREATMENT. 
 
 In the treatment of small-pox, much diversity of opinion 
 exists among eclectic physicians ; but the treatment about 
 to be described has not only proved universally successful 
 in my own practice, but in that of several of my colleagues, 
 who have had the most ample experience in this disease. 
 
 If called in the early stage, the first thing to be done is 
 to give the patient an active cathartic of Podophyllin and 
 Antibilious physic. The patient should then take a 
 thorough spirit-sweat, after which the body should be tho- 
 roughly bathed in hot lye water, and the patient placed in 
 bed, in a room well ventilated. The following compound 
 should then be given : 
 
 U Bay berry Bark, Pulv. , gss. 
 
 Ginger, Pulv gj. 
 
 Macrotys, Pulv gij. 
 
 Capsicum ^j. 
 
 Mix, put it in one quart of water, steep for fifteen or 
 twenty minutes, strain, sweeten, and give two or three 
 tablespoonfuls every hour during the development of the 
 disease. If there is fever, give Aconite to control it, and 
 small doses of diaphoretic powders at night to procure 
 rest, if necessary. The surface should be bathed in lye 
 water and whiskey three or four times a day. 
 If the pustules should not fill well, and the strength of 
 
MEASLES. 169 
 
 the patient should fail, small doses of equal parts of Hy- 
 drastin and Quinine should be given three or four times a 
 day. Also, give milk punch, beef tea, and such other 
 articles of diet as are easy of digestion and nutritious. 
 Collodion should be applied as a wash morning and even- 
 ing, to prevent being marked by the eruption. If the dis- 
 ease be of the complicated variety, the constitutional symp- 
 toms will require more attention. 
 
 If the lungs become affected either by congestion cr in- 
 flammation, they should be relieved by Lobelia and Capsi- 
 cum. If the liver is thus diseased, Euonymine and Lep- 
 tandrin may be used. If the glands of the bowels should 
 become diseased, Hydrastin and the Nitrate of Silver pill 
 as directed under the head of Typhoid Fever, should be 
 given. 
 
 The fever should be controlled as in the simple form, and 
 the patient's strength maintained by the use of beef tea, 
 wine, porter, vegetable tonics, Chalybeates, &c. 
 
 RUBEOLA, OR MEASLES.* 
 
 In our humble opinion, this is both a contagious and 
 infectious disease, affecting, in this climate, children and 
 adults with almost equal severity; the disease is inflam- 
 matory, affecting at once the skin and gastro-pulmonary 
 mucous membrane ; in which, after catarrhal fever has 
 continued about three days, a rash appears on the skin, at 
 first in small stigmatized dots, not unlike flea-bites, which 
 presently coalescing, form patches of a crescent or semi- 
 lunar form ; first on the face, and thence spreading gradu- 
 ally downwards over the whole body and limbs, at the end 
 of four days they disappear by desquamation of the 
 cuticle. In short, the symptoms which usher in an attack 
 of measles, are the symptoms of coryza and catarrh.* 
 
 * Massie's Practice of Medicine. 
 15 
 
HO MEASLES. 
 
 TREATMENT. 
 
 Iii the great majority of cases, but little treatment is 
 necessary, save to have the patient confined to the house, 
 which should be kept of an agreeable temperature, and 
 freely ventilated. The clothing should be changed daily, 
 and the bowels kept regular by small doses of Neutralizing 
 Mixture and Leptanclrin. 
 
 Should symptoms of Pneumonia, Bronchitis, or Laryn- 
 gitis make their appearance, an emetic of Lobelia and 
 Sanguinaria should be administered, together with the 
 warm bath and laxative enema. As soon as the effects of 
 the emetic have passed off, the following compound should 
 be given, if a child over eight years of age ; if younger, 
 in proportion to the age : 
 
 U Triturated Belladonna gr. x. 
 
 Sulphate of Cinchonin gr. xx. 
 
 Triturated' Leptandnn , gr. xx. 
 
 Mix, divide into ten powders, and give one every two 
 hours ; also give freely of warm sage tea. 
 
 If there should be fever, and pain in the head, five 
 drops of Aconite, added to three ounces of water, and a 
 teaspoonful given every half hour, will soon control it. 
 
 If, as sometimes happens, the patient should be seized 
 with convulsions, small doses of equal parts of Lobelin 
 and Scutellarin, given every ten or fifteen minutes, will 
 relieve them. 
 
 The surface should be frequently sponged, and if there 
 is heat in the head, moderately cold packs should be ap- 
 plied and continued until the head is relieved. 
 
 The diet should be light, and taken in small quantities. 
 If Ophthalmia makes its appearance during the disease or 
 afterwards, mild zinc ointment should be used, and the 
 eves should be frequently bathed in warm milk and water. 
 
CHICKEN-POX — MANIA-POTU. 171 
 
 VARICELLA, OR CHICKEN-POX. 
 
 This is a contagious disease, and in its first appearance, 
 bears some resemblance to small-pox. 
 
 SYMPTOMS. 
 
 Small, pointed, transparent red vesicles, some of which 
 become pustular. They run their course in from five to 
 six days, without producing any very marked constitu- 
 tional disturbance. 
 
 TREATMENT. 
 
 The diet should be regulated, and regularity of the 
 bowels maintained. If fever arises, give Aconite in small 
 quantities, and a gentle purgative of Euonymine and 
 neutralizing; mixture. 
 
 MANIA-POTU, OR DELIRIUM 
 TREMENS. 
 
 This disease in some of its symptoms, resembles inflam- 
 mation of the brain. It is caused by the use of Alcoholic 
 drinks. 
 
 SYMPTOMS. 
 
 Constant wakefulness, and motion of the hands and 
 arms, and continual delirious talk. The whole body is in 
 a state of tremor, wrongs are imagined, injuries appre- 
 hended, and the patient constantly beholds imaginary 
 images, which terrify his mind, producing great mental 
 excitement. This disease is easily distinguished from 
 Pleuritis, by the softness of the pulse, the flushed face, 
 and the habits of the patient. 
 
 13 
 
172 DROPSY OF THE BRAIN. 
 
 TREATMENT. 
 
 In this disease it is necessary to continue the use of 
 stimulants, in a moderate degree. The patient should 
 take warm whiskey toddy, mixed with starch water, often 
 enough to maintain a decided influence of the spirits upon 
 "the brain. At the same time give freely of beef tea, wine 
 whey, soft boiled eggs, &c. If the disease does not yield 
 to the above treatment, give the following compound : 
 
 R Morphine gr. ij. 
 
 Capsicum gr. xx. 
 
 Divide into ten powders, and give one every two or three 
 hours till the disease yields. 
 
 Or, 
 
 U Scutellarin gr. xx. 
 
 Hyosciamin gr. iij. 
 
 Cypripedin gr. xx. 
 
 Triturate, mix, divide into ten powders, and give one 
 every hour. When the disease becomes manageable, the 
 use of alcoholic drinks should be discontinued, and the 
 patient warned against the use of a drug, the effects of 
 which are fraught with so much evil. During the treat- 
 ment, the bowels should be kept regular, by the use of 
 mild stimulating alteratives, and the skin thoroughly 
 cleansed by bathing. 
 
 HYDROCEPHALUS, OR DROPSY OF 
 THE BRAIN. 
 
 SYMPTOMS. 
 
 When the disease comes on moderately, the patient 
 becomes peevish and fretful. If it is a child, which is 
 most frequently the case, there will be frequent extension 
 of the hands to the head, and the sleep will be disturbed 
 
DROPSY OF THE BRAIN. 173 
 
 by frightful dreams, causing starting, jumping, and 
 screams. 
 
 As the disease advances, there is anorexia, dizziness, 
 vertigo, nausea, vomiting, and delirium. 
 
 The pulse is soft and quick, and the tongue is covered 
 with a light coat. In the early stage of the disease, the 
 bowels are costive ; but in the latter stage, there is fre- 
 quently diarrhsea. Paralysis and convulsions often result 
 from this disease. 
 
 TREATMENT. 
 
 In the early stage of this disease, Aconite should be 
 given to control the fever and inflammation. After which, 
 a purgative of Podophyllin and Jalapin should be given. 
 Warm water and whiskey should be applied to the head, 
 and sinapisms to the feet and calves of the legs. After 
 the operation of the cathartic, give the following com- 
 pound : 
 
 B Syrup of Marshmallow §iij. 
 
 Iodide of Potassium ^ij. 
 
 Mix, and give one half teaspoonful every hour. At the 
 same time, give two or three tablespoonfuls of strong 
 Buchu and uva ursi tea, and ten drops of sweet-spirits of 
 Njtre every three hours. If there is much debility, con- 
 nected with periodical symptoms, the following compound 
 may be given, with the above treatment : 
 
 B Quinine gr. x. 
 
 Ferrocyanide of Potassium gr. j. 
 
 Digitalin gr. j. , 
 
 White Sugar gr. xl. 
 
 Triturate, mix ; divide into twelve powders, and give one 
 every three hours. The purgative should be repeated, and 
 the strength of the patient maintained by the free use of 
 Iron, vegetable tonics, and a nutritious diet. 
 15* 
 
1T4 DROPSY OF THE ABDOMEN. 
 
 ASCITES, OR DROPSY OF THE ABDOMEN. 
 
 SYMPTOMS. 
 
 Swelling of the bowels, and often a fluctuation which 
 may be perceived by laying the hand on one side of the 
 abdomen, and at the same time gently rubbing the other 
 side. This disease is mostly connected with Anasarca, or 
 a collection of water in the cellular tissue, indicated at 
 first by swelling of the feet and ankles towards night, but 
 which disappear before morning. Pressure of the swollen 
 parts with the finger in the evening, produces indentation, 
 which remains for some time. The swelling gradually 
 ascends to the trunk of the body, the arms and the head. 
 
 At this time the breathing becomes difficult, the urine is 
 scanty and high-colored, the bowels are costive, the 
 countenance is heavy and bloated, the skin is dry, and has 
 a dirty sallow appearance, there is a dry cough and a slow 
 irregular fever. 
 
 When these symptoms have continued for a longer or 
 shorter time, there is generally a deposition of tuber- 
 culous matter in the lungs, a hectic fever, and unless the 
 progress of the disease is arrested by timely treatment, 
 death is the result. The use of Mercurials, the suppression 
 of the Catamenia, Chronic ague, improper diet, &c, are 
 among the causes of this disease. 
 
 TREATMENT. 
 
 The first object should be to remove the cause. At the 
 same time, means should be resorted to by which the blood 
 may be restored to a natural condition, and at the same 
 time relieve the different tissues from their incumbrance of 
 water. The patient should be placed upon a strong 
 nutritious diet, and should freely use beef tea, porter, &c, 
 and should take the following compound : 
 
31 U MPS. 175 
 
 U Iron by Hydrogen gr. xx. 
 
 Syrup of dwarf Elder Oss. % 
 
 Cream of Tartar -ss. 
 
 Mix, and give one tablespoonful three or four times a clay. 
 Two or three times a week the patient should take a 
 thorough spirit-sweat, and the body should be sponged 
 every morning in warm or cold water, as the condition of 
 the case may indicate. 
 
 If the patient's strength will warrant, a cathartic of 
 Jalapin and Cream of Tartar may be given once or twice a 
 week. "When the above course has been pursued for a few 
 days, if the patient does not manifest signs of rapid re- 
 covery, give the following compound : 
 
 R Digitalin gr. iij. 
 
 Cinchonine gr. xxx. 
 
 Phosphate of Iron gr. xxx. 
 
 "White Sugar ;. -j. 
 
 Mix, triturate ; divide into sixteen powders, and give one 
 four times a day in watermelon seed tea. 
 
 After these are all taken, the syrup should be resumed, 
 and the vapor bath continued. 
 
 Every possible means should be resorted to by which 
 the patient's strength may be maintained. 
 
 PAROTITIS, OR MUMPS. 
 
 This is a contagious disease, affecting the Parotid gland. 
 
 SYMPTOMS. 
 
 The skin becomes hot and dry, the pulse increases in 
 frequency. The tongue is covered with a thin white coat, 
 the bowels are costive, and the urine is scanty and high- 
 colored. These symptoms are followed by a swelling just 
 
116 EPILEPSY. 
 
 below the angle of the lower jaw, sometimes on one side, 
 at others* on both. The swelling increases rapidly for 
 about two days, when it begins to decline. 
 
 This disease is frequently transferred from the glands of 
 the neck to the mammary glands, in the female, and to 
 the testicles of the male. 
 
 TREATMENT. 
 
 If there is much fever in the active stage, the body 
 should be bathed in warm lye water, and Aconite given in 
 quantities sufficient to subdue it. The patient should keep 
 quiet, and in bed. If the bowels are confined, a mild dose 
 of Antibilious Physic may be given. If there should be a 
 metastasis of the disease, a stimulating liniment should be 
 applied, such as Tinct. of Capsicum and Myrrh, and a 
 mild alterative of Euonymine given two or three times a 
 day. 
 
 EPILEPSY. 
 
 SYMPTOMS. 
 
 The patient falls suddenly, and is seized with convul- 
 sions. The features are distorted and fixed, the senses are 
 suspended, and the subject paralyzed. During the struggle, 
 mucus, commingled with bubbles of air, issues from the 
 mouth. The breathing is generally hurried, and the pulse 
 is feeble and frequent. These attacks return at stated 
 periods, and generally increase in severity as the patient 
 grows older. The disease is frequently developed by irri- 
 tation from teething, worms, suppression of the menses, 
 blows upon the head, spermatorrhea, &c. 
 
EPILEPSY. 117 
 
 TREATMENT. 
 
 In the early stage of the disease, but little need be done 
 save to remove the cause. But after the disease has become 
 established, the convulsions will continue, although the 
 cause be removed. 
 
 In such cases the intermittent and antiperiodic treatment- 
 is that only which has proved successful in my hands. 
 While the patient is laboring under the paroxysms, the 
 following mixture should be given : 
 
 B Fluid Extract of Scutellaria, \ 
 
 " " of Lobelia, > ad libitum. 
 
 " •' of Cypripedrin, J 
 
 Equal parts. Mix, and give from ten to twenty drops 
 every ten or twenty minutes, until the convulsions cease. 
 Then open the bowels by a mild, neutralizing physic, and 
 the skin by tepid baths, after which give the following 
 compound : 
 
 U Chinoidin gr. xxx. 
 
 Fiburine gr. xx. 
 
 Quinine . gr. x. 
 
 Mix, divide into twenty powders, and give one three times 
 a-day. Continue the powders between the first four or five 
 paroxysms, and relieve the patient during the paroxysms 
 by the anti-spasmodic mixtures, followed by the cathartic, 
 If the above treatment does not interrupt the paroxysms 
 in the course of eight or ten weeks, the following mixture 
 may be given between the spasms : 
 
 R Port Wine Oss. 
 
 Hydrocyanic acid gutt. xx, 
 
 Quinine gr. xx. 
 
 Iron by Hydrogen gr. xxx. 
 
 Mix, and give one teaspoonful three times a-day. The 
 patient's bowels should be opened by mild purgatives, 
 The mind should be kept cheerful, and the diet should be 
 nutritious, and of easy digestion. The antiperiodic and 
 
1?8 APOPLEXY. 
 
 intermittent treatment should be pursued until a cure is 
 effected, which will be the case in the course of time, unless 
 there is some organic lesion of the brain. 
 
 APOPLEXY. 
 
 Sanguineous Apoplexy is the effusion of blood into the 
 substances of the brain. Traumatic, or Apoplexy caused 
 by blows on the head, is the effusion of blood into the mem- 
 branes of the brain. 
 
 SYMPTOMS. 
 
 Apoplexy is generally preceded by giddiness, pain and 
 swimming in the head, ringing in the ears, and laborious 
 respiration. In Sanguineous apoplexy, if the person does 
 not drop dead at once, he gradually becomes stupid, until 
 he passes into a profound sleep ; the face is swollen, the 
 eyes are fixed, the blood-vessels about the neck beat rapidly 
 and forcibly, the breathing is sonorous, and it is impossible 
 to arouse the patient from his state of lethargy. 
 
 TREATMENT. 
 
 Ligatures should be placed around the arms close to the 
 shoulder ; also, around the legs at their connection with 
 the body. They should be so adjusted as to admit of the 
 passage of the blood through the arteries, but to prevent 
 its return through the veins. 
 
 If the patient can swallow, a large dose of antibilious 
 physic should be given. The feet should be placed in hot 
 w T ater, and cold water applied to the head. If the circula- 
 tion continues to be rapid, Veratrum should be given in 
 quantities sufficient to moderate its action. 
 
 The ligatures should be kept on until the patient appears 
 entirely relieved, but should be tightened or loosened 
 according to circumstances. If symptoms indicate hemor- 
 
CHOREA — PALSY. 1^9 
 
 rhage to any considerable extent, small closes of Digitalin 
 should be given three or four times a day, in connection 
 with Iodide of Potassium. The bowels should be kept 
 regular, and the diet mild. 
 
 CHOREA, OR ST. TITUS 7 DANCE. 
 
 SYMPTOMS. 
 
 There is a lameness of one leg, which is partly deprived 
 of its natural motion. The arms are next affected, and 
 are thrown into various contortions. The muscles of one 
 side of the face have a constant involuntary motion. The 
 appetite is lost, and the bowels become irregular. 
 
 TREATMENT. 
 
 R Scutellaria gr. xxx. 
 
 Cypripedin gr. xx. 
 
 Carbonate of Iron gij. 
 
 Port Wine Oj. 
 
 Give one tablespoonful three times a clay. The bowels 
 should be kept open with small doses of Euonymine, and 
 the surface should be bathed with tepid water every morn- 
 ing. If the disease should be caused by suppression of 
 the menses, Macrotin should be given in connection with 
 Iron. If by worms, Santonine and Podophyllm. If by 
 ague, some of the antiperiodic compounds may be given. 
 
 PARALYSIS, OR PALSY. 
 
 If the palsy is confined to one side of the body, it is 
 called Hemiphlegia. If to the lower half, Paraphlegia. 
 
 TKEATMEXT. 
 
 TThen the palsy attacks the heart, lungs, or any other 
 vital organ, it soon terminates in death. But when it 
 
180 PALSY. 
 
 arises from injuries of the spine, effusions into or softening 
 of the brain, or in a deficiency of nervous fluid, the follow- 
 ing treatment may he resorted to with hopes of success. 
 First. The patient should be enjoined to remain quiet in 
 bed, and if an injury to the spine is the cause of the dis- 
 ease, the irritating plaster should be applied along the 
 spine. The bowels should be acted upon by giving small 
 doses of antibilious physic, and a mild current of electricity 
 should be passed from above the part of the injury through 
 the paralyzed parts. The diet should be sufficient to 
 maintain an ordinary degree of health. A liniment should 
 be applied to the palsied part, composed of the following 
 substances : 
 
 U Oil of Origanum gij. 
 
 " Capsicum gj. 
 
 " Stillingia gfjjj. 
 
 " Alcohol Oj. 
 
 Mix, and bathe the affected part three or four times a day, 
 following the same by brisk friction. The patient should 
 take from one to three drops of the Tinct. of Rhus Toxico- 
 dendron from one to three times a day. If the disease 
 occurs from injuries of other parts of the body, a similar 
 course should be pursued, both as regards the electricity 
 and counter-irritation. If there should be softening of the 
 nervous centres, or brain, from one to five drops of the 
 Tinct. of Phosphorus should be given three or four times 
 a day, in connection with chalybeates and vegetable 
 tonics. 
 
 This course should be persisted in for some length of 
 time, unless the disease yields. In quite a number of cases 
 with which I have been familiar, recovery has taken place 
 after a lapse of more than a year's treatment. 
 
LOCKED JAW — HYDROPHOBIA. 181 
 
 TETANUS, OR LOCKED JAW. 
 
 This disease generally arises from wounds, but occa- 
 sionally it is a symptom of other diseases. 
 
 SYMPTOMS. 
 
 Stiffness in the back of the neck, difficulty of swallow- 
 ing, rigidity of the muscles of the lower jaw, also of those 
 of the spine, and sometimes nearly all the muscles of 
 the body are involved. 
 
 TREATMENT. 
 
 If this disease is caused by a wound, it should be tho- 
 roughly burnt with caustic, and a poultice applied until a 
 complete discharge is produced. At the same time the 
 patient should take a lobelia emetic, followed by Euony- 
 mine and Jalapin, until it operates as an active cathartic. 
 After wilich, give the following compound : 
 
 Jfc Dioscorine gr. xx. 
 
 Scutellaria gr, xxx. 
 
 Quinine gr. xx. 
 
 Mix, divide into ten powders, and give one every two 
 hours until all are taken. If the disease is not removed, 
 the Lobelia emetic should be repeated, and again followed 
 by the powders. The skin should be kept cleansed by lye 
 water baths, and a free diet allowed. 
 
 The above treatment has proved triumphantly successful 
 in my hands in several w^ell-marked cases of this disease. 
 
 HYDROPHOBIA. 
 
 This disease is caused by the bite of rabid animals. 
 The wound generally heals rapidly, and it is not until 
 16 
 
182 DIABETES. 
 
 twenty or thirty days have elapsed that any pain is felt in 
 the wound. 
 
 SYMPTOMS. 
 
 Anxiety, restlessness, nervousness, loss of sleep, horror 
 of water, and finally convulsive spasms, are the prominent 
 symptoms of the affection. 
 
 TREATMENT 
 
 In the treatment of this disease, much depends upon 
 thoroughness and perseverance. The wound should be 
 canterized with caustic Potassa, and caused to discharge 
 freely for five or six weeks. The patient should take an 
 active Lobelia emetic, followed by a brisk Podophyllin 
 cathartic, and a spirit .sweat. After which, the following 
 compound should be given : 
 
 R Scutellarin gr. xx. 
 
 Cypripedin , gr. xx. 
 
 Lobelin gr. v. 
 
 Quinine gr. xxx. 
 
 Mix, divide into ten powders, and give one every two 
 hours until all are taken. At the same time, a strong 
 decoction of Plantain should be drunk freely during the 
 day. Lupulin and Hyosciamin should be given at bed- 
 time, to produce sleep. The emetic and other remedies 
 should be continued until the patient is entirely relieved 
 from the disease. 
 
 This treatment has proved successful in the hands of 
 several eclectic physicians. 
 
 DIABETES, OR SACCHARINE URINE. 
 
 This disease has its primary cause in the stomach. 
 
DIABETES. 183 
 
 SY3IPT0MS. 
 
 It is generally preceded by debility, anorexia, dry skin, 
 pain in the lumbar region, and great thirst, with alternate 
 attacks of chills and fever. On examining the urine, it is 
 found to have a sweetish taste and smell. 
 
 TREATMENT. 
 
 Give one grain of Aletrine in a tablespoonful of brandy 
 toddy three times a day, and keep the surface freely 
 bathed in warm broke water and whiskey. 
 
 In the early stage of the disease, this treatment, if per- 
 sisted in for three or four weeks, will generally effect a 
 cure. But in the more advanced stage, where the kidneys 
 have become organically affected, the irritating plaster 
 should be applied over that region, and the following 
 compound given : 
 
 U Xantkoxylin gr. x. 
 
 Populin gr. x. 
 
 Prunin gr. x. 
 
 Sach. Alba gr. xxv. 
 
 Mix, divide into twelve powders, and give one every three 
 hours. After which, give the following : 
 
 U Syrup of Sugar gij. 
 
 Tinct. of Capsicum gij. 
 
 Muriated Tinct. of Iron gj. 
 
 Mix, and give one teaspoonful three times a day. If there 
 are intermittent symptoms, some of the antiperiodic com- 
 pounds should be given, followed by bitters made of 
 Brandy and Aletris Farinosa. 
 
 The bowels should be kept regular, and the stomach 
 evacuated with Sanguinarin, and Lobelia if indicated. 
 
184 RHEUMATISM. 
 
 RHEUMATISM. 
 
 Acute rheumatism commences with weariness, shivering, 
 quick pulse, restlessness, thirst, and fever. The patient 
 soon complains of pains in some of the joints, which in- 
 crease by motion. The parts swell, and have a red and 
 inflamed appearance, the tongue is covered with a heavy 
 white coat, the bowels are costive, the urine scanty and 
 high-colored. 
 
 TREATMENT. 
 
 R Podophyllin gr. ij. 
 
 Xanthoxylin gr. iij. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, and divide into eight powders. Give one 
 every hour until it operates as a cathartic. After which, 
 give the following compound : 
 
 R Sanguinarin < gr, ij. 
 
 Iridin gr. j. 
 
 Quinine gr. x. 
 
 Mix, divide into ten powders, and give one every three 
 hours. The body should be thoroughly bathed in strong 
 salt and water, and the inflamed joints packed with hot 
 cloths. If the disease does not yield, a pill may be given 
 composed of the following materials : 
 
 R Ext. Hyosciamus gr. ij. 
 
 Ext. Indian Hemp gr. xx. 
 
 Capsicum gr. x. 
 
 Mix, form a mass, and make three-grain pills. Give one 
 every three or four hours. If there is fever, Aconite or 
 Veratrin should be given to control it. If the rheuma- 
 tism is of a chronic character, give the following : 
 
 R White Pine Turpentine gr. xxx. 
 
 Extract of Poke Root gr. x. 
 
 Macrotin gr. v. 
 
 Apocynin gr. x. 
 
croup. 185 
 
 Mix, form a mass, and make three-grain pills. Give one 
 every five hours. Animal broths should be taken freely 
 as a diet. The kidneys should be stimulated by mucila- 
 ginous diuretics, and stimulating liniments should be 
 applied to the affected limbs. 
 
 Much care should be taken not to induce metastasis to 
 the heart ; but if that should occur, Aconite, compound 
 syrup of Stillingia, and Iodide of Potassium are the 
 remedies. 
 
 TRACHEITIS, (CROUP, OR INFLAM- 
 MATION OF THE TRACHEA.) 
 
 This disease is divided into two varieties, the spasmodic 
 and pseudo-membranous. In the spasmodic form, there is 
 a sudden contraction of the Trachea, owing to a slight 
 cold, or the transmission of irritation to that organ from 
 the stomach and gums in teething. The only treatment 
 required in this form of the disease, is some active anti- 
 spasmodic. It may be distinguished from the Pseudo- 
 membranous variety, by its sudden appearance at night, 
 when the child was apparently well during the day, and by 
 its almost as sudden disappearance on the administration 
 of a few drops of Tinct. of Lobelia, and the application 
 of a wet pack to the neck. 
 
 The symptoms of the spasmodic kind, are a sudden 
 hoarse cough, followed by a whistling and difficult respira- 
 tion. 
 
 The symptoms of the pseudo-membranous kind, are 
 very insidious. The child is irritable, restless, and 
 peevish, and at times has a fever. He will also be ob- 
 served to spit frequently. These symptoms, in the course 
 of from twenty-eight to thirty-six hours, will be followed 
 by a slight cough, which increases, and the voice soon 
 becomes hoarse. 
 16* 
 
186 croup. 
 
 The disposition to spit also increases, and the sputa, if 
 examined, is found to be of an albuminous character, thus 
 clearly indicating the nature of the disease. 
 
 The symptoms are all aggravated at night, the pulse 
 becoming quick, and the breathing laborious ; but in the 
 morning, they are much ameliorated. In the afternoon, 
 the symptoms again appear, and are greatly aggravated. 
 
 The child throws his head back, and frequently grasps 
 at the neck, the expectoration ceases, the breathing is 
 more labored, and the pulse more frequent. He is unable 
 to speak above a whisper, and unless relieved by proper 
 treatment, soon becomes stupid and expires. 
 
 TREATMENT. 
 
 The treatment here recommended, is of a very simple 
 character, and rather belongs to Prof. J. Gr. Jones than 
 to myself. And as all other methods with which I have 
 been familiar have almost universally failed, while this has 
 always proved successful, I most confidently recommend it 
 to the profession as the only radical cure ever offered for 
 this hitherto almost invariably fatal disease. 
 
 In the early stage, a thorough Podophyllin and Cream 
 of Tartar cathartic should be given, the feet should be 
 placed in hot water, and a cold wet pack applied to the 
 throat. The pack should be changed sufficiently often to 
 keep it cold. After which, the patient should be put upon 
 a mild acetic syrup : 
 
 R Sanguinaria Pulv gj. 
 
 Acetic acid giij. 
 
 White Sugar giij. 
 
 Mix, steep for fifteen or twenty minutes, and give one half 
 teaspoonful every half hour. This prescription should be 
 continued as long as any symptoms of the disease remains. 
 If the treatment is not commenced until the disease is far 
 advanced, the cathartic should be omitted, and the syrup 
 
WORMS. 187 
 
 given at once. The bowels should be moved by laxative 
 enema, and the surface frequently sponged in tepid water. 
 
 If the disease proves obstinate, two or three antiperiodic 
 powders should be given during the Apyrexia. The 
 syrup should also be continued. There should be no 
 more of the syrup given than the stomach will* tolerate. 
 
 The strength should be maintained by a generous diet, 
 and all excitement should be avoided. 
 
 WOBMS. 
 
 According to the classification of the entozoist, the 
 following are the different varieties that infest the alimen- 
 tary canal : 
 
 1st. Ascaris Lumbricoides, or common round worm. 
 
 2d. Ascaris Yermicularis, or- thread worm. 
 
 3d. Tricocephalus Dispar, or long thread worm. 
 
 4th. Taenia Solium, or common tape worm. 
 
 5th. Taenia Lata, or broad tape worm. 
 
 The most common varieties of worms met with in this 
 country, are the common found worm, mostly found in the 
 small intestines, and the short thread worm, which inhabits 
 the rectum or lower portion of the bowels. 
 
 SYMPTOMS. 
 
 The symptoms of worms are various. The most com- 
 mon are frequent flashes of fever, which disappear in a few 
 hours ; irregular appetite, irritable temper, symptoms of 
 irritation about the fauces, tumefaction of the glands, fre- 
 quent changes in the appearance of the urine, which is at 
 one time scanty, and of a milky appearance ; at others, 
 copious and limpid. The irritation will be so great at 
 times as to affect the brain, and convulsions follow. If the 
 
188 WORMS. 
 
 worms infest the rectum, there will be constant itching and 
 uneasiness of that part, and at times a slight sanious 
 discharge. 
 
 TREATMENT. 
 
 For the long round worm : 
 
 U Santonine , gr. vj. 
 
 Podophyllin g r «j- 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, divide into twelve powders, and give one 
 every three or four hours until they act upon the bowels. 
 If this should fail, the following mixture may be given : 
 5t Neutralizing mixture giij. 
 
 Essence of Wormwood gj. 
 
 Tinct. of Aloes- gss. 
 
 Santonine gr. x. 
 
 Mix, and give one teaspoonful three times a-day. 
 
 Or — 
 
 U Santonine „ gr. x. 
 
 White Sugar gr. xxx. 
 
 Triturate, divide into ten powders, and give one every night 
 on going to bed. After two or three days, give a mild 
 purgative. If the patient is troubled with Ascarides, in 
 addition to the above, injections should be given : 
 
 R Santonine gr. xx. 
 
 Hydrastin gr. xx. 
 
 White Sugar gj. 
 
 Warm water t giv. 
 
 Mix, and give as an injection every morning and evening. 
 If either variety of the tape- worm afflicts the patient, the 
 following mixtures may be given ; 
 
 R Fresh Pumpkin-seeds after the shell is taken off ... gij. 
 White Sugar gij. 
 
 Bruise and mix. Give one teaspoonful every half hour 
 until all is taken. After which give a brisk purgative of 
 Podophyllin. If the first mixture does not succeed, it may 
 be repeated. Or the following compound may be given : 
 
CHLOROSIS. 189 
 
 R Oil of Male Fern gij. 
 
 " Turpentine gij. 
 
 " Red Cedar gj. 
 
 " Worm Seed gij. 
 
 Castor Oil giij. 
 
 Mix, and give one teaspoonful every half hour until it 
 operates upon the bowels. During the treatment for the 
 tape-worm, the patient should abstain from food; and if 
 the passage of the worm is commenced, it should be care- 
 fully wound around a stick, to prevent it from being 
 broken. 
 
 ANEMIA, OR CHLOROSIS. 
 
 SYMPTOMS. 
 
 The symptoms of this disease are paleness of the skin 
 and mucous surface, and a peculiar white appearance of 
 the conjunctiva. When the disease has advanced for some 
 time, the countenance assumes a sallow and bloated ^ap- 
 pearance. The patient is feeble, and cannot bear much 
 exertion. The circulation is irregular and weak ; the re- 
 spiration, although natural when the patient is quiet, 
 becomes labored on the least exertion, and there is fre- 
 quently violent palpitation of the heart. 
 
 The nervous system is most disordered ; vertigo, dizzi- 
 ness, and feelings of fainting are not uncommon. At times 
 there are violent neuralgic pains in the head, back, limbs, 
 and side. In females the menses are almost entirely sup- 
 pressed or altogether wanting. The blood in this disease 
 is found to be deficient in iron. 
 
 TREATMENT. 
 
 R Carbonate of Iron gij. 
 
 Port Wine Oj. 
 
 Common Salt gij. 
 
 Hydrastin ~ £j. 
 
190 MILIARY FEVER. 
 
 Mix, and give one teaspoonful three times a day. If the 
 patient is a female with partial or complete suppression of 
 the menses, the following pill should be given : 
 
 R Senecin , gr. xx. 
 
 Macrotin gr. v. 
 
 Vallee's mass gr. xxx. 
 
 Podophyllin gr. j. 
 
 Mix, form a mass, and make three-grain pills. Give one 
 in connection with the wine tonic three times a-day. The 
 diet should consist of rich animal broths, and the patient 
 take plenty of out-door exercise. The bowels should be 
 kept open by the use of some mild laxative, such as Apo- 
 cynia and Euonymine. If the disease does not yield, the 
 following compound may be given : 
 
 ]£ Brandy ....* Oss. 
 
 Water Oss. 
 
 Phosphate of Lime gij. 
 
 Iron by Hydrogen gr. xxx. 
 
 White Sugar giv. 
 
 Mix, and give one tablespoonful three times a-day. The 
 above treatment, together with cold baths, followed by a 
 reaction, will generally prove effectual. 
 
 MILIARY FEYER 
 
 Is characterized by an irregular eruption of round vesi- 
 cles of the size of a millet-seed, upon slightly elevated and 
 inflamed patches of cuticle. 
 
 It mostly commences with rigors and languor, a quick 
 pulse, hot and dry skin, and thirst. The eruption gener- 
 ally appears about the fifth or sixth day from the "com- 
 mencement of the febrile attack. Previous to its appear- 
 ance, there is a sense of pricking or itching of the skin. 
 The patient complains of great precordial oppression, but 
 is soon relieved by a profuse perspiration, and in the course 
 
MILIARY FEVER. 191 
 
 of from three to five days the vesicles form into small 
 scales, and fall off. 
 
 The eruption is generally distinct, but is sometimes con- 
 fluent. It is said rarely to affect the face, and different 
 crops may appear in the same fever. It is mostly a symp- 
 tomatic disease, and occasionally appears in the course of 
 nearly all low forms of fever; — although it may be idio- 
 pathic when it attacks those who have been previously 
 weakened by fatigue, or a long exposure to damp and 
 malarious atmosphere ; or who have been for a long time 
 confined to a bad regimen. 
 
 TREATMENT. 
 
 As this disease is mostly dependent upon constitu- 
 tional debility, caused by some previous difficulty, it will 
 be of the first importance to ascertain the cause, and re- 
 move it ; after which the skin should be thoroughly bathed 
 in warm lye water, and small doses of Aconite adminis- 
 tered until a free perspiration is produced. For the pur- 
 pose of stimulating the secretions, and as a mild purgative, 
 the following compound should be given : 
 
 Euonyniin gr. iij. 
 
 Irisin gr. ij. 
 
 White Sugar, gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one 
 every hour until all are taken, or until they act upon the 
 bowels. If the disease does not yield to this mild treat- 
 ment, small doses of Quinine and Iron together, with an 
 active, stimulating, and nutritious diet, should be resorted 
 to. When the active stage of the disease is passed, the 
 patient should be allowed a liberal quantity of porter, in 
 connection with vegetable tonics and chalybeates.. If the 
 disease is connected with a scrofulous diathesis, the com- 
 pound syrup of Stillingia, with Iodide of Potassium, should 
 be given until the patient is entirely restored. 
 
192 ROSE-RASH — NETTLE-RASH. 
 
 ROSEOLA, OR ROSE-RASH, 
 
 Is a fever attended with a rose-colored efflorescence, 
 and not contagious. It has often been confounded with 
 measles and scarlet-fever. It mostly depends upon indi- 
 gestion, and seldom requires medical treatment. The 
 diet should be regulated, and if the fever is troublesome, 
 small doses of Aconite, and a gentle purgative of Neu- 
 tralizing mixture, may be given. 
 
 URTICARIA, OR NETTLE-RASH, 
 
 Is characterized by circular elevations of the cuticle, of 
 a red color, with a white spot in the centre. 
 
 The eruption is generally preceded by gastro-intestinal 
 irritation and fever. There is frequently restlessness, 
 languor, and anorexia. If the eruption is extensive, the 
 patient suffers much from the itching and heat which it 
 occasions. This disease is frequently caused by excess in 
 eating and drinking, also by undue heating of the blood. 
 It may continue for an indefinite period, and reappear 
 whenever the stomach becomes deranged. 
 
 TREATMENT. 
 
 The patient's diet should be well regulated, and all 
 excesses carefully avoided. The surface should be freely 
 bathed, two or three times a week, and a mild vegetable 
 alterative and tonic be given. If the disease assumes a 
 periodic character, as it sometimes does, an antiperiodic 
 should be administered, succeeded by the following com- 
 pound : 
 
 R Cream of Tartar gr. xxx. 
 
 Leptandrin gr. xx. 
 
 White Sugar : gr. xxx. 
 
 Triturate, mix, divide into ten powders, and give one 
 three times a day. 
 
THE PLAGUE. 193 
 
 THE PLAGUE. 
 
 This disease is regarded as nothing more than a malig- 
 nant typhus fever, attended during its course, by buboes 
 and carbuncles. 
 
 Mackintosh gives the following diagnostic symptoms of 
 the Plague : 
 
 It is ushered in by rigors and oppression, followed by 
 heat of the skin, great prostration of strength, giddiness 
 and headache. The expression of the countenance is be- 
 sotted, and the eyes have a muddy glistening appearance. 
 
 The intellect is sometimes cloudy, at others there is 
 insensibility and fixed delirium. 
 
 Occasionally, stupor takes place, and in some instances 
 the functions of the brain remain distinct and clear. The 
 patient in general seems indifferent respecting his fate. 
 The tongue is at first moist, although it is more or less 
 loaded. There is sometimes constipation, at others diar- 
 rhaea. The stools are very offensive, and there is constant 
 nausea and vomiting. About the third clay from the 
 attack, there is acute pain, followed by redness and swell- 
 ing in the arm-pits and groins, which terminates in car- 
 buncles and buboes, unless it is immediately relieved. 
 And unless suppuration soon takes place, death speedily 
 follows. It is stated that if the patient survives the fifth 
 day, and the buboes appear well-formed, the patient may 
 be pronounced convalescent. The points of danger in 
 this disease appear to be, the time in which the buboes 
 ought to appear, and the time of maturation. For a full 
 description of this disease, the reader is referred to the 
 writings of Dr. James McGregor, who has described it 
 minutely, as it appears in India and Egypt. 
 
 It 
 
194 DIFFICULT DENTITION. 
 
 TREATMENT. 
 
 Cullin condemns both blood-letting and purgatives in 
 this disease, and states that the chief object in the treat- 
 ment should be to relieve the spasms of the extreme 
 vessels. For this, he recommends the application of oil 
 to the surface, and some antispasmodic internally. There 
 can be no doubt that this disease requires a vigorous, 
 stimulating, and antiperiodic treatment from the com- 
 mencement. From all the information I can obtain, I 
 should make a liberal use of hot alkaline baths, anti- 
 periodics, and a free use of Aconite to control the fever. 
 Also a liberal use of tonics, antispasmodics, and stimu- 
 lants, with a nutritious diet. 
 
 DIFFICULT DENTITION. 
 
 Few children pass through the process of dentition 
 without more or less suffering, and often a variety of com- 
 plicated symptoms make their appearance, all depending 
 upon one general cause, viz : dentition. It has long been 
 observed, that children w r ho pass through the period of 
 teething early, suffer less than those whose teeth are longer 
 making their appearance. 
 
 The ages at which children cut their teeth are various. 
 There are instances of children being born with full sets 
 of teeth, as is recorded of Richard the Third and Louis 
 Fourteenth. In general, however, the teeth begin to 
 appear between the age of six and eight months. The 
 two centre incisors of the lower jaw, are commonly cut 
 first, and are soon followed by those of the upper, after 
 which the two lateral incisors of the lower, and then 
 those of the upper jaw make their appearance. Between 
 the twelfth and sixteenth months, the intergrinders of the 
 
DIFFICULT DENTITION. 195 
 
 lower jaw appear, and next in succession are the cuspicles 
 or eye teeth. The others soon follow, so that by the age 
 of two years, the child has its complete set of teeth, 
 twenty in number. The formation of each tooth goes on 
 in a membranous and vesicular sack, which is firmly united 
 to the gum. It is supposed that in tedious and difficult 
 dentition, the sack becomes more vesicular, and is materi- 
 ally thickened. This, together with the pressure of the 
 teeth upon the gums, is supposed to be the only cause of 
 the various ills incident to this period. 
 
 The teeth are composed of Phosphate and Carbonate 
 of Lime, Fluoride of Calcium and Cartilage. 
 
 On analysis by Berzelius they were found to be com- 
 posed of 
 
 Cartilage and vessels 28.0 
 
 Phosphate of Lime 64.3 
 
 Carbonate of Lime 5.3 
 
 Phosphate of Magnesia...... 1.0 
 
 Soda with Chloride of Sodium 1.1 
 
 According to Lessaigne, it appears that as the teeth « 
 become older there is an increase of the Phosphate of 
 Lime, and a corresponding diminution of the Carbonate. 
 From the above facts, it seems the food should contain 
 these elements, to enable the teeth to become perfectly and 
 timely developed. The cause of the diseases so frequently 
 identified with dentition, is a lack of the proper histo- 
 genetic material, thereby causing a drain upon the other 
 tissues, which, together with the long-continued irritation 
 of the teeth upon the nerves, produces a train of morbid 
 symptoms, which are attributed to anything but their true 
 source. 
 
 The child, under these circumstances, becomes restless, 
 fretful and feverish, the sleep is disturbed, the bowels are 
 irregular, the face is flushed, and in some cases there is 
 slight spasmodic twitching of the muscles, and in others 
 general convulsions. 
 
196 DIFFICULT DENTITION. 
 
 Sometimes the child becomes troubled with an irritable 
 cough, with wheezing, a hot skin, quick pulse and scanty 
 urine, denoting great irritation of the bronchial and pul- 
 monary tissues. Cutaneous and glandular affections often 
 occur. The sub-maxillary glands are those most com- 
 monly affected. Occasionally there is inflammation of the 
 eyes, causing purulent Ophthalmia. 
 
 The enumeration of the above symptoms will show the 
 importance of a correct diagnosis in these cases. 
 
 TREATMENT. 
 
 There is no disease in which the ordinary allopathic 
 treatment proves more mischievous than in this. 
 
 The poor child has its gums scarified and mutilated to 
 no purpose. In some cases its stomach and bowels are 
 entirely destroyed by the drastic doses of Calomel, Rhu- 
 barb, Prepared Chalk, and the like ; while in other cases, 
 Opium, Paregoric, Godfrey's Cordial, Bateman's Drops, and 
 a long catalogue of irritants and narcotics, tending still 
 farther to depress the feeble vitality of the child, cause 
 Dropsy of the Brain, Tabes Mesenterica, and Tuberculous 
 Consumption. Now these medicines have not one particle 
 of the aliment needed to build up the structure which is 
 making such extensive drains upon the other tissues, and 
 causing such derangement of the vital powers. The scari- 
 fying of the gums frequently produces an irreparable injury 
 [to the teeth, by denuding them of their soft enamel, an 
 injury seldom repaired. Hence the frequent premature 
 decay of the teeth. The proper treatment consists in 
 administering in small quantities those elements of which 
 the system is deficient. For instance : 
 
 R Phosphate of Lime..... gr. xx. 
 
 Carbonate of Magnesia gr. x. 
 
 Phosphate of Iron gr. v. 
 
 Simple Syrup giij. 
 
DIFFICULT DENTITION. 197 
 
 Dose, one teaspoonful three or four times a day. If there 
 is fever, a few doses of Aconite, given at intervals of from 
 half an hour to an hour, will be sufficient to control it. If 
 the disease proves persistent, or assumes a periodical 
 character, Quinine may be given in combination with some 
 of the other articles, or alone as indicated. If Bronchial 
 irritation is the prominent symptom, two or three drops of 
 the Tct. of Veratrum may be given every three or four 
 hours until the symptoms subside. If there is diarrhoea, 
 Neutralizing Mixture, with small doses of Geranin, should 
 be given. The surface should be frequently bathed, and 
 the diet should be nutritious and of easy digestion. The 
 Lime, Magnesia and Iron should be continued from time 
 to time until dentition is complete. 
 
 Many cases might be adduced to illustrate this mode of 
 treatment, but one will suffice. 
 
 In June, 1855, I was called to see a child fourteen 
 months old, in which the teeth had not made their appear- 
 ance. 
 
 The Doctor (Allopathic) had pronounced it to have 
 Pneumonia. It had been afflicted with alternate diarrhasa 
 and costiveness for three months, and on two or three 
 occasions had had convulsions. Its gums had been lanced 
 eight or ten times. I immediately ordered Magnesia, 
 Lime and Iron, with small closes of Quinine, and a good 
 diet, and in three weeks the constitutional difficulties had 
 disappeared, and the teeth had begun to make their ap- 
 pearance. In the course of six months, by the occasional 
 use of the above remedies, the teeth were fully developed, 
 and the child restored to perfect health. 
 
 IT* 
 
198 OESOPHAGITIS. 
 
 INFLAMMATION AND ULCERATION OF THE 
 (ESOPHAGUS. 
 
 There is no structure in the human body more exempt 
 from disease than the oesophagus ; but when it becomes 
 inflamed, it is quite difficult to detect it until ulceration 
 and constriction take place. 
 
 Inflammation may be partial, affecting only a small 
 portion of the oesophagus, and if ulceration occurs, there 
 will be no contraction ; but the patient will feel slight 
 pain, and there will be momentary stoppage of the food as 
 it passes on to the stomach. If the whole caliber is in- 
 flamed, the difficulty of swallowing will be much greater, 
 not so much owing to the stricture of the oesophagus, as 
 to the constant tendency to vomit. There will be more or 
 less constitutional symptoms, as debility, hot skin, scanty 
 urine, &c. Not unfrequently the entire system materially 
 sympathizes with the local affection. 
 
 TREATMENT 
 
 The constitutional symptoms should be removed, and at 
 the same time an irritating plaster should be applied to 
 the throat, or the region of the inflamed and ulcerated 
 parts, and caused to remain until a free discharge ensues. 
 The bowels should be maintained in a soluble state, and 
 the skin freely bathed in hot lye water and whiskey as often 
 as two or three times a week. And the following com- 
 pound should be administered : 
 
 U Syrup of Marshmallow ^iij. 
 
 Syrup of Iodide of Iron , gij. 
 
 Compound Syrup of Stillingia gj. 
 
 Mix, dose one teaspoonful three times a day. The diet 
 should be nutritious and easy of digestion, and every pos- 
 sible exertion should be made to maintain the integrity of 
 
GASTRODENIA. 199 
 
 the constitution. If the ulceration proves unyielding, a 
 strong solution of Hydrastin, to which may be added a 
 few drops of the Tct. of Iodine, may be taken in reason- 
 able doses three or four times a day. 
 
 If the above treatment should not prove successful, the 
 application of a mild solution of nitrate of silver may be 
 made once or twice a week by means of a probang. The 
 above remedies will be sufficient to effect a cure, provided 
 the cause of the disease has received due attention. 
 
 GASTRODENIA. 
 
 Gastrodenia is a neuralgic affection of the stomach, and 
 is closely allied to dyspepsia, and in some instances ap- 
 pearing as one of its symptoms. Sometimes the appetite 
 remains good, but generally it is impaired. There is 
 gnawing pain in the stomach, extending to the back, 
 accompanied with anxiety and sense of constriction, with 
 a strong tendency to vomit. There is constipation of the 
 bowels, and more or less pain in the head. The principal 
 causes of this disease are the long-continued use of indi- 
 gestible food, very warm or very cold drinks, or the use 
 of Alcoholic drinks, schirrous and cancerous affections of 
 the stomach, &c. 
 
 TREATMENT. 
 
 If the disease is dependent, either upon irregularities of 
 eating or drinking, or upon the excess of either, this should 
 be carefully avoided. During the attack, much benefit 
 may be derived from an emetic. 
 
 R Lobelia Seed Pulv gr. x. 
 
 Bayberry Bark Pulv gr. xxx. 
 
 Mix, add one half pint of warm water, two tablespoonfuls 
 of milk, sweeten, steep fifteen minutes, and give a wine-glass 
 full every fifteen minutes till it operates freely as an emetic. 
 After which, 
 
200 HAMATE MESIS. 
 
 U Lupulin gr. x. 
 
 Scutellarin ., gr. xx. 
 
 Leptaudrin gr. xxx. 
 
 Mix, triturate ; divide into fifteen powders, and give one 
 every three or four hours. If the pain still continues in 
 the stomach, small doses of Morphine may be taken at bed- 
 time. The constitutional symptoms should be carefully 
 attended to, and if the disease becomes periodical, one of 
 the antiperiodic preparations should be administered. The 
 diet should consist of animal and vegetable broths, and 
 the body well bathed in warm or cold water as often as 
 three or four times a week. 
 
 HJ1MATBMESIS. 
 
 This disease most frequently attacks women, particularly 
 those who are of a plethoric habit, and at times when there 
 is a suppression of the catamenia. Each attack is gene- 
 rally preceded by rigors. Pure blood is seldom vomited, 
 unless caused by internal violence or corrosion of the 
 vessels of the stomach. The blood seldom coagulates, and 
 seems to be the product of passive hemorrhage, or exuda- 
 tion from the minute vessels of the mucous membrane. 
 
 The diagnostic symptom of hemorrhage from the sto- 
 mach is a sense of weight and pain in that region, unac- 
 companied by cough. Every part of the mucous mem- 
 brane of the alimentary canal is perhaps equally liable to 
 passive hemorrhagic exudation. 
 
 Occasionally the disease is so general as to give rise to 
 a sanguineous cholera. In some instances it is confined to 
 the bowels, the stomach not participating in it. The most 
 alarming intestinal hemorrhage is called meleena, and is 
 characterized sometimes by full discharges of black blood, 
 resembling ink mixed with sand ; but at others, it is more 
 of a sanguineous character. Hemorrhage from the stomach 
 
HEMORRHAGE, 201 
 
 and bowels produces great exhaustion, and unless relieved, 
 soon proves fatal. This disease frequently accompanies 
 some form of fever, especially typhoid fever. When the 
 hemorrhage is from the stomach, it is a less fatal symptom 
 than when it occurs from the bowels ; yet it rapidly 
 exhausts the patient, and frequently proves disastrous, 
 unless timely relief is given. 
 
 T R E A T M E N T . 
 
 Iii hemorrhage from the stomach or bowels, an infusion 
 of matico, in connection with the ligatures, and hot 
 turpentine and mustard sinapisms, will generally give re- 
 lief. If the patient is an adult, give two or three table- 
 spoonfuls of a strong tea, made of the matico leaves, every 
 five minutes*. At the same time apply the ligatures to the 
 arms and legs ; also, a sinapism over the stomach or 
 bowels, as the case may be, made by taking one table- 
 spoonful of mustard, four tablespoonfuls of pulverized slip- 
 pery elm, and one of oil of turpentine, mixed with hot 
 water, and applied as warm as the patient will bear it. The 
 matico tea should be continued until the hemorrhage 
 ceases, or for one or two hours. If it proves ineffectual, 
 a pill may be given, made as follows : 
 
 B: Nitrate of Silver gr. j. 
 
 Geranin gr. x. 
 
 Pulv. GuraArabic gr. xxx. 
 
 Triturate, and make sixteen pills. Give one every half 
 hour while the hemorrhage continues. After which the 
 patient's strength should be well supported by vegetable 
 tonics, iron, and a generous diet. If the hemorrhage 
 should be owing to a suppression of the catamenia, the 
 feet should be immediately placed in a tub of warm water, 
 and a large Galbanum plaster applied along the spine and 
 across the lower portion of the abdomen. Also, ten or 
 fifteen drops of the oil of Erigeron should be given every 
 
202 JAUNDICE. 
 
 fifteen minutes, until the hemorrhage ceases. After which 
 the patient should be treated as directed under derange- 
 ment of the menses. 
 
 JAUNDICE, OR YELLOWNESS. 
 
 This appearance is owing to the deposit of the coloring 
 matter of the bile in the skin and other tissues and fluids. 
 This substance must be presumed to exist in the blood of 
 
 . the jaundiced patient, and it is claimed to be found in 
 healthy blood. But the prevalent belief is* that the bile- 
 pigment is absorbed after having been secreted by the 
 liver : an opinion founded upon the most common cause 
 of jaundice, i. e., the obstruction of the ductus communis, 
 or one or more of the branches of the hepatic duct, by a 
 gall stone, or by the pressure of a tumor, &c. But among 
 the most common causes of jaundice is a deficiency of the 
 secreting cells of the liver ; consequently no biliary secre- 
 tion takes place. Jaundice is considered by some as an 
 idiopathic disease, but it is mostly a symptom of some spe- 
 cific difficulty, and for which it serves as a diagnostic 
 symptom. It is a phenomenon of several fevers, viz. : 
 bilious remittent and yellow ; also of different affections 
 of the liver, gall-ducts, and stomach. When it comes on 
 with indigestion, slight fever, sluggishness, and pain in 
 the hypochondrium, it may be regarded as a functional 
 disease of the liver and stomach. But when it follows vio- 
 lent and spasmodic pain in the region of the liver, it is 
 dependent upon the arrest of gall-stone in the biliary pas- 
 sage. When it precedes delirium or coma and convul- 
 sions, it indicates disorganization of the hepatic cells ; and 
 when it comes on slowly and lasts a long time, and acquires 
 a dark tinge, it depends either upon organic disease of the 
 
 * liver, or some of the neighboring organs obstructing the 
 discharge of bile into the duodenum. The symptoms of 
 
JAUNDICE. 203 
 
 jaundice, excepting the yellowness, depend much upon the 
 cause of the difficulty, though in all cases the skin is husky 
 and dry ; the urine partakes of the color of the skin ; the 
 faeces are either of a dough or grey-ash color, and in most 
 cases there is constipation of the bowels. The other symp- 
 toms vary in different cases. 
 
 TREATMENT. 
 
 The treatment of this disease should depend entirely 
 upon its cause as indicated by the symptoms connected 
 with it. If it depends upon a functional disorder of the 
 liver, the following compound may be given : 
 
 Euonymine gr. x. 
 
 Podophyllin gr. ij. 
 
 Gelsemin gr. j. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, divide into six powders, and take one every 
 two hours. After which — 
 
 U Phytolaccin ... gr. vj. 
 
 Flour of Sulphur gr. xxx. 
 
 Extract Dandelion jj. 
 
 Make twenty pills, and take one four times a day. The 
 surface should be freely bathed, and the diet should be 
 easy of digestion. After the pills are taken, the following 
 may be given : 
 
 R Cream of Tartar ,.. gij. 
 
 Sanguinarin gr. x. 
 
 Sulphur gr. xx. 
 
 Iron by Hydrogen gr. xx. 
 
 Best Gin Oj. 
 
 Mix, and take one tablespoonful three times a-day. When 
 the disease is dependent upon the arrest of gall-stone in 
 the biliary passage, a thorough Lobelia emetic should be 
 given, followed by a spirit-sweat and a brisk purgative, as 
 follows : 
 
204 DISEASES OF THE HEART. 
 
 1£ Podophyllin « gr. ij. 
 
 Cream of Tartar gr. x. 
 
 Gelsemin • gr. ss. 
 
 Mix, triturate, and divide into four powders, and give one 
 every two hours until it operates as a cathartic. 
 
 If the above prescriptions fail to give relief, they should 
 be repeated at proper intervals. 
 
 DISEASES OF THE HEART. 
 
 The most common disease of this organ is fluttering or 
 palpitation. This may be connected with various structural 
 changes in the organ, yet it frequently exists independent 
 of any such change. " The distinction between organic and 
 functional disease of the heart," says Dr. Walshe, " is far 
 from being easily made. Many of the general rules given 
 for this purpose fail clinically. " The inconstancy of func- 
 tional and the constancy of organic ailment are strongly 
 dwelt upon for examples. But all the subjective and many 
 of the objective symptoms may disappear temporarily in 
 cases of extensive organic disease. The existence of secon- 
 dary changes, such as sub-cutaneous oedema, congestion 
 of the lungs, &c, commonly proves the cardiac affection to 
 be organic, but not always ; for spansemia, added to ner- 
 vous palpitation, may induce oedema. If exercise relieves 
 a disturbed condition of the heart, its affection is pro- 
 nounced to be dynamic only ; but if spansemia exist, exer- 
 cise may be unbearable. From these remarks of Dr. 
 Walshe, it will be perceived that without much care, func- 
 tional and organic disease of the heart are liable to be con- 
 founded. Indeed, nothing was more common than this, 
 previous to the discovery of physical diagnosis and their 
 complete elucidation by Laennec. And now, without re- 
 peated physical examinations, even an adept in this method 
 
DISEASES OF THE HEART. 205 
 
 of diagnosis may mistake mere irregularity of rhythm for 
 structural cardiac disease ; as it is now universally admit- 
 ted that palpitation, when connected with spansemia, will 
 not only produce a basic systolic murmur, but a systolic 
 murmur at the mitral apex may be generated by the irregu- 
 lar action of the musculi papillaries, and even the area 
 of dulness may be extended temporarily, owing to the dis- 
 tension of the cavity of the heart with blood. 
 
 SYMPTOMS OF DYNAMIC PALPITATION. 
 
 According to Laennec, the first impression conveyed by 
 the stethescope is, that the heart is not enlarged. The 
 sound is not heard loudly over a great extent, but this de- 
 pends very much upon the thickness of the chest. Laennec 
 states that in nervous palpitation of the heart, the heat 
 of the patient is never sensibly elevated by the increased 
 action of the heart, which is the case in organic disease of 
 this organ. This may be true as a general rule, but is far 
 from being universally so, as my own professional expe- 
 rience has proved. Dr. Walshe states that in nervous affec- 
 tions of the heart, the area of dulness remains unaltered ; 
 but that distension to the right of the sternum may occur 
 in prolonged paroxysms. He states also that the first 
 sound is too loud and clear at the mitral apex, and some- 
 what abrupt and short. The sound is duller and less click 
 ing than is natural at the mid-sternal base. The first sound 
 may be loud enough to be audible both to the patient and 
 to the bystanders at a distance of some inches from the 
 chest. Reduplication of the second sound at the base is 
 common ; and a clear metallic ring or a praecardial rub 
 may accompany the shock at the mitral apex. 
 
 Prof. Calkins remarks, that in order to form a correct 
 
 diagnosis, we should recollect that the character of organic 
 
 disease of the heart is to progress ; that of functional to 
 
 occur at regular intervals; that active exercise almost 
 
 18 
 
206 DISEASES OF THE HEART. 
 
 invariably aggravates organic, but seldom increases the 
 symptoms of functional ; that the physical signs generally 
 are soon developed, and remain permanent in organic, 
 while they seldom exist — and when they do, they arise 
 from chlorosis — in functional. The rational symptoms, 
 which more frequently occur in nervous disease of the heart, 
 than in functional, are choking in the throat, precordial 
 anxiety, with faintness and actual syncope, or active pains 
 simulating angina. The pulse beats with increased fre- 
 quency, and there is a clammy coldness of the extremities, 
 with a flushed face. The fits of palpitation may last for a 
 few minutes, or they may last for hours, or even days. 
 
 TREATMENT. 
 
 During the paroxysms, the remedies should be of such 
 character as to lessen their intensity, and, if possible, at 
 the same time to remove the cause. If this cannot be done, 
 the paroxysm should be relieved, and an effort made to 
 remove the cause afterwards. For the purpose of relieving 
 the paroxysm, 
 
 U Gelsemin gr. j. 
 
 Scutellarin gr. x. 
 
 Cypripedin,... gr. xv. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate ; divide into eight powders, and give one 
 every hour until the paroxysm is relieved. At the same 
 time, the feet should.be bathed in warm water, and the 
 patient should avoid all mental and bodily excitement. 
 After which, if there is spansemia, 
 
 U Quinine gr. x. 
 
 Iron by Hydrogen '. gr. xij. 
 
 Hydrastin gr- xj. 
 
 "White Sugar gr. xxx. 
 
 Mix, triturate ; divide into ten powders, and give one 
 three times a day. The diet should be generous, and the 
 following tonic should succeed the powders : 
 
ANGINA PECTORIS. 207 
 
 R Scutellarin gr. xx. 
 
 Precipitated Carbonate of Iron. gr. xxx. 
 
 Caulophyllin gj. 
 
 White Sugar lbss. 
 
 Mix, triturate ; add to one pint of good port wine, and 
 take one tablespoonful three times a day before eating. 
 The bowels should be kept in a free state by the use of 
 Leptandrin and Neutralizing Mixture, and the patient 
 should avoid all undue exercise. 
 
 ANGINA PECTORIS. 
 
 This is a disease characterized by paroxysmal pains and 
 tenderness in the precordial region, extending to the head, 
 shoulders, arms and legs, and in some cases producing 
 numbness. The pain is sudden in its onset, but is mostly 
 of a dull character, although in. some. cases it is lancinating 
 or tearing, producing exquisite torture and contractive 
 suffocation. There may be slight dyspnoea or orthopnoea, 
 with lividity of the countenance. The heart usually pal- 
 pitates, the extremities become cold, the urine is passed in 
 large quantities, and is mostly of a limpid appearance. 
 The bowels are constipated, and in most cases there is 
 more or less constitutional disturbance for some time pre- 
 vious to the attack. If there are cardiac murmurs in con- 
 nection with the disease, there is reason to apprehend that 
 it is connected with some organic difficulty of the heart. 
 This disease may be a pure neuralgic affection of that 
 organ, accompanied by hysteria and anaemia, or it may be 
 of a periodic character, of miasmatic origin, — a mere 
 masked ague — or it may depend upon some organic 
 disease of the heart. 
 
208 CONGESTION, 
 
 TREATMENT. 
 
 In this affection, the first object should be to relieve the 
 urgent symptoms. For this purpose, the feet should be 
 placed in hot water, a large sinapism applied over the 
 region of the heart, and the patient caused to take one 
 drop of Aconite every five minutes until the symptoms are 
 relieved. If they are not relieved in the course of half an 
 hour, the following compound should be given : 
 R Lobelin gr. j. 
 
 Lupulin gr. vj. 
 
 Hyosciamin gr. ij. 
 
 White Sugar gr. xxx. 
 
 Mix, divide into ten powders, and give one every ten 
 minutes until relief is obtained. As soon as the severity 
 of the paroxysm is relieved, the cause of the disease should 
 be ascertained, and such a course pursued as will effect a 
 permanent cure. Antiperiodics should be given where the 
 disease is produced by miasm, chalybeates and tonics 
 where it is dependent upon anaemia, and if it originates in 
 organic disease of the heart, the proper treatment may 
 be found under that head. 
 
 CONGESTION, OR, ACCUMULATION OF BLOOD 
 IN THE CAVITIES OF THE HEART. 
 
 Congestion, or accumulation of blood in the cavities of 
 the heart, may occur in consequence of fibrinous deposits 
 interfering with the free movement of the valves. This 
 deposit seems mostly to be a product of endocarditis, 
 although it may arise from regurgitation during fits of 
 dyspnoea, and whenever there is sudden obstruction of the 
 circulation through the lungs. 
 
PERICARDITIS. 209 
 
 SYMPTOMS. 
 
 These are orthopncea, cough, lividity of the countenance, 
 oppression and anxiety. The physical signs are extended 
 area of dulness, irregular rhythm and a labored impulse 
 of the heart. Dropsical effusions and anaemia are fre- 
 quently produced by this disease. 
 
 TREATMENT. 
 
 Give a free purgative of Podophyllin and Cream of 
 Tartar, followed by Syrup of Marshmaliow and Iodide 
 of Potassium. If the disease proves obstinate, an irrita- 
 ting plaster should be placed over the region of the heart, 
 and allowed to remain until a free discharge* ensues. 
 Aconite should be given to control the circulation, and 
 the diet should be nutritious. 
 
 PERICARDITIS, OR 1XFLAMMATIOX OF THE 
 PERICARDIUM. 
 
 The symptoms of this disease depend much upon the 
 state of the inflammation, during the first stage of the 
 inflammatory process. There is more or less fever, with 
 increased frequency of the pulse, cough and dyspnoea. 
 The physical sign is a sound of grating friction. In the 
 second stage, which is that of exudation, there is pain in 
 the region of the heart, irregular pulse, anxiety, dyspnoea, 
 cough, and a tendency to syncope. The features are 
 sharp, and indicate distress. There is scanty and high- 
 colored uriue, with alternate fever and apyrexia. 
 
 The physical signs are frictional sound, and valvular 
 
 murmurs, dependent upon endocarditis. In the third 
 
 stage, bulging of the precordial region may be observed, 
 
 and if there is extensive effusion, displacement of the apex 
 
 18* 
 
210 PERICARDITIS. 
 
 of the heart upwards. The area of dulness will be 
 changed, and very materially enlarged. The sound of 
 the heart will be indistinct and muffled. If adhesion of 
 the pericardial surface to the heart should occur, the 
 action of the heart will be tremulous and unsteady. As 
 the disease advances, the head* is kept elevated, or- 
 thopnea is a constant symptom, and the patient dreads 
 movement of any kind. In fatal cases risus sardonicus 
 often occurs, with tenderness of the Epigastrium, Spas- 
 modic dysphagia, nausea, and vomiting, quasimania, 
 stupor, and death. Or the severity of the symptoms may 
 gradually yield, and the patient recover. 
 
 CAUSE. 
 
 This disease may be caused by metastasis of inflamma- 
 tion from other parts, as in pleuritis, pneumonia, rheuma- 
 tism, phlebitis, &c, and in some cases it is said to be 
 idiopathic. 
 
 TREATMENT. 
 
 In the first stage of this disease, the bowels should be 
 opened by full doses of Podophyllin and Cream of Tartar, 
 a warm sinapism should be applied over the region of the 
 heart, and the surface thoroughly bathed in lye water and 
 whiskey. The operation of the cathartic should be fol- 
 lowed by from one to five drops of the Tinct. of Aconite 
 every hour, until free diaphoresis ensues. This course 
 will control the active form of the inflammation, after 
 which the patient should take the following diuretic and 
 alterative mixture : 
 
 R Syrup *of Marshmallow gv. 
 
 Iodide of Potassium gss. 
 
 Mix, and give one teaspoonful every three hours. At the 
 same time, give from five to ten drops of the Muriated 
 
ENDOCARDITIS. 211 
 
 Tinct. of Iron every five hours. If the disease should he 
 of a periodic character, from five to ten grains of the 
 Sulphate of Cinchonin, and one-eighth of a grain of 
 Gelsemin should be given every three or four hours until 
 that symptom is controlled. If extensive effusion should 
 occur, from one-eighth to one-fourth of a grain of Phyto- 
 laccin to the Syrup of Potassa and Marshmallow, may be 
 added. If, after the active symptoms of the disease, there 
 should still remain some cardial disturbances, the acetic 
 syrup of Sanguinaria will generally suffice to control them. 
 
 ENDOCARDITIS. 
 
 The symptoms of this disease are pain and uneasiness 
 in the region-.of the heart, with precordial pressure. The 
 decubitis is dorsal. The skin is hot, the countenance is 
 livid, and there is cough, dyspnoea, and tendency to syn- 
 cope. The physical signs are uneasiness, and increase of 
 the action of the heart, and a grating accompanying the 
 bellows sound. The normal systolic murmurs will be 
 changed, corresponding to the stage of the disease. 
 
 TREAT M ENT. 
 
 The treatment of endocarditis, is essentially the same 
 as in pericarditis. The surface should be bathed in lye 
 water, a warm pack applied over the cardiac region, and 
 Aconite or veratrum given until the active stage of the 
 disease is removed. These should be followed by diu- 
 retics, alteratives, and tonics. 
 
212 CARDITIS — ATROPHY. 
 
 CARDITIS, OR INFLAMMATION OP THE 
 SUBSTANCE OF THE HEART. 
 
 This disease is mostly connected with endocarditis or 
 pericarditis, and even when it exists as an idiopathic dis- 
 ease, its symptoms are so closely allied to them that as yet 
 the diagnostic symptoms are very obscure. The treatment 
 should be the same as of inflammation of its membranes. 
 
 ATROPHY OF THE HEART. 
 
 In valvular atrophy, says Dr. Walshe, when the chordae 
 tending of the mitral valve are shortened or extremely 
 thin, they are probably purely atrophous.; the large 
 tongue of the valve is simply defective in size, without 
 obvious puckering, or other evidence of past inflamma- 
 tion : in either case regurgitation may occur. The sig- 
 moid and pulmonary valves may also become atrophous, 
 causing regurgitation in the aorta and pulmonary veins ; in 
 the former producing syncope, in the latter asphyxia. 
 
 The physical signs are regurgitation with bellows sound. 
 Where there is atrophy of the parenchyma of the heart, 
 the area of dulness will be diminished, and the diastole 
 and systole will both be feeble. 
 
 The rational symptoms are pallor, coldness of the ex- 
 tremities, cough, irregular respiration, palpitation, pre- 
 cordial oppression, cedema of the extremities, and in 
 females, irregularities of the catamenia, haemoptysis, and 
 it frequently terminates in dropsy and phthisis. In old 
 age, the valves of the heart becoming atrophied, fre- 
 quently causes pulmonary apoplexy. 
 
HYPERTROPHY OF THE HEART. 213 
 
 TREATMENT. 
 
 The patient should avoid all excesses, in mental and 
 bodily exercise. The diet should consist of rich animal 
 broths, with a liberal amount of fats and sugar. Give the 
 following compound : 
 
 R Precipitated Carbonate of Iron ^j. 
 
 Hydrastin spj. 
 
 'White Sugar ..., giij. 
 
 Port Wine Oj. 
 
 Water Oss. 
 
 Dose, one tablespoonful three times a day. If there is 
 much irregularity in the action of the heart, one grain of 
 Myricin, and one-sixteenth of a grain of Teratrin, given 
 twice or three times a day, will usually give relief. In 
 old age, much benefit is sometimes derived from a mode- 
 rate quantity of malt liquor once or twice a clay. 
 
 HYPERTROPHY OF THE HEART. 
 
 By this disease, is understood thickening of one or 
 more of the cavities of the heart. It may exist with, or 
 without other affections of this organ. The difficulties 
 with which it is most frequently connected are dilatation 
 and ossification of the valves. It is said that hypertrophy 
 is mostly confined to the ventricles, and that it is more 
 commonly met with in the left ventricle, than the right. 
 This may sometimes be true, yet, in my practice, it is far 
 from being generally so ; as in some thirty cases of both 
 complicated and uncomplicated hypertrophy, the majority 
 occurred in the auricles. Hypertrophy of the heart may 
 be caused by a preternatural determination of blood to 
 the organ, from a latent form of inflammation, or it may 
 arise from a long-continued increase of action dependent 
 upon nervous disease. 
 
214 HYPERTROPHY OF THE HEART. 
 SYMPTOMS. 
 
 The symptoms of hypertrophy of the left ventricle are a 
 sensible, constant increase of the action of the heart ; the 
 pulse strong, full, and vibrating. On percussion the area 
 of dulness is extended ; and on auscultating the chest, the 
 sound of the heart will be found very much enfeebled, and 
 if hypertrophy is connected with dilatation, the diastole 
 will be materially prolonged. In this way we may be ena- 
 bled to distinguish between simple hypertrophy and that 
 accompanied with increase in the capacity of the cavity. 
 In hypertrophy of the right ventricle, the signs are very 
 nearly the same as above, except the shock of the heart's 
 action will be felt at the base of the sternum, instead of 
 between the fifth and sixth ribs, as in hypertrophy of the 
 left side. 
 
 In hypertrophy of the ventricles, the impulse will be 
 much increased, and the systole shortened in duration, 
 while the diastole will be prolonged. The diseases pro- 
 duced by these cardiac derangements are : dropsy, haemop- 
 tysis, asthma, tubercles, phthisis, and asphyxia. 
 
 TREATMENT. 
 
 In treatment of hypertrophy of the whole or different 
 portions of the heart, all stimulating articles of food and 
 drink should be avoided, as also the use of tobacco. To 
 lessen the action of the heart, and thereby prevent the 
 abnormal supply of nutrition, is another essential element 
 of the treatment. For this purpose a sufficient amount of 
 Tct. Veratrum Yiride maybe given, say from five to ten drops 
 three or four times a-day. The pulse should be maintained 
 at about fifty-five or sixty by the use of the Yeratrum. At 
 the same time one teaspoonful of the solution of Iodide of 
 Potassium should be taken three times a-day. If the disease 
 proves persistent, and should not yield to this plan of treat- 
 
DILATATION. 215 
 
 ment, from one-eighth to one-fourth of a grain of Phyto- 
 lacca may be given every night at bed-time. The bowels 
 should be moved once or twice a- week, with Podophyllin and 
 Cream of Tartar, and the patient should avoid all mental 
 and bodily excitement. 
 
 DILATATION, OR ENLARGEMENT OF THE 
 CAVITIES OF THE HEART. 
 
 Dilatation may be confined to one cavity of the heart, or 
 it may extend to all. The cause of this disease, says Dr. 
 Bertin, is owing to some obstruction in the circulation of 
 the blood, as diseases of the valves, &c, while Laennec 
 attributes it to congenital disproportion in the parts of the 
 heart, But what is a more common cause of the disease 
 in this country is an impoverished state of the blood, pro- 
 ducing a weak and lax state of the muscles, thus giving 
 rise to dilatation. 
 
 SYMPTOMS. 
 
 The patient is often attacked with violent dyspnoea and 
 palpitation, followed by a weak and feeble pulse ; ten- 
 dency to syncope, and in some cases nausea and vomiting. 
 The bowels are mostly constipated, and there is frequently 
 pain and precordial pressure. According to Laennec, the 
 most constant and characteristic sign of this disease is 
 a swollen state of the jugular veins without pulsation. 
 
 TREATMENT. 
 
 The principal classes of medicines indicated in this dis- 
 ease are tonics and astringents, such as Hydrastin, Macro- 
 tin, Myricin, and Muriated Tincture of Iron. The diet 
 should be fall and nutritious, and the patient allowed to 
 drink porter or ale once or twice a-day, with his meals. 
 The Muriated Tincture of Iron should be taken in from 
 
216 PHLEBITIS AND PHLEGMASIA DOLENS. 
 
 five to ten drop doses three or four times a day in a small 
 quantity of beef tea or starch water. The Macrotin, Myri- 
 cin, and Hydrastin, should be used in the form of a syrup 
 two or three times a-day. 
 
 PHLEBITIS AND PHLEGMASIA POLENS. 
 
 Phlebitis is inflammation of the inner membrane of a 
 vein. It may occur as the effects of blood-letting, the 
 application of ligatures, pressure upon some venous trunk, 
 &c. The pathological effects of inflammation of the veins 
 vary according to the extent and severity of the inflamma- 
 tion. In most cases the affected vein is swollen, thickened, 
 and indurated to such a degree as to very much resemble 
 an artery. A diffused swelling, connected with acute pain, 
 coated tongue, scanty urine, constipated bowels, and py- 
 rexia, are among the prominent symptoms of this disease. 
 Upon examination, the adipose, cellular, and subcutaneous 
 tissues are found to be filled with fluid ; and when the parts 
 are laid open, clots of blood and lymph are found adhering 
 to the inner coats of the veins. If the inflammatory pro- 
 cess continues, the clots of blood and lymph are converted 
 into purulent matter, rupturing the vessels, and forming a 
 deep phlegmonoid abscess in the adjacent tissue. 
 
 Phlegmasia Dolens is an inflammation of the veins of 
 the leg, mostly caused by pressure of the gravid uterus, 
 upon the iliac and other veins, generally making its ap- 
 pearance on the second or third week after delivery. It 
 occurs for the most part in one leg, exhibiting to the touch 
 numerous irregular prominences under the skin. 
 
 fYMP T QMS. 
 
 In the course of two or three weeks after confinement, 
 pain and uneasiness are complained of in the hypogastric, 
 
PHLEBITIS AND PHLEGMASIA D0LENS. 217 
 
 lumbar and inguinal regions On examining the limb, it 
 will be found tense, elastic and shining, mostly painful to 
 the touch. It will also be flexed. 
 
 The skin will be hot, the pulse quick, with great thirst 
 and restlessness. If the disease is allowed to advance, the 
 tongue will be covered with a dark sordes, the respiration 
 becomes hurried, and delirium, coma, and death, rapidly 
 follow. Or the symptoms will continue in a mild form for 
 weeks, or even months, and the patient recovers, but with 
 a shattered constitution. 
 
 The above are the most ordinary symptoms, yet they 
 vary exceedingly in different cases. Sometimes the pain 
 commences in the knee, and is of a sharp darting character, 
 extending to the groin. The limb is but slightly swollen, 
 -and cold, but has a peculiar glistening appearance. The 
 secretions of milk will be interrupted, and the bowels 
 irregular. At other times the disease will assume a decided 
 periodic character. The symptoms, such as pain, redness 
 and fever, will all become exceedingly aggravated, at a 
 certain stated period, and remain so for a few hours, 
 followed by a distinct remission ; or the disease may be 
 transferred to other organs, as the peritoneum, pleura, or 
 lungs, producing extensive organic disease of those organs, 
 
 TREAT M E NT. 
 
 The treatment of phlebitis, when it is traumatic, con- 
 sists in the application of warm emollient poultices, as 
 slippery elm, saleratus and myrrh, kept moist with the 
 Tinct. of Arnica, and the administration of brisk purga- 
 tives of Podophyllin and Cream of Tartar, or Cream of 
 Tartar and antibilious physic, succeeded dv a mixture as 
 follows : 
 
 U Muriated Tinct. of Iron gss. 
 
 Pure Water gvi. 
 
 Sulphate of Cinchonin.. ....... gss, 
 
 19 
 
218 PHLEBITIS AN© PHLEGMASIA DOLENS. 
 
 Mix, and give one teaspoonfal five or six times a day. If 
 there is fever, Aconite or Yeratrum should be given to 
 eontrdl it. The purgative should be repeated as often as 
 indicated. After the swelling is subdued, the limb should 
 be evenly bandaged, and kept wet with the Tinct. of 
 Lobelia. 
 
 In Phlegmasia Dolens, the poultice should be applied 
 with a bandage over it. A purgative should be given 
 similar to that in traumatic phlebitis, succeeded by the 
 following compound : 
 
 ]J Sulphate of Bebeerine gr. xxx. 
 
 Caulophyllin gr. xj. 
 
 White Sugar , gr. xxx. 
 
 Mix, triturate ; divide into ten powders, and give one 
 every three hours. . Aconite may be given to control the 
 fever, and the back, hips, and lower part of the bowels be 
 bathed in a liniment prepared as follows : 
 
 R Oil of Turpentine gj. 
 
 Eggs v. 
 
 Common Salt gss. 
 
 Mix, and use two or three times a day. If the disease 
 should assume a periodic character, 
 
 U Muriated Tinct. of Iron gss. 
 
 Water gij. 
 
 Quinine , gr. xx. 
 
 Give one teaspoonful every three or four hours. The sur- 
 face should be thoroughly bathed, and if practicable, a 
 spirit-sweat given once or twice a week. When the active 
 stage of the disease has passed, small doses of Carbonate 
 of Iron, with Euonymine, may be given three or four times 
 a day. If there should be a chronic diseased condition of 
 the vessels of the limb, the bandage should be continued, 
 and kept moist by vegetable astringents. The patient 
 
BLUE SKIN DISEASE. 219 
 
 should also take Iodide of Potassium in connection with 
 tonics. The diet should be full and nutritious, and entire 
 rest should be enjoined. 
 
 CYANOSIS, MORBUS CERULEUS, OR BLUE 
 SKIX DISEASE. 
 
 This disease is confined to infants. The symptoms are 
 a peculiar livid or blue appearance of the skin, frequently 
 extending to the mucous membrane of the mouth. There 
 is constant cough, dyspnoea, and palpitation. In some 
 cases the dyspnoea becomes so excessive, as to produce 
 syncope and death. 
 
 The causes of these symptoms have been shown by Dr. 
 Giritrae, to be as follows : 
 
 , In 22 cases, the aorta was found to arise from both 
 ventricles. 
 
 " 30 " the foramen ovale was open. 
 
 " 14 " the ductus arteriosus was open. 
 
 " 4 " a single heart with one auricle and ven- 
 tricle. 
 
 11 5 li the ventricular septum was imperfect. 
 
 " 22 " the pulmonary artery was contracted. 
 
 " 5 " the pulmonary artery was obliterated. 
 
 11 1 " the aorta was obliterated. 
 
 r< 4 u the aorta arose from the right ventricle. 
 
 The above table shows that this disease is mostly de- 
 pendent upon congenital deformities of the heart and its 
 appendages. 
 
 TREATMENT. 
 
 But little can be done in the treatment of this disease, 
 more than to give temporary relief. Where there is syn- 
 cope, the child should be placed in a warm bath, and 
 ammonia or camphor applied to its nostrils. After which 
 it should be wiped dry, and wrapped in a warm flannel. 
 
220 HEADACHE. 
 
 For the cougli one or two drops of the Tinct. of Lobelia 
 should be given in a teaspoonful of breast milk. The 
 action of the heart may be regulated by Aconite, and in 
 some cases, where the deformity is only partial, the child 
 will gradually recover. 
 
 HEADACHE. 
 
 This is frequently a mere symptom of idiopathic dis- 
 ease, yet we often meet with cases where the difficulty 
 constitutes the only perceptible ailment. Headache may 
 be caused by a preternatural determination of blood to 
 the brain, by the too frequent use of intoxicating liquors, 
 by a disordered condition of the stomach and bowels, by 
 a loss of balance between the venous and arterial circula- 
 tion, by an injudicious use of tea and coffee, undue mental 
 or bodily exertion, imperfect menstruation, and the too 
 frequent use of purgative medicines. It is also a symp- 
 tom of most Idiopathic fevers, as well as most other acute 
 diseases. 
 
 TREATMENT. 
 
 When headache is dependent upon over-exertion of the 
 mind or body, add one-half grain of Belladonna to one- 
 half tumbler full of water, and give one teaspoonful every 
 fifteen minutes, until the pain ceases. If dependent upon 
 constipation of the bowels, mix one ounce of neutralizing 
 mixture and one grain of Podophyllin, and take one or 
 two teaspoonfuls a-day, or a quantity sufficient to keep 
 the bowels in a soluble condition. If upon imperfect 
 menstruation : 
 
 R Macrotin » gr. vj. 
 
 Vallet's ferruginous mass gr. xxx. 
 
 Mix, make twelve pills, and take one every night. Where 
 the headache depends upon eating and drinking more 
 than nature requires, this should be carefully corrected. 
 
CONVULSIONS. 221 
 
 CONVULSIONS IN ADULTS AND CHILDREN. 
 
 When convulsions occur in adolescence, it may indicate 
 inflammation of the brain, plethora, or anserhia, ossifica- 
 tion of the arteries of the brain, growth of tumors on the 
 inner table of the skull, &c. When they occur in chil- 
 dren, although frequently arising from disease of the 
 brain and spinal marrow, they are nevertheless produced, 
 in a great majority of cases, from irritation, transmitted 
 to these parts, from the digestive organs. 
 
 TREATMENT. 
 
 When the disease occurs in adults, the treatment de- 
 pends principally upo.n the cause. Although during the 
 convulsions, small doses of equal parts of the Tinct, of 
 Lobelia and Scutellaria, should.be frequently administered 
 into the stomach, if practicable ; otherwise mixed with 
 starch water, and given in the form of an enema. The 
 circulation should be equalized by hot baths, sinapisms to 
 the calves of the legs, feet, &c. 
 
 When thus relieved, the patient should be treated ac- 
 cording to the cause. Where children are seized with 
 convulsions, the first object should be to evacuate the 
 stomach and bowels. For this purpose, four or five drops 
 of the compound Tinct. of Lobelia should be given, every 
 five or ten minutes, until the stomach is thoroughly evacu- 
 ated. At the same time, the bowels should be injected 
 with equal parts of warm water, oil of olives, and molasses. 
 The child should be placed in a warm bath during the 
 action of the emetic and injection. When the child has 
 been relieved by the above course, all irritating food 
 should be carefully avoided, and a weak tea of Hydrastin 
 and ginger, well sweetened, should be given occasionally 
 for the purpose of giving tone to the stomach. 
 19* 
 
222 NEURALGIA. 
 
 NEURALGIA. 
 
 Neuralgia has alternately been classified under the head 
 of surgical and medical disease. But from the almost 
 universal failure of surgical practice to relieve it, this dis- 
 ease is now almost generally treated as belonging to the 
 medical department. 
 
 There is yet, however, some difference of opinion with 
 respect to its pathology. Prof. Jones and others regard 
 it as but a form of ague ; while Craigie and others con- 
 sider it to have its seat in an inflammation of the neurilema 
 or covering of the nerve. Dr. Mcintosh states that the 
 cause of this disease may frequently be traced to a dis- 
 ordered state of the stomach, and alimentary canal. Dr. 
 Elliotson in the 3d volume of the Cyclopedia of practical 
 medicine, p. 388, states that the nature of neuralgic affec- 
 tions may be evident immediately, or, not till after a 
 lapse of time ; may become evident after death only, 
 or, may never be discovered. He further states that 
 inflammatory conditions of the nerves, and structural 
 changes, as well as mechanical causes, may be detected 
 during life, if the seat of these conditions is within the 
 reach of observation; and symptoms may be induced, 
 which clearly point out the inflammation or structural 
 changes, even if those should be beyond our observation. 
 
 Occasionally, however, the seat and cause of the irrita- 
 tion is not only beyond our reach during life, though dis- 
 coverable afterwards, but no symptoms are produced which 
 indicate them. From the above remarks, and many other 
 observations which might be made, we perceive that quite 
 a diversity of opinion exists relative to its pathology. In 
 order to harmonize the conflicting theories, resulting as 
 they do from actual observation, we might conclude that 
 occasionally it has its origin in inflammation of the mem- 
 branes of the nerves, in spinal irritation, in derangement 
 
NEURALGIA, 223 
 
 of the stomach and bowels, and in affections of the kidneys ; 
 also, that it frequently arises as one of the effects of miasm, 
 and assumes a disguised remittent character. 
 
 SYMPTOMS. 
 
 In the most aggravated form the pain is lancinating or 
 tearing, as the patient expresses it. It is sharper at some 
 times than others, and in some instances the parts become 
 red, and assume the appearance of inflammation, although 
 this is not generally the case. When this disease attacks 
 the nerves of the face, it is called Tic Doloareux. 
 
 All the soft tissues seem to be liable to this affection. 
 The attacks are mostly sudden, and last from a few hours 
 to several days. The constitutional symptoms connected 
 with them are frequently very slight, although, in some 
 cases, the pulse becomes quick, the urine scanty and high- 
 colored ; a light brown coat will appear on the tongue, 
 and there will be alternate fever and perspiration. In other 
 cases the paroxysms will commence with rigors and chills, 
 followed by fever and perspiration ; in short, manifesting 
 all the essential symptoms of ague. 
 
 TREATMENT. 
 
 As shis disease is decidedly of an intermittent character, 
 where there is no obvious organic lesion or perceptible 
 cause of the disease, the treatment should be commenced 
 by giving full doses of antiperiodics, such as the following : 
 
 U Scutellarin gr. x. 
 
 Gypripedin gr. v. 
 
 Quinine gr. x. 
 
 Prussiate of Iron gr. xij. 
 
 Mix, triturate, divide into ten powders, and give one every 
 two hours, till all are taken. At the same time the affected 
 parts should be thoroughly bathed in a strong, hot solution 
 
224 HYSTERIA. 
 
 of Ferrocyanide of Potassium. These applications should 
 be made in the form of fomentations, and changed as often 
 as cold. When the antiperiodic powders are all taken, the 
 bowels should be thoroughly evacuated by the use of anti- 
 bilious physic and Leptandrin. If the above prescription 
 be not sufficient to remove" the disease, give, the following : 
 R Tinct. of Gelseminum gij. 
 
 " Macrotys Kacemosa ....... gj. 
 
 " Iodine £ss. 
 
 Mix, and give three drops every three hours, until the 
 symptoms yield. If there should be a tendency to a peri- 
 odic return of the disease, the antiperiodic powders should 
 be repeated from time to time. The bowels should be kept 
 in a natural condition by the use of Neutralizing mixture, 
 and as often as once or twice a week, the surface should be 
 thoroughly bathed. Where the disease is dependent upon 
 spinal irritation, in addition to the above mentioned causes, 
 an irritating plaster should be placed along the spine, and 
 remain until a free discharge ensues. Where there is de- 
 rangement of the menses, Senecine and Bebeerine should 
 also be used as circumstances seem to indicate. 
 
 HYSTERIA. 
 
 This is a disease of the nervous system, and almost 
 wholly confined to females, although it is said that males 
 are not exempt from it. The invasion of the disease is 
 sudden and irregular, but in many cases decidedly periodi- 
 cal. In slight attacks the patient bursts into a fit of weep- 
 ing, soon followed by convulsive laughter, which lasts for 
 a longer or shorter time, and may be followed by compa- 
 rative composure. 
 
 In more severe cases, the complaint is ushered" in by a 
 sharp pain in the abdomen or chest, which is soon followed 
 
HYSTERIA. 225 
 
 by a sense of suffocation and oppression at the Epigastrium. 
 The bowels are tense and the surface is cold. The coun- 
 tenance varies ; in some cases it is red and swollen, in 
 others it is pale, and the features are contracted. In 
 some very severe cases, there is a convulsive affection of 
 the muscles, amounting to clonic spasms. The urine is 
 mostly discharged in large quantities, and has a light 
 limpid appearance. 
 
 CAUSES, 
 
 We seldom meet with this disease before puberty, or 
 after the period of life when menstruation finally ceases, 
 and as it mostly makes its appearance during the cata- 
 menial flow, it is supposed to have its origin mostly in 
 deranged uterine action, 
 
 TREATMENT. 
 
 During the paroxysms, the feet should be placed in warm 
 water, and a hot sinapism applied to the lower part of the 
 abdomen. The patient should take equal parts of Cypri- 
 pedin and Scutellarin, one grain every half hour until the 
 paroxysms subside. If the above is not sufficient to con- 
 trol the disease, the compound ginger and Bayberry tea 
 may be given freely, followed by ten or twenty of Beach's 
 sudorific drops, or thirty or forty drops of the Tinct. of 
 Castor, followed by a pill of assafcetida. After the parox- 
 ysm, the patient should take from five to ten grains of 
 Bebeerine, and the same amount of phosphate of Iron, 
 every day for two or three weeks. 
 
 To remove the uterine affection, Macrotin, Cauiophyllin 
 and Senecin should be used, as the nature of the case 
 seems to indicate. When the disease is dependent upon 
 indigestion and constipation of the bowels, tonics and 
 laxatives are the remedies. If upon spinal irritation, the 
 proper treatment will be found under that head. 
 
226 MYELITIS. 
 
 myelitis; or inflammation and irrita- 
 tion OF THE SPINAL MARROW. 
 
 The symptoms of this disease are a sharp pain up and 
 down the back, rigors, fever, headache, and not unfre- 
 quently delirium and coma. In some cases dysuria occurs, 
 in others retention of the urine. Rigidity of the muscles 
 of the back and neck is almost a constant symptom. The 
 body may be bent backwards, opisthotonos, or forwards, 
 emprosthotonos, or there may be a simple rigid state of 
 the muscles, and the decubitis normal. In other cases 
 there may be tetanus, convulsions, or paralysis. The 
 muscles of deglutition are often so affected as to occasion 
 much difficulty of swallowing. The pulse is mostly hard 
 and quick, the bowels are extremely constipated, and 
 frequently there is nausea and vomiting. The respiration 
 is slow and irregular, and occasionally death is suddenly 
 produced by asphyxia. 
 
 PROGNOSIS. 
 
 The prognosis of this disease is usually favorable under 
 the eclectic system, if it receives timely treatment. 
 
 TREATMENT. 
 
 A sinapism should be applied along the spine, and the 
 feet should be placed in warm water. The patient placed 
 upon the Tinct. of Veratrum Yiride, if of a plethoric habit ; 
 if otherwise, Aconite should be given, and the following 
 cathartic may be administered : 
 
 R Cream of Tartar gr. xx. 
 
 Podophyllin gr. iij. 
 
 Capsicum gr. x. 
 
 Mix, triturate ; divide into six powders, and give one every 
 hour until a cathartic effect is produced. The powders 
 
SPINAL IRRITATION. 22T 
 
 should be assisted in their action by warm stimulating 
 enema. If the disease still proves persistent, a (spirit? 
 vapor bath should be given, followed by an emetic of the 
 acetic tincture of Lobelia and Sanguinaria, also repeat the 
 cathartic and continue the sinapism to the spine. If there 
 should be muscular spasms, give the fluid extract of 
 Lobelia. Cypripedin and Scutellaria, equal parts, from 
 five to ten drops every half hour until that symptom sub- 
 sides. After the active stage of the disease is passed, to 
 prevent disorganization of the spinal marrow and its 
 membranes, with 'its consequences, such as paralysis, &c, 
 a full antiperiodic course of medicine should be given, 
 followed by two or three drops of the Tinct. of Phos- 
 phorus once or twice a day. The bowels should be kept 
 open, and the system supported by the liberal use of 
 Hvdrastin and Euonvmine. 
 
 SPIXAL IRRITATION. 
 
 This affection might be more properly designated as 
 chronic inflammation of the spinal marrow, and its mem- 
 branes. In fact the various morbid changes observable 
 as the symptoms of what is usually designated spinal 
 irritation, such as softening, effusion, hypertrophy, &c, 
 all clearly indicate the previous existence of a latent 
 inflammatory process. 
 
 S Y M P T M S . 
 
 Says Prof. J. G. Jones : "The proteian manifestations 
 of spinal irritation, and the great liability that exists to 
 mistake some of the numerous disturbances produced by 
 disease seated in the spinal nerves, for other and more 
 serious organic affections, remote from the source of trouble, 
 renders the consideration of this subject scarcely less im- 
 portant to the student of medicine, than that of any other 
 
228 SPINAL IRRITATION. 
 
 topic connected with disease. Scarcely an organ in the 
 body can be found that is not by turns made the scapegoat 
 upon which these great nervous centres play off their fan- 
 tastic representations of serious organic or functional dis- 
 turbances, and thereby mislead the unsuspecting attendant, 
 at the expense to the patient, of a severe course of 
 medication directed to disease having its real seat far 
 remote from the organ manifesting embarrassment and 
 functional disturbance. " It will be perceived by these 
 remarks of Prof. Jones, that irritation of the spinal 
 marrow assumes a great variety of symptoms, which is 
 actually the case. 
 
 Not unfrequently females who are troubled with the 
 latent form of spinal affection, exhibit symptoms of uterine 
 derangement, heart disturbances, irritation of the lungs 
 and bronchi, irregularity of the bowels, neuralgic pains, 
 &c, succeeding each other in a rapid series of changes. 
 The diagnosis must be made up, in these cases, by care- 
 fully examining each organ, thus sympathetically affected, 
 by itself ; and, in the absence of any serious organic dis- 
 ease, together with the extreme nervousness of the patient, 
 it will enable us to arrive at the true source of the 
 complaint. On pressure of the spinal processes, there 
 will generally be found more or less tenderness, although 
 I have seen quite a number of cases of evident spinal irri- 
 tation where this symptom was not present. 
 
 TREATMENT. 
 
 In cases of spinal irritation, the irritating plaster should 
 be applied along the diseased part of the spine, and caused 
 to remain until a free discharge ensues, and the following 
 tonic and alterative given : 
 
 R Phosphate of Iron gr. xxx. 
 
 Sctttellarin « gr. xx. 
 
 Syrup of Iodide of Potassium gijj. 
 
 Port Wine 6j. 
 
HYPOCHONDRIASIS. 220 
 
 Mix, and give one tablespoonful three times a day. The 
 surface should be bathed in warm or cold water, as indi- 
 cated, twice or three times a week ; and the bowels should 
 be kept regular by the use of small doses of Neutralizing 
 mixture. TThen the above course has been pursued for 
 some time, and the disease is not removed, the following 
 compound may be given : 
 
 U Valerianate of Quinine gr. xx. 
 
 Cypripedin gr. x. 
 
 Sanguinarin gr. xx. 
 
 White Sugar ., gss. 
 
 Mix, triturate, and give ten grains four or five times a day. 
 Also, bathe the surface in a warm solution of Ferrocyanide 
 of Potassium every morning. If there is Leucorrhcea con- 
 nected with the spinal difficulty, Macrotin and Caulophyl- 
 lin should be given in addition to the above. 
 
 HYPOCHONDRIASIS. 
 
 The symptoms of this disease are exceedingly various, 
 and are both imaginary and real. The imaginary ones are 
 numerous, such as want of sleep, constipation of the bowels, 
 inability to sleep, &c. Nothing is more common than to 
 hear the patient state that he has been unable to close his 
 eyes in sleep for several nights, when the fact is that he has 
 slept regularly. Or that the bowels have not moved for 
 days, or even weeks, when they are perfectly regular. Or 
 there may be a great variety of imaginary difficulties at 
 the same time. The complaints of one individual that I 
 treated for this disease will serve to illustrate the imagi- 
 nary symptoms of this class of cases : The patient was a 
 male about 45 years of age. He first complained of ina- 
 bility to walk, and accordingly took to his bed. He was 
 soon unable to speak above a whisper, and imagined he 
 was laboring under an attack of acute phthisis, and, as he 
 20 
 
230 HYPOCHONDRIASIS. 
 
 said, had excessive dyspnoea and violent cough, although 
 he neither coughed nor apparently had any difficulty of 
 breathing. He also complained of an entire loss of appe- 
 tite, and inability to take food, yet he ate three hearty 
 meals daily. At times he thought he was about to die 
 from an extensive affection of the heart ; and also, that his 
 liver and kidneys were consumed. In short, he was com- 
 posed of a congeries of all the ills that afflict the human 
 family. He continued in this state for twelve years, only 
 leaving his bed for a few minutes at a time, and then with 
 great difficulty. During the whole time, he only spoke 
 above a whisper, except when angry. He would then be- 
 come very boisterous, and talk exceedingly loud, which in 
 one or two instances lasted for several days. But when 
 the fit passed off, he was as seemingly incapable of speech 
 as before. On examination, no apparent disease existed 
 further than the natural debility dependent upon so long 
 confinement. By a proper course of mental and physical 
 treatment, he soon recovered, and resumed his ordinary 
 occupation, that of farming. And although it is now over 
 ten years, he has enjoyed uninterrupted good health. Fe- 
 males who are afflicted with this diseased condition of 
 the mind, often imagine they have some severe uterine 
 derangement. And frequently the medical attendant being 
 as ignorant of the cause of the disease as herself, subjects 
 her to a very disastrous course of medication. Another 
 class of patients afflicted with hypochondriasis have, in 
 addition to the imaginary symptoms, some real organic 
 affections which require especial treatment. 
 
 Hypochondriasis, no doubt, is induced by a want of 
 harmonious action between the different organs of the 
 brain. 
 
 TREATMENT. 
 
 The treatment of this malady should consist principally 
 in quieting, as far as practicable, the already-excited facul- 
 
OPHTHALMIA. 231 
 
 ties of the brain, and bringing other faculties into action. 
 The mind should be constantly directed to other subjects 
 than those to which it has been previously directed ; and 
 those subjects should be sufficiently exciting to arrest his 
 former meditations. The head, should be frequently show- 
 ered in cold, and the body, in tepid water. He should be 
 induced to take as much exercise as his enfeebled condition 
 will warrant. The bowels are to be regulated by mild 
 aperients, and in some cases chalybeates and vegetable 
 tonics will be required. If the disease is complicated with 
 organic affections, it should be treated accordingly. 
 
 OPHTHALMIA, OR IXFLAMMATIOX OF THE 
 EYES. 
 
 The eye is one of the most delicate as well as one of the 
 most complicated organs of the -body. 
 
 Diseases of the eye have been until recently very imper- 
 fectly understood. ; Thus has the patient been duped, not 
 only in a pecuniary point, but too often mourns the loss 
 of that inestimable organ. 
 
 Ophthalmia is mostly described as a surgical disease, 
 but considering that a large majority of cases of this class 
 originate in some defect of the constitution, the propriety 
 of treating upon them, in a work on practical medicine, 
 will readily be perceived. 
 
 Inflammation of the eye may be divided into external, or 
 inflammation of the conjunctiva, and deep-seated, or inflam- 
 mation of the other tunics, including amaurosis, which is 
 frequently produced by inflammation. This disease is again 
 divided into acute and chronic. 
 
232 CATARRHAL OPHTHALMIA. 
 
 INFLAMMATION OF THE CONJUNCTIVA. 
 
 The first symptom complained of, in this form of inflam- 
 mation of the eye, is a sensation as if particles of sand had 
 insinuated themselves beneath the lids, accompanied by 
 heat, pain, and increased lachrymal secretion ; also, intole- 
 rance of light. In severe cases there are headache, nausea, 
 constipation of the bowels, anorexia, and more or less 
 disposition to fever. The causes of this form of Ophthal- 
 mia are mostly local — as particles of sand, dust, or insects 
 beneath the lids, inversion of eyelashes, &c. 
 
 TREATMENT. 
 
 The first object should be to remove the cause. If there 
 is an irritating substance beneath the lid, the eye should be 
 thoroughly bathed in cold Water while the lid is held open. 
 If the substance is not removed in this manner, a vial cork 
 should be rubbed perfectly smooth with a dry flannel : the 
 particle may then be removed by touching it lightly with 
 the cork. Particles of iron or steel may be removed in 
 this manner; also, by means of a small magnet. When 
 the eye is thus relieved, it may be packed in cold water, 
 and the patient's bowels moved by a dose of anti-bilious 
 physic. If the injury be sufficient to cause inflammation 
 of the eye, a mild diet may be adopted for a few days, and 
 the packs changed as often as necessary to keep them cool. 
 
 CATARRHAL OPHTHALMIA. 
 
 SYMPTOMS. 
 
 After exposure to cold, the eyes are noticed to have a 
 smarting or burning sensation, and the capillaries to be 
 sufficiently dilated to admit of the red corpuscles, whereas 
 
CATARRHAL OPHTHALMIA. 233 
 
 in a normal condition they only convey white ones. The 
 dilated capillaries at first exhibit a radiated appearance, 
 but soon become confluent, and the entire conjunctiva 
 assumes a red and highly inflamed aspect. This con- 
 dition of the eye is accompanied by chilliness, aching of the 
 •bones, and some degree of fever. There is also intolerance 
 to light, and, when the disease has become established, a 
 puriform discharge from the eyes. 
 
 TREATMENT. 
 
 As this form of inflammation of the eye is dependent 
 upon exposure to cold ; in other words, upon a contracted 
 state of the superficial capillaries, and consequent con- 
 gestion, or inflammation, of the deep capillaries, — the first 
 indication of treatment is to relax the vessels of the surface, 
 and thus unload the congested internal vessels. To effect 
 this the surface should be thoroughly bathed in warm lye 
 water, the patient placed in bed, and the following emetic 
 given : 
 
 B Lobelia seed, pulverized gr. xx. 
 
 Ginger Tea Oj. 
 
 Add the Lobelia to the ginger tea while warm, and give 
 one wine-glass full every fifteen minutes, until a thorough 
 emetic effect is produced. The bowels should be opened 
 by the liberal use of antibilious physic. During the action 
 of the emetic and cathartic, the eyes should be kept packed 
 in cold, soft water. If the disease has assumed a chronic 
 form, the pack should be applied as warm as the patient 
 will bear it, and an astringent wash used once or twice 
 a day, such as one gr. of nitrate of silver added to one oz. 
 of pure soft water, and a small quantity applied to the eye 
 by means of a camel's hair pencil once or twice a-day ; or 
 the eye may be bathed in a strong decoction of Hydrastin 
 every morning and evening. All irritating salves and eye- 
 washes should be carefully avoided, as they always prove 
 20* 
 
234 INFLAMMATION OV THE EYES. 
 
 injurious. If there should be fever, it should be con- 
 trolled by the use of Aconite. The diet should be cool 
 and bland, the eye precluded from light, and the. patient 
 kept quiet. 
 
 INFLAMMATION OF THE EYES OF INFANTS, 
 OR PURULENT OPHTHALMIA. 
 
 SYMPTOMS. 
 
 The symptoms of purulent ophthalmia of children, are 
 somewhat similar to those of catarrhal ophthalmia of 
 adults. The eyes are kept constantly closed, the lids are 
 red and swollen, and glued together by thick puriform 
 matter becoming dry. The skin will be dry, and the 
 bowels irregular. If this disease is neglected, it will 
 result in ulceration of the cornea and loss of the organ. 
 The cause of this disease is exposure to cold, damp cloth- 
 ing, and injuries in washing the child ; also the introduc- 
 tion of acrid matter, which is upon the child, into the eye. 
 
 TREATMENT. 
 
 In the treatment of this affection, the eyes should be 
 thoroughly bathed in a cold, w r eak solution of Hydrastin, 
 four or five times a-day. They should be kept packed in 
 cold soft water, to which is added a small amount of the 
 Tinct. of Lobelia. The bowels should be kept open by the 
 use of neutralizing mixture and Leptandrin, and from one- 
 half to one drop of Aconite, given every four or five 
 hours. Where the eye-lids become granulated, they 
 should be inverted, and lightly touched with a camel's 
 hair pencil, moistened with a solution of vegetable caustic, 
 once or twice a-day ; but much care should be taken that 
 the caustic be all removed before the lids are closed. All 
 poultices should be avoided. Where the disease is of a 
 
AMAUROSIS. 235 
 
 scrofulous character, either iu children or adults, Muriated 
 Tinct. of Iron, Compound Syrup of Stillingia, Hydrastin, 
 Scrophularia, Quinine, Iodide of Potassium, Iodide of 
 Iron, and a generous diet, are the remedies. 
 
 AMAUROSIS. 
 
 The term amaurosis is used to denote a partial or total 
 loss of vision, affecting one or both eyes. The causes of 
 this affection are various. It may arise from the inflam- 
 mation of the sclerotic coat, from inflammation of the iris, 
 from inflammation of the retina, by congestion of the 
 vessels of the retina, by congestion of the brain, by effu- 
 sion into the base of the brain, by the too free use of 
 ardent spirits, by gastro-intestinal irritation, by tubercu- 
 lous affection of the optic nerve, by spermatorrhea, in- 
 ternal use of mercury, exposure of the eye to too strong 
 light, &c. 
 
 SYMPTOMS. 
 
 The symptoms of amaurosis very much depend upon 
 the cause. Yet the following may be enumerated as 
 generally present in cases of this kind : imperfect vision, 
 pain in the eye, flashes of light, dark spots appearing 
 before the eyes, and in some cases the pupil will be ob- 
 viously dilated. The disease is mostly insidious, and its 
 progress very slovr, although in some cases it is rapid, 
 destroying the vision almost at once. 
 
 TREATMENT. 
 
 If amaurosis is dependent upon any of the inflammatory 
 affections, a thorough purgative should be given at once. 
 As, 
 
 B Podophyllin gr. iij. 
 
 Jalapin gr. j. 
 
 Cream of Tartar gr. xxx. 
 
236 AMAUROSIS. 
 
 Mix, divide into eight powders, and take one very hour 
 until it operates. After which the patient should be put 
 upon full doses of Tinct. of Teratrum, the pulse main- 
 tained at about fifty-five or sixty beats per minute, and 
 the following diuretic or alterative given : 
 
 IJ Syrup of Marshmallow Oss. 
 
 " Iodide of Potassium... gij. 
 
 Mix ; dose, one teaspoonful three or four times a-day. 
 The eye should be kept constantly packed with cold water, 
 the diet should be low, and the patient should avoid all 
 exposure of the eyes to the light, and all mental and 
 physical labor. If effusion of lymph has taken place 
 wkhin the tunics of the optic nerve ; or any part of the 
 eye, causing amaurosis, absorption can be produced by 
 the following pill : 
 
 R Xanthoxylin gr. xx. 
 
 Iridin gr. x. 
 
 Podophyllin gr. iij. 
 
 Iodide of Potassium gr. xxx. 
 
 Ext. of Dandelion, in quantity sufficient 
 to make a pill mass. 
 
 Make three-grain pills, and let three to six be taken per 
 day. At the same time, the kidneys should be stimulated 
 by the use of Cream of Tartar water and vegetable diu- 
 retics, as Queen of the Meadow, &c. Where there is 
 loss of power in the nerve, bathing the forehead in strong 
 Tinct. of Capsicum, three or four times a-day, will be 
 very beneficial. The eyes should be well protected from 
 strong light, and from three to five drops of Tct. Rhus 
 Radicans given three times a day. If this remedy should 
 fail to give relief in the course of a few weeks, the follow- 
 ing mixture should be given : 
 
 R Hydrocyanic Acid gtt. viij. 
 
 Quinine Sul.ph gr. xx. 
 
 Aqua giij. 
 
DISEASES OF THE SKIN. 231 
 
 Mix ; dose, one teaspoonful four or five times a day. The 
 bowels should be kept open by the occasional use of a 
 stimulating purgative. Cold baths should be taken as 
 often as every third day. Where the disease is of long 
 standing, indicating paralysis of the optic nerve, the fol- 
 lowing may be used to advantage : 
 
 R Extract Macrotys gr. xx. 
 
 " Mux Vomica gr, x. 
 
 " Euonymine gr. xxx. 
 
 Mix, and form a pill mass, and make two-grain pills. 
 Dose, from one to three pills, three times a day. During 
 the entire course of treatment, the anterior portion of the 
 head should be frequently bathed with a stimulating pre- 
 paration. 
 
 i 
 
 DISEASES OP THE SKIN. 
 
 HERPES, OR SALT RHEUM. 
 
 SYMPTOMS. 
 
 Small vesicles grouped together upon inflamed patches 
 of skin ; the vesicles contain a thin, light, transparent 
 fluid, which is absorbed or evaporated, leaving a thin 
 transparent scale. This desiccation will desquamate and 
 leave the part, which will again become affected in the 
 same manner. There are two other varieties of Herpes 
 spoken of by writers, viz : Herpes Zoster or Shingles, and 
 Herpes Circinatus or Ring-worm. The symptoms of 
 Herpes Zoster are full and quick pulse, dry skin with 
 fever, tenderness of the Epigastrium, constipation of the 
 bowels ; and the herpetic eruption which generally com- 
 mences on the bowels, and spreading frequently, encircles 
 the body. The appearance of the eruption, is almost 
 identical with salt rheum : it is in fact the acute form of 
 
238 DISEASES OF THE SKIN. 
 
 it. The symptoms of Herpes Circinatus are very simple ; 
 it being only what is known as a ring-worm, no farther 
 description will be required. 
 
 TREATMENT. 
 
 As an external application, an ointment may be used 
 made as follows : 
 
 R Iodide of Zinc gr. xxx. 
 
 Ext. of Phytolocca Decandra gr. xx. 
 
 " Black Walnut Bark gr. xxx. 
 
 " Balsam Copaiba §ij. 
 
 Mix, and rub a small portion on the diseased part, morn- 
 ing and evening. Previously, the part should be well 
 bathed in a strong decoction of Black "Walnut buds or 
 leaves. At the same time, the following compound should 
 be taken internally : 
 
 R Juglandin 3J. 
 
 Irisin gss. 
 
 Sac Alba , giij. 
 
 Mix, triturate, and give from ten to fifteen grains twice a 
 day. Also give one teaspoonful of compound syrup of 
 Stillingia three times a day. If there is tenderness in the 
 parts after the disease seems to be removed, they should 
 be protected by liquid collodion for a few months, to 
 prevent a return. For Herpes Circinatus, or ring- worm, 
 wash the parts m Saleratus water, and cover with Col- 
 lodion. 
 
 In Herpes Zoster, or Shingles, the eruptive surface 
 should be well bathed in a strong solution of zinc, after 
 which apply a slippery elm poultice. A purgative of 
 Juglandin and Cream of Tartar should be given, and 
 repeated from time to time as long as the disease proves 
 active. To control the fever, Aconite or Veratrum should 
 be used, and the surface frequently bathed in lye water. 
 If the disease is periodical, some of the antiperiodic medi- 
 
ECZEMA. 239 
 
 cines should be given. The zinc wash should be repeated 
 from time to time, until the active inflammation is sub- 
 dued. Afterwards use the liquid Collodion instead. 
 
 ECZEMA. 
 
 This is another form of herpetic eruptive disease, and 
 like all others, it is characterized by small blisters or 
 vesicles. There are several varieties of this form of erup- 
 tive disease, such as Eczema of the face, or crusta lactea, 
 Impetigo, or moist tetter, &c. The causes of these cu- 
 taneous eruptive diseases are as numerous as the varieties. 
 They may arise from improper diet, exposure to cold, 
 teething in children, intestinal irritations, &c. They are 
 also, hereditary. The symptoms depend very much upon 
 the cause ; but in ail cases, where the disease is in any 
 way severe, there is more or less constitutional disturb- 
 ance, such as irregularity of the bowels, fever, quick 
 pulse, scanty and high-colored urine, &c. The limits of 
 this work will not allow of a minute description, of every 
 form, of these eruptive diseases and their symptoms. But 
 as the treatment varies only, as the causes are different, 
 the descriptions and symptoms given will be found suffi- 
 ciently minute for all practical purposes. 
 
 TREATMENT. 
 
 There is no class of remedies more efficacious in skin 
 diseases, than the preparations of the Juglans cinerea ; 
 and the most efficient of these is the Juglandin. This 
 should be used in connection with bi tartrate of potassa, in 
 sufficient quantities to produce a mild purgative effect. 
 The best preparation of that kind is the following : 
 
 R Juglandin gr. xxx. 
 
 Cream of Tartar gr. xxx. 
 
 Pulv. Cubebs gr. xx. 
 
240 ITCH. 
 
 Mix, triturate, and divide into twenty powders, and give 
 one every morning and evening. 
 
 The above may be given in connection with, or alter- 
 nated with antiscrofulous syrup; or Iodide of Potassium. 
 In some cases, iron and antiperiodics will be required. 
 The external applications should be tar ointment, nitro- 
 muriatic acid, zinc ointment, ointment of Baptism, acetic 
 Tinct. of Bloodroot, astringent washes, slippery elm poul- 
 tices, and Collodion. These different remedies may be 
 used as the nature and character of the disease seem to 
 indicate. In the active stage, the preparations of zinc 
 are the best adapted to remove the disease, while the 
 others are more efficient in the chronic stages. 
 
 ITCH, OR SCABIES. 
 This disease is caused by minute white insects, the 
 Acarus Scabiei, or Sareoptis hominis, which insinuate 
 themselves beneath the cuticle, and travel over the differ- 
 ent portions of the rete mucosum. It is said that these 
 insects travel in pairs — male and female — and that the 
 female is very much smaller. By the aid of the micro- 
 scope, they are observed to have a large number of bristles 
 upon the head or proboscis. When they find a soft and 
 moist portion of skin, they burrow beneath a small der- 
 moid scale, and luxuriate until a deposition of a small 
 quantity of serum from the blood warns them, that unless 
 they take their departure, a flood will soon overtake them. 
 But before taking their final leave, the female deposits her 
 eggs at the point of the vesicle ; thus a nidus is formed 
 for the complete development of the acarii. 
 
 SYMPTOMS. 
 
 A vesicular eruption makes its appearance between the 
 fingers, and in other soft portions of the skin, accompanied 
 by an intolerable itching. If the vesicle is opened, a 
 small amount of sero-albuminous matter will escape, and 
 if allowed to dry, will form a light brown scale. 
 
PUSTULOUS CUTANEOUS. 241 
 TREAT MEN T . 
 
 The only remedy necessary in the treatment o;' this 
 disease is sulphur, and the reason why this remedy is 
 not more successful, is the inefficiency of its applica- 
 tion. The entire surface of the patient should first be 
 washed with soap and water ; immediately afterwards, 
 a strong decoction of sulphur should be applied to every 
 portion of the body, and allowed to remain from one-half 
 hour to an hour, when the whole surface should be wiped 
 with a towel, wrung out of strong saleratus water. One 
 application of the sulphur, used as directed above, will 
 generally remove the disease : yet, it is advisable to renew 
 the application several times. The sulphur, on coming in 
 contact with the insect, immediately destroys it, 
 
 PUSTULOUS CUTANEOUS DISEASE. 
 
 All the diseases characterized by pustules, may be cor- 
 rectly classified under the above head. Willan and Bate- 
 man specify four varieties of this form of non-contagious 
 disease, viz : phlyzacium, psydracium, achor, and favus. 
 
 SYMPTOMS. 
 
 A greater or less number of distinct tumefied eruptions, 
 which gradually mature and become filled with a sero- 
 purulent matter, and having an inflamed base. These 
 may appear in small clusters, and disappear in a few days, 
 or they may cover a considerable part of the hands, face, 
 or other portions of the body, and be accompanied with 
 extensive inflammation of the integument, and extending 
 in some instances to the adjacent tissues, terminating in 
 phlegmonoid abscess. Nearly all the forms of tetter come 
 under this class, as do also impetigo and acne. In some 
 cases, there are constitutional symptoms, as fever, quick 
 21 
 
242 PUSTULOUS CUTxlNEOUS. 
 
 pulse, headache, loss of appetite, &c. The causes of this 
 kiud of cutaneous disease, are essentially the same as of 
 the vesicular, but they are more apt to be connected with 
 an impoverished condition of the blood. 
 
 TREATMENT. 
 
 If this disease appears on the head, it is called porrigo, 
 or scald head. The hair should be shaved close to the 
 scalp, and the head must be thoroughly washed with soap 
 and water, after which the zinc and tar ointment must be 
 alternately applied, morning and evening — the zinc in the 
 morning, and the tar in the evening : the patient should 
 likewise take a full dose of the alterative syrup three times 
 a day. This course, if persisted in, will remove the dis- 
 ease. When the eruption appears on other parts of the 
 body, the nitro-muriatic acid should be first applied, and 
 be followed by the Tar ointment. A mild purgative of 
 Juglandin and Cream of Tartar, also simple syrup of 
 Stillingia and Scrophularia, equal parts, should be taken 
 in small quantities during the application of the external 
 remedies. When the pustular eruption is connected with 
 extensive inflammation of the skin, a slippery elm poultice 
 should follow the application of the ointment. Should the 
 disease prove obstinate, equal parts of vegetable caustic 
 and pulverized Sanguinaria, should be sprinkled over the 
 parts before each application of the ointment. If there 
 are constitutional symptoms, they should be treated accord- 
 ing to their nature ; in most cases, iron and vegetable 
 tonics will be required. The diet should be nutritious, 
 and the surface freely bathed once or twice a day. To 
 remove the small pustules which appear on the face, apply 
 a liniment made of equal parts of ammonia and sweet oil. 
 Or, when they first appear, touch them with ammonia, and 
 cover them with Collodion. 
 
PURPURA. * 243 
 
 PURPURA. 
 
 There are several varieties of this disease : as simplex, 
 or petechial scurvy, purpura hemorrhagica, purpura 
 nautica, purpura scarlatina. By the term purpura, we 
 understand a greater or less number of livid spots on the 
 skin from extravasated blood. In purpura simplex, the 
 effusion is confined to the skin and cellular tissue, mostly 
 occurring on the arms, legs, and breasts. The spots at 
 first are small, resembling flea-bites, and are frequently 
 very numerous. The countenance is pale, and the patient 
 complains of great debility, loss of appetite, irregularity 
 of the bowels, and periodic fever. If the disease is al- 
 lowed to progress, it will terminate in what is called pur- 
 pura hemorrhagica, and is described by Dr. Bateman as 
 follows : 
 
 "The petechias are often of a large size, and are inter- 
 spersed with vibices, echymoses, or livid stripes and 
 patches, resembling the marks left by the strokes of a 
 whip, or violent bruises. They commonly appear first on 
 the legs, and at uncertain periods afterwards, on the 
 thighs, arms, and trunk of the body ; the hands being 
 more rarely spotted with them, and the face generally free. 
 They are usually of a bright red color when they first 
 appear, but soon become purple or livid ; and when about 
 to disappear, they change to a brown or yellowish hue ; 
 so that, as new eruptions arise, and the absorption of the 
 old ones slowly proceeds, this variety of colors is com- 
 monly seen in the different spots at the same time. The 
 cuticle over them appears smooth and "shining, but it is 
 not sensibly elevated ; in a few cases, however, the cuticle 
 has been seen raised into a sort of vesicles, containing 
 black blood. This more frequently happens in the spots, 
 which appear on the tongue, gums, palate, and inside of 
 the cheeks and lips, where the cuticle is extremely thin, 
 
244 * PURPURA. 
 
 and breaks from the slightest force, discharging the effused 
 blood. The gentlest pressure on the skin, even such as is 
 applied in feeling the pulse, will often produce a purple 
 blotch, like that which is left after a severe bruise. The 
 same state of the system which gives rise to these effusions 
 under the cuticle, produces likewise copious discharges of 
 blood, especially from the internal parts, which are de- 
 fended by more delicate coverings. These hemorrhages 
 are often very profuse and not easily restrained, and there- 
 fore sometimes prove suddenly fatal ; but in other cases, 
 they are less copious ; sometimes returning every day at 
 stated periods, and sometimes less frequently, and at 
 irregular intervals ; and sometimes there is a slow and 
 almost incessant oozing of blood. The bleeding occurs 
 from the gums, nostrils, throat, inside of the cheeks, 
 tongue, lips, and sometimes from the lining membrane of 
 the eyelids, the urethra and the external ear ; and also 
 from the internal cavities of the lungs, stomach, bowels, 
 uterus, kidneys, and bladder. There is the greatest 
 variety, however, in different instances as to the period of 
 the disease, in which the haemorrhages commence and 
 cease, and as to the proportion which they bear to the 
 cutaneous efflorescence. 
 
 "This singular disease is often preceded, for some 
 weeks, by great lassitude, faintness, and pains in the 
 limbs, which render the patient incapable of any exertion ; 
 but, not unfrequently, it appears suddenly in the midst of 
 apparent good health. It is* always accompanied by 
 great debility and depression of spirits ; the pulse is some- 
 times quickened ; and heat, flushing, perspiration, and 
 other symptoms of febrile irritation, recurring like the 
 paroxysms of hectic, occasionally attend. In some 
 patients, deep-seated pains have been felt about the pre- 
 cordia, and in the chest, loins, and abdomen ; and in 
 others, a considerable cough has accompanied the com- 
 
PURPURA. 245 
 
 plaint, or a tumor and tension of the epigastrium, right 
 or left hypochondrium, with tenderness on pressure, and a 
 constipated, or irregular state of the bowels. Bat in 
 many cases, no febrile appearances have been noticed ; and 
 the functions of the intestines are often natural. In a 
 few cases, frequent syncope has occurred. When the dis- 
 ease has continued for some time, the patient becomes 
 sallow, or of a dirty complexion, with much emaciation, 
 and some degree of oedema appears in the lower extremi- 
 ties, which afterwards extends to other parts. The disease 
 is extremely uncertain in its duration ; in some instances 
 it has terminated in a few days, while in others it has con- 
 tinued not only for many months, but even for years." 
 
 When the disease runs a rapid course and terminates in 
 death, it is generally dependent upon the occurrence of 
 hemorrhage into some of the vital organs. Such is the 
 disposition to hemorrhage in this stage of the disease, that 
 although a patient may appear convalescent on retiring to 
 bed in the evening, he may be suddenly seized with violent 
 dyspnoea and orthopnoea, which rapidly increases until 
 death ensues by asphyxia. In such a case, there has been 
 a sudden effusion of blood into the pulmonary tissue, pro- 
 ducing pulmonary apoplexy. 
 
 Or there may be acute haemoptysis, caused by the escape 
 of blood into the air passages. In this event, the hemor- 
 rhage may be controlled, and the patient recover under 
 proper treatment. The hemorrhage may occur in other 
 organs, as the brain, producing apoplexy and death ; or, 
 into the cavities of the chest and abdomen. It also 
 occurs into the cellular tissue, producing extensive eeclrv- 
 niosis, inflammation, gangrene, and death ; or the purple 
 spot will gradually assume a yellow appearance, absorp- 
 tion of the effused blood occur, and the patient recover. 
 
 In purpura nautica, the purple spot mostly occurs at 
 the roots of the hair, on the gums, and mucous membrane 
 21* 
 
246 PURPURA. 
 
 of the mouth and pharynx. In this form of the disease, 
 the gums become spongy and bleed upon the slightest 
 injury, the teeth become loose, and frequently fall from the 
 gums : there is great debility, a sallow countenance, ir- 
 regular sleep, and night-sweats, followed by fever ; the 
 bowels are irritable, and there is mselena. This latter 
 form of it, Prof. J. GL Jones has treated as a separate 
 disease, under the head of Scurvy or Scorbutus ; and con- 
 siders it the same as various writers have described as sea- 
 scurvy : although he does not favor the opinion, at one 
 time very prevalent, that salt water causes the disease ; but 
 states, that the cause is generally more of a positive 
 than a negative character, being the want of such articles 
 of food as furnish the system through the medium of the 
 blood, with certain elements indispensable to life and 
 health. He is of the opinion that these deficiencies con- 
 sist in the lack of vegetable acids. 
 
 On comparing the description of scurvy by Prof. Jones, 
 Mcintosh, Bateman, and others, with purpura, as it is 
 described by various individuals, the only difference be- 
 tween what is known as sea-scurvy, and purpura, is the 
 circumstances under which it makes its appearance ; both 
 evidently depend upon the same pathological condition of 
 the system. 
 
 CAUSE. 
 
 The causes of the different varieties of this disease, 
 seem to depend upon a deficiency of vegetable aliment, 
 and long exposure to a damp atmosphere ; also, a lack of 
 due exercise, an unwholesome diet, and anything which 
 tends to an impoverished state of the blood. The influ- 
 ence of improper diet, in developing purpura, has been 
 remarkably exemplified within the past year. Owing to 
 the failure of fruit, as well as the potato crop and other 
 vegetables, bread, butter, and meats have been the princi- 
 pal articles of diet ; and purpura, which was hardly known 
 
PURPURA, 247 
 
 in the country, has become a prevalent disease. So 
 much so, that the most trifling complaints are attended 
 frequently by active hemorrhage. On examining the 
 blood, it is found to be deficient in fibrine, but feebly 
 disposed to coagulate, and very abundant in serum. 
 
 TREAT 31 E NT. 
 
 When the disease first makes its appearance in the 
 simple form, little more is necessary than a liberal diet of 
 fresh vegetables, with out-door exercise, and a small 
 amount of Muriated Tinct. of Iron, say from five to ten 
 drops three times a day. "Where the disease assumes a 
 hemorrhagic character, the following may be given : 
 
 U Quinine gr. xv. 
 
 Citrate of Iron gr. xxx. 
 
 Capsicum gr. xx. 
 
 Mix, triturate, divide into eleven, powders, and take one 
 every three hours. The patient should at 'the same time 
 make a free use of lemonade, and take a free diet of green 
 vegetables, salt meats, eggs, &c. After the powders are 
 all taken, the following mixture should be given : 
 
 R Port Wine Oj. 
 
 Phosphate of Lime , gss. 
 
 Carbonate of Iron giij. 
 
 Mix, shake well, and take one tablespoonful, three or four 
 times a day. If effusion has occurred into the cellular 
 tissue of one of the limbs, it should be carefully ban- 
 daged, and kept constantly wet in a strong liniment of 
 camphor, whiskey, and spirits of turpentine. The bowels 
 should be moved once or twice a week, by the use of 
 Antibilious physic and Cream of Tartar. The body 
 should be frequently bathed in warm or cold water as 
 indicated. 
 
 Should hemorrhage occur into the bowels, lungs, or any 
 other organ, the oil of Erigeron may be given in five or 
 
248 RETENTION OF URINE. 
 
 six drop doses every half hour. If there should be me- 
 laena, and the oil of Erigeron should fail to arrest it, the 
 nitrate of silver pill may be given as directed under the 
 head of typhoid fever. Or from five to ten grains of 
 Matico, may be given every fifteen or twenty minutes, 
 until* the hemorrhage ceases. If there is much debility, 
 porter, ale, or brandy, should be given in such quantities 
 as the nature of the case may indicate. The patient 
 should avoid all active exercise, and exposure to a damp, 
 moist atmosphere ; let him repeat the Quinine and Iron 
 from time to time, until the disease is removed. 
 
 ISCHURIA, RETENTION OP URINE. 
 
 In this disease, the urine, accumulated in the bladder, 
 cannot be evacuated without extreme difficulty, or without 
 assistance ; when it cannot be evacuated without assist- 
 ance, the retention is said to be complete ; and when it is 
 evacuated without assistance, but with great difficulty, it 
 is said to be incomplete. 
 
 CAUSES. 
 
 The causes of retention of urine are various ; as in- 
 flammation of the bladder, small stones or gravel lodging 
 in the urinary passages, hard faeces lying in the rectum, 
 pregnancy, stricture of the neck of the bladder, swelling 
 of the hemorrhoidal veins, paralysis of the bladder, pro- 
 lapsus uteri, inflammation of the mucous surface of the 
 urethra ; it also occurs in female hysteria, and from in- 
 flammation of the meatus urinarius. 
 
 SYMPTOMS. 
 
 When the bladder becomes abnormally distended with 
 urine, there will be a dull pain in the back, with sharp 
 lancinating pains passing through the bladder. As the 
 
RETENTION OF URINE. 249 
 
 accumulation of urine goes on, the pain increases until it 
 becomes excruciating, the arterial system is much excited, 
 and the pulse beats with increased frequency, rising to 100 
 or 140 beats per minute. The respiration is hurried, and 
 the skin hot and dry. If the uric acid is allowed to be 
 absorbed into the blood, the brain will sympathize with 
 the other constitutional symptoms, producing delirium, 
 and as I have seen in several eases, clonic spasms. Unless 
 the bladder is evacuated, it will become perforated, pro- 
 ducing death ; or death may occur as the result of zymotic 
 influence upon the blood and nerves. 
 
 T R E A T M E N T . 
 
 When the retention is dependent upon inflammation of 
 the bladder, kidneys, or urethra, the bladder should first 
 be evacuated by means of a catheter ; after which the 
 disease should be treated, as directed under the head of 
 inflammation of these parts. If it depends upon a stric- 
 ture, it can generally be overcome by injecting into the 
 urethra, a solution of the extract of Belladonna or Gel- 
 seminum : 
 
 R Extract of Belladonna , gr. x. 
 
 Warm "Water -iij. 
 
 Dissolve the extract in the water, and inject one third into 
 the urethra. If this is not soon followed by relief, it may 
 be repeated every fifteen or twenty minutes. If, in a 
 reasonable time, relief is not effected, the Ext. Gelseminum 
 be used in the same manner. In my hands this treat- 
 ment in strictures of the urethra has proved efficacious in 
 a large number of eases. TVhere the disease is occasioned 
 by a gravelly deposit in the bladder, 
 
 U Ext. Eupurpurin gr. xxx. 
 
 Cre;vm of Tartar 3J. 
 
 Apocynin gr. xx. 
 
250 INCONTINENCE OF URINE. 
 
 Mix, triturate ; divide into ten powders, and give one 
 three times a day in one teaspoonful of Syrup of Iodide of 
 Potassium ; the hypogastric and lumbar regions should be 
 bathed every morning and evening in equal parts of sweet 
 oil and spirits of turpentine. Where there is pressure on 
 the neck of the bladder, by faeces lying in the rectum, by 
 pregnancy, or other cause, it should be removed. And 
 then, by the use of Marshmallow, Clivers or flaxseed tea, 
 a cure may be effected. In females, where it is dependent 
 upon irritation of the meatus urinarius, a warm elm poul- 
 tice, applied to the vulva, and melon-seed tea, will gene- 
 rally effect a cure. If there should be debility of the 
 bladder, with a tendency to paralysis, tonics, combined 
 with Iron, should be used, and the nerves of the back 
 gently stimulated by the application of the electro-magnetic 
 current once or twice a day. During the treatment of 
 retention of urine, whatever the cause may be, the bladder 
 should be evacuated every day by the use of the catheter. 
 
 ENURESIS, INCONTINENCE OP URINE. 
 
 Incontinence of urine, like retention, is often associated 
 with some constitutional weakness. In advanced life it is 
 usually associated with disease of the neck of the bladder, 
 prostate gland, or with paralysis. Incontinence of urine, 
 in children, mostly occurs in the night only, while asleep ; 
 and, not unfrequently, in these cases the urine passes off 
 involuntarily under the influence of a dream. 
 
 It is said that in such cases the acid property of the 
 urine is the exciting cause, and that there is a strong ten- 
 dency to gravelly deposits. In young people, where the 
 urine passes off in the night involuntarily, it is usually 
 retained, at any time, with much difficulty, and will be of 
 a very pale color, and far less serous than is natural. In 
 
HEMATURIA. 251 
 
 old people, this difficulty arises from paralysis, produced 
 by injuries of the spine, or over-distension of the bladder, 
 injuries of the neck of the bladder, &c. 
 
 TREATMENT. 
 
 In children, where the disease depends upon a changed 
 condition of the urine, the diet should be well regulated, 
 and warm or cold baths given three or four times a week. 
 A syrup of equal parts of Hydrastus Canadensis and 
 Aletris Farinosa should be given in teaspoonful closes 
 three times a day. Where it depends upon spinal irrita- 
 tion, the irritating plaster should be applied to the spine, 
 and from five to ten drops of the oil of Erigeron given 
 three times a day, with a free use of cold baths and 
 friction. 
 
 If the bladder is in an irritable state, give the following : 
 
 R Dwarf Elder gj. 
 
 Indian Hemp ^ij. 
 
 Marslimallows gj. 
 
 Make one pint of syrup, and add one half pint of gin. 
 Dose, one teaspoonful three times a day. If there is an 
 enlarged condition of the prostate gland, one drachm of 
 Iodide of Potassium should be added to the syrup, and 
 the same quantity taken. 
 
 HEMATURIA, OR HEMORRHAGE FROM THE 
 TJRIXARY ORGANS. 
 
 This frequently occurs, in certain epidemics of the 
 malignant type, as in cholera and severe remittent and 
 typhoid fever, in which the spleen and liver are implicated ; 
 also in Purpura, Scurvy, and all diseases in which the 
 blood is in an impoverished state. The exciting cause of 
 hematuria may be of a mechanical nature, that is, a cal- 
 
252 URINARY HEMORRHAGE. 
 
 cuius concretion ; or it may be from ulcerations of the 
 bladder, kidneys, or their appendages. When the hemor- 
 rhage cannot be traced to some constitutional disturbance, 
 it may be considered directly mechanical. This may 
 depend upon a calculus, either causing irritation or wound- 
 ing some blood-vessel ; or the hemorrhage may occur from 
 ulceration of the bladder, by the irritating effect of the 
 urine itself. 
 
 DIAGNOSIS. 
 
 When the patient is laboring under no .constitutional 
 disease, that is usually accompanied by hemorrhage, or has 
 not been afflicted with calculous affections, if he complains 
 of pain in the urinary organs, and voids blood with the 
 urine, mixed with mucus, and especially if mixed with 
 purulent matter, a breach of surface must exist somewhere 
 in the urinary apparatus. Having ascertained the cause 
 of the hemorrhage, its seat should be sought for. When 
 there are sharp twisting pains along the line of the ureter, 
 darting to the urethra and testicles, accompanied with 
 nausea and vomiting, it may be reasonably supposed that 
 it depends upon the presence of calculus in the ureter or 
 kidneys. On the other hand, when the hemorrhage comes 
 on after exercise, and there is occasional retention, accom- 
 panied by a twinging pain in the penis, there can be but 
 little doubt that the hemorrhage is caused by stone in the 
 bladder. Where the hemorrhage is from the kidneys, the 
 first urine that flows is generally clear, the blood mostly 
 passing at the close of micturition. 
 
 T REAT ME N T . 
 
 The treatment of hsematuria will depend upon the 
 cause, the degree and locality, 
 
 Where the disease is dependent upon scurvy or purpura, 
 it should be treated as directed under that head, with the 
 addition of astringents, such as an injection of a weak 
 
URINARY HEMORRHAGE. 253 
 
 solution of Matico into the bladder, and the oil of Erigerop 
 taken internally. If occurring as melama, the effect of 
 obstruction of the liver and spleen, give the following : 
 
 R Muriated Tinct. of Iron gij. 
 
 Quinine gr. xx. 
 
 Water giij 
 
 Mix, and give one tablespoonful every four or five hours 
 until the active stage of the disease is passed. After which, 
 the following mixture : 
 
 R Gin Oj. 
 
 Sugar lbj. 
 
 Water Oj. 
 
 Aletrin gj. 
 
 Euonymine 31J. 
 
 Mix, and give one tablespoonful three or four times a day. 
 The region of the liver and spleen should be bathed two or 
 three times a day in a liniment composed of sweet oil and 
 spirits of turpentine. Where haematuria is connected with 
 a gouty diathesis, a free purgative of Podophyllin and 
 Cream of Tartar may be given in the commencement of 
 the treatment, followed by full doses of the oil of Erigeron, 
 until the hemorrhage ceases. After which, nitro -muriatic 
 acid and Euonymine should be given. If calculus in the 
 kidneys is the cause of the disease, a strong decoction of 
 the Queen of the Meadow will dislodge it and arrest the 
 hemorrhage ; after which, mucilaginous diuretics should 
 be given, such as marshmallow, flaxseed, &c. "When the 
 cause of haematuria is seated in the bladder, it should be 
 injected first with warm water, afterwards with a strong 
 solution of Matico mixed with starch-water. The back 
 and loins being thoroughly bathed with a liniment pre- 
 pared as follows : 
 
 R Oil of Capsicum gtt. x. 
 
 Alcohol Oss. 
 
 Oil of Origanum ,, £iij. 
 
 22 
 
254 UTERINE CONGESTION. 
 
 Mix, and use as heretofore directed. If there is mu h 
 inflammation of the bladder, scarify and cup over that re- 
 gion, and apply hot packs. At the same time give Aco- 
 nite or Yeratrum until the symptoms are controlled. If the 
 bladder should become distended with a large amount of 
 coagulated blood, recourse must be had to a large-sized 
 catheter; and by the aid of an exhausting syringe and an 
 occasional injection of the bladder with cold water, the 
 coagula may be removed. Should the hemorrhage become 
 active while thus evacuating the bladder, it may be arrested 
 by injecting a solution of Matico into the rectum. 
 
 CONGESTION AND INFLAMMATION OF THE 
 UTERUS. 
 
 This disease is but imperfectly understood; and more 
 frequently than otherwise passes unobserved both by the 
 patient and her medical attendant. In a great majority 
 of cases it is treated by physicians as prolapsus uteri, ame- 
 norrhea, dysmenorrhea, menorrhagia, or leucorrhaea ; the 
 primary cause of the disease is overlooked, and the symp- 
 toms only receive attention. Hence it is that but little if 
 any benefit is derived from the ordinary course of medica- 
 tion in this class of cases. 
 
 The hydropathists have acquired some reputation for 
 treating this class of cases, and in many instances they have 
 had superior success. Their success, however, is not de- 
 pendent upon a more extensive knowledge of the affections 
 so much as the remedy upon which they rely being better 
 adapted to relieve this peculiar pathological condition 
 of the uterus, than the remedies generally- used for this 
 purpose. 
 
 Congestion of the uterus, like congestion of other organs, 
 is a disease of frequent occurrence, and is caused by the 
 
UTERINE CONGESTION, 25o 
 
 accumulation of blood in the veins and capillaries. The 
 congestion is generally combined with infiltration into the 
 cellular tissue of the uterus, producing oedema of the ute- 
 rus, and in some cases the oedema is very considerable. 
 
 SYMPTOMS, 
 
 On making a vaginal examination of the uterus, a com- 
 plete congested appearance is manifest. The uterus is 
 enlarged and vesicular, and in places the veins have a 
 varicose appearance. In the incipient congestion of the 
 uterus the appearance very much resembles that of early 
 pregnancy. The uterus is tender upon pressure, and if the 
 disease is of long standing, the broad ligaments and vagina 
 also present a similar congested condition. In other cases 
 there is excoriating granulations, or ulceration of the neck 
 of the uterus and its lining membrane. Congestion of the 
 uterus, like the congestion of other similar tissues, is fol- 
 lowed by pathological changes, such as an increased afflux 
 of blood to the part ; a loaded condition of the capillaries, 
 the blood circulating with less and less force until it finally 
 ceases, and a complete barrier is formed to the further cir- 
 culation of blood in the part. At this stage inflammation 
 is said to commence. But where congestion assumes a 
 chronic form, as it mostly does in the uterus, the vessels, 
 after having been thus distended for some time, contract 
 upon their own contents, forcing the more fluid portions 
 of the blood out of the vessel into the adjacent areolar and 
 cellular tissues ; and in this way the parenchyma of the 
 uterus becomes extensively infiltrated with the fluid portion 
 of the blood. Where the congestion extends to the vagina 
 and inner membrane of the uterus, a similar exosmosis 
 occurs from the congested capillaries of the parts ; instead 
 of being retained in the parenchyma, it escapes into the 
 cavity of the uterus and vagina, mixing with the mucus, 
 and thus constituting what is known as the whites. In case 
 
256 UTERINE CONGESTION. 
 
 the blood is anaemic, and the patient of a scrofulous cachexia, 
 the salts of the blood held in solution will make their escape 
 with the serum, and, mingling with mucus, cause a muco- 
 purulent or muco-serous discharge. If there is abrasion 
 of the uterus or its appendages, the sanious secretion from 
 the ulcer, mixed with the disintegrated tissues of the parts, 
 often renders the discharge not only offensive but exceed- 
 ingly irritating, denuding the vagina of its mucous surface 
 and inducing either an acute or chronic inflammation. The 
 constitutional symptoms are a sense of weakness, weight, 
 or pain in the back ; the patient complains of nervousness, 
 pains in the head and shoulders, often changing to different 
 parts of the body. The functions of the stomach and 
 bowels become deranged ; the countenance is sallow, and 
 the skin has a dry and husky appearance ; the lips lose 
 their color, and the eyes their natural brilliancy; the feet 
 and hands are mostly cold, although in some cases, and 
 in some portions of the day, they are hot and burning. 
 The menses are mostly irregular either in quantity, quality, 
 or time of occurrence. I have observed all these symptoms 
 in connection with congestion of the uterus. If the disease 
 is allowed to advance, palpitation of the heart will occur, 
 with cough, bronchial irritation and expectoration of mu- 
 cus. At this stage of the disease, the increased weight of 
 the uterus, together with the relaxed condition of the mus- 
 cular tissue, causes the uterus to gravitate into the pelvis, 
 resulting in what is usually known as prolapsus uteri. The 
 lower floor of the abdominal cavity thus giving way, ena- 
 bles the whole contents of the abdomen and thorax to settle 
 from their normal position. The bowels, stomach, liver, 
 spleen, heart, and lungs, all being thus displaced, put the 
 pneumogastric nerve and upper portion of the lung upon 
 a stretch, producing a constant irritation and materially 
 increasing the cough, which before was considerable. If 
 this condition of things is allowed to continue, the blood 
 
UTERINE CONGESTION. 25T 
 
 soon becomes impoverished, owing to a defective appetite, 
 irregular respiration and leucorrhaea, and a tuberculous 
 deposition occurs in the lungs. In cases where the uterus 
 has become impregnated, the symptoms frequently somewhat 
 abate, although in several cases I have known them to be 
 very much aggravated, and maintain an uncommon obsti- 
 nacy during the entire stage of gestation. Where the ute- 
 rus remains thus congested during pregnancy, the disease 
 is very liable to terminate in inflammation immediately after 
 delivery, proving very obstinate, and, unless properly 
 treated, disastrous to the patient. In these cases there is 
 acute pain just above the pubes, quick pulse, hot skin, and 
 retention of urine, either partial or complete. The tongue 
 will soon be covered with a dark brown coat, and many 
 times there are convulsions. The bowels are constipated, 
 and in many cases there is nausea and vomiting. 
 
 If the disease is not controlled, delirium, coma, and 
 death ensue. The inflammation may be less acute, ex- 
 tending to the peritoneum, causing a tympanitic condition 
 of the bowels, suppression of the lochia and milk, with 
 violent fever. There are other points of great interest 
 connected with this form of uterine derangement, which 
 the limits of this work will not allow me to consider. 
 
 CAUSES. 
 
 There are a variety of causes which may produce this 
 condition of the uterus ; such as the frequent use of era- 
 menagogues, which contain mercury, exposure of the 
 feet to the damp and cold earth by wearing thin shoes ; 
 the practice of dressing in such a manner as to compress 
 the waist, thus preventing the return of the venous blood 
 to the heart by the superficial veins, also obstructing the 
 capillary circulation ; hence the blood is forced through 
 the deep capillaries, inducing congestion of the uterus. It 
 may also be caused by repeated abortions, by excessive 
 
258 UTERINE CONGESTION. 
 
 venery, by cold and exposure ; in short, anything which 
 will induce it in any of the internal viscera, will produce 
 it in the uterus. 
 
 TREATMENT. 
 
 In commencing the treatment of this disease, the cause 
 should be constantly kept in view, and as far as possible 
 be removed. To remove the congestion, a plaster should 
 be applied to the abdomen over the uterus, composed of 
 the following materials : 
 
 1J Gum Galbannm gij. 
 
 White Pine Gum , t ^j. 
 
 White Wax gjss. 
 
 Melt the gums and wax together, add one drachm of 
 pulverized blood-root, and stir until it becomes thickened ; 
 spread a coat of it upon a thin piece of leather, large 
 enough to cover the uterus, and apply. It should be 
 renewed from time to time until relief is effected. At the 
 same time, give the following compound : 
 
 U Gelsemin gr. ij. 
 
 Bebeerine.... gr. xxx. 
 
 Caulophyllin gr. x. 
 
 White Sugar gr. xxx. 
 
 Mix, triturate, divide into twelve powders, and give one 
 every six hours. During the administration of these 
 powders, vaginal injections of the cold infusion of Cin- 
 chona should be used two or three times a day. During . 
 the early part of the treatment, a thorough hand-bath 
 should be taken every morning as indicated ; also an oc- 
 casional sitz bath. The above treatment should be pur- 
 sued for ten or fifteen days ; the following may then be 
 substituted : 
 
 R Carbonate of Iron gj. 
 
 Pulv. Queen of the Meadow ,|ij. 
 
 Cream of Tartar gj. 
 

 UTERINE CONGESTION. 259 
 
 Port Wine Oj. 
 
 Sugar lbj. 
 
 Gin Oj. 
 
 Dose, one tablespoonful three times a day. At the same 
 time: 
 
 R Fol. Jugland Regice, or Fresh Walnut leaves. 3 v j- 
 Port Wine Oj. 
 
 Make a Tincture, and use a syringe full, as vaginal injec- 
 tion, once or twice a day. The plaster should be removed, 
 and a wet girdle worn around the lower portion of the 
 abdomen and back. During the entire course of treat- 
 ment, the bowels should be regulated by the use of neu- 
 tralizing mixture. If any of the symptoms, described as 
 dependent upon this disease, should remain after using the 
 above remedies for a reasonable length of time : 
 
 U Macrotin * gr. xx. 
 
 Senecin gr. x. 
 
 Capsicum . gr, xx. 
 
 Vallet's Ferruginous Mass gj. 
 
 Mix, and form a mass. Make three-grain pills, and let 
 one be taken three times a day, alone, or in connection 
 with other medicines as indicated. If there should be 
 ulcers upon the vagina or uterus, the speculum should be 
 introduced, and the vegetable caustic be applied, after 
 which the ulcer should be covered with powdered slippery 
 elm. Much care will be required in making this applica- 
 tion, to prevent the caustic from coming in contact with 
 parts not diseased. If there should be a scrofulous dia- 
 thesis, connected with this disease, Stillingia and Iodide 
 of Potassium may be used in connection with the other 
 remedies. The diet in any case should be free and nutri- 
 tious. In case the congestion should terminate in a latent 
 form of inflammation, Muriated Tinct. of Iron, Yeratrum, 
 Cinchonine, and Cornine, in connection with the local 
 applications, as directed under the head of congestion. 
 
260 CESSATION OF THE MENSES. 
 
 Where active inflammation ensues, a full cathartic of 
 Podophyllin and Cream of Tartar should be given in the 
 commencement, followed by cold packs to the bowels, and 
 full doses of Muriated Tinct. of Iron and Quinine. If 
 convulsions are connected with the inflammation, Gelse- 
 min, Lobelin, and Belladonna, should be used in sufficient 
 quantities until that symptom is relieved. During the 
 inflammatory stage, the patient must be kept quiet, but 
 in the congestive form of the disease, moderate exercise 
 should be taken. 
 
 CESSATION OF THE MENSES. 
 
 At the period of life when the menses should cease, the 
 discharge usually becomes irregular; sometimes being 
 obstructed for two or three months or more. Among 
 the symptoms of this period, are nausea and vomiting, 
 swelling of the abdomen, tenderness of the breasts, &c. 
 These symptoms are frequently mistaken for pregnancy ; 
 connected with the above, there are frequently uterine 
 pains, with dragging sensation in the back and loins ; at 
 times there is fever, accompanied by violent headache, a 
 fall, strong pulse, a loaded tongue, and symptoms of indi- 
 gestion. The nervous system generally sympathizes with 
 the other affections, causing nervous headache, neuralgic 
 pains; periodic diarrhoea, and costiveness. These symp- 
 toms may all be mitigated by a sudden return of the 
 menses, which may last much longer than is natural, and 
 also be more profuse ; upon their cessation they may 
 again return in an aggravated form. 
 
 This period in female life is truly designated the critical 
 period ; and, although this is necessarily the case, owing 
 to the important physiological changes which occur at this 
 time, yet it is frequently made much more so, from the 
 abuse of quack medicines. 
 
CESSATION OF THE MENSES, 261 
 
 TREATMENT. 
 
 When the symptoms are slight, but little more will be 
 necessary than to regulate the bowels and diet, bathe the 
 surface, and occasionally to wear a pack on the lower 
 portion of the bowels, wet with equal parts of water and 
 whiskey ; but, where the symptoms are severe, in addition 
 to this, a purgative of anti-bilious physic should be taken 
 and afterward the following compound : 
 
 R Aletrin gr. xxx. 
 
 Cypriped.in gr. xx. 
 
 Pterin gr. xxx. 
 
 Carbonate of Iron. gr. xxx. 
 
 White Sugar , giij. 
 
 Mix, and add to one pint of Port-wine. Dose, .one table- 
 spoonful three times a day. Also, 
 
 U Irisin.... gr. xxx. 
 
 Hyoscianrin. gr. v. 
 
 Podophyllin gr. ij. 
 
 Extract of Dandelion sufficient to make thirty pills. Let 
 one be taken night and morning. 
 
 If neuralgic pains should occur, 
 
 U Belladonna gr. j. 
 
 Quinine gr. xv. 
 
 "White Sugar gr. xx. 
 
 Mix, triturate, divide into eight powders, and take one 
 three times a day. Constitutional symptoms of every va- 
 riety manifesting themselves during the period, should be 
 met with such remedies as are indicated. 
 
262 DISEASES OF THE OVARIES. 
 
 DISEASES OF THE OTAEIES. 
 
 The ovaries are subject to a number of diseases, as 
 dropsy, sarcoma, hypertrophy, atrophy, &c. Among the 
 most common is dropsy ; hence, I shall confine this article 
 mostly to that disease. 
 
 SYMPTOMS. 
 
 A slight fugitive pain will be felt in the region of the 
 ovaries. The ovary will be found to be larger on one 
 side than on the other. This tumor, which is but very 
 small at first, gradually increases in size, until it finally 
 presses upon the uterus and vagina, causing uterine and 
 vaginal irritation, difficult micturition, and prolapsus ani. 
 On examination, the tumor may be felt between the vagina 
 and rectum. This is particularly the case before it becomes 
 very much enlarged. Sometimes this tumor ascends into 
 the cavity of the abdomen, and presents very much the 
 appearance of the gravid uterus. The tumor may gradually 
 increase until it becomes of an enormous size. 
 
 A specimen is now in the museum of the Eclectic Col- 
 lege of Pennsylvania, of a tumor which grew to such an 
 enormous size as to contain over three gallons of fluid. 
 In some instances, the fluid becomes spontaneously ab- 
 sorbed. This occurred in a case which came under my 
 observation, where the ovarian cyst was of a size sufficient 
 to hold a gallon. 
 
 In other cases, inflammation occurs in the cyst, which 
 may produce death. Sometimes the cyst adheres to the 
 parietes of the abdomen, to the bowels, or vagina ; in this 
 event, occasionally, a fistulous opening occurs, and the 
 fluid makes its escape ; but as the internal membrane of 
 the cyst is so organized as to constantly secrete this gela- 
 tinous fluid, a discharge will be maintained until death 
 ensues from exhaustion. 
 
DISEASES OF THE OVARIES. 263 
 
 TREAT 31 ENT. 
 
 I do not propose to speak of the surgical treatment of 
 this disease, but to confine my remarks entirely to that 
 form of medical treatment which has proved successful in 
 my hands in removing the disease in its early stage. 
 
 In the commencement, a pad should be placed over the 
 tumor, kept in its place and caused to make gentle pres- 
 sure upon it, by a bandage passing around the body. The 
 pad should be vet with the Tinct. of Iodine before ap- 
 plying it, and afterwards once or twice a day throughout 
 the entire treatment. The bandage should be so adjusted 
 as to maintain a constant pressure. The patient may also 
 take the following syrup : 
 
 U Syrup of Iodide of Iron..... Oss. 
 
 Syrup of Stillingia Oss. 
 
 Dose, one teaspoonful four or five times a day. The 
 bowels should be evacuated once or twice a week with 
 Cream of Tartar and Podophyllin. When this course 
 has been pursued for four or five weeks, substitute the 
 folio whig : 
 
 R Syrup of 3Iarshraallow Oj. 
 
 Iodide of Potassium gij. 
 
 Mix, and give one teaspoonful four times a clay, occasionally 
 using the purgative as before. 
 
 This treatment persisted in, has in my hands proved 
 successful in several cases of ovarian dropsy, and in some 
 where it was considerably advanced. The pressure, in 
 connection with the Iodine, acts as a constant stimulant 
 to the absorbents, and by the alterative effect of the medi- 
 cine, the cyst ceases to secrete the gelatinous fluid. 
 
264 SCROFULA. 
 
 SCROFULA. 
 
 Scrofula, says*Erieksen, is a peculiar constitutional con- 
 dition, either hereditary or acquired, that leads to the 
 formation of, and in its full development is characterized 
 by the presence of tubercle. It is, however, only when 
 fully developed that scrofula gives rise to the local deposit 
 of tuberculous matter. The constitutional condition that 
 tends to this is sufficiently characteristic ; but although we 
 may recognize its existence, and speak of the individual 
 possessing such a constitution, as having a scrofulous 
 tendency or diathesis, he can scarcely be considered to 
 labor under the fully formed disease, unless tubercle be 
 deposited in some of the tissues or organs. The scrofu- 
 lous diathesis is a peculiar constitutional state that is 
 often erroneously confounded with general debility. It 
 may and often does co-exist with this, but is by no means 
 synonymous with weakness of constitution. Debility often 
 exists without any scrofulous tendency or taint, more par- 
 ticularly in individuals of the nervous temperament; many 
 delicate people, though weak, being perfectly healthy, and 
 showing no disposition to this peculiar affection ; on the 
 contrary, the scrofulous tendency is often conjoined with 
 much muscular power and mental activity, no weakness 
 being manifested in either of these respects. Scrofula is 
 invariably conjoined with debility and a perversion of the 
 nutritive functions of the organism. This is especially mani- 
 fested in certain tissues, such as the mucous and cutaneous, 
 and in those organs the vitality of which is low, as the 
 lymphatic glands, the bones and joints. In these, scrofula 
 is especially apt to influence the products of nutrition and 
 of inflammation, more particularly during the earlier 
 periods of life, when these actions are most energetic, in 
 such a way as to render its existence evident to the sur- 
 geon. It is this tendency to the occurrence of particular 
 
SCROFULA. 265 
 
 diseases, and to the engrafting of special characters on 
 affections of certain tissues, that may be considered as 
 specially indicative of the scrofulous diathesis, of that 
 condition which, in its fulness of development, gives rise 
 to deposits of tubercle in the organs and tissues. 
 
 The existence of this diathesis is marked by the presence 
 of a peculiar temperament, — by special modifications 
 of the seat, form, and products of inflammation, and, lastly, 
 by the development of tubercle. 
 
 The scrofulous temperament assumes two distinct forms, 
 and each of these presents two varieties. The most com- 
 mon, is that which occurs in persons with fair, soft, and 
 transparent skin, having clear blue eyes, with large pupils, 
 light hair, tapering fingers, and clear white teeth ; indeed, 
 whose beauty is often striking, especially in early life, being 
 dependent rather on roundness of outline, then grace of 
 form ; and whose growth is rapid and precocious. In 
 these individuals the affections are strong, and the pro- 
 creative powers considerable; the mental activity is great, 
 and is usually characterized by much delicacy and softness 
 of feeling, and vivacity of intellect. Indeed, it would ap- 
 pear that the nutritive, procreative, and mental powers 
 are rapidly and energetically developed in early life, but 
 become proportionably and prematurely exhausted. In 
 another variety of the fair scrofulous temperament, we find 
 a coarse skin, short and rounded features, light grey eyes, 
 crisp and curling sandy hair, a short and somewhat ungainly 
 stature, and clubbed fingers ; but not uncommonly, as in 
 the former variety, great and early mental activity, and 
 occasionally much muscular strength. 
 
 In the dark form of the scrofulous temperament, we 
 usually find a somewhat heavy, sullen, and forbidding 
 appearance ; a dark, coarse, sallow, greasy-looking skin ; 
 short, thick, and harsh curly hair ; a small stature, but 
 often a degree of torpor or languor of the mental faculties, 
 23 
 
266 SCROFULA. 
 
 though the powers of intellect are sometimes remarkably 
 developed. The other dark strumous temperament is 
 characterized by clear, dark eyes, fine hair, a sallow skin, 
 and by mental and physical organization that pretty closely 
 resembles the first-described variety of the fair strumous 
 diathesis. 
 
 In all these varieties of temperament, the digestive 
 organs will be found to be weak and irritable. This con- 
 dition, which I believe is invariably associated with struma, 
 and the importance of which* has been pointed out by Sir 
 James Clark, must be regarded as one of the most essential 
 conditions connected with scrofula, and as tending greatly 
 to that impairment of nutrition which is so frequent in 
 this state. This gastric irritability is especially charac- 
 terized by the tongue, even in young children, being 
 habitually coated towards the root with a thick white fur, 
 through which elongated papillae project, constituting the 
 pipped or strawberry tongue ; the edges and tip, as well 
 as the lips, being of a bright-red color. This state of the 
 tongue is aggravated by stimulants, high living, and the 
 habitual use of purgatives. In the fair varieties, the 
 bowels are usually somewhat loose ; but in the dark forms 
 of struma, there is a torpid condition of the intestinal 
 canal. In all cases the action of the heart is feeble, the 
 blood is thin and watery, and there is a tendency to cold- 
 ness and often to clamminess of the extremities. 
 
 One of the most marked characteristics of struma, is 
 certainly the peculiar modification that inflammation 
 undergoes, whether we regard the course that it takes, the 
 form that it assumes, its products, or its seat. The course 
 of inflammation in strumous subjects is always slow, 
 feeble, and ill-developed, the more active and sthenic con- 
 ditions being rarely met with. In its form, it is either 
 ulcerative, congestive, or suppurative, and in its products 
 it is characterized by little tendency to adhesion, by the 
 
SCROFULA. 267 
 
 production of thin, weak, blue, and ill-developed cica- 
 trices, and by the formation of thin, curdy pus, with much ■ 
 shreddy corpuscular lymph. 
 
 The seat of strumous inflammation varies greatly ; the 
 peculiar modifications of its course, form, and products, are 
 assumed, according to the part that it affects. The tissues 
 implicated by it, are chiefly the skin and mucous mem- 
 branes, the joints, and the bones ; occasioning a great 
 variety of special diseases, according as one or another of 
 these structures is affected. It is as the result of, or in 
 connection with, these local affections, that the general 
 symptoms of struma become most marked. Whatever the 
 temperament may be, the individual becomes emaciated, 
 sallow, cachectic, and debilitated, and at length falls into 
 a state of hectic or marasmus. . 
 
 When affecting the skin, scrofula declares itself under a 
 variety of cutaneous eruptions, especially the different 
 forms of eczema of the scalp, and various ulcers on the 
 surface, usually weak and largely granulating, with con- 
 siderable swelling of surrounding parts, and a tendency to 
 the formation of thin, blue, and glazed cicatrices. 
 
 The mucous membranes are commonly extensively 
 affected, and often present the earlier forms of scrofulous 
 disease in childhood ; this is more especially the case with 
 those of the eyelids and nose. The conjunctiva becomes 
 chronically inflamed, with# perhaps ulceration of the 
 cornea ; the mucous membrane of the eyelids may be 
 permanently congested and irritated, with loss of eyelashes, 
 constituting the different forms of psorophthalmia. The 
 mucous membrane lining the nostrils becomes chronically 
 congested, red, and swollen, giving rise to habitual sniff- 
 ling of the nose, and to a sensation as of a constant cold. 
 Occasionally the lining of the antrum becomes irritated, 
 and may then occasion an enlargement of this cavity, or 
 the discharge of unhealthy pus into the nostrils. The 
 
268 SCROFULA. 
 
 tonsils are often found chronically enlarged and indurated, 
 with occasional tendency to fresh inflammation ; and the 
 larynx may become the seat of various forms of aphonia, 
 dependent on congestion of its lining membrane. The 
 state of the gastro-intestinal mucous membrane, has al- 
 ready been described when speaking of the state of the 
 tongue ; and that of the genito-urinary organs is also 
 marked by a tendency to. debility and irritation, indicated 
 by the occurrence of discharges from the urethra, under 
 the influence of very slight exciting causes, and that are 
 often very permanent in their character. The occurrence 
 of calculus in the bladder, especially in children, may 
 also occasionally be attributed to the scrofulous diathesis. 
 
 Perhaps the most important local diseases arising under 
 the influence of this agency, are those of the bones and 
 joints. The bones are liable to the occurrence of various 
 forms of caries and necrosis ; more especially those that 
 are spongy in their texture, as the short bones of the foot, 
 and the articular ends of the long bones. The joints are 
 liable to that large class of affections that are commonly 
 known as ivhite swellings, and which consist of thicken- 
 ing, disorganization, ulceration, and suppuration of the 
 synovial membranes and cartilages. 
 
 Lastly, some of the glandular organs are peculiarly 
 prone to scrofulous disease. Enlargement of the lym- 
 phatic glands, more particularly those at the side of the 
 neck, and the glands of the jaw, is of such frequent oc- 
 currence, and is usually so early a sign, that the surgeon, 
 in determining whether an individual is scrofulous or not, 
 commonly passes his hand over the glands in these situations, 
 in order to ascertain their condition and size ; these glan- 
 dular enlargements are especially apt to run into un- 
 healthy and chronic suppuration. The testes and the 
 mammae are occasionally affected; and other glandular 
 
SCROFULA. 269 
 
 structures, though sometimes implicated, are by no means 
 so commonly found diseased, as those just mentioned. 
 
 The occurrence oitvhercle must be looked upon as the dis- 
 tinctive characteristic of scrofula, and when it occurs it may 
 be considered a sure sign of this affection, which has then 
 reached its ultimate development. In those cases in which 
 the scrofulous diathesis exists without having given rise to 
 this product, it must be considered as not having been 
 called into full and active operation, having merely mani- 
 fested itself in the minor forms of the disease, such as 
 ulceration of the skin and mucous surfaces. 
 
 Tubercle, though sufficiently well marked by its appear- 
 ances and progress, cannot be looked upon as a specific 
 affection, but must be considered to be a perverted or un- 
 healthy development of the nutritive materials, destined 
 for the repair of the body and the restoration of the blood. 
 According to Mr. Simon, it consists of the lymph or nas- 
 cent blood. It is a "dead concretion," a " fibriniform 
 product, insusceptible of development. '_? " The scrofulous 
 diathesis," says Mr. Simon, "consists in a peculiarity of 
 blood development, under which the nascent blood tends 
 to molecular death by superoxydation." According to 
 Dr. Williams, tubercle is a degraded condition of the 
 nutritive material from which the old textures are renewed, 
 and the new ones formed, and it differs from fibrin e or 
 coagulable lymph, not in kind, but in degree of vitality 
 and capacity of organization. " 
 
 " Tubercle essentially occurs in two forms, as semi-trans- 
 parent grey granulations, smooth and cartilaginous in 
 look, somewhat hard, closely adherent, and accumulated 
 in groups, often with a good deal of inflammatory action 
 in the surrounding tissues. These grey granulations, 
 usually about the size of a small pin's head, appear to con- 
 sist of a modified exudation of matter. They have a tendency 
 to run into masses, and to form the true yellow tubercle, 
 23* 
 
270 SCROFULA. 
 
 which is met with in opaque, firm, but friable concretions, 
 of a dull whitish or yellowish color, homogeneous in struc- 
 ture, and without any appearance of vascularity. 
 
 The microscopic characters of tubercle present no very 
 specific appearances. We find that this product presents 
 under the lens, a homogeneous struma, w T hich chiefly occurs 
 in the grey granulations, a granular matter which is prin- 
 cipally met with in yellow tubercles, drops of molecular 
 oil, and, lastly, considerable quantities of imperfectly de- 
 developed exudation cells, more or less disintegrated, 
 stationary or degraded. 
 
 The progress of tubercle is most commonly to disinte- 
 gration and liquefaction, at the same time that it gives 
 rise, by its irritation, to inflammation and suppuration in 
 the surrounding tissues ; hence it commonly leads to ab- 
 scesses, the pus of which is always curdy and shreddy. In 
 some cases tubercle may become indurated, and undergo a 
 species of calcification. The causes of scrofula, unless this 
 be of an hereditary character, though very various in their 
 nature, are usually such conditions as influence injuriously 
 the nutrition of the body. The hereditary nature of 
 scrofula is well known, both to the public and to the pro- 
 fession, for although the disease is not commonly connate, 
 yet the tendency to it is, and the characteristic nature of 
 the affection often manifests itself at an early period, not- 
 withstanding every effort to prevent its development. That 
 a parent may develop a tendency to malnutrition, to mis- 
 development of the blood, just as he may a peculiar feature 
 or mental condition, is undoubted. It is by the hereditary 
 transmission of peculiar combinations and modifications 
 of action in the organization, that hereditary diseases 
 develop themselves at certain periods in the life of the 
 offspring, when the injurious results of the morbid actions 
 that have been transmitted, have had time to be produced. 
 There are certain conditions which, though not scrofulous, 
 
SCROFULA. 2"1 
 
 are supposed to have a tendency to develop this disease in 
 the offspring to which they are transmitted ; thus dyspeptic 
 parents are said, and I believe with reason, to have stru- 
 mous children; so, also, the offspring of very old or very 
 young people, often exhibit a proneness to scrofulous 
 affections. The influence of intermarriage is still a matter 
 of doubt, though I believe it exerts but little influence in 
 this respect, and it is commonly stated that the inhabitants 
 of little communities, who intermarry closely, such as those 
 in the isles of Portland and Man, are not more liable to 
 scrofula than other individuals. The most potent cause 
 of scrofula, and that which in civilized countries is like- 
 wise most frequent, is mal-nutrition, arising either from 
 want of food, or the use of inferior food by the poorer 
 classes, or from over-feeding, .and over-stimulation of 
 the digestive organs in the children of the wealthier 
 orders of society, thus inducing chronic irritation of 
 the mucous membrane of the stomach, interference with 
 the digestive powers, and consequently with nutrition. 
 The influence of food that is insufficient in quantity, or 
 innutritious in quality, has been shown by Mr. Phillips, in 
 his excellent treatise on scrofula, to be the more immediate 
 cause of this disease ; and when conjoined with the injuri- 
 ous atmosphere of large towns, of close and over-crowded 
 rooms, and want of light and exercise, may be considered 
 as sufficient to occasion the disease in those cases in which 
 no predisposition to it exists, and greatly to develop any 
 tendency to it in the system. It is to the conjoined influ- 
 ence of agencies such as these, that we -must attribute the 
 prevalence of scrofula amongst the lower orders of town 
 and rural populations. 
 
 Scrofula is often called into immediate action by the 
 debility induced by previous diseases, such as measles, 
 scarlatina, hooping cough, &c. It usually develops itself 
 at an early age, though seldom before the child has reached 
 
272 SCROFULA. 
 
 its second year. It is most commonly about the period 
 of the second dentition that the disease declares itself, 
 and it is rare to meet with it, for the first time, after the 
 ages of twenty-five or thirty-five. 
 
 According to Phillips, when it is fatal it generally 
 proves so before the fifteenth year; 60 to 70 per cent, of 
 the deaths occurring before this age. Sex does not ap- 
 pear materially to influence this disease, though according 
 to the same authority, the deaths of males from scrofula, 
 exceed those of females in this country by 20 per cent. If, 
 however, we are to regard phthisis as an allied affection, 
 people who are scrofulous in early life, often having 
 phthisis developed at a later period, these numbers may 
 require correction. 
 
 TREATMENT. 
 
 The treatment of Scrofula may be divided into preven- 
 tive and curative. The preventive treatment consists in 
 so regulating the diet, as to supply all deficiencies in the 
 histogenic material of the different tissues. The digestive 
 and assimilating organs should receive special attention, 
 every possible effort being made to increase their tone. 
 The surface should be bathed three or four times a week 
 in warm or cold water, as best agrees with the constitu- 
 tion. A liberal amount of exercise in the open air should • 
 be taken, and the patient should avoid all excesses, both 
 physically and mentally. When these means fail to arrest 
 the tendency to scrofula, a moderate amount of stimulants, 
 in combination with small quantities of Iron, may be 
 taken before each meal. When the disease has become 
 fully developed, whether in the skin, lungs, bones, liver, 
 stomach, uterus, kidneys, or any other part of the system, 
 the constitutional treatment should consist in a thorough 
 tonic and alterative course. In case the disease appears 
 in the form of herpes or pustules, the treatment has been 
 fully described under that 'head. Or, if in the form of 
 
SCROFULA, 213 
 
 phthisis, the treatment has already been given. "When 
 scrofula manifests itself in the form of ulcers, of an indo- 
 lent or irritable character, the constitutional treatment 
 should consist of the following remedies : 
 
 B Scrophularin gr. xx. 
 
 Bitartrate of Iron gij. 
 
 Chloride of Sodium srj. 
 
 White Sugar giij. 
 
 Mix, triturate, and take one teaspoonful three times a day. 
 The diet should consist of rich animal broths, ripe fruit, 
 &c. ; and a wine-glass full of malt liquor should be drunk 
 with each meal. The ulcer should be stimulated by the 
 occasional application of a mild solution of sulphate of 
 zinc, or vegetable caustic. The limb should be bandaged 
 with moderate tightness, and the ulcer covered with a soft 
 slippery elm poultice. After the above treatment has 
 been pursued for about two weeks, it should be changed 
 to the following : 
 
 R Compound Syrup of Stillingia Oss. 
 
 Syrup of Apocynum Oss. 
 
 Syrup of Iodide of Potassium gij. 
 
 Mix; dose, from one teaspoonful to one tablespoonful 
 three times a day. This treatment should be pursued for 
 two or three weeks, when it should be omitted, and the 
 following substituted : 
 
 R Phosphate of Lime gss. 
 
 Carbonate of Iron giij. 
 
 Phytolacein , gr. xv. 
 
 White Sugar ibj. 
 
 Mix, triturate and add to one pint of water, and one pint 
 of best gin. Dose, one tablespoonful three times a clay. If 
 the ulcer should still prove indolent, it may be touched 
 with caustic of potassa, followed by a poultice of slippery 
 elm, wet with Tinct. of Arnica. Where the disease appears 
 in the form of caries or necrosis of the bone, the dead por- 
 
274 piles. 
 
 tion should be destroyed by the sulphate of zinc or 
 caustic potassa. The sore should be stimulated as in ulcer 
 of the soft parts, until it becomes healthy. After which, 
 collodion or a mild ointment may be applied, until union 
 takes place. In no case, however, in disease of the bones, 
 should the ulcer be allowed to heal until the necrosed por- 
 tion of bone has been entirely exfoliated, and the ulcer 
 healthy in every respect. 
 
 Where scrofula attacks the glands of the axilla, groin, 
 or breast, causing enlargement and irritability of these 
 parts, absorption should be promoted, if practicable, by the 
 use of Iodine ointment and moderate pressure ; if this fails, 
 suppuration may be induced by the application of a poul- 
 tice of equal parts of gum -myrrh, capsicum and slippery 
 elm. In such cases, Phytolaccin, Iodide of Potassium, 
 Apocynin, in connection with the compound alterative 
 syrup, are the remedies to be used. In the treatment of 
 this disease, the surface should be frequently bathed, the 
 diet should be nutritious, and consist of both vegetable and 
 animal food. The sleeping apartments should be freely 
 ventilated, and the habits of exercise well regulated. 
 
 PILES, OR HEMORRHOIDS. 
 
 A varicose condition of the hemorrhoidal veins, allowed 
 to exist for a considerable length of time, causes a disease 
 of its coats, and a consequent infiltration into the adjacent 
 cellular tissue. 
 
 The blind piles are essentially the same, only occurring 
 higher up in the rectum. 
 
 SYMPTOMS. 
 
 A greater or less number of dark purple or pulsating or 
 erectile tumors around the margin of the anus, or within 
 
piles. 275 
 
 the anus. They mostly cause much pain, and in some 
 cases the oedema of the parts is so great that defecation 
 is almost impossible. In other cases there are constitu- 
 tional symptoms, as fever, headache, loss of appetite, 
 debility, &c. Where the patient is of a scrofulous dia- 
 thesis, piles may terminate in fistula in ano. 
 
 CAUSES. 
 
 The causes of hemorrhoids are congestion of the liver, 
 costiveness, ascaricles, pregnancy, and all affections which 
 tend to produce inflammation of the parts. 
 
 TREATMEXT. 
 
 R Sulphur gr. xxx. 
 
 Cream of Tartar ; gij. 
 
 Cane Molasses Oj. 
 
 " Best Gin Oj. 
 
 Mix ; dose, from one teaspoonful to one tablespoonful three 
 times a day. Shake the mixture well before taking. As 
 an external application, an ointment may be used com- 
 posed of the following ingredients : 
 
 R Tannin gj. 
 
 Fresh Lard gj. 
 
 Sulphate of Zinc... gr. vj. 
 
 Mix, form an ointment, and apply after each movement 
 of the bowels. Where the hemorrhoids are confined to the 
 upper portion of the rectum, and are accompanied with 
 hemorrhage, from five to ten drops of the oil of Erigeron 
 should be taken three or four times a day. If the first 
 mixture should not be sufficient to maintain a soluble con- 
 dition of the bowels, from one eighth to one fourth of a 
 grain of Podophyllin should be taken every night on going 
 to bed. When the piles first make their appearance, they 
 can generally be removed by returning the pile tumor, and 
 
2t6 FISTULA IN ANO. 
 
 afterwards rubbing gently with the finger which has been 
 anointed with simple cerate, until the congested veins 
 become emptied, and the tumor disappears. 
 
 FISTULA IN ANO. 
 
 This is an indolent ulcer, situated in the lax cellular 
 tissue, adjacent to the rectum. This ulcer or sinus usually 
 communicates externally with the sphincter muscle, by 
 means of a small pipe, in which case it is called an open 
 fistula. Occasionally it communicates with the intestine, 
 without any external opening, in which case it is called a 
 blind fistula. 
 
 CAUSES. 
 
 Fistula in Ano may be caused by piles, injuries of the 
 part, or anything which will cause cellular inflammation 
 in these parts. 
 
 SYMPTOMS. 
 
 These are often quite obscure, at other times a heavy dull 
 pain will be felt in the region of the anus, extending at 
 times to the back, accompanied by febrile reaction, scanty 
 urine and accelerated pulse. Sooner or later a small 
 tumor will make its appearance, and is usually mistaken 
 for piles ; but on opening, a small quantity of sanious mat- 
 ter will be discharged, which will continue until the disease 
 is removed. Or if blind fistula, the pain and constitutional 
 symptoms may be followed by a discharge from the bowels, 
 through the communication between the intestine and the 
 sinus, by the completion of the fistulous tube, 
 
 TREATMENT. 
 
 As this disease is usually connected with a scrofulous or 
 tuberculous habit, a constitutional and local treatment 
 
MERCURIAL DISEASE. 277 
 
 should be commenced at the same time. The patient 
 should take Alterative Syrup, Iron, Quinine, and Iodide 
 of Potassium, with such other remedies as the state 
 of the disease may indicate. At the same time, the 
 fistula should be injected with a strong solution of sul- 
 phate of zinc. The injection should be of sufficient 
 strength to disorganize the walls of the sinus, and the 
 fistulous tube. After the fistula has been injected, the 
 parts should be brought as closely in contact as possible, 
 by means of adhesive straps. The injection should be 
 repeated from time to time, until the fistula is entirely 
 cured. Or if, after disorganizing the tube with the zinc, 
 the ulcer still proves obstinate, a strong solution of bay- 
 berry and golden seal will generally effect a cure. 
 
 If it is a blind fistula, an external opening should be 
 made by means of the caustic potassa, and followed by 
 an injection as before. Previous to injection of the zinc, 
 where the opening communicates with the intestine, the 
 rectum should be injected with slippery elm, to prevent the 
 caustic from comins: in contact with the bowels. 
 
 MERCURIAL DISEASE. 
 
 There is no disease more formidable in its attack upon 
 the organic tissues than this ; not only in its tendency to 
 develop a great variety of pathological conditions, but in 
 the peculiar obstinacy with which it resists the efforts of 
 the physician to arrest its progress. I\Iercurial diseases 
 manifest themselves in periodic rheumatic affections of 
 the joints, in enlarged and indurated condition of the 
 various glands of the body, in the form of dropsies, 
 anaemia, phthisis, palpitation of the heart, dyspepsia, blind- 
 ness, deafness, loss of teeth, convulsions ; in fact, there is 
 no form of disease that is not occasionally represented by 
 24 
 
2T8 MERCURIAL DISEASE. 
 
 the disastrous influence of mercury. When once intro- 
 duced into the system, the manner in which mercurial pre- 
 parations affect the different tissues, is as yet a matter of 
 some dispute. Although it is claimed by those who still 
 persist in its use, that it possesses the power to change the 
 morbid condition of the part affected into another morbid 
 state, which is far less dangerous to the life of the patient 
 than the primary affection ; that it acts as a stimulant to 
 the liver, and a. purgative to the bowels; in short, it is 
 claimed by those who still adhere to the dogmatism of 
 allopathy, that it is essential to the successful treatment of 
 nearly all inflammatory, as well as chronic diseases. But 
 in what way it stimulates the liver, or how it arrests fever, 
 or subdues inflammation, they are unable to tell us beyo.nd 
 mere conjecture. 
 
 It certainly cannot be owing to its power to increase 
 the histogenetic material for the reparation of injured 
 organs, nor to its tendency to reorganize the blood, or 
 other fluids, as the most minute chemical analysis has 
 failed to detect the least trace of mercury in the organic 
 tissue, unless it had been first introduced into the stomach, 
 and then always acting as a foreign agent, and in no way 
 identified as an element of the human organism. The 
 only way by which the modus operandi of mercurials upon 
 the organic tissues can be explained, is that by which we 
 explain the inability of all foreign agents to produce 
 disorganization, unless the quantity be sufficient to over- 
 power the vis-vitas of the part with which it comes in 
 contact. When a foreign body is introduced into the ex- 
 ternal soft tissue, the vitality of the part is at once sum- 
 moned to remove the intruder, consequently a deposition 
 of lymph occurs around the foreign body, which soon be- 
 comes organized in such a way as to cut off all communi- 
 cation between the foreign body and the adjacent tissues. 
 Inflammation and suppuration are the agents used to 
 
MERCURIAL DISEASE. 279 
 
 expel the body, so when mercury is introduced into the 
 system, it acts as a foreign body to every tissue with which 
 it comes in contact, and an effort is made to expel it. 
 When mercury is combined with chlorine, as in calomel, it 
 may entirely dissolve the tissues, such as the mucous mem- 
 brane of the stomach, bowels, lungs, &c. But whether 
 we are able or not to account for all the morbid conditions 
 produced by this agent, we have the most positive assu- 
 rance,- that in the whole catalogue of predisposing causes 
 to disease, there is none more prolific than this. Allo- 
 pathists themselves are beginning to observe this fact, in 
 confirmation of which, I will introduce the remarks of 
 W. Porter, M. D., F. R. C. S. I., &c, as published in the 
 Dublin Medical Press of Feb. 10, 1847. 
 
 Dr. Porter observes : "I think that mercurial diseases, 
 properly so called, that is, such, as arise from mercury 
 alone, admit of subdivision into two classes, according as 
 they seem to be products of a small or a large close of the 
 poison ; when taken in small quantities, it appears to be 
 determined to the tegumentary structure of the skin, the 
 mucous membranes and analagous tissues, such as the con- 
 junctiva of the eye, and therefore bowel complaints, 
 cutaneous eruptions, and superficial inflammations are 
 generally met with, at an early period, and before the 
 specific effects of the medicine ought to be expected to 
 appear ; when taken in large quantities, the nervous system 
 is most likely to suffer, and that too where the specific 
 effects have not been developed at all, which is the case 
 most pregnant with danger, or that being present and in 
 fall operation, .they have been suddenly checked, or other- 
 wise interfered with, by improper or incautious exposure. 
 Some few cases occur whilst patients are under complete 
 salivation ; but it is so difficult to say that such may not 
 have been guilty of some irregularity, that they may be 
 placed within the latter category, and at all events they 
 
280 MERCURIAL DISEASE. 
 
 are of rare occurrence. Such is the arrangement I propose 
 to follow in considering these affections ; not, however, 
 without being conscious of its imperfections, and that 
 numerous diseases arise, or seem to arise, from the irrita- 
 tion of mercury, that run a wild and unbridled course, 
 w r hich it would be impossible in the present state of our 
 knowledge to subject to this or almost any other classifica- 
 tion. Persons, for instance, whilst taking mercury, be- 
 come deranged : the examples of this which I have seen 
 were all maniacal, and the symptoms such as might be 
 expected from inflammation of the brain and its mem- 
 branes ; these patients all died. Whether such an event 
 w r as the effect of too sudden exposure to wet or cold — 
 whether it could be regarded as a kind of metastatic trans- 
 fer of the mercurial irritation to the brain, or whether it 
 had any direct connection with the mercury at all, I am 
 unable to prove, but certainly at the time when each 
 occurred, I could not help placing the mercury and the 
 madness in the relation of cause and effect. Again, per- 
 sons whilst taking mercury have become paralytic. When 
 I was in college, a young friend of mine, slightly under 
 the influence of the medicine, was exposed to an incessant 
 shower of rain for nearly two hours ; he went to bed, where 
 he had a rigor, but fell asleep, and awoke perfectly para- 
 lytic on one side ; he lived many years afterwards, but 
 never recovered the use of his limbs. A young clergyman 
 who had taken mercury for a liver complaint, and had 
 apparently nearly recovered from its effects, incautiously 
 fell asleep on the grass ; he awoke paralytic, and nevei 
 recovered, although he lived to more than middle age. 
 Perhaps it may be said that these are not fair specimens 
 of the morbid influence of mercury upon the nervous 
 system ; perhaps it may be doubted whether mercury had 
 any relation to such cases at all, inasmuch as persons have 
 become paralytic from exposure, who have never taken a 
 
MERCURIAL DISEASE. 281 
 
 grain of the medicine. I know not how this may be. My 
 opportunities of investigation have been too limited to 
 enable me to speak with confidence on a matter of so mnch 
 obscurity ; but my experience in many instances has led me 
 to believe that mercury may prove eminently mischievous in 
 this particular manner. But suppose we acknowledge that 
 mercury may and does act injuriously on the nervous system 
 in all its parts and in its various ways, how are we to account 
 for its prejudicial influence on other systems and structures, 
 particularly as to its production of an hemorrhagic ten- 
 dency ? Several years ago, when investigating the patho- 
 logy of aneurism, I remarked the frequency of that disease 
 in persons who had been subjected to protracted courses 
 of mercury, and I then hazarded an opinion that this 
 fearful and dangerous affection might be occasionally thus 
 induced ; since then, I have paid great attention to the 
 subject, and have observed different kinds of hemorrhage 
 so frequently ensue after mercury had been extensively 
 used, that I feel convinced of its injurious influence in this 
 respect. Almost all the aged people treated with mer- 
 cury for syphilis, have, according to my observation, died 
 shortly afterwards of haemoptysis, or else of apoplexv ; 
 nor are such casualties confined to the aged, for I have 
 seen several instances of young persons under similar cir- 
 cumstances, being seized with spitting of blood, and dying 
 rapidly of consumption. It may be imagined that I am 
 presenting the possible injurious effects of mercury in too 
 strong colors, and that my apprehensions on this subject, 
 as being derived from the experience of a few cases, are 
 little more than visionary ; be it so ; but having remarked 
 the fact, I think it my duty to state it, and leave it to be 
 established or contradicted by future experience. 
 
 " The tendency of mercury to produce a hemorrhagic 
 condition, is readily explicable by the effects of the mineral 
 upon the fibrin of the blood. " AY. H. Ranking, M. D. 
 24 * 
 
282 MERCURIAL DISEASE. 
 
 Mercurial erythema is sometimes preceded by symptoms 
 resembling those which usher in erysipelas, shivering, 
 nausea, foul tongue, thirst, headache, cough, and pains 
 about the praacordia, and these febrile symptoms, not only 
 continue throughout, but in severe cases become daily ag- 
 gravated ; sometimes it occurs without any premonitory 
 notice, except 'a harsh dryness of the skin ; and I have 
 known it to appear suddenly the day after the administra- 
 tion of three or four grains of calomel as a purge. It may 
 be a consequence of administering mercury in any of its 
 forms or preparations, but seems more frequently produced 
 by its administration internally. I have, however, seen an 
 exceedingly well marked case of it from dressing a sore 
 with the red precipitate. It appears as a dark red blush 
 at some of the folds of the body, the seat of the scrotum, 
 the groin, axillae, or anterior parts of the elbow, from 
 which it spreads with a greater or less degree of rapidity, 
 according to the severity of the case. This is distinguished 
 from ordinary erysipelas, by its surface being slightly rough 
 to the touch — by its edge not being distinctly defined — by 
 its intolerable itching, which is the local inconvenience 
 chiefly complained of in the first instance — and by its 
 vesicular appearance when viewed through a magnifying 
 glass. Whenever the surfaces of the body lie in opposite 
 contact, such as in the perineum, the inside of the thighs, 
 or between the folds of the nates, these vesicles break 
 almost as soon as formed, the parts become abraded, and 
 there is a constant oozing of a serous fluid, foul and abomi- 
 nably fetid. In modern times, the disease seldom pro- 
 gresses beyond this, which is termed the first stage ; but 
 suppose it neglected, and the use of mercury still perse- 
 vered in, the febrile symptoms become exasperated, the 
 eruption spreads, and may so extend as to occupy the 
 entire body, and the vesications, or rather vesicles, run 
 into each other and break. Where surfaces are opposed, 
 
MERCURIAL DISEASE. 283 
 
 the discharge increases in quantity, assumes a puriform 
 character, and becomes, if possible, still more offensive ; 
 when they do not, a branny scurf or scale is formed, which 
 falls off, and is renewed so abundantly, that after the night, 
 or even after a few hours, a great quantity may be found in 
 the patient's bed. In general, this desquamation of the 
 skin is attended with febrile symptoms, and the patient 
 slowly recovers ; but if otherwise, if the disease has been 
 more than usually malignant, or if the medicine has been 
 still persevered with, the parts engaged (and these may be 
 the entire body) swell, apparently by the formation of 
 thicker scabs or crusts, which are deeply cracked or fis- 
 sured (not inaptly compared to the scored skin of roasted 
 pork), discharging sometimes sanies, sometimes blood, and 
 so sore and painful that the patient can scarcely bear to 
 turn himself in bed. I am not quite sure that I ever saw 
 a fatal case of mercurial erythema. About five years ago 
 a poor Scotchman was brought into the hospital covered 
 with a scurfy eruption, and in a miserable state of debility, 
 who attributed his illness to having taken some medicine, 
 which he believed to have been corrosive sublimate, for 
 the cure of clap, in despite of the treatment, he died (as 
 several thought) of this disease ; but if it was so, there was 
 a symptom here present not described hitherto as apper- 
 taining to it, namely : a discharge of purulent matter as 
 foul and offensive as that from a glanderecl horse, from 
 every mucous outlet of his body, mouth, nostrils, eyes, ears, 
 anus and urethra. I know not, I say, whether this was a 
 specimen of the disease or not; but without passing to 
 such extremity, the description given by those who had 
 witnessed the latter stages of the malignant erythema, is 
 sufficiently appalling. The cough becomes very severe, 
 and is accompanied by great soreness of the chest ; the 
 matter expectorated is sometimes highly tinged with blood, 
 which is so coagulated as to threaten suffocation. The 
 
284 MERCURIAL DISEASE. 
 
 pulse is frequent and irregular, the surface of the body is 
 intensely hot and sore, the thirst becomes unquenchable, 
 the tongue becomes parched and black in the centre, and 
 the urine is high-colored, small in quantity, and without 
 sediment, "Wretched, indeed, is the situation of the 
 patient in this stage of the disease ; without the enjoy- 
 ment of one moment's repose, afflicted in body with the 
 most excruciating anguish, and depressed in mind to the 
 lowest state of despair, he soon falls beneath these com- 
 plications of wretchedness. Diarrhaea and low delirium 
 speedily supervene, the pulse sinks, the body mortifies, 
 and a state of insensibility at length announces the termi- 
 nation of a complaint that at once exhibits a distressing 
 proof of the inefficiency of medicine, and the insufficiency 
 of human skill." 
 
 Before I speak of the treatment, allow me to revert for 
 a moment to the history of this disease. Alley states, 
 "that before the nature of this disease was known, it was 
 considered as a more virulent form of Syphilis. In 
 proportion, therefore, as the disorder advanced, mercury 
 in some form or other was exhibited in greater quantity ; 
 the fever, consequently, was soon found to be increased to 
 an alarming degree, by the action of the mercury thus 
 heaped upon an already overloaded system ; and lest the 
 patient should sink too rapidly under the oppression of 
 this fever, recourse was had to tonics and stimulants. 
 Among these the bark and wine were resorted to, without 
 any regard to symptoms and appearances. It is almost 
 unnecessary to add, that the disease was in almost every 
 instance dreadfully aggravated, and that very few re- 
 covered. " Now, recollect that all this happened in a 
 Lock Hospital, and at a time when all cases of venereal 
 disease were treated with mercury. The patient was sur- 
 rounded by, and actually breathing a mercurial atmo- 
 sphere, and you can easily understand why medicine and 
 
MERCURIAL DISEASE. 285 
 
 medical skill were inefficacious and insufficient. It was 
 useless to prescribe purgatives, and acids, and antinionials, 
 and other cooling medicines, the cause of the fever re- 
 maining ever present ; it was in vain to endeavor to 
 support the strength by bark, and wine, and opium, while 
 the tendency to putrescence was constantly on the increase. 
 At present the disease is known to be mercurial. 
 
 Mercurial Erethismus. — Mr. Pearson tells us, that in 
 the course of two or three years after his appointment to 
 the Lock Hospital, he observed that in almost every year, 
 one or two cases of sudden death occurred among the 
 patients ; that these could not be traced to any ostensible 
 cause, and that the subjects were those who had nearly 
 and sometimes entirely completed their mercurial course. 
 He consulted Messrs. Bromfield and Williams on the 
 subject, and they were unable to give him any information, 
 more than that they had carefully examined the bodies of 
 many who had thus died unexpectedly, without being able 
 to discover any morbid appearances. On watching the 
 effects of mercury on the patients, he ascertained that 
 these deaths were attributable to the mineral acting as a 
 poison on the system, and that its deleterious effects were 
 neither in proportion to the inflammation of the mouth, 
 nor to the actual quantity of mercury absorbed into the 
 body." 
 
 TREATMENT. 
 
 The treatment of mercurial disease is usually less suc- 
 cessful than the treatment of most other diseases ; although 
 much good may frequently be done by a proper course of 
 medication. 
 
 If mercurial disease is manifested in a mild form, the 
 patient should be caused to take a gentle purge of Podo- 
 phyilin, the surface should be freely bathed in salt water, 
 a mild course of tonics should be commenced and pursued, 
 
286 MERCURIAL DISEASE. 
 
 and a generous diet should be allowed. This course will 
 frequently remove the most troublesome symptoms. 
 
 In more severe cases, as much of the mercury should 
 be extracted from the system as possible, by recourse to 
 the galvanic battery. After which, Compound Syrup of 
 Stillingia, in connection with small doses of Sulphur, will 
 be required. The surface should bo frequently bathed in 
 Saline water, and Iron and Hydrastin given in doses suffi- 
 cient to maintain the patient's strength. Where the dis- 
 ease appears to confine its poisonous action chiefly to the 
 skin, much benefit will frequently be derived from the use 
 of an ointment made of equal parts of tar and sulphur. 
 
 IMPORTANCE OF CERTAIN SYMPTOMS IN DIAGNOSIS. 
 
 In order to form a correct opinion of the nature, cha- 
 racter, and identity of disease, it is necessary to take a 
 general survey of the physical characteristics of the 
 patient : as his weight, height, temperament, age, whether 
 his constitution is of a strumous or scrofulous diathesis, 
 whether of temperate habits, and whether he has been 
 subjected to a mercurial course of medication. 
 
 Every possible item of information relative to the dis- 
 ease, should be obtained from the patient and nurse, which 
 will in the least assist in forming a correct diagnosis of 
 the case. If the heart, lungs, liver, or spleen are impli- 
 cated, auscultation, percussion, palpation, and mensura- 
 tion, should be practised, for the purpose of forming a 
 correct opinion of the true nature of the disease. Some 
 of the special symptoms which should engross our atten- 
 tion, are the appearance of the tongue, the appetite, 
 respiration, circulation, sleep, the skin and secretions, and 
 state of the intellect. Pain is the result of some impres- 
 sion made upon the nerve, and transmitted to the braiu ; 
 the pain may be remote from the impression, as in hip 
 disease the pain is generally in the knee ; the irritation 
 
DIAGNOSTIC SIGNS. 287 
 
 causing pain in the head, may be in the stomach ; or pain 
 in the shoulder may occur, as the result of congestion of 
 the liver. The amount of pain suffered by different indi- 
 viduals from the same disease is various, owing to the 
 different sensibilities of the persons, and dependent upon the 
 temperament. Hence the amount of the pain experienced 
 by the patient, is indicative of the amount of the disease, 
 ceteris paribus. A dull heavy pain generally indicates 
 congestion, effusion, or the pressure of some tu^nor ; fugi- 
 tive pain indicates a stretch of some part ; lancinating 
 pain is characteristic of cancer, rheumatism, pleuritis, or 
 neuralgia ; a heavy, throbbing pain, indicates the collec- 
 tion of pus ; itching pain is mostly confined to the skin 
 and mucous membrane ; on the skin it is caused by erup- 
 tive diseases, and on the mucous surface by ascarides in the 
 rectum, &c. When pain suddenly ceases, followed by cold 
 clammy sweats, weak pulse, and sunken countenance, an 
 attack of the affected part by gangrene is indicated. 
 
 The tongue affords many important indications of dis- 
 ease of the digestive organs. When the tongue is thickly 
 furred, and of a white or brownish color, it indicates a 
 derangement of the mucous membrane of the stomach. 
 If, in addition to the above, it should have a red appear- 
 ance at the end, it indicates the mucous membrane of the 
 stomach to be in a high state of irritation or inflamma- 
 tion. A dry red tongue also indicates the same state of 
 the stomach. A cracked and swollen tongue, indicates an 
 extensive irritation of the nerves of the stomach, and also 
 that the brain is involved. When the tongue is tremulous, 
 great nervous prostration is indicated. A dry, furred, or 
 red and tremulous tongue, is often present in typhoid 
 fever. A light, flat tongue, is characteristic of most 
 forms of intermittent fever. Much information, relative 
 to disease, may be obtained by a thorough knowledge of the 
 circulation, as indicated by the pulse. The conditions of 
 
288 DIAGNOSTIC SIGNS. 
 
 the pulse, indicative of disease, are various. The in- 
 creased frequency of the pulse is one of its most common 
 varieties, and may exist in a great many pathological 
 conditions of the system. The number of beats per 
 minute, constituting an increase of pulse, varies much in 
 different individuals, and also at different periods of life. 
 In infancy, the normal pulse is said to be from 78 to 180 
 per minute. Between the age of two and six months, 
 from 100 4p 120 per minute. Between the age of two and 
 seven years, about 110 per minute. From seven years to 
 twenty-five, from 80 to 85. From twenty-five to sixty-five 
 years, the average pulse per minute is about 70 to 75. In 
 females it will be found to be somewhat faster : the 
 number of pulsations per minute is greater during the day 
 than night ; and more frequent just after a meal than 
 before. From the above statement, it will be perceived 
 that a great variety of circumstances must necessarily be 
 considered, in order to derive much benefit from this con- 
 dition of the circulation in diagnosis. When the pulse is 
 slow, or much less than the usual number of beats per 
 minute, it frequently indicates disease of the brain ; it is 
 also characteristic of other diseases. An intermittent 
 pulse indicates either a disease of the brain, or extreme 
 exhaustion of nervous energy. A weak and feeble pulse 
 indicates anaemia and debility. Hope states, that when 
 the pulse is jerking, quick, hard, and strong, and stops 
 abruptly, it indicates a deficiency in the semilunar valves 
 of the aorta. In inflammation of the peritoneum, the * 
 pulse is mostly small and quick, but quick and hard in 
 inflammation of the lungs and pleura. When the pulse is 
 easily compressed under the finger, it indicates a feeble 
 condition of the heart. When the pulse ceases to be felt 
 in the extremities, it indicates great danger, unless it is 
 merely temporary. The appetite is another symptom of 
 much importance to be observed in disease. In most 
 
DIAGNOSTIC SIGNS. 289 
 
 diseases, the appetite is defective, indicating inability of 
 the stomach to digest food, and loss of assimilating power. 
 Under these circumstances, food introduced into the stomach, 
 acts as a foreign substance, and is the cause of much mis- 
 chief. In some diseases the appetite is not defective ; in 
 these cases, the powers of the stomach, as well as the 
 assimilating functions, remain unimpaired. In some forms 
 of phthisis, the rapid exhaustion of the nutritive material 
 increases the demand for food beyond its normal amount. 
 In chlorosis, the appetite is frequently capricious, craving 
 lime, clay, slate, stones, &c. This kind of appetite indi- 
 cates a lack *of proper histogenic material, as well as a 
 deficiency in the salts of the blood. In children, the 
 appetite frequently craves sugar, fats, &c, which indicates 
 a deficiency of the combustive material, and a consequent 
 loss of temperature. 
 
 There may also exist a variety of morbid appetites, 
 such as a craving for stimulating liquors, opium, tobacco, 
 ether, &c, all of which indicate a diseased condition of 
 the stomach or brain. Respiration should also be care- 
 fully noticed in forming a diagnosis of disease. If respira- 
 tion is increased in frequency, it denotes obstructed .circu- 
 lation through the pulmonary tissue. It may also indi- 
 cate irritation of the lungs or bronchial tubes. There are 
 a variety of conditions, which may tend to increase the 
 functions of respiration. The respiration may be irregular 
 and imperfect, as in tuberculous condition of one or both 
 lungs, or from a valvular disease of the heart and inflam- 
 mation of the pleura. 
 
 The menses are deranged in many diseases. They may 
 be scanty or they may be profuse. In some instances they 
 are entirely suppressed. They are at times changed in 
 quality, and the period of their return may be irregular. 
 When the catamenia is scanty, it either indicates a diseased 
 condition of the ovaries or deficient nutrition. Suppression 
 25 
 
290 DIAGNOSTIC SIGNS. 
 
 of the menses may indicate a variety of opposite conditions. 
 It may depend upon pregnancy, upon nursing, or upon 
 age. It may exist in any of these cases without inducing 
 disease. The menses may be suppressed by the extreme 
 exhausted condition of the system, as in the last stage of 
 phthisis, dropsy, &c. Or they may be suppressed by sud- 
 den exposure to cold or damp during the catamenial flow. 
 The menses may also be vicarious, making their exit from 
 the system through the lungs, stomach, bowels, &c. A 
 change in the quality of the menses denotes disease of the 
 uterus, or ovaries, or a scrofulous diathesis. Excess of the 
 menses indicates a chronic inflammation of 'the lympha-tic 
 glands of the uterus, spermatorrhea, &c. 
 
 SIGNS FROM THE URINE. 
 
 Healthy urine, when recently voided, has very nearly 
 the temperature of the body ; it is of a light yellow color, 
 emits a peculiar aromatic odor, has a bitter saline and 
 pungent taste, and a slight acid reaction ; its specific 
 gravity is about 1.018. From 90 to 93 parts to 100 of 
 healthy urine is water, the remainder is made up of uric 
 acid, saline and organic matter. 
 
 About 2i oz. of solid nitrogenized and uric matter is 
 thrown off from the kidneys every twenty four hours. If 
 the urine be acid, it will redden blue litmus paper ; if it be 
 alkaline, it will turn red litmus paper blue ; if neutral, it 
 will have no effect on the color of either. If the urine 
 contains albumen, heat or nitric acid will cause it to co- 
 agulate, and give the urine a thick milky appearance. If 
 the urine contains blood, heat or nitric acid will cause it 
 to lose its transparency. If it contains bile, nitric acid 
 will turn it green ; if it contains uric acid, nitric acid will 
 cause it to look dark, and precipitate a brownish sediment. 
 If it contains sugar, it may be ascertained by evaporating 
 a small quantity to the consistency of molasses, which will 
 
DIAGNOSTIC SIGNS. 291 
 
 have a sweet taste. A milky appearance may be caused 
 by mucus, albumen, or ammonia. If it contains ammonia, 
 nitric acid will cause a brisk effervescence ; if it contains 
 mucus or albumen, nitric acid will cause it to coagulate. 
 Dr. Bird states, that if the sediment of morbid urine be 
 white, and the urine acid, it consists mostly of urate of 
 ammouia ; but if it should disappear by heat, it is phos- 
 phate of ammonia. If a deposit be made of any color in- 
 clining to dark pink, or reel, it is almost sure to be urate 
 of ammonia, unless visibly crystalline, in which case it 
 consists of uric acid. When the urine contains albumen, 
 it indicates granular degeneration of the kidneys, or Bright's 
 disease, unless it is connected with low forms of fevers, or 
 in certain forms of heart disease. If the urine contains sugar, 
 it indicates mal-assimilation or diabetes mellitus. A gritty 
 sediment denotes a tendency to some of the forms of gravel. 
 Mucus in the urine is usually owing to the enlargement of 
 the prostate gland. Pus in the urine indicates abrasion 
 of the bladder, kidneys, or urethra. Bile in the urine in- 
 dicates # re-absorption of the bile from the liver, or that 
 the liver fails to secrete the bile from the blood. This 
 symptom is present in most forms of intermittent fever, 
 jaundice, disease of the liver, &c. 
 
 THE FAECES AS INDICATING DISEASE. 
 
 The inspection of alvine evacuations is of great import- 
 ance in making up the diagnosis of disease. Where the 
 bile is deficient, they are of a light ash color ; if there is 
 an excess, they are quite yellow. A red appearance of the 
 stools indicates passive congestion ; if red and thin, they 
 indicate hyperemia. If they are of a bloody mucous cha- 
 racter, inflammation of the colon is indicated. When the 
 stools are bloody in typhoid fever, they indicate ulceration 
 of the glands of the bowels. When the faeces are very 
 thin, and of a rice color, deep capillary congestion is indi- 
 cated, as in cholera, cholerine, &c. 
 
292 DIAGNOSTIC SIGNS. 
 
 The condition of the mind should also be taken into 
 consideration in diagnosis. To what extent the mind con- 
 trols or influences the morbid tendencies of the body, is 
 difficult to determine ; but, that it has a powerful influence, 
 not only in increasing the severity of morbid phenomena, 
 but also of controlling it, is a fact too apparent 'to every 
 observing physician to need comment. The conditions of 
 mind, however, which contribute to the amelioration or 
 increase of organic disease, are as yet but imperfectly 
 understood. Kossuth stated, in one of his addresses 
 before the American people, that while lying very low with 
 fever, not having been out of bed for a considerable length 
 of time, he received very important intelligence, upon 
 which he arose, and entered at once upon active duties, 
 without feeling any further embarrassment from his disease. 
 
 Instances are of almost daily occurrence, in which pa- 
 tients, who have for a long time labored under some low 
 chronic disease, hear of a new remedy, which, if taken, 
 is sure to remove it ; and if taken at the time when the 
 mind is most positive, for a time, at least, all the syxnptoms 
 undergo improvement. 
 
 There are other instances of the most violent mental and 
 physical agonies being relieved by the supposed virtue im- 
 parted to a glass of water or a bread-pill by a clairvoyant, 
 or so-called spiritual medium, magnetic passes, &c. These 
 things may appear to the novice in observation, absurd ; 
 yet they are living facts which must be met and should be 
 investigated. This class of cures is not confined to the 
 nervous and weak alone ; but the athletic are frequently 
 the passive subjects of these mysterious operations of the 
 human mind. Even infants, whose minds are not suscep- 
 tible of imaginary impressions, are said by the best of 
 authority, to have disease controlled by the action of other 
 minds. A circumstance was related to me to-day by a 
 gentleman of undoubted veracity, of a child while laboring 
 
DIAGNOSTIC SIGNS. 293 
 
 under a protracted brain affection, being relieved in a few- 
 hours by one who claimed to be a spiritual medium. He 
 magnetized a glass of water, as he stated, and by giving 
 a teaspoonful every five minutes, the child was relieved. 
 Another instance was related, of a similar glass of water 
 acting as a cathartic in fifteen minutes, although there was 
 obstinate costiveness at the time. Mental impressions, as 
 affecting disease, have been noticed from the earliest 
 history of medicine until the present time. 
 
 The mystic ceremonies of the Esculapians, the incanta-. 
 tions of Galen, the rites and ceremonies of Avicenna, 
 were another mode of producing the same results. The 
 effects of Indian charms, the supposed power of the 
 seventh son, of men born with a caul over the face, of 
 touching a dead body for the cure of cancers, of taking 
 water, in which sugar pills have been placed, are all 
 examples of the effect of the mind over the diseases of the 
 body. 
 
 While the mind may be thus beneficially directed upon 
 diseased organs of the body, it frequently has an opposite 
 tendency. It is a familiar fact, that nearly every disease 
 that affects the human family, may be, and is occasionally 
 induced by a perverted action of the mind upon the body. 
 Fevers are frequently caused by a long continued exercise, 
 or by powerful emotions, of the mind. 
 
 Phthisis is frequently induced in persons of a consump- 
 tive tendency, by constantly anticipating it. Cholera is 
 not only induced, but its fatality increased, by the des- 
 pondent mind. Disappointments cause loss of appetite, 
 fever, changes of the urine, &c. ; diarrhea, pains in the 
 head, &c, may be caused by mental impressions. One 
 of the most remarkable instances of the influence of the 
 mind over the body, in producing morbid changes, is re- 
 lated by Dr. Cheyne, of Col. Townsend, who could at any 
 time produce all the phenomena of death, not only arrest- 
 25* 
 
294 DIAGNOSTIC SIGNS. 
 
 ing circulation, respiration, &c, but would remain in this 
 state for hours, and then by an effort of the will, be re- 
 stored to his natural condition. 
 
 He carried his last experiment too far, and it resulted 
 in actual death. The limits of this work will not allow me 
 to enter further into the investigation of the subject. The 
 above facts are sufficient to give some idea of the influ- 
 ence of the mind over matter, and the physician who 
 would treat disease skilfully, must seek to investigate such 
 facts, and as far as possible, to understand their cause and 
 study their effects. The condition of the mind, whether 
 diseased or healthy, with all its manifestations, should be 
 taken into account. The condition of the skin, the tempe- 
 rature of the body, the temperament of the patient, his 
 peculiar idios}mcrasies, together with his habits of living, 
 occupation, external influences, &c, should be considered, 
 before he assumes the responsibility of administering medi- 
 cine, for the removal of disease. 
 
A LIST 
 
 OF 
 
 SOME OF THE PRINCIPAL REMEDIES 
 
 USED BY 
 
 THE AMERICAN ECLECTIC PROFESSION, 
 
 ALSO THE METHOD OF 
 PREPARING AND USING THE SAME. 
 
 Aconitum Napellus. 
 
 Common name, Monk 7 s-kood. This is an European 
 plant. The tincture of the leaves is the preparation mostly 
 used by eclectic physicians, in doses of from one to five 
 drops, repeated at intervals of from one-half hour to an 
 hour. It is used in all fevers and inflammations of an 
 asthenic character. It is an active diaphoretic and se- 
 dative to the circulation, and at the same time increases 
 the nervous forces. There is no remedy known, which 
 possesses greater power to arrest typhoid and kindred 
 fevers in their incipient stages. In peritoneal inflamma- 
 tion, the tincture of Aconite is of the greatest importance, 
 frequently controlling the disease in a very few hours. It 
 may also be used in dysentery, erysipelas, cerebral con- 
 gestion, croup, hooping cough, &c. 
 
 Much care should be observed in.preparing the tincture, 
 which should be made from the recently dried leaves, in 
 proportion of two ounces of dried leaves to one pint of 
 diluted alcohol. After standing fourteen days, it should 
 be strained and bottled for use. The active principle of 
 
 (205) 
 
296 LIST OF REMEDIES. 
 
 the plant is the aconitine, which may be used in all cases 
 where the tincture is indicated. It should be triturated, 
 one grain to ten of powdered sugar, and one grain of the 
 trituration is a dose, repeated as indicated. The proper- 
 ties are the same as the tincture. 
 
 Asclepin 
 
 Is the active principle of the Asclepias Tuberosa. 
 Common names, White Root, Pleurisy Root, &c. The 
 Asclepin is the preparation mostly used. It should be 
 triturated, one grain to ten of white sugar. From three 
 to four grains is a dose. It is tonic, expectorant, diapho- 
 retic and diuretic. It is used in pleurisy, pneumonia, 
 phthisis, bronchitis and low forms of fever. The White 
 Root is used in the same disease in the form of syrup and 
 tincture. 
 
 Apocynin 
 
 Is the active principle of the Apocynum Andro-soemi- 
 folium. Common name, Bitter Root. The Apocynin is 
 the preparation mostly used. It is diuretic, emetic and 
 anthelmintic. It is used in dropsy, dyspepsia, constipa- 
 tion, diabetes ; and for worms, congestion of the uterus 
 and scrofula. It is used with good effect for worms in the 
 rectum. It should be- triturated, one grain to ten of sugar, 
 of which three to five grains is a dose. 
 
 Alnuin 
 
 Is the active principle of the Alnus Serrulata. Common 
 name, Swamp Alder. 
 
 The Alnuin is the preparation used. It is employed in 
 intermittent and remittent fevers, in chronic indurations of 
 the liver, in necrosis, cancer, &c. 
 
 It should be triturated, one grain to ten of sugar, and 
 from two to three grains given at a dose. 
 
LIST OF REMEDIES. 29? 
 
 Aletrin 
 
 Is the active principle of the Aletris Farinosa. Common 
 name, unicorn, star grass, &c. 
 
 The Aletrin is the preparation mostly used. It is anti- 
 periodic, stimulant, nervous, tonic, and is a valuable 
 alterative for the uterus, ovaries and kidneys. It is a 
 remedy greatly valued in most affections of the uterus and 
 kidneys, in irregularities of the menses, prolapsus uteri, 
 passive congestion, resulting in leucorrhaea, &c. Also in 
 diabetes, and Bright's disease of the kidneys, it may be 
 used to much advantage. It is also valuable in most ner- 
 vous affections. 
 
 It should be triturated, ten grains to the one hundred ; 
 from one to three grains of the trituration is a dose. 
 
 Althcea Officinalis. 
 
 Common name Marshmallow. It is a mucilaginous 
 diuretic, and is best used by adding a small quantity of 
 the pulverized root to cold water. It should be used in 
 all forms of fever in the active stages, and in all diseases 
 where a mucilage and diuretic is indicated. 
 
 Amaranthus Hypochondriacus. 
 
 Common name Red Cock's-comb. It is alterative, tonic, 
 and astringent ; is mostly used in the form of a warm in- 
 fusion, and is beneficial in scrofulous consumption, also in 
 diarrhoea, aphthous sore mouth, &c. The close of the 
 strong tea is a tablespoonful every half hour. 
 
 Ammonice Hydrochloras. 
 
 Common name, Muriate of Ammonia. It is diuretic, 
 stimulant, alterative and resolvent. When triturated, it is 
 of much value mixed with Podophyllin, owing to its resolvent 
 and alterative powers, breaking down old adhesions, soft- 
 
298 LIST OF REMEDIES. 
 
 erring indurated livers, operating with great efficiency in 
 all cases where such remedies are indicated. It may be 
 given in powder or syrup. The dose is from one to ten 
 grains every two or three hours. 
 
 Apium Fetroselinum. 
 
 Common name, Parsley. The root is the part mostly 
 used, in the form of a strong decoction. It is diuretic, 
 aromatic, stimulant, and may be used in dropsies, incipient 
 phthisis, retention of urine, &c. 
 
 Apocynum Cannabinum. 
 
 Common name, Indian Hemp. It is hydrogogue, ca- 
 thartic, diuretic and nervine. It is used in dropsies, liver 
 complaint, bronchitis, scrofula, and is almost a specific for 
 neuralgia. The root is the part employed, and as the 
 active principles have but just been obtained, a strong de- 
 coction is now mostly used. Dose of a strong decoction 
 one tablespoonful every half hour. The Hydro-alcoholic 
 extract, as prepared by Tilden & Co., may be used in two 
 or three grain doses, in the place of the decoction. 
 
 Arnica Montana. 
 
 Common name, Leopard's-bane. This is indigenous to 
 the mountainous districts of Europe. It is antiperiodic, 
 tonic and stimulant, and in large doses acts as an altera- 
 tive cathartic. The tincture is the preparation principally 
 employed. It is used in intermittent fevers, in aphthous con- 
 ditions of the mucous surface, and in most forms of eruptive 
 diseases. Externally, the tincture is used in the form of a 
 liniment in all cases of bruises, sprains, &c. A dose of 
 the tincture is from five to ten drops every two or three 
 hours as an intermittent, and should be used between the 
 paroxysms. For ulceration of the mucous surface, the 
 dose is from one to five drops three or four times a day. 
 
LIST OF REMEDIES. 299 
 
 Amjjelopsin 
 
 Is the active principle of the Arnpelopsis Quinquefolia. 
 Common name, Woodbine. The Ampelopsin is the pre- 
 paration mostly nsed. It is one of our most reliable 
 alteratives, acting with great certainty and power upon 
 the lymphatic system, removing scrofula, syphilis, and 
 mercurial taint, with great promptness. When used for 
 syphilis, it should be combined with Iodide of Potassium 
 and Phytolaccin. It should be triturated, ten grains to 
 one hundred of sugar, dose from five to ten grains. The 
 crude article is used in the form of a syrup, for the same 
 disease. 
 
 Baptisin. 
 
 This medicine is prepared from the Baptisia-Tinctoria 
 (common name, Wild Indigo Weed. Its medical proper- 
 ties are antiseptic, emmenagogue, and alterative ; it is one 
 of the metastic remedies used in typhoid fever; is also 
 used to good advantage in scrofula. As an emmenagogue, 
 it is quite efficient, and may be used in all cases where 
 such a remedy is indicated. Triturate ten grains, to one 
 hundred of sugar, of which from five to ten grains is a 
 
 dose. 
 
 Belladonna. 
 
 Common name, Deadly Xight Shade. The extract is 
 the preparation mostly used. It should be triturated, by 
 adding one grain of the extract, to one hundred grains of 
 White Sugar. Belladonna thus prepared, is a specific for 
 simple scarlet fever, and is a valuable remedy in other 
 forms of the disease, in connection with Hyclrastin, &c. 
 It is also valuable in nervous headache, neuralgia, and 
 erysipelas. Dose of the trituration, is from one to three 
 grains, diluted in a tablespoonful of soft water. 
 
300 LIST OF REMEDIES, 
 
 Bryonia Alba. 
 
 Common name, Wild Hops. The extract is the prepa- 
 ration mostly used. It should be triturated five grains of 
 the extract, to one hundred grains of White Sugar. Thus 
 prepared, the Bryonia is used in the advanced stage of 
 typhoid fever, malignant dysentery, and the suppurative 
 stage of internal inflammation. 
 
 Bebeerine. 
 
 The sulphate of Bebeerine is the active principle of the 
 bark from the Bebeeru, a tree which is indigenous to 
 India. The Bebeerine is one of the most important anti- 
 periodics known ; and by many, it is deemed superior to 
 the sulphate of quinine. It is used in intermittent and 
 remittent forms of fever. Also in neuralgia, strumous 
 ophthalmia, leucorrhcea, intermittent headache, &c. 
 Dose, from one to three grains, may be given every two 
 or three hours, until forty or fifty grains are taken. It 
 may be repeated as often as indicated. 
 
 Bidens Bipinnata. 
 
 Common name, Spanish Needles. A watery infusion 
 is the form in which this article is mostly used. It is em- 
 menagogue, tonic, and expectorant. It is used in dys- 
 menorrhea, amenorrhea ; also in chronic pneumonia, 
 jaundice, &c. Dose of the strong infusion is, from one 
 to two tablespoonfuls every three or four hours. 
 
 Caulophyllin. 
 
 The caulophyllin is obtained from the Blue Cohosh. It 
 is diuretic, diaphoretic, emmenagogue, and tonic. It is 
 used in all uterine diseases dependent on debility of that 
 organ. It is also used in acute and chronic rheumatism. 
 
LIST OF REMEDIES. 301 
 
 The caulophyllin should be triturated ten grains, to the 
 hundred of white sugar ; from three to five grains of the 
 trituration is a dose, repeated as indicated. 
 
 Cerasin, 
 
 The eerasin is prepared from the bark of the cerasus 
 virginiana, choke cherry. Properties and use : Cerasin is 
 antiperiodic, astringent, and tonic. It is used in inter- 
 mittent and remittent fevers, in chorea, spermatorrhoea, 
 and dysentery. It should be triturated ten grains, to the 
 hundred of sugar, and from five to ten grains given for a 
 dose. 
 
 Chelonin. 
 
 The chelonin is obtained from the snakehead or bal- 
 mony. Medical properties and use. Tonic and altera- 
 tive. It is used in indigestion, hypertrophy of the liver, 
 chronic diarrhaea, &c. It is to be triturated ten grains, 
 to a hundred of sugar, of which from two to five grains is 
 a dose. 
 
 Cornin. 
 
 Obtained from the Cornus Florida or Dogwood, 
 Medical properties and use : Antiperiodic and tonic. It 
 is used in all cases where quinine is recommended. In 
 low forms of fever it is preferable to quinine, on the ac- 
 count of its tonic property in connection with its anti- 
 periodic. Dose not triturated is from one to three grains. 
 
 Corydalin, 
 
 The corydalin is derived from the Corydalis Formosa. 
 Common name, Turkey Pea. This remedy is one of the 
 most valuable antisyphilitics known to the medical profes- 
 sion. It is also very valuable in the treatment of scrofula 
 and eruptive diseases. It should be triturated ten to the 
 hundred of sugar, and from one to five grains given at a dose. 
 26 
 
302 LIST OF REMEDIES. 
 
 Cypripedin. 
 The cypripedin is prepared from the Lady's Slipper 
 or nerve root. Cypripedin is nervine, tonic, and antispas- 
 modic. It is used in all nervous and spasmodic diseases. 
 In chronic ague, in combination with Cerasin, it is a 
 remedy of much value. It is one of the ingredients of the 
 intermittent drops. The cypripedin should be triturated 
 ten grains to the hundred, and from five to ten grains 
 given for a dose. 
 
 Cinchonin. 
 
 Cinchonin is commonly obtained from the pale Peruvian 
 Bark. Its medical properties are similar to the quinine, 
 and it is used in-all diseases in which the quinine is admis- 
 sible, Dose is from three to five grains. 
 
 Collodion. 
 
 Collodion is an ethereal solution of Gun Cotton. It is 
 
 used to form an external protection to abraded surfaces. 
 
 Also as an external application in erysipelas. It should 
 
 be applied with a small sponge and repeated as indicated. 
 
 Cimicifugin. 
 The cimicifugin is the same as macrotin. It is the 
 active principle of the Cimicifuga Bacemosa. It is a 
 tonic, nervine, and antiperiodic. The cimicifugin is very 
 extensively used in all uterine affections, in rheumatism, 
 chronic ague, &c. It should be triturated ten grains to 
 the hundred of sugar before being used. From two to 
 ten grains of the trituration is a dose, repeated as indi- 
 cated. 
 
 Chinoidine. 
 
 The Chinoidine is one of the active principles of the 
 cinchona. It is tonic, antiperiodic and alterative, and is 
 used in all cases where Quinine is recommended. By some 
 it is supposed to be much better than Quinine, on account 
 of its alterative and tonic properties. 
 
LIST OF- REMEDIES. 303 
 
 Capsicum. 
 
 Cayenne pepper is an active stimulant, and is used to 
 great advantage in all low forms of fever, also in chronic 
 dyspepsia, &c. Dose from one to five grains. 
 
 Capsicum Oil, 
 
 This is an oleo-resinous substance which contains all the 
 active properties of the crude pepper, and is used for the 
 same purpose. It should be triturated with white sugar, 
 ten grains to the hundred. Dose from three to five grains, 
 repeated as often as indicated. 
 
 Digitalin. 
 
 This medicine is derived from the Digitalis Purpurea. 
 Common name, Foxglove. Properties and use : The 
 digitalin is diuretic, sedative and antiphlogistic. Owing 
 to the sedative influence of the digitalin over the heart and 
 arteries, together with its almost specific influence over the 
 lymphatic system, it is much used in all cases of a febrile 
 character, accompanied with an accelerated pulse and an 
 obstructed condition of the secretions. It is also used in 
 dropsical effusions, asthma, rheumatism, disease of the 
 heart, &c. It should be triturated, five grains to the 
 hundred of white sugar, and from one to three grains of 
 the powder given at a dose. 
 
 Dioscorin. 
 
 The Dioscorin is the active principle of the Dioscorea 
 Yillosa, or wild yam. The dioscorin is a specific remedy 
 for bilious colic. It is also used in other spasmodic 
 diseases. It operates most efficiently by being triturated 
 ten grains to the hundred of sugar. The dose of the tri- 
 turation is five or ten grains every five or ten minutes, until 
 relief is produced. 
 
304 LIST OF RE ME DIES, 
 
 Euphorbin. 
 
 The Euphorbin is derived from the root of the Euphor- 
 bia cor ollata.. Common name, Bowman Root. The Eu- 
 phorbin is emetic, cathartic, diaphoretic and expectorant. 
 It is used in the forming stage of fever, in dropsy, dysen- 
 tery and chronic affections of the liver. As an emetic, 
 from one to three grains should be added to one half pint 
 of warm ginger tea, and one tablespoonful taken every five 
 minutes until it produces free emesis. As an alterative, it 
 should be triturated ten grains to the hundred of white 
 sugar, and from two to five grains of the trituration given 
 as a dose, and repeated three or four times a day. 
 
 Eupurpurin. 
 
 The Eupurpurin is obtained from the Eupatorium Pur- 
 pureum. Common name, Queen of the Meadow. The 
 Eupurpurin is resolvent, diuretic and stimulant. It is used 
 in gravel, strangury, gout, dysentery, scrofula, necrosis, 
 cancer, and in chronic affections of the uterus. It should 
 be triturated ten grains to the hundred, and from three to 
 five grains of the trituration given as a dose. 
 
 Eupatorine. 
 
 The Eupatorine is prepared from the Eupatorium Per- 
 foratum, or Boneset. It is antiperiodic, alterative, and 
 in large doses emetic and purgative. It is used in all 
 diseases where such remedial properties are indicated, such 
 as ague, dyspepsia, &c. It should be triturated ten to the 
 hundred, and from one to five grains of the trituration is a 
 
 dose. 
 
 Euonymine. 
 
 The Euonymine is obtained fi'om the Euonymus Atro- 
 purpureus. Common name, Wahoo. The Euonymine is 
 one of the most valuable alteratives known to the profes- 
 
LIST OF REMEDIES. 305 
 
 sion. Its specific tendency is towards the liver, upon 
 which it acts with far more certainty than mercury or any 
 other known remedy. It may be used in all chronic affec- 
 tions of the liver, and wherever a thorough alterative and 
 tonic is indicated. It operates best by being triturated 
 with sugar, 100 parts of sugar to 10 of Euooymine. Dose 
 from five to ten grains of the trituration. 
 
 E rig era n Philade Iph ic um. 
 
 Common name, Colt's Tail, Rag-weed, &c. Erigerin 
 is a concentrated preparation obtained from the plant, and 
 is tonic, astringent and diuretic. Like other concentrated 
 remedies, it operates best by being triturated with sugar. 
 From five to ten grains of the trituration is a dose. The 
 volatile oil of Erigeron Philadelphicum is the most valuable 
 medical part of the plant. It is anti-hemorrhagic and 
 diuretic, used in all cases of hemorrhage, and is a remedy 
 of inestimable value. Prof. Sites, who has had very large 
 experience with this article, regards it as a specific, in all 
 cases of uterine hemorrhage. It is also used in haemop- 
 tysis, dysentery, gravel and rheumatism. Dose from five 
 to ten drops as often as indicated. 
 
 Elaterin 
 
 The Elaterin is the active principle of the Momordica 
 Elaterium. Common name, ivild or squirting Cucumber. 
 The Elaterin is a powerful hydragogue cathartic. It is 
 used in dropsy, and as a revulsive to some cerebral affec- 
 tions. It should never be used without trituration. It 
 should be triturated by adding ten grains to the hundred 
 of sugar. Dose of the trituration is from one to three 
 grains, 
 
 Gelsemin. 
 
 Obtained from the root of the Gelseminum Sempervirens. 
 Common name Yellow Jessamine, Woodbine, &c. Pro- 
 26* 
 
306 LIST OF REMEDIES. 
 
 perties and uses : Antiperiodic, antispasmodic and seda- 
 tive. It is used in all fevers where there is not congestion 
 of the brain. It is also used in pleurisy, pneumonia, 
 rheumatism, acute and chronic. The Gelsemin possesses 
 great power over the circulation, reducing the pulse from 
 a hundred or a hundred and thirty, to sixty or seventy in 
 the course of one or two hours. It also excites perspira- 
 tion and quiets nervous excitement, hence it has been very 
 extensively used in neuralgia. The Gelsemin should be 
 triturated ten grains to the hundred of sugar, and from 
 one to two grains of the trituration given at a dose. The 
 tincture of the crude root is also used in the same diseases. 
 Dose of the tincture is from 15 to 20 drops. 
 
 Geranin. 
 
 The Geranin is obtained from the Geranium Maenlatum 
 or Crane's Bill. The Geranin is one of the most powerful 
 astringents known to the profession, and is used in all 
 cases where a vegetable astringent is indicated. It may 
 be used with or without trituration. Dose of the triturated 
 is from three to five grains ; of the crude, from two to three 
 grains is a dose. 
 
 Helonin. 
 
 Obtained from the Helonias Bioica, or Unicorn Root, 
 Starwort, &c. The helonin is tonic, diuretic, and ner- 
 vine. There is no medicine known, which exerts a more 
 salutary influence over the assimilating powers of the 
 system, than the helonin. Hence it is an invaluable 
 remedy in the treatment of diabetes : it is also used in 
 leucorrhsea, and in all cases where passive congestion of 
 the uterus appears to be the prominent cause of the ail* 
 ment The helonin should be triturated ten grains of 
 helonin to one hundred grains of White Sugar. Dose 
 from five to ten grains. 
 
LIST OF REMEDIES. 307 
 
 Hydrastin. 
 
 The hydrastin is obtained from the Hydrastus Cana- 
 densis, or Golden Seal. The hydrastin is a pure tonic, 
 and appears to operate equally well upon all the tissues of 
 the body. Hence it is very extensively used in all low 
 forms of fevers, in all cases of debility, &c. A much less 
 quantity produces the same effect by being triturated one 
 grain to ten. Of the triturated from one to three grains 
 is a dose, repeated as indicated. 
 
 Hyosciamin. 
 
 The Hyosciamin is obtained from the Hyosciamus 
 Niger, or Henbane. It is anodyne, antispasmodic, and 
 laxative. It is used in neuralgia, gout, asthma, phthisis, 
 irritability of the urinary organs-, and nervous affections. 
 It should be triturated one grain to ten of sugar, and from 
 one-half to one grain of the trituration is a dose. 
 
 Irisin. 
 
 The Irisin is obtained from the Iris Versicolor, or Blue 
 Flag. It is alterative, purgative, diuretic, and anthel- 
 mintic. It is used in syphilis, chronic hepatitis, scrofula, 
 rheumatism, &c. The trituration of this remedy is ten to 
 the hundred, and from five to ten grains is a dose. 
 
 Jalapin. 
 
 The Jalapin is obtained from the Iponiaea Jalapa, or 
 Jalap. The Jalapin is a hydragogue cathartic, and is 
 used in dropsy, congestion of the liver, &c. The dose of 
 the triturated is from five to ten grains. 
 
 Juglandin. 
 
 The Juglandin is prepared from the Juglans Cinerea, 
 or Butternut. It is cathartic and alterative. It appears 
 
308 LIST OF REMEDIES. 
 
 to exert' most of its influence upon the dermoid tissues, 
 where it is used in cutaneous diseases with very happy 
 results. It is triturated the same as the other concentrated 
 remedies : give it in ten or twelve-grain doses three times 
 in the twenty-four hours. 
 
 Leptandrin. 
 
 The Leptandrin is prepared from the Leptandra Vir- 
 ginica, Culver's Physic, or Black Root. It is alterative, 
 tonic, and hepatic. It is used very extensively as an altera- 
 tive to the mucous surface, in inflammation of the glands 
 of the bowels, in chronic diarrhsea, and dysentery. 
 It is also used in scrofula and chronic bronchitis. The 
 leptandrin is to be triturated ten to the hundred, and from 
 ten to twenty grains given at a dose. 
 
 Lobelin. 
 
 The Lobelin is obtained from the Lobelia inflata. It is 
 emetic, diaphoretic, antispasmodic, and expectorant. The 
 lobelin is one of the most valuable medicines in the materia 
 medica. It is used in all cases where a remedy possessing 
 those properties is indicated. As an antispasmodic, it may 
 be used in all cases of convulsions, croup, &c. Also in 
 asthma and spasmodic croup. As an emetic, it may fre- 
 quently be indicated in the formative stage of fevers, 
 dysentery, jaundice, lung fever, &c. As an expectorant, 
 it may be used in chronic catarrh, pneumonia, &c. The 
 lobelin should be triturated ten to the hundred of sugar, 
 of w 7 hich from one to ten grains may be given as an 
 expectorant, from ten to forty as an emetic, and from five 
 to ten as an antispasmodic. 
 
 Lupulin. 
 
 Lupulin is obtained from the Humulus Lupulus. Com- 
 mon name, Hops. The lupulin is tonic, anodyne, and 
 
LIST OF REMEDIES, 309 
 
 anaphrodisiac, It is used very extensively in all nervous 
 diseases in the place of morphine, for which it serves as a 
 good substitute ; it is also used in spermatorrhoea and 
 chronic gonorrhaea, for which it operates with great effi- 
 ciency. For loss of sleep it serves all the purposes of 
 morphine. And of late it is becoming quite a popular 
 remedy for ague ; and its power over that disease leads 
 me to infer it to be quite a strong antiperiodic. It may 
 be triturated, and from five to ten grains given as a dose, 
 and repeated as indicated. 
 
 Lycopus Virginicus. 
 
 Common name, Bugle weed. It is used with great 
 effect in haemoptysis, in diabetes, and phthisis ; it is 
 also recommended in leucorrhoea, &c. The preparation 
 mostly used is the infusion, which should be made strong, 
 and one tablespoonful given at a dose ; to be repeated 
 as indicated. 
 
 Myrictn. 
 
 The Myricin is obtained from the Myrica Cerifera. 
 Common name, Bayberry. It is astringent and alterative. 
 It is used in scrofula, dysentery and follicular stomatitis. 
 There are but few remedies which exert a more salutary 
 influence over a diseased condition of the mucous surface 
 than this. It is also used externally upon indolent ulcers. 
 It should be triturated ten grains to one hundred, of which 
 from five to ten grains are a dose. When used externally, 
 the triturated powder should be sprinkled upon the surface, 
 followed by an elm poultice. 
 
 Morphia. 
 This article is prepared from opium, and contains its 
 narcotic properties. It is used to allay pain and to quiet 
 nervous excitement. Although it is a valuable remedy 
 when properly applied, it should be used with much cau- 
 tion, owing to its paralyzing properties. Dose from one 
 sixteenth to one half a grain. 
 
310 LIST OF REMEDIES. 
 
 Menispermin 
 
 Is the active principle of the Menispermum Canadensis, 
 or yellow parilla. It is sialagogue, tonic, alterative, diu- 
 retic, and in large doses purgative. It is a remedy of 
 great value in the earliest stages of phthisis. It is also 
 used in chronic enlargement of the liver and spleen. In 
 combination with* other remedies, it is valuable in syphilis, 
 scrofula and meningitis. It should be triturated ten grains 
 to the hundred, and given in from five to ten grains per 
 
 dose. 
 
 Phytolaccin 
 
 Is the active principle of the Phytolacca Decandria. 
 Common names, Poke Root, Garget, Skake Root, &c. 
 It is alterative, purgative, diuretic and antisyphilitic. 
 This remedy possesses almost specific power over syphilis. 
 It is used in tuberculous affections of the liver and spleen ; 
 also in cancer and scrofulous cachexia. It is used exter- 
 nally for indolent scrofulous ulcers, necrosis and cancers. 
 I have found an ointment of this article valuable in 
 obstinate hemorrhoids. For internal use it should be tri- 
 turated ten grains to one hundred of sugar. In syphilis, 
 from three to five grains of the trituration should be given 
 three or four times a day. If there should be chancre, a 
 small quantity of the untriturated should be spread upon 
 it. If this course is persisted in until a constitutional im- 
 pression is made by the Phytolaccin, a cure will generally 
 be effected. In scrofulous and hepatic diseases, one or two 
 grains of the triturated should be given two or three times 
 a day. 
 
 Podophyllin. 
 
 This is obtained from Podophyllum Peltatum. Com- 
 mon names, May Apple, Mandrake. It is alterative, 
 emetic, cathartic and resolvent. The action of Podo- 
 phyllin upon the glands is somewhat like the mercurials. 
 
LIST OF REMEDIES. 311 
 
 When given alone, as a cathartic, its action is very slow, 
 requiring from six to twelve hours. As an alterative, it 
 is used in all cases of hypertrophy and local congestion. 
 It exerts a specific influence over the liver, stimulating it 
 to increased secretion of bile. As a resolvent, it is used 
 iri adhesive inflammation, following pneumonia, peritonitis 
 and pleuritis. It is used to defibrinate the blood in altera- 
 tive doses, and as a general stimulant to the absorbents. 
 It should be triturated ten grains to the hundred. From 
 one to two grains are used as an alterative, and from two 
 to five grains acts as a cathartic. 
 
 Populin. 
 The Populin is obtained from the Populus Tremuloides, 
 or Quaking Aspen. The Populin is tonic, alterative, 
 vermifuge and stomachic. It is -used in dyspepsia, cos- 
 tiveness, hysteria, &c. It is to be triturated, and from 
 three to five grains given as a dose. 
 
 Prunin. 
 The Prunin is obtained from the Primus Virginiana. 
 Common name, Wild Cherry. It is a tonic expectorant 
 and nervous sedative. The Prunin is a remedy well cal- 
 culated to act beneficially in the early stage of phthisis, 
 and in chronic bronchitis. It has been used lately as an 
 antiperiodic with good success. The prunin should be 
 triturated, ten of prunin to the hundred of sugar, and from 
 five to ten grains given at a dose. 
 
 Ptelin. 
 
 The Ptelin is obtained from the Ptelia Trifoliata. Com- 
 mon name, Swamp Dogwood. The Ptelin is tonic and 
 stimulant. It is a remedy of much value in diabetes, in 
 chronic diarrhasa and indigestion. It should be triturated 
 ten parts to the hundred of sugar, and from five to ten 
 grains given at a dose. 
 
312 LIST OF REMEDIES. 
 
 Rhusin. 
 The Rhusin is obtained from the Rhus Glabra. Com- 
 mon name, Upland Sumach. It is a valuable remedy in 
 purpura, scurvy and dysentery. It is also used with good 
 effect, as an external remedy, in indolent ulcers and piles. 
 For internal use it should be triturated as the other con- 
 centrated remedies, and from one to five grains of the tri- 
 turation given at a dose. As an external remedy for ulcers 
 or piles, it should be made into an ointment with Balsam 
 
 of Fir. 
 
 Rumicin. 
 
 The Rumicin is obtained from the Rumex Obtusifolius, 
 or Yellow Dock. It is a remedy of great value in consti- 
 tutional cancerous affections, and in scrofula. It should 
 be triturated and given in three or four grain doses. 
 
 Sanguinarin. 
 The Sanguinarin is obtained from the Sanguinaria Ca- 
 nadensis. Common name, Blood Root. The Sanguinarin 
 is one of the most valuable remedies known, in the treat- 
 ment of pseudomembranous croup. It has proved as much 
 of a specific for that disease, as Quinine has for ague. I 
 have seen it used in a great number of cases, and have 
 never known a single failure. It is also used in pnemonia 
 with good effect. As a mild alterative and sedative, it is 
 also valuable. . Externally, sanguinarin is used in open 
 cancer with good effect. When used for the croup, it 
 should be made into an acetic syrup, by adding twenty 
 grains of Sanguinarin to four ounces of vinegar; steep 
 and add one ounce of sugar to form a syrup. D-ose one 
 teaspoonful as often as indicated. As an alterative and 
 expectorant, it should be triturated ten grains to the hun- 
 dred of sugar, and from three to fiYe grains given at a dose. 
 Externally, for cancer, it is mixed with the white of an 
 egg, and applied in the form of a paste. 
 
LIST OF REMEDIES. 313 
 
 Scutellaria. 
 
 The Scutellarin is prepared from the Scutellaria Lateri- 
 flora, or Scuilcap. It is one of the most valuable nerve 
 tonics and antispasmodics. It is a specific in nervous 
 chorea, and very valuable in all other forms of nervous 
 affections. It is one of the ingredients of the inter- 
 mittent drop. In the low stage of typhoid fever, it allays 
 the nervous irritation with great efficiency. I am in the 
 habit of using the scutellarin in all cases where I formerly 
 used morphine. It should be triturated ten to the hun- 
 dred, and given in three or four grain doses. 
 
 Senecin 
 
 Is obtained from the Senecio Gracilis. Common name, 
 Life Root. The Senecin is one of the most efficient known 
 remedies in irregularity of the menses, and appears to act 
 specifically upon the uterus, relieving that organ of con- 
 gestion and inaction. From the efficiency with which the 
 medicine relieves uterine derangement, its use is mostly 
 confined to that class of cases. The dose of the triturated 
 is from three to six grains. 
 
 Staphylea Trifolia. 
 
 This medicine is used in the form of a cold infusion. The 
 bark of the root is the part mostly employed. It is anti- 
 periodic and tonic, and is used in the treatment of inter- 
 mittent fever and debility of the stomach. Dose, one or 
 two tablespoonfuls of a strong infusion. 
 
 Stillingia Sylvaiica. 
 
 Common name, Queen's Root. The Stillingian is a 
 concentrated preparation prepared from the root of the 
 Stillingia Sylvatica. This preparation, however, does 
 not contain all the active medical properties of the plant. 
 
 27 
 
314 LIST OF REMEDIES. 
 
 Hence the crude article is mostly used in the form of a 
 syrup. The syrup is extensively used in syphilis, scrofula, 
 and mercurial diseases. By those who are the most familiar 
 with its medicinal properties, it is believed to possess more 
 power over mercurial diseases than any other. In order 
 to obtain the best effect, its use should be persisted in 
 for a considerable length of time. Dose of the simple 
 syrup, one teaspoonful three or four times a day. 
 
 Trillin. 
 
 The trillin is obtained from the root of the Trillium 
 Pendulum. Common name, Beth Boot. The trillin is 
 astringent, styptic, alterative, and tonic. It is used in 
 uterine hemorrhage, lencorrhcea, and prolapsus uteri. The 
 trillin should be triturated ten grains to the hundred of 
 sugar, and from five to ten grains of the trituration is a 
 dose. 
 
 Veratrin. 
 
 The veratrin is obtained from the Veratrum Viride. 
 Common name, Swamp Hellebore. It is sedative, dia- 
 phoretic, alterative, diuretic, and in large doses emeto- 
 cathartic. There are but few remedies by which the 
 heart's action can be so readily controlled as by this. 
 Hence in all sthenic disease in which there is great increase 
 of circulation, as in miasmatic fevers, the veratrin consti- 
 tute one of the most important remedies in use. In many 
 cases of intermittent, remittent, and bilious fevers, the 
 vetratrin is the only remedy needed. It is also very 
 valuable in the treatment of pneumonia, pleurisy, and 
 bronchitis of a sthenic character. But where the powers 
 of the system are feeble, and the disease of an asthenic 
 character, the veratrin should not be given. As it proves 
 too debilitating, a tincture made from the fresh root is 
 also used in the same diseases as the veratrin. The 
 veratrin should be triturated ten grains to the hundred of 
 
LIST OF REMEDIES. 315 
 
 sugar, and from one to three grains of the trituration 
 
 given as a dose. Dose of the trituration is from three to 
 
 ten drops. 
 
 Viburin. 
 
 The Viburin is obtained from the Viburnum oxycoccum. 
 Common name, High Cranberry. It is antiperiodic, 
 tonic, and alterative. The Viburin is a valuable remedy 
 in the treatment of ague and remittent fever. It is also 
 valuable in periodic pneumonia and pleuritis. While it 
 arrests the periodicity of pneumonia, it also facilitates 
 expectoration. This remedy has proved highly valuable 
 in obviating the casualties of pregnancy. It is frequently 
 prepared in the form of a syrup and given under the name 
 of mother's relief. When given in the form of a syrup, 
 it should be prepared by adding one drachm to the pint 
 of the syrup of sugar. Dose, one tablespoonful three 
 times a day. Dose of the triturated from three to ten 
 
 grains. 
 
 Xanthoxylin. 
 
 Obtained from the Prickly Ash. The Xanthoxylin is 
 one of the most powerful diffusible stimulants known to 
 the profession. When given in full doses, it produces 
 effects upon the nerves as though slight shocks of elec- 
 tricity were passing through the system. From its powerful 
 stimulating properties, it is used in all low forms of fever, 
 in passive congestion, in cholera, diarrhasa, and dysentery. 
 It is also a remedy of great value in congestive chills. It 
 should be triturated ten grains to the hundred of White 
 Sugar, and from five to ten grains is a dose. A tincture 
 is made of the Prickly Ash Berries, by adding an ounce 
 of the berries to one pint of brandy. Dose, one teaspoon- 
 ful as often as indicated. It is used in the same diseases 
 as the Xanthoxylin. 
 
316 LIST OF REMEDIES, 
 
 Peruvian Bark and its Alkaloids. 
 
 These medicines are without doubt among the most 
 precious remedies known to the profession. And the 
 prejudice which exists against them, is owing to their 
 having been combined with mercury, arsenic, &c, in the 
 allopathic practice. The cinchonas and their alkaloids 
 are as innocent remedies, when properly used, as any other 
 vegetable medicines. The active principles of the Peru* 
 vian Bark are Quinine, Cinchonin, Chinoidin, and Qui- 
 noidine. The medical properties of all these are very 
 nearly the same, although the Quinine is much the strongest. 
 They are all antiperiodics, and may be used in all cases 
 where a periodicity is a symptom of the disease. Dose 
 of the Quinine is from one to ten grains, of the other 
 alkaloids from five to twenty grains, 
 
 Gossypium Herbaceum . 
 
 Commonly called Cotton Root, The hydro-alcoholic 
 extract is the preparation mostly used. It is emmena- 
 gogue and antiperiodic. This extract is extensively cir- 
 culated as a quack medicine for producing abortion. It 
 is prepared in the form of pills. It is used in chlorosis, 
 amenorrhea, dysmenorrhea, and in periodic diseases. 
 Dose of the extract is from three to five grains. 
 
 The limits of this work will not permit me to further 
 consider each separate remedy. I will therefore refer the 
 reader to the American Electic Dispensatory, by John 
 King, M. D., where all the resources of American Eclectic 
 Physicians are fully considered. Formulae for a few Eclectic 
 compounds, will be given. 
 
LIST OF REMEDIES. SI T 
 
 Mother's Cordial, 
 
 Or Compound Syrup of Partridge Berry, according to 
 the American Eclectic Dispensatory. Take Partridge 
 Berry, one pound, Helonias Root, High Cranberry Bark, 
 Blue Cohosh Root, of each four ounces. Grind and mix 
 the articles together, place the whole in a convenient 
 vessel, cover them with fourth-proof brandy, and macerate 
 for three days. Then transfer the whole to a displace- 
 ment apparatus, and gradually add Brandy until three 
 pints of spirituous tincture have been obtained, which 
 reserve. Then continue the displacement with Hot Water 
 until the liquid passes tasteless, add to this two pounds of 
 Refined Sugar, and evaporate by a gentle heat to five pints, 
 remove from the fire, add the reserved three pints Spiritu- 
 ous Tincture, and flavor with essence of Sassafras. This 
 preparation, says Dr. King, is a uterine tonic and anti- 
 spasmodic. It may be used in all cases where the func- 
 tions of the internal reproductive organs are deranged, 
 as in amenorrhea, dysmenorrhea, menorrhagia, leucor- 
 rhcea, and to overcome the tendency to habitual abortion. 
 The dose is from one to four tablespoonfuls three times a 
 day ; pregnant females, especially those of a delicate or 
 nervous system, will find an advantage in taking one or 
 two doses daily. 
 
 Neutralizing Cordial, 
 
 Or Compound Syrup of Rhubarb and Potassa. Take of 
 India Rhubarb and Bicarbonate of Potassa each one pound, 
 good brandy one gallon, tincture the Rhubarb and Potassa 
 for fourteen days, then express the tincture by pressure. 
 Add the dregs to one gallon of water, and evaporate clown 
 to one half gallon ; strain the liquor, and w r hile it is hot 
 dissolve in it four pounds of white sugar. After it gets 
 cool, add six ounces of good peppermint essence. This 
 27* 
 
318 LIST OF REMEDIES. 
 
 syrup is a valuable medicine in diarrhsea, dysentery, flatu- 
 lency, and most chronic irregularities of the bowels. Dose 
 is one teaspoonful repeated as often as indicated. 
 
 Antiscrofulous Syrup. 
 
 As prepared according to the Eclectic Dispensatory. 
 Take Yellow Dock Root two pounds, bark of the root of 
 False Bittersweet one pound, bark of American Ivy, Am 
 pelopsis Quinquefolia, and Figwort, of each half a pound, 
 refined sugar sixteen pounds ; grind and mix the drugs 
 together, place the whole five pounds in a convenient vessel, 
 cover them with alcohol of 16 per cent., and macerate for 
 two days. Then transfer the whole to a common displace- 
 ment apparatus, and gradually add hot water until two 
 pints have been obtained, which retain and set aside. 
 Then continue the percolation, and of the second solution, 
 reserve so much as contains a sensible amount of spirits, 
 and evaporate the alcohol from it. Continue the displace- 
 ment by hot water until the solution obtained is almost 
 tasteless, and boil down this weaker infusion till it begins 
 to thicken, or until when added to the balance remaining 
 of the second portion after the evaporation of the alcohol, 
 it will make twelve pints. To these two solutions com- 
 bined, add sixteen pounds of refined sugar, and by heat 
 dissolve, carefully removing the scum which arises as it 
 comes to the point of boiling. Then, if it exceeds that 
 quantity, evaporate the syrup with constant stirring to 
 fourteen pints, remove from the fire, and when nearly cold 
 add the two pints of tincture first obtained, and make two 
 gallons of syrup. Each pint will contain the virtues of 
 four ounces of the ingredients. It may be flavored with 
 essence of wintergreen. It is used in all cases where an 
 alterative is indicated in chronic hepatitis, rheumatism, 
 syphilis, scrofula, cutaneous diseases, ulcers, white swell- 
 
LIST OF REMEDIES. 319 
 
 ing, rickets, necrosis, and every taint of the system. Dose 
 from a teaspoonful to a tablespoonful three or four times a 
 day. 
 
 Syrup of Siillingia. 
 
 U Queen's Root 3 ft). 
 
 Prickly Ash Berries 1 J ft). 
 
 1. Grind and mix the articles together, place the whole 
 four pounds and a half in a convenient vessel, cover them 
 with alcohol of 76 per cent., and macerate for three days. 
 Then transfer the whole to a displacement apparatus, and 
 gradually add alcohol until five pints of the alcoholic tinc- 
 ture have been obtained, which retain and set aside. 
 
 2. Continue the percolation, and of this second solution 
 reserve as much as contains a sensible amount of spirits, 
 and distil or evaporate the alcohol from it, 3. Continue 
 the displacement by hot water until the solution obtained 
 is almost tasteless, and boil down this weak infusion until 
 when added to the second solution after the evaporation 
 of its alcohol it will make twenty -four pints. 4. To these 
 two solutions combined, add thirty-two pounds of refined 
 sugar, and dissolve it by heat, carefully removing any scum 
 which arises as it comes to the point of boiling, and if it 
 exceeds twenty-eight pints, evaporate to that quantity with 
 constant stirring. Then remove from the fire, and when 
 nearly cold, add the four pints of reserved alcoholic tinc- 
 ture, and make four gallons of syrup, each pint of which 
 will be equal to four ounces of the ingredients in medicinal 
 virtue. This syrup is one of the most powerful alteratives 
 known. It is used in all cases of syphilis, scrofula, mer- 
 curial and glandular diseases. Dose one teaspoonful three 
 or four times a day. (This syrup is prepared according to 
 the formula of the American Eclectic Dispensatory, 
 John King, M. D.) The above formula is the best 
 method of preparing the syrup of stillingia, and by 
 
320 LIST OF REMEDIES. 
 
 tincturing and carefully boiling, the strength may be ob- 
 tained, and the syrup prepared and used as directed. For 
 domestic practice, however, these syrups can be bought 
 already prepared, as most druggists keep them for sale. 
 
 Acetic Syrup of Sanguinaria, or Blood Boot. 
 
 R Blood Root in powder 31. 
 
 Acetic Acid, or Vinegar J pt. 
 
 Water J pt. 
 
 Add the blood root to the vinegar and water mixed, 
 and steep for two hours, then strain and add three pounds 
 of white sugar. Simmer until a syrup is formed. This 
 is the specific remedy for pseudo-membranous croup. It 
 is also used in infantile pneumonia and bronchitis. Dose 
 for croup is from one-half teaspoonful to one tablespoonful ; 
 but it should not be given in quantities sufficient to pro- 
 duce vomiting, unless there is imminent danger of suffoca- 
 tion ; and then only sufficient to eject the mucus, adhering 
 to the upper part of the bronchi and trachea. 
 
 Syrup of Marshmallow. 
 
 R Pulv. Marshmallow , giij. 
 
 Warm Water 1 qt. 
 
 Add the marshmallow to the water and simmer for half 
 an hour, or until the water is evaporated to one pint, then 
 strain, and add three pounds of white sugar and form a 
 syrup. This syrup is mucilaginous and diuretic. Four 
 ounces of syrup of marshmallow, and one drachm of 
 Iodide of Potassium, make a preparation of great value 
 in empyema and dropsical effusions. Dose of the simple 
 syrup, one tablespoonful every three or four hours, of the 
 Syrup and Iodide of Potassium, one teaspoonful three 
 times a day. 
 
LIST OF REMEDIES, :> l M 
 
 Compound Syrup of Stillingia, 
 
 Be Take Stillingia Root, Root of Turkey Cora, 
 
 each 2 Jb. 
 
 Blue Flag Root, Elder Flowers, and Pipsis- 
 sewa leaves each 1 lb. 
 
 1. Grind and mix the articles together, place the whole 
 seven pounds in a convenient vessel, cover them with 
 alcohol fef 16 per cent, and macerate for three days. 
 Then transfer the whole to a displacement apparatus, and 
 gradually add hot water until four pints of the alcoholic 
 tincture have been obtained, wiiich retain and set aside. 
 
 2. Then continue the percolation, and of this solution, 
 reserve as much as contains a. sensible amount of spirit, 
 and distil or evaporate the alcohol from it. 3. Continue 
 the displacement by hot water, until the solution obtained 
 is almost tasteless, and boil this weaker infusion, until 
 w T hen added to the sound solution after the evaporation 
 of its alcohol, it will make twenty-four pints. 4. To 
 these two solutions combined, add thirty-two pounds of 
 refined sugar, and dissolve it by heat, carefully removing 
 any scum which arises as it comes to the point of boiling, 
 and strain. When nearly cold add the four pints of re- 
 served Alcoholic tincture, and make four gallons of syrup. 
 Properties and use : The Compound Syrup of Stillingia 
 is one of the most powerful and effective alteratives, and 
 is extensively used by Eclectic practitioners in all cases of 
 syphilis, scrofula, osseous, mercurial, hepatic, and glandular 
 diseases, or in every case where an alterative is indicated. 
 It is most commonly given with one ounce of Iodide of 
 Potassium to each pint of syrup. The dose is a fluid 
 drachm three or four times a day (American Eclectic 
 Dispensatory, by John King, M. D.). 
 
322 LIST OF REMEDIES. 
 
 Syrup of Alum. 
 
 U Take of Pulverized Alum gi. 
 
 Water 1 pint. 
 
 Heat the water until the alum is all dissolved, and add 
 one pound of refined sugar, simmer until a syrup is formed, 
 strain, and when it is cool it is fit for use. The syrup of 
 alum is very valuable in hooping cough, in chronic catarrh, 
 and the early stage of pulmonary consumption. *It is also 
 used in leucorrhoea and diabetes. Dose is from one to 
 two teaspoonfuls three times a day as often as indicated. 
 
 Pulmonary Balsam. 
 
 Take of the Roots of Spikenard, Elecampane, Comfrey 
 and Blood Root, of the leaves and flowers of Hoarhound, 
 and of the bark of Wild Cherry, each one pound. These 
 may all be ground and tinctured by adding alcohol, water 
 and sugar, sufficient to make three gallons of syrup. Or 
 any portion of the above compound may be tinctured in 
 sufficient alcohol to cover them, when the drugs may be 
 boiled until the strength is obtained, and the tincture and 
 watery infusion may be mixed, and a sufficient amount of 
 refined sugar added to make a thick syrup. The Pulmo- 
 nary Balsam is one of the most valuable cough and expec- 
 torant syrups in use. It may be used in all cases of coughs 
 and colds, also in bronchial and pulmonary affections. 
 Dose is from one to two teaspoonfuls four or five times a 
 day. 
 
 Bronchitis Drops. 
 
 Take the fluid extract of Rumex Crispus, Rhus Glabra, 
 Hyosciamus Niger, Uvularia Perfoliata, and Cypripedium 
 Pubescens ; mix well together. The Bronchitis drops are 
 valuable in chronic Bronchitis, Laryngitis, &c. Dose from 
 five to ten drops, repeated as indicated. 
 
LIST OF REMEDIES. 323 
 
 Antibilious Physic. 
 
 Hi Take Pulveriz-ed Senna 1 lb. 
 
 Jalap J ft). 
 
 Ginger 1 §. 
 
 Mix. This mixture forms one of the most valuable purga- 
 tives in use. It is mild, yet efficient, and is well adapted to 
 evacuate the stomach and bowels, whenever it is indicated. 
 Dose five or ten grains every two or three hours until it 
 operates. 
 
 Worm Mixture. 
 
 U Take Santonin ...f, 10 grs. 
 
 Podophyllin 2 grs. 
 
 Populin , 10 grs. 
 
 White Sugar 30 grs. 
 
 Mix and triturate thoroughly, and bottle for use. Dose 
 for a child from one to three grains every night on going 
 to bed. The above mixture seldom fails to remove worms 
 in children. 
 
 Lac tin. 
 
 Lactin is the sugar of milk, and is very extensively used 
 by some physicians to triturate their medicines with ; but I 
 have not been able to discover any advantage in the use 
 of the lactin, over pure white sugar. 
 
THE 
 
 DIFFERENT SYSTEMS OF PRACTICE. 
 
 That the reader may become familiar with the resources, 
 not only of the American Eclectic System of Practice, but 
 also with the practice of the Allopathist, Homoeopathist 
 and Hydropathist, I will here introduce a list of diseases, 
 with their remedies, from the most approved authority of 
 each system of practice. The Allopathic treatment I 
 have given strictly according to Prof. Eberle, one of the 
 most popular authors upon that system of practice. The 
 Homoeopathic practice is given according to J. Lourie, 
 M. D., an author of great popularity among Homceopa- 
 thists. The size of the dose and the trituration are given 
 according to Jahr-s and Gruner's Homoeopathic Pharma- 
 copoeia. The Hydropathic treatment is given according to 
 Shew, Trail, and other standard authorities. 
 
 ALLOPATHIC PRACTICE. 
 
 Intermittent Fever. — Treatment : — Emetics, opium 
 blood-letting, nitre, camphor, sulphuric ether, magnesia, 
 calomel and jalap, cinchona, quinine, potash, cloves, 
 leeches, blisters, arsenic, sulphate of zinc, black pepper 
 salivation. 
 
 Remittent Fever. — Treatment : — Blood-letting, cathar- 
 tics, calomel and jalap, ipecac, nitre, salivation, epsom 
 salts, castor oil, magnesia, opium, antimony, ammonia, 
 cold water, leeches, blisters, balsam copaiva, sinapisms, 
 warm bath, enemas, lemonade, quinine, gentian, serpen- 
 
 taria. 
 
 (324) 
 
ALLOPATHIC PRACTICE. 325 
 
 Yellow Fever. — Treatment: — Blood-letting, calomel, 
 salivation, enemata, epsom salts, sponge with cold water, 
 leeches, blisters, aperients, diaphoretics, quinine, wine, 
 ammonia. 
 
 Synocha or simple continued Fever. — Treatment: — 
 Blood-letting, purgatives, soda, magnesia, antimony, jalap, 
 cream of tartar, calomel, diaphoretics, nitre, James's 
 powders, digitalis, salivation, ipecac, sponging with cold 
 water, blisters, cupping, leeches, enemata. 
 
 Synochus Fever. — Treatment : — The same as synocha 
 throughout. 
 
 Typhus Fever. — Treatment : — Emetics, ipecac, calomel, 
 gentle purgatives, castor oil, enemata, epsom salts, croton 
 oil, salivation, blood-letting, effusions of cold water, 
 diaphoretics, laudanum, nitre, wine, ammonia, camphor, 
 opium, quinine, blisters, capsicum; serpentaria, camomile. 
 
 Glossitis, inflammation of the tongue. — Treatment : — 
 Blood-letting, leeches, scarifying, incisions with scalpel, 
 laxative enemata, blisters on the back of the neck. 
 
 Tonsillitis, Quinsy,' — Treatment : — Blood-letting, scari- 
 fying the tonsils, cupping, an active purge, mild aperients, 
 calomel, enemata, nitre, antimony, ammonia, liquorice, 
 blisters, spirits turpentine, emollient poultices. 
 
 Parotitis, Mumps. — Treatment: — Keep the bowels 
 open, diaphoretics, blisters, mercurial ointment, camphor, 
 rubefacient liniments. 
 
 Acute Gastritis. — Treatment : — Blood-letting, leeches, 
 blisters, mercurial ointment, mucilaginous drinks, vegetable 
 acids, laxative enemata, opium, calomel. 
 
 Chronic Gastritis. — Treatment : — Leeching or cupping, 
 blisters, tartar emetic ointment, sulphate of iron, hyoscia- 
 mus, morphia, nitrate of silver, borax, Dover's powder, 
 balsam of copaiva, syrup of poppies, purgative enemata. 
 
 Peritoneal Enteritis. — Treatment : — Blood-letting, pur- 
 gatives, laxative enemata, calomel, castor oil, opium, 
 28 
 
326 ALLOPATHIC PRACTICE, 
 
 spirits turpentine, blisters, emollient poultices, digitalis, 
 wine. 
 
 Dysentery. — Treatment : — Bleeding, purgatives, castor 
 oil, calomel, laudanum, emetics, ipecac, diaphoretics, sali- 
 vation, mucilaginous liquids, nitrous acid, sugar of lead, 
 leeches, blisters, emollient poultices, balsam of copaiva, 
 turpentine, enemata, dogwood bark, diet, rice, barley. 
 
 Chronic Enteritis. — Treatment: — Proper diet, castor 
 oil, laudanum, leeches, blisters, tartar-emetic ointment, 
 calomel, balsam of copaiva, spirits turpentine, sulphate 
 of iron, nitrate of silver, hyosciamus, elm bark. 
 
 Acute Peritonitis. — Treatment : — Blood-letting, leeches, 
 emollient poultices, active cathartics, castor oil, spirits 
 turpentine, cream of tartar, calomel, jalap, blisters, 
 leeches, salivation, opium, digitalis, wine. 
 
 Chronic Peritonitis. — Treatment: — Leeches, blisters, 
 mercurial ointment, tartar-emetic ointment, emollient poul- 
 tices, warm baths, castor oil, cream of tartar, Dover's 
 powder. 
 
 Acute hepatitis. — Treatment : — Blood-letting, mercury, 
 castor oil, leeches, salivation, blisters, opium, antimony, 
 warm bath, nitro-muriatic acid, cicuta, tonic bitters, nitric 
 acid, extract of conium. 
 
 Chronic hepatitis. — Treatment : — Blood-letting, mer- 
 cury, leeches, salivation, blisters, emollient poultices, blue- 
 pill, conium, laxatives, epsom salts, gentian, columbo, 
 nitro-muriatic acid, white precipitate, setons. 
 
 Splenitis. — Treatment : — Blood - letting, purgatives, 
 counter-irritants, warm bath, leeches, tartar-emetic, mer- 
 cury, setons, hyosciasmus, diaphoretics, antimony, muriate 
 of ammonia, ipecacuanha, iodine. 
 
 Phrenitis, phrensy. — Treatment : — Blood-letting, 
 leeches, cold water or ice, active purgatives, calomel, 
 senna, blisters, nitre, antimony, digitalis. 
 
 Arachnitis, hydrocephalus. — Treatment : — Laxatives, 
 
ALLOPATHIC PRACTICE. 327 
 
 calomel, blue-pill, castor oil, blood-letting", leeches, manna, 
 laxative enemata, spigelia, ipecac, salivation, mercurial 
 ointment, blisters, ice, tartar-emetic ointment, James's and 
 Dover's powder. 
 
 Cerebritis, softening of the brain. — Treatment : — 
 Blood-letting, sinapisms, opium, cold to the head, blisters, 
 calomel, salivation. 
 
 Peripneumonia. — Treatment : — ■ Bleeding, leeches, 
 digitalis, nitre, castor oil, emetics, cooling diaphoretics, 
 muriate of ammonia, antimony, calomel, opium, camphor, 
 ipecacuanha, expectorants, blisters, squills, tartar-emetic 
 ointments, setons, conium. 
 
 Cynanche Laryngea, Laryngitis. — Treatment : — Blood- 
 letting, leeches, blisters, emollient poultices, emetics, calo- 
 mel, sinapisms to the feet, lunar caustic, alum, bron- 
 chotomy. 
 
 Cynanche Trachealis, Croup. — Treatment : — Bleed- 
 ing, blisters, emetics, warm bath, mercurial purgatives, 
 antimony, enemata, salivation, ipecac, friction with turpen- 
 tine, polygala senega. 
 
 Acute bronchitis. — Treatment : — Blood-letting, ene- 
 mata, castor oil, emetics, tartar-emetic, ipecacuanha, 
 squills, expectorants, opium, calomel, blisters, leeches, 
 emollient poultices, warm bath, columbo, gentian. 
 
 Chronic Bronchitis, Bronchial Consumption. — Treat- 
 ment : — Bleeding, leeches, warm climate, tartar-emetic 
 ointment, emollient poultices, emetics, digitalis, antimony, 
 squills, balsam copaiva, quinine, opium, conium, ipecac, 
 prussic acid, sugar of lead, blue-pill, or calomel, saliva- 
 tion. 
 
 Pthisis Pulmonalis. — Treatment : — Blood-letting, digi- 
 talis, tartar-emetic blisters, issues and setons, gum arabic, 
 prussic acid, acetate of lead, opium, uva ursi, expectorants, 
 muriate of ammonia, tartar-emetic ointment, salivation, 
 squills. 
 
328 ALLOPATHIC PRACTICE. 
 
 Nephritis. — Treatment : — Blood-letting, cupping or 
 leeches, active cathartics, calomel, castor oil, enemata, 
 emollient poultices, blisters, diaphoretics, antimony, steam 
 bath, Dover's powder, uva ursi, opium, conium, lime 
 water, balsam copaiva. 
 
 Cystitis. — Treatment : — Bleeding, leeches, emollient 
 poultices, gentle laxatives, enemata, opium, introduction 
 of catheter, steam bath, antimony, calomel. 
 
 Chronic cystitis. — Treatment : — Cupping, leeches, 
 blood-letting, castor oil, magnesia, caustic issues on the 
 thigh, m'uriated tincture of iron, beech leaves, uva ursi, 
 ursi, elm bark injected into the bladder. 
 
 Hysteritis. — Treatment: — Bleeding, leeches, emollient 
 poultices, calomel, epsom salts, injecting warm emollient 
 fluids into the vagina, blisters, nitre, antimony, opium. 
 
 Chronic hysteritis. — Treatment : — Blood-letting, cup- 
 ping, purgatives, leeches, blisters, emollient injections, 
 warm bath, mercury, camphor, antimony, balsam copaiva, 
 muriate of ammonia, liquorice. 
 
 Pericarditis. — Treatment : — Calomel, bleeding, opium, 
 salivation, leeches, blisters, cream of tartar, diuretics, 
 squills, pustulation with tartar-emetic ointment, or a caus- 
 tic issue over the region of the heart. 
 
 Acute Rheumatism. — Treatment : — Blood-letting, pur- 
 gatives, calomel, epsom salts, emetics, antimony, opium, 
 diaphoretics, salivation, quinine, colchicum, magnesia, 
 stramonium, leeches, blisters. 
 
 Chronic Rheumatism. — Mercury, rhubarb, quinine, 
 antimony, salivation, sarsaparilla, vapor bath, sulphate of 
 zinc, stramonium, colchicum, arsenic, leeches, cups, blis- 
 ters, spirits turpentine, capsicum, camphor, warm bath. 
 
 Gout. — Treatment: — Bleeding, cathartics, calomel, 
 emetics, ipecac, opium, eupatorium perfoliatum, colchicum, 
 magnesia, blue pill, camphor, ginger, savin, laudanum, 
 sinapisms, enemata, cupping, leeching. 
 
ALLOPATHIC PRACTICE. 329 
 
 » 
 
 Catarrhal Ophthalmia. — Treatment : — Scarifying, anti- 
 mony, calomel and jalap, emollient applications, opium, 
 solution of zinc, nitrate of silver, corrosive sublimate, 
 ipecac, blisters, lunar caustic, quinine, bark, arsenic. 
 
 Rheumatic Ophthalmia. — Treatment : — Bleeding, anti- 
 mony, opium, calomel, Dover's powder, blisters, cupping, 
 puncturing the cornea, aqueous solutions of opium. 
 
 Purulent Ophthalmia. — Treatment : — Blood-letting, 
 leeches, decoction of poppy-heads, calomel, ipecac, anti- 
 mony, castor oil, blisters, emollient fomentations, lime, 
 nitrate of silver, quinine, nitric acid. 
 
 Scrofulous Ophthalmia. — Treatment : — Leeches, pur- 
 gatives, calomel, castor oil, rhubarb, emetics, antimony, 
 Dover's powders, sarsaparilla, quinine, barytes, iodine, 
 nitrate of silver. • 
 
 Syphilitic and strumous iritis. —Treatment : — Mercury, 
 antimony, jalap, salivation, belladonna, precipitate oint- 
 ment, chalk, quinine, setons in the nape of the neck. 
 
 Variola, Small-pox. — Treatment : — Blood-letting, pur- 
 gatives, calomel, emetics, diaphoretics, nitre, antimony, 
 ammonia, cooling regimen, wine, camphor, quinine, opium, 
 blisters, scarifications, chalk, ipecac, warm bath. 
 
 Rubeola, Morbilli, Measles. — Treatment : — Mild laxa- 
 tives, diaphoretics, sage, elder blossoms, balm, eupatoriurri, 
 bleeding, antimony, nitre, warm baths, stimulating friction, 
 sinapisms, camphor, ammonia, opium, blisters, calomel, 
 squills, serpentaria. 
 
 Scarlatina. — Treatment: — Gentle aperients, cool or 
 tepid drinks, emetics, brisk mercurial purges, warm baths, 
 nitre, antimony, ammonia, sulphuric acid, cold water to 
 the surface, blisters, blood-letting, camphor, calomel, opium, 
 sinapisms, wine, quinine, capsicum, enemata, serpentaria. 
 
 Erysipelas. — Treatment : — Blood-letting, purgatives, 
 calomel, emetics, diaphoretics, antimony, ipecacuanha, 
 magnesia, castor oil, warm bathing, bark, wine, opium, 
 28 * 
 
830 ALLOPATHIC PRACTICE. 
 
 camphor, capping, blisters, enemata, corrosive sublimate, 
 nitrate of silver, incisions in the inflamed skin. 
 
 Herpes Phlyctenodes. — Treatment : — Gentle aperients, 
 simple diet, diaphoretics, calomel, ipecac, warm bath, 
 bleeding, Dover's powder, lunar caustic. 
 
 Herpes Lahialis.- — Treatment : — Fomentations of white 
 poppy-heads, acetate of lead. 
 
 Herpes Preputialis. — Treatment: — A solution of borax, 
 nitrate of silver, chloride of sodium in solution. 
 
 Pemphigus. — Treatment: — Mild laxatives, rest, tepid 
 bathing, bleeding, diuretics, calomel, Fowler's arsenical 
 solution, opium, quinine, sulphuric acid. 
 
 Urticaria, Nettle Bash, — Treatment : — Emetics, ipecac, 
 mild laxatives, simple diet, cooling drinks, rest, magnesia, 
 quinine, sulphuric acid, iron, Fowler's solution, tepid bath. 
 
 Miliaria, Miliary Fever. — Treatment : — Ipecac, emetics, 
 warm bathing, diaphoretics, Dover's powder, ammonia, 
 serpentaria, camphor, opiates. 
 
 Lichen.— Treatment : — Tepid bathing, mild aperients, 
 diluent acidulated drinks, cream, calomel, unsalted butter, 
 sulphuric acid, bleeding, Fowler's solution, laxatives, low 
 diet. 
 
 Eczema. — Treatment : — Sulphur ointment, tepid bath- 
 ing, mild laxatives, nitre, tartar emetic, Dover's powders, 
 calomel, nitric acid, soda, sarsaparilla, camphor, opium, 
 stramonium, borax, eantharides, arsenic, Fowler's solu- 
 tion. 
 
 Herpes Zoster. — Treatment :— Gentle aperients, simple 
 diet, diaphoretics, calomel, ipecac, warm bath, bleeding, 
 Dover's powders, lunar caustic. 
 
 Herpes Circinatus, Ring Worm.. — Treatment : — Alka- 
 line washes, sulphate of copper or zinc, ointment of narrow- 
 leafed dock, mild laxatives. 
 
 Erythema. —Treatment : — Light diet, gentle diapho- 
 
ALLOPATHIC PRACTICE. 331 
 
 retics, mineral acids, warm baths, tepid ablutions, borax, 
 acetate of lead, opium. 
 
 Roseola. — Treatment: — Rest, mild aperients, acidulated 
 cooling diluents, simple diet, refrigerant diaphoretics. 
 
 Hemorrhagica Petechialis. — Treatment : — Tonics, cin- 
 chona, serpentaria, sulphuric acid, wine, nitrate of silver, 
 spirits of turpentine, blood-letting, purgatives, calomel and 
 jalap, oil of turpentine, bathing the surface with a decoc- 
 tion of oak bark. 
 
 Hemorrhages. — Treatment : — Blood-letting, digitalis, 
 cold, blisters, sinapisms, warmth, sugar of lead, alum, 
 muriated tincture of iron. 
 
 Epistaxis. — Treatment: — Bleeding, cool drinks, laxa- 
 tives, nitre, cold water applied to the head, neck and 
 genital organs, sugar of lead, gallic acid, blisters to the 
 nape of the neck, pediluvium, sinapisms to the feet. 
 
 Hcematemesis, bleeding at the stomach. — Treatment : — 
 Blood-letting, sinapisms to the epigastric and hypocondriac 
 regions, cupping, warm bath, laxatives, enemas, active 
 purgatives, emetics of ipecac, sugar of lead, spirits of tur- 
 pentine, castor oil, tincture of iron, juice of the common 
 nettle. 
 
 Hcematuria, bleeding of the urinary organs. — Treat- 
 ment: — Bleeding, warm bath, opium, cupping, sugar of 
 lead, sinapisms over the kidneys, muriated tincture of iron, 
 mucilaginous drinks, alum, ipecac, decoction of logwood, 
 cold water to the genitals, inject cold solutions of the 
 sugar of lead. 
 
 Hcemoptysis, bleeding at the lungs. — Treatment: — 
 Blood-letting, common salt, sugar of lead, sinapisms to 
 the breast, cooling drinks, laxative enemata, nitrate of 
 potash, opium, calomel, emetics, capsicum, digitalis, caustic 
 issue-s, setons, leeches to the anus, camphor, ipecac, can- 
 tharides, warm hip bath. 
 
 Menorrhagia, uterine hemorrhage. — Treatment: — 
 
332 ALLOPATHIC PRACTICE. 
 
 Bleeding, sugar of lead, ipecac, opium, camphor, cinna- 
 mon, alum, nitre, astringent injections into the vagina, 
 elixir of vitriol, tampons, emetics, valerian prussiate of 
 iron, ergot, savin. 
 
 Phlegmasia Dolens. — Treatment : — Blood - letting, 
 leeches, purgatives, magnesia, colchicum, antimony, calo- 
 mel, opium, ipecac, nitre, frictions with dry flannel, fomen- 
 tations with hot vinegar and water. 
 
 Apoplexy. — Treatment: — Copious blood-letting, cold 
 water to the head, fomentations, sinapisms of the tincture 
 of capsicum to the feet, cupping, active purgatives, calomel 
 and colocynth, croton oil, castor oil and turpentine, ene- 
 mata, aloes, antimony, emetics, zinc, blisters, issues. 
 
 Hemiplegia, palsy of one side ; Paraplegia, palsy of 
 the legs. — Treatment: — Blood-letting, purgatives, salts, 
 aloes, calomel, scammony, colocynth, capsicum, emetics, 
 blisters to the neck, sinapisms to the ankles, stimulating 
 enemata, friction, stimulating baths, electricity, galvanism, 
 strychnine, salivation, iodine, warm bath. 
 
 Epilepsy. — Treatment : — Bleeding, cold water in large 
 draughts, emetics in large draughts, emetics of ipecac, 
 calomel, diaphoretics, warm bath, antimony, camphor issues, 
 setons, emetics, spirits of turpentine, castor oil, oil of tur- 
 pentine, misletoe, oxide of zinc, nitrate of silver, tin, 
 lead. 
 
 Catalepsy. — Treatment: — Sulphuric ether, stimulating 
 applications to the feet, enemata, bleeding, purgatives, 
 galvanism, electricity, country air, regular exercise, tepid 
 bathing, blue pill, camphor, tepid shower bath, zinc, vale- 
 rian, musk, castor, opium. 
 
 Chorea, St. Vilus-s Dance. — Treatment : — Purgatives, 
 mercury, quinine, aloes, bleeding, vegetable diet, Dover's 
 powder, magnesia, valerian assafoetida, hyoscyamus, cam- 
 phor, opium, turpentine, warm pediluvium, blisters, savin, 
 
ALLOPATHIC PRACTICE. 333 
 
 iron, leeches and warm bath, sulphur, issues, tartar-emetic 
 ointment, &c. 
 
 Convulsive affections of infants.— Treatment :— Emetics 
 of ipecac, purgatives, enemata, infusions of savin and 
 spigelia, bleeding, calomel, pediluvium, cold water to the 
 head, blisters, assafcetida, musk, opium, Dover's powder, 
 warm bath, setons, issues, sulphur. 
 
 Hysteria. — Treatment: — Bleeding, sinapisms, emetics, 
 sulphate of zinc, ipecac, opium, assafcetida, musk, sul- 
 phuric ether, castor, enemata, warm pediluvium, turpentine, 
 enemata, camphor, valerian, ictodes-foetida, antimony, 
 iron, mercury, cold shower bath, &c. 
 
 Puerperal Convulsions. — Treatment : — Blood-letting, 
 sinapisms to the feet, purgative enemata, cupping, cold 
 applications to the head, active cathartics, calomel, jalap, 
 aloes. 
 
 Tetanus. — Treatment : — Bleeding, leeches, mercury, 
 opium, warm bath, purgatives, castor oil, spirits of tur- 
 pentine, wine, prussic acid, cold effusions. 
 
 Hydrophobia. — Treatment : — Local applications to 
 the wound, wash the wound with warm water, excision, 
 cautery, cupping, glysters, ligatures, belladonna, water 
 plantain, vinegar, cantharides, mercury, cold bathing, 
 copious bleeding. 
 
 Monomania. — Treatment : — Blood-letting, leeches, pur- 
 gatives, mercury, castor oil, ^alap, spigelia, turpentine, 
 emetics, regimen, exercise, warm bath, cold bath, blisters, 
 circular swing, music. 
 
 Delirium Tremens. — Treatment: — Opium the sheet 
 anchor, castor oil, laxatives, enemata, cupping, emetics 
 of tartar-emetic, ipecacuanha, cold and tepid effusions, 
 ammonia, assafcetida, camphor, Hoffman's anodyne. 
 
 Neuralgia. — Treatment: — Divide the nerve with a 
 scalpel, quinine, arsenic, carbonate of iron, stramonium, 
 frictions with the extract of belladonna, oil of turpentine, 
 
334 ALLOPATHIC PRACTICE. 
 
 moxa, leeches, strong magnet, lobelia, zinc, leeches to the 
 anus, aloes, 
 
 Amaurosis. — Treatment : — Bleeding, free purging with 
 calomel, epsom salts, antimony, salivation, belladonna, 
 blisters or setons on the neck, leeches to the temples, blue- 
 pill, ipecac, sarsaparilla, arsenic, bark, cold bath, capsi- 
 cum, opium, emetics, leeches around the anus. 
 
 Asthma. — Treatment : — Blood - letting, hyosciamus, 
 stramonium, emetics of ipecac, squills, vinegar, digitalis, 
 opium, skunk cabbage, lobelia inflata, galvanism, tonics, 
 bark, quinine, arsenic, carbonate of iron, blue-pill, tepid 
 shower bath, warm bath. 
 
 Asphyxia from drowning. — Treatment : — Artificial 
 inflation of the lungs, gradual warmth, friction with a .dry 
 flannel, mustard and capsicum, stimulating injections, 
 warm wine, weak brandy toddy, infusions of balm, sage 
 or catnip. 
 
 Asphyxia, from mephitic gases.-— Treatment : — Dash- 
 ing cold water on the face and breast, dry frictions to the 
 extremities, cold wine, cold shower bath at short intervals, 
 flesh brush, ammonia, stimulating injections, artificial 
 respiration, abstraction of blood, warm wine, galvanism. 
 
 Asphyxia from Electricity. — Treatment : — Cold water 
 copiously dashed over the whole body, frictions with the 
 flesh-brush. 
 
 Asphyxia from cold. — Treatment: — Gradual communi- 
 cation of warmth to the body, immersion in spring water 
 continued forty minutes, gentle frictions with flannel, arti- 
 ficial respiration, gentle stimulants, such as balm, sage, 
 warm wine, &c. 
 
 PneumoxAhorax. — Treatment : — Blistering, tartar- 
 emetic ointment, cupping, moxa, issues, setons, &c. 
 
 Dilatation of the ventricles. — Treatment: — Bleeding, 
 low diet, starvation and venesection, diuretics, squills, 
 nitre, digitalis, purgatives, antimony, valerian, orange 
 
ALLOPATHIC PRACTICE. 335 
 
 flowers, catmint, mercury, castor oil, bine-pill, tepid 
 shower bath. 
 
 Sympathetic affection of the heart. — Treatment: — 
 Gentle aperients, tepid bath, gentle tonics, bitters, iron, 
 bleeding, warm pediluvium, digitalis. 
 
 Angina- Pectoris. — Treatment: — Bleeding, ether, cam- 
 phor, opium, hyoscyaruus, ammonia, draughts of cold 
 water, emetics, leeches, sinapisms to the legs, mild diet, 
 blue-pill, tepid or cold bathing. 
 
 Indigestion. — Treatment : — Diet, gentle aperients, mild 
 tonics, regular exercise, rhubarb, aloes, soda, ipecac, 
 hyoscyamus, boneset, mild tonics, alkalies, calomel, gen- 
 tian, iron, white mustard seed, mercury, antimony, nitro- 
 muriatic acid bath, opium, ammonia, nitrate of potash, 
 leeches, blisters. 
 
 Diarrhoea. — Treatment : — Mild purgatives, calomel, 
 castor oil, ipecac, laudanum, chalk, warm bath, leeching, 
 Dover's powder, acetate of lead, balsam copaiva, sul- 
 phate of copper, injections of mallows, flaxseed or barley 
 water, sulphuric acid. 
 
 Cholera. — Treatment: — Opium, sinapisms to the region 
 of the stomach and liver, free use of bland drinks, fric- 
 tions with spirits of turpentine, calomel, warm bath, 
 tinct. of" capsicum to the extremities, camphor in vitriolic 
 ether, mucilages in a warm state, ipecac, columbo, calomel, 
 ammonia. 
 
 Cholera Infantum. — Treatment : — Leeches to the 
 temple, calomel, poultices over the abdomen, blisters 
 behind the ears, ipecac, mild laxatives, castor oil, warm 
 bath, spirits-, Dover's powder, magnesia, tartrate of iron, 
 charcoal, wine whey, milk punch, ammonia, common soot. 
 
 Flatulent colic. — Treatment: — Rapid friction with the 
 flesh-brush, camphor, laudanum, vitriolic ether, oil of 
 juniper, emetics of ipecac, essence of peppermint, ca- 
 
336 ALLOPATHIC PRACTICE. 
 
 thartics, enemata, castor oil, turpentine, laudanum, bleed- 
 ing, leeches, blisters. 
 
 Bilious Colic. — Treatment: — Emetics, eupatorium, or 
 camomile tea, antimony, calomel, sinapisms, or epispastics 
 to the epigastrium, castor oil, enemata of castor oil and 
 turpentine, opium, salivation, blood-letting, calomel, mag- 
 nesia, warm bath. 
 
 Golica Pictonum. — Treatment: — Blood-letting, opium, 
 calomel, salivation, purgatives, castor oil with spirits of 
 turpentine, purgatives, enemata, gl auber salts, flaxseed tea, 
 blisters, leeches, tartar-emetic ointment, warm bath, senna, 
 alum. 
 
 Ileus. — Treatment: — Bleeding, cupping, leeches, opium, 
 purgatives, calomel, castor oil, enemata of warm water, 
 tobacco, cold water, &c, cold effusions, mercury, tincture 
 of rhubarb, and aloes. 
 
 Constipation. — Treatment : — Proper diet, active exer- 
 cise, regular attempts at stool, calomel, rhubarb, jalap, 
 aloes, enemata, blue-pill, aloes and antimony, castor oil, 
 oil of turpentine, salivation. 
 
 Intestinal Worms. — Treatment : — Spare and liquid 
 diet, mild purgatives, epsom salts, spigelia, followed by 
 calomel and jalap, tin filings, spirits of turpentine, male 
 fern, pomegranate root. 
 
 Hemorrhoids, Piles. — Treatment : — Light vegetable 
 diet, bleeding, sulphur, cream of tartar, blue mass, nitre, 
 cupping, sinapisms, blisters, injections of cold water, 
 acetate of lead, quinine, opium, cinnamon, aloes, ipecac, 
 astringents, injections, excision of tumors, balsam copaiva, 
 oil of turpentine, aloetic purgatives. 
 
 Jaundice. — Treatment : — Opium, warm bath, leeching, 
 frictions, emollient applications to the epigastrium, bleed- 
 ing, purgatives, enemata, emetics, ipecac, mercury, mer- 
 curial frictions, nitro-muriatic acid bath, proper diet. 
 
 Diabetes Mellitus. — Treatment: — Bleeding, leeching, 
 
ALLOPATHIC PRACTICE. 33T 
 
 cupping, opium, lime water, alum, uva ursi, active exer- 
 cise, friction with flannel, carbonate of ammonia, blisters, 
 quinine, exclusive animal diet. 
 
 Diabetes Insipidus. — Treatment : — Tonics, alkalies, 
 opium, quinine, bitartrate of soda, mercury, ipecac, mag- 
 nesia and rhubarb, lime water, uva ursi, hyoscyamus, cam- 
 phor, gum arabic, mineral acids, quinine, iron, burgundy 
 pitch, galbanum and turpentine to the loins, castor oil. 
 
 Lithic acid diathesis. — Treatment : — Proper diet, mild 
 aperients, alkalies, bitters, vegetable tonics, calomel, anti- 
 mony, magnesia, soda, salorratus, gentian, columbo, warm 
 bath, opium, hyoscyamus, vegetable diuretics, bleeding, 
 cupping, colchicum. 
 
 Phosphatic diathesis'. — Treatment : — Opium, tonics, 
 mineral acids, cinchona, uva ursi, pitch, soap or galbanum 
 plaster to the kidneys, issues in the back, hyoscyamus, 
 country air, exercise. 
 
 Ischuria renalis. — Treatment : — Bleeding, cupping, 
 leeching, warm bath, blisters, stimulating diuretics, spirits 
 turpentine, castor oil, balsam copaiva, juuiper oil, nitre 
 and laudanum, mercury. 
 
 Retention of urine. — Treatment : — Introduction of 
 catheter, canth, camphor, blisters to the pubic region, 
 spirits of turpentine, juniper, oil, dipple oil, Peruvian bal- 
 sam, cold water to the pubic region, blood-letting, leeching, 
 emollient clysters, fomentations, mild purgatives, anti- 
 mony, warm bath, calomel, opium. 
 
 Dysuria, pain in voiding urine. — Treatment : — Mild 
 laxatives, flaxseed tea, gum arabic, Dover's powder, castor 
 oil, rhubarb, calomel, ipecac, lunar caustic, borax, citron 
 ointment, zinc or alum injected into the vagina, diluents, 
 opiates, fomentations, anodyne enemata, flaxseed tea. 
 
 Enuresis, incontinence of urine, — Treatment : — Alum, 
 cantharides, uva ursi, iron, cold shower bath, electricity, 
 stimulating frictions, cupping the perineum, blisters, ano- 
 29 
 
338 ALLOPATHIC PRACTICE. 
 
 dyne enernata, Dover's powder, stramonium, tonics, iron, 
 quinine, oxyde of zinc, spirits of turpentine. 
 
 Ascites. — Treatment : — Blood-letting, cups, leeches, 
 blisters, setons, drastic purgatives, cream of tartar, ele- 
 terium gamboge, diuretics, squills, digitalis, acetate of 
 potash, nitrate of potash, cantharides, juniper berries, col- 
 ohicum, spirits of turpentine, erigeron, heteraphullum and 
 parsley, calomel. 
 
 Scrofula. — Treatment : — Diet and regimen, pure air, 
 calomel, blue mass aperients, rhubarb, tonic vegetable 
 bitters, gentian, quinine, leechos, saturnine solutions, nitrate 
 of silver, sulphate of copper, corrosive sublimate, sarsa- 
 parilla, conium, antimony, setons. 
 
 Bronchocele, Goitre. — Treatment : — Iodine, burnt 
 sponge, calcined egg shells, sea water, squills, kermes 
 minerals, belladonna, conium, digitalis, mercury, antimony, 
 blistering, cataplasms, mercurial ointment. 
 
 Scorbutus, Scurvy. — • Treatment : — Fresh vegetables 
 and animal food, lemon juice and vinegar, nitre, iron tonics, 
 cinchona, muriate of lime, lunar caustic. 
 
 Chlorosis.' — Treatment: — Exercise, purgatives, aloes, 
 rhubarb, calomel, ipecac, hyoscyamus, Dover's powders, 
 diet, sea-bathing, tepid shower bath, tonics, iron. 
 
 Gonorrhoea, Clap. — Treatment : — Blood-letting, saline 
 purgatives, nitre, antimony, gum arabic, warm fomenta- 
 tions, opium, camphor, balsam copaiva, cubebs, spirits of 
 turpentine, injections of sulphate of zinc, and sulphate of 
 copper, nitrate of silver, lunar caustic, cantharides, sarsa- 
 parilla, mercury. 
 
 Syphilis. — Treatment : — Mercury, emollient poultices, 
 lead, sulphate of copper, citron ointment, corrosive subli- 
 mate, lunar caustic, bleeding, antimony, zinc, nitre, quinine, 
 opium, hyoscyamus, cicuta, nitrate of silver, Venice tur- 
 pentine, balsam of copaiva, myrrh, red precipitate oint- 
 ment, salivation, warm bath, guaiacum. 
 
HOMOEOPATHIC PRACTICE. 339 
 
 Buboes. — Treatment : — Mercury, frictions, emollient 
 poultices, hydriodate ointment, bleeding, purgatives, anti- 
 mony, lead water, blisters, opium, sarsaparilla, lead, copper, 
 corrosive sublimate, galbanum, cicuta, carrot poultices, 
 nitric acid, hyoscyamus. 
 
 Amenorrhea. — Treatment : — Blood-letting, opium, 
 ether, active cathartics, purgatives, enemata, sinapisms, 
 warm pediluvium, camphor, ergot, blisters, warm bath, 
 antimonials, iron, ipecac, castor oil, balsam copaiva, 
 spirits of turpentine, cantharides. 
 
 JDysmenorrhcea. — Treatment : — Camphor, Dover's 
 powder, elder blossoms, or eupatorium tea, opium, ipecac, 
 warm bathing, bleeding, aperients, blue-pill, ipecac emetics, 
 antimony, guiacum, sulphur, stramonium. 
 
 Leucorrhcea, fluor albus. — Treatment: — ^Bleeding, 
 purgatives, antimony, blue-pill, injections of warm water 
 and sugar of lead into the vagina, cantharides, balsam 
 copaiva, turpentine, alum, ipecac, astringent injections, 
 such as zinc, copper, alum, oak bark, sulphuric acid, and 
 nitrate of silver. 
 
 Cholera Asphyxia. — Treatment : — Calomel, opium, 
 camphor, sulphuric ether, mild purgatives, rhubarb, or 
 castor oil, sinapisms, alcoholic vapor bath, blood-letting, 
 cupping, leeches, frictions with tincture of capsicum, brandy, 
 ammonia, turpentine, sugar of lead, mustard, emetics. 
 
 HOMOEOPATHIC PRACTICE. 
 
 The following are Hahnemann's remarks on the tritu- 
 rating process of Homoeopathic remedies, as transcribed 
 from Jahr's and Gruner's Pharmacopeia. 
 
 "All those homoeopathic drugs which constitute the 
 pure materia medica, are prepared in the manner pointed 
 out below. The following anti-psorics come under this 
 remark : silica, calcarea carbonica, natrum carbonicum, 
 ammonium carbonicum, magnesia carbonicum, baryta carbo- 
 
340 HOMOEOPATHIC PRACTICE. 
 
 nica, carbo-vegetabilis, carbo-animalis, graphites, sulphur, 
 antimonium erudum, antimonium, gold, platinum, zinc, 
 copper, silver, tin. Lumps of these metals, not the foil, 
 are rubbed upon a hard, fine hone, under water, or some- 
 times under alcohol ; for example, iron. Of these pulve- 
 rized substances you take one grain, mercury may be used 
 in the liquid state ; of petroleum you take one drop instead 
 of one grain. Put this grain into an unglazed porcelain 
 mortar, then you take thirty -three grains of sugar of milk, 
 and mix them with the drug, by triturating the mass with 
 some force for about six minutes, by means of a porcelain 
 pestle ; before you triturate, stir the mass for a little while 
 with a spatula. Having triturated the mass, you stir it 
 again for about four minutes, scraping up that part which 
 covers the bottom of the porcelain mortar, and also that 
 which adheres to the pestle ; then you triturate again with 
 great force for about six minutes, without, however, adding 
 anything new. This mass you scrape up again for about 
 four minutes ; then add another thirty-three grains of 
 sugar of milk, stir the new compound for a minute with a 
 spatula, then triturate it for six minutes with the pestle, 
 scrape it up for four minutes, triturate again with great 
 force for six minutes, scrape up the mass again four min- 
 utes, then add the last thirty-three grains of sugar of milk, 
 and with this last added portion proceed as with the two 
 former. This powder you enclose in a well-corked glass 
 vial, and mark it with the name of the substance, and the 
 figure t -Jq, to show that this is the first potency of the 
 substance. In order to prepare the degree T o-Joo> ^ ou 
 take one grain of the degree T -J ^, and add to it thirty- 
 three grains of the sugar of milk. Stir up this mass for 
 a moment with the spatula. Then triturate for six min- 
 utes, stir it up for four minutes, triturate again for six 
 minutes, and then stir up again for four. After this, you 
 
HOMEOPATHIC PRACTICE. 341 
 
 add the second thirty-three grains of sugar of milk, pro- 
 ceed then as before ; afterwards add the last thirty-three 
 grains of sugar of milk, stir up and triturate again as 
 before, and enclose the mass in a well-corked vial, marked 
 T<raoo> or second potency. 
 
 " To prepare the degree T ooijooo> or tnirc l potency, you 
 take one grain of the degree T o wo> an d &° through the 
 processes of stirring and triturating in the same way as 
 before, employing upwards of an hour for the preparation 
 of each different potency. For the sake of establishing a 
 sort of uniformity in preparing homoeopathic remedies, 
 and especially the anti-psorics, I never carry the tritura- 
 tion above the millionth degree. From this degree, I 
 derive the dilutions in their various degrees of potency. 
 For the process of trituration, a certain force should be 
 employed ; not too much, however, lest the mass adhere 
 too tenaciously to the mortar, to be scraped up in four 
 minutes. 
 
 "Froin the millionth degree of trituration, the dilutions 
 in the various degrees may be obtained by dissolving these 
 triturated substances in alcohol or water. Chemistry is 
 not acquainted with the fact that, all substances, after 
 having been triturated up to the millionth degree, can be 
 dissolved in either alcohol or water. Sugar of milk cannot 
 be dissolved in pure alcohol ; this is the reason why the 
 first dilution should be composed of one-half water, and 
 one-half alcohol. To one grain of the millionth, you add 
 fifty drops of distilled water, and turn the vial several 
 times around its axis ; by this means the sugar of milk 
 becomes dissolved : then, you add fifty drops of good 
 alcohol, and shake the vial twice, first carrying the arm 
 up and then down. Only two-thirds of the vial should be 
 filled with the solution. 
 
 " This vial is then marked with the name of the medicine, 
 29* 
 
342 HOMOEOPATHIC PRACTICE, 
 
 and the number T -J- . Of this solution you take one drop, 
 and mix it with ninety-nine or one-hundred drops of pure 
 alcohol, shaking the vial twice after it has been corked ; 
 this vial is marked T q^oo- Of this solution you take one 
 drop, and mix with it ninety-nine or one-hundred drops 
 of pure alcohol, then shake the vial twice, and mark it 
 tooIjooo* 0^ ^ s potency you again take a drop, and 
 mix it with ninety-nine or one-hundred drops of alcohol, 
 shaking this third vial twice, and mark it TT . In the same 
 way you continue the prepartion, and marking of the 
 higher potencies, TJ5J5 TT , TUTJTnj TT , TTT , m ? , &c 
 
 11 The intermediate vials are put in perpendicular boxes 
 and kept in the dark, in order not to be affected by the 
 light of day. In practice only the full vials are used. 
 The shaking being accomplished by means of moderate 
 strokes with the arm, it is desirable that the vials be of 
 such size that the one-hundred drops will only two-thirds 
 fill them. Vials that have contained one medicine, ought 
 never to be used for another even if they have been pre- 
 viously rinsed with great care." 
 
 " Vegetable substances which can only be had dry, are 
 triturated in the same manner. The millionth trituration 
 may then be dissolved, like all the other substances, either 
 in water or alcohol. In this state, they may be preserved 
 much better and longer than the common tinctures which 
 easily spoil. 
 
 " Of the juiceless vegetable substances, oleander, thuja, 
 mezereum, you may take one grain and a half, the fresh 
 leaves, bark, roots, &c , and convert them into the mil- 
 lionth trituration, with three times one-hundred grains of 
 sugar of milk. Of this trituration you take one grain, 
 and carry it through the vials, obtaining in this way any 
 degree of potency that may be desired ; shake each vial 
 twi^e, first carrying the arm up and then down. The 
 
HOMEOPATHIC PRACTICE. 343 
 
 same process of trituration may be resorted to in regard 
 to the recently obtained medicinal juices. Squeeze the 
 juice out of the substance, triturate one drop with the 
 necessary quantity of sugar of milk to obtain the millionth 
 trituration. Of these you take one grain, dissolve it in an 
 equal proportion of water and alcohol, and then carry a 
 drop of this mixture through a series of twenty-seven 
 vials, obtaining in this way the degree of potency that is 
 desired. 
 
 " By triturating the juice first, the medicinal virtues of 
 the drug are better developed, than by simply mixing the 
 juice with the alcohol by means of two shakes. I know 
 this from experience. 
 
 "In the beginning of my practice, I gave a small portion 
 of a grain of the millionth trituration at a dose. But the 
 uncertainty of this mode of exhibiting the remedy, led me 
 to the discovery of preparing the dilutions, and to the use 
 of the globules, any definite number of which may be 
 moistened with the dissolved drug. Homoeopathy being 
 based upon a law of nature, it should avoid and exclude 
 all uncertainties. 
 
 "Frequent observations have convinced me that it is 
 better to shake the vial twice only, in order to develop the 
 medicinal virtue of the drug just enough to affect the 
 disease in a proper manner. By shaking the vial ten 
 times, as I was in the habit of doing, the proportion be- 
 tween the progressively developed intensity of action of 
 the medicinal properties of the drug, and the degree of 
 potency, were destroyed. The object of the dynamizing 
 process, is to develop the intensity of action of the medi- 
 cinal properties of the drug, at the same time as that 
 action is reduced to a milder tone. Two shakes are suffi- 
 cient to establish the due proportion between these two 
 effects. 
 
344 HOMOEOPATHIC PRACTICE. 
 
 Table showing the quantity of alcohol or fluid, required to dissolve 
 one single grain or drop of a homoeopathic drug (as sulphur^ 
 aconite, etc.), down into the following homoeopathic attenuations 
 or dilutions. — [Dr. Simpson on Homoeopathy, p. 285.] 
 
 1st attenuation. — One grain or drop in one and half tea- 
 spoonful of alcohol. 
 
 2d attenuation. — One grain in twenty-one fluid ounces 
 of alcohol. 
 
 3d attenuation. — One grain in two thousand and eighty 
 ounces, or in one hundred and four pints of alcohol. 
 
 6th attenuation. — One grain in thirteen million gallons, 
 or in two hundred and six thousand hogsheads, or 
 in fifty-one thousand tuns of alcohol. 
 
 9th attenuation. — One grain in a lake of alcohol with a 
 volume of about fourteen cubic miles, or in a lake of 
 fifty fathoms in depth, and presenting two hundred 
 and fifty square miles of surface. 
 
 12th attenuation. — One grain in a sea containing about 
 fourteen million cubic miles of alcohol, or in a quan- 
 tity of fluid equal to a sea six times the size of the 
 Mediterranean Sea. 
 
 15th attenuation. — One grain in an ocean of fourteen bil- 
 lion cubic miles of alcohol, or in an ocean about 
 forty-six thousand times greater than the whole waters 
 of all the oceans of the earth. 
 
 24th attenuation. — One grain in an ocean of fourteen 
 quintillion cubic miles of alcohol, or in a quantity 
 sufficient to make one hundred and forty masses, each 
 filling a sphere extending from limit to limit of the 
 orbit of the planet Neptune. 
 
HOMOEOPATHIC PRACTICE, 345 
 
 30tli attenuation. — One grain in an ocean of fourteen sep- 
 tillion cubic miles of alcohol, or in a quantity suffi- 
 cient to make one hundred and forty billion spherical 
 masses, extending from limit to limit of Neptune's 
 orbit, or in a quantity equal to many hundred spheres, 
 each with a semidiameter or radius extending from 
 the earth to the nearest fixed star. 
 
 List of diseases and Homoeopathic remedies by Dr. J. Laurie. 
 
 The remedies of the vegetable kingdom are the third attenua- 
 tion, those of the mineral kingdom of the fourth. 
 
 Typhus fever. — Remedies : — Bryonia, arsenic, rhus 
 toxico, croton oil, nux vomica, aconite, belladonna, cam- 
 phor, hen-bane, cocculus Indicus, arnica. The sugar 
 globules are moistened with these tinctures, and five or 
 six given every two or three hours: 
 
 Intermittent fevers. — Remedies : — Quinine, arsenic, 
 ipecac, nux vomica, antimony, belladonna, opium, coc- 
 culus Indicus, Ignatia or St. Ignatius' bean, white helle- 
 bore, aconite, Cayenne pepper. 
 
 Bilious fever. — Remedies: — Aconite, belladonna, bry- 
 onia, chamomilla, nux vomica, mercurius, Pulsatilla, qui- 
 nine, digitalis, ipecac, tartar-emetic, arsenic. 
 
 Yellow fever. — Remedies : — Belladonna, bryonia, rhus 
 toxicodendron, arsenic, nux vomica, veratrum album, la- 
 chesis, or viper poison, Spanish flies, mercurius. 
 
 Scarlet fever. — Remedies: — Belladonna, mercurius, 
 arsenic, nux vomica, pulsatilla, aconite, opium, tartar- 
 emetic. 
 
 Scarlet Rash. — Remedies : — Belladonna, aconite, coffea, 
 sulphur, ipecac, pulsatilla, bryonia, dulcamara, belladonna, 
 arsenic, phosphorus, rhus tox, swamp sumach, cinchona, 
 conium, mercurius, capsicum. 
 
 Rubeola, measles. — Remedies: — Aconite, coffea, pulsa- 
 tilla, sulphur, nux vomica, bryonia, ipecac. 
 
346 HO MYOPATHIC PRACTICE. 
 
 Variola, small-pox. — Remedies : — Coffea, chamomilla, 
 aconite, ipecac, tartar-emetic, bryonia, rhus, belladonna, 
 Pulsatilla, stramonium, muriatic acid, mercurius, sulphur, 
 lachesis, vegetable charcoal, arsenic, cinchona, phosphorus, 
 sulphuret of lime, acetate of copper. 
 
 Varicella, chicken-pox. — Remedies : — Aconite, coffea, 
 belladonna, emetic tartar, mercurius. 
 
 Miliary fever. — Remedies : — Aconite, coffea, bella- 
 donna, veratrum, arsenic, ipecac, bryonia, nux vomica, 
 carbonate of lime, chamomilla, tincture of sulphur, acetate 
 of copper. 
 
 Urticaria, nettle-rash. — Remedies: — Dulcamara, aco- 
 nite, nux vomica, pulsatilla, crude antimony, belladonna, 
 sulphuret of lime, rhus, bryonia, nettles, sulphur, nitric 
 acid, lime. 
 
 Quinsy.— Remedies : — Mercurius, lachesis, pulsatilla, 
 cantharides, nux vomica, chamomilla, coffea, ignatia, sul- 
 phur, veratrum, capsicum. 
 
 Mumps. — Remedies: — Mercurius, belladonna, coccu- 
 lus, carbo-vegetabilis. 
 
 Indigestion. — Remedies: — Pulsatilla, arsenic, chamo- 
 milla, rhus toxicodendron, sulphur, ipecac, cinchona, nux 
 vomica. 
 
 Flatulent Colic. — Remedies: — Cinchona, arsenic, nux 
 vomica, pulsatilla, carbo-vegetabilis, colchicum, belladonna. 
 
 Hcematemesis, vomiting blood. — Remedies : — Nux vo- 
 mica, pulsatilla, cinchona, arnica, sulphur. 
 
 Constipation. — Remedies : — Opium, bryonia, lachesis, 
 alum, nux vomica, lead, platina, nitro-muriatic acid, silicea, 
 lycopodium, china. 
 
 Hemorrhoids. — Remedies : — Aconite, nux vomica, 
 sulphur, arsenic, belladonna, rhus, pulsatilla, platina, 
 ignatia, colocynth. 
 
 Prolapsus ani. — Remedies : — Ignatia, nux vomica, 
 mercurius, sulphur, calcarea. 
 

 HOMCEOPATHIC PRACTICE. 347 
 
 Diarrhoea. — Remedies : — Dulcamara, bryonia, cinchona, 
 cbamomilla, mercurius, rhubarb, pulsatilla, ipecac, nux 
 vomica, colocynth, arsenic, crude antimony, rhus, lachesis, 
 nitric acid, phosphoric acid, magnesia. 
 
 Dysentery. — Remedies : — Aconite, chamomilla, ipecac, 
 mercurius, corrosive sublimate, bryonia, arsenic, carbo- 
 vegetabilis, cinchona, cantharides, sulphur. 
 
 Cholera. — Remedies : — Ipecac, veratrum album, arsenic, 
 cinchona, pulsatilla, copper, sulphur, carbo vegetabilis, 
 nux vomica, ergot, stramonium. 
 
 Cholerine. — Remedies : — Yeratrum, mercurius, pul- 
 satilla, nux vomica, chamomilla, colocynth, ferruin, Dul- 
 camara, carbo vegetabilis, cantharides. 
 
 Inflammation of the liver. — Remedies : — Belladonna, 
 aconite, nux vomica, chamomilla, mercurius, arsenic, Pul- 
 satilla, nux vomica. 
 
 Jaundice. — Remedies : — Mercurius, cinchona, pulsa- 
 tilla, digitalis, chamomilla. 
 
 Inflammation of the spleen. — Remedies: — Aconite, 
 arsenic, cinchona, nux vomica, bryonia. 
 
 Inflammation of the stomach. — Remedies : — Aconite, 
 belladonna, ipecac, crude antimony, nux vomica, lachesis, 
 Pulsatilla, arsenic, cantharides, hyoscyamus, arnica. 
 
 Inflammation of the bowels. — Remedies : — Arsenic, 
 mercurius, nux vomica, lachesis, nitric acid, bryonia, pul- 
 satilla, colocynth, chamomilla, cinchona, colchicum, phos- 
 phorus, sulphur, silicea. 
 
 Inflammation of the peritoneum. — Remedies : — Aco- 
 nite, belladonna, arsenic, chamomilla, lycopodium, colo- 
 cynth. 
 
 Worms. — Remedies: — Aconite, ferrum, nux vomica, 
 mercurius, sulphur, calcarea, silicea, pulsatilla, ipecac, 
 antimony, cicuta, cinchona. 
 
 Laryngitis. — Remedies : — Sulphur, burnt sponge, 
 Aconite, lachesis, belladonna, hyoscyamus. 
 
348 HOMOEOPATHIC PRACTICE. 
 
 Hooping Cough. — Remedies : — Dulcamara, Pulsatilla, 
 mercurius, belladonna, aconite, ipecac, nux vomica, cha- 
 momilla and sulphur. 
 
 Group. — Remedies : — Aconite, sulphur, burnt sponge, 
 arsenic, tartar emetic, lachesis, caustic, ammonia, bromin. 
 
 Influenza. — Remedies : — Camphor, aconite, mercurius, 
 arsenic, bryonia, phosphorus, belladonna, pulsatilla, arnica. 
 
 Bronchitis. — Remedies : — Aconite, pulsatilla, bryonia, 
 sponge, belladonna, nux vomica, lachesis, mercury, lyco- 
 podium, stannum, dulcamara, arsenic, ipecac, tartar-emetic. 
 
 Pneumonia. — Remedies : — Aconite, bryonia, phos- 
 phorus, tartar - emetic, mercurius, belladonna, lachesis, 
 arsenic, antimony, sulphur. 
 
 Pleuritis. — Remedies : — Aconite, bryonia, sulphur, 
 mercurius, arsenic, arnica. 
 
 Hcemoptysis. — Remedies : — Pulsatilla, bryonia, nux 
 vomica, rhus, arnica, aconite, ipecac, iron, opium, cin- 
 chona. 
 
 Consumption. — Remedies : — Ipecac, arsenic, nux 
 vomica, bryonia, pulsatilla, tartar-emetic, opium, china, 
 sambucus, musk, belladonna, lachesis, veratrum, dulcamara, 
 cinchona, stannum. 
 
 Determination of the blood to the head. — Remedies : — 
 Aconite, nux vomica, calcarea, belladonna, opium, coffea, 
 chamomilla, ignatia, arnica, mercurius, pulsatilla, lycopo- 
 dium, dulcamara, sanguinaria, cinchona, sulphur, carbo- 
 nate of lime, opium, conium. 
 
 Inftamxmation of the brain and its membranes. — Reme- 
 dies :— Aconite, belladonna, bryonia, hyoscyamus, opium, 
 stramonium, zinc, acetate of copper, rhus, lachesis, mer- 
 curius. 
 
 Apoplexy. — Remedies : — Aconite, belladonna, nux 
 vomica, opium, lachesis, arnica, pulsatilla, ipecac, carbo- 
 nate of barytes. 
 
 Paralysis, Palsy. — Remedies : — Arnica, bryonia, rhus, 
 Bulphur, electricity, galvanism. 
 
HOMOEOPATHIC PRACTICE. 349 
 
 Tetanus. — Remedies : — Belladonna, cicuta, opium, 
 arnica, ignatia, stramonium, hyoscyamus. 
 
 Delirium Tremens. — Remedies : — JSux vomica, opium, 
 aconite, belladonna, lachesis, sulphur, calcarea. 
 
 Epilepsy. — Remedies: — Belladonna, copper, hyoscya- 
 mus, ignatia, lachesis, nux vomica. 
 
 Neuralgia. — Remedies : — Belladonna, platina, lyco- 
 podium, arsenic, colocynth, veratrum, china, assafcetida, 
 spigelia. 
 
 Headache. — Remedies: — Belladonna, bryonia, rhus, 
 sepia, silicea, pulsatilla. china, veratrum, lachesis, mer- 
 curius, colocynth, chamomilla, sulphur. 
 
 Erysipelas. — Remedies : — Aconite, belladonna, bryonia, 
 Pulsatilla, rhus, arsenic, lachesis, sulphur, copper. 
 
 Carbuncle. — Remedies: — Lachesis, silicea, arsenic. 
 
 Chilblains. — Remedies : — Nux vomica, pulsatilla, bel- 
 ladonna, rhus, nettles, arsenic, sulphur. 
 
 Corns. — Remedies: — Arnica, ammonia, bryonia, nux 
 vomica, rhus, ignatia. 
 
 Scabies, Itch. — Remedies : — Sulphur, mercurius, vera- 
 trum, silicea, sulphuric acid, arsenic, dulcamara, pulsa- 
 tilla. 
 
 Herpes Circinatus, Ringworm. — Remedies : — Rhus, 
 sulphur, calcarea. 
 
 Scald - head. — Remedies : — Rhus, sulphur, arsenic, 
 dulcamara, bryonia. 
 
 Inflammation of the kidneys. — Remedies : — Aconite, 
 cantharides, arsenic, sulphur, mercurius, arnica, nux 
 vomica. 
 
 Cystitis, inflammation of the bladder. — Remedies : — 
 Cantharides, pulsatilla, digitalis, arsenic, carbo-vegetabilis, 
 sulphur, nux vomica. 
 
 Gravel. — Remedies : — Sarsaparilla, nux vomica, gra- 
 phites, sulphur, cannabis, lycopodium, calcarea. 
 30 
 
350 HOMEOPATHIC PRACTICE. 
 
 Retention of the urine. — Remedies : — Aconite, cam- 
 phor, arsenic, phosphorus, belladonna, cantharides. 
 
 Difficulty in discharging urine. — Remedies : — Aconite, 
 sulphur, belladonna, cantharides, opium, pulsatilla, spirits 
 of camphor, mercurius, nux vomica. 
 
 Suppression of urine. — Remedies : — Aconite, cantha- 
 rides, pulsatilla, camphor, belladonna, opium, lycopodium, 
 
 Diabetes. — Remedies : — Veratrum, mercurius, nitric 
 acid. 
 
 Hcematuria. — Remedies : — Cantharides, quinine, pulsa- 
 tilla, mercurius, sulphur, ipecac, camphor, carbo-vegeta- 
 bilis, arnica, nux vomica, nitric acid, aconite, squills, zinc, 
 calcarea, petroleum, cannabis, cocculus indicus, capsicum. 
 
 Gout. — Remedies: — Aconite, pulsatilla, arsenic, iron, 
 nux vomica, bryonia, sanguinaria, sulphur, saffron. 
 
 Rheumatism. — Remedies : — Aconite, bryonia, sulphur, 
 belladonna, rhus, chamomilla, ignatia, conium, mercurius, 
 lachesis, pulsatilla, arnica, mezereum, euphorbium, pink 
 root, digitalis, phosphorus, veratrum, caustic. 
 
 Lumbago. — Remedies : — Aconite, bryonia, nux vomica, 
 rhus, belladonna, pulsatilla, mercurius. 
 
 Ophthalmia. — Remedies: — Aconite, belladonna, nux 
 vomica, cinchona, arsenic, euphrasia, ignatia, pulsatilla, 
 mercurius, sulphur. 
 
 Scrofulous Ophthalmia. — Remedies : — Arsenic, conium, 
 crude sulphur, lime, bitter sweet, iron, graphites, gold, 
 lycopodium, indian hemp, chamomilla, digitalis, iodine, 
 mercurius, corrosive sublimate, magnesia, nitric acid, 
 lachesis, cinchona, pink root. 
 
 Ulceration of the cornea. — Remedies : — Nitric acid, 
 arsenic, euphrasia, sulphur, calcarea, mercurius, lachesis, 
 silicea, nitre. 
 
 Epistaxis. — Remedies : — Aconite, belladonna, bryonia, 
 mercurius, carbo vegetabilis, graphites, pulsatilla, calcarea, 
 
HOMOEOPATHIC PRACTICE. 351 
 
 arnica, rhus, iron, sepia, nux vomica, lachesis, bryonia, 
 dulcamara, saffron, musk, ammonia, silicea. 
 
 Stomacace. — Remedies : — Mercurius, nitric acid, nux 
 vomica, capsicum, carbo-vegetabilis, sulphur, nitre, borax, 
 iodine, lemon juice, dulcamara. 
 
 Scurvy. — Remedies: — Vegetable carbon, mercurius, 
 nux vomica, Pulsatilla, sulphur, creosote, belladonna, 
 nitric acid, quinine, alum, arnica, chamomilla. 
 
 Ascites. — Remedies : — Arsenic, cinchona, iron. 
 
 Anasarca.— Remedies : — Hellebore, bryonia, mercurius, 
 arsenic, phosphorus, iron, colchicum. 
 
 Hydrothorax, dropsy of the chest. — Remedies : — Ar- 
 senic, dulcamara, digitalis, pink root, bryonia, aconite. 
 
 Hydrophobia. — Remedies : — Belladonna, hyoscyamus, 
 stramonium, cantharides. 
 
 Amenorrhea. — Remedies: — Xux vomica, sulphur, 
 opium, aconite, veratrum, pulsatilla. 
 
 Menorrhagia. — Remedies : — Nux vomica, chamomilla, 
 sabina, ignatia, platina, veratrum, sulphur. 
 
 Dysmenorrhoea. — Remedies : — Pulsatilla, belladonna, 
 nux vomica, coffea, sulphur, calcarea, chamomilla. 
 
 Turn of life. — Remedies : — Cocculus, aconite, pulsatilla, 
 nux vomica, lachesis. 
 
 Leucorrhcea. — Remedies : — Pulsatilla, china, calcarea. 
 
 Hysteria. — Remedies : — Calcarea, nitric acid, veratrum, 
 belladonna, pulsatilla, gold, stramonium. 
 
 Difficult dentition. — Remedies : — Chamomilla, bryonia, 
 zinc, sulphur. 
 
 Sugar globules are medicated with these remedies, in 
 the third to the sixth potencies. 
 
552 
 
 HOMEOPATHIC PRACTICE. 
 
 Method of preparing the sugar globules, from Jahr and Gruner, 
 p. 27. 
 
 These are made by confectioners, and are composed of 
 sugar and starch ; they can be had of different sizes, from 
 that of a millet-seed to that of a buck-shot. The whitest, 
 dryest, and hardest, should be selected for medicinal use ; 
 they should be all of equal size, and not mixed with sugar- 
 dust. After having moistened the globules with the medi- 
 cine in some suitable vial, we turn them out on paper with 
 raised edges, and agitate them until they cease to adhere 
 one to the other. Should we afterwards wish to put them 
 into the same bottle in which we had moistened them, we 
 should take care to dry it also, before making use of it. 
 The complete desiccation of the globules, before bottling 
 them, is absolutely indispensable, since, without that pre- 
 caution, they fall into powder in a short time, and lose 
 their medicinal virtues. 
 
 A table showing the amount of alcohol required to form the dif- 
 ferent dilutions. One grain of the millionth degree of tritura- 
 tion, is added to 100 drops of alcohol, and one drop of that to 
 100 more of alcohol, making the first dilution. 
 
 First 
 
 attenuation 
 
 = 
 
 1 
 
 = 
 
 100 = hundredths 
 
 Second 
 
 a 
 
 — 
 
 2 
 
 = 
 
 10,000 = ten thousandths. 
 
 Third 
 
 n 
 
 z= 
 
 3 
 
 = 
 
 I = millionths. 
 
 Fourth 
 
 " 
 
 — 
 
 4 
 
 = 
 
 100 I = hundred millionths. 
 
 Fifth 
 
 a 
 
 z=z 
 
 5 
 
 zz 
 
 10,000 I = ten thousand millionths 
 
 Sixth 
 
 a 
 
 zz 
 
 6 
 
 3= 
 
 II — billionths. 
 
 Seventh 
 
 <t 
 
 zz 
 
 7 
 
 — 
 
 100 II zz hundred billionths. 
 
 Eighth 
 
 it 
 
 zz 
 
 8 
 
 = 
 
 10,000 II = ten thousand billionths. 
 
 Ninth 
 
 a 
 
 = 
 
 9 
 
 = 
 
 Ill zz trillionths. 
 
 Tenth 
 
 a 
 
 zz 
 
 10 
 
 — 
 
 100 III zs hundred trillionths. 
 
 Eleventh 
 
 a 
 
 — 
 
 11 
 
 ~ 
 
 10,000 III = ten thousand trillionths. 
 
 Twelfth 
 
 a 
 
 fc= 
 
 12 
 
 — 
 
 IV =: quadrillionths. 
 
 Fifteenth 
 
 a 
 
 = 
 
 15 
 
 — 
 
 V zz quintillionths. 
 
 Eighteenth 
 
 a 
 
 — 
 
 18 
 
 — 
 
 VI =: sextillionths. 
 
 Twenty-first 
 
 '" 
 
 fc 
 
 21 
 
 ~ 
 
 VII zz septilliontlfs. 
 
 Twenty-fourth 
 
 it 
 
 = 
 
 24 
 
 — 
 
 VIII zz octillionths. 
 
 Twenty-seventh 
 
 a 
 
 = 
 
 27 
 
 ~ 
 
 IX ~ nonillionths. 
 
 Thirtieth 
 
 a 
 
 — 
 
 30 
 
 zz 
 
 X =: decillionths. 
 
HYDROPATHIC PRACTICE. 353 
 
 HYDROPATHY. 
 
 By Hydropathy is understood a system of medical prac- 
 tice, in which water, in its various applications, consti- 
 tutes the only remedy. R. T. Trail, M; D., in his work 
 on the hydropathic system of practice, states, that in order 
 to understand the philosophy of water-cure, it is necessary 
 to understand the physiological relations of water to the 
 healthy organism. These he states in the following pro- 
 positions : 
 
 "1. Water constitutes the greater proportion of the 
 entire bulk of the body. 
 
 " 2. Water composes more than three-fourths of the 
 whole mass of blood, more than seven-eighths of the sub- 
 stance of the brain, and more than nine-tenths of the 
 various colorless fluids and secretions. 
 
 "3. Water is the only medium through which waste, 
 or effete particles of extraneous matter, are conveyed from 
 all parts of the system to the excretory organs to be ex- 
 pelled. 
 
 " 4. Water is the only solvent diluent and detergent in 
 existence, for animal and vegetable excrementitious matter. 
 
 " 5. Water is- the only material capable of circulating in 
 all the tissues of the body and penetrating their finest 
 vessels, without vital irritation or mechanical injury. 
 
 " 6. The only morbid effects result from improper tem- 
 perature, and over-distension of the hollow viscera, or 
 circulating vessels, from excess of quantity — effects never 
 necessarily unavoidable." 
 
 Hydropathists claim disease to be the result of the mis- 
 use or abuse of some one or more of the hygienic agencies, 
 such as bad air, impure light, defective aliment, indolence, 
 &c. They still further claim, that medicinal drugs never 
 tend to correct the functional disturbances produced by 
 these morbid inflnences, although animal organism consists 
 30* 
 
354 HYDROPATHIC PRACTICE. 
 
 of true medicinal elements, and for the want of a due 
 amount of which, disease is frequently produced. The 
 teeth cannot be developed without lime, carbonic and phos- 
 phoric acids, nor the enamel without fluoride of calcium. 
 Healthy bile, mucus, sweat, saliva, tears, cartilage, &c, 
 all contain carbonate of soda, and if the soda is deficient, 
 these fluids are diseased. Phosphate of lime is one of 
 the constituents of serum, saliva, bones and muscles, which 
 may become diseased by a deficiency of this material ; by 
 administering this article to the patient, he is restored. 
 Hydrochloric acid is one of the ingredients of gastric 
 juice, a deficiency of which, causes dyspepsia ; the most 
 ample experience shows that salt will remedy the difficulty. 
 Iron is oue of the ingredients of the blood, and without 
 it the blood is ancemic. Iron will correct the difficulty. 
 The above facts, with many others that might be adduced 
 to show the utter fallacy of depending entirely upon water 
 to correct the abnormal conditions of the system, yet it is 
 a valuable auxiliary. The various methods of applying 
 water for the cure of disease, are the following : 
 
 1. The wet sheet pack : The mode of applying this bath, 
 according to Dr. Trail, is as follows : Take a sea-grass or 
 straw mattress, upon which spread from three to five large 
 thick comfortables, then a soft flannel blanket, and lastly 
 the wet sheet, wrung sufficiently so as not to drip. Two 
 pillows placed upon the mattress are necessary for the 
 head. The patient lying down on the back is quickly 
 enveloped in the sheet, followed by th.e blanket and com- 
 fortables. A light feather bed may be thrown over the 
 top, in which case two less comfortables will be required. 
 If the feet remain cold, bottles of hot water should be 
 placed to them. Headache is prevented by the application 
 of cold packs. In wrapping up the patient, great care 
 should be taken to turn the clothing snugly and smoothly 
 around the neck and feet. For very delicate persons, the 
 
HYDROPATHIC PRACTICE. 355 
 
 sheet should first be wrung out of tepid or even warm 
 water. On coming out of the pack, the plunge, douche, 
 rubbing wet-sheet, or towel washing may be employed, as 
 indicated. 
 
 This bath is used by hydropathists in a great variety of 
 diseases, both acute and chronic. In chronic disease it is 
 used for the purpose of producing reaction ; hence the 
 packing is continued for a considerable length of time, and 
 a full amount of clothing is used. When it is used in 
 acute diseases to overcome inflammation and restore the 
 superficial capillary circulation, the water is used at a lower 
 temperature, and the packs are more frequently changed. 
 This method of applying water is a very favorite one 
 among most hydropathists, in typhoid fever, inflammation 
 of the bowels, lungs, &c. 
 
 The Half Pack' Sheet. 
 The half pack is the application of the wet sheet to a 
 portion of the body only ; as to the bowels in Enteritis, or 
 to the lungs in pneumonia. This bath is also used on 
 feeble persons, and in chronic diseases where there is much 
 debility. This method of applying water is a favorite one 
 of mine, in all cases of inflammation of the lungs, and 
 bowels, also in most chronic affections of the uterus. 
 
 The Douche Bath, 
 The douche bath may be applied either warm or cold. 
 It is given by allowing a stream of cold water to fall upon 
 a portion of the body from a height of four or five feet. 
 The stream should be from one eighth to one half of an 
 inch in diameter, and should be repeated from time to time 
 as indicated. It is used in chronic affections of the liver, 
 tumors, local rheumatism, inflammation of the brain, hip 
 disease, &c. When the vital reaction is feeble, the water 
 should be warm, but where it is vigorous, cold water should 
 be used. 
 
356 HYDROPATHIC PRACTICE. 
 
 Dripping Sheet. 
 
 The dripping sheet is another form of applying cold 
 water. It is given as follows : The patient standing in a 
 tub, the sheet is suddenly thrown around his body, which 
 it envelopes from the head to the feet, and the body is 
 rubbed by the hands of the attendant, outside the sheet, 
 for five or ten minutes, when the sheet should be removed, 
 and the body rubbed with a dry towel. 
 
 This bath is used in the early stage of fevers, also in 
 most chronic diseases. I have found this form of bathing 
 a very convenient one, not only in removing disease, but 
 when used once or twice a week an excellent preventive. 
 
 The Hip or Sitz Bath. 
 
 For the sitting bath, sufficient water should be placed 
 in a tub to cover the hips and lower portions of the abdo- 
 men, when the patient is in a sitting posture. The water 
 may be of any temperature to suit the indications. This 
 bath is beneficial in diseases of the uterus, as leucorrhoea, 
 dysmenorrhoea and prolapsus. In these diseases the baths 
 are mostly used cold. 
 
 This bath is also used in dysentery, piles, hip disease, 
 &c. The baths should be repeated as often as the nature 
 of the case appears to indicate. 
 
 Shallow Bath. 
 
 This bath is taken in a tub large enough for the patient 
 to sit upright with ease. The water should be from four 
 to six inches deep. The temperature of the water, as in 
 other forms of bath, should be warm or cold as indicated. 
 The shallow bath is used in all cases where the sitz bath is 
 recommended, and in many cases to much advantage. 
 
HYDROPATHIC PRACTICE. 35T 
 
 Plunge Bath. 
 
 This process consists in immersing the whole body up to 
 the neck in water quickly, where there is room sufficient 
 for the patient to exercise his limbs under water. A plunge 
 bath may be easily constructed where there is a running 
 stream. A box eight or ten feet long, and five or six feet 
 high, may serve a good purpose for this bath. This form 
 of bath is of utility in all cases where there is' sufficient 
 vital reaction, except in organic disease of the heart, and 
 tuberculous affections of the lungs. 
 
 Foot Bath. 
 
 By foot bath is meant merely placing the feet in warm 
 water. This is a valuable auxiliary in acute and most 
 chronic diseases. It acts as a revulsive to diseases of the 
 brain, stomach and bowels. Where there is determination 
 of blood to the head, stomach or bowels, the bath should 
 be hot, and followed by brisk friction. The benefit of the 
 bath will be much increased by the addition of lye and 
 pulverized mustard, in acute diseases. 
 
 Head Baths. 
 
 The head bath may be given in two ways. By laying 
 folded towels upon the head that have been wrung out of 
 cold water, or by allowing a stream of water to fall upon 
 the head. The most common method in acute diseases is 
 to wrap the head in wet cloths, and change as often as 
 they become warm. In some violent affections of the brain, 
 more benefit may be derived from a stream of cold water 
 falling upon the head from some distance. 
 
 Cataract Bath. 
 
 This bath consists in two streams of water falling ob- 
 liquely upon opposite parts of the body. This form of 
 
358 HYDROPATHIC PRACTICE. 
 
 bath may be used for the same purpose as the douche, as 
 also a substitute for the wave bath or plunge, when the 
 patient is too weak to take the latter. 
 
 Dry Pack, or Sweating Bath. 
 
 This is managed as the wet-sheet packing, except for 
 the wet sheet a dry blanket is substituted. In either pro- 
 cess, wet cloths should be applied to the head, and plenty 
 of air should be admitted into the room. This bath is 
 useful where the patient has not sufficient vitality to render 
 the wet-sheet pack or other cold applications practicable. 
 Ague chills may be much lessened in their severity by 
 this process of sweating. 
 
 The Vapor Bath. 
 
 This is valuable in colds the first stages of fevers, &c. 
 The patient may sit on an open chair with a blanket of 
 sufficient thickness to retain the steam pinned about the 
 neck. A pan of water may be placed under the chair, in 
 which hot bricks are immersed to keep a vapor constantly 
 rising ; or a small quantity of alcohol may be burnt beneath 
 the chair, to produce perspiration. This bath may be 
 continued from fifteen to twenty-five minutes. 
 
 The Wave Bath. 
 
 This consists in extending the body in a swift current of 
 water. It is for the same purpose as the plunge bath. 
 
 The Bain Bath. 
 
 This is taken by walking in a brisk shower, dressed in 
 thin apparel. This is used for producing reaction ; it 
 stimulates the glands, hence it is useful in scrofula. The 
 walk should not be prolonged to produce fatigue ; when 
 the patient returns, the cloths should be removed, and the 
 body wiped with a dry towel. 
 
HYDROPATHIC PRACTICE. 359 
 
 Portable Shower Bath. 
 This process may be performed by showering the body 
 with an ordinary tin shower-pot. 
 
 The Affusion Bath. 
 
 This consists in pouring water over different parts of the 
 body, while the patient is standing in a tub. 
 
 This is a favorite method of applying water in fevers and 
 inflammatory diseases. Where this bath is used for cool- 
 ing the body, it should be repeated until the object is 
 accomplished. 
 
 Towel or Sponge Bath. 
 
 This bath consists in washing the surface with a towel 
 or sponge. This is the most convenient of all the baths. 
 It is used extensively in fevers. It should never be neg- 
 lected in their treatment, but should be repeated two or 
 three times a day. A small amount of saleratus added to 
 the water is a valuable auxiliary. 
 
 Wet Dress Bath. 
 
 The patient is enveloped in a dripping night dress, placed 
 in bed, and treated the same as in the wet sheet pack. 
 
 Leg-Bath. 
 
 The leg-bath consists in immersing the legs in a tub of 
 water. It is used for gout, rheumatism, ulcers, diseases 
 of the joints, &c. 
 
 Fomentations. 
 
 These are cloths wrung out of hot water, and applied 
 to different parts of the body, as may be indicated. 
 
 Wet Bandages. 
 
 This is another method of applying cold or warm water 
 to different parts of the- body. The cold, wet girdle, is 
 used to good advantage in prolapsus uteri, and leucorrhoea. 
 
360 HYDROPATHIC PRACTICE. 
 
 Hand Friction. 
 
 This should be applied after all baths. It is preferable 
 to any other kind of friction. In all cases where baths 
 are made use of to invigorate the system, friction should 
 be applied until reaction is produced. 
 
 Temperature of Baths.* — Hot, warm, tepid, cool, 
 and cold, are only employed as approximate terms. Water 
 that feels hot to one may only be warm to another. The 
 sensations are generally a better guide for regulating the 
 temperature of a given bath than the thermometer ; 
 still the latter is indispensable in many cases, and in all, 
 convenient. As a general rule, the more feeble and deli- 
 cate the patient, the more strictly should we follow the 
 test of his feelings, in administering tepid, warm, or cold 
 baths. When the circulation is vigorous, and the vital 
 temperature well developed, we may regulate any bath 
 with sufficient precision by the thermometer. It is a 
 useful precaution, when commencing treatment with very 
 susceptible patients, to test their sensibility to different 
 temperatures of water, after which the physician or patient 
 can prescribe them thermometrically. Some Water-Cure 
 books seem to make it an especial point, to be thermo- 
 metrically exact in directing particular baths for given dis- 
 eases : as, for example, sitz baths, at 59° ; shallow-baths, 
 at 63°; half-bath, 74°, &c. These nice distinctions are 
 not to be arbitrarily imitated, but may be regarded as 
 land-marks, to keep us within reasonable bounds. 
 
 Baths may be distinguished into cold, below 65° Fahr. ; 
 tepid, 65° to 80° ; warm, 80° to 98°. But a better 
 division may be made thus : 
 
 Very cold, 
 
 32° to 40° 
 
 Tepid, 
 
 72° to 85° 
 
 Cold, 
 
 40° to 55° 
 
 Warm, 
 
 85° to 98° 
 
 Cool, 
 
 55° to 65° 
 
 Hot, 
 
 98° to 115° 
 
 Temperate, 
 
 65° to 72° 
 
 Vapor, 
 
 98° to 125° 
 
 * Trail. 
 

 CHRONO-THERMAL SYSTEM. 361 
 
 ChronO'tkermal. — A system of medicine so called, from 
 chronos, time, and therma, heat, first introduced by Dr. 
 Dickson, of London, in 1836. He lays down the follow- 
 ing propositions as the basis of his system : 
 
 " 1. The phenomena of perfect health consist in a regu- 
 lar series of alternate motions or events, each embracing 
 a special period of time. 
 
 " 2. Disease, under all its modifications, is, in the first 
 place, a simple exaggeration or diminution of the amount 
 of the same motions or events; and, being universally 
 alternative with a period of comparative health, strictly 
 resolves itself into fever, Remittent or Intermittent, 
 Chronic or Acute ; — every kind of structural disorganiza- 
 tion, from Tooth-Decay to Pulmonary Consumption, and 
 that decomposition of the knee-joint, familiarly known as 
 ivhite-siceUing, being merely developments in its course — 
 Tooth-Consumption, Lung-Consumption, Knee-Consump- 
 tion, &c, &c. 
 
 "3. The tendency to disorganization, usually denomi- 
 nated Acute, or Inflammatory, differs from the chronic or 
 Scrofulous in the mere amount of motion and temperature ; 
 the former being more remarkably characterized by excess 
 of both, consequently, exhibits a more rapid progress to 
 decomposition or cure ; while the latter approaches its 
 respective terminations by more subdued, and, therefore, 
 slower and less obvious terminations of the same action 
 and temperature. In what does consumption of a tooth 
 differ from consumption of the lungs, except in the differ- 
 ences of the tissue involved, and the degree of danger to 
 life, arising out of the respective offices of each V 
 
 The remedies used in the treatment of disease, Dr. 
 Dickson terms Chrono-Thermal, from the relation which 
 their influence bears to time or period, and temperature 
 (cold and heat) ; chronos being the Greek word for time, 
 and therma for heat or temperature. These remedies are 
 31 
 
362 CONSIDERATION OF FEVERS. 
 
 all treated of in the various modern works upon the Ma- 
 teria-Medica. The only agents this system rejects, are the 
 bleeding lancet, the leech, and the cupping-instrument. 
 
 PHYSIOLOGICAL, PATHOLOGICAL, 
 AND PRACTICAL CONSIDERATION 
 OF FEVERS. 
 
 Pathological researches have not as yet been as suc- 
 cessful in revealing the seat, nature, and character of 
 fevers, as of some other diseases. This may be owing in 
 part to the nature of the investigation. The investigation 
 being mostly confined to autopsic appearances, while a 
 correct physiological analysis of the symptoms manifested 
 in the progress of the disease, has been in a great measure 
 neglected. 
 
 In order to arrive at a correct idea of the nature of 
 fevers, a study of the causes, symptoms, and effects, pro- 
 duced by the remedies, and the character of these pheno- 
 mena, with those of organic modifications in a; state of 
 health, with microscopic autopsic appearances, will enable 
 us to arrive at a more just conclusion relative to all the 
 pathological changes connected with fevers. 
 
 The phenomena of fevers are so numerous and so dif- 
 ferent in appearance, that it would be almost impossible 
 to give a minute description of them. There is not a 
 single derangement of function, or of tissue, which I have 
 not observed in these diseases. They have then no specific 
 symptom nor pathognomic sign ; even the hot skin, rigors, 
 and accelerated pulse, exist in diseases when fever is not 
 present. Although this is true relative to a single pheno- 
 menon of fever, there are a series of phenomena, which is 
 so uniformly present in what is termed idiopathic fevers, 
 that we call the disease fever, when the symptoms are 
 manifested in the following order : 
 
CONSIDERATION OF FEVERS. 303 
 
 1. Nervous depression, characterized by languor, lassi- 
 tude, and debility. 
 
 2. Rigors and chills, connected with superficial capil- 
 lary congestion, an irregular pulse, and hurried and op- 
 pressed breathing. 
 
 3. Reaction, characterized by a dry tongue, scanty 
 urine, and loss of appetite. When these symptoms 
 appear in the order in which they are here laid down, we 
 denominate the disease fever. Although the above series 
 of symptoms must always be present in the above order to 
 constitute fever, it by no means includes the entire number 
 of symptoms present in this disease. These symptoms 
 indicate the disturbance of, or abnormal manifestation of, 
 
 1. The nervous system, as indicated by the debility, 
 lassitude, aversion to mental and physical exertions, rest- 
 lessness, creeping chills, horripilations, alternations of 
 flushing heat, and irregular breathing. 
 
 2. A hurried and irregular action of the heart and 
 arteries, dependent upon the abnormal nervous manifesta- 
 tion. 
 
 3. Immediately following this increased circulation of 
 the blood, is an increased and abnormal temperature, a 
 derangement of the secretions, as indicated by the scanty 
 urine, dry tongue, hot skin, increased thirst, anorexia, 
 &c, giving unmistakable evidence of the entire inability 
 of the nervous system to afford these important organs 
 the necessary stimulus. In thus carefully noting the series 
 of changes which manifest themselves in all idiopathic 
 fevers, we can commence at the derangement of the brain 
 and nervous system, and follow the entire series of physio- 
 logical and symptomatica! changes, as arising from, and 
 dependent upon, the primary cause of this entire class of 
 diseases, i. e., a derangement of the brain and its append- 
 ages. 
 
 In our classification of fevers, we have adopted that 
 
364 CONSIDERATION OF FEVERS. 
 
 which appears to us to be the only one warranted by the 
 manifestations of this disease. 
 
 1st. Ephemeral Fever is the simplest of all forms of 
 fever, yet it manifests the entire series of phenomena ; but, 
 owing to the mildness of the cause, it lasts only twenty- 
 four hours. The cure is effected by the recuperative 
 powers of the system. 
 
 The next form is that of Intermittent Fever, in which 
 so much of the cause is removed as to relieve the nervous 
 system for the time, but not entirely relieving the system 
 from the morbid influences. During the thermal changes 
 of the body in rest and sleep, the poisonous cause makes 
 a sufficient impression upon the brain and nervous system 
 to obstruct the proper supply of vital stimulus to the .de- 
 pendent organs of the body, and the result is a repetition 
 of the paroxysm or Intermittent Fever. If the shock 
 received by the brain and nerves, is of sufficient intensity 
 to prevent a temporary restoration and reaction, the fever 
 is called Remittent or Continued. When the secretory 
 and excretory system is so far deprived of the necessary 
 stimulus as to produce an entire suspension of these func- 
 tions, and the circulating organs are exceedingly languid 
 from the same cause, the fever is called Typhus or Con- 
 gestive Fever. When, in addition to these symptoms, a 
 disorganizing tendency is manifested in the glands of the 
 bowels, the fever is termed Typhoid. 
 
 The condition of the capillary vessels in fevers, as recorded by 
 David Craigie, M. D. y F. R. S. E., in his Pathological Ana- 
 tomy, pp. 156 to 163. 
 
 "In fevers, whatever be the form, intermittent, remit- 
 tent, or continued, the capillary vessels are the seat of 
 disorder. Nor is the affection confined to the capillaries 
 of one region, of one organ, or of one tissue. The seat 
 of fever is to be sought neither in the capillaries of the 
 
CONSIDERATION OF FEVERS. 365 
 
 brain and spinal chord, nor in those of the kings, nor in 
 those of the alimentary canal ; but it is diffused over the 
 minute ramifying communications of the aortic and venous 
 branches, in whatever part of the body these communica- 
 tions are found. To establish the truth of this statement, 
 it is requisite merely to consider the phenomena of fever 
 in the living body, and its traces and effects in the dead. 
 
 "I presume that the affection of the capillary system 
 of the brain, both cranial and vertebral, is too generally 
 admitted to require being formally demonstrated. In 
 point of fact, the pain in the head in the beginning of all 
 fevers, the derangement of thought during their progress, 
 and the tendency to stupor, and absolute coma towards 
 the conclusion, are sufficient alone to prove disorder of 
 the cerebral capillaries. But when blood or serous fluid 
 is found effused into the ventricles, when the vessels of the 
 brain are found turgid, distended with blood, and more 
 numerous than natural, it is impossible to resist the infe- 
 rence as to the over-loaded state of the cerebral capillaries 
 during life. I am aware that cases of fever are sometimes 
 adduced, in which neither pain of the head nor deranged 
 thought are observed. I can only say, that, among a 
 very great number of cases which I have observed, though 
 in a few the patient did not complain of headache, it was 
 always possible to recognize more or less derangement of 
 thought. 
 
 "In all cases, pain is felt when the patient coughs or 
 stoops, or when the head is slightly shaken ; and when no 
 pain is said to be felt, it indicates that the stage of natural 
 Sensation is passed, and that he complains not, because he 
 does not feel. 
 
 "In ague, the oppression of the cerebral cavities may 
 
 be so great as to constitute inflammation (Siriasis iEgyp- 
 
 tiaca), or phrenitic ague ; or, in various degrees, the sleepy 
 
 quotidian, the sleepy, lethargic, hemiphlegic, carotic, and 
 
 31* 
 
360 CONSIDERATION OF FEVERS. 
 
 apoplectic tertian, and the comatose quartan of practical 
 authors (Werlhof, Torti, La-utter, Sydenham, Morton, 
 &c), the same disease which has been named by Lancisi, 
 Baglivi, and Morgagni, epidemic apoplexy. 
 
 " The disorder of the capillaries of the spinal chord is 
 indicated by pain and weight in various parts of the 
 column, by the derangement in the muscular motions, 
 especially local palsy, e. g., of the arms, legs, &c, by the 
 tetanic spasms and convulsions taking place in many 
 fevers. After death, much serous fluid flows from the 
 theca ; the vessels of the chord are distended and numer- 
 ous ; in all instances, serous fluid is effused, and sometimes 
 pure blood issues from its capillaries. 
 
 "That the capillary system of the lungs is overloaded 
 and oppressed in all fevers, is one of the most certain 
 points in pathology. During the ague fit, the respiration 
 is invariably quicker than natural, sometimes to the 
 amount of thirty or thirty-six in the minute; the patient 
 complains of s^nse of weight in the breast, cannot breathe 
 fully, pants, and has frequent cough. In continued fever, 
 the respiration is invariably quicker and more laborious 
 than natural ; a deep breath cannot be drawn easily, and 
 more or less sense of weight and oppression is felt. I 
 have found the respiration in continued fever so quick as 
 thirty-six in the minute, while in ordinary cases, the appli- 
 cation of the stethoscope indicates an embarrassed state 
 of the circulation in the pulmonary capillaries. In persons 
 predisposed, expectoration, streaked with blood (hsemoptae), 
 is not unfrequent during continued fever. 
 
 11 The same conclusion is clearly established, by examin- 
 ing the lungs of persons cut off either by intermittent 
 or by continued fever, In many instances of the former, 
 it induces bronchial inflammation, or proceeds to actual 
 peripneumonia or pleurisy, constituting the catarrhal, 
 pneumonic, or pleuric tertian respectively (Werlhof, Torti, 
 
., SIDERATION OF FEVERS. o()7 
 
 Laneisi, &c). In the latter, the bronchial mucous mem- 
 brane is always more or less red, sometimes crimson or 
 purple, or of a deep brown color, rough and much thick- 
 ened ; the sub-mucous tissue is brown and loaded with 
 serous fluid ; and the minute vessels are much distended 
 with dark-colored blood. The bronchial tubes are very 
 commonly, in fatal cases, perfectly filled with thick, viscid 
 mucus, which adheres to the inner surface of the bronchi; \ 
 membrane. The serous surface of the organ is generally 
 livid or marbled from this cause ; but the pleura itself is 
 not much changed, save from the bloody serum discharged 
 into its cavity. The lungs, in totality, are generally dense, 
 and firmer than in the natural state. 
 
 "These changes arise from the minute ramifying vessels 
 at the termination of the pulmonary artery, and the organs 
 of the pulmonary veins being unusually loaded with blood. 
 As they are more so than can be readily affected by the 
 ordinary quantity of air admissible in such a state, imper- 
 fect respiration and undue change of venous blood con- 
 tributes powerfully to the bad symptoms and the unfavor- 
 able termination of the disease. In such a state of the 
 organs of respiration, the bronchial arteries are less able 
 to counteract the bad effects of imperfectly respired blood, 
 in so far as they receive from the aorta blood which has 
 not been sufficiently arterialized. 
 
 "In the capillary system of the chylopoietic and assistant 
 chylopoietic viscera, traces of the same condition may be 
 recognized, both from the symptoms during life and its 
 appearance after death. In these organs, two capillary 
 systems may be distinguished, a primary and a secondary 
 one. The primary is that which consists of the ultimate 
 divisions of the splenic, gastric, and duodenal arteries, and 
 of the superior and inferior mesenteric arteries, and their 
 corresponding veins, which afterwards terminate in the 
 splenic and superior and inferior mesenteric veins. The 
 
368 CONSIDERATION OF FEVERS. 
 
 secondary capillary system is that which results from the 
 union of the minute extremities of the portal vein, and of 
 the hepatic artery with those of the vena cava hepatica. 
 
 11 It is unnecessary to dvvellon the proofs of the loaded 
 state of the capillary system of the alimentary canal. It 
 is sufficient to remind the student that the furred or brown 
 totfgue, the thirst, the sense of internal heat, the loathing, 
 squeamishness, and sometimes sickness, with weight, op- 
 pression, and tenderness of the epigastric region, suffi* 
 ciently demonstrate the morbid state of the capillaries of 
 the oesophagus, stomach, and duodenum ; while the consti- 
 pation of the bowels at the commencement, insensibility 
 to cathartic medicine throughout, and occasional looseness 
 at the conclusion, indicate the deranged condition of those 
 of the intestines. After death, the minute vessels of the 
 whole of these parts are found much distended with blood/ 
 generally dark-colored. 
 
 "In one form of fever, the abdominal or intestinal 
 typhus, the ileum and its mucous follicles are very much 
 affected. The follicles become enlarged, elevated, and 
 prominent, and swelled in consequence of their proper 
 tissue being attacked, and perhaps their secreting pores 
 being obstructed. The apices become dead, and are 
 thrown off in the form of sloughs ; and in their place are 
 left small ulcers, which, in no long time, enlarge, spread, 
 and increase in depth. These changes may take place 
 either in the isolated follicles, or in the aggregated patches, 
 or in both orders of glands. 
 
 "In certain forms of fever, there are pain, distension, 
 and uneasy sensations in the right iliac region ; and when 
 percussion is employed, the sound emitted is dull, while a 
 peculiar croaking noise is heard, and a gurgling movement 
 is felt beneath the fingers, as if produced by air and liquid 
 moving within the intestine. 
 
 (l These symptoms continue the greater part of the 
 
CONSIDERATION OF FEVERS. 369 
 
 duration of the fever; and though they are abated by local 
 depletion, by means of leeches aud and laxative medicines, 
 they do not disappear until the fever itself either abates or 
 altogether retires. 
 
 " The portal vein constitutes, among the vessels of the 
 digestive organs, a secondary capillary system, in which 
 the blood is not less accumulated than in the primary one. 
 It may be thought that, as the blood is accumulated in the 
 first, it ought not so readily to find its way into the trunk, 
 branches, and ramifications of the second. 
 
 " But this objection will vanish, when it is remembered 
 that, at the same time, both the primary and secondary 
 system of capillaries become overloaded. This state of 
 the capillaries of the portal and hepatic system is estab- 
 lished by the appearance of the liver in persons cut off by 
 fever. 
 
 " The spleen may suffer so much from this capillary dis- 
 tension as to resemble a mass of clotted blood without 
 trace of organization. This morbid and extraordinary 
 distension of the primary and secondary capillary systems 
 of the chylopoietic organs, though distinct enough in the 
 fevers of temperate countries, is most conspicuously de- 
 monstrated in the agues and remittents of warm climates, 
 and especially in the severe and extreme form termed 
 yellow fever. In the former, great sickness and epigastric 
 tenderness, with more or less vomiting, are frequent; and, 
 in the latter, constant symptoms. The vomiting, however, 
 is not bilious, as has been too generally imagined. It is, 
 at the commencement, always a watery fluid, evidently 
 derived from the capillaries of the gastric, and, perhaps, 
 from the duodenal mucous membrane. After some time, 
 it begins to be mixed with bile, expressed, no doubt, from 
 the gall-bladder by the pressure of the stomach in the act 
 of vomiting. A much more uniform occurrence, however. 
 if the disease does not subside spontaneously, or is checked 
 
310 CONSIDERATION OF FEVERS. 
 
 by art, is the gradual admixture of blood, somewhat 
 darkened, with the watery fluid. This blood issues from 
 the capillaries of the gastric and intestinal tissues by a 
 process analogous to exhalation in the sound state, but 
 differing in so far as, in the capillaries from which it pro- 
 ceeds, a degree of disorganization has taken place. 
 
 " As the blood escapes into the cavity of the canal, 
 originally not highly scarlet, it is rapidly blackened by 
 the action of the carbonic acid and sulphuretted hydrogen 
 gases, at all times present in greater or less quantity. 
 This bloody exudation is at first scanty, but gradually in- 
 creases as the disease goes on, until it constitutes the 
 greater part of what is discharged both by vomiting and 
 by stool. In the former case, it forms the black-vomit or 
 coffee-ground matter (vomito prieto), so frequent in cases 
 of remittent or yellow fever. In the latter, it forms the 
 dark, tarry, or treacle-like stools, mentioned by practical 
 authors in the same disease. The description, now given 
 is general, and applies to this capillary disorganization, 
 as it takes place both in bad agues and remittents, and in 
 yellow r fever. In the former it is less frequent, but, never- 
 theless, takes place sufficiently often. In the latter, it is 
 seen in its most aggravated form, and is almost invariable 
 in fatal cases. Its origin and formation have been traced 
 in the most satisfactory manner by repeated dissections. 
 
 " The idea that black vomit is morbid or vitiated bile, 
 deserve-s no attention. In some cases of severe yellow 
 fever, a dark colored fluid of the same physical characters 
 as those found in the intestinal tube, may be traced coming 
 down the biliary and hepatic duct, from the pori biliarii. 
 This, however, instead of being bile, is blood which has 
 oozed from the hepatic capillaries, in the same manner as 
 that from the intestinal ones. 
 
 "The capillaries of the urinary system are much affected 
 
CONSIDERATION OF FEVERS. 371 
 
 during fever. Both in intermittents and in continued 
 fever, bloody urine has been discharged. 
 
 "•'In the same manner, the capillaries of the muscles, 
 of the filamentous tissue, and of the skin, are morbidly 
 distended. One of the most common symptoms of fever is 
 pain, soreness, and a sense of bruising in the muscular 
 parts and limbs in general. In fatal cases, when these 
 parts are examined by incision, unusual vascular distension 
 and extravasation of blood are frequently seen. The livid 
 spots and patches (molcepes; vibices ecchymosata) are 
 proofs of the same state of the capillaries of the fila- 
 mentous tissue, as petechial eruptions denote this in the 
 skin. In short, there is scarcely a texture or organ of the 
 animal body, the capillaries of which are not disordered 
 in the different forms of fever ; and this disorder, instead 
 of being confined to the capillaries of a single organ, is 
 extended throughout the capillary system at large. 
 
 "It is doubtless true, that in individual cases, this dis- 
 order may be greater and more distinct in one set of 
 capillaries than in another. In one set of patients, the 
 capillaries of the brain may be most disordered ; in an- 
 other, those of the lungs ; in a third, those of the intestinal 
 canal ; and in a fourth, those of the urinary organs. It is 
 always found, however, in such cases, that the affection 
 of one organ does not entirely exclude that of another ; 
 and while the capillaries of the one are very much affected, 
 though those of the others are less so, they are by no 
 means in the healthy state. In all cases of severe and 
 exquisite fever, whether intermittent, remittent, or con- 
 tinued, the capillaries of the brain, of the lungs and heart, 
 of the chylopoietic organs, of the urinary organs, of the 
 muscles, of the cellular tissue, and of the skin, are affected 
 nearly in the same degree. 
 
 "An important question is to decide the nature of this 
 
3?2 CONSIDERATION OF FEVERS. 
 
 affection. The dissections of Home, Plocquet, Mills, 
 &c, as to the brain ; those of Schenck, Morgagni, Lieu- 
 taud, Sarconi, and others, as to the thoracic organs ; and 
 those of Lieutaud, Petit, and Serres, Broussais, Lermi- 
 nier, and Andral, Louis, Chomel, and Bright, as to the 
 intestinal canal, might favor the supposition that the 
 morbid process of fever consists in inflammation. 
 
 "Against this conclusion, however, various facts and 
 arguments may be added. 
 
 " 1st. In fatal cases of fever, unequivocal traces of 
 inflammation are not uniformly or invariably found. The 
 proportion in which these marks, as albuminous effusion, 
 suppuration, ulceration, &c, are observed, is small, com- 
 pared with the number in which accumulation of blood iu 
 the capillaries, and more or less disorganization of these 
 vessels, are observed. 2d. In cases of pure, genuine, and 
 unmixed inflammation of the internal organs, whether 
 spontaneous or from injury, the concomitant symptoms, 
 though febrile, are totally different from those that distin- 
 guish either intermittent or continued fever. 3d. The 
 marks or effects of inflammation, which are found in the 
 bodies of persons cut off by fever, are accidental compli- 
 cations, and may almost invariably be traced to inflam- 
 matory reaction supervening on the febrile process, in 
 consequence either of the physical peculiarities of the 
 individual, the local weakness of the parts, or the influence 
 of external morbific causes. 4th. Inflammation is a local 
 action confined to the capillaries of one tissue, or at most 
 of one organ and contiguous tissues ; and while the struc- 
 ture and functions of the organ may be completely im- 
 paired, those of others remain unaltered. In fever, on 
 the contrary, the capillaries of all the tissues, and of every 
 organ are affected ; and while no individual organ is much 
 affected at the commencement, every organ suffers a little 
 in the general disorder of the capillary system. 5th. 
 
CONSIDERATION OF FEVERS. 3*73 
 
 Inflammation gives rise to albuminous exudation, suppura- 
 tion, ulceration, and in certain parts, to serous, or sero- 
 purulent effusion. In fever, the morbid state of the capil- 
 laries terminates in complete destruction or disorganiza- 
 tion of their organic extremities, and the consequent 
 oozing of blood, from the surface of the several mem- 
 branes and organs. 
 
 In conclusion, though it may be regarded as established, 
 that, during the morbid process of fever, the whole capil- 
 lary system is unduly distended and loaded with an inordi- 
 nate quantity of blood, which really moves more slowly 
 and imperfectly than in health, we have no facts that 
 enable us to determine what induces this peculiar and 
 excessive accumulation. Much has been said lately of 
 congestion, and especially of venous congestion. The 
 state of the capillary system which I have attempted to 
 describe is that of congestion or accumulation ; and so far 
 the hypothesis of congestion is intelligible. Of the existence 
 of venous congestion, however, unless as an effect of that 
 in the capillary vessels there is neither proof nor proba- 
 bility. It is not a primary, but a secondary, or rather a 
 remote consequence." — (Marsh.) 
 
 The Condition of the Blood in Fevers. 
 
 11 It is obvious," says Dr. Carpenter, "that increase of 
 fibrine in the blood does not exist as the result of fever." 
 
 Dr. Andral has observed a marked diminution of fibrine 
 in the blood in all idiopathic fevers ; he also found the red 
 corpuscles and serum slightly increased. It is probable, 
 however, that the increase of red corpuscle is relative in 
 proportion to the amount of fibrine, and not in proportion 
 to the entire bulk of the blood. "In typhoid fever, " says 
 Dr. Carpenter, "the decrease in the proportion of fibrine 
 is much more decidedly marked ; and that it does not 
 depend upon abstinence from food, as, in all cases, as soon 
 32 
 
374 CONSIDERATION OF FEVERS. 
 
 as a favorable change occurs in the disease, the proportion 
 of fibrine is much more decidedly marked." " In malig- 
 nant forms of fever, " says Dr. Simon, "the blood frequently 
 becomes so deteriorated in amount of fibrine as to com- 
 pletely lose the power of coagulation." Another remarkable 
 change which has been observed in the blood in Typhoid 
 and other malignant forms of fever, is the want of due 
 arterialization, as indicated by its dark blue appearance in 
 the veins and arteries, as well as that of the capillaries. 
 This being a very important one in a practical point, I 
 will introduce the remarks of Dr. Cragie upon this subject : 
 
 " What is the cause of these changes ? It is reasonable 
 to think that for the cause we ought to look in the lungs 
 chiefly. The lungs, I have already observed, are in all 
 cases of fever more or less disordered, their vessels are 
 congested and oppressed ; their action is impaired ; and 
 there is proof of great derangement in the action of the 
 bronchial membrane, imperfect admission of air to the 
 bronchial tubes and their membranes, and, accordingly, 
 inadequate arterialization, or, it may be, the lowest possible 
 degree of that function. These may be regarded as matters 
 of fact, capable of demonstration. Does this morbid state 
 of the blood, then, begin in the lungs or in some other 
 organ or set of vessels ? When we consider the large 
 extent of the bronchial membrane ; the fact that, upon it are 
 ramified the capillary divisions of the pulmonary artery ; and 
 the fact that through these vessels passes the whole of the 
 blood of the body ; and the further fact of the manifest 
 disorder of the whole blood of the system in fever, it is 
 impossible to resist the conclusion, that it must be chiefly, 
 perhaps solely, on the blood of the lungs that the cause of 
 the fever begins to display its primary and initial operation. 
 
 " On the nature of this cause it is not possible to speak 
 with confidence or certainty. But if the general opinion 
 that it is a poison diffused through the air, be well founded, 
 
CONSIDERA-TION OF FEVERS. 315 
 
 it is not difficult to perceive at least some traces of its mode 
 of operation. Whether that poison be extricated in the 
 form of a vapor or exhalation from the surface of the earth, 
 and is telluric in its origin ; or is eliminated from vegetable 
 matters in certain circumstances of decay or change ; or 
 from vegetable and animal matters conjoined ; or is given 
 off as a subtle effluvium from the bodies of living human 
 beings, in circumstances unfavorable to ventilation and the 
 healthy performance of the functions ; or is the result of 
 some unknown and inappreciable state of the atmosphere; 
 — it must equally be inhaled in the air in inspiration, and 
 thus thoroughly mixed with the blood of the lungs in suc- 
 cessive acts of the function of respiration. If it be so 
 mixed, it must be circulated with the circulating blood, 
 and in this manner distributed through the whole vascular 
 system to every organ of the body, In doing so, however, 
 this poisonous material will have so altered the blood in 
 the lungs as to produce in that blood, and in these organs, 
 a more decided effect than elsewhere. The shock first 
 inflicted on the blood in these organs appears, it is natural 
 to think ; the great cause of the loss of coagulating pow r er 
 and the impaired arterialization. We know that one of 
 the great uses of the lung, next to or along with the 
 arterialization of the blood, is to maintain the coagulating 
 power, and restore it when impaired. It is, therefore, 
 natural to infer, that when the coagulating power is dimin- 
 ished, it depends upon some important impediment to the 
 function of respiration, and that when the function of respi- 
 ration is imperfectly performed, that it should evince its 
 effects in a diminished proportion of coagulating power. 
 
 If these views be well founded, it follows that, when the 
 blood thus altered is circulated, however imperfectly, it 
 must operate hurtfully on the organs to which it is trans- 
 mitted. It must act, in truth, as a poison, and many of 
 the phenomena of fever are similar, certainly, to the effects 
 
3tG CONSIDERATION 0*F FEVERS. 
 
 of poison, especially a poison at first irritant, and then 
 sedative and narcotic. This appears to be the mode in 
 which, towards the latter stage of fever, its cause acts on 
 the brain and spinal marrow. H 
 
 The ancients supposed fever to depend upon a warfare 
 between the vital forces of the body and some noxious 
 element which had invaded the system. 
 
 Hippocrates ascribed the different fevers to the four 
 humors ; blood, phlegm, and yellow and black bile. Galen 
 supposed that the different forms of ague depended upon 
 the corruption of the different fluids. That quotidian 
 arose from the corruption of phlegm, the tertian from the 
 corruption of yellow bile, and the quartan from that of 
 black bile. He also supposed that, in whatever part of 
 the body the heat began, it ultimately terminated in the 
 heart, causing increased motion of the blood and accelerated 
 pulse, followed by an effort of the vis vitas to expel the 
 poisonous agents from the system, and to assimilate the 
 healthy fluids to sustain the different organs of the body. 
 Sydenham says, "that reason dictates that a fever is 
 nothing else than an effort of nature to thrust from the 
 system morbific matter, in order to restore the patient to 
 health ; that seeing it has pleased God, the Governor of 
 all things, so to constitute human nature as to be subject 
 to a variety of diseases ; that these diseases are introduced 
 into the system in the form of poisoned air and otherwise, 
 and that when once introduced into the system they become 
 so identified with it that it is beyond the art of man to 
 separate it, hence nature has provided for herself a method 
 and concatenation of symptoms, so that she might thereby 
 expel the poisonous matter which would otherwise ruin the 
 whole fabric. Avicenna attributed the phenomena of fever 
 to the superabundance of the different humors. Dr. Stahl 
 maintained that fevers depended upon plethora or over- 
 fulness of the vessels, and a depraved condition of the 
 
CONSIDERATION OF FEVERS. 311 
 
 fluids. Hoffman maintained that fever consisted in a spasm 
 of the capillaries. He attributed the cause of these spasms 
 to some morbid affection of the nervous system. Cullen 
 contended that fever depended upon certain abnormal 
 changes occurring in the brain. Dr. Benjamin Huso, that 
 all diseases are a unit ; and that fevers, as well as other 
 diseases, depend upon an irregular action, and this irregular 
 action, in its turn, is the proximate cause of every form 
 and modification of disease. Ploucquet claimed that all 
 fevers were dependent upon inflammation of the brain. 
 Broussais that all fevers depended upon an altered condi- 
 tion of the mucous surface of the stomach and bowels. 
 That this alteration was mostly confined to the mucous 
 follicles ; and that, as the disease advanced, they passed into 
 a state of suppuration. Relative to the opinion of Brous- 
 sais, Dr. Andral remarks as follows: ''Admitting that 
 simple or follicular enteritis is the commencement of a 
 great number of fevers, can everything be explained by 
 them ? We never thought so ; and it has always appeared 
 to us that these fevers never become severe except in con- 
 sequence of a disturbance which supervenes in the innerva- 
 tion and hematosis. This has been very satisfactorily 
 proved by Prof. Bouillaud, who has contributed to give 
 considerable weight to the doctrine of the localization of 
 fevers, by placing this doctrine on a broader basis, more 
 particularly by establishing the reality of the alterations, 
 which on the one hand the blood, and on the other the 
 nervous centres, undergo in a great number of fevers. The 
 part performed by these has been also clearly demonstrated 
 by the valuable observations of M. Chaufford, of Avignon. 
 This disturbance of hematosis and innervation, which 
 gives rise to the phenomena called adynamic and ataxic, 
 or in other words, to the typhoid state, may be the result 
 of several lesions, different in their nature and in their 
 seat. 
 
 32 * 
 
SIS CONSIDERATION OF FEVERS. 
 
 First, gastro-intestinal inflammations give rise to it more 
 frequently than diseases of an}' other organ. Of these 
 inflammations, some are directed principally to the intesti- 
 nal follicles, which become tumefied, and ulcerate ; others 
 consist merely in a simple ulceration of the mucous mem- 
 brane itself. Other organs also, however, though less 
 frequently than the digestive tube, may become the occasion 
 of that profound disturbance of innervation and hematosis, 
 a disturbance which constitutes the adynamic and ataxic 
 fever of Pinel. Thus phlebitis, pneumonia, particularly in 
 aged persons, erysipelas, phlegmon, inflammation of the 
 urinary passages, an abscess developed in the prostate, 
 metritis, several forms of inflammation of the liver, variola, 
 acute inflammations of the synovial membranes, etc., may 
 give rise to it. M. Boisseau has clearly proved this in 
 his physiological pyretology, and it has been put out of 
 all doubt by several other works ; by those of Pance, in 
 particular. 
 
 Thus the ataxo adynamic, or typhoid state, may be de- 
 veloped, in consequence of a great number of affections 
 widely differing from each other : it is a collection of 
 symptoms identical as to their ultimate seat, but not as to 
 their origin. Thus symptoms, identical also as to their 
 nature, differ only in their greater or less intensity ; with 
 regard to their progress and duration, they are subordinate 
 to the progress and duration of the affection, in conse- 
 quence of which the typhoid symptoms have been de- 
 veloped. If it be a primary alteration of the blood which 
 gives rise to them, these symptoms may acquire, in a few 
 hours, their highest degree of development; and, in some 
 cases, even occasion sudden death. If the commencement be 
 in an organ where inflammation is rapidly developed, as in 
 a lung, or in a vein, the typhoid symptoms shall have a 
 quick course and a rapid termination, similar to this in- 
 flammation. If, on the contrary, they are connected with 
 
CONSIDERATION OF FEVERS. 3T9 
 
 an inflammation, which, as that of the intestinal follicles, 
 has stages, which it passes through with a certain degree 
 of slowness, they will be like the inflammation itself, slow 
 in their development, and slow in their termination, 
 whether favorably or fatally. 
 
 This is, we think, all the difference between a typhoid 
 fever, which is connected with phlebitis, for instance., 
 and that which follows dothiteritis. There will be, 
 however, in each of them, some particular symptoms, 
 which will depend on the local lesion, as the diarrhoea in 
 the case of follicular enteritis. We may, no doubt, as M. 
 Louis has done, reserve the term typhoid fever for the 
 morbid state which proceeds along with the affection of 
 Peyer's glands; this, however, is a distinction purely 
 arbitrary ; and, besides this mode of proceeding., seems to 
 us to be attended with the inconvenience of thus desig- 
 nating a great number of cases' of follicular enteritis, in 
 which the term typhoid affection has no longer any mean- 
 ing ; for all cases of follicular enteritis, certainly are not 
 accompanied either with stupor, or with the different phe- 
 nomena of adynamic or ataxic fever ; all do not resemble 
 typhus : they are oftentimes mere inflammatory, bilious, or 
 mucous fevers, to use for a moment the language of the 
 Nosograph ie Philosophique. 
 
 We do not think it right then to retain the term typhoid 
 fever, because this term leaves a vagueness in the mind, 
 not consistent with science, and because it often fails in ex- 
 actness, with respect to the symptoms which it represents. 
 We admit as a possible, but never a necessary consequence, 
 a typhoid state in a great number of diseases ; that is to 
 say, a state in which there appear some general symptoms 
 more or less similar to those which characterize typhus. 
 This state indicates that the disease no longer exists in the 
 organ where it had commenced — it i^, in some degree, the 
 signal that the blood and nervous centres participate in 
 
380 CONSIDERATION OF FEVERS. 
 
 the disease. Thenceforward, the nature of the disease is 
 no longer the same, and other therapeutic indications 
 present themselves to be fulfilled. 
 
 The term typhoid, when applied to fevers in this work, 
 is not used as an adjective, defining typhus, but as a noun, 
 the name of a fever which is characterized by a specific 
 glandular affection of the bowels. Dr. Samuel Dickson, 
 of London, donounces, in the most emphatic terms, the 
 opinion entertained by the great body of the medical pro- 
 fession, that not only fevers, but all other diseases, are very 
 various, and may be developed by a plurality of causes ; 
 and adopts the maxim of Hippocrates, " Omnium mor- 
 borum units et idem modus est." The type of all dis- 
 eases is one and identical. Upon this subject he remarks, 
 "a disease is not a devil to be cast out, an acrimony or 
 crudity to be expelled, nor any fanciful chemical goblin 
 to be chemically neutralized ; neither is the state errone- 
 ously termed inflammation, so commonly the cause, as a 
 coincident part of the general disorder. Disease is an 
 error of action ; a greater or less variation in the motion, 
 rest, and revolutions of a systematic series of periodic 
 alternations. 
 
 Whatever be the cause or causes of corporeal aberration, 
 in obedience to the law of all matter, the first effects are 
 changes of motion and changes of temperature ; the patient 
 accordingly has a feeling of heat and cold ; his muscular 
 movements are less under the control of their respective 
 influences, thus becoming tremulous, spasmodic, or varied. 
 The breathing is irregular ; the heart beats with increased 
 force, and often with much irregularity of motion. The 
 secretions are changed. The functions of the brain are 
 disturbed, and the body undergoes material physical 
 changes. He further states the cause of all disease, of various 
 name, place and degree, is only one in their real nature, 
 and may be found in a deprivation of any adapt ntion of 
 
CONSIDERATION OF FEVERS, 381 
 
 the identical forces which continue life in health ; the same 
 natural agencies, in a word, by which every motion or 
 event is produced throughout the universe. They com- 
 prise everything, therefore, which connects us directly or 
 indirectly with the external world. The cause of disease, 
 then, never originates in any single organ of the body, ex- 
 cept as far as that organ may be predisposed by inherent 
 weakness of the attractive powers of the atoms of its parts 
 to receive grave impressions from outward agencies that 
 affect other parts of the body in a slight manner. He 
 claims health to consist in a periodic alternation of har- 
 monious molFlments, some longer, some shorter, and that 
 intermittent fever is the type of all diseases ; in other 
 words, that all diseases are but a modification of fever, of 
 which ague is the type. 
 
 Whether this doctrine of fever, according to Dr. Dick- 
 son, be true, and that every fever is but a modification of 
 the primitive type, ague, is a subject worthy of investiga- 
 tion. The opinion of Prof. J. G. Jones, that disease, 
 throughout the entire western country, is decidedly of a 
 periodic character, with the almost universal success of 
 antiperiodie remedies in its treatment ; and not only that 
 which is acknowledged to be of an intermittent type, but 
 also that which is supposed to depend upon a series of 
 uninterrupted morbid changes, is a confirmation of the 
 doctrine of the periodicity of disease, at least to a certain 
 extent. 
 
 Also the doctrine of disease as advocated by my learned 
 colleague, Prof. Chase, M. D., which is, that disease de- 
 pends upon the too positive or too negative condition of 
 the electrical forces of the brain and nerves, or cerebral 
 spinal system ; and that these alternate changes in the 
 electrical condition of the nervous system give rise to all 
 the pathological changes characteristic of not only fever, 
 but all other diseases. He maintains that all medicine 
 
382 CONSIDERATION OF FEVERS. 
 
 acts upon the system in increasing or diminishing the 
 positive or negative electrical condition of the brain and 
 nerves. Also that medicines are beneficial in proportion 
 as they regulate the positive and negative electrical forces 
 of the body. These views being true, we can harmonize 
 the doctrine of Dr. Dickson with the manifest phenomena 
 of fever. The limits of this, work will not allow of a 
 further consideration of the nature of fever, but the subject 
 will be fully considered in my large work, now in the 
 course of preparation, upon the Principles and Practice 
 of Medicine. 
 
 The anatomical character of fever varies wfth the type 
 of the disease. In intermittent, autopsy has shown traces 
 of inflammation of the arachnoid membrane of the brain. 
 The liver is frequently the seat of lesion, and sometimes 
 undergoes a change of structure. In chronic ague, it pre- 
 sents the appearance described by Dr. Craigie, caused by 
 the congested condition of its capillaries. But of all the 
 organs of the body, the spleen is the most uniformly affected. 
 It is not only changed in structure, but becomes very much 
 enlarged, and in all fatal cases proves to be the principal 
 organ on which the disease has spent its force. In remit- 
 tent and congestive fevers, the essential anatomical charac- 
 ter is alteration in the condition and structure of the liver 
 and gall-bladder, although other organs, such as the spleen, 
 lungs, brain, and we might add the entire capillary system, 
 at times manifest organic lesion and congestion. 
 
 In typhoid fever the principal anatomical characteristic 
 appears to be confined to the glands of the bowels. On 
 summing up the locality of fevers, w^e may reasonably 
 infei; that the intermittent form is intimately connected 
 with a deranged condition of the spleen, while the remit- 
 tent and congestive spend their force upon the liver and 
 stomach, and typhoid upon the bowels. Yet it is contrary to 
 the universal characteristics of all forms of fever, to confine 
 
ECLECTIC REMEDIES. 383 
 
 their anatomical and physiological changes to any definite 
 boundary, as each and every organ of the body is neces- 
 sarily more or less dependent upon the entire organism 
 which constitutes the whole. So disease, although local 
 in its incipiency, soon extends its abnormal influence to 
 nearly, if not every, tissue of the body. 
 
 METHOD OF PREPARING ECLECTIC 
 REMEDIES. 
 
 All the concentrated remedies which are prepared in a 
 powdered form, should be triturated either with sugar of 
 milk or pure white sugar. The object of this is, 1st, to 
 prevent the local influence of the medicine upon the 
 stomach ; 2d, it enables it to become- more readily ab- 
 sorbed and conveyed into the circulation, to perform its 
 mission of removing disease, as it passes through the dif- 
 ferent tissues, with the blood. All the fluid extracts should 
 be diluted with pure syrup of sugar, in the same propor- 
 tion as the powdered materials, i. e., ten parts to one 
 hundred of the syrup. The tincture should be given largely 
 diluted with soft water. The triturations, tinctures and 
 syrups, should all be thoroughly prepared and well secured 
 from light, moisture and heat. They should be kept in 
 ground-stopper jars, and should be prepared as often as 
 once or twice-a year. My recipes in this work are full doses 
 for an adult, or what might be considered a medium dose. 
 To enable the prescriber to proportion the dose to the age, 
 sex, idiosyncrasies, temperament, &c, I introduce the fol- 
 lowing table from the A. E. W, p. 1315. 
 
384 
 
 TABLE OP DOSES. 
 
 Table of Proportionate Dose for Different ages. 
 
 Under J year, 
 
 1 " 
 
 2 " 
 
 3 " 
 
 4 « 
 7 " 
 
 14 " 
 
 20 " 
 
 21 " 
 63 " 
 77 " 
 
 100 " 
 
 one-fifteenth of a full dose, 
 
 one-twelfth " 
 
 one-eighth u 
 
 one-sixth " 
 
 one^fifth " 
 
 one-third " 
 
 one-half " 
 
 two-thirds " 
 the full dose 
 
 eleven- twelfths " 
 
 five-sixths " 
 
 two-thirds u 
 
 4 grains. 
 5 
 
 n 
 
 10 
 
 12 
 
 20 
 
 30 
 
 40 
 
 1 drachm. 
 
 55 grains. 
 
 50 " 
 
 40 " 
 
 To the above rule there are certain exceptions ; thus 
 castor oil requires to be given in larger proportionate 
 doses, while opium, and the narcotics generally, should be 
 administered in smaller proportionate doses. 
 
 Sex, temperament and idiosyncrasy, have also a modi- 
 fying effect upon the dose, and they should always be kept 
 in view in the administration of medicines. 
 
 Females usually require smaller doses than males ; and 
 persons of a sanguine temperament bear depletory medi- 
 cines better than the phlegmatic. 
 
 Explanations of the Abbreviations occurring in the For- 
 mulas of this Work. 
 
 R. 
 
 Recipe — Take. 
 
 
 lb. Libra — Pound. 
 
 M. 
 
 Misce — Mix. 
 
 
 g. Uncia — An ounce. 
 
 gr. 
 
 granum— A grain. 
 
 
 5. Drachma — A drachm or dram 
 
 O. 
 
 Octarius — Pint. 
 
 
 Gutt. Gutta — Drop. 
 
 ss. 
 
 Semi— A half. 
 
 
 Tinct. Tinctura — A tincture. 
 
 aa 
 
 of each ingredient equal pi 
 
 irt$. 
 
 Ext. Extractum — An Extract. 
 
MEDICAL TERMS. 385 
 
 GLOSSARY OF MEDICAL TERMS EMPLOYED IN 
 THIS WORK. 
 
 Abdomen. The cavity situated between the lower part of the 
 thorax and the region of the pelvis, containing the intestines, &c. 
 
 Abnormal. Unhealthy. 
 
 Abortion. Miscarriage. 
 
 Abrasion. Excoriation. 
 
 Abscess. Cavity containing pus. 
 
 Absorbents. The lacteals and lymphatic vessels. 
 
 Absorption. The act of taking or sucking up. 
 
 Acacia. Gum Arabic. 
 
 Acarus Scabiei. The itch insect. 
 
 Acetate. A salt containing acetic acid, united to a base. 
 
 Acetic Acid. Vinegar. 
 
 Acetic Tincture. A tincture made with vinegar. 
 
 Acid. A compound body which neutralizes alkalies and other 
 bases. 
 
 Aconite, Monk's-hood. A native of Europe. This plant is culti- 
 vated in gardens as an ornament. It is very extensively used by 
 Eclectics as a febrifuge. 
 
 Aconitum Napellus. 
 
 Acme. The heighth of a disease. 
 
 Acne. Small red pimples appearing upon the face, mostly of 
 young persons. 
 
 Adhesive Inflammation. That kind of inflammation which glues 
 parts together, by means of coagulable lymph. 
 
 Adipose. Fatty. 
 
 Ether. The name of the oxyde of Ethyle. 
 
 Afferent. Name of lymphatics conveying lymph to the glands ; 
 also, nerves which convey impressions to the brain. 
 
 Afflux. The act of flowing to. 
 
 Ague-Chill. The cold stage of an intermittent. 
 
 Albumen. A substance found in animals and vegetables, and 
 which constitutes the chief part of the white of eggs. 
 
 Alcohol. The rectified spirits of wine. 
 
 Aletris Farinosa. Star-grass. 
 
 Aliment. Any kind of food. 
 
 Alimentary Canal. The entire passage through which the food 
 passes from the mouth to the anus. 
 33 
 
386 GLOSSARY OF 
 
 Alkali. A substance, having a metallic base, which neutralizes 
 acids, as potash, soda, and ammonia. 
 
 Allopathy. The system of curing one disease, by substituting 
 another. 
 
 Aloes. The inspissated juice of the aloe spicata. 
 
 Alnuin. Concentrated remedy from the swamp alder. 
 
 Alteratives. Medicines intended to change the morbid action by 
 restoring the healthy functions of the secretions, &c, by a gradual 
 process. 
 
 Alum. Super sulphate of alumina and potash. 
 
 Alvine. Relating to the intestines. 
 
 Amaurosis. A paralysis of the optic nerve. 
 
 Ammonia. Volatile alkali. 
 
 Amphoric. A sound, like blowing into a decanter, heard in aus- 
 cultating the chest in certain diseases. 
 
 Amenorrhcea. Absence of the menses. 
 
 Ampelopsin. A concentrated remedy from the woodbine. 
 
 Anaemia. An impoverished state of the blood. 
 
 Analysis. Resolution of a compound body into its elements. 
 
 Anasarca. Dropsy of the cellular tissue, or membrane, beneath 
 the skin. 
 5 Aneurism. Morbid enlargement of an artery. 
 
 Angina. Generic name of morbid affections of the throat. 
 
 Anorexia. Want of appetite. 
 
 Anthelmintic. A worm-medicine. 
 
 Antidote. A medicine given to destroy a morbid cause. 
 
 Antimony. A metal used in medicine. 
 
 Antiperiodic. A remedy for periodic diseases, as ague. 
 
 Antiphlogistic. A remedy for inflammation. 
 
 Antiseptic. A preservative from putrefaction. 
 
 Anus. The inferior opening of the rectum. 
 
 Aorta. The large artery passing off from the heart. 
 
 Aperient. A gentle purgative. 
 
 Aphonia. Loss of voice. 
 
 Apthus. Sore patches on the mucous membrane. 
 
 Apocynin. A concentrated remedy prepared from the bitter root. 
 
 Apoplexy. Hemorrhage into the brain. 
 
 Apyrexia. Intermission, or absence of fever. 
 
 Arachnoid. Web-like membrane covering the brain. 
 
 Areolae. The interstices between fibres composing organs. 
 
MEDICAL TERMS. 387 
 
 Arnica Montana. Leopards' bane ; a remedy used in intermittent 
 fever, &c, and for mechanical injuries. 
 
 Artery. The name of a blood vessel which conveys blood from 
 the heart. 
 
 Arthritis. Gout. 
 
 Assafoetida. The inspissated juice of a plant growing on the 
 shores of the Mediterranean. 
 
 Ascarides. Small worms infesting the rectum. 
 
 Ascites. Dropsical effusion within the abdomen. 
 
 Asclepin. Concentrated remedy obtained from the pleurisy root. 
 
 Asphyxia. Apparent death from suffocation. 
 
 Asthenic. Applied to disease of a low grade of action. 
 
 Asthma. A disease of the lungs, accompanied by difficult 
 breathing. 
 
 Astringents. Medicines used to contract the animal fibre. 
 
 Atony. A want of tone or energy in the muscular power. 
 
 Atrophy. A morbid state of the digestive system, in which tire 
 food taken into the stomach fails to afford sufficient nourishment. 
 A wasting of the whole or different organs of the body. 
 
 Auricles. The superior cavities of the heart. 
 
 Aurium, Tinnitus Ringing in the ears. 
 
 Auscultation. Method of detecting disease by listening to the 
 abnormal sounds produced in the lungs, in inspiration and expira- 
 tion, by direct application of the ear, or by means of a hollow tube 
 applied to the chest, called a stethoscope 
 
 Axilla. The arm-pit. 
 
 Balcony. Chelona Glabra, Snake's-head, Bitter Herb. Exten- 
 sively used as a stomachic and tonic. 
 
 Balsam Copaiva. Liquid resin used for chronic inflammation of 
 the mucous membrane. 
 
 Balsam of Tolu. Liquid resin used for coughs and catarrhal af- 
 fections. 
 
 Baptisin. A concentrated remedy, prepared from the wild indigo 
 or Baptisia Tinctoria. 
 
 Battery, Galvanic. A connected series of zinc and copper plates, 
 alternately arranged, with acid and water. 
 
 Bayberry. An astringent plant used as a tonic and astringent. 
 
 Beeberine. Active principle of the bark of the Beeberu. 
 
 Belladonna. Deadly Night Shade. 
 
 Bellows sound. A sound produced in the lungs and heart, analo- 
 gous to a bellows. 
 
388 GLOSSARY OF 
 
 Berberin. Active principle of the barberry ; antiperiodic, tonic 
 and laxative. 
 
 Benzoic Acid. Flowers of Benzoin. 
 
 Bicuspides. The first grinding teeth, molars. 
 
 Bifurcate. To divide into two branches. 
 
 Bile. A yellowish fluid secreted by the liver ; its use is to re- 
 move from the fluids superfluous hydro-carbons. 
 
 Bistoury. Small knife used by surgeons. 
 
 Bitartrate of Potassa. Cream of tartar. 
 
 Bleb. Small blister. 
 
 Borax. Salt of boracic acid and soda, sub-borate of soda. 
 
 Bronchi. The tubes into which the trachea or windpipe divides. 
 
 Bougie. Small elastic rod for dilating strictures of the urethra ; 
 also for evacuating the bladder. 
 
 Bronchitis. Inflammation of the ramifications of the wind-pipe. 
 
 Bronchial Sound. Sounds heard over the bronchi. 
 
 Bronchophony. Resonance of the voice heard over the bronchial 
 tubes, or conveyed through a consolidated lung, or through an 
 accumulation of fluid. 
 
 Bronchocele. Enlargement of the thyroid gland. 
 
 Bryonia. Medicine used in typhoid fever. 
 
 Bubo. Inflamed gland occurring in the groin or axilla. 
 
 Cadaverous. Countenance resembling a corpse. 
 
 CsQCum. The head of the colon ; so-called from being perforated 
 at one end only. 
 
 Cajeput. Volatile oil used for rheumatism, &c. 
 
 Calculus. Stone in the bladder. 
 
 Calomel. Combination of chlorine and mercury; a proto-chlo- 
 ride. 
 
 Camphor. A valuable antispasmodic and nervine. 
 
 Cannabis Indica. Indian hemp. 
 
 Canula. A hollow tube. 
 
 Cantharides, Spanish flies, , for blistering; used extensively by 
 allopaths and homoeopaths. 
 
 Capillaries. Hair-like vessels for conveying the blood from the 
 arteries to the veins. 
 
 Capsicum. Bed pepper, Cayenne ; pure stimulant, used in two or 
 three grain doses, whenever a stimulant is indicated. 
 
 Carbo-ligni. Charcoal ; carbo-vegetabilis. 
 
 Carbonates. Combinations of carbonic acid, with a base. 
 
 Cardiac. Appertaining to the heart. 
 
MEDICAL TERMS. 389 
 
 Cardialgia. Pain in the stomach. 
 
 Carditis. Inflammation of the heart. 
 
 Caries. Disease of the bone. 
 
 Cartilage. Gristle. 
 
 Carotid. Name of the artery passing up each side of the neck, 
 conveying the blood to the brain. 
 
 Castor. A secretion found in a sac near the anus of the beaver. 
 
 Catalepsy. A nervous affection, involving loss of consciousness. 
 
 Catamenia. The menstrual flux. 
 
 Cataplasm! A poultice. 
 
 Catarrh. Flow of mucus. 
 
 Catharsis. Purging. 
 
 Cataract. Opacity of the crystalline lens. 
 
 Catheter. A hollow silver tube used for evacuating the bladder. 
 
 Caulophyllin. The active principle of the blue cohosh. 
 
 Caustic. A substance which destroys parts by combining chemi- 
 cally, or disorganizing them. 
 
 Ceanothus. New Jersey tea. 
 
 Cellular Tissue. The fine or net-like tissue connecting most of 
 the structures of the human body. 
 
 Cephalitis. Inflammation of the brain. 
 
 Cephalome. A morbid tumor, the matter of which resembles the 
 brain. 
 
 Cerate. An ointment made of wax. 
 
 Cerasin. Active principle of the choke-cherry; used very exten- 
 sively as an antiperiodic and febrifuge ; the medium dose from three 
 to five grains, repeated every two or three hours until thirty or forty 
 grains are given. 
 
 Cerebellum. The posterior portion of the brain. 
 
 Cerebrum. The anterior portion of the brain. 
 
 Cerebritis. Inflammation of the brain. 
 
 Cervex Uteri. Neck of the womb. 
 
 Chalybeate. Containing iron. 
 
 Chancre. Syphilitic ulcer. 
 
 Chelona Glabra. Snake's head, balmony. It is tonic and vermi- 
 fuge, used in the form of infusion. 
 
 Chelonin. The active principle of the chelona glabra. 
 
 Chlorine. An elementary gas. 
 
 Chlorosis. Green sickness. 
 
 Cholerine. A modified species of cholera. 
 
 Cholera Morbus. Bilious vomiting and purging. 
 33* 
 
390 GLOSSARY OF 
 
 Cholera Infantum. Summer complaint of children. 
 
 Chorea. St. Vitus' dance. 
 
 Chyme. The pulp formed by the food mixing with the gastric 
 secretions, after it has been for some time in the stomach. After 
 the chyme becomes mixed with the pancreatic and biliary secretions 
 of the duodenum, it is converted into chyle. 
 
 Cicatrix. A scar. 
 
 Cicatrization. Process of healing. 
 
 Cicuta. Poison hemlock. 
 
 Cicutin. The alkaloid of cicuta. 
 
 Cimicifugin. The concentrated principle of the black snake-root. 
 
 Cinchona. Peruvian Bark. 
 
 Cinchonine. An alkaloid of the cinchona. It is antiperiodic, and 
 used in the same cases as quinine. 
 
 Citric acid. Acid of lemons. 
 
 Clinic. A school in which medicine is taught by examining 
 diseased patients at the bedside. 
 
 Clysters. Injections per ano and per vagina. 
 
 Cnicene. One of the active principles of the blessed thistle. 
 
 Coagulum. A clot of blood or milk. 
 
 Coffea, Coffee. A homoeopathic remedy for nervous diseases. 
 
 Colchicin. The alkaloid of colchicum autumnale. 
 
 Cold. Catarrh in the head. 
 
 Colic. Griping in the intestines. 
 
 Colitis. Inflammation of the mucous membrane of the colon. 
 
 Collapse. Kecession of blood from the superficial capillaries, and 
 failing of the vital powers. 
 
 Colliquative. Excessive evacuation. 
 
 Colombin. Proximate principle of columbo. 
 
 Colon. The large intestine. 
 
 Coma. Drowsiness, lethargy. 
 
 Comatose. Drowsy. 
 
 Compatibles. Medicines which can be used together without im- 
 pairing their properties. 
 
 Confluent. Running together ; one variety of small-pox. 
 
 Congenital. Being present at birth. 
 
 Congestion. Over fulness of the blood-vessels. 
 
 Congestive Diseases. Those in which congestion is the most 
 prominent symptom. 
 
 Congestive Fever, is a fever, where the stomach, liver and spleen, 
 are the congested organs. 
 
MEDICAL TERMS. 391 
 
 Conjunctiva. The outer membrane of the eye. 
 
 Conjunctivitis. Inflammation of the conjunctiva. 
 
 Constipation. Costiveness. 
 
 Constitutional. Hereditary, or acquired predisposition ; a disease 
 is said to be constitutional when it affects the whole system. 
 
 Consumption. Wasting away. 
 
 Contagion, Propagation of disease by contact. 
 
 Continuity. Direct connection ; identity of surface. 
 
 Cornea. The horny transparent coat of the eye. 
 
 Corneitis. Inflammation of the cornea. 
 
 Cornus Florida. Dog-wood. 
 
 Cornine is the active principle of the cornus Florida, and is 
 used as a substitute for quinine. 
 
 Corrugated. "Wrinkled. 
 
 Corydalin. The active principle of the Turkey pea ; it is a spe- 
 cific remedy for syphilis. 
 
 Critical. Applied to certain symptoms, and certain stages of 
 disease indicating crisis. 
 
 Croup. Inflammation of the trachea. 
 
 Cutis Anserinus. Goose-skin. 
 
 Cynanche. Any inflammatory disease of the throat. 
 
 Cypripedin. The active principle of the lady-slipper. 
 
 Cystitis. Inflammation of the bladder. 
 
 Decoction. Preparation made by steeping. 
 
 Decomposition. Dissolution of the animal tissue. 
 
 Decubitus. Lying down. 
 
 Deglutition. The act of swallowing. 
 
 Delirium. Aberration of the mind. 
 
 Delirium Tremens. Disease produced by excessive use of intoxi- 
 cating liquors. 
 
 Dementia. Loss of mind ; idiocy. 
 
 Dental. Appertaining to the teeth. 
 
 Dentition. Process of cutting the teeth. 
 
 Depletion. Diminishing the fulness of a part, by evacuating re- 
 medies. 
 
 Derangement. Applied to functional disturbances of the organs. 
 
 Dermoid. Resembling the skin 
 
 Desiccation. Drying, scabbing. 
 
 Desquamation. Scaling off. 
 
 Determination. Unnatural flow of blood to the part. 
 
392 GLOSSARY OF 
 
 Diabetes. Disease characterized by mal-assimilation and saccha- 
 rine urine. 
 
 Diagnosis. Distinction of maladies. 
 
 Diagnostic. Characteristic of disease. 
 
 Diaphorous. Transparent. 
 
 Diaphoresis. A gentle perspiration. 
 
 Diaphoretic. Medicines having a tendency to excite perspiration. 
 
 Diaphragm. The partition separating the thorax from the abdo- 
 men. 
 
 Diarrhoea. Looseness of the bowels. 
 
 Diastole. A periodical dilatation of the heart and arteries, when 
 the blood enters their cavities. It is the opposite movement to 
 cystole, in which the heart and arteries contract to send forth the 
 blood. 
 
 Diathesis. Constitutional tendency. 
 
 Digestion. Conversion of food into blood. 
 
 Digitalis. Fox-glove. 
 
 Digitalin. A concentrated preparation from the digitalis ; it is 
 diuretic and sedative ; from one-fifth to one-half grain is a dose. 
 
 Dilatation. Widening. 
 
 Dioscorea Villosa. Yam-root. 
 
 Dioscorine. The active principle of the yam-root ; a specific for 
 bilious colic. 
 
 Discutient. A repelling medicine. 
 
 Disorganization. Destruction of an organ. 
 
 Dissection. The anatomical examination of the parts of the body. 
 
 Diuresis. An increased flow of urine. 
 
 Diuretic. Medicine which increases the secretion of the urine. 
 
 Dorsal. Pertaining to the back. 
 
 Drachm or dram, g. Sixty grains by weight, and an ordinary 
 teaspoonful by measure. 
 
 Drastic. Powerful purge. 
 
 Dropsy. Effusion of serum into any of the cavities. 
 
 Drug. A medicine which has not undergone a preparation. 
 
 Duct. A canal for conveying fluids. 
 
 Dulcamara. Bitter-sweet. 
 
 Dura-mater. The outer membrane of the brain. 
 
 Dysentery. Inflammation of the colon. 
 
 Dysmenorrhoea. Painful menstruation. 
 
 Dyspnoea. Difficulty of respiration, shortness of breath. 
 
 Dysuria. Difficulty in passing urine. 
 
MEDICAL TERMS. 393 
 
 Ecchymosis. Effusion of blood beneath the skin. 
 
 Eclectic Physicians. Those who select their remedies from all 
 the systems of practice. 
 
 American Eclectic Physicians. This refers to a large class of 
 physicians, "who believe that the investigation and practice of medi- 
 cine shall be free. That all remedies should be applied that can be 
 of any utility in removing disease, no matter from what system they 
 may be derived. They also claim that the science of medicine is 
 progressive, and that no dogmatic creed should be adopted to im- 
 pede its progress. By the Eclectic profession, the valuable reme- 
 dies of the other systems have not only been adopted, but a large 
 number of new ones are introduced, which enable them to combat 
 disease with far greater success than by any exclusive system. 
 
 Eczema. Eruption on the skin. 
 
 Efferent. To carry. Efferents may be the lymphatics, blood- 
 vessels, or nerves. 
 
 Effusion. Pouring out of blood, or any other fluid, into the 
 areolar membrane or cavities of the body. 
 
 Effete. Worn out, 
 
 Egophony. A sound heard when the lung is hepatized, or the 
 pleural sac partly filled with fluid ; when the voice strikes the ear 
 it yields a tremulous or goat-sound. 
 
 Elaterin. The active principle of the wild cucumber; a drastive 
 purgative. 
 
 Electricity. Galvanism, electro-magnetism, and animal magne- 
 tism, are used for rheumatism, amaurosis, paralysis, and most 
 nervous diseases. 
 
 Element. A simple constituent or principle of the body, or any 
 other substance. 
 
 Emaciation. Wasting away. 
 
 Emesis. Vomiting. 
 
 Emetics. ]\Iedicines provoking vomiting. 
 
 Emetine. The alkaloid and emetic principle of ipecac ; it is used 
 as an emetic in one-grain doses. 
 
 Emeto-Cathartic. A medicine that produces vomiting and purg- 
 ing. 
 
 Emmenagogues. Medicines believed to have the power of ex- 
 citing the menses. 
 
 Emollients. Medicines tending to soften parts that are tense and 
 inflamed. 
 
394 GLOSSARY OF 
 
 Empyema. Collection of pus in the pleural cavity. 
 
 Emphysema. Cavity tilled with air; or the air may pervade the 
 cellular tissue; it is divided into traumatic and idiopathic. 
 
 Enamel. The outer surface of the tooth. 
 
 Encysted. Covered with a sac. 
 
 Endemic. A disease prevailing in a certain district; not epidemic. 
 
 Endosmosis. The passage of liquids or gases through membranes. 
 
 Endocarditis. Inflammation of the internal membrane of the 
 heart. 
 
 Endocardium. The membrane that lines the interior of the 
 heart. 
 
 Enema. Injection into the rectum. 
 
 Engorgement. Accumulation of blood in its vessels. 
 
 Enteric. Belonging to the intestines. 
 
 Enteritis. Inflammation of the small intestines. 
 
 Epidemic. A disease prevailing over an extensive country or 
 district. 
 
 Epidermis. The scarf-skin; cuticle. 
 
 Epigastric. Above the stomach. 
 
 Epigastrium. The region above the stomach. 
 
 Epilepsy. Falling-sickness ; fits. 
 
 Epistaxis. Bleeding at the nose. 
 
 Ergot. Spurred rye. 
 
 Erysipelas. Inflammation of the skin. 
 
 Erythema. Simple redness. 
 
 Euonymine. The active principle of the Euonymus Atropurpu- 
 reus ; a valuable alterative, acting with great efficiency upon the 
 liver. 
 
 Eupurpurin. The active principle of the Queen of the Meadow; 
 a valuable remedy for gravel and uterine diseases. 
 
 Eupatorin (perfo). Active principle of the Eupatorium Perfoli- 
 atum, or boneset ; a valuable tonic and antiperiodic. 
 
 Euphorbin. The active principle of Bowman's root; used as an 
 emetic, cathartic, and diaphoretic. 
 
 Eustachian. A tube, leading from the throat to the internal ear. 
 
 Exacerbation. Aggravation of fever, or other disease. 
 
 Excretion. Anything thrown off. 
 
 Exfoliation. A separation of dead from living bone. 
 
 Exhalants. Vessels which throw out. 
 
 Exosmosis is the passing of rarer fluids to the denser, through 
 the membranes. 
 
MEDICAL TERMS. 395 
 
 Exostosis. Morbid enlargement of the bone. 
 
 Exotic. Belonging to a foreign country. 
 
 Expectorant. Medicine causing a discbarge of mucus from the 
 bronchi. 
 
 Extravasation. The effusion of blood into cavities, or beneath 
 the skin. 
 
 Fascia. Tendonous expansions, covering certain muscles, &c. 
 
 Fauces. The pharynx; back part of the mouth. 
 
 Favus. A pustule resembling the honey-comb. 
 
 Febrifuge. Medicine to subdue fever. 
 
 Febrile. Belonging to fever. 
 
 Fel Bovum. Ox-gall ; specific for quinsy. 
 
 Felon. A deep abscess upon the finger. 
 
 Fever. Disease characterized by three stages — cold, hot, and 
 sweating stage. 
 
 Fistula. Deep-seated ulcer, with a tube or canal opening ex- 
 ternally. 
 
 Flaccid. Soft, pliable, relaxed. 
 
 Flatulence. Collection of gas in the stomach and bowels. 
 
 Fluctuation. Sensation produced by percussion, when the cavity 
 contains pus. 
 
 Follicles. Folds ; as the follicles of the mucous membrane. 
 
 Formula. Prescription for preparing medicines. 
 
 Fremitus. A vibration felt by laying the hands upon the chest. 
 
 Function. The action by which vital phenomena are produced. 
 
 Functional Diseases. Those diseases in which there is supposed 
 to be only derangement of action. 
 
 Galbanum. A genus of plants, the gum of which forms a valu- 
 able warming plaster for diseases of the spine. 
 
 Gail-Bladder. A small sac connected with the liver, being the 
 reservoir for the bile. 
 
 Gangrene. Partial death of a part. 
 
 Gastric. Belonging to the stomach. 
 
 Gastritis. Inflammation of the stomach. 
 
 Gaultheria. The box-berry; wintergreen. The oil is used as a 
 diuretic and stimulant. 
 
 Gland. Applied to those organs which separate from the blood 
 any fluid whatever. 
 
396 GLOSSARY OF 
 
 Globule. A small globe. The blood is composed of globules, the 
 red, white and grey. 
 
 Glossitis. Inflammation of the tongue. 
 
 Glottis. A small oblong body in the larynx. 
 
 Glycyrrhiza. Liquorice. 
 
 Gonorrhoea. Flux from inflammation of the urethra. 
 
 Gossypium Herbaceum. Cotton plant; the fluid extract is ex- 
 tensively used as an emmenagogue. 
 
 Gout. Inflammation of the fibrous and ligamentous parts of the 
 joints. 
 
 Gravel. Small stones in the bladder. 
 
 H^matembsis. Vomiting of blood. 
 
 Hematuria. Hemorrhage from the bladder. 
 
 Haemoptysis. Hemorrhage from the lungs. 
 
 Hemorrhage. Bleeding. 
 
 Hemorrhoidal. Relating to hemorrhoids. 
 
 Hemorrhoids. Piles. 
 
 Heart. Centre of circulation. 
 
 Hectic. A low form of an exhausting fever, characterized by in- 
 termissions and remissions, and is mostly dependent upon some 
 organic affection, as consumption. 
 
 Hemiphlegia. Paralysis of one side of the body. 
 
 Helonin. The active principle of the star-grass. 
 
 Hepatic. Pertaining to the liver. 
 
 Hepatization. Conversion of tissue into substance like liver. 
 
 Hernia. Protrusion of the intestine. 
 
 Herpes. One kind of tetter. 
 
 Histogenic. Producing organic textures. 
 
 Homoeopathy. Hahneman's doctrine of curing disordered actions 
 in the human body, by inducing disordered action of the same kind, 
 but more easily controlled. (See Homoepathy). 
 
 Hospital. An institution for the reception and treatment of the 
 sick and injured. 
 
 Humors. All the fluids of the body except the blood. 
 
 Hydatids. A species of encysted Entozoa. 
 
 Hydrogogues. Medicines producing watery evacuations. 
 
 Hydrastin. Active principle of Golden seal. 
 
 Hydrocephalus. Dropsy of the brain. 
 
 Hydropathy. Presnitz's method of curing disease by the external 
 and internal use of water. (See Hydropathy). 
 
MEDICAL TERMS. 39? 
 
 Hygiene. The science of preserving health. 
 Hyosciamin. Active principle of the hen-bane. 
 Hypogastrium. The lower part of the abdomen, below the um- 
 bilicus, and above the pubic region. 
 
 Hysteria. A nervous disease peculiar to females. 
 
 Icterus. Jaundice. 
 
 Idiopathic. Primary or original disease; one not dependent upon 
 others. 
 
 Idiosyncrasy. An individual peculiarity of constitution. 
 
 Ignatia Amara. Plant bearing St. Ignatius' bean. 
 
 Ileum. The longest portion of the small intestines ; also one of 
 the bones of the pelvis. 
 
 Imperforate. The congenital closure of any foramen. 
 
 Impetigo. Moist tetter. 
 
 Imponderables. "Without weight, as light, electricity, heat, &c. 
 
 Incision. A clean cut by a sharp instrument. 
 
 Incisors. The front teeth. 
 
 Incompatibles. Medicines that cannot be used together without 
 impairing their properties. 
 
 Incontinence. The inability to retain the natural evacuations. 
 
 Incubus. Nightmare. 
 
 Indication. That which demonstrates what ought to be done. 
 
 Indigenous. That which is peculiar to a country. 
 
 Indigestion. Dyspepsia. 
 
 Indolent Ulcers. Those which do not incline to heal. 
 
 Induration. Hardness of a tissue. 
 
 Infectious. Communicable. 
 
 Infiltration. Extravasation of blood or other fluids into the soft 
 tissues. 
 
 Infinitesimal. Inconceivably minute. (See Homoeopathy). 
 
 Inflammation. A state in which the capillaries of the affected 
 parts are interrupted in their proper function, are morbidly relaxed 
 and over distended, and in which the blood which is passing through 
 them is first abnormally excited and chemically changed, and then 
 stagnates and coagulates. (Calvin Newton). 
 
 Inflammatory. That which relates to inflammation. 
 
 Iufluenza. Epidemic catarrh or cold. 
 
 Infusion. Watery decoction. 
 
 Ingestia. Food or drink. 
 34 
 
398 GLOSSARY OF 
 
 Inhalation. The act of inspiration; also the method of curing 
 disease by inhaling vapors. 
 
 Injection. Clyster; enema. 
 
 Innoculation. The insertion of morbific matter into any part of 
 the system. 
 
 Inorganic. Not organized. 
 
 Insane. An unsound mind or intellect. 
 
 Insanity. A deviation from the natural manifestations of mind. 
 
 Inspiration. The act of receiving air into the lungs. 
 
 Integument. That which covers anything ; as the skin, &c. 
 
 Intermission. The intervening time between the paroxysms of 
 periodical diseases. 
 
 Intermittent Fever. (See Fever and Ague.) 
 
 Invagination. A portion of the intestines, falling into one an- 
 other, becoming strangulated. 
 
 Iodine. Elementary body obtained from sea-weed. 
 
 Iodide of Potassium. Compound of iodine and potassium. 
 
 Irisin. The active principle of blue-flag. 
 
 Iritis. Inflammation of the pupil of the eye. 
 
 Irritability. A contractility of the solids, when stimulants are 
 applied. 
 
 Irritation. The effect of stimulants. 
 
 Jalap. A purgative root. 
 Jalapin. The active principle of the jalap. 
 Jaundice. A disease accompanied with yellowness. 
 Juglandin. The active principle of the butternut. 
 
 Kings'-Evil. Scrofula. 
 
 Kinesopathy. Method of curing disease by rubbing. 
 Kaino Miasmata. Malaria; exhalation from putrifying sub- 
 stances. 
 
 Labia. Lip. 
 
 Lactine. Sugar of milk. 
 
 Languor. Debility. 
 
 Laryngeal. Belonging to the larynx. 
 
 Laryngitis. Inflammation of the larynx. 
 
 Larynx. The upper part of the windpipe. 
 
 Laxative. A mild purgative. 
 
 Leech. An aquatic worm. 
 
MEDICAL TERMS. 399 
 
 Leptandrin. A valuable alterative obtained from the black-root. 
 
 Lethargy. Continued sleep or stupor ; coma. 
 
 Leucorrhcea. Sexual weakness, peculiar to females. 
 
 Litmus Paper. Used for detecting acids and alkalies. 
 
 Lobelia-Inflata. Indian tobacco. 
 
 Lobelin. The active principle of lobelia, which is extensively 
 used as a medicine. 
 
 Lumbago. Rheumatic affection of the back. 
 
 Lumbrici. Round worm of the intestines. 
 
 Lupulin. One of the active principles of the hop ; used in ague 
 and nervous diseases. 
 
 Lymph. A thin, transparent fluid, which circulates in the lym- 
 phatics. 
 
 Lymphatics. Vessels carrying lymph. 
 
 Maceration. Softening in water. 
 
 Magnesia, Sulphas. Epsom Salts. 
 
 Magnesia. One of the earths, having a metallic basis. 
 
 Malaria. Supposed to be a noxious gas, arising from decomposi- 
 tion of vegetable matter. 
 
 Malformation. Defective, irregular. 
 
 Marshmallow. A valuable mucilaginous diuretic. 
 
 Matico. A styptic plant ; native of Mexico. 
 
 Measles. An eruptive fever. 
 
 Meatus. A passage. 
 
 Melasna. Discharge of dark blood from the bowels. 
 
 Melancholy. Species of deranged mental action. 
 
 Melanosis. Black deposits of a tuberculous character. 
 
 Meningitis. Inflammation of the membranes of the brain. 
 
 Meningial. Relating to the membranes of the brain. 
 
 Menorrhagia. Excessive menstruation. 
 
 Menstruation. The catamenia. 
 
 Mercurial. Pertaining to mercury. 
 
 Mercury. Quicksilver. Hydrargyrum. 
 
 Mesmerism. Somnambulism ; first produced by Mesmer. 
 
 Metamorphosis. Transformation. 
 
 Metastasis. Change in the seat of the disease. 
 
 Metritis. Inflammation of the womb. 
 
 Miasm. Poisonous emanation from decomposing vegetable and 
 animal substances. 
 
 Miliary Fever. Name given to eruptive fever in children. 
 
400 GLOSSARY OF 
 
 Mollities Ossium. Softening of the bones. 
 Morbific. , Causing diseases. 
 Morbus Coxarius. Hip-disease. 
 Mortification. Death of a part. 
 Mucilage. A watery solution of gum. 
 Mucus. Animal Mucilage. 
 
 Murmurs, Respiratory. Are the sounds produced by the air 
 passing in and out of the lungs. 
 
 Myricin. The alkaloid of the bayberry. 
 
 Narcotic. Remedy producing sleep or stupor. 
 Nausea. Sickness at the stomach. 
 Necrosis. Death of a bone. 
 
 Nerves. Small cords conveying sensation to different parts of the 
 system. 
 
 Nervine. Medicine allaying nervous excitement. 
 
 Neuralgia. Pain in the nerves. 
 
 Nitre. Saltpetre. 
 
 Nitro-muriatic Acid. Used as a styptic. 
 
 Nutrition. Increase, growth. 
 
 Nymphsea Odorata. White pond lily. 
 
 Occult. Hidden, latent. 
 
 (Edema. Effusion into the cellular membrane. 
 
 (Esophagus. Passage leading from the back part of the mouth to 
 the stomach. 
 
 Olfactory. Relating to the sense of smell. 
 
 Ophthalmia. Inflammation of the eyes. 
 
 Opium. The concrete juice of the poppy. 
 
 Optic. Relating to the eye. 
 
 Organs. Parts performing a definite function. 
 
 Organic Diseases. In Pathology, diseases in which there is 
 derangement or alteration of structure, are termed organic. 
 
 Orthopnoea. Difficult respiration, requiring the erect posture. 
 
 Os. A bone. 
 
 Osseous. Bony. 
 
 Ostitis. Inflammation of the bone. 
 
 Otitis. Inflammation of the ear. 
 
 Otorrhcea. A purulent discharge from the ear. 
 
 Ovaries. Two small oval* bodies attached to the uterus, one on 
 each side. 
 
MEDICAL TERMS. 401 
 
 Ovum. An egg. 
 
 Oxygen. One of the most extensively diffused elements in nature. 
 
 Ozaena. A fetid ulcer in the nose. 
 
 Painters' Colic. A dangerous kind of colic, ascribed to absorp- 
 tion of lead. 
 
 Palate. The roof of the mouth. 
 
 Palpation. The method of examining the chest by application of 
 the hand. 
 
 Palpitation. An increased and irregular action of the heart. 
 
 Panacea. A remedy used for all diseases. 
 
 Pancreas. The gland situated behind the stomach. 
 
 Pancreatic Juice, The secretions of the pancreas. 
 
 Paralysis. Loss of motion. 
 
 Paraplegia. Paralysis of the lower half of the body. 
 
 Parenchyma. The cellular tissue ; the principal part of an organ. 
 
 Pathognomonic. Characteristics of disease. 
 
 Pathological. Morbid changes. 
 
 Pathology. Doctrine of disease. 
 
 Pediluvian. Foot-bath. 
 
 Pemphigus. Eruptive disease, characterized by small blisters. 
 
 Periostitis. Inflammation of the periosteum. 
 
 Peritoneum. Serous membrane lining the abdomen. 
 
 Pertussis. Hooping-cough. 
 
 Pharmacy. The art of preparing and combining medicines. 
 
 Pharyngitis. Inflammation of the pharynx. 
 
 Pharynx. Back part of the mouth. 
 
 Phlebitis. Inflammation of the veins. 
 
 Phlogistic. Inflammatory. 
 
 Phrenitis. Inflammation of the brain. 
 
 Phthisis. Consumption. 
 
 Physiology. Science of life. 
 
 Phytolaccin. A concentrated remedy prepared from the poke- 
 root, a valuable alterative. 
 
 Piles. Varicose veins appearing about the anus. 
 
 Piperin. A concentrated remedy prepared from the black pepper. 
 
 Plethora. Over-distension of the blood-vessels. 
 
 Pleura. A serous membrane lining the chest. 
 
 Pleuritis. Inflammation of the pleura. 
 
 Pneumonia. Inflammation of the lungs. 
 34* 
 
402 GLOSSARY OF 
 
 Podophyllin. A concentrated remedy prepared from the man- 
 drake. 
 
 Poison. That substance which, when taken into the system, 
 produces disease, rapidly tending to dissolution. 
 
 Polypus. A tumor growing in the cavities of the body. 
 
 Populin. Concentrated remedy prepared from the poplar. 
 
 Precordia. The fore part of the thorax. 
 
 Probang. An instrument used to apply caustics to the throat. 
 
 Prunin. Concentrated remedy prepared from the wild cherry. 
 
 Pulmonary. Belonging to the lungs. 
 
 Pulsatilla. The anemone pratense. 
 
 Pulse. Beating of the heart an$ arteries. 
 
 Purgatives. Medicines which increase the peristaltic motions of 
 the bowels. 
 
 Purpura. Scurvy. 
 
 Purulent. Besembling pus. 
 
 Pus. Matter produced by suppuration. 
 
 Quack; Quac.ksalber. An ignorant physician. 
 
 Quack' Medicines. Secret remedies administered by quacks. 
 
 Quassia. A bitter wood ; used as a tonic. 
 
 Quicksilver. Mercury. 
 
 Quinine. Alkaloid of Peruvian bark. 
 
 Quinsy. Inflammation of the tonsils. 
 
 Bash. Patches of redness on the skin. 
 
 Begurgitation. Beturn of blood, as from the ventricle of the 
 heart to the auricle. 
 
 Begimen. Begulation of diet, so as to promote health. 
 
 Bemission. Time between paroxysms of ague. 
 
 Besonance. A revibration of sound. 
 
 Bespiration. Breathing. 
 
 Bheum Palmatum. Bhubarb. 
 
 Bheumatism. Inflammation of the membranes of the joints. 
 
 Boseola. Bose-rash. 
 
 Bubeola. Measles. 
 
 Salicin. Concentrated remedy, prepared from the willow. 
 Sanguinarin. Concentrated remedy, prepared from Bloodroot. 
 Santonine. A crystalline body, obtained from worm seed. 
 Scarlatina. Eruptive fever. 
 
MEDICAL TERMS. 403 
 
 Schirrous. Hard. 
 
 Scorbutus. Scurvy. 
 
 Scrofula. A chrome disease of the lymphatic system. 
 
 Scutellaria Concentrated remedy, prepared from the skull-cap. 
 
 Sedative. A remedy that lessens arterial and nervous excite- 
 ment. 
 
 Senecin. Concentrated remedy, prepared from the Senecio gra- 
 cilis. 
 
 Serous. Watery. 
 
 Sialagogue. Medicines that increase the flow of saliva. 
 
 Sibilant. A hissing sound heard in disease of the lungs. 
 
 Sinapism. Mustard-poultice. 
 
 Solidist. One who ascribes all diseases to the solids. 
 
 Somnambulism. Sleep-walking. 
 
 Spasm. Morbid contraction of the muscles, cramp, &c. 
 
 Specific. A remedy competent to remove the disease. 
 
 Spermatorrhoea. A seminal weakness. 
 
 Spleen. An organ found on the left of the stomach. 
 
 Stethoscope. An instrument employed for examining diseases 
 of the chest. 
 
 Stillingia Sylvatica. Queen's root. 
 
 Stomacace. Canker of the mouth. 
 
 Stomatitis. Inflammation of the mouth. 
 
 Strangury. Painful discharge of the urine. 
 
 Strumous. Scrofulous. 
 
 Sudorific. Producing perspiration. 
 
 Suppuration. Formation of pus. 
 
 Syncope. Fainting. 
 
 Syphilis. Venereal disease. 
 
 Systole. Contraction of the heart. 
 
 Tannic Acid. Astringent property of oak bark. 
 Tartar Emetic. Tartarized antimony. 
 
 Tenesmus. A griping in the lower portion of the bowels, and 
 constant desire to go to stool. 
 
 Turpentine. Concrete juice and oil from pine. 
 Thorax. The chest. 
 Thrush. White ulcers in the mouth. 
 Tinnitus Aurium. Drumming in the ears. 
 Tolu. Balsam extracted from a species of fir. 
 Tormina. Griping pain in the bowels. 
 
404 GLOSSARY OF MEDICAL TERMS. 
 
 Trachea. Windpipe. 
 
 Tracheitis. Inflammation of the mucous membrane of the trachea. 
 Tubercles. Applied to scrofulous tumors. 
 Tuberculous Phthisis. Scrofulous affection of the lungs. 
 Tumid. Distended. 
 Tympanitis. Abdominal distension. 
 Tympanum. Drum of the ear. 
 
 Typhoid Fever. Fever, in which the disease is principally located 
 in the bowels. 
 
 Ulcer. A morbid solution of the continuity of the part. 
 Umbilicus. Navel. 
 
 Urea. Cyanate of ammonia ; a constituent of the urine. 
 Urethra. Canal from the bladder, for the passage of the urine. 
 Uriscopist. Quack doctor, who pretends to form diagnosis of 
 disease from the urine. 
 
 Vaccination. Insertion of cow-pox virus, as a protection against 
 small-pox. 
 
 Valerian. Root used as a nervine. 
 
 Variola. Small-pox. 
 
 Varioloid. Modified small-pox. 
 
 Vascular. Belonging to vessels. 
 
 Venesection. Bleeding from a vein. 
 
 Veratrum Viride. A valuable remedy for fevers. 
 
 Veratrin. Concentrated principle of the veratrum. 
 
 Vermifuge. Medicine given for worms. 
 
 Vertigo. Dizziness. 
 
 Vesicle. Bladder of water. 
 
 Viburine. Concentrated remedy, prepared from the high cran- 
 berry. 
 
 Vital. Connected with life. 
 
 Vomica. An abscess in the lungs. 
 
 White Swelling. An inflammation of the periosteum and dis- 
 ease of the bone. 
 
 Xanthoxylin. Active principle of the xanthoxylum fraxineum, 
 or prickly ash. 
 
 Zimotic. Contagious. 
 
 Zinc Sulphas. Styptic salt, and mild caustic. 
 
APPENDIX, 
 
 CONTAINING 
 
 AN OUTLINE OF ECLECTIC PHARMACY AND 
 MEDICAL PREPARATIONS, TO BE USED IN 
 DOMESTIC PRACTICE. 
 
 Every family should obtain a case of concentrated medicines, in 
 order to make their own prescriptions when medical aid is indicated, 
 unless the nature of the case is such that it can only be understood 
 by a physician well versed in his profession. The non-professional 
 individual, before attempting to prescribe for a patient, should care- 
 fully observe all the symptoms present, and as carefully compare 
 them with those described in this work, or by other reliable authors ; 
 for unless the indications to be fulfilled are fully understood, it is 
 far better to leave the disease to the unaided efforts of nature, than 
 to attempt medical interference, bearing in mind that unskilful 
 medication always lessens the chances of recovery. The next duty 
 is to fully understand the properties of -the remedy to be used, and 
 its preparation for administration. In the use of the concentrated 
 remedies described in this work, they should be triturated with 
 sugar, by adding ten grains of the article to be used to one hundred 
 of pure white sugar. Place both in a wedge-wood mortar, and tritu- 
 rate for thirty or forty minutes, or until every particle of the medi- 
 cine is thoroughly incorporated with the sugar. The doses recom- 
 mended in this work mostly have reference to the triturated article. 
 It will be noticed, that where the medicine is thus prepared, a much 
 less quantity is required than when given in a crude state ; besides, 
 when the articles are taken into the stomach in a crude state, they 
 produce local irritation, frequently causing rejection, or producing 
 constitutional symptoms, which very much lessen their curative 
 powers. 
 
 The quantity to be administered must depend altogether upon the 
 age, temperament, constitution, &c. of the patient. For the pro- 
 portionate doses of different ages, the reader is referred to the table 
 
 (405) 
 
406 APPENDIX. 
 
 of doses, as modified by age, in another part of this work. The 
 time required for an ordinary dose of triturated medicine to pass 
 into the circulation is from one to two hours ; consequently, if the 
 first dose is not sufficient to accomplish the object for which it was 
 given, it may be repeated every one or two hours until the desired 
 effect is produced. Pure soft water is the best material in which to 
 mix the medicine for administration; all jams and jellies should be 
 carefully avoided, as they frequently entirely neutralize the medi- 
 cinal properties of the article. If the medicine is a tincture, as 
 aconite or vei'atrum, it may be largely diluted in soft water, as one 
 half dram ofthe tincture may be added to one half tumbler of water, 
 and one tablespoonful given every fifteen or twenty minutes until 
 the requisite quantity has been taken. All the tinctures may be 
 taken in this way. In acute diseases, but one kind should be given 
 at once, unless there is a marked indication for some other remedy 
 which is compatible with the one being taken ; or, unless the medi- 
 cines possess the same properties, and one be mixed with the other 
 to modify its action ; as quinine and cornin, both being antiperiodics, 
 when combined, one facilitates the action of the other ; so with many 
 other remedies. But, in domestic practice, unless the prescriptions 
 are followed as laid down in connection with each separate disease, 
 the remedies had better be used one at a time. The best method of 
 using crude articles of medicine is in the form of an infusion or 
 syrup. 
 
 To make an infusion of any article of medicine. Take one pint 
 of warm or cold water, for one ounce of the remedy, much care 
 being taken to prevent boiling or overheating, as this frequently 
 destroys the virtue of the remedy. 
 
 Syrup. 
 
 In chronic diseases, syrup is often the best form of administering 
 medicine, as much benefit is derived from the sugar it contains ; 
 frequently the sugar is more beneficial than the medicine. 
 
 Sugar serves the purpose of combustion in the lungs and extreme 
 capillaries, thereby increasing the animal temperature, promoting 
 secretion, excretion, &c. It is stated, upon good authority, that 
 the negroes on the sugar plantations become very fat and free from 
 disease during sugar boiling. And, as I have already stated, in the 
 treatment of Consumption, sugar is of great value. The best method 
 of preparing syrup for domestic practice is to add one pound to one 
 pint of strong infusion. 
 
APPENDIX. 407 
 
 Tinctures. 
 The method of preparing tinctures for domestic practice is to 
 add two ounces of the green vegetable to one pint of good pure 
 whiskey, and let it stand fourteen days, "when it should be strained 
 and bottled for use. 
 
 Pills. 
 
 The most uncertain method of using medicines is in the form of 
 pills, as they frequently become dry and hard, requiring a long time 
 to digest; they also frequently lose their strength by standing. Yet 
 it is sometimes advisable to use some of the extracts in the form of 
 a pill. They may be made by rolling in pure starch or pulverized 
 liquorice, and only as fast as used. 
 
 Purgatives. 
 
 Purgative medicines are those which increase the alvine evacua- 
 tions, or increase the peristaltic action of the bowels. This class of 
 medicines, although of great service in many diseases, is also capa- 
 ble of producing very bad effects. 
 
 The constant use of purgative medicines has a tendency to irritate 
 and derange the action of the bowels. They are mostly useful in 
 case of obstinate constipation ; in most brain affections ; in inflam- 
 mation of the peritoneum ; and in some other diseases ; but in 
 typhoid fever, inflammation of the stomach and bowels, and in all 
 cases of great debility they are utterly inadmissible. Among the 
 best purgatives, are Euonymine, Podophyllin, Iridin, Neutralizing 
 Cordial, and Anti-bilious Physic. 
 
 Emetics. 
 
 Emetics are those remedies which evacuate the stomach. They 
 are serviceable in the commencement of many fevers, also in some 
 chronic diseases, and always when the stomach is loaded with some 
 foreign substance. The best medicines for emetics are Lobelia, 
 Blood-root, and Ipecac. 
 
 Before administering an emetic, the patient should drink a mode- 
 rate quantity of some warm tea, as chamomile, catnip, ginger, or 
 Thomson's composition. If lobelia is given, from one half to one 
 teaspoonful of the tincture may be taken every five or ten minutes, 
 until it operates as desired. The tincture of blood-root and ipecac 
 may be used in larger quantities, say in teaspoonful doses. The 
 pulverized seed of lobelia may be given, by adding one half tea- 
 
408 APPENDIX. 
 
 spoonful to one teacupful of warm water, and, after steeping ten or 
 fifteen minutes, one tablespoonful may be taken every ten minutes 
 until the desired effect is produced. Thirty grains of pulverized 
 ipecac, and sixty grains of pulverized blood-root may be used in 
 the same way. 
 
 Diuretics. 
 
 Diuretics increase the secretion and flow of urine. These remedies 
 are often of great value in the treatment of disease. They operate 
 with the greatest efficiency when largely diluted with warm water* 
 and the surface is kept cool. Among the best diuretics are Marsh- 
 mallow, Clivers, Indian Hemp, Queen of the Meadow, and Dwarf 
 Elder. 
 
 Diaphoretics. 
 
 These are medicines which lessen the heat, by increasing the 
 moisture of the surface of the body. They are serviceable in all 
 cases of fevers. Aconite and Veratrum are among the best diapho- 
 retics. 
 
 Expectorants. 
 
 Expectorants increase the discharge from the mucous membrane 
 of the bronchi and lungs. They are valuable in some cases of acute 
 and chronic affection of these -organs. But in all cases of true 
 phthisis they are very injurious. Among the best expectorants are 
 Lobelin, Sanguinarin, and Eupatorin. 
 
 uisms, or Mustard Poultices. 
 These are prepared by adding one tablespoonful of mustard to three 
 of flour, mixing with equal parts of vinegar and water. They are 
 beneficially used to attract the blood from the deep-seated to the 
 superficial capillaries. They are also applied to the spine and nape 
 of the neck in inflammation of the brain. 
 
 Cataplasms, or Poultices, 
 
 May be made by moistening bread-crumbs with milk. They may 
 also be made of flaxseed. Roasted onions, snake-root, &c, may be 
 used for poultices. They are useful in nearly all cases of local 
 inflammations. 
 
 Clysters, or Injections. 
 
 When these are used merely to act upon the bowels, warm water 
 or flaxseed water may be used. Any medicine may be thus admin- 
 istered when the stomach will not tolerate them. 
 
APPENDIX. '409 
 
 Fomentations. 
 Cloths wrung out of hot water, or an infusion of any medicinal 
 substance, are applied for local congestion or inflammation. In 
 these applications, the adjacent clothing should be protected from 
 
 moisture by oil-silk. 
 
 Plasters. 
 
 These are made by compounding medicines with gums, resins, &c. 
 
 The Irritating Plaster. 
 This is made by using boiled tar, one pound ; Burgundy pitch, 
 one-half ounce ; "White gum turpentine, one ounce ; Rosin, two 
 ounces. Melt the tar, rosin, and gum, together, remove from the 
 fire, and add finely pulverized mandrake root, bloodroot, pokeroot, 
 indian turnip, each one ounce. This plaster is used extensively in 
 all cases where counter-irritation and revulsives are indicated; as 
 in rheumatism, neuralgia, and chronic affections of the liver and lungs. 
 By Eclectic physicians, this is used in many cases where blisters are 
 used by the "old school," and experience has shown it to be far 
 superior. 
 
 Adhesive or Strengthening Plaster. 
 
 Take of Rosin, one pound; Beeswax, one ounce; Burgundy 
 Pitch, one ounce ; Mutton Tallow, one ounce. Melt them together, 
 and add, Olive Oil, Pulverized Camphor, and Sassafras Oil, of each 
 one-sixth of an ounce ; West India Rum, one fluid ounce. Stir well 
 together, pour into cold water, and form it into rolls with the hands. 
 This is an excellent plaster in weakness of the joints, rheumatism, 
 weak back, weak chest, ulcers, &c. 
 
 Ointments. 
 An ointment for the cure of burns may be made as follows : take 
 fresh butter, one.-half pound ; Yellow Dock root, cut in small pieces, 
 one ounce ; fresh Raspberry leaves, one-half ounce ; White Wax, 
 one ounce. Melt the butter and wax together, add the Raspberry 
 leaves and Dock root, simmer fifteen or twenty minutes, and strain 
 while warm. This is an excellent ointment for burns and scalds. 
 
 Domestic Treatment for Diseases of Common Occurrence. 
 For Burns and Scalds, wrap the part immediately in cloths, wet 
 in cold water ; change as often as necessary to keep them cool ; apply 
 until the pain entirely ceases. After which, spread the ointment, 
 35 
 
410 APPENDIX. 
 
 for burns and scalds, upon apiece of cloth, and apply to the abraded 
 surface. Change and wash as often as indicated. If the patient is 
 drowsy or sleepy after the burn, a stimulating cordial should be 
 given ; as a little whiskey-sling, or tincture of capsicum. 
 
 Convulsions in Children. 
 The feet should be placed immediately in warm water, a weak 
 mustard poultice applied to the stomach, friction to the spine, a 
 cold cloth to the head, and give from five to ten drops of the tinc- 
 ture of lobelia, until relieved. If the child is unable to swallow, 
 the lobelia should be mixed with starch-water, and given as an in- 
 jection. Unless relief is immediately effected, place the child in a 
 warm bath. As soon as the convulsion is relieved, the cause should 
 be ascertained and removed ; as otherwise, it might assume an 
 epileptic character. 
 
 For Children troubled with Worms. 
 Take ten grains of Santonine, and one hundred grains of sugar, 
 triturate well together. For a child five years old, one tenth of it 
 is a dose every other night on going to bed. If the worms are not 
 expelled, continue this until the whole is taken. If the child has 
 fever, one or two drops of the Tincture of Aconite may be given 
 two or three times a day. If the worms are not expelled when the 
 medicine is all given, a mild purge may be administered. This 
 seldom fails to remove worms from the alimentary canal in any 
 
 case. 
 
 For Files in Children or Adults. 
 
 A few drops of the oil of fire-weed, made into an ointment, with 
 fresh butter, and applied externally. Take also, one or two drops 
 of the oil internally, once or twice a day. This will effect a cure. 
 
 Tooth-ache. 
 
 Take two grains of the extract of Belladonna ; one grain of the 
 extract of Cicuta ; one-half ounce of Chloroform. Dissolve the 
 extracts in the chloroform, wet a little lint, and apply to the tooth. 
 This affords instant relief. 
 
 For Diarrhoea. 
 
 The most valuable remedy for this, is the neutralizing cordial, 
 which no family should be without. It is made as follows: One 
 half pound of rhubarb ; of cinnamon and cloves, each one-fourth 
 of a pound ; peppermint and saleratus, each one-half pound. Add 
 
APPENDIX. 411 
 
 to one gallou of water. Steep for one-half hour. Strain, add two 
 pounds of white sugar. Simmer fifteen minutes ; when cool, add 
 one pint of brandy, and bottle for use. Dose for children, one tea- 
 spoonful ; for adults, one tablespoonful. 
 
 Chilblains. 
 The best method for curing chilblains, is to bathe them in warm 
 turpentine, once or twice a day, wearing cotton next the feet. 
 
 Warts. 
 For their removal, rub every day with the juice of garden parsley. 
 
 For Bites of Insects. 
 Bathe with the tincture of pennyroyal. This gives immediate 
 
 relief. 
 
 Chronic Dyspepsia. 
 
 Drink freely of cold water, with a little salt in it, every morning 
 on rising. This, and the avoidance of strong medicine, will gene- 
 rally give relief. 
 
 Croup. ■ 
 
 Syrup of Bloodroot, as directed in another part of this work, is 
 a sure remedy. 
 
 Flatulency, or Wind- Colic in Children. 
 
 Give one or two drops of equal parts of Gelseminum and pepper- 
 mint essence, which will afford immediate, relief. 
 
 Sore Nipples. 
 Bathe in strong infusion of bayberry bark, two or three times a 
 day ; and wash well with soap and water after nursing, 
 
 Food and Drink for the Sick. 
 
 The best drink is pure cold water, which should be allowed under 
 all ordinary circumstances, in liberal quantities. 
 
 Frequently, but little food is demanded in acute diseases. When 
 it is given, it should be in the form of broths, gruel, &c. Beef- tea, 
 prepared as under the head of typhoid fever, is an excellent article, 
 and may be given in all cases of fever where food is required. 
 Bread, water, rice-water, rice, coffee, &c, may also be given. 
 Those who have charge of the sick, should carefully avoid urging 
 them to take food against their inclination, as much mischief may 
 be done, by crowding the stomach with food which it is not able to 
 digest. 
 
412 APPENDIX. 
 
 Ventilation. 
 The apartment of the sick should be thoroughly ventilated, by 
 allowing a free circulation of fresh air to pass through the room, in 
 such a manner as not to come directly in contact with the head of 
 the patient. All the excretions from the bowels and bladder should 
 be removed immediately, and the room purified, by a free ingress 
 of fresh air, instead of still further vitiating it by fumes of vinegar, 
 sugar, &c. 
 
 Bathing the Sick. 
 
 In all cases of acute disease, the surface should be thoroughly 
 bathed, as often as once or twice a day. The sick room should be 
 always kept quiet, and the linen of the bed and person changed 
 every twenty-four hours. 
 
 32* 
 
ALPHABETICAL INDEX. 
 
 PAGE 
 
 Abbreviations, explanation of. 384 
 
 Ague and fever 50 
 
 Allopathic treatment 324 
 
 Amaurosis 235 
 
 Anasarca 174 
 
 Angina Pectoris 207 
 
 Anti-bilious Physic , 323 
 
 Anti-scrofulous Syrup 318 
 
 Apoplexy 17S 
 
 Appendix 405 
 
 Ascaris* lumbricoides 187 
 
 vermicularis 187 
 
 Ascites 174 
 
 Asiatic Cholera 162 
 
 Asthma 159 
 
 Atrophy of the heart 212 
 
 Blue skin disease 219 
 
 Brain, dropsy of 172 
 
 " hemorrhage of. 178 
 
 u inflammation of 74 
 
 Bronchitis . 152 
 
 Bronchitis drops.. 322 
 
 Cardialgia 204 
 
 Carditis 212 
 
 Cephalalgia 220 
 
 Chicken Pox..., 167 
 
 Chlorosis 189 
 
 Cholera Asphyxia 162 
 
 Morbus 161 
 
 " Sporadic 162 
 
 Chorea 179 
 
 Cbrono-thermal system 361 
 
 Colic. Lead, or Painters' 90 
 
 " spasmodic 89 
 
 Colitis 83 
 
 Congestion, uterine 254 
 
 Conjunctivitis 232 
 
 Consumption 113 
 
 Convulsions 221 
 
 Cough, Hooping 94 
 
 Croup. Pseudo-membranous 185 
 
 ; - Spasmodic 1S5 
 
 Cyanosis 219 
 
 Cynanche Maligna 91 
 
 ; * parotidea 175 
 
 " tonsillaris 78 
 
 Cynanche trachealis 185 
 
 Cystitis 157 
 
 Delirium tremens 171 
 
 Diabetes Mellitus 182 
 
 Diagnostic signs 286 
 
 Different systems of practice 324 
 
 Diseases of the heart 204 
 
 35* 
 
 PAGE 
 
 Diseases of the skin 237 
 
 Dentition, difficult 194 
 
 Dilitation of the heart 215 
 
 Doses, proportionate 384 
 
 Dropsy of the abdomen 174 
 
 " * brain 172 
 
 " general 174 
 
 Dysentery 83 
 
 Dyspepsia 81 
 
 Eclectic remedies 295 
 
 " " their preparation... 383 
 
 Eczema 239 
 
 Emphyema 107 
 
 Emphysema 155 
 
 Encephalitis 74 
 
 Endocarditis 211 
 
 Enteritis 82 
 
 Enuresis 250 
 
 Epilepsy 176 
 
 Erysipelas 95 
 
 Erythema 277 
 
 Exanthemata 167 
 
 Fever, ephemeral 49 
 
 intermittent.- 50 
 
 miliary 190 
 
 pathology of 362 
 
 remittent 53 
 
 scarlet 57 
 
 typhoid.. 62 
 
 typhus 57 
 
 yellow 69 
 
 Fistula in ano 276 
 
 Gastritis.. ,. 80 
 
 Gastrodynia 199 
 
 Glossary of medical terms 385 
 
 Haematemesis 200 
 
 Hematuria 251 
 
 Haemoptysis 149 
 
 Headache 220 
 
 Heart disease 209 
 
 " burn 204 
 
 Hemiplegia 179 
 
 Homoeopathic Treatment 339 
 
 Hemorrhage, cerebral 178 
 
 gastric 200 
 
 pulmonary 149 
 
 Hemorrhoids 274 
 
 Hepatitis 1S8 
 
 ■Herpes circinatus 238 
 
 " zoster 237 
 
 Hooping Cough 94 
 
 Hydrocephalus. 172 
 
 (413) 
 
414 
 
 INDEX. 
 
 Hydropathic Treatment 353 
 
 Hydrophobia 181 
 
 Hypertrophy of the heart 213 
 
 Hypochondriasis 229 
 
 Hysteria 221 
 
 Icterus 202 
 
 Incontinence of urine 250 
 
 Inflammation 72 
 
 " of the bladder 157 
 
 " " brain 74 
 
 " " colon 83 
 
 " " conjunctiva 232 
 
 " " ear 79 
 
 " " intestines 82 
 
 " " kidneys 156 
 
 " " liver 158 
 
 « " lungs 87 
 
 " " oesophagus 198 
 
 " " parotid 175 
 
 " " pericardium 209 
 
 " ''• peritoneum 86 
 
 " « pleura 97 
 
 " " stomach 80 
 
 " " thorax 97 
 
 " " tonsils 78 
 
 " " trachea 185 
 
 " " veins 216 
 
 Ischuria 248 
 
 Itch, or Scabies 240 
 
 Jaundice 202 
 
 Lead colic 90 
 
 List of Eclectic remedies , 295 
 
 Liver, inflammation of. 158 
 
 Lock-jaw 181 
 
 Mania-potu 171 
 
 Measles , 169 
 
 Medical terms 385 
 
 Meningitis 74 
 
 Menses, cessation of 260 
 
 Mercurial disease... 277 
 
 Metritis 254 
 
 Morbus Cseruleus 219 
 
 Mothers' Cordial 317 
 
 Mumps 175 
 
 Myolitis 226 
 
 Nephralgia 223 
 
 Nephritis 156 
 
 Nettle rash 192 
 
 Neuralgia 223 
 
 (Esophagitis. 198 
 
 Ophthalmia, catarrhal 232 
 
 " purulent 234 
 
 Otitis 79 
 
 Ovarian disease 262 
 
 Palpitation of the heart 205 
 
 Paracentesis Ill 
 
 Paralysis 179 
 
 Paraplegia , 179 
 
 Parotitis 175 
 
 PAGE 
 
 Peritonitis 86 
 
 Pertussis 94 
 
 Phlebitis 216 
 
 Phlegmasia Dolens c 216 
 
 Phrenitis 74 
 
 Phthisis ;.... 113 
 
 Piles.. 
 
 274 
 
 Plague 195 
 
 Pleurisy , 97 
 
 Pneumonia 87 
 
 " typhoid 87 
 
 Preparation of Eclectic remedies 383 
 
 Pulmonary Balsam 322 
 
 Purpura hemorrhagica 243 
 
 Pustulge 241 
 
 Pericarditis 209 Worms 
 
 Quinsy 78 
 
 Rabies canina 181 
 
 Retention of urine 248 
 
 Rheumatism 184 
 
 Roseola a... 192 
 
 Rubeola 169 
 
 Salt rheum 237 
 
 Scabies 240 
 
 Scarlatina 91 
 
 Scrofula 264 
 
 Scurvy 243 
 
 Small-pox 167 
 
 Spasmodic croup 185 
 
 Spasms 221 
 
 Spinal irritation 227 
 
 Spitting of blood 149 
 
 Stomatitis 77 
 
 St.Vitus' dance 179 
 
 Suppression of urine 248 
 
 Syrup of Alum 322 
 
 " " Marshmallow -320 
 
 " " Stillingia 319 
 
 " " {i compound 321 
 
 Table of doses 384 
 
 " " Homoeopathic dilutions 352 
 
 Taenia , 187 
 
 Tetanus 181 
 
 Thoracic disease 87 
 
 Thrush 76 
 
 Tic Douloureux 223 
 
 Tonsillitis 78 
 
 Tracheitis 185 
 
 Trismus ; 181 
 
 Typhoid fever 62 
 
 " pneumonia 87 
 
 Urine, bloody 251 
 
 " diabetic 182 
 
 " incontinence of. 250 
 
 " retention of 250 
 
 Urticaria ,. 192 
 
 Uterine congestion 254 
 
 Varicella... 167 
 
 Variola 167 
 
 Worm mixture 323 
 
 187 
 
ECLECTIC MEDICAL COLLEGE OF PENNSYLVANIA, 
 
 LOCATED IN PHILADELPHIA. 
 
 Sessions commence on the second Wednesday in October, and close about the first of 
 February following. 
 
 FACULTY OF MEDICINE. 
 
 Joseph Sites, M. D., Professor of Obstetrics and Diseases of Women and Children. 
 
 Henry Hollembaex, M.D., Professor of Materia Medica and Therapeutics. 
 
 Thomas G. Chase, M.D., Professor of Chemistry and Medical Jurisprudence. 
 
 Wm. Paine, 31. D., Professor of the Theory and Practice of Medicine and Pathology. 
 
 Marshall Calkins, M. D., Professor of the Institutes and Practice of Surgery. 
 
 J. B. Holland. M.D., Professor of Anatomy and Physiology. 
 
 Marshall Calkins. M. D., Demonstrator of Anatomy. 
 
 Marshall Calkins. M.D., Dean of the Faculty, Xo. 913 Race Street, Philadelphia. 
 
 This Institution (the only chartered one of the kind in this section of the country) 
 teaches the Eclectic System of Medical Practice. The advocates of this system 
 contend that no one system of medical practice, separately considered, is, in itself, 
 perfect; that in each there is much that is good, while there is more or less of im- 
 perfection ; "being to some extent either defective in efficiency, or exerting, in connec- 
 tion with their beneficial action, an influence which has proved, in many instances, 
 positively injurious. 
 
 "While, therefore, they would not rely upon any one system of practice, so as to 
 use it altogether to the exclusion of every other, they would, with wise discrimi- 
 nation, separate whatever is truly good in each from all that it contains which is 
 useless or injurious; leaving it to each individual to make his choice as to the par- 
 ticular system or systems which he may prefer, using them separately or in combi- 
 nation, as his own judgment may dictate; keeping in view, however, the grand and 
 important idea that he is to select what will be most efficient, and discard what is 
 hurtful; always endeavoring, in the choice and application of remedial processes 
 and agents, to select such as shall not injure the constitution, or entail upon the 
 system secondary diseases, which may be far more serious than those which they 
 were originally given to overcome. Blood-letting, Mercurializing, &c, are, there- 
 fore discarded, and such remedies and applications are made choice of as tend to 
 correct disordered action and augment the vital energy, thus enabling the body 
 which is disease! to throw off the load under which it is laboring. 
 
 The principles which characterize Eclecticism, are such as appeal to the common 
 sense and reason of mankind; it is not surprising, therefore, that it is becoming 
 more prized as it becomes better known, and that large accessions are making to 
 the ranks of its advocates, out of all the different systems of medical practice of 
 the day. Even Homoeopathy and Hydropathy are contributing largely to swell 
 
416 ECLECTIC MEDICAL COLLEGE 
 
 the numbers of those who believe in the correctness of the theory which it pro- 
 mulgates, and the superior efficacy of the method of treatment which it sanctions. 
 
 The Eclectic Medical College of Pennsylvania was chartered by the State Legis- 
 lature in 1850, and is endowed with all the powers and privileges which are pos- 
 sessed by institutions of a similar character. It possesses a Museum which is valu- 
 able, and sufficiently ample for the illustration of the subject of disease and the 
 structure of the human system. 
 
 Concerning the Faculty, the Philadelphia Sunday Mercury, of March 1st, 1857, 
 comments freely: — 
 
 " Characteristics of the Faculty of the Eclectic Medical College. 
 
 "Dr. Sites is a graduate of the Syracuse Medical College, and a man who has, by 
 perseverance in study and practice, become one of the most successful teachers of a 
 difficult hranch of the profession. He is decidedly original and independent in his 
 views, giving little heed to precedent or mere book authority. He has now in 
 manuscript, a Treatise on the American Eclectic Practice of Obstetrics, the publi- 
 cation of which the liberal physicians of this country are anxiously awaiting. In 
 his lectures, he is very impressive, driving his ideas, as if by force, into the minds 
 of his pupils. Everything connected with his department is fully and completely 
 illustrated. A large number of choice obstetric preparations in the College are due 
 to his energy and generosity. 
 
 " Dr. Hollembaek is a graduate of the Pennsylvania Medical College, and has, like 
 Dr. Sites, devoted himself assiduously to the interests of the Eclectic Medical 
 College. In his lectures, he devotes much time to the consideration of the various 
 remedial agents of different sects, explaining their proper and improper uses and 
 applications. 
 
 "Dr. Hollembaek has now in course of preparation a work on Materia Medica, 
 the completion of which the profession are anxiously awaiting. He is an interesting 
 and agreeable lecturer, and is highly respected by the Eclectic Profession in this 
 section of the country. 
 
 "Dr. T. G. Chase is a graduate of Harvard University, both in Arts and Medicine, 
 and, in 1821, visited Europe for the purpose of obtaining more extensive informa- 
 tion. He is a man of great scientific attainments, and has labored much for the 
 interests of the College, with which he is now connected. 
 
 " Dr. Chase is a good lecturer on Chemist^, and appears to be an agreeable gentle- 
 man. Our personal knowledge of him being limited, we are unable to present his 
 antecedents and social qualities, although he stands in high estimation in his circle 
 of friends and acquaintances. 
 
 "Dr. Calkins received the degrees of A. B. and A.M. at Union College, and, at the 
 Worcester Medical Institution, the degree of M. D. He was a pupil of the late, 
 learned, eminent and lamented Dr. Calvin Newton, who, at the time of his decease, 
 had in course of preparation a work on Thoracic Diseases, wbich was completed 
 by Dr. Calkins. It has had a rapid sale, and meets the wauts and approval of liberal- 
 minded physicians on both sides of the Atlantic. We have in our possession a copy 
 of this work, and consider it the most original, lucid, and satisfactory work on 
 Consumption, and kindred diseases, we have ever perused. Dr. Calkins has much 
 experience as a teacher, both in literary and medical institutions, and has contri- 
 buted many valuable pages to the liberal medical journals of the country. He is 
 a concise and pleasing lecturer, always endeavoring, as much as possible, to deduce 
 from the teachings of Physiology those scientific principles which are a sure and 
 unerring guide to all successful medication. He is an affable and entertaining 
 
OF PENNSYLVANIA. 417 
 
 gentleman, and .uighly appreciated for his scientific accomplishments and Lis ex- 
 cellent moral and social qualities. 
 
 " Dr. Paine received a medical education at the Berkshire (Mass.) Medical Institu- 
 tion, and commenced practice in Ohio upon Allopathic principles. Becoming dis- 
 gusted with the result of his labors, he sought means of relief for the sick in 
 Thomsonism, in Homoeopathy and Hydropathy. At the time of the establishment 
 of the Eclectic Medical Institute of Cincinnati., in 1840, Dr. Paine was among its 
 students and supporters. Here he received a diploma, and has since been engaged 
 in a very extensive and lucrative practice. In 1856, he was elected to the chair of 
 Theory and Practice in the College, in which he now gives his agreeable and 
 instructive lectures. He strenuously refuses to submit to the ipse dixit of any sect 
 in medicine, and seems to have a peculiar tact in selecting from all the schools 
 that only which is really valuable and worthy of retention. He has ample expe- 
 rience as a teacher in academies; and, as a public lecturer on political and scientific 
 topics, has very few equals or superiors." 
 
 Dr. J. B. Holland has recently been elected to his chair in this Institution. He 
 has long been one of the most successful teachers of scientific subjects New England 
 afforis, and has received the degree of A. M. from Amherst College, Mass. He 
 comes to us from the Medical Department of Dartmouth, N. H., where he has long- 
 been devoting especial attention to his chair of instruction. The Institution is 
 fortunate in securing the services of one so eminently qualified to fill, with honor 
 to himself and the Institution, the chair of Anatomy and Physiology. 
 
 The advantages which Philadelphia affords to the student of medicine are un- 
 surpassed by any city on the Continent. The hospitals, which are of the finest 
 character, being accessible on the same terms to the students of all medical insti- 
 tutions. 
 
 FEES. 
 
 Matriculation Ticket (paid on the first session only) $ 5 00 
 
 Course of Lectures (six professors) 48 00 
 
 Graduation and Diploma 25 00 
 
 Demonstrators Fee 5 00 
 
 The requirements for Graduation are three years' study, good moral character, a 
 competent literary education, attendance on two courses of medical lectures, one 
 of which must have been in this college, and the sustaining of a thorough ex- 
 amination by the Faculty, and the writing and defense, before the Faculty, of a 
 Thesis, upon some medical subject. 
 
 Students, on arriving in the city, should call on the Dean at his residence, No. 
 913 Race street — also found in the City Directory. For further information, address 
 
 MARSHALL CALKINS, M. D., No. 913 Race street, Philadelphia. 
 
Will be Published, October 1st, 1857, by 
 
 H. COWPERTHWAIT & CO., 
 
 THORACIC DISEASES: 
 
 THEIR PATHOLOGY, DIAGNOSIS, AND TREATMENT. 
 
 BY 
 
 CALVIN NEWTON, A. M., M. D., and MARSHALL CALKINS, A. M., M. D. 
 SECOND EDITION, 
 
 REVISED AND GREATLY ENLARGED. 
 
 Containing a full description of the modern improvements in treatment, 
 and of the Eclectic Concentrated Remedies, and their application, to 
 the removal of Pulmonary and Cardiac Affections. The work will con- 
 tain over five hundred octavo pages, printed on good paper, and hand- 
 somely bound. Price, in cloth, $2.75; in sheep, $3. 
 
 TESTIMONIALS. 
 
 {t A most valuable contribution to our Medical literature, which should be on the 
 shelf of every practitioner." A. R. THOMAS, M. D., 
 
 Professor of Anatomy in Penn Medical University. 
 
 "Prof. Calkins — Dear Sir: I have read with unusual interest the very original 
 and lucid work on Thoracic Diseases, commenced by the late Prof. C. Newton, and 
 finished by yourself. A more able and valuable work has never been published. I 
 say this from having perused nearly every work on the subject, written by the 
 most eminent physiologists and pathologists of the age. It is complete and satis- 
 factory, particularly in regard to the pathology of the various diseases of the throat 
 and chest, and their treatment. It should be in the library of every practitioner 
 of philanthropic and liberal principles. It can be read with the greatest pleasure 
 and benefit by all intelligent laymen. It ought to be universally read, and doubt- 
 less will be when its remarkable merits are sufficiently made known. I cordially 
 commend it to the Profession and the community. 
 
 " With high respect, I am yours, M. HARDIN ANDREWS, M. D., 
 
 "Prof, of Mental Philosophy and Med. Jurisprudence in Penn Med. University." 
 
 ." This is a work of sterling merit, full of knowledge, and rich in both philosophy 
 and experience. The whole volume gives evidence of long observation, careful 
 thinking, and much experience."— New York Journal of Medical Reform. 
 
 " We cheerfully recommend this work as the very best, on the subjects embraced, 
 in the American language; and any medical man who fails to read it must be but 
 little desirous- of acquitting himself in the best manner towards his patients or the 
 Profession." — Middle States' Medical Reformer, 
 
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