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T II E 
 
 Body and its Ailments: 
 
 21 ^cmfrboolc of Jamiltar JDtrattons 
 
 CARE AND MEDICAL AID IN THE MORE USUAL. 
 COMPLAINTS AND INJURIES 
 
 ADULTS AND CHILDREN 
 
 TO WHICH IS ADDED 
 
 A FAMILY HEALTH RECORD. 
 
 EDITED FROM THE WORKS OF DRS. SOUTH, TURNER, AND 
 OTHERS, WITH AN INTRODUCTION, 
 
 BY 
 
 GEORGE H. NAPHEYS, A.M., M.D., 
 
 MEMBER OF THE PHILADELPHIA COUNTY MEDICAL SOCIETY, ETC. , ETC. J AUTHOR OF " THE PHYSICAL LIFE OF 
 
 WOMAN;" "THE TRANSMISSION OF LIFE;" " MODERN THERAPEUTICS ]" 
 
 "LETTERS FROM EUROPE," ETC. 
 
 ... 
 JlUwtrafcfc bp omx ©ne §\xvtoKtt> <£tiQxamn$8 curt QLoloxeb platw. 
 
 PHILADELPHIA- 
 H. C. WATTS & CO., 
 
 No. 1224 CHESTNUT STREET. 
 
 1876. 
 
Entered according to Act of Congress, in the year 1875, by 
 
 D. G. BRINTON, 
 
 In the office of the Librarian of Congress, at Washington. 
 All rights reserved. 
 

 PUBLISHERS' PREFACE. 
 
 In completing the excellent works of Dr. George H. Napheys 
 on popular medical science, by the present volume, the pub- 
 lishers believe that they present to the public a series of vol- 
 umes unsurpassed in the literature of this department of study. 
 The completeness of the present work, its practical character, 
 its careful arrangement, and its fullness of illustration, make it 
 unique of its kind. Of its high scientific and literary merit 
 it is needless to speak ; for its plan and arrangement the reader 
 is referred to the Introduction. 
 
 m 
 
CONTENTS. 
 
 List of Illustrations, . . . . . . 17 
 
 Introduction. . 21-23 
 
 Parti. STRUCTURE AND ACTION OF THE BODY. 
 
 CHAPTER I. 
 
 THE FRAMEWORK OF THE BODY, AND ITS MOVEMENTS. 
 
 PAGE 
 
 Section I.— The External Coverings of the Body. . . 26-32 
 The Skin — Its structure and uses — How it regulates the heat 
 of the body — How it drains off waste products — Its coloring 
 matter — Hygienic hints on the care of the skin — Clothing — 
 Dwellings— The Hair — The Nails. 
 
 Section II.— The Flesh and Muscles. . . . . . 32-46 
 
 The structure of a muscle — Home gymnastic exercise without 
 apparatus — Other forms of exercise. 
 
 Section III. — The Bones and Joints. 47-55 
 
 The structure of bones — The four different classes of bones 
 — The bones of the head — The bones of the trunk — The bones 
 of the limbs — The different kinds of joints — Deformities of the 
 bones; how avoided and remedied— The Teeth — Directions for 
 their preservation. 
 
 CHAPTER II. 
 
 THE INSTRUMENTS OF THE BODY AND THEIR OFFICES. 
 
 Section I.— The Air Passages and Organs 57-61 
 
 The Lungs- — Their structure and use — What happens to the 
 breathed air in the air tubes and cells — On ventilation — Sim- 
 ple ways of changing the air in a room without draughts. 
 
 Section II.— The Food Passages and Organs. . . . 61-66 
 The manner in which food reaches the stomach — The process 
 of digestion — The structure of the stomach and bowels — 
 Classification of food — Practical directions for the corpulent 
 for reducing flesh — How to become stouter — Appetite and 
 hunger. 
 
 IX 
 
x Contents. 
 
 PAGE 
 
 Section III.— The Blood Passages and Organs. . . . 66-72 
 The structure and action of the heart— The course of the blood 
 —The capillary vessels, what they are and how they act— The 
 arteries and veins— The changes taking place in the blood, in 
 the lungs, and in the network of small vessels— The office of 
 the blood— How at the same time it nourishes and purines the 
 body. 
 
 Section IV.— The Waste Passages and Organs. . . . 72-73 
 The action of the lungs, the skin, and the kidneys, in remov 
 ing the products of waste and decay. 
 
 Section V.— The Special Senses 73-85 
 
 The five gateways of knowledge— Of Smelling— How effected 
 — The nose a respirator — Uses of the sense of smell— Its duties 
 as a sentinel — Of Tasting — The manner in which the impres- 
 sion of taste is produced — The importance of pleasing the 
 palate of the sick — Of Touch — The feelers of the skin — Of 
 Hearing— The structure of the ear — How sound reaches the 
 brain — Hints on the hygiene of the ear — Of Seeing — The 
 structure of the eye — The offices of its different parts — A ray 
 of light on its journey to the retina — Defects of the eye, their 
 cause and prevention — Short sight — Long sight — Old sight. 
 
 Section VI.— The Brain and Nerves 85-88 
 
 The structure of the brain — Its office — The distribution of the 
 nerves — Their office. 
 
 Part n. SICKNESS IN ADULT LIFE. 
 
 CHAPTER III. 
 
 The Domestic Management of the Sick Room. . . . 90-102 
 Choice of the Sick Room — Its furniture — Air and ventilation 
 — Hints in regard to its warmth — How it should be lighted — 
 The importance of cleanliness — Duties and deportment of those 
 nursing the sick — Personal attentions required by the sick — 
 Management of those recovering from sickness — Household 
 remedies— Family thermometry. 
 
 CHAPTER IV. 
 
 ailments affecting the whole body. 
 
 Section I.— Ailments Attended with Fever as the Prom- 
 inent Symptom. . . 103-130 
 
 Typhoid Fever — Typhus Fever — Bilious Remittent Fever — 
 
Contents. xi 
 
 PAGE 
 
 Chills and Fever — Break Bone Fever — Catarrhal Fever — Yel- 
 low Fever — Small-Pox — Milk Sickness. 
 Section II.— Ailments Attended with Pain as the Promi- 
 nent Symptom 130-141 
 
 Neuralgia — Headache — Rheumatism — Gout — Lockjaw. 
 Section III. — Ailments Attended with Sleeplessness as 
 
 the Prominent Symptom 141-144 
 
 Wakefulness — Delirium Tremens. 
 Section IV. — Ailments Attended with Wasting as the 
 
 Prominent Symptom 144-150 
 
 Starvation— Scrofula — Poverty of the blood— Night Sweats — 
 Dropsy. 
 Section V. — Ailments Attended with Insensibility as the 
 
 Prominent Symptom 150-153 
 
 Fainting — Apoplexy. 
 Section VI.— Ailments Attended with Fits as the Promi- 
 nent Symptom. 153-155 
 
 Falling Sickness — Hysterics— St. Vitus' Dance. 
 
 CHAPTER V. 
 
 AILMENTS OF PARTS OF THE BODY. 
 
 Section I.— Ailments Seated in the Air Passages. . . 156-167 
 
 Cold in the Head — Cold in the Chest— Sore Throat — Asthma — 
 
 Pleurisy — Pneumonia— Consumption. 
 Section II.— Ailments Seated in the Food Passages. . . 168-180 
 
 Dyspepsia — Colic — Constipation — Diarrhoea — Dysentery — 
 
 Cholera — Jaundice. 
 Section III.— Ailments Affecting the Blood Passages. . 180-184 
 
 Heart Disease— Swelling of Arteries. 
 Section IV.— Ailments Affecting the Waste Passages. . 184-190 
 
 Kidney Diseases— Diseases of the Bladder— Diabetes. 
 Section V.— Ailments Seated in the External Cover- 
 ings of the Body 190-199 
 
 Diseases of the Skin— Of the Hair and Nail3. 
 
 CHAPTER VI. 
 
 ACCIDENTS, INJURIES, AND POISONS, 
 
 General Directions for Treating Accidents. . . . 200-201 
 Bandages, Splints, and Dressings 201-204 
 
1 2 Contents. 
 
 PAGE 
 
 Bed Soees m 204 
 
 Bites 2 05 
 
 Of Mad Dogs— Hydrophobia, Rabies— of Snakes— Spiders. 
 Bleeding or Hemorrhage. . , . . . . 206 
 
 From Wounds— from Nose— from Large Arteries. 
 Bones 211 
 
 Broken — Out of Joint — (fractures and dislocations). 
 Brain , 222 
 
 Compression and Concussion of. 
 Bruises 222 
 
 Blows — Contusions. 
 Burns and Scalds. . . . 223 
 
 Scars from. 
 
 Cuts. 225 
 
 Drowned 225 
 
 To Restore. 
 Fainting and Faint Spells. , . . . . . . . 230 
 
 Falls 230 
 
 Hurts from. 
 Frozen Persons. .;........ 230 
 
 To Restore — Frozen Limbs — Chilblains — Frost Bite. 
 Railroad Injuries 232 
 
 Spinal Shocks. 
 
 Rings. 232 
 
 To get off. \ 
 
 Ruptures, or Hernia. ........ 232 
 
 Trusses. 
 Scars ,..,.. 233 
 
 From Wounds — Burns — Small-Pox. 
 
 Shock 233 
 
 Sprains and Strains 234 
 
 Stings of Insects : .235 
 
 Stroke. . 235 
 
 Sun-stroke — Heat-Stroke — Sun Headache — Sun Pain — Light- 
 ning Stroke. 
 
 Suspended Animation from Suffocation 237 
 
 From Fixed Air, or Carbonic Acid Gas — Well Damp and 
 Choke Damp — Charcoal Fumes — Common Burning Gas and 
 Coal Gas — Strangulation — Hanging. 
 Teeth Knocked Out . 239 
 
Contents. 1 3 
 
 PAGE 
 
 Things . 239 
 
 In the Eye — in the Ear — in the Nose— in the Throat — in the 
 Lower Bowel— in the Flesh — Needles— Pins— Fish-Hooks— 
 Splinters or Thorns. 
 
 Veins 242 
 
 Swollen— Bursting of. 
 
 Wounds 243 
 
 How to Dress— Bandages — Gunshot Wounds— Torn Wounds — 
 Cuts— Stabs and Thrusts— Cut Throat— Scalp Wounds. 
 
 Passive Movements 246 
 
 For Wounds and Inj uries— Illustrations of. 
 
 Poisons and Poisonings 248-254 
 
 General Directions — Acids, Mineral — Alcohol — Aconite — Am- 
 monia — Antimony — Arsenic — Baryta — Belladonna — Bismuth 
 — Bitter Sweet — Camphor — Copper — Corrosive Sublimate — 
 digitalis — Henbane — Iodine — Iron — Lead — Mushrooms — Ni- 
 trate of Potash — Nitrate of Silver — Opium — Oxalic Acid — Poi- 
 son Ivy, or Vine — Prussic Acid — Phosphorus — Savine — Stra- 
 monium — Strychnia — Tobacco. 
 
 Laying out the Dead . m m 254 
 
 Part III. SICKNESS IN CHILDHOOD, 
 
 CHAPTER VII. 
 
 DISEASES OF CHILDREN AILMENTS AFFECTING THE WHOLE 
 
 BODY. 
 
 Infantile Remittent Fever. ,..,... 256 
 
 Wasting Fever — Gastric Fever — Worm Fever. 
 Teething Fever. , , „ . . ... .258 
 
 Scarlet Fever. 259 
 
 Scarlatina — Scarlet Hash — Putrid Sore Throat. 
 
 Measles. „ „ . . ,262 
 
 French Measles — Black Measles. 
 
 Mumps 263 
 
 Chicken-Pox, or Varicella 264 
 
 Small-Pox, and Vaccination. ....... 264 
 
 Chorea, or St. Vitus' Dance. 266 
 
 Jaundice, or Yellows 266 
 
 Worms, and Worm Troubles 266 
 
 Hydrocephalus, or Water on the Brain. . . . , 268 
 
 Marasmus. . . . .'._,*". . . . • . . 269 
 
 Wasting, or Decline. 
 
H Contents. 
 
 PAGE 
 
 Scrofula. . 271 
 
 Scrofulosis, or King's Evil—Management of Scrofulous 
 Children — Hygienic Treatment. 
 
 Rickets, or Rachitis. 277 
 
 Fits, or Convulsions 279 
 
 Night Terrors, and Excessive Nervousness 282 
 
 CHAPTER VIII. 
 
 Ailments Affecting Parts of the Body 284-305 
 
 Snuffles — Stomatitis — Thrush — Sore Throat — Croup Diph- 
 theria—Whooping Cough— Coughs and Colds in Children- 
 Infantile Pneumonia— Colic— Summer Complaint— Falling 
 of Bowel— Bed- Wetting— Weaning Brash— Milk Crust. 
 
 CHAPTER IX. 
 
 Accidents, Injuries, and Surgical Ailments of Children. 306-318 
 Lancing the Gums — Tongue Tie — Hare Lip — Wry Neck— Sore 
 Eyes — Cross Eyes— Ingrowing Eyelashes — Styes — Running, 
 or Catarrh of the Ears— Earache — Crushed Fingers — Hip 
 Disease— Spinal Diseases — Curvature of the Spine — Inflam- 
 mation of the Spine — Dropsy of the Spine — Club Foot — 
 Weak Ankles — Knock Knee — Rupture, or Hernia — Cancer — 
 Swellings of the Glands of the Neck. 
 
 Part IV. SPECIAL RECEIPTS FOR CARE OF THE 
 
 SIOE. 
 
 CHAPTER X. 
 
 DIETETIC RECEIPTS FOR THE SICK ROOM. 
 
 Importance of the subject — Rules for preparing and serving 
 
 food for the sick. 320-322 
 
 Nutritious, Cooling, and Soothing Drinks. . . . 322-325 
 
 Lemonade — Effervescing lemonade — Barley water — Linseed 
 tea — Arrowroot drink — Milk punch — Wine whey — Egg and 
 sherry— Ice — Toast and water — Nutritious coffee — Milk and 
 Isinglass — A soothing drink — Milk and cinnamon drink — 
 Caudle — Apple water— Chocolate — Chocolate milk — The In- 
 valid's tea— Rose tea — Sage tea — Oatmeal tea. 
 
 Gruels. . . • .325 
 
 Water gruel — Milk gruel — Flour gruel — Rice gruel — Barley 
 gruel. 
 
Contents. xv 
 
 PAGE 
 
 Broths and Soups ' . . . . 326-327 
 
 Chicken broth — Mutton broth — Whole beef tea — Quickly- 
 made beef tea — Vegetable soup — Bread soup — Spinach soup — 
 Beef and hen broth. 
 
 Meats and Vegetables for Invalids 327-328 
 
 Table, in order of digestibility, of some articles of animal 
 food — Boiled pigeon or partridge — Bread sauce — Relish for 
 fish — Minced fowl and egg — Fowl and rice — Stewed oysters — 
 The invalid's cutlet — The invalid's mashed potato — Potato 
 surprise. 
 
 Jellies for Invalids. . . 329-330 
 
 Isinglass jelly — Strengthening jelly — Mutton jelly — Bread 
 jelly — Rice blanc-mange — Arrowroot blanc-mange — Sago jelly 
 — Tapioca jelly — Panada — Calves' feet jelly — Currant jelly 
 — Irish moss blanc-mange — Gelatine blanc-mange. 
 
 Puddings for Invalids 330-331 
 
 Rice pudding — Bread pudding — Batter pudding — Milk for 
 puddings or stewed fruit — Rice and apple — Vermicelli pud- 
 ding. 
 
 CHAPTER XL 
 
 MEDICAL RECEIPTS FOR THE SICK ROOM. 
 
 Baths and Douches 333-336 
 
 The hygienic importance of bathing — Rules for the use of the 
 bath in health — Division of baths according to their warmth 
 — The cold bath and directions for its employment — Warm 
 and hot baths, when useful. 
 
 Medicated Water Baths 336-339 
 
 Soap bath — Bran bath — Starch bath— Oil bath — Alkaline bath 
 — Valerian bath — Gelatine bath — Bark bath — Iron bath — 
 Mustard bath — Salt water bath — Liver of sulphur bath — Tur- 
 pentine bath — Vapor baths — Simple vapor bath — Medicated 
 vapor bath — Warm air bath — Turkish bath — Russian and 
 Roman baths — Fumigations — Shower baths — Douche baths — 
 Sand and mud baths — Hip baths or sitz baths — Foot baths — 
 Shallow baths. 
 
 Cold Affusion 337 
 
 Wet-sheet packing — The dripping sheet — The wet compress — 
 The sponge bath. 
 
 Blisters 339-340 
 
 Cathartics or Purgatives . 340-341 
 
 Remarks in regard to their use — Receipts for Effervescing 
 cream of tartar — Magnesia and rhubarb — Rhubarb and Epsom 
 
xvi Contents. 
 
 PAGE 
 
 salts — May apple — Jalap and cream of tartar — Calcined mag- 
 nesia — Seidlitz powders — Purgative mineral water. 
 Clystees or Injections. . . * . . . . . . 341-342 
 
 A purgative injection — An astringent injection — Nutritive in- 
 jections. 
 
 Cold, Mode of Applying 342 
 
 Counter-irritants. ... . ^ 342-343 
 
 Cupping. . . " . . 344 
 
 Disinfectants. . . ... . . . . . 344-345 
 
 Emetics 345 
 
 Eye Washes or Waters 346 
 
 Fomentations, or Stupes and Steaming. . . . . , 346-347 
 
 Gargles. 347 
 
 Heat, Mode of Applying. . . . 347-348 
 
 Herb and other Medicinal Teas. ...... 348-350 
 
 Receipts for. 
 
 Inhalations 350-351 
 
 Directions for Administering. 
 Leeching. . . . . . . . . . . . 352 
 
 Liniments 353-354 
 
 Lotions or Washes 354-356 
 
 Ointments or Salves. .356 
 
 Pain Removers, or Anodynes. 356-358 
 
 Poultices. . - . . 358-360 
 
 Bread and water poultice — Flaxseed meal poultice — Bran 
 poultice — Stimulating poultices — Yeast poultice — Molasses 
 poultice — Starch poultice — Charcoal poultice — Carrot poultice 
 — Alum poultice — Mush poultice — Slippery elm poultice — Ar- 
 rowroot poultice — Onion poultice — Mustard poultice — Bread 
 and Milk poultice. 
 
 Tonics . \ . , . . . 360-361 
 
 Receipts for the Hygiene of the Person 361-366 
 
 Tooth powders — Mouth washes — Washes for foul breath — Hair 
 tonics — Ointments and washes for dandruff— Lip salves and 
 lotions — Ointments and washes for chapped hands — Ointment 
 for fetid feet — Lotions for the face — Washes for removing 
 freckles — Ointment for sunburn. 
 
 CONCLUSION. 
 
 Charity to the Poor and Sick. . . . ' , . v 367-370 
 
 THE FAMILY HEALTH RECORD. 
 
 Appendix 371-388 
 
 Index. 
 
LIST OF ILLUSTRATIONS. 
 
 Internal Anatomy 
 
 (colored). 
 
 . Frontispiece 
 
 
 THE EXTERNAL COVERINGS OF THE BODY. 
 
 
 
 
 
 
 PAGE 
 
 Fig. 1. 
 
 Section of 
 
 Skin 
 
 
 27 
 
 Fig. 2. 
 
 Inside of a Hair . . . . 
 
 
 30 
 
 Fig. 3. 
 
 Comparative Diagram 
 
 THE FLESH AND MUSCLES 
 
 
 32 
 
 Fig. 4. 
 
 Muscular Fibre 
 
 
 33 
 
 Fig. 5. 
 
 Muscles about the Jaws . 
 
 
 34 
 
 Fig. 6. 
 
 Knee-pan < 
 
 ind Muscles 
 
 HOME GYMNASTICS. 
 
 
 35 
 
 Fig. 7. 
 
 Movement 
 
 1 
 
 
 37 
 
 Fig. 8. 
 
 Movement 
 
 2 
 
 
 
 37 
 
 Fig. 9. 
 
 Movement 
 
 3 
 
 
 
 37 
 
 Fig. 10. 
 
 Movement 
 
 4 
 
 
 
 38 
 
 Fig. 11. 
 
 Movement 
 
 5 
 
 
 + 
 
 38 
 
 Fig. 12. 
 
 Movement 
 
 6 
 
 
 
 38 
 
 Fig. 13. 
 
 Movement 
 
 7 
 
 
 
 38 
 
 Fig. 14. 
 
 Movement 
 
 8 
 
 
 
 39 
 
 Fig. 15. 
 
 Movement 
 
 9 
 
 
 
 39 
 
 Fig. 16. 
 
 Movement 10 
 
 
 
 39 
 
 Fig. 17. 
 
 Movement 11 
 
 
 
 39 
 
 Fig. 18. 
 
 Movement 12 
 
 
 
 40 
 
 Fig. 19. 
 
 Movement 
 
 13 
 
 
 
 40 
 
 Fig. 20. 
 
 Movement 14 
 
 
 
 40 
 
 Fig. 21. 
 
 Movement 15 
 
 
 
 41 
 
 Fig. 22. 
 
 Movement 
 
 16 
 
 
 
 41 
 
 Fig. 23. 
 
 Movement 17 
 
 
 
 41 
 
 XVll 
 
XV111 
 
 List of Illustrations. 
 
 
 
 
 
 
 PAGE 
 
 Fig. 24. 
 
 Movement 18 
 
 41 
 
 Fig. 25. 
 
 Movement 19 
 
 
 
 
 42 
 
 Fig. 26. 
 
 Movement 20 
 
 
 
 
 42 
 
 Fig. 27. 
 
 Movement 21 
 
 
 
 
 42 
 
 Fig. 28. 
 
 Movement 22 
 
 
 
 
 43 
 
 Fig. 29. 
 
 Movement 23 
 
 
 
 
 43 
 
 Fig. 30. 
 
 Movement 24 
 
 
 
 - . 
 
 43 
 
 Fig. 31. 
 
 Movement 25 
 
 
 
 
 44 
 
 Fig. 32. 
 
 Movement 26 
 
 
 
 
 44 
 
 Fig. 33. 
 
 Movement 27 - . 
 
 
 
 
 44 
 
 Fig. 34. 
 
 Movement 28 
 
 
 
 
 45 
 
 
 THE BONES AND JOINTS. 
 
 
 Fig. 35. 
 
 The Thigh Bone — Example of the Long 
 
 Bones . 47 
 
 Fig. 36. 
 
 Wrist Bones — Example of the Short Be 
 
 )NES '. 48 
 
 Fig. 37. 
 
 Shoulder Blade — Example of the Flat 
 
 Bones . 48 
 
 Fig. 38. 
 
 A Vertebra — Example of the Irregulae 
 
 » Bones 48 
 
 Fig. 39. 
 
 Spinal Column . . 
 
 49 
 
 Fig. 40. 
 
 The Chest Cage 
 
 
 
 50 
 
 Fig. 41. 
 
 The Bones of the Abdome 
 
 S T 
 
 
 50 
 
 Fig. 42. 
 
 The Skeleton 
 
 
 
 50 
 
 Fig. 43. 
 
 The Permanent Teeth 
 
 
 
 53 
 
 Fig. 44. 
 
 The Inside of a Grinder 
 
 
 
 53 
 
 
 THE AIR PASSAGES £ND ORGANS 
 
 
 Fig. 45. 
 
 The Lungs .... 
 
 57 
 
 Fig. 46. 
 
 Window Sash Ventilator 
 
 THE BLOOD PASSAGES AND ORGAN 
 
 60 
 
 s. 
 
 Fig. 47. 
 
 Inside of the Heart 
 
 66 
 
 Fig. 48. 
 
 Plan of the Circulation of the Blood 
 
 68 
 
 Fig. 49. 
 
 Magnified Capillary Vessels 
 
 THE SPECIAL SENSES. 
 
 69 
 
 Fig. 50. 
 
 The Feelers of the Skin . 
 
 77 
 
 Fig. 51. 
 
 Section of the Ear 
 
 79 
 
 Fig. 52. 
 
 The Little Bones i 
 
 n the ] 
 
 3ar 
 
 
 . • 80 
 
t List of Illustrations. 
 
 XIX 
 
 Fig. 53. The Outer, Middle and Inner Ear 
 Fig. 54. The Eyeball and Its Muscles 
 Fig. 55. The Chamber of the Eye . 
 
 THE BRAIN AND NERVES. 
 Fig. 56. The Brain, Spinal Cord, and Nerves 
 
 DOMESTIC MANAGEMENT OP THE SICK ROOM. 
 Fig. 57. Supporting Cradle 
 
 BANDAGES AND DRESSINGS. 
 Fig. 58. Bandaging a Leg with Adhesive Strips 
 Fig. 59. A Roller Bandage 
 Fig. 60. Bandaging a Leg . 
 Fig. 61. A Four- tailed Bandage . 
 Fig. 62. A Many-tailed Bandage . 
 Fig. 63. Irrigating a Limb . 
 Fig. 64. Pressure to Check Bleeding from the Forearm 
 Fig. 65. Pressure to Check Bleeding from Finger 
 Fig. 66. Pressure to Check Bleeding at the Armpit 
 Fig. 67. Pressure to Check Bleeding in Upper Arm 
 Fig. 68. Handkerchief Tourniquet on the Arm . 
 Fig. 69. Pressure on the Artery of the Thigh . 
 Fig. 70. Handkerchief Tourniquet on the Thigh 
 Fig. 71. Temporary Bandage for Fractured Limb 
 Fig. 72. A Convenient Litter 
 Fig. 73. Bandage and Sling for Collar-Bone Fracture 
 Fig. 74. Bandage and Splints for Fracture of Upper 
 
 Arm 
 Fig. 75. Bandage and Splints for Fracture of Lower 
 
 Arm ..... 
 
 Fig. 76. Box for Broken Leg 
 Fig. 77. Reducing a Jaw out of Joint 
 Fig. 78. Bandage for a Collar-Bone out of Joint 
 Fig. 79. Reducing an Arm out of Joint . 
 Fig. 80. Reducing an Arm out of Joint without Assist 
 
 ance ..... 
 
XX 
 
 List of Illustrations. 
 
 Fig. 81. Reducing a Thigh out of Joint >. 
 
 Fig. 82. The Index Finger out of Joint 
 
 Fig. 83. The Clove Hitch . 
 
 Fig. 84. Reducing a Finger out of Joint 
 
 Fig. 85. Cupping back of Neck 
 
 Fig. 86. Extinguishing Flames on Clothing 
 
 TO RESUSCITATE DROWNED PERSONS. 
 Fig. 87. Artificial Respiration . 
 Fig. 88. The First Movement 
 Fig. 89. The Second Movement 
 Fig. 90. The Third Movement 
 Fig. 91. The Sting and Poison Bag of a Bee 
 Fig. 92. Removing an Object from the Eye 
 Fig. 93. Bandage for an Injury to the Eye 
 Fig. 94. Dressing Ruptured Ham-string . 
 Fig. 95. Applying Sticking Plaster 
 Fig. 96. Bandage for a Scalp Wound 
 Fig. 97. Passive Motion of the Trunk 
 Fig. 98. Passive Motion of the Chest and Abdomen 
 Fig. 99. Passive Motion of Limbs (Forward) 
 Fig. 100. Passive Motion of Limbs (Backward) 
 DISEASES OF CHILDREN. 
 Fig. 101. A " Hip-bath " Tub for Children 
 Fig. 102. Lancing a Child's Gums . 
 
 BATHS AND DOUCHES. 
 Fig. 103. A Home-made Bath Tub . 
 Fig. 104. A Home-made Shower Bath 
 
 INHALATIONS. 
 Fig. 105. An Inhaling Bottle 
 
INTRODUCTION. 
 
 Science has no secrets. Whatever it wins, it is ready to 
 apply to the benefit of all, not retain for the profit of a guild 
 or a profession. Its stores are bountifully open, and ignorance 
 alone is barred from their use. To lessen this, to bring 
 knowledge to the reach of all, to make every one acquainted 
 with every fact he can profitably use — this is the high calling 
 of the teacher. 
 
 What is thus true of science generally, is especially so of 
 medical science. The health, the happiness, the life of man, 
 are here concerned. What, his religious hopes excepted, has a 
 more direct claim on his time, his mind, his money ? Yet the 
 ignorance of the simple facts of anatomy, and of the proper 
 action in time of accidents, is appalling. Too many of those 
 who have set out to diminish it have failed through the use of 
 pedantic terms, through the use of big words, and the writing 
 of big books. 
 
 The present volume is an endeavor to condense, in brief yet 
 simple language, those remedial measures, those resources in 
 emergencies which all should know, as well as the knowledge 
 of the human body, which makes this information clear and 
 available. It aims to do more than this, namely : to supply a 
 volume of such a size that a traveler can have it always by 
 him, containing instructions by which all the ordinary diseases 
 of childhood, youth, and adult life can be properly treated by 
 
 xxi 
 
xxii Introduction. 
 
 any intelligent person* Nofc that it is intended to take the 
 place of a physician ; but where one who is reliable cannot be 
 obtained, this work will prove a respectable substitute. Based 
 on several of the most recent and able authorities, its recom- 
 mendations will be found practical, and to the purpose. 
 
 In one point, it will be found different from most, if not all 
 other popular treatises on the subject, that is, the diseases 
 peculiar to the sexes are omitted. The reasons for this were 
 several. In the first place, by this omission, the present is a 
 volume which need never be put under lock and key, but can 
 and should always be kept on the family reading-table, where 
 it can be consulted at any moment, and read whenever there 
 is leisure for it; again, those diseases are so obscure that they 
 cannot be sufficiently discussed in so brief a volume as this ; 
 and lastly, they have been handled in full in the works, 
 " The Physical Life of Woman " and " The Transmission of 
 Life," both by the editor of this work ; the former treating of 
 the diseases incident to the female, the latter, of those peculiar 
 to the male sex. These works, published by the same house 
 who publish the present book, are supplementary to* it, and 
 with it form a comolete body of popular and practical Do- 
 mestic Medicine. 
 
 Great care has been taken that the arrangement of the 
 present work should be clear, simple, and easy of reference. 
 The diseases are classified : first, as those of adults and those 
 of children ; secondly, under each of these heads, those ail- 
 ments are first mentioned which affect the whole of the body, 
 and next those which affect its several parts; again, under the 
 first of these headings, that is, the diseases affecting the whole 
 of the body, they are classified according to the most promi- 
 nent symptom they display. By impressing on the mind this 
 
Introduction. xxiii 
 
 scheme, the reader will find no difficulty in identifying an 
 ailment which he may be called upon to treat. 
 
 The medicines recommended have been carefully selected 
 from the vast number which now fill the drug lists. Sim- 
 plicity, cheapness and efficiency have been the guides here. A 
 half dozen or so really excellent drugs are about all used by 
 enlightened physicians in nine-tenths of their cases ; and the 
 longer a physician practices, the fewer remedies he usually 
 comes to employ. The receipts for a considerable number are 
 given in Part rv, and referred to in the course of the work. 
 In addition to them, prescriptions are added occasionally in the 
 body of the book and several well-known preparations recom- 
 mended. 
 
 The pages of this volume which are devoted to the Family 
 Health Record merit the attention of every mother. By ex- 
 pending the slight labor necessary to fill them up, she will 
 often render the physician more positive in his knowledge of 
 her childrens' constitutions, and more certain, therefore, in 
 his treatment, than by any amount of vague conversation. 
 
PART I. 
 STRUCTURE AND ACTION OF THE BODY. 
 
 THE DIVISIONS OF THIS PART. 
 
 The body consists of a framework, and of instruments or " organs" 
 within it. This framework is made up of the bones or "skeleton," 
 covered by soft parts, and has its pieces so joined together as to 
 enable us to move. These organs are instruments for performing 
 the various acts essential to life. 
 
 We, therefore, invite the reader first to the study of the frame- 
 work of the body and its movements, and then to that of the 
 instruments of the body and their offices, aiming to draw therefrom 
 not merely dry facts and figures, for mental satisfaction, but practical 
 lessons in health, for physical good. Fortified by the knowledge 
 thus acquired, of the structure and action of the body, we can pass 
 to the consideration of its more usual ailments, and of the manner 
 in which they may be treated and avoided. 
 
 " Not in the world of light alone, 
 Where God has built His blazing throne, 
 Nor yet alone on earth below, 
 With belted seas that come and go, 
 And endless isles of sunlit green, 
 Is all thy Maker's glory seen — 
 Look in upon thy wondrous frame, 
 Eternal wisdom still the same ! " 
 
 3 25 
 
CHAPTER I. 
 
 THE FRAMEWORK OF THE BODY, AND ITS MOVEMENTS. 
 
 Section I.— The External Coverings of the Body.— The Skin— 
 Its structure and uses — How it regulates the heat of the body — How it 
 drains off waste products — Its coloring matter — Hygienic hints on the 
 care of the skin — Clothing — Dwellings — The Hair — The Nails. 
 
 Section II.— The Flesh and Muscles.— The structure of a muscle- 
 Home gymnastic exercises without apparatus — Other forms of exercise. 
 
 Section III.— The Bones and Joints.— The structure of bones— The 
 four different classes of bones — The bones of the head — The bones of the 
 trunk — The bones of the limbs — The different kinds of joints — Deformi- 
 ties of the bones; how avoided and remedied — The Teeth — Directions 
 for their preservation. 
 
 The skin, which, with its outgrowths, the hair and the nails, 
 makes up the external covering of the body, envelops the flesh and 
 muscles, which, in turn, clothe the bones. Starting with the de- 
 sign of proceeding in our study from the best known to the least 
 known, from the seen to the unseen, we shall first turn our attention 
 to the external coverings, and then direct our course to the inner 
 and deeper mysteries of that wonderful structure we call "the 
 body." 
 
 I. The External Coverings of the Body. 
 
 The body is covered by the skin and its outgrowths, the hair and 
 nails. The skin is a membrane of greater or less density, envelop- 
 ing the entire surface of the body. It serves the purpose of pro- 
 tecting the parts lying beneath, of regulating the animal heat, 
 of affording an outlet for waste and used-up matters, and of estab- 
 lishing sensitive relations between the living frame and surrounding 
 objects. It is the principal seat of the sense of touch. The tissue 
 
 26 
 
The External Coverings of the Body. 
 
 27 
 
 of the skin is compact, but pierced by numerous passages. It con- 
 sists of two layers, the scarf skin and the true skin, the latter of 
 which, when prepared by the chemical process of tanning, consti- 
 tutes leather. Figure 1 shows the side, greatly magnified, of a cut 
 made through the skin. Nos. 1, 2 and 3 are the scarf skin; 8, the 
 true skin; 4, the coloring matter of the skin; 6, nipple-like emi- 
 nences, by which we have the sense of touch; 7, sweat glands, with 
 ducts or tubes, 9, passing through the true skin and the scarf skin, 
 to the pores on the surface, 11, to throw out perspiration. 
 
 The skin is the great heat regulator of 
 the body. This it accomplishes by increas- 
 ing the sweat when the body is too hot, and t 
 by lessening it when it is cool. But it will j 
 be asked, how does this increase of sweat] 
 reduce the animal heat? Very simply.! 
 All fluids as well as solids possess two forms j 
 of heat: one of which is not perceptible to 
 the touch or thermometer, and therefore! 
 termed latent or hidden; while the other] 
 can be detected by the touch and measured j 
 by the thermometer. But a gas or vapor j 
 has many (almost seven hundred) times asj 
 much latent or hidden heat as a fluid, hence, 
 when the water of the perspiration is* 
 poured out upon the skin and becomes? 
 vapor, it absorbs heat from the skin and 
 blood, and so cools us off. 
 
 When we are quiet the skin has little moisture upon it, but when 
 we exert ourselves violently the water trickles from the surface, and 
 by its evaporation, rids us of unnecessary heat. We are thus en- 
 abled, also, to resist unnaturally high temperatures, as well as very 
 low ones. So long as the air be dry very great heat can be borne. 
 In some trades workmen enter furnaces the air of which has a 
 temperature of a hundred and fifty degrees above that which boils 
 water. Under these circumstances the sweat glands are stimulated 
 to extraordinary activity, and pour out a large quantity of water 
 upon the skin, which quickly evaporates, and so cools down the body 
 
 Section of Skin. 
 
28 Structure and Actio?i of the Body. 
 
 to the natural temperature. If, however, the air be moist instead 
 of dry, and if sweating be in any way interfered with, the body 
 soon becomes unnaturally warm, and death results if the exposure 
 be long continued. 
 
 The process of perspiration goes on without our aid or will, but 
 is effected by variations in the temperature, by exercise, by various 
 nervous conditions, such as anxiety, excitement, irritation or Jassi- 
 tude, and may be controlled, to a great extent, by the amount of 
 clothing we wear, or of the fuel we put in our stoves. The total 
 number of sweat pores reaches the enormous sum of seven millions, 
 and the total length of the sweat tubes of the body is nearly 
 twenty-eight miles. 
 
 This vast array of tubes and pores not only serves to regulate the 
 temperature of the body, as we have just explained, but also to give 
 an outlet to the products of the waste of the system, and thus aid the 
 kidneys, which are apt to become disordered when anything inter- 
 feres with the free action of the skin. Some animals, as frogs and 
 salamanders, breathe largely through the skin as well as the lungs. 
 In these animals the skin is very moist, flexible, and copiously sup- 
 plied with blood vessels. While the animals are beneath the surface 
 of the water, and therefore unable to breathe by the lungs, respira- 
 tion takes place through the skin. We also breathe by the skin, 
 but to a much more limited extent. This enables us to understand 
 the desirableness of keeping the skin moist in fevers, in which there 
 is great heat and dryness of the surface, since the breathing process 
 cannot go on through a dry membrane. Cold and tepid sponging 
 affords, therefore, in these cases, much relief. The myriads of 
 sweat glands and pores, and the miles of sweat ducts, also teach us 
 the importance of proper exercise to stimulate them into action, and 
 of personal cleanliness to remove the matter thrown out. Many 
 diseases are consequent upon inactive habits of life and want of 
 ablution. 
 
 The color of the skin is determined by the tint of the layer of 
 coloring matter found between the scarf skin and the true skin, as 
 shown by No. 4, in Figure 1. Here we have the seat of the varied 
 hues which characterize the different races of men, as, for example, 
 the fair and ruddy Saxon, the jet-black Negro, the olive Mongolian, 
 
The Skin Affected by Climate, 29 
 
 and the copper-colored Indian. Redness of the cheeks is almost 
 wholly confined to the white races. " It is only," writes Humboldt, 
 "in white men, that the instantaneous penetration of the skin by 
 the blood can take place, that slight change of color which adds so 
 powerful an expression to the emotion of the soul. 'How can 
 those be trusted, who know not how to blush?' says the European, 
 in his inveterate hatred to the negro and the Indian." Still, in 
 some very light examples of the brown and yellow races, blushing 
 has been observed. Climate has a great influence over the com- 
 plexion. The fairer races live remote from the tropics. People 
 inhabiting high mountains and countries of great elevation, are 
 generally of a lighter color than those living upon a lower level, 
 such as swampy or sandy plains at the seaside. Albinos, or those 
 whose skin is of an unnaturally white tint, are found among the col- 
 ored as well as in the white races, so that there are white negroes 
 and white red men. There are several authentic cases upon record 
 of change of color in the negro, the change being so complete that, 
 at least in one instance, that of a negro who was perfectly black 
 until the age of twelve, "but for his hair, which was crisped or 
 woolly, no one would have supposed that his progenitors had offered 
 any of the characteristics of the negro, his skin presenting the 
 healthy vascular appearance of that of a fair-complexioned Euro- 
 pean," The artificial colors imparted to the skin by tattooing, so 
 frequently seen among sailors, and of which such curious and often 
 very elegant examples are found among the South Sea Islanders, 
 are indelible, residing as they do in the true skin, and can only be 
 removed by the destruction of the part. They may, however, be 
 concealed, for a time at least, by pricking in over the marks a fine 
 rouge of the exact color of the skin, repeating the operation when 
 necessary. 
 
 Hairs are found upon almost every portion of the surface of the 
 body, except the palms of the hands and the soles of the feet. A 
 hair is composed of a bulb or root, which is the part imbedded in the 
 skin ; of a shaft, which is the free portion ; and of a point. In figure 
 2, there is shown the inside of a hair, by which it will be seen to be 
 a delicate tube. The minute canal there pictured is filled with air. 
 The walls of the hair tube are double, the outer coat consisting of 
 3* 
 
30 Structure and Action of the Body. 
 
 flat scales, the inner coat of cells which contain the coloring matter. 
 
 The surface of each hair is therefore covered by minute scales, like 
 
 2 those of a fish. They overlap each other from root 
 
 to point, which is the reason that a hair, when drawn 
 
 through the fingers from the root to the point, feels 
 
 smooth, but rough when drawn from point to root. 
 
 The number of the hairs on a healthy head have been 
 
 calculated to be over a hundred thousand. The hair 
 
 of the head grows at the rate of about eight or ten 
 
 inches a year. The influence of the mind upon the 
 
 color and growth of the hair of the head is well known, 
 
 fear, anxiety, and dismal emotions weakening it and 
 
 turning it gray. Usually, the change in color is 
 
 gradual, but authentic instances are on record of the 
 Insideofahair. hair turnmg gray in a single nigllt 
 
 " A tedious night indeed, that makes a young man old," 
 
 The subject of hair washes and tonics will occupy us in their 
 proper place, in accordance with the plan of the book, and can be 
 found by reference to the index. 
 
 The Nails are situated, as we all know, upon the backs of the 
 ends of the fingers and toes. Each nail consists of a root, the part 
 imbedded in a groove of the skin; of a body, and of afree edge. 
 
 We are much less protected than animals, by natural coverings, 
 against the vicissitudes of weather, and the rigors of inhospit- 
 able climates. They are furnished with hair, fur, or feathers, of 
 such a quantity and color as to enable them to bear different temp- 
 eratures and climates. We are endowed with reasoning powers 
 which teach us how to clothe and house ourselves, in order to guard 
 against the various degrees of heat and cold we encounter. A few 
 words upon the hygiene of clothing and dwellings may here be in 
 place. 
 
 Clothing. For the under-clothing, woolen is preferable all the 
 
 year round, from infancy to old age — heavy flannels for the winter, 
 
 light merinoes for the summer. Muslin next the skin is warmer than 
 
 linen, which should never be so worn, as it tends to give cold by the 
 
 t sensation of cold it imparts after the body has been heated and 
 
Hygiene of Clothing and Dwellings. 31 
 
 thrown into a perspiration. For the outer-clothing, a cloak, over- 
 coat or shawl, which should also be of wool, is necessary to be worn 
 or thrown aside, according to the weather and the feelings. For the 
 intermediate clothing, the quality and quantity are determined by 
 the manner of living, the occupation, and the season of the year. 
 Wool is best for cold weather ; cotton goods and silk may be worn 
 at other times by women, and linen, perhaps, by men. We see, 
 therefore, that woolen fabrics make the best article of clothing, for 
 outdoor and indoor wear, and for all seasons. The clothing at night 
 should also be of wool, as heavy cotton counterpanes weigh the body 
 down and cause great fatigue. The coverings of the bed, therefore, 
 except the sheets, should all be blankets. The number of blankets 
 used must vary with the state of the health, the sick and feeble 
 requiring greater warmth at night than the well ; with the age, old 
 people and children needing more night clothing than those in 
 middle life ; and, naturally, with the weather and season. When a 
 woolen night dress is worn, which is preferable to a muslin one in 
 cold weather, and particularly for the very young and aged, and 
 these subject to rheumatism, fewer blankets will be required. Per- 
 sons with cold feet are usually more comfortable with woolen stock- 
 ings. Two light stockings are warmer than a single heavy one. 
 Great care should be taken to keep the hands and feet of aged 
 persons warm. Inattention to the clothing of very old people and 
 infants, who are alike sensitive to cold, is a frequent cause of death 
 in winter. 
 
 A dwelling should be in a healthful locality, dry, light, well ven- 
 tilated and roomy. Its site should be dry and high. The soil 
 should be either impermeable or permit of the rapid passage of 
 water. A house on a hill is usually less cold in winter, and cooler 
 in summer than one lying in a neighboring valley. Damp soils and 
 made ground are to be avoided in building. A clay soil is cold, wet 
 and unhealthy, unless thoroughly drained. Grass land about a 
 house is better than arable, both summer and winter. Brick makes 
 a dryer and warmer building material than stone or wood. No 
 garbage, heaps of rubbish, or filth of any kind should be permitted 
 near the house. No waste pit, cesspool, privy, surface nor under- 
 ground drain should go close to a well; neither should slops or 
 
32 
 
 Structure and Action of the Body. 
 
 dish-water be thrown near it, for fear of fouling the water. Every 
 house should have a cellar, with windows, under the whole of the 
 lowest, and a garret or attic, with windows, over the whole of the 
 highest story. Rooms ought to be made of a size to permit of 300 
 cubic feet, at least, to each occupant. Figure 3 shows a room 15 
 
 Fig. 3. 
 
 15 FEET- 
 
 feet long, 10 wide, and 10 high. In the 1500 cubic feet that it 
 contains five persons might live, if the room were well ventilated. 
 The size of a man in the room, and the bulk of the air (14 cubic 
 feet) which he breathes every hour, are shown in proportion. 500 
 cubic feet to a person, or three persons in such a room, is a better 
 allowance than 300 cubic feet to a person. This subject of pure air 
 and ventilation will be discussed in speaking of the air passages and 
 organs. No room should be without sun a part of the day. For this 
 reason, and because it is a cause of dampness, thick foliage closely 
 about a house is to be avoided. 
 
 II. The Flesh and Muscles. 
 
 The word flesh is applied to every soft part of the body, but 
 more especially to the muscles, which are often called muscular 
 flesh. The muscles of animals constitute the lean of the meat which 
 is served up to us as food. They are the active agents of motion 
 in the body, the means by which all our movements are effected. 
 They act like cords attached to levers, and work according to strict 
 mechanical principles. As our movements are diverse and com- 
 plex, our muscles are numerous, there being about four hundred of 
 
The Flesh and Muscles. 
 
 33 
 
 them. Most of them are under the command of the will, being set 
 and kept in motion at our pleasure, and are therefore called volun- 
 tary muscles. Such, for instance, are those by which we move our 
 limbs. Many of them, however, are entirely beyond the control of 
 the will, it being utterly impossible for us to put or keep them in 
 motion in accordance with our wishes, and are, therefore, called in- 
 voluntary muscles. Such, for instance, are those of the heart and 
 stomach. Still, over some of these involuntary muscles the will 
 exerts a partial control. Though we cannot hasten, lessen, nor stop 
 altogether the beats of the hollow muscle forming the heart, we can, 
 to a limited extent, quicken or suspend the action of the muscles 
 which enable us to breathe ; though we are unable to control the 
 movements in the walls of the gullet, stomach and bowels, by which 
 food is carried along the digestive tract, we can to a certain extent 
 interfere in the acts of swallowing and vomiting. The most im- 
 portant actions of the system, the circulation of the blood, and the 
 digestion of food, for instance, are performed by the involuntary 
 muscles. This is wisely ordained, like all the other operations 
 within us. If such nice complicated movements, 
 upon which our lives depend, were left to the 
 direction of our minds, they would occupy too much 
 of our attention, and be naturally neglected during 
 sleep. We are, happily for ourselves, restricted in 
 our control to those muscular movements which 
 can be easily performed, and which do not require 
 to be constantly and regularly kept up in order to 
 maintain life. 
 
 The muscles are fleshy bodies, of various lengths 
 and sizes. They are formed of fibres, and con- 
 nected with the bones by means of sinews. The 
 involuntary muscles are unconnected with bones. 
 Figure 4 shows the striped fibre of a voluntary 
 muscle. The muscle consists of bundles of such 
 fibres, made up of hundreds of smaller fibres, as 
 shown at B. The striped or crossed lines, which 
 characterize voluntary muscles, are shown at A. In- 
 voluntary muscular fibre is smooth, without stripes. Muscular Fibre. 
 
 Fig. 4. 
 
34 Structure and Action of the Body. 
 
 The voluntary muscles pass from one bone to another, con- 
 nected with it by a joint, so as to permit the one to move upon the 
 other, like a hinge or a ball and socket. That end of the muscle 
 which adheres to the most fixed part, is called the origin or head ; 
 the extremity which adheres to the more movable part, the inser- 
 tion or tail ; the intervening part or body being called the belly of 
 the muscle. The muscles possess the power of shortening or con- 
 tracting themselves, and, as a necessary consequence of this diminu- 
 tion of their length, move in various directions, upon their joints, 
 the bones to which they are attached. AH the motions of the body 
 are, in this manner, performed by the combined action of the various 
 muscles. Thus in eating, the under jaw, by the shortening which 
 takes place in accordance with our wish, of one set of muscles, is 
 drawn up with force, so that the food is crushed and ground by the 
 lower against the upper teeth ; this shortening lasts but for a moment, 
 the muscles are then relaxed, and another set draws the jaw down. 
 These movements go on with rapidity while we continue eating. 
 The muscles which move the jaw and lips are seen in Figure 5. 
 Fig. 5 Nos. 9, 10 and 11, are those 
 
 which lift the angle of the 
 mouth; 12 and 13 those which 
 draw the mouth downward; 
 18 that which draws the mouth 
 backward and presses the food 
 between the teeth; 15 the 
 strong muscle drawing the jaw 
 upward and backward ; 22 and 
 24 that which opens the mouth. 
 In the sinews of some mus- 
 cles, little seed-like bones are 
 sometimes developed. They 
 occur near the joints, particu- 
 larly of the toes and fingers, 
 Muscles about the Jaws. and are more numerous in men 
 
 than in women. The object of these little bones is to allow the 
 sinew to attach itself at a greater angle to the bone the muscle is 
 designed to move, and thus increase its leverage power. The best 
 
The Wonders of the Muscular System. 
 
 35 
 
 Fis. 6. 
 
 example of a development of this kind is seen in the knee-pan, 
 seated in the sinew of the great mnscle which extends the leg. 
 This is well displayed in Figure 6. 
 
 The marvelous beauty of 
 our muscular organization is 
 best shown, not by the opera- 
 tion of a single muscle, won- 
 drous though it be in its 
 simplicity and completeness of 
 means to end, but by the sym- 
 metry and harmony of com- 
 bined muscular movements. 
 The perfection of our organi- 
 zation, in this respect, is re- 
 markably evinced by the fact 
 that no machinist, however 
 ingenious, has ever yet suc- 
 ceeded in building up an au- 
 tomaton which can walk like 
 a man. Yet we are able to go 
 through the whole series of 
 complex movements necessary 
 in walking, so readily, as to be 
 scarcely conscious of an effort. Knee-pan and Mnscles. 
 
 The muscles of different animals, and their limbs, are adapted, by 
 their situation and shape, to the particular kinds of motion their 
 mode of life requires. Thus, in monkeys and apes, who climb trees 
 for their food and to escape beasts of prey, the limbs are especially 
 fitted for climbing, and they go with difliculty on the level ground, 
 either on four legs or two. 
 
 The rapidity with which muscles can shorten and relax their 
 fibres, is almost inconceivable. Thus, by the movements of the 
 tongue, and other instruments of speech, fifteen hundred letters can 
 be distinctly pronounced in a minute by some people ; the production 
 and cessation of these sounds require one or several muscles to 
 contract upon themselves fifty times in a second. It has been 
 calculated that in the legs of a dog, running at full speed, muscular 
 
36 Structure and Action of the Body. 
 
 contractions take place twelve hundred times in a second, for many 
 minutes together. The wings of many insects, it is well known, 
 strike the air several thousand times a second, producing, by the 
 rapidity of their vibrations, a musical note. The power of motion 
 possessed by animals is proportioned to their weight and structure. 
 Could an elephant or a horse leap several hundred times its own 
 length, as a flea can, its weight would crush it to atoms. 
 
 Muscles increase in size and in strength as they are exercised, a 
 fact illustrated by the arm of the blacksmith and the leg of the 
 ballet dancer. We see, therefore, the importance of gymnastic ex- 
 ercise in order to develop the different classes of muscles and to 
 make the body more agile and adroit, and thus more useful to us. 
 But gymnastic exercises recommend themselves for other and 
 higher reasons than the purpose of securing huge muscled and 
 great adroitness of movement. They expand the chest, rid us of 
 superfluous water and fat, excite the action of the skin and lungs, 
 improve the digestion and give tone to the nervous system. In 
 order to obtain full benefit from these, the attention should not be 
 directed chiefly to the attainment of great strength, or even of 
 superior agility. Many practiced gymnasts, while getting and 
 keeping up enormous muscles and the ability to perform feats of 
 astounding agility, ruin their health. Strength and health do not 
 always go hand in hand. Great moderation and judgment are 
 necessary in order to avoid over exciting the action of the heart and 
 lungs, and by excess, inducing exhaustion and disease, rather than 
 health. For family use, a scheme of gymnastics is necessary which 
 may be carried out without danger, and without apparatus, in 
 which nature herself is made to furnish the means of self-ifnprove- 
 ment. With this object in view, we give below a series of simple 
 but well studied movements, a succession of efforts at once gentle 
 and energetic, of which each has its reason and object. Let no 
 one smile at the apparent insignificance of certain of the move- 
 ments. They are all grouped so as to form a complete system of 
 home exercise for children and adults, and for both sexes. Greater 
 amusement, and perhaps benefit will be afforded by a number going 
 through the movements together like soldiers under command, 
 
Exercise without Apparatus. 37 
 
 and even to the accompaniment of music. But no class is neces- 
 sary ; every one can exercise himself. 
 
 There are few who would fail to derive a benefit which would 
 astonish them, from devoting twenty minutes daily to these gradu- 
 ated exercises. They also form excellent means for the physical 
 education of children. 
 
 FIRST MOVEMENT. 
 
 Place the hands upon the hips, the heels 
 together, the toes turned out. Turn the head from 
 right to left (six times in each direction), counting 
 one, two. The head should be turned so as to 
 carry the chin nearly directly over the shoulder. 
 Bring the head to the front and rest a moment. 
 
 SECOND MOVEMENT. 
 
 Bend the head to the right and then to the left 
 
 (six times in each direction), counting one, two. 
 
 At one, incline the head toward the right shoulder ; 
 
 at two, raise it and repeat the movement toward 
 
 the other shoulder. 
 
 Fig. 7. 
 
 Movement 1. 
 
 Movement 2. 
 
 THIRD MOVEMENT. 
 
 Carry the head forward and backward (six 
 times), counting one, two. 
 
 At one, lower the head on the chest ; at two, raise 
 it and carry it backward. 
 
 Movement 3. 
 
38 
 
 Structure and Action of the Body. 
 
 Fig. 10. 
 
 Movement 5. 
 Fig. 12. 
 
 Movement 6. 
 Fig. 13. 
 
 FOURTH MOVEMENT. 
 
 Turn the body to the right and then to the left 
 (six times), counting one, two. 
 
 At one, turn the trunk and upper part of the 
 body toward the right, keeping the legs fixed ; at 
 two, repeat the same movement in the opposite 
 direction. 
 
 FIFTH MOVEMENT. 
 
 Bend the trunk to the right and then to the 
 left (six times), counting one, two. 
 
 At one, bend the trunk toward the right, with- 
 out changing the position of the axis of the body ; 
 at two, bring it upright and repeat the movement 
 in the opposite direction. No stopping between 
 movements. 
 
 SIXTH MOVEMENT. 
 
 Incline the body forward and bend it backward 
 (six times), counting one, two. 
 
 At one, incline the body forward without bending 
 the knees; at two, straighten it and carry it back- 
 ward, drawing in the shoulders. 
 
 The above six movements should be gone 
 through with slowly. 
 
 SEVENTH MOVEMENT. 
 
 The fists against the chest, extend the arms up 
 vertically (six times), counting one, two. 
 
 At one, jerk the arms into the air, the hands 
 clenched, the thumbs within. At two, return the 
 arms to the chest. 
 
 Movement 7i . 
 
Home Gymnastics. 
 
 39 
 
 Fig. 14. 
 
 EIGHTH MOVEMENT. 
 
 Strike the arms out horizontally forward (six 
 times), counting one, two. 
 
 At one, thrust the arms out, side by side, 
 directly in front; at two, draw them quickly back 
 to the chest. 
 
 NINTH MOVEMENT. 
 
 The hands being brought near to- 
 gether on the chest, throw the arms 
 horizontally outward and backward 
 (six times), counting one, two. 
 
 At one, extend the arms, in arching 
 slightly the chest; at two, bring them 
 back to the chest. 
 
 £g 
 
 Movement 9. 
 
 Fig. 16. 
 
 TENTH MOVEMENT. 
 
 The wrists being crossed on the back, bend the 
 knees (six times), counting one, two. 
 
 At one, bend slowly the knees, holding the 
 body straight; at two, rise without uncrossing the 
 arms. 
 
 ELEVENTH MOVEMENT. 
 
 The arms being dropped along the sides of the 
 body, bend the knees and extend the arms forward 
 (six times), counting one, two. 
 
 At one, bend the knees, resting on the soles of 
 the feet, and at the same time extend the arms 
 horizontally forward; at two, rise, bringing the 
 arms back to the sides of the body. 
 
 Movement 10. 
 Fig. 17. 
 
 Movement 11. 
 
40 
 
 Structure and Action of the Body. 
 
 Fig. 18. 
 
 Movement 12. 
 
 Fig. 19. 
 
 TWELFTH MOVEMENT. 
 
 The legs being stretched apart, the arms in the 
 air, balance the body (six times), counting one, 
 two. 
 
 At one, bend the body forward and throw the 
 arms quickly between the knees ; at two, raise the 
 body and extend the arms above the head. This 
 movement ought to be made with suppleness. 
 Now bring the feet together and the arms to the 
 sides, and rest a minute. 
 
 THIRTEENTH MOVEMENT. 
 
 The arms being behind the back and the hands 
 closed, raise the arms vertically (ten times), count- 
 ing one, two. 
 
 At one, carry the arms, extended, in front of 
 the face, to a straight, vertical position above the 
 head; at two, bring them back quickly to the 
 starting position. 
 
 Movement 13. 
 
 \ 
 
 ^ 
 
 FOURTEENTH MOVEMENT. 
 
 The hands being open, raise the 
 arms sideways (ten times), counting 
 one, two. 
 
 At one, raise the arms, extended 
 from each side, to the vertical position, 
 above the head; at tico, let them fall 
 to the side of the body, without bend- 
 ing the elbows. 
 
 Movement 14. 
 
Health Movements. 
 
 4i 
 
 FIFTEENTH MOVEMENT. Fi S- 21. 
 
 The right foot being advanced, and 
 the left leg well stretched, turn the 
 left arm around with the windmill 
 movement (ten times), counting one, 
 two, three, etc. 
 
 At one carry the left arm backward 
 and then forward, by a circular move- 
 ment, counting two on the second 
 revolution, three on the third, etc., 
 until ten turns have been made with- 
 out stopping. Then repeat the same manoeuvre for 
 the right arm, the left foot being advanced. 
 
 Movement 15. 
 
 Fig. 22. 
 
 SIXTEENTH MOVEMENT. 
 
 The hands being on the hips, raise alternately the 
 knees (ten times), counting one, two, three, four, etc. 
 
 At one, bend the right leg and lift it towards the 
 chest; at two, lower it; at three and four, repeat 
 the same exercise with the left leg. 
 
 SEVENTEENTH MOVEMENT. 
 
 The hands being on the hips, extend the legs 
 alternately, straight out, as nearly as possible, in 
 front (ten times), counting one, two, three, four. 
 
 At one, extend the right leg, nearly horizontally, 
 in front; at two, bring it back to place; at three 
 and four, repeat the same exercise with the left 
 leg. 
 
 EIGHTEENTH MOVEMENT. 
 
 The hands being on the hips, carry 
 the legs alternately backward (ten 
 times), counting one, two, three, four. 
 
 At one, throw the right leg back- 
 ward, in bending lightly the left knee, 
 and slightly leaning forward ; at two, 
 bring it to place and straighten the 
 body; at three and four, repeat the 
 same exercise with the left leg. 
 
 Movement 16. 
 Fig. 23. 
 
 -K? 
 
 ^ 
 
 Movement 17. 
 
 Fig. 24. 
 
 Movement 18. 
 
42 
 
 Structure and Action of the Body. 
 
 Fig. 25. 
 
 ^^?z? 
 
 NINETEENTH MOVEMENT. 
 
 The hands being on the hips, throw 
 the right leg from tne side (six times), 
 counting one, two. 
 
 At one, turn the toes of the right 
 foot out, and throw the right leg out- 
 ward, in turning slightly the head to 
 the same side ; at two, bring the leg 
 back, keeping the toes out. Repeat 
 the same exercise with the left leg. 
 
 Fig. 26. 
 
 Movement 20. 
 
 TWENTIETH MOVEMENT, 
 
 The hands being on the hips, stretch 
 out the legs alternately in front (ten 
 times), counting one, two, three, four. 
 
 At one, lift the right bended knee 
 toward the chest; at two, extend the 
 leg in front ; at three, rebend the knee ; 
 at four, return to place. Repeat the 
 same exercise with the left leg. 
 
 Fig. 27. 
 
 TWENTY-FIRST MOVEMENT. 
 
 Carry one foot forward and revolve 
 both arms backward together, at the 
 side of the body (ten times), counting 
 one, two, three, etc. 
 
 The motion is to be kept up without 
 stopping, counting two at the second 
 turn, three at the third, up to the 
 tenth. 
 
 Movement 21. 
 
Physical Education. 
 
 43 
 
 Count 
 
 TWENTY-SECOND MOVEMENT. Fig. 28. 
 
 Carry the right foot forward, and 
 revolve the arms at the sides, in oppo- 
 site directions (six times), counting 
 one, two, three, etc. 
 
 At one, carry the right foot forward, 
 bending the knee, elevating at the 
 same time the right arm in the air, 
 and extending the left backward. At 
 two, revolve the arms forward, the 
 right arm descending in front, while 
 the left is rising behind, by a continued circular movement, 
 one at each turn of the arms, to ten. 
 
 TWENTY-THIRD MOVEMENT. 
 
 The right hand being at the left 
 shoulder, and the left arm stretched 
 out horizontally well back, throw the 
 arms around the body (six times), 
 counting one, two. 
 
 At one, carry the right hand, closed, 
 to the left shoulder, and extend the 
 left arm horizontally, well back; at 
 two, throw the arms horizontally about 
 the body, from left to right and from right to left, so as to describe 
 a semicircle. 
 
 This exercise should be executed with sufficient vigor to impress 
 upon the trunk a rotation movement upon the hips. The legs 
 should rest immovable. 
 
 Movement 22. 
 
 Fig. 29. 
 
 "t***- 
 
 tfL:.:;^j? 
 
 Movement 23. 
 
 TWENTY-FOURTH MOVEMENT. 
 
 The right foot being in advance, 
 and the two fists against the sides of 
 the chest, thrust the two arms straight 
 forward, and then carry them outward 
 and backward, always extended (six 
 times), counting one, two, three, etc. 
 
 At one, 'carry the closed fists to the 
 chest; at two, thrust them quickly 
 
 c^::::::::::: 
 
 ......::^<3 
 
 Movement 24. 
 
44 
 
 Structure and Action of the Body. 
 
 ^1 
 
 Movement 25. 
 
 forward; at three, carry them outward and backward, always 
 extended horizontally, the head being thrown back. 
 
 Fig. 31. TWENTY-FIFTH MOVEMENT. 
 
 The charging step in fencing (six 
 times), counting one, two. 
 T\^--^ lA IL^j J At one, make, quickly, a long step, 
 
 obliquely to the right, carrying, at the 
 same time, the left arm upward and 
 backward, and bending it slightly, so 
 that the wrist will be above the level 
 of the head, and throwing forward the 
 right arm, extended without stiffness. 
 It is the movement of the right arm, indicated by the dotted semi- 
 circle in the figure, which swings the whole body to the right. At 
 two, return with vivacity the right leg to the side of the left, and 
 let the arms fall by the side. Repeat the same movement to the left. 
 
 TWENTY-SIXTH MOVEMENT. 
 
 Throwing oneself forward, first on 
 the one, then on the other leg, in 
 elevating the arms in the air (ten 
 times), counting one, two. 
 
 At one, make a long stride forward 
 with the right foot, throwing the arms 
 above the head backward, bending the 
 right knee, and extending energetically 
 the left leg; at two, bring the right 
 
 leg back to position, and let the arms fall to the sides. Repeat the 
 
 same exercise with the left leg. 
 
 Fig. 33. 
 
 Movement 26. 
 
 Movement 27. 
 
 TWENTY-SEVENTH MOVEMENT. 
 
 Bending and throwing the whole 
 body forward (six times), counting 
 one, two, three. 
 
 At one, make a long stride forward 
 with the right foot, as in the preced- 
 ing movement; at two, bend the body 
 over the right leg in letting the hands 
 fall to the floor; at three, raise the 
 
Healthful Exercises. 
 
 45 
 
 Movement 28. 
 
 body in describing a large circle with the arms, and without bend- 
 ing the left leg. The arms should be brought up side by side, and 
 without any bending, to above the head, and there separated to 
 describe their circle, in being brought down to the sides. Repeat 
 the same exercise with the left leg in advance.. 
 
 TWENTY-EIGHTH MOVEMENT. Fig. 34. 
 
 Separating the legs and bending the 
 body to the right and left, in four 
 motions (six times), counting one, two, 
 three, four. 
 
 At one, raise the arms vertically in 
 the air, and extend them well back; 
 at two, turn the trunk of the body 
 only, and bend over and down to the 
 right, letting the arms fall in front 
 until the fingers touch the right heel ; 
 at three, rise, with the arms above the head, as at first; at four, turn 
 the body on the hips to the left, and repeat the movements just 
 made, to the right. 
 
 Other Forms of Exercise. — Walking is a convenient and 
 excellent mode of exercise within the reach of all. A walk, as long 
 as can be taken short of fatigue, a couple of hours after breakfast, 
 or two hours before sunset, with some object in view, in easy shoes 
 sufficiently thick to keep the feet dry, is an admirable " constitu- 
 tional," as the English call the daily promenade. Horseback 
 Exercise is of great use to those threatened with consumption or 
 disease of the liver, but hurtful to those with piles, or heart disease. 
 Carriage riding is of especial benefit to those in such feeble health, 
 or so weak from the effects of a sickness just recovered from, that 
 walking or horseback riding is out of the question. Dancing, 
 during the midnight hours^and in close rooms, far from being a 
 healthful exercise, as some pretend, is a fertile source of disease to 
 delicate female organizations. Rowing, Swimming and Boxing, 
 are useful for the strong, but dangerous, unless great caution be 
 taken, for those with weak hearts and lungs. Croquet and quoit 
 playing are admirable out-door sports in which invalids may join. 
 
 But our muscles cannot always be in motion; they are intended 
 
46 Structure and Action of the Body. 
 
 for interrupted, not continuous action. Rest and sleep are as neces- 
 sary as food and exercise. 
 
 A portion of each day must be devoted to repose and recreation, 
 as well as to exercise. 
 
 "Nor does Apollo always bend his bow." 
 
 In regard to the amount of sleep required, few can do with less 
 than eight hours, and the very young and old need ten or more. 
 While there are, doubtless, many sluggards, who relax their bodies 
 and dull their minds by too much sleep, most Americans do not 
 sleep enough. Time is better gained, for both brain work and hand 
 labor, by increasing the attention and energy when awake, than by 
 encroaching upon the hours which should be passed in bed. A 
 short nap in the afternoon is of great service to invalids and old 
 persons. The venerable President Thiers, a remarkably long and 
 hard intellectual worker, takes an hour's siesta every day, toward 
 evening. 
 
 Deformities. Stooping and relaxed figures, and round 
 shoulders, are better remedied by strengthening the muscles of the 
 back by judicious exercise, such as we have just recommended, than 
 by strapping on shoulder braces. Properly adjusted light steel 
 braces, with pads and springs, are, however, of service in cases of 
 " spinal irritation" and curvature. In our work upon female 
 hygiene, a The Physical Life of Woman," we have spoken of the 
 evil effects of tight lacing, and of improperly constructed braces 
 and supports, and need not here dwell upon the subject. 
 
 The application of exercise to medicine as a mode of treatment in 
 many diseased conditions, especially for the correction of deformities, 
 has of late received much and increasing attention. An enthusi- 
 astic Swede, Ling, first erected a building devoted to the art of heal- 
 ing by regulated exercise, known as "the movement cure." Such 
 institutions are now quite numerous in Europe. When we come 
 to speak of the various ailments of the body, we shall have occasion 
 to mention and describe these movements in their proper places, in 
 the treatment of the affections in which they may be usefully em- 
 ployed. 
 
The Different Classes of Bones. 
 
 47 
 
 III. The Bones and Joints. 
 
 The bones are intended to support the soft parts, the flesh of the 
 body, to form cavities for the protection of the delicate internal 
 organs, and to afford attachment to the various muscles. For these 
 purposes they are well fitted by their strength and hardness. 
 
 The analysis of the chemist shows that the bones consist of 
 one-third animal matter, as it is called, that is to say of gelatine and 
 blood vessels, and two-thirds of earthy matter, that is to say, of the 
 phosphate of lime, and other salts of lime, magnesia and soda. The 
 proportion of the animal to the earthy materials varies at different 
 ages. As we get older, the earthy matter in our bones increases in 
 quantity, while the animal matter loses both in quantity and 
 quality, hence the bones become more brittle, and as a consequence, 
 break oftener. In children, as the animal matter Fi s- 35. 
 is more abundant, the bones are more difficult to 
 fracture, and it is frequently seen after an injury to 
 a limb, which would have broken it outright in 
 more advanced life, that the bone is only bent or 
 partially broken, because of the large amount of 
 flexible animal matter it contains. Many of the 
 diseases to which the bones are liable depend upon 
 a change in the proportionate quantities of their 
 two constituents. This is observed in " rickets," a 
 disease common among the children of scrofulous 
 parents, where the bones become bent and curved 
 under the weight of the body or the action of the 
 muscles. 
 
 Bones are divided according to their shape, into 
 four classes: long bones, short bones, flat bones 
 and irregular bones. 
 
 The Long Bones are placed, principally, in the 
 
 limbs, where they act as levers, sustain the weight 
 
 of the body, and ^e us our powers of motion. 
 
 They are hoL to f blinders, the central canal 
 
 being filled up wi f „ ow. Figure 35 shows the 
 
 ^high bone, one of the long bones of the body. The Thigh Bone. 
 tl tii 'iii t% j j Example of the 
 
 he short Bones are strong and compact, and are Long Bones. 
 
4 8 
 
 Structure and Action of the Body. 
 
 placed where only slight and limited motion is wanted, as in the 
 wrist. Figure 36 shows the bones of the wrist. The Flat Bones 
 
 Fig. 37. 
 
 Fig.? 
 
 Wrist Bones— Example of the 
 Short Bones. 
 
 Shoulder Blade— Example of the 
 Flat Bones. 
 
 Fig. 38. 
 
 are thin, broad, flat plates, intended to afford extensive protection to 
 the parts beneath, or to provide a wide surface for the attachment 
 of muscles. The bones of the skull, the breast bone, and the shoulder 
 blades, are examples of flat bones, one of which the shoulder blade, 
 is shown in figure 37. 
 
 Irregular or Mixed Bones are those 
 which, on account of their shape, 
 cannot be grouped either under the 
 long, short or flat bones. Examples 
 are seen in the chain of bones which 
 make up the spinal column, the 
 vertebrae, as they are called, and in 
 the jaw bones. Figure 38 shows, as 
 an example of th^ irregular bones, a 
 vertebra. \: r ^ 
 
 The body containsWo hundred and 
 irregular Bones. f our distinct bones. These are jo) ^ 
 
 together, and form what is called the skeleton. The skull is a 
 
 A Vertebra — Example of the 
 
The Back Bone. 
 
 49 
 
 posed of 8 bones; the face of 14; the ears of 6; the backbone of 
 26 ; the chest of 26 ; the upper limbs of 64 ; the lower limbs of 
 60. Children have a few more bones than adults, as a number of 
 their bones afterward unite to form one. 
 
 These bones grouped together make up the three great divisions 
 of the body, the head, the trunk, and the extremities. 
 
 The head includes the skull and face. The skull is a large, bony 
 cavity, made up of eight wide, thin and arched bones, immovably 
 dovetailed into each other. It contains the brain, and gives passage 
 to the spinal marrow through a hole in its lower part, communicat- 
 ing with the canal of the backbone. The face is formed of fourteen 
 bones, the principal being the upper and lower Fi s- 39 - 
 
 jaws, and of the organs of sight, smell and 
 taste. These bones, like those of the skull, are 
 of complicated forms and difficult to describe. 
 The backbone or spine, is the main support 
 of the trunk of the body. It is composed of 
 twenty-six distinct bones, called vertebras, 
 placed one above the other so as to form a 
 pillar or column, on the top of which is the 
 head, so joined as to move freely upon it; see 
 Figure 39. Seven of these vertebrae belong to 
 the neck, twelve to the back, five to the loins, 
 and two make the lower end of the column. 
 Anatomists give to these the names, derived 
 from the Latin, of cervical, dorsal, lumbar and 
 sacral vertebrae. They increase in size and 
 strength from above downward, so that the 
 bones of the loins (the lumbar vertebrae) are 
 much larger and stronger than those of the 
 neck and back. Those of the back (the dorsal 
 vertebrae) have attached to them the ribs, twelve 
 in number, on each side, which arch forward 
 and are joined to the breast bone by gristle, 
 forming the cavity or cage of the chest, to 
 contain the heart and lungs, see Figure 40. 
 This cavity is separated from that of the belly 
 5 
 
SO Structure and Action of the Body. 
 
 Fig. 40. 
 
 Fig. 41. 
 
 The Bones of the Abdo- 
 men. 
 
 The Chest Cage. 
 
 or abdomen, which lies below it, by a muscular curtain attached 
 
 to the edge of the lower ribs, called the diaphragm, or midriff. 
 
 Fi s- 42 - The cavity of the belly or abdomen, which 
 
 contains the stomach, liver, spleen, bowels, 
 
 kidneys, etc., is protected in front and at 
 
 the sides by skin, fat and muscles only, 
 
 and has no bony walls excepting below 
 
 and behind. Its floor is made up of 
 
 four bones attached to the lower end of 
 
 the back, and spread out so as to form 
 
 a sort of basin, called by anatomists, the 
 
 pelvis, see Figure 41. 
 
 Having thus passed in review the bony 
 framework of the head and of the trunk 
 of the body, it only remains for us to 
 say a few words on the extremities or 
 limbs, see Figure 42. The upper ex- 
 tremity is composed of the shoulder, 
 which has two bones, the collar bone and 
 The Skeleton. the shoulder blade, connecting it with the 
 
The Different Kinds of Joints. 5 1 
 
 trunk; of the arm, which has only one bone, extending from the 
 shoulder-joint to the elbow; of the forearm, which has two bones, 
 extending side by side from the elbow to the wrist; of the wrist, 
 which has eight short bones; and of the hand, which has four 
 bones in each of the four fingers, and three in the thumb. The 
 ends of these bones, where they are joined together, are smooth 
 and polished, so as to move freely and easily upon each other. 
 
 The lower extremity is composed of the thigh bone, the 
 largest and strongest bone in the body, which extends from the hip 
 joint to the knee; of the knee-pan, placed in the sinew of the large 
 muscle lying in front of the knee joint; of the two bones of the leg, 
 extending side by side from the knee to the ankle ; of the ankle, 
 which has seven small bones, one pointing out behind to form the 
 heel; and of the foot, which has the same number of bones as the 
 fingers and thumb, but shorter, and incapable of moving so freely 
 upon each other. 
 
 All of these two hundred and four bones which compose the 
 head, trunk and extremities, constituting "the skeleton," are con- 
 nected together by means of joints. Some of these joints, like 
 those uniting the bones of the skull, are immovable, but most of 
 the others are movable joints. The movable joints are surrounded 
 by strong, flexible bands, called ligaments,' which keep the ends of 
 the bones together in place, while permitting of perfect freedom of 
 movement. When, by severely applied force, the ends of the 
 bones, in spite of the resistance of the bands surrounding them, are 
 thrown out of place, the joint is said to be dislocated. The treat- 
 ment of dislocations will occupy us in the part of this volume 
 devoted to accidents and injuries. 
 
 There are four hinds of movable joints : The Gliding Joint, in 
 which the surfaces of the bones glide upon each other, as is seen in 
 the joint between the breast and the collar bones. The Ball and 
 Socket Joint, in which a round head is received into a cup-like 
 cavity, permitting of motion in every direction, as is seen in the 
 hip and shoulder joints. The Hinge Joint, in which the only 
 motion is backward and forward, as is seen in the elbow and knee. 
 The Pivot Joint, in which a pin-like process turns within a ring, as 
 is seen in the attachment of the head to the spinal column. 
 
52 Structure and Action of the Body. 
 
 Various deformities in the position and shape of the bones are 
 met with. The defect frequently spoken of as the "growing out 
 of the shoulder blades," is one of the penalties of tight lacing, in 
 girlhood. It also occurs in feeble children growing too rapidly, 
 and then calls for nourishing food and healthful exercise. Constant 
 confinement, writing or painting, with one arm elevated and the 
 other at rest, gives the shoulders a "one-sided" appearance, and the 
 habit of leaning forward imparts to the chest a "dished" appear- 
 ance, particularly displeasing in women. "Chicken-breasted" or 
 narrow-breasted children require especial attention to their health, 
 little study, and vigorous out-door country life, to escape the fatal 
 disease of the lungs with which they are threatened. "Club-foot" 
 is usually found at birth, but may be developed afterward by fits, 
 spasms, or a vicious habit of walking, owing to the presence of a 
 corn, or sore, which causes the person to tread on one side of the 
 foot, and so distort the bones. It may affect one or both feet, and 
 should always receive prompt attention from the surgeon, when a 
 perfect cure may be confidently expected. The longer the necessary 
 surgical treatment is deferred the more difficult and the more unsat- 
 isfactory the operation becomes. Parents who allow children to 
 grow up with this deformity, now so readily remediable, are guilty 
 of a great wrong. The usual cause of "bandy legs" or "bow-legs," 
 is allowing children to walk too soon, at a time when there is too 
 little of that earthy matter, of which we have been speaking, 
 in the bones of the legs, in proportion to the animal matter, to 
 support the weight of the body without bending. Once bent in 
 this way they cannot be straightened. 
 
 The Teeth. Though born toothless, we are afterward furnished 
 with two sets of teeth, which appear at different periods of life. 
 The first set, called temporary, milk, or baby teeth, present them- 
 selves in infancy. They are twenty in number, four front, two 
 canine, and four grinders in each jaw. The second set, called 
 permanent teeth, also appear early in life. They are thirty-two in 
 number. In each jaw there are four front or cutting teeth (termed 
 also incisors), to divide the food ; two canine (the upper are also called" 
 eye teeth), to pierce the food ; four small or false grinders (named also 
 bicuspids), and six grinders or molars, to grind the food. The last 
 
The Teeth. 
 
 53 
 
 arrivals, the third grinders, or those furthest back in each jaw, have 
 received the name of wisdom teeth, from their late appearance 
 through the gum. Occasionally a third set of teeth re-garnish the 
 mouth in very advanced life, which are as solid and serviceable as 
 their predecessors. 
 
 A few words upon the structure of the teeth. Each tooth has 
 three parts: the crown or body, which projects above the gum; the 
 root or fang, by which it is attached to the jaw; and the neck, 
 which is the narrowed part just below the crown. 
 
 Fig. 43. 
 
 The Permanent Teeth. 
 Figure 43 shows the shape of each of these different teeth, in 
 the order in which they occur, on one side of each jaw. On cutting 
 through a tooth a cavity will be found to exist inside, occupying the 
 center of the crown, and running down into each root, to a very 
 small opening at its extremity. This cavity Fig. 44. 
 
 contains the pulp of the tooth, and is furnished 
 with blood vessels and nerves through the small 
 openings at the ends of the roots. This is shown 
 in Figure 44. The solid part of the tooth is 
 composed of three different substances: the ivory, 
 or tooth bone (called also the dentine) ; the enamel, 
 which covers the crown; and the cement, which 
 covers the root and sets it in its socket. The a Grinder? 
 
 enamel, the hard and white glittering armor of the tooth, should be 
 carefully cared for, as upon its preservation depends that of the 
 5* 
 
54 Structure and Action of the Body. 
 
 whole tooth. If chipped off, or eaten through by decay, the tooth soon 
 rots and aches. Being mainly composed of lime, it is readily corroded 
 or softened by anything that is sour. The constant use of acid 
 fruits or fluids, as also of very hot or very cold foods or drinks, unless 
 great caution be exercised, is injurious. But, by far the greatest 
 source of injury lies in the fermentation of particles of food indo- 
 lently left between the teeth. For this reason, the habit should be 
 formed of rinsing the mouth and picking the teeth (but only 
 with a quill, ivory, tortoise shell or gold pick), after each meal. 
 The enamel is sometimes observed to change in color with the state 
 of the health. Thus, in bilious people it turns yellow, and in 
 consumptive people it occasionally becomes of an unnatural pearly 
 whiteness. Receipts for the care of the enamel, by tooth powders 
 and mouth washes, we give later on in their place in the work ; for 
 the page consult the index. 
 
 The teeth of the upper jaw, in consequence of its having a larger 
 curve than the lower, overlap the teeth of the lower jaw. Thus 
 the edges of the cutting teeth do not blunt each other, as they would 
 if they met. 
 
 The periods for the appearance of the first set (the temporary, 
 milk, or baby teeth) are as follows : — 
 
 Seventh month, the middle front. 
 
 Seventh to tenth month, the side front. 
 
 Twelfth to fourteenth month, the front grinders. 
 
 Fourteenth to twentieth month, the canine. 
 
 Eighteenth to thirty-sixth month, the back grinders. 
 
 The second set (the permanent teeth) appear at the following 
 periods, those of the lower jaw showing themselves a short time 
 before those of the upper: — 
 
 Six and a half years, the first grinders. 
 
 Seventh year, the two middle front. 
 
 Eighth year, the two side front. 
 
 Ninth year, the first false grinders, or double teeth. 
 
 Tenth year, the back false grinders, or double teeth. 
 
 Eleventh to twelfth year, the canine. 
 
 Twelfth to thirteenth year, the second grinders. 
 
 Seventeenth to twenty-first year, the wisdom teeth. 
 
The Teeth. 55 
 
 Hygiene of the Teeth. When there is a hereditary tendency 
 to decay of the teeth, especial care should be taken to keep the 
 spaces between them clean and bright. Sometimes, particularly in 
 the case of young girls, the tops of the gums, which become spongy 
 or swollen, hang down between the teeth, and so conceal decay 
 until serious mischief has been done. The teeth should be brushed 
 with a soft brush, every morning and evening, and a toothpick 
 used, and the mouth rinsed out with tepid water after every meal, 
 to prevent the accumulation of particles of food between the teeth. 
 The enamel of the teeth is quickly attacked by the acids generated 
 by the decomposition of fragments of food suffered to find a lodging 
 place between the teeth. 
 
 To keep the teeth clean, and prevent the deposit of tartar, it is 
 not sufficient to brush their fronts. The backs of the teeth, par- 
 ticularly those of the front teeth of the lower jaw, require attention. 
 A useful brush is especially made for this purpose, and sold by 
 most druggists. 
 
 A tooth-sponge is often preferable to a tooth-brush, which, if it 
 be hard, hurts the gums and wears the enamel. It is made by 
 attaching a piece of fine sponge, about the size of a walnut, to a 
 handle, and furnishes a very pleasant substitute for a brush when 
 the gums are tender. The sponge enters the inequalities of the 
 teeth more readily than bristles, does not uncover the necks of the 
 teeth by rubbing away the gums, as sometimes happens from inju- 
 dicious friction with a brush, and can be easily kept clean. 
 
 When, in consequence of advancing years, or of neglect of hygiene, 
 the teeth decay and drop out, their place should be supplied by 
 artificial ones, the making of which has now become such an art, 
 and one in which American dentists have acquired so much celeb- 
 rity. Much of the dyspepsia of old age is to be attributed to the 
 inability to properly chew the food and mix it with the saliva. 
 In such cases, the dentist is the best doctor, and a set of artificial 
 teeth the best stomachic. Attention to this suggestion will, in 
 many instances, remove prolonged ill health, of which the true 
 cause has not been suspected. 
 
CHAPTER II. 
 
 THE INSTRUMENTS OF THE BODY AND THEIR OFFICES. 
 
 Section I.— The Air Passages and Organs.— The Lungs— Their struc- 
 ture and use — What happens to the breathed air in the air tubes and 
 cells — On ventilation — Simple ways of changing the air in a room without 
 draughts. 
 
 Section II. — The Food Passages and Organs. — The manner in which 
 food reaches the stomach — The process of digestion — The structure of 
 the stomach and bowels — Classification of food — Practical directions for 
 the corpulent for reducing flesh— How to become stouter — Appetite and 
 hunger. 
 
 Section III.— The Blood Passages and Organs.— The structure and 
 action of the heart — The course of the blood — The capillary vessels, 
 what they are and how they act — The arteries and veins — The changes 
 taking place in the blood, in the lungs, and in the network of small ves- 
 sels — The office of the blood — How at the same time it nourishes and 
 purifies the body. 
 
 Section IV.— The Waste Passages and Organs.— The action of the 
 lungs, the skin, and the kidneys, in removing the products of waste and 
 decay. 
 
 Section V.— The Special Senses.— The five gateways of knowledge— 
 Of Smelling— How effected — The nose a respirator — Uses of the sense of 
 smell — Its duties as a sentinel— Of Tasting — The manner in which the 
 impression of taste is produced — The importance of pleasing the palate 
 of the sick — Of Touch— The feelers of the skin — Of Hearing — The struc- 
 ture of the ear — How sound reaches the brain — Hints on the hygiene of 
 the ear — Of Seeing — The structure of the eye — The offices of its different 
 parts — A ray of light on its journey to the retina — Defects of the eye, 
 their cause and prevention — Short sight — Long sight — Old sight. 
 
 Section VI.— The Brain and Nerves. — The structure of the brain- 
 Its office — The distribution of the nerves — Their office. 
 
 Hitherto we have been occupied with the framework of the 
 body, its coverings and its motions. But the skin, the muscles and 
 the bones, are not the most important parts of our bodies. Within 
 this framework are certain instruments or organs, which perform the 
 
 56 
 
The Instruments of the Body and their Offices. 57 
 
 various offices which keep us in life. In order to live we must 
 breathe and eat, our blood must circulate, and the waste products 
 of our bodies must be thrown out of the system; for these pur- 
 poses we areJurnished with air, food, blood, and waste passages and 
 organs. In order to enjoy life, provide ourselves with food, and 
 protect ourselves against injury, we are furnished with special 
 senses, five in number, sight, hearing, smell, taste and "touch. We 
 shall, therefore, complete our study of the structure and action of 
 the body, by a consideration of these various passages and organs, 
 and of the senses, which are their servants and guards. 
 
 I. The Air Passages and Organs. 
 
 The air enters the cavities or sacs of our bodies called lungs, by 
 means of the windpipe or air tube, which is divided into two 
 bronchial tubes, which go on breaking in twos and twos, until the tubes 
 
 The Lungs, 
 are hardly larger than thick pins. Each of these ultimate delicate 
 tubes end in a little cell or pit, called the " pulmonary cell" or 
 "vesicle," which is only $% of an inch in diameter. This distribu- 
 tion of the windpipe and its branches is well shown in Figure 45. 
 
58 Structure and Action of the Body. 
 
 W is the windpipe, dividing into the right and left bronchial tubes, 
 3, which go on subdividing. B indicates the blood vessels which 
 accompany the bronchial tubes; 1, being the pulmonary artery, 
 conveying blood to the lungs ; 2, the pulmonary veins, returning it 
 back to the heart. Of the use of these arteries and veins we shall 
 have to speak directly, when we come to the blood passages. The 
 space around the air cells is filled with spongy structure, and the 
 lungs themselves are covered or clothed with a smooth membrane, 
 called the pleura. It is the inflammation of these air cells and of 
 the spongy structure about them, which makes the disease known 
 as lung fever, or pneumonia; inflammation of the membrane 
 covering the lungs is what is known as pleurisy; inflammation of 
 the lining membrane of the air tubes constitutes bronchitis. These 
 diseases and their treatment will be discussed in the second part of 
 this work, devoted to the ailments of the body. 
 
 The air, entering by the mouth and nostrils, is conveyed, by 
 the windpipe and its numerous branches, to the minute lung-cells, 
 where it comes in contact with a thin layer of blood spread out 
 around the walls of each cell in tiny blood-vessels. An important 
 change there takes place in the blood thus exposed to the action of 
 the air, which we shall explain shortly. 
 
 The lungs are filled with air by the expansion of the chest, 
 effected by the muscles around the ribs, and by the large muscular 
 curtain, the diaphragm, already described, separating the chest from 
 the abdomen. The action of these muscles, though to a limited 
 extent under the control of our will, goes on as previously mentioned, 
 without our knowledge or assent. Death ensues from stopping the 
 motion of the chest, as nearly happened in the case of a negro, 
 whose fine bust induced some artists to take a mould of it. As 
 the plaster in which he was encased set, he could neither cry out 
 nor breathe, and would have perished, if one who knew the actions 
 of the body had not come in and dashed to pieces the cast. With 
 each movement of respiration, we take in and discharge from the 
 lungs about twenty cubic inches, or nearly half a pint, of air. As 
 we breathe about eighteen times a minute, we inspire about three 
 hundred and sixty cubic inches of air a minute, fourteen cubic feet 
 an hour, or nearly three hundred and fifty cubic feet daily. 
 
The Lungs and Their Work. 59 
 
 What happens to the air thus breathed? Most of our readers 
 know that the atmospheric air is almost entirely a mixture of two 
 gases, oxygen and nitrogen, in the proportion of about one-fifth 
 oxygen to four-fifths nitrogen. It also contains a very small quan- 
 tity of carbonic acid gas, about one part in two thousand, a varying 
 amount of watery vapor, and some traces of ammonia. But these 
 ingredients are altogether insignificant beside the oxygen and nitro- 
 gen which constitute its great mass. After expulsion from the 
 lungs, the air is found, when collected and examined, to have 
 undergone the following important changes : it has lost oxygen, it 
 has gained carbonic acid, and it has absorbed the vapor of water. 
 It has also become somewhat warmer. But by far the most import- 
 ant change which has taken place in the breathed air, is its loss of 
 oxygen and its absorption of carbonic acid. The lost oxygen has 
 gone to, and the gained carbonic acid has come from, the blood, 
 passing through the thin covering of the blood-vessels spread in a 
 fine network about the air-cells of the lungs. This supply of oxygen 
 to the blood, and the escape of carbonic acid from it, is necessary to 
 life ; if it be interrupted only for a few minutes, death follows. 
 
 The carbonic acid thus thrown out contaminates the air about 
 us, and unfits it for rebreathing. The quantity exhaled from the 
 lungs varies with the sex, the age, and the constitution. Men 
 produce a larger quantity than women, usually nearly twice as much 
 between the ages of sixteen and forty. The quantity increases in 
 the male from eight to thirty years of age, and then begins to 
 decrease, so that near the close of life the quantity may be no 
 greater than at ten years of age. With women, on the contrary, 
 the quantity increases from eight years of age until about the four- 
 teenth year is reached, and then remains stationary until about the 
 age of forty, when it decreases, as in men, towards old age. The 
 stronger the constitution and the more developed the muscles, the 
 greater the quantity of carbonic acid given off from the lungs in 
 both sexes. The quantity is increased during digestion and active 
 exercise ; lessened by sleep, repose, fatigue, and whatever interferes 
 with perfect health. 
 
 The process of breathing is not strictly limited to the lungs, but 
 this exchange of oxygen from the air for carbonic acid from the blood, 
 
6o 
 
 Structure and Action of the Body. 
 
 Fig. 46. 
 
 takes place, to a certain extent, through the skin, as mentioned in the 
 chapter on the external coverings of the body. That this exchange 
 of gases actually takes place through the skin, has been ingeniously 
 proved by enclosing one of the limbs in an air-tight case, when it 
 was found that the confined air lost oxygen and gained carbonic 
 acid. It is supposed that from the whole surface of the human body 
 a quantity of carbonic acid escapes equal to about one-sixtieth to one- 
 thirtieth of that given off, during the same period, from the lungs. 
 We now understand why rebreathed air and close rooms are 
 poisonous, and see the necessity of 
 ventilation, the object of which is to 
 furnish us with a constant supply of 
 pure air for breathing. 
 
 Ventilation. Air, to be fit for 
 breathing, should be changed at the 
 rate of about two thousand cubic feet 
 an hour for each person. In construct- 
 ing houses, every room should be fur- 
 nished with ventilators, on the system 
 of "base ventilation," which permits of 
 the escape of the vitiated air, not from 
 the top of the room, but from openings 
 near the floor. The open fire-place 
 acts upon this principle, and, as is well 
 known, is one of the best of ventilators. 
 The windows are the only means for 
 ventilation provided in most houses; 
 and as these are closed in stormy 
 weather, and occasion direct drafts 
 when open, they answer the purpose 
 very imperfectly. A number of inge- 
 nious window-sash ventilators have 
 been lately invented and patented, 
 which are permanently fitted to the 
 sash, and supply fresh air in small 
 Window Sash Ventilator. currents, without any direct draft, while 
 the window itself is closed and securely fastened. A simple, effective, 
 
How to Make a Ventilator of a Window. 61 
 
 and " non-patented " window ventilator may be readily made out of a 
 piece of board the exact breadth of the lower sash. This board is 
 placed under the lower sash, which is thus raised a few inches, and 
 its upper edge elevated above the lower edge of the upper sash, so 
 that a current of air passes through the opening so formed, without 
 causing any direct draft. Figure 46 gives a very clear idea of this 
 simple method of ventilation. A represents the piece of wood, an 
 inch or more in thickness, three inches wide, and the length of the 
 breadth of the window. If this slip be well fitted, no draft will 
 occur between it and the sill, or the frame of the sash. D shows 
 the separation between the lower edge of the upper sash and the 
 upper edge of the lower ; and the arrows the perpendicular currents 
 of air passing in and out of the room, without any inconvenience 
 from draft or exposure to rain. 
 
 II. The Food Passages and Organs. 
 
 The body is a working machine, and, like all other machines, 
 wears away in use. Our bones and muscles, so firm and strong, 
 need constant repair to keep them so. For this purpose, food is 
 necessary, and a series of instruments or organs by which it may be 
 changed within us into flesh and bone. We are, therefore, furnished 
 with teeth to chew, palates to taste, throats to swallow, stomachs to 
 digest, and bowels to carry off refuse matter. 
 
 Food, in the first place, is taken into the mouth. It is there 
 mixed with saliva, and cut and ground into a sort of paste by the 
 jaws and teeth. The lower jaw moves in every way, so that we 
 chop like a dog and grind like a cow. This operation is a very 
 necessary one, and should never be hastily performed. If the food 
 be bolted in undivided masses, it lies for a long time in the stomach, 
 which it irritates and disturbs, while, if well chewed, it is readily 
 attacked by the juices of the stomach and quickly digested. The 
 chewed mass, when swallowed, enters a long muscular canal, the 
 gullet, which passes through the chest, behind the heart and lungs, 
 and is thus conveyed to the stomach. The stomach is an irregularly 
 shaped muscular bag or sac, curved upon itself, lying in the upper 
 part of the abdomen, at the spot commonly named the " pit of the 
 6 
 
62 Structure and Action of the Body. 
 
 stomach." It is the principal organ of digestion, measuring in the 
 average, when moderately full, about twelve inches across and about 
 four inches up and down, and containing easily a quart of water. It 
 is capable, however, of great extension or contraction, according to 
 the amount put into it. There are two openings ; one at its highest 
 part, communicating with the gullet, the other a lower one, on its 
 right side, communicating with the small bowels. The food here 
 comes in contact with a peculiar fluid, called the gastric juice, with 
 which it is thoroughly intermixed by the movements of the stomach, 
 which rock, as it were, the food to and fro. The gastric juice is 
 nearly tasteless, colorless, and odorless, but acts in a most powerful 
 manner upon the substances exposed to its influence, converting 
 them into a grayish mass, like thick cream, called chyme. The 
 process of digesting or dissolving the food in the stomach being 
 thus completed, a portion of it is slowly taken up by the veins, and 
 the rest passes out through the lower opening into the small or first 
 bowel. Liquids taken into the stomach are, for the most part, 
 sucked up by the blood-vessels in its walls, and do not enter the 
 small bowel. The solid food, thus converted into chyme, is now 
 subjected, in the small bowel, to the action of the bile and the pan- 
 creatic juice. The bile is a very bitter fluid, prepared by the liver, 
 a large organ placed in the right side of. the abdomen, just beneath 
 the ribs. The bile is collected in the gall bladder, where it is re- 
 served for use. The pancreatic juice, which looks very much like 
 the saliva, is prepared by the pancreas, an organ lying just below 
 the stomach. Neither sugar, starchy nor oily or fatty matters are 
 dissolved in the stomach, but in the small intestine, by the action 
 of these two fluids, which also secure the proper digestion of other 
 parts of the food that may have escaped the stomach. When the 
 chyme comes in contact with these two fluids, it is separated into 
 two parts, the one a thin, whitish, milk-like liquid, called chyle; the 
 other is the portion of the food unfit for nourishment, which is re- 
 jected and thrown out of the bowels as useless. The chyle is sucked 
 up by an army of minute vessels, which have their mouths in the 
 walls of the small bowel. It is emptied by these numerous vessels 
 into a long tube, about the size of a goose-quill, called the thoracic 
 duct This duct, eighteen to twenty inches in length in the adult, 
 
The Food Passages and Organs, 63 
 
 ascends the abdomen along the back, resting against the spine, and 
 pours its contents, under the left collar bone, into the vein coming 
 from the left arm, where they mingle with the blood, and so the 
 food finally enters the circulation, becomes a part of the blood, and 
 is carried throughout the body by the heart, arteries and veins. 
 
 The colored frontispiece of this book shows in a beautiful manner 
 these food passages and organs, in a way which makes them clear to 
 every one. On lifting the leaf an inside view of the cavities of the 
 chest and abdomen is obtained. We see the little white vessels carry- 
 ing the chyle, coming from all points, grouping themselves into knots, 
 and finally uniting to constitute the reservoir of the thoracic duct, 
 vp } from which the duct, c t, starts, which ascends, resting against 
 the spinal column, passing behind the blood vessels of the neck, and 
 opening into the vein coming from the left arm, v s g. Over this 
 picture of the open trunk is seen one of the digestive canal, from 
 the mouth to the lower bowels, namely, the mouth, b; the gullet, 
 se; the stomach, e; the opening from the stomach to the small 
 bowel, py; the liver,/; the small bowel, Hi; the pouch which 
 begins the large bowel, cce; the transverse portion of the large 
 bowel, c t, and the descending portion of the large bowel, c d. 
 
 The small bowel is that part of the digestive canal where the food 
 already acted upon by the stomach and converted into what is called 
 chyme, as already explained, is mixed with the bile, the pancreatic ~ 
 juice, and the products of various glands imbedded in the walls of 
 the bowel, and where the separation of the nutritive principle of the 
 food, called chyle, is effected, as we have just shown. It is a curved 
 or rolled up tube, twenty feet long, with folds to prevent the contents 
 from passing along too rapidly, with little pits and gland-cells, which 
 pour out fluid, and with minute processes projecting from its walls, 
 through which the small white vessels, called lacteals, suck up the 
 chyle, to carry it to the reservoir, in the manner just pointed out. The 
 small bowel is designated by the letters Hi in the colored frontispiece. 
 
 The large bowel is about five feet long, and passes from the right 
 haunch, where it has valves to prevent its contents from returning 
 into the small bowel, to below the left haunch. The muscles in the 
 walls of the bowels, which, as was pointed out in speaking of the 
 muscular system, in the first chapter, belong to the class of involun- 
 
64 Structure and Action of the Body. 
 
 tary muscles, give worm-like movements to the bowels, which propel 
 their contents and expel them when all that is useful to the blood 
 has been extracted. 
 
 Food may be divided into those articles that warm us, as fat, starch 
 and sugar, and those that form us, as the flesh of animals. The 
 heat-foods are also fattening foods. Hence the corpulent should be 
 chary in the consumption of fats and vegetables, which contain 
 starch and sugar in large quantities ; on the contrary, those who are 
 too lean should partake freely of these substances. The articles 
 which the corpulent should specially be frugal in the use of are : 
 bread, butter, milk, sugar, sweet and white potatoes, molasses, fat 
 meat, Indian corn, pastry, beer. The more nearly these articles are 
 excluded altogether from the table, the more rapid will be the reduc- 
 tion of weight. At the same time, as little fluids of all kinds should 
 be drank as is consistent with comfort. To decrease in size, the diet, 
 therefore, should consist principally of animal food. To increase in 
 size, a diet largely vegetable is required : among the vegetables, the 
 roots are ordinarily particularly fattening, while those which ripen 
 above ground are less so. The articles which spare persons should 
 avoid if they desire to become stouter are : pickles, vinegars, highly 
 spiced food, sour wines or fruits, acid vegetables. Those who think 
 themselves too fat or too thin, should frequently weigh themselves, 
 so as to learn what articles of food are, in their individual cases, 
 the most fattening. Thus some have found in their own persons 
 that sugar is that which most rapidly heaps up fat ; others find 
 fresh milk the most fattening ; while with not a few, starch, in the 
 form of arrowroot, sago, tapioca, or farina, is the most rapidly 
 converted into fat. 
 
 The above remarks contain, in a few words, the secret of 
 Bantingism, the doctrines of Mr. Banting, that pursy Englishman 
 whose writings on corpulence have lately attracted so much attention. 
 
 The foods which principally furnish us with heat and fat, have 
 also nearly all the business of supplying us with force to work the 
 machinery of the body. The body may be aptly compared to the 
 steam engine, and food to its fuel. The masses of iron, steel and 
 brass which make up the engine, are as useless without the fuel to 
 create heat, and thus force and motion, as would be the bones,, 
 
Appetite and Hunger. 65 
 
 muscles, sinews, blood vessels and nerves, which make up our body, 
 without the food to give birth to heat and force within us. But 
 the steam engine differs from the human body, in the fact that its 
 parts, when they wear out, can be removed and renewed. No such 
 rough method of repair is possible in the case of the body, which is 
 a machine constantly working, constantly wasting, and constantly 
 repairing its. own wear and tear. Food is, therefore, more to us 
 than fuel is to the steam engine; as it has the threefold office of 
 supplying us with heat, with the means of motion, and with the 
 elements of repair. Hence it must consist of more than one kind 
 of material. If we regard bread and meat as the staple of life, we 
 find all that is necessary for the threefold mission of giving heat, 
 force and substance. The bread is composed chiefly of starch, 
 which may be compared to the coal of the steam engine; the meat 
 is composed of two parts, the fat and the lean, of which the former aids 
 the starch in propelling the machine, and the latter repairs the waste. 
 A few hours' want of food causes, in a healthy person, appetite; 
 longer abstinence, gives rise to hunger. The symptoms of starva- 
 tion, faintness, coldness, shrinking of the body, and wandering of 
 the rnind, result, if no food be had for a day or two. Death ensues, 
 usually, at the end of about a week's total deprivation of food and 
 water, that is to say, when the body has consumed about two-fifths of 
 itself, for when a person has nothing to eat he lives upon himself. 
 But if water be taken, a case upon record shows that life may be 
 prolonged, entirely without solid food, during thirteen days. Thirst is 
 more quickly fatal than hunger, because of the thickening of the 
 blood which rapidly takes place. An urgent feeling of hunger is 
 not a prominent symptom in cases of gradual starvation ; if it exist 
 at first it soon disappears, and is followed by a feeling of exhaustion, 
 faintness, and even loathing of food, and death is ushered in by 
 listlessness and torpor. Thus we find in this, as in other modes by 
 which death may approach, 
 
 " Many are the ways that lead 
 To his grim cave, all dismal ; yet to sense 
 More terrible at the entrance than within." 
 
 The proper treatment of starvation will occupy us when we come 
 to speak of the ailments of the body. It is an important subject, 
 G* 
 
66 Structure and Action of the Body. 
 
 as not only sailors and travelers, but also the poor waifs of our streets 
 (for people yet die of quick as well as slow starvation in our large 
 cities), have, when rescued, lost their lives through the ill-advised 
 efforts of their zealous but ignorant benefactors. 
 
 III. The "Blood Passages and Obgans. 
 
 The blood in our bodies is in constant motion. This motion is 
 called the circulation, and takes place through the heart, arteries 
 and veins. The mainspring of the circulation is the hollow muscle 
 called the heart ; the pipes or canals which carry the blood from the 
 
 Fig. 47. 
 
 Inside of the Heart. 
 
 heart to the different parts of the body are called the arteries, and 
 those which bring it back to the heart after it has made its course 
 are called the veins. 
 
 The heart, in size somewhat larger than the fist, is double, con- 
 sisting of two parts, each forming a complete and distinct organ. 
 They are separated from each other internally, though their walls are 
 united externally, and are known under the names of the right and 
 
The Blood Passages and Organs. 67 
 
 left sides of the heart ; one, the right, pumping the blood to the lungs ; 
 the other pumping it through the body. They are each subdivided 
 into two rooms or cavities, holding about a wineglassful of blood, 
 the upper, called the auricle, the lower, called the ventricle. This 
 is well shown in Figure 47, representing the heart cut through, with 
 each half turned back, so as to display the structure of the two sides, 
 which, it must not be forgotten, do not communicate directly the 
 one with the other. 
 
 The right side of the heart has its own work to do, very different 
 from that performed by the left side. It is the province of the right 
 side to receive the blood from all parts of the body, brought to it by 
 two veins, which open into the right auricle, ra, whence it passes 
 into the right ventricle ry, and to send it to the lungs through the 
 large vessel, shown in the figure, called the pulmonary artery. It is 
 the province of the left side of the heart, on the contrary, to receive 
 the blood from the lungs, brought to it by four veins, called the 
 pulmonary veins, which open into the left auricle, la, whence it passes 
 into the left ventricle, Iv, and to send it to the body through the large 
 artery, shown in the figure, called the aorta. The direction of the 
 arrows indicate the course of the blood. Thus, it will be seen, there is 
 a double circulation as well as a double heart ; one round of circulation 
 from the lower chamber of the right side of the heart (the right 
 ventricle), through the lungs, to the upper chamber of the left side 
 of the heart (the left auricle) ; the other round of circulation from 
 the lower chamber of the left side of the heart (the left ventricle), 
 through the body, to the upper chamber of the right side of the 
 heart (the right auricle). 
 
 The rapidity with which the blood circulates through the body 
 varies at different hours of the day, being the greatest when the 
 necessity is the most urgent. After a meal, for instance, the heart's 
 action is increased, rising a number of beats per minute, for one and 
 a half to two hours, or more, after which it lessens until the next 
 meal, when it again rises and falls. The pulsation of the heart 
 is the slowest and the most feeble during the night, between two 
 and five in the winter, and between one and three in the summer. 
 At these hours, therefore, many persons who are very ill die, and 
 the sick require the most careful watching. 
 
68 Structure and Action of the Body. 
 
 Figure 48 shows a scheme or plan of the circulation. The 
 uppermost circuit is that of the head, neck, and arms, the middle 
 that of the lungs, and the lower that of the trunk and lower limbs. 
 Fig * 48 - The lines on the right side of 
 
 the figure (the left side of the 
 heart) indicate arteries, by which 
 the blood is conveyed from the 
 heart ; the lines on the left side of 
 the figure (the right side of the 
 heart) indicate the veins, by which 
 the blood is returned to the heart. 
 The course of the blood through 
 the heart is, therefore, as follows : 
 From the two great veins, one 
 from the upper, and the other 
 from the lower part of the body, it 
 passes into the right auricle, ra, 
 Figure 47, and from the right 
 auricle into the right ventricle, rv. 
 This right ventricle contracts forci- 
 bly, driving the blood through the 
 pulmonary artery to the lungs, it 
 being prevented from returning 
 into the right auricle by the clos- 
 ing of the little doors or valves 
 which guard the opening. Re- 
 turning from the lungs, it enters, 
 by the four pulmonary veins, the 
 left auricle, Za, thence passes into 
 the left ventricle, Iv, from which it 
 
 is driven with great force into the 
 Plan of the Circulation of the ^ ^^ ^ aQrta? which dig _ 
 
 tributes it, by means of its ramifications, throughout the body. 
 The passage ways from the auricles to the ventricles, as well as the 
 mouth of the pulmonary artery, which leads to the lungs, and that 
 of the main artery, the aorta, which leads to the general system, 
 are furnished with doors or valves, which prevent the blood from 
 
The Circulation of the Blood. 
 
 6 9 
 
 Fig. 49. 
 
 going out of its right course. These valves are often put out of 
 order by rheumatism, an ailment which is, therefore, especially to 
 be dreaded, because of the permanent heart disease which some- 
 times follows it. 
 
 The arteries end and the veins begin, that is to say, they are 
 connected together, by an infinite number of small vessels, called 
 capillaries, so named because they are as fine as a hair. These 
 capillaries are of different sizes, and branch in various directions all 
 over the body, being woven into every part, and it is by them that 
 the blood is brought into intimate contact with the substance of the 
 tissues, and spends itself as it passes through them, on its way from the 
 arteries to the veins, to be returned to the heart for another round. 
 
 Figure 49 shows the manner in 
 which these capillaries are inter- 
 laced in the web of a frog, which 
 being transparent, displays beauti- 
 fully, under the microscope, the 
 passage of the blood in these 
 minute vessels, which, on account 
 of their fineness, admit only a 
 single blood cell at a time. The 
 cells which crowd the blood rush in 
 from the artery, pass, one at a time, Magnified Capillary Vessels. 
 slowly along these capillaries, lingering to nourish the tissues and 
 take up their waste, and then hurry away by the vein. Or, as Dr. 
 Holmes poetically expresses it, 
 
 " Far and wide a crimson jet 
 Leaps forth to fill the woven net, 
 Which in unnumber'd crossing tides 
 The flood of burning life divides, 
 Then, kindling each decaying part, 
 Creeps back to find the throbbing heart." 
 
 The action of the heart and the course of the blood, constituting 
 what is known as "the circulation," was discovered and first 
 described by Dr. Harvey, an eminent English physician, in 1619. 
 Twenty years previous to this, however, the great poet of nature, 
 
JO Structure mid Action of the Body. 
 
 Shakspeare, indicated the way the blood goes in fainting, and what, 
 in that condition, should be guarded against, as follows: — 
 
 " Why does my blood thus muster to my heart, 
 Making both it unable for itself 
 And dispossessing all my other parts 
 Of necessary fitness ? 
 
 So play the foolish throngs with one who swoons ; 
 Come all to help him, and so stop the air 
 By which he should revive." 
 
 The blood does not flow through the heart steadily and continu- 
 ously, but is impelled through by alternate contractions and 
 relaxations of the muscular walls ; at each squeezing together of the 
 sides, a successive portion of blood is received by the auricles, 
 delivered into the ventricles, and by them discharged into the 
 arteries. Each of these actions is called a beat or pulsation of the 
 heart, and as they occur every second, there are, during an ordinary 
 life, three thousand millions of beats, without a break. 
 
 The Arteries and Veins. We have spoken of the heart as 
 the organ into which the veins open, and from which the arteries 
 arise, and of the capillaries, as the minute vessels interwoven 
 throughout the tissues, in which the arteries end, and from which 
 the veins begin. It now remains for us to say a few words in regard 
 to these arteries and veins themselves. The main artery is the 
 aorta, which, as already mentioned, is given off from the lower 
 chamber of the left side of the heart (the left ventricle). In man it 
 is about an inch in bore, but in the whale it is over a yard in 
 diameter. It furnishes branches for the head and arms, curves to the 
 back of the chest, supplies the organs in the trunk, and ends at the 
 loins in two branches, for the haunches and legs. These varion 
 branches go on dividing and subdividing into smaller and smaller ves 
 sels, which finally end in the capillaries. The veins which begin at 
 the capillaries run into each other, uniting, so as to form fewer and 
 fewer, and larger and larger vessels, until finally they make but two, 
 one from the upper, and the other from the lower part of the body, 
 which pour their contents into the upper chamber of the right side 
 of the heart (the right auricle). The knots in the veins, which 
 may be distinctly seen in those on the back of the hand, are made 
 
The Blood and its Offices. J l 
 
 by the little valves inside, which open toward the heart so as to 
 permit of the passage of the blood in that direction, and prevent it 
 from going in the other. 
 
 The Blood. When the blood has passed through the system, 
 and arrives at the right side of the heart, it is of a dark bluish red 
 or purple color, approaching almost to black. Because of its color, 
 it is commonly called black blood. It is unfit for circulation in the 
 vessels, or for accomplishing its great work, the nourishment of the 
 different parts of the body. In this condition it is sent to the 
 lungs. When speaking of the air passages and organs, we described 
 the lungs as made up of a collection of air tubes, terminating in 
 air cells, surrounded by blood vessels, and explained the manner in 
 which the air was drawn through the windpipe, and distributed to 
 every part of the lungs, and thus brought in contact with the blood 
 contained in the thinly-coated blood vessels running around the 
 air-cells. We also mentioned that the air, while in the lungs, lost 
 some of its oxygen, and received carbonic acid. The dark, venous 
 blood, unfit for circulation and nourishment, is sent to the lungs 
 from the right side of the heart, in order to receive oxygen from 
 the air, and to give off carbonic acid. There, it changes color, and 
 becomes of a bright crimson or vermillion hue. Then, being fitted 
 for the purposes of life, it is brought to the left side of the heart, to 
 be distributed (through the ramifications of the great artery, the aorta, 
 which, as we have seen, supplies the whole body with blood) to the 
 network of capillary, or hair-like, vessels, spread out in the substance 
 of all the structures and tissues of the body. Here, in this system 
 of capillary vessels, while going to the veins, it undergoes a change 
 exactly opposite to that it experienced in the lungs. It loses its 
 bright red color and becomes of a dark purple hue. This change 
 is in consequence of the office which the blood performs in the 
 nutrition of the body, in parting with some of its constituents, 
 which combine with the texture of the flesh, tissues and bones, in 
 order to supply waste and maintain life. 
 
 But this is not the only office of the blood, important as it is — to 
 serve as a kind of fluid flesh, and bone, and brain, and to bring, 
 during a year, as it is calculated to do, over a ton of material from 
 the food, for the building of our bodies. It is also the great drain, 
 
72 Structure and Action of the Body. 
 
 which carries to the lungs, skin and kidneys, to be cast out of the 
 system, the broken down products of wear and tear, which, if 
 retained, would soon destroy us. Wonderful fluid, which at one 
 and the same time imparts the germs of life, and bears away the 
 poisonous results of decay. 
 
 In speaking of the food passages and organs, we have shown how 
 the blood is renewed, and in treating of the blood passages and 
 organs, have just explained how it is spread throughout the body. 
 It now remains for us to study the means by which it is cleansed, 
 namely, the waste passages and organs. 
 
 IV. The Waste Passages and Organs. 
 
 Every part of the body is in a constant state of change; the 
 food we swallow and the air we breathe are converted into the 
 natural ingredients which make up our tissues. While, on the one 
 hand, we are thus constantly supplying ourselves with materials for 
 repair and growth, on the other there is steadily going on within 
 us a process of waste and decomposition. Thus Nature 
 
 " Builds life on death — on change duration founds. ' 
 
 The food we eat and convert into flesh and bone does not remain 
 long in this shape, but almost immediately begins to decompose and 
 pass out of the body. If the discharge of these products of de- 
 composition, which represent the waste of the system, is interfered 
 with, they accumulate, become poisonous, and destroy life. We 
 see, therefore, that the passages and organs for the carrying off of 
 the waste of the body are quite as important as those which fur- 
 nish it with- nutriment. These waste products pass out through 
 the lungs, the skin, the liver and the bowels, but principally through 
 the kidneys, which alone of all the organs of the body do not supply 
 anything for our growth or sustenance, but merely expel or drain 
 away that which is useless, and which, if retained, would soon be- 
 come hurtful. 
 
 The kidneys are two in number, one on each side, in the back 
 part of the lower portion of the abdominal cavity. Each is about 
 four inches in length, two in breadth, and one in thickness. The 
 
The Waste of the Body. 73 
 
 quantity of fluid which they discharge is about two pints daily 
 in a healthy adult. . 
 
 We have now seen how food is taken into the stomach, the 
 manner in which it is digested, and finally absorbed by the blood, 
 and how the air is taken into the lungs, and the manner in which 
 it supplies oxygen to the blood, and have also learned how the 
 carbonic acid and other waste substances are discharged from the 
 body. It becomes, therefore, interesting to know the absolute quan- 
 tity of matter thus absorbed by and ejected* from the body each 
 day. The healthy adult absorbs and discharges daily rather more 
 than seven pounds. In the seven pounds of matter absorbed, water 
 figures for nearly five pounds, oxygen for one pound, the rest con- 
 sisting of the various ingredients of food. In the seven pounds 
 of matter discharged, carbonic acid and the vapor of water expelled 
 from the lungs figure for over a pound each, the perspiration for 
 nearly two pounds, the bowels and the kidneys throwing off the 
 rest. Hence it follows that in a person of the average weight of 
 140 pounds a quantity of material equal to the entire weight of 
 the body passes through the system every twenty days. The whole 
 substance of which the body is composed is, therefore, incessantly 
 renewed, under the operation of that mysterious influence which we 
 term life. 
 
 V. The Special Senses. 
 
 We, in common with all other animals known to us, have certain 
 peculiar faculties, called the special senses, by which we obtain 
 information as to the things in the world about us which we could 
 get in no other way. No animal is without some of these senses, 
 and none has more than five of these gateways of knowledge, 
 namely, the senses of smell, of taste, of touch, of hearing, and 
 of seeing. Each of these instruments of sensation has its own ex- 
 clusive office. Thus, odors are only known to us through the sense of 
 smell ; sounds, however loud, and light, however intense, can only be 
 appreciated by the ear and eye. It is to the nerves that we are 
 indebted for the conveyance of these sensations to our minds ; and 
 
 7 
 
74 Structure and Action of the Body. 
 
 it is one of the most mysterious parts of our nature that nerves 
 which are nearly alike all over the body, should, when distributed 
 over the nose, the tongue, the ear, the eye, carry to our minds feel- 
 ings so different. 
 
 We shall begin the study of the special senses with that 
 
 Of Smelling. The nose is the instrument of the sense of 
 smell. The nerves of this sense, called the olfactory nerves, are 
 distributed, in almost a naked condition, over the lining membrane 
 of the nostrils, so as to freely expose them to the air, which bears 
 the odorous particles to them when passing through the nose in 
 the act of breathing. In order, however, to protect them from 
 acrid odors and the undue action of the atmosphere, the nostrils 
 secrete a thick, insipid mucus. 
 
 In the acuteness of this sense we are inferior to many of the 
 lower animals. In the dog, for instance, as every one has observed, 
 it is very acute and delicate. Not only can he thus track different 
 kinds of game in the forest, but he can recognize particular in- 
 dividuals and the articles of their dress, by their odor, and even, 
 incredible as it would be to us, were it not a matter of common ob- 
 servation, can trace the odor of his master's feet through all the 
 winding streets of a populous city. 
 
 It is worthy of note that the senses of smelling and of tasting 
 are in all animals placed near each other. Brute animals select 
 their food chiefly by the sense of smell, and even we, in this selec- 
 tion, are greatly influenced by it. The two senses are, therefore, 
 placed together, like two sentinels over all that which passes our 
 lips. 
 
 It is not out of place here to remark, speaking of the nose, that 
 the habit of breathing through the mouth instead of the nostrils is 
 an injurious one, and one that the children must not be permitted 
 to form. Teach them to keep the mouth shut when not eating 
 or talking. The nose is a natural respirator, furnished with 
 means for warming and moistening the air breathed, as well as 
 with the sense of smell, for warning us against noxious airs and 
 vapors. 
 
 Children should not be permitted to form the habit of picking 
 the nose, which often gives rise to troublesome sores. If the prac- 
 
The Sense of Smell. 75 
 
 tice be due to the presence of worms in the bowels, as is sometimes 
 the case, the proper treatment, which we shall mention when we 
 treat of that ailment, will remove the cause. 
 
 The sense of smell is a lowly faculty, ranking below sight and 
 hearing. Though we are more readily moved through the ear than 
 the nose, yet to many the sweet breath of flowers in the air is as 
 the warbling of music. The poets have recognized in the sweet 
 scents of nature a deep meaning and a spiritual association. Thus, 
 Tennyson, in his " Dream of Fair Women : " 
 
 "The smell of violets, hidden in the green, 
 Poured back into my empty soul and frame 
 The times when I remember to have been 
 Joyful and free from blame.' ' 
 
 Of Tasting. The tongue and palate are the instruments of the 
 sense of taste. The tongue, however, is more particularly the seat 
 of this sense. The saliva which constantly moistens it, though 
 tasteless itself, is one of the great causes of all tastes, and every sub- 
 stance brought in contact with the tongue is partially dissolved by 
 it before we can taste. In fevers and other diseases where the 
 tongue becomes dry and coated, the sense of taste is impaired or 
 annulled. 
 
 A substance is not properly tasted until it is pressed by the 
 tongue against the roof of the mouth, and, indeed, its full flavor is 
 not brought out until it is actually swallowed. From this arises 
 the pleasure we have in chewing and swallowing. The whole internal 
 surface of the mouth and throat being thus brought around about 
 the savory morsel, we have the highest enjoyment of which this 
 sense is capable. 
 
 The impression of taste lingers upon the tongue for some time 
 after the substance has been ejected or swallowed. This is par- 
 ticularly the case with articles very bitter or very sweet. We are, 
 therefore, unable to detect and appreciate several different flavors in 
 rapid succession, the taste of the first resting in the mouth mingles 
 with and masks the second, and this the third, and so on. This 
 fact can be utilized in giving disagreeable medicines. If some 
 highly flavored and pungent substance be first taken in the mouth, 
 
y6 Structure and Action of the Body. 
 
 a nauseous draught may be swallowed immediately after, without 
 discomfort. 
 
 It has been well said that what is salutary for the stomach is 
 generally pleasant to the taste. Animals are influenced more than we 
 are by the sense of taste in the selection of food ; we are governed 
 a great deal by our judgment and experience, and too often by our 
 prejudices, in what we eat and drink. Some persons have a natural 
 aversion to particular articles of food which are ordinarily agreeable. 
 Surfeit, produced by overloading the stomach, is frequently a cause 
 of disgust, ever after, for the dish so imprudently indulged in. That 
 tastes may be cultivated is a matter of daily experience. Children 
 should not be allowed to be finical at the table, and grow up with 
 antipathies for usual and healthful articles of food. 
 
 In health, and particularly in sickness, food that is enjoyed in 
 the eating is far more nutritious than that which is indifferent or 
 unpleasant to the palate. This is an important physiological fact, 
 too frequently overlooked in the treatment of disease. We, there- 
 fore, give, in Part Fourth, Chapter Eleventh, of this work a large 
 number of choice and novel receipts for the preparation of delicacies 
 for the sick table. We cannot too much insist upon the usefulness 
 of pleasant flavors to secure the taking and digestion of wholesome 
 food by those who most need such nourishment. 
 
 Of Touch. The sense of feeling, or of touch, differs from 
 the other senses, in being extended over all parts of the body, 
 internal as well as external, while the others are confined to par- 
 ticular organs situated in the head. But what is called the sense 
 of touch is properly restricted to the sensation imparted by the 
 contact of objects with the skin, and more particularly with the tips 
 of the fingers. The sensation produced by the contact of an object 
 is, however, precisely the same in character, whether felt by the 
 tips of the fingers, the backs of the hands, the lips, cheeks or other 
 parts, differing only in the degree of its development. 
 
 In describing the skin, we spoke of the nipple-like elevations, 
 similar to the nap of velvet, although very much smaller, produced 
 by the terminations of the nerves on the surface of the skin. These 
 little protuberances have received the name of papillae. They are 
 the animal feelers, the immediate instruments of the sense of touch. 
 
The Sense of Touch. 
 
 77 
 
 Fig. 50. 
 
 By them we appreciate roughness, smoothness, and other characters 
 of the surface of objects. They are very numerous about the 
 points of the fingers. They 
 are well shown in the cut. 
 surface, greatly magnified 
 of the skin of the front of 
 the fore-finger, in Figure 
 50. There are seen the 
 branches of the nerves of 
 the sense of touch, which, 
 after numerous ramifica- 
 tions, terminate in the 
 minute protuberances, the 
 papillse, shown on the sur- 
 face of the true skin. The The Feelers of the Skin, 
 improvement of which the sense of touch is capable, by practice, is 
 illustrated by the wonderful skill acquired by the blind. 
 
 Of Hearing. The instrument or organ of this sense is the ear, 
 which collects and transmits sounds to the nerve of hearing, to be 
 conveyed to the mind. It is a very beautiful, delicate, and complex 
 structure, that we will try, in plain language, with the aid of excel- 
 lent, carefully-made engravings, to describe clearly to the reader. 
 
 The ear consists of three parts: the outer ear; the middle ear, 
 called also, from its character and office, the " drum;" and the inner 
 ear , which, from its intricate and involved form, has also received 
 the name of the "labyrinth." There are two tubes or canals 
 leading to the middle ear or drum, one from the outer ear, called 
 the Auditory (that is to say the hearing) Canal, and the other from 
 the throat, called, after the Italian physician, Eustachius, who first 
 described it, the Eustachian tube. 
 
 The outer ear is that expanded, trumpet-shaped, gristly portion 
 at the side of the head, that we can all see and touch. Its object 
 is to collect the waves or vibrations of air, which produce sounds, 
 and direct them through the auditory canal, to the middle ear. In 
 quadrupeds the outer ears are large, and furnished with muscles by 
 which they can be erected, and carried from side to side, in order 
 the better to collect the waves of sound. Although we have the 
 
 7* 
 
78 Structure and Action of the Body 
 
 same muscles, few of us can move our ears. The more prominent 
 this outer ear, the better is the hearing, as is shown by placing the 
 half-closed hand behind it, and so collecting, to a still further degree, 
 the vibrations of the air. Those whose ears are nearly flattened to 
 the side of the head, do not hear so well as others ; as the size and 
 form of the outer ear varies, the sense of hearing varies also. 
 
 From the outer ear there is a tube or canal, the auditory canal 
 before mentioned, leading to the middle ear. At the bottom is a 
 tightly-stretched membrane, which makes the outer wall of the 
 middle ear, or the head of the drum. The auditory canal is about 
 an inch and a quarter long, and slightly curved upon itself, so as to 
 be higher in the center than at either end. It carries in, just as an 
 ear-trumpet does, the waves or undulations of the air, collected by 
 the outer ear, to the middle ear. The hairs at the entrance of this 
 canal, and the wax which keeps it soft, are for the purpose of 
 excluding dust, insects and other substances. The wax sometimes 
 gets hard, and increases to such an extent as to cause noises in the 
 ear, and partial or entire deafness. In such cases it may be removed 
 by gently throwing up, from a syringe, warm water with a little soap 
 in it. Children frequently fall into the habit of picking the ear 
 with the finger, thus irritating it, and exciting inflammation and 
 running. Many adults, also, cannot let their ears alone, but are 
 constantly thrusting toothpicks, pins and needles into them, to 
 clean them out. This habit often leads to permanent injury, and 
 not unfrequently, by an accident, punctures the drum of the ear, 
 and destroys the hearing. The practice which some people have of 
 stopping up this tube with pieces of wool, "to keep out the cold," 
 is absurd and hurtful; absurd, because if nature intended the ear 
 to be thus shut up, she would have done it herself; hurtful, as it 
 heats the ear, makes it very sensitive and liable to take cold and 
 become inflamed. 
 
 Figure 51 shows the surface of a cutting made through the ear. 
 a, is the auditory canal, the external tube running from the outer 
 ear to the drum, b, is the inner end of the eustachian tube, where 
 it opens into the drum. This tube is from an inch and a half to 
 two inches long, and commences at c in the upper part of the throat, 
 at the back and side. It supplies the middle ear with air. When 
 
The Sense of Hearing. 
 
 79 
 
 the throat is inflamed, the opening into this tube may be closed, 
 and the hearing thus impaired. Some persons, by swallowing, can 
 readily force air into it, which is felt to crack in the ear. 
 
 Fig. 51. 
 
 Section of the Ear. 
 
 The middle ear, the drum or barrel of the ear, is a cavity, about 
 half an inch long by a quarter of an inch high and wide. It lies 
 at the bottom of the auditory canal, from which it is separated by 
 the thin, tightly-drawn, drum membrane, and gets air from the 
 throat by the eustachian tube, just described. This cavity is filled 
 with air, and is traversed by a chain of small, movable bones. 
 These bones are very pretty and curious. They are three in 
 number, called, from their shape, the hammer, the anvil, and the 
 stirrup. The hammer is connected with the head of the drum, the 
 stirrup with the oval membrane separating the middle from the 
 inner ear, and the anvil is placed between the two, to which it is 
 united by very delicate joints. This chain of bones, therefore, 
 carries across the cavity of the drum any vibrations into which the 
 drum-membrane is thrown, by the waves of air coming through the 
 auditory canal, and communicates these vibrations to the inner oval 
 membrane, which, in turn, sets in motion the fluid contained in the 
 
8o 
 
 Structure and Action of the Body. 
 
 canals of the inner ear. The object of this arrangement we will 
 see directly. The examination of the figure will give a better idea 
 Fig# 52. than any description in words, of these , 
 
 little bones, m is the hammer, of 
 which h is the handle, by which it is 
 attached to the drum membrane, a 
 is the anvil and s the stirrup. 
 
 Their position and action will be 
 made still plainer by Figure 53, 
 which is the face of a cutting through 
 the ear, made so as to show the chain 
 of bones in the drum, and the outlines 
 of the inner ear. 
 The Little Bones in the Ear. The inner ear, or the labyrinth, 
 consists of a series of arched cavities, channeled out in the sub- 
 stance of the bone, shown at the left of Figure 53. It is shut out 
 Fig. 53. from the middle ear 
 
 by an oval membrane, 
 to which is fitted the 
 base of the stirrup 
 bone. This bony 
 labyrinth contains 
 fluid, and within it 
 there is a closed sac, 
 which has the same 
 form as the bony 
 passages in which it 
 is inclosed. The 
 closed sac, which is 
 called the membran- 
 ous labyrinth, also 
 The Outer, Middle and Inner Ear. contains fluid, and 
 
 within it the fine, thread-like ends of the auditory nerve, or the 
 nerve of hearing, are spread out. 
 
 Sounds are propagated by the medium of the air, being produced 
 by waves or undulations in it, like to the circling ripples caused in 
 still water by the throwing in of a stone. That air is the medium 
 
The Course of a Wave of Sound. 8 1 
 
 of sound, is established, by the fact that a bell suspended in the 
 receiver of an air-pump, from which the air has been exhausted, 
 ' gives out no sound, no matter how violently it may be rung ; while, 
 if air be forced into the receiver by a condenser, the sound increases, 
 in proportion as the quantity of air is increased. 
 
 Knowing now how sound is produced in the air, and how the ear 
 is constructed, we can understand how the appreciation of sound or 
 hearing takes place. The waves of sound strike the external ear, 
 are collected and directed into the auditory canal, where, dashing 
 against the drum membrane, they throw it into vibration. The chain 
 of little bones iuthe middle ear receives the impulse, and carries it 
 across the drum to the oval membrane, which is thus made to 
 vibrate and communicate the motion to the fluid filling the circular 
 canals and arched passages of the inner ear, and so agitate the deli- 
 cate filaments of the nerve of hearing floating therein. The nerve 
 so affected transmits, by its peculiar power, the sound to the brain, 
 where " that which seems mere motion in the ear, and in the nerve, 
 turns into joy or sorrow in the soul.' , 
 
 ^Hark, how the rolling surge of sound, 
 Arches and spirals circling round, 
 Wakes the hushed spirit through thine ear, 
 • With music it is heaven to hear." 
 
 Of Seeing. Of all the instruments of sensation, the organ of sight, 
 the eye, is the noblest, the most delicate and refined. It is retained 
 and moved within its bony Fig. 54. 
 
 socket by the aid of mus- 
 cles. These muscles are 
 six in number. They are 
 distinctly drawn in Figure 
 54, and are named from 
 their office: the inner 
 straight muscle (No. 3); 
 the outer straight muscle 
 (No. 4) ; the upper straight 
 muscle (No. 2) ; the lower The Eyeball and its Muscles, 
 
 straight muscle (No. &\: the upper oblique; and the lower oblique 
 
82 Structure and Action of the Body. 
 
 (No. 6). The broad muscle which lifts the upper eyelid is also 
 shown (No. 1). These four straight muscles are attached to the 
 globe of the eye in such a way that they turn it inward, outward, up- 
 ward and downward, as their names express. The oblique muscles 
 rotate the eyes. 'In cross-eyes, or squint, one of these straight mus- 
 cles, usually the inner, is contracted or shortened, and so draws the 
 eye forcibly to that side. Children so affected should be operated 
 on early by a surgeon. The operation consists simply in cutting 
 through the offending muscle, so as to permit the eye to move 
 freely about in its socket. 
 
 Now that we know the muscles which enable us to turn the 
 eyeball, we will have but a word to say upon the eyelids, before 
 considering the internal structure of the eye. The eyelids may be 
 compared to vails or shutters, designed to protect the organ of sight. 
 Their borders, the eyelashes, prevent the entrance of dust and other 
 foreign substances. 
 
 The eyeball is, therefore, securely placed in its orbit, where, while 
 protected from injury, it is so situated as to command a wide range 
 of vision, and is freely moved in all directions by its numerous mus- 
 cles, and shielded in front by its lids and their lashes. The inter- 
 nal structure of the eye, and the manner in which its different parts 
 concur in transmitting the rays of light and the images of objects, 
 next demand our attention. 
 
 The interior of the eye is a dark chamber, into which the light 
 enters through a circular transparent membrane, called the cornea, 
 fitted like a watch-glass into its front. The cornea is, therefore, the 
 window of the chamber ; the rest of its circular wall consists of the 
 white coat of the eye, a tough case with holes for nerves and vessels. 
 The inner surface of the wall of this globular chamber is black, to ab- 
 sorb the scattered rays of light. In front of the chamber, a little dis- 
 tance behind the window, or cornea, there is a muscular curtain, called 
 the iris, with a hole through its centre, called the pupil, which varies 
 in size so as to let in more or less light as the eye wants it, becoming 
 larger when the light is feeble, smaller when it is very bright and 
 strong. The iris curtains off, in this manner, a sort of an ante- 
 chamber in the front part of the eye. This antechamber is filled 
 with a fluid, called the watery humor, in which the iris hangs and 
 
The Passage of a Ray of Light Through the Eye. 83 
 
 easily plays. Behind the iris is the lens, kept in place by a row of 
 dark folds. The rest of the chamber is occupied by a jelly-like 
 mass of a greenish hue, called the vitreous or glassy humor. These 
 structures are so plainly delineated in Figure 55 that, with the aid 
 of the above description, .the drawing explains itself. 
 
 Fig. 55. 
 
 The Chamber of the Eye. 
 
 The vitreous or glassy humor holds out, like a globe, the thin 
 coat, called the retina, into which the nerve of sight spreads out 
 when it enters the eyeball, and on the outer layer of which pictures 
 are formed of all we see. The retina of the eye, therefore, resem- 
 bles a canvas, on which forms and colors are painted, or a screen, on 
 which they are thrown. 
 
 It is easy now to trace the course of a ray of light in its passage 
 through the eye to the nerve of sight. The parts just described 
 bend to & focus the rays of light coming from an object, and with- 
 out these parts we could only see things the size of the pupil. The 
 rays of light first pass through the window of the eye, that is to say, 
 the transparent outer structure, called the cornea, enter the ante- 
 chamber, in which hangs the curtain, called the iris, pass through 
 
84 Structure and Action of the Body. 
 
 the curtain, by the hole in its centre, called the pupil, and pierce the 
 lens, which is so constructed as to converge the rays of light to a 
 certain point. In passing through the chambers of the eye the 
 rays of light are so bent out of their course by the parts described 
 that the rays from the top of an object cross those from the bottom, 
 so that the retina receives the image of an object upside down, but, 
 with the mind's eye, we see it right. 
 
 That structures so delicate as those which make up the eye 
 should be sometimes defective in their action, will not excite sur- 
 prise. Two defects, in particular, are quite common, namely, short 
 sight and long sight Most persons see objects, as, for instance, the 
 type of this page, in the most perfect degree at a distance of about 
 sixteen inches from the eye. The short-sighted hold their books 
 nearer than this, sometimes very close to the eye, while the long- 
 sighted hold them two feet or more away. These defects are occa- 
 sioned by the quantity of water in the antechamber of the eye ; 
 thus, in the short-sighted, the cornea is observed to be too round or 
 bulging, while, in the long-sighted, it is too flat. Naturally, in 
 youth, the eye is fuller than in middle life and in old age, so that 
 the tendency of the young is to short sight, that of the old to long 
 sight. It is a fact deserving attention that the number of short- 
 sighted children and of far-sighted adults is increasing. Parents 
 should know the causes of short sight, and take care that their 
 children are not exposed to them. It is very frequently developed 
 by the habit of holding books and other objects unnecessarily close 
 to the eyes, or bending down the head very near to them. There- 
 fore, small print, bad ink and paper, delicate drawing, fine needle- 
 work, imperfectly lighted rooms, high seats and low desks or tables, 
 are to be avoided, as leading to the habit in question. 
 
 Those who are short-sighted would do well to observe certain sim- 
 ple rules for the preservation of their sight. They should naturally 
 choose books with large type, and hold the book up to the eyes, not 
 the eyes down to the book. Bending over a flat table in writing 
 must be avoided by the use of a high desk. No close nor fatiguing 
 work should be undertaken, and the eyes must never be overtasked by 
 too continuous labor, but relieved by frequent rests. In regard to 
 the use of spectacles, those who are only slightly affected may 
 
The Brain and Nerves. 85 
 
 usually dispense with them, but those who are affected to a con- 
 siderable degree will find safety as well as advantage in their use. 
 In no case, however, must too strong glasses be employed, as they 
 are injurious. The short-sighted need feel no alarm, unless the 
 trouble is evidently increasing from year to year, when rest, and, per- 
 haps, treatment, become imperative. 
 
 Old sight is different from long sight. Old people do not see 
 better in the distance than young ; they are merely unable to see 
 so well objects close at hand. This impairment of vision sometimes 
 begins at the early age of thirty-five, without attracting notice ; ten 
 years after, the book is held, instinctively, several inches further 
 from the eyes than in youth. The impairment gradually increases 
 with advancing years, until at last the book has to be held so far 
 that the letters can no longer be distinguished, and all reading 
 without glasses becomes impossible. This defect is remedied by 
 spectacles, which have to be made stronger and stronger with invad- 
 ing years. When the glasses habitually employed have to be put 
 at a distance, and kept on the tip of the nose in order to render 
 them of service, stronger ones should at once be obtained, and the 
 eyes not fatigued by attempting to make the old ones do. The 
 glasses should be sufficiently strong to permit of the book or news- 
 paper being held within a foot of the eye. 
 
 Weak eyes frequently result from reading, drawing or sewing, in 
 a light either too bright or too dim. The full glare of the sun and 
 twilight are equally injurious. The practice of reading in bed, or 
 when lying on a lounge, is also often a cause df weak eyes. It is 
 better, therefore, always to sit up to read. 
 
 VI. The Brain and Nerves. 
 
 The muscles, the organs, and the other parts of the body which 
 have occupied us thus far, are acted upon and ruled over by the 
 nerves, the servants of the brain. The nerves not only excite, but 
 control and regulate all the actions of the body. 
 
 The nervous system consists of three great parts, the brain, the 
 spinal cord, and the nerves. Our noblest part, the brain, is situated 
 within the skull. By it we feel and will, think and remember. 
 8 
 
86 Structure and Action of the Body. 
 
 The spinal cord is a long, nervous, cord-like mass, about the thickness 
 of a finger, extending from the brain to the base of the spinal column, 
 the cavity of which it occupies, constituting what is called, in 
 common language, the spinal marrow. It gives off thirty-one 
 pairs (one nerve for each side) of nerves ; eight in the neck, twelve 
 in the back, five in the loins, and six in the haunches. These nerves 
 arise by two roots from the cord — a back one, which brings feeling 
 to the cord, and a front one, which carries orders to the muscles. 
 As these roots unite together, they thus spread over the whole of the 
 body the powers of sensation and motion. The brain gives off nine 
 pairs of nerves, among which are the nerves of the sense of smell, 
 of sight, of hearing and of taste. 
 
 Flg * 56 ' Figure 56 shows the brain, the 
 
 spinal cord, and the manner in which 
 the nerves branch off from them. 
 
 These thirty-one pairs of spinal 
 nerves go to the muscles and coverings 
 of the neck, trunk, and extremities, 
 and impart to them the power of feel- 
 ing and the power of motion. This 
 transmission of feeling and of motion 
 through the nerves is effected in a 
 very beautiful manner. Each spinal 
 nerve, as we have just mentioned, 
 arises from the spinal cord by two 
 slender threads or roots. The hack 
 root conveys sensation or feeling to the 
 cord, while over the front root passes 
 the impulse of motion. Each of 
 these front and back roots extends up 
 along the spinal cord to the brain, on 
 the one hand, and, on the other hand, 
 is continued along the nerve of which 
 it makes a part, throughout its whole 
 course. When we touch anything, 
 The Brain, N Spinal Cord, and the j^^^ pro duced on the skin is 
 
 conveyed along that slender thread of the nerve which carries 
 
The Domain of the Brain. 87 
 
 feeling, and the back root of the nerve, to the spinal cord, and 
 thence upward along its prolongation in the spinal cord to the 
 brain, where it causes a sensation corresponding in character to the 
 impression made. In this manner we feel or have the power of 
 sensation. When, on the contrary, we desire to move a muscle, 
 the impulse of motion which we originate in our brain passes down 
 the spinal cord, along the continuation of the front root of the 
 spinal nerve, and over the front root and its prolongation in the 
 nerve and branches, until the muscle to which the message is sent 
 is reached. In this manner we move our muscles, or have the 
 power of producing motion. We see, therefore, that each nerve is 
 made up of two very different fibres, one conveying sensation and 
 the other motion; that these fibres separate at the spinal cord, 
 constituting the front and back roots of the nerve ; and that they 
 are prolonged up through the spinal cord to the brain, putting 
 it thus in telegraphic communication with every part of the body, 
 for the receipt and transmission of messages. It is easy now 
 to understand why it is that, when, by accident or disease, the 
 spinal cord is severed or destroyed at one spot, all motion 
 and sensation in the parts of the body below that spot cease, and 
 that paralysis and insensibility are the necessary consequence of the 
 cutting off of the communication of these parts with the brain, the 
 great seat of sensation and motion. 
 
 It is by and in the brain that we feel ; it is there that all impres- 
 sions made upon our bodies are converted into conscious sensations. 
 These sensations are, in a condition of health, at once referred to 
 their proper source, so that we seem to feel in the part affected. 
 When, for instance, the finger is pricked, it is the brain which 
 feels the pain and not the finger. That the brain is the seat of 
 sensation is shown by the fact that if the nerves connecting it with 
 any part be cut, that part cannot be made to feel or suffer. 
 
 Not only is the brain the seat of feeling, but of all voluntary 
 motion. Every time we designedly move a muscle, we do it by a 
 mental effort, that is to say, by an act of the will. In speaking of 
 the muscles of the body, in the first chapter of this book, we said 
 that the muscles are of two kinds, voluntary and involuntary, and 
 that those which perform actions which require to be unremittingly 
 
88 Structure and Action of the Body. 
 
 kept up to sustain life, such, for instance, as breathing and the 
 beating of the heart, are fortunately independent of our minds. 
 These involuntary actions are carried on through the spinal cord. 
 There is, therefore, no mind in them, otherwise death would soon 
 result. All the involuntary actions of the body devolving upon 
 the spinal cord, which keeps them up without consciousness or 
 effort on our part, the mind is left free for the higher life of thought, 
 and feeling, and design. Even voluntary actions, when habitual, 
 soon need so little attention that they cease to occupy much of our 
 thoughts. Thus we hold ourselves erect, walk and talk, without a 
 conscious effort, although the numerous muscles concerned in these 
 very complicated and difficult acts are all worked by the will. Thus, 
 also, the hand of the practiced workman or the skillful artist glides 
 over his work almost unconsciously, while the beginner bungles, in 
 spite of the closest attention. 
 
 From the above sketch of the nervous system, it will be seen in 
 what intimate relations the brain is kept, by the nerves, with 
 external objects. Hence the supply of wholesome impressions 
 through the special senses, the lungs and the skin, largely contributes 
 to mental health. Fresh air and pure water are not only useful to 
 the lungs, and skin, and blood, but directly to the nervous system, 
 which they tone up. Pleasant sights and sounds are excellent 
 mental tonics. Everything that brings happiness is a cordial to the 
 brain and nerves. These are elementary principles in mental 
 hygiene which all should know and heed. 
 
PART II. 
 
 SICKNESS IN ADTJLT LIFE, 
 
 THE DIVISIONS OF THIS PART. 
 
 Thus far we have been occupied with the structure and action 
 of the body. The ailments of the body, their prevention and treat- 
 ment, now demand our attention. For convenience of arrangement, 
 as well as because of the different nature of the complaints, we 
 shall first take up the ailments of adults and then those of children. 
 
 Before entering upon the study of the special maladies to which 
 the body is liable, some general directions on the manner of keeping 
 the chamber, and of caring for the persons of the sick, and upon the 
 use and administration of remedies, are necessary. Of the four 
 chapters of this part, on Sickness in Adult Life, the first, therefore, is 
 devoted to the Domestic Management of the Sick Room ; the next 
 treats of those Ailments- — such as fevers, for instance — which assail 
 the Entire Body ; the following discusses those — such as pleurisy, 
 for instance — which attack a Particular Organ or Part ; while the 
 concluding chapter is given to Accidents, Injuries, and Emergencies 
 of various kinds. 
 
 8* 89 
 
CHAPTER III. 
 
 THE DOMESTIC MANAGEMENT OF THE SICK ROOM. 
 
 Choice of the Sick Room — Its furniture — Air and ventilation — Hints in 
 regard to its warmth — How it should be lighted — The importance of 
 cleanliness — Duties and deportment of those nursing the sick — Personal 
 attentions required by the sick — Management of those recovering from 
 sickness — Household remedies — Family thermometry. 
 
 Choice of the Sick Room. The room in which a person is 
 confined to bed with a serious and protracted ailment should be 
 large, lofty, and well ventilated; the window sashes ought to lower 
 from the top as well as raise from below, and work with as little 
 noise as possible. Walls painted in oil are better than those in 
 plaster or paper. The door must be noiseless, with a ventilator 
 over it or made in one of the pannels. A painted or polishecl 
 floor is better than a carpeted one. It should be swept, or at the 
 most lightly wiped, but not frequently washed, as the slow evapo- 
 ration from the wet boards renders the room injuriously damp. 
 
 The room should be a light one, exposed to the direct rays of 
 the morning and mid-day sun. Blinds and shades should be pro- 
 vided, for modifying the light when desirable. 
 
 Warmth of the Sick Room. As we have said, a thermometer 
 should always be in the invalid's room, and by it the temperature 
 must be regulated. The best temperature is that of 60°. If, how- 
 ever, the patient feels chilly at this temperature, it may be raised three 
 or four degrees. In fevers and diseases of the nervous system a 
 lower temperature is preferable, about 50° ; while in consumption 
 and other affections of the chest an atmosphere of 65° is the most 
 agreeable to the inflamed air-passages. 
 
 90 
 
Furniture of the Sick Room. 91 
 
 In the early morning hours a sick person is apt to be chilly, 
 which is just the time when the room is usually the coolest — a fact 
 that must be borne in mind, and precautions taken, lest the patient 
 suffer serious injury from this cause. 
 
 A low-down grate is much the best way of warming the sick 
 room. 
 
 Furniture of the Sick Room. All unnecessary furniture must 
 be banished from the room. There is no need of any wardrobe, 
 bureau, trunks or bandboxes. Two tables, at least, are wanted ; one 
 of them should be small, and on casters, so as to roll easily to the 
 side of the bed, for the immediate use of the patient ; the other, a 
 larger one, for the reception of medicine bottles, spare glasses, cups, 
 spoons, and other articles in constant use. In the drawer of the 
 latter table there should be constantly kept a sponge, a bundle of 
 soft old linen, a pair of large, and another of small scissors, a full 
 pin-cushion, needles and thread, a piece of adhesive plaster, and one 
 of isinglass plaster, and oiled silk for covering poultices. A third 
 table, if there be room for it, is useful as a dressing table, on which 
 to place the brush, comb, and other toilet articles. Over it a look- 
 ing glass may be hung, but never in such a position as to permit 
 of the invalid seeing himself in it as he lies in bed. A movable 
 washstand, on casters, so that it can be readily shoved to the side 
 of the bed, is very useful. An ample supply of clean towels should 
 be constantly on hand. There ought not to be more than three 
 chairs, of which one should, if possible, be an easy or reclining 
 chair. A lounge or sofa is of great utility, particularly during 
 recovery, when the sitting posture cannot be long maintained ; it is 
 of service, also, for the patient to recline upon, when his strength 
 permits, while his bed is being made. The bedstead should not be 
 too wide. A greater width than three and a half feet renders it 
 often difficult to reach and move the patient. Two bedsteads are 
 much better than one. Each should be provided with its own 
 sheets and cover. The patient passing half the time in one, per- 
 mits the entire bedding of the other to be thoroughly aired out 
 of the room, a very important measure in prolonged illness. The 
 bedstead must be low, so as to permit of the patient getting in and 
 out easily, and of his being lifted and moved with facility. Iron 
 
92 Domestic Management of the Sick Room. 
 
 bedsteads are much to be preferred to wooden ones. The bed 
 should be without curtains, and placed with its head to the wall, so 
 as to admit of access on each side. It is best placed between two 
 windows, or at the side of a window. The bed clothing must be 
 light. Heavy cotton counterpanes and Marseilles coverlets must be 
 discarded from the sick bed, and only good light blankets employed. 
 The pillow-cases and sheets are better of cotton than of linen, and 
 should be frequently changed ; daily, in the case of infectious fevers. 
 The pillows must be firm and elastic, and arranged so as to support 
 the back, and not piled up in such a manner as to thrust the head 
 forward upon the chest, and so increase the difficulty of breathing. 
 The bed should be level, and not too hard. Curtains and heavy 
 drapery of all description are objectionable in a sick room, as they 
 harbor dust and contagious matter. Besides these main pieces of 
 furniture, there are a number of articles of use in every sick room. 
 Among these we may mention the following, viz. : a thermometer 
 (one so constructed that it can be put in water to get the heat of a 
 bath) should hang on the wall,*at the height of the bed ; a foot 
 warmer, which may be made of a common bottle filled with hot 
 water, or of a rubber bottle or cushion, or an earthenware bottle 
 sold for the purpose, should be at hand when wanted ; a stomach 
 warmer, made of an India-rubber bottle or bag filled with hot 
 water, is often of use ; air and water cushions, or a cushion in the 
 shape of a ring, filled with bran, are serviceable in warding off 
 
 Fig. 57. 
 
 Supporting Cradle, 
 pressure from prominent parts, giving support, etc. ; a pillow rest, 
 made of a bag of the same width, but twice the length, of a pillow 
 case, stuffed with hay, straw or oat-chaff, in such a manner as to 
 make it taper down like a writing desk, from back to front, is an 
 
Artie tes for the Siek Room. 93 
 
 excellent thing for propping up pillows ; a cradle, such as is repre- 
 sented in Fig. 57, to support the bed-clothes, and prevent them 
 pressing upon a painful part, is useful in many ailments ; folding 
 rests for the legs, made in the shape of an open book, and covered 
 by a blanket, give comfort to the weary limbs ; a medicine glass, 
 marked so as to measure exactly a teaspoonful, a dessertspoonful, 
 and a tablespoonful, enables medicine to be given with much greater 
 exactitude than can be done with spoons, which vary in size ; a 
 medicine spoon, which can be obtained at most druggists', permits 
 of medicines being administered to very weak and partially uncon- 
 scious patients, as it is covered, and has an opening near the end, so 
 as to avoid all spilling ; a feeder, consisting of a half-covered vessel 
 furnished with a spout, for giving soups, teas, and other fluids, is 
 convenient for administering drinks to the patient when lying in 
 bed ; a bed-side pocket, to be pinned at the side of the bed, makes 
 a convenient place for keeping the pocket handkerchief, a bottle of 
 scent, etc., within the reach of the invalid ; a sick tray, consisting 
 of a board hollowed out in front to fit the body, and supported on 
 four short legs, to be placed on the bed before the patient, is often 
 much more convenient than an ordinary waiter on the knees or a 
 table at the side of the bed ; a bed-chair is often of service ; a bed- 
 pan, or slipper, is necessary for those too weak to rise from the bed ; 
 two baskets, with divisions or compartments, are useful for medicine 
 bottles, one containing medicines for internal use, the other, of 
 another color and form, containing external applications ; and two 
 baskets for cups and dishes, one for those needing washing, which 
 are to be quickly sent out of the room and exchanged for the other 
 basket with its clean ware. The following articles must not be 
 kept in the sick room, viz. : dirty linen, implements of cooking, pre- 
 pared food, medicines discontinued by the physician, soiled cups 
 or glasses, slop basins or pails. 
 
 Air of the Sick Room. Fortunately the prejudice against ad- 
 mitting fresh pure air into the chambers of the sick, particularly of 
 fever patients, is to a great extent a thing of the past. The custom 
 of almost hermetically sealing the rooms of patients in fever was 
 very prevalent among nearly all classes, some forty or fifty 
 years ago. Dr. James Gregory, of Edinburgh, the celebrated pro- 
 
94 Domestic Management of the Sick Room. 
 
 fessor of medicine, used to mention in his lectures, that as no argu- 
 ment was of avail in procuring the admission of fresh air into the 
 sick rooms of the poor, he generally pushed his cane through the 
 panes of the windows. This, however, was not always adequate to 
 insure the intended effect, as he often found the broken panes 
 pasted over with paper on his next visit. No such forcible measures 
 are now, usually, required. People generally err from carelessness 
 rather than ignorance or prejudice, as few can be unaware of the 
 fact, the subject having been so widely discussed, that foul air is 
 poisonous for sick and well. In many cases, it is useful, once or 
 twice a day, to cover the patient well in bed and protect him from 
 drafts, and then open wide all the doors and windows, so as to wash 
 out the room with fresh air. An excellent test for foul air is the 
 nose ; pure air is tasteless and free from all smell. 
 
 The air of the room should never be permitted to become too 
 dry, as is the tendency in heated rooms in winter. A basin of 
 boiling water occasionally brought into the room, and replaced by 
 another when it becomes cold, will usually give sufficient moisture. 
 
 A constant supply of pure air is important for others in the sick 
 chamber as well as for the patient, as it lessens their chance of con- 
 tracting the disease. The confinement of a contagious principle in 
 a close room increases its force ; the more poisonous emanations 
 are diluted by admixture with fresh air the less dangerous they 
 become. Hence certain diseases are more frequently propagated in 
 winter, when doors and windows are kept shut, than in summer, 
 when the outside air is freely admitted. 
 
 While keeping the air that the sick breathe fresh and pure, by 
 ventilation, care must be taken not to chill the patient. There is 
 little danger, however, with ordinary precautions, of taking cold 
 when lying in bed. Sick people usually catch their colds by rising 
 for a moment from a warm bed without throwing any wrap around 
 them, or by sitting up in bed without a covering over the shoulders. 
 
 Of course, no air is pure which contains smoke from a badly- 
 made fire, or from the chimney of an oil lamp. Not only smoke, 
 but gas, frequently escapes from a stove, and proves a source of 
 trouble to the sick, particularly those affected with chest ailments. 
 
 Of all the sources of contamination of the air of the sick chamber, 
 
How Invalids are Poisoned. 95 
 
 one of the worst is the chamber utensil. On this subject, Florence 
 Nightingale, with her usual good sense and thoroughness, writes : 
 " The use of any chamber utensil without a lid should be utterly 
 abolished, whether among sick or well. You can easily convince 
 yourself of the necessity of this absolute rule, by taking one with a 
 lid, and examining the under side of that lid. It will be found 
 always covered, whenever the utensil is not empty, by condensed 
 offensive moisture. Where does that go when there is no lid ? 
 But never, never should the possession of this indispensable lid 
 confirm you in the abominable practice of letting the chamber 
 utensil remain in a patient's room unemptied, except once in twenty- 
 four hours. Yes, impossible as it may appear, I have known the 
 best and most attentive nurses guilty of this. Earthenware, or if 
 there is any wood, highly polished and varnished wood, are the only 
 materials fit for patient's utensils. A slop pail should never be 
 brought into a sick room. It should be a rule invariable, that the 
 utensil should be carried directly to the water-closet, emptied there, 
 rinsed there, and brought back. There should always be water and 
 a cock in every water-closet, for rinsing. But even if there is not, 
 you must carry water there to rinse with. I have actually seen, 
 in the private sick room, the utensils emptied into the foot pan, 
 and put back under the bed. I can hardly say which is most 
 abominable, whether to do this or to rinse the utensil in the sick 
 room. In the best hospitals, it is now a rule that no slop-pail shall 
 ever be brought into the wards, but that the utensils shall be car- 
 ried direct, to be emptied and rinsed at the proper place. I would 
 it were so in the private house." 
 
 In typhoid fever, dysentery, and other similar affections, in which 
 the infectious principle of the disease resides in the discharges, the 
 chamber utensil, so soon as it is cleaned, which should be at once 
 after use, should have poured into it about half a tumblerful of a 
 strong solution of sulphate of iron, kept on hand for the purpose in 
 a large bottle or jug, and made by dissolving a pound of copperas 
 in a gallon of water. Directly after the vessel is used, and before 
 its contents are emptied, about a tumblerful of the same solution 
 should be poured in, to destroy the fetor and lessen the liability of 
 infection. 
 
96 Domestic Management of the Sick Room. 
 
 Light of the Sick Room. The sick require plenty of light as 
 well as an abundance of air. It is only in the beginning and 
 violent stages of certain diseases, and in some nervous affections, 
 that it is advisable to partially darken the room. 
 
 It is a fact in regard to which there can be no doubt, that the 
 sick do better and recover more quickly in a sunlit room, than in 
 one into which its rays cannot enter, or from which they are always 
 excluded. An agreeable view from the window is also desirable, 
 especially during convalescence, to relieve the tired eye, and gratify 
 the craving, nearly always experienced, for looking' out of the 
 window. 
 
 The night light must be so placed as not to throw a shadow on 
 the ceiling over the patient, or on the wall in front of him. Shadows 
 of things or persons in the room often assume, to the fearful gaze 
 of the weakened patient, forms of terror, and may excite delirium or 
 even convulsions. If oil be burned, care must be taken that the 
 lamp does not smoke nor smell ; if gas, that the gas does not escape. 
 
 Cleanliness of the Sick Room. Cleanliness and order are 
 important in the chamber in which the sick lie, but the dust and 
 noise made in sweeping and arranging the room are frequently a 
 source of great annoyance to the silent sufferer. As after a night's 
 rest the patient is best able to bear a little bustle, the morning 
 should be selected for putting the room to rights. If there be a 
 carpet on the floor, it is to be sprinkled with moist tea-leaves before 
 being lightly swept with a hand-brush and dust-pan. 
 
 The furniture, the bed and bedding, the floor and walls, and 
 every article in the sick room, should be always clean. No vessel 
 or implement used by the patient should be suffered to remain in 
 the apartment, but be at once taken out, to be returned so soon as 
 cleaned. Every glass, eup or plate in which food is administered, 
 must be taken immediately out of the room and washed. Neither 
 ought any glass or spoon in which medicine is given be suffered to 
 remain with the small portion which is always left in it ; it must be 
 instantly and well cleansed. 
 
 Duties and Deportment of those Nursing the Sick. Those 
 women make the best nurses for the sick who are between the 
 ages of twenty-five and fifty-five, active and vigorous, in good health, 
 
Duties of Nurses. 97 
 
 of happy, cheerful disposition, with kind feelings, and a temper not 
 easily ruffled, and of orderly, clean and neat habits. 
 
 The nurse should cook nothing in the sick room ; move about 
 without noise, fidget, hurry or bustle; keep the room in order, 
 sweet and clean ; take out of the room instantly all evacuations of 
 the patient, slops, soiled linen and wet towels ; avoid eating any- 
 thing that gives a bad smell to the breath ; order food so as to have 
 it ready promptly at the time for giving it ; observe minutely the 
 orders received for administering food and medicine; see that the 
 patient's mouth and nostrils remain uncovered during sleep ; never 
 express a doubt in regard to the propriety or efficacy of the treat- 
 ment employed; always look confidently for recovery; make no 
 comparisons with other cases; say nothing to discourage or alarm 
 the invalid ; never whisper ; give no prohibited food, and permit of 
 no forbidden indulgences ; see that there is a supply of fresh air, 
 and that the patient is kept out of all drafts ; preserve a proper 
 uniform temperature, by means of the thermometer. 
 
 She should also keep in writing, jotting down at the moment, the 
 exact time, by the watch, of all the important events of the day, 
 such as the taking of food and medicine, the coming on of sleep, or 
 delirium, or restlessness, the dejections of the patient, any remarkable 
 change in the symptoms, and other matters of interest bearing upon 
 the progress of the ailment and the condition of the patient. For- 
 tunate is he who has a wife, daughter, mother or sister who can 
 fulfill these requirements, and sensible is the woman who tries to fit 
 herself, by thought, reading and observation, to take care, in a proper 
 manner, of those dear to her, in their hours of pain and weakness, 
 under the shadow of death. 
 
 The dress of the attendant on the sick is deserving of attention. 
 It should be neat and clean, of a soft, warm color, and of a material 
 which will wash. Black is always nasty to the delicate sense of 
 smell of the sick. A dress that rustles must never be worn in the 
 sick room. Creaking shoes or slippers are, of course, improper. In 
 many cases of illness, particularly if the room be not carpeted, it is 
 well to have a pair of large loose slippers outside the door, to be 
 slipped on over their shoes, by those entering, not excepting thg 
 doctor. 
 
 9 
 
98 Domestic Management of the Sick Room. 
 
 Personal Attention Required by the Sick. When there is 
 a tendency, which exists in many diseases, to coolness of the sur- 
 face of the body, heat should be kept up by means of hot water 
 bottles, warm bricks, or tin cans filled with hot water, etc., applied 
 externally. 
 
 The shin of the patient must be kept clean by sponging with 
 tepid water, to which a little whisky or vinegar may be added. 
 Care must be taken while thus cleansing the skin, not to expose 
 the person to a draft, and not to uncover more of the body than is 
 necessary at one time. This sponging of the entire person may be 
 repeated, in most cases with advantage, every day. In any event, 
 the patient's face and hands should be washed every morning, and 
 the feet at least twice a week. Recovery is retarded in cases in 
 which the disease is assisted by the presence of dirt. 
 
 The bed should be tidied and put straight every day, and the 
 sheet upon which the patient lies should be kept smooth and free 
 from crumbs. 
 
 The body linen must be changed at least once a week, in most 
 cases oftener. The following rules in regard to changing are 
 useful : — 
 
 1. Do not begin to change until all that is likely to be needed 
 is ready. 
 
 2. See that there is no draft from an open window or door. 
 
 3. Have the fresh linen well aired and warmed beforehand. 
 
 4. Avoid moving or uncovering the patient more than is abso- 
 lutely necessary. 
 
 5. Do not call upon the patient for too much help. 
 Delirious patients must, of course, never be roughly dealt with, 
 
 neither must they be argued with or contradicted in their asser- 
 tions. It is best to appear interested in their conversation, while 
 watching over and controlling with gentleness but firmness all their 
 actions likely to do them injury. Such patients should never be 
 left alone, nor should one person be in attendance without being 
 able to call for immediate assistance at a moment's notice. 
 
 For rules in regard to cooking for the sick, and for special re- 
 ceipts for the invalid's table, see Chapter IX, commencing on page 
 320. 
 
Home Treatment. 99 
 
 For directions in regard to giving baths, and applying blisters, 
 cups, leeches, poultices, etc., see Chapter X, page 332. 
 
 Management of those Recovering from Sickness. Quiet 
 and rest are essential in every recovery from sickness. The mind 
 as well as the body demands repose after suffering. Any prolonged 
 or violent exertion or mental excitement is, for a long time after 
 recovery has set in, injurious, and may occasion a relapse. 
 
 After every illness, as soon as the invalid becomes strong enough, 
 a change of air and scene is of the utmost service. To those living 
 in the city, a visit to the country is especially useful. The sick 
 must not, however, be deprived of home care and comforts too 
 soon. A journey, however short, is always fatiguing to the feeble, 
 and a removal to a new abode, always a source of excitement and 
 some discomfort to those not long from a bed of sickness. When 
 the proper time arrives, the return of health is greatly facilitated by 
 a judicious change of residence for a while. 
 
 Household Remedies. The articles which are used to restore 
 the sick to health are often and conveniently divided into "house- 
 hold remedies" and " drugs." By the former, those articles are 
 understood which are found in every grocery store and household, 
 which are bought and kept for use in health, but possess medical 
 properties, sometimes very valuable ones. Such, for example, are 
 salt, mustard, vinegar, oil, spices, ginger, etc. An acquaintance 
 with their virtues as medicines, and their proper use in curing dis- 
 ease, is an acquisition which every one ought to make. Often such 
 simple articles answer the purpose much better, with more prompt- 
 ness, and at less cost, than the more unknown products of the 
 apothecary shop. 
 
 In the latter, the numerous bottles and drawers, with their labels 
 in large letters, presenting strange words and mysterious abbrevia- 
 tions, bewilder the ordinary visitor. He is deeply impressed with 
 the difficulties in the study of physic; and the danger of meddling 
 with what he knows is often poisonous is present to his mind. 
 These sentiments are just, for many of these drugs are dangerous, 
 others are rare and costly, others difficult to prepare and administer. 
 It is not wise for any one who has not seriously studied medicine to 
 
ioo Domestic Management of the Sick Room. 
 
 tamper with them, and hence, in such a manual of domestic practice 
 as this, it would be inexcusable to recommend them. 
 
 Fortunately, it is not necessary. Although there are so many 
 hundred drugs in every pharmacy, their multiplication is a matter 
 of trade rather than necessity. The most learned and successful 
 physicians do not use very many remedies. Probably the essential 
 parts of a hundred prescriptions from their hands would, in ninety 
 cases, be found in less than ten different drugs. 
 
 We propose, in this work, to take advantage of the same principle 
 of selection, and shall make the reader familiar with a limited 
 number of drugs of wide application, and which have the further 
 advantages of being not costly, not dangerous, and of decided vir- 
 tues. They can be used in many different complaints, and in the 
 forms which we shall recommend are peculiarly suitable for those 
 to use who have not studied the details of the druggist's trade and 
 the physician's calling. They will be often referred to, and when 
 they are once provided in the family, we shall endeavor to render 
 them sufficient for the treatment of nearly all ordinary diseases, 
 supplemented, as we shall presume them to be, with those "house- 
 hold remedies" to which we have already referred. 
 
 It would be advisable, therefore, for every one who intends to 
 make practical use of this book to obtain these remedies, a list of 
 which we shall presently give. They should be carefully put up 
 and kept in a locked chest or box, where children cannot get at 
 them. All the articles can be had of any druggist, though, as some 
 of them are often adulterated, and others spoil if kept too long, care 
 should be exercised in their purchase and preservation. 
 
 Sometimes, when several drugs are mingled, they act differently 
 and more successfully than either of them (or any other substance) 
 when taken alone. This is why, in most prescriptions or recipes, 
 one sees three or four or more articles mentioned. Another ad- 
 vantage, and a very great one in children and delicate persons, is 
 that it gives the chance to conceal the taste of a disagreeable drug, 
 and often to render it quite palatable. 
 
 Many of these firms keep on hand medicine chests containing a 
 select assortment of such drugs as are most commonly used by 
 
Domestic Management of the Sick Room. ioi 
 
 emigrants, missionaries, ship-captains, and others remote from 
 apothecary stores. 
 
 The number of these offers a wide choice, as not all are selected 
 with reference to the great principles which should govern the 
 selection of medical agents for popular use, which we take to be 
 (1) that they are efficient; (2) that they are not dangerous; (3) 
 that they do not readily spoil by time and change of temperature; 
 (4) that they are not distressingly unpalatable ; (5) that they are 
 not too bulky; (6) that they are not very costly. Of the 
 " Family medical chests " which have come under our notice, we 
 like, as well as any, and in some respects better than any, that 
 which has been sold by the M Medical Commission Agency," in 
 Philadelphia (115 South Seventh street). It is called " The Traveler's 
 Medical Kit," and having been carefully selected with a view to 
 the above requirements, may serve as a sample of them. Its 
 contents have been more or less changed, from time to time, as 
 improvements in the manufacture of drugs seemed to suggest. 
 Lists can be obtained from the Agency, giving their prices and 
 contents. 
 
 In Part IV of this work a number of selected receipts will be 
 given which will answer the above requirements, and which will 
 be freely referred to under the treatment of diseases. Any of these 
 can be obtained from the apothecary store, and, if used according 
 to directions, will answer a good purpose. A number of them 
 might be prepared and kept on hand ready for use. Others, which 
 will be spoken of, are the following : — 
 
 Ammonia, or Hartshorn. The preparations of ammonia which 
 will be referred to are, first, the "aromatic spirits of ammonia," 
 a valuable stimulant, serving in place of alcoholic fluids. The dose 
 of it, for an adult, is twenty drops, in a tablespoonful of water, 
 repeated when necessary. Second, the solution of the acetate of 
 ammonia. A tablespoonful of this, in a wineglass of water, is 
 the quantity for an adult. It acts on the skin and kidney, and is 
 very cooling in fevers, and similar conditions. 
 
 Bromides. These are the bromide of potassium or of sodium. 
 They are given to allay pain and nervousness, in doses of 20 or 30 
 grains. 
 
 9* 
 
1 02 List of Medicines. 
 
 Iodine. Tincture of Iodine, which is iodine dissolved in alco- 
 hol, is frequently used as an external application, to cause gentle 
 counter-irritation, and remove swollen glands, chilblains, stiffness of 
 joints, slow rheumatism, etc. The iodide of potassium , dose ten 
 grains, and syrup of iodide of iron, dose half a teaspoonful, are 
 very valuable "alteratives/' that is, they "alter" the general con- 
 ditions of the body. 
 
 Opium, one grain of which is an adult's dose, is generally given 
 as laudanum, which is opium dissolved in alcohol, one grain in 
 twenty drops ; or morphia, which is a chemical extract of opium, 
 one quarter of a grain of which equals one grain of opium; or 
 paregoric, which contains one grain of opium to an ounce; or as 
 Dover's powder, which has one grain of opium in each ten. All 
 these must be used with caution. 
 
 A Thermometer is useful, not only to maintain the air of a sick 
 room at a proper temperature, and to test the heat of warm baths, 
 foot baths, and the like, but in the hands of a judicious person, is 
 a great aid in deciding the severity of a case of disease, by ascer- 
 taining the temperature of the patient. For this purpose, the 
 instrument is so made that its bulb can be placed under the tongue 
 or in the arm-pit. Hold it there three or four minutes, and you 
 have the temperature of the skin and blood of the patient. This 
 should not be above 99°, nor below 97°. Any material variation 
 from these limits indicates danger, although the symptoms in other 
 respects do not appear threatening. " Family Thermometers " 
 have been devised, with a zero, showing the animal heat in health, 
 so that any deviation from it is perceptible by the most inexperi- 
 enced hand. 
 
CHAPTER IV. 
 
 AILMENTS AFFECTING THE WHOLE BODY. 
 
 Ailments attended vrith Fever as the Prominent Symptom : — Typhoid 
 Fever — Typhus Fever — Bilious Remittent Fever — Chills and Fever — 
 Break Bone Fever — Catarrhal Fever — Yellow Fever — Small Pox— Milk 
 Sickness. Ailments attended with Pain as the Prominent Symptom: — 
 Neuralgia — Headache — Rheumatism — Gout — Lockjaw, Ailments at- 
 tended with Sleeplessness as the Prominent Symptom : — Wakefulness — 
 Delirium Tremens. Ailments attended with Wasting as the Prominent 
 Symptom : — Starvation — Scrofula — Poverty of the Blood — Night Sweats — 
 Dropsy. Ailments attended with Insensibility as the Prominent Symp- 
 tom : — Fainting — Apoplexy. Ailments attended with Fits as the Promi- 
 nent Symptom : — Falling Sickness — Hysterics— St. Vitus' Dance. 
 
 I. Ailments attended with Fever as the Prominent 
 
 Symptom. 
 
 Typhoid Fever. This disease is frequently spoken of as slow 
 nervous fever, and sometimes as common continued fever. It also 
 bears the names of putrid fever, autumnal or fall fever, and night- 
 soil fever. 
 
 How Brought On. Exposure to foul air, as that of sewers, 
 water-closets, privy- wells, etc., is one of the most powerful causes 
 of typhoid fever. Depressing influences, such as anxiety, home 
 sickness, great fatigue, seem to occasion it in some instances. The 
 discharges of the patient may, if not disinfected, impart the disease ; 
 wells have been contaminated in this way, so that their water has 
 become a source of wide-spread contagion. The age at which 
 typhoid fever is most apt to occur is between fifteen and thirty 
 years, rarely before ten, and still more rarely after fifty. The ap- 
 
 103 
 
1 04 Diseases of Adults. 
 
 pearance of the disease does not seem to be influenced by climate 
 or locality. 
 
 How Distinguished. Typhoid fever is usually preceded for 
 several days by headache, loss of appetite, prostration of strength 
 and great disinclination to make any physical or mental exertion. 
 Bleeding from the nose is often an early symptom, so also is a 
 slight cough. Increasing weakness and the coming on of fever 
 force the patient to take to his bed. Considerable fever and thirst 
 are then complained of. The nights are wakeful and delirious ; 
 the days are passed in dozing and muttering. Soon, towards the 
 close of the first week, the belly swells, and diarrhoea ordinarily sets 
 in about the same time. The face takes on a dull look, and a dark 
 purple flush. Hardness of hearing is not unusual about the middle 
 of the second week. Towards the close of the second week, a few 
 small rose-colored spots, which are peculiar to the disease, show 
 themselves on the belly; they disappear for a moment when pressed 
 upon by the finger, but quickly return after the pressure is removed. 
 
 Recovery may begin at the end of the second week, but ordi- 
 narily not before the fourth week, while the attack, in rare cases, 
 lasts two or three months. Great wasting of the body and trouble- 
 some bed-sores accompany protracted cases. 
 
 The patient gets well very slowly, and is liable, for a long time, 
 to a relapse. About one case in twenty ends fatally, death taking 
 place usually in the neighborhood of the eighteenth or twentieth 
 day. 
 
 How Treated. Good nursing is of more consequence than medi- 
 cine in typhoid fever, as there is no remedy known which will cut 
 the disease short. At the outset, if the bowels are costive, a tea- 
 spoonful of castor oil, or half a tumblerful of the effervescing solu- 
 tion of citrate of magnesia (to be obtained of any druggist) may be 
 given ; afterwards, however, no purgative is to be ever administered. 
 When the diarrhoea becomes excessive, half a wineglassful of lime 
 water mixed with an equal quantity of milk, is an excellent sooth- 
 ing drink. Headache is best relieved by cutting the hair short and 
 applying iced cloths, or, in severe cases, pounded ice enclosed in a 
 bladder or rubber bag. To allay heat of the skin, sponge the body 
 with slightly warm whisky and water, or vinegar and water, care 
 
Typhoid Fever. 1 05 
 
 being taken to expose only one part at a time to the air. If much 
 pain and tenderness of the bowels be complained of, apply a large 
 hot mush poultice, mixed with one-fourth part of mustard. Great 
 attention must be paid to preventing bed-sores, by keeping the bed- 
 clothes always smooth, by frequently changing the position of the 
 patient, and by bathing the parts most pressed upon with whisky, 
 or with a mixture of spirits of camphor and sweet oil. 
 
 The diet is of the utmost importance in the treatment of typhoid 
 fever. Neither during the sickness, nor for a long time after re- 
 covery, should solid food be given. A neglect of this caution often 
 causes the death of the patient, by occasioning a rupture of the sore 
 places which always exist in the bowels in this disease. Although 
 fluid, the diet must be supporting. The quantity given at a time 
 must be small, not much more than a wineglassful, so as not to 
 distend the stomach, but it is to be repeated frequently, every hour 
 or two. An excellent diet is a wineglassful of milk, to which a 
 tablespoonful of lime water is added, given every two hours ; in 
 the alternate hours, a wineglassful of beef tea. Receipts for making 
 beef tea will be found on page 326. Great care must be taken not 
 to let the patient sink, from the want of frequently repeated concen- 
 trated liquid food. Iced lemonade or ice water may be taken to 
 quench the thirst, but not more than a wineglassful at one time. 
 
 As to medicines, few are required. A laxative may be given at 
 the outset of the disease, as already mentioned. For a tonic, 
 quinine is excellent. Few cases are treated without it at the 
 present day. A good way of administering it is to procure it in 
 powders, of two grains each, from the druggist, and give one of 
 these three times a day, in a spoon, surrounded with scraped apple, 
 which will disguise the bitter taste. 
 
 How Prevented. Foul air and water, being the great causes of 
 typhoid fever, must be avoided. Hence, close, badly ventilated 
 rooms, houses the air of which is vitiated by gases from the sewer 
 entering through imperfect water closets, or by emanations from a 
 privy well, or from decaying vegetables or timber, or by the foul 
 odor from pools of waste water or drains, or masses of filth near by, 
 and wells of drinking water contaminated by the neighborhood of 
 pig-sties, sink drains, and human excrement, are all sources of 
 
io6 Diseases of Adults. 
 
 danger which must be guarded against. It is asserted, also, that 
 cast iron stoves, and the hurtful gas which they throw off when 
 heated, are answerable for many cases of typhoid fever. Whatever 
 lowers the general health and depresses the tone of the nervous 
 system, predisposes to the disease. 
 
 Typhus Fever. This disease is also known as ship fever, camp 
 fever, jail fever, putrid fever, petechial fever, spotted fever, hospital 
 fever, brain fever, bilious fever, and low fever, etc. 
 
 How Brought On. This form of disease, which is essentially a 
 disease of the blood, is brought on by the absorption of what is 
 known as " crowd poison," which is developed by the exhalations 
 from the bodies of many persons congregated together m badly 
 ventilated or filthy houses, jails, ships, camps or hospitals. This 
 disease prevails almost entirely during the colder portions of the 
 year. This is due to the want of thorough ventilation, apt to 
 occur in the effort to avoid the cold. It is also extremely liable to 
 prevail under all circumstances of privation and misery. It is a 
 contagious disease, though very many who are exposed to it do not 
 contract the disease. 
 
 How Distinguished. For a few days prior to the full develop- 
 ment of the disease premonitory symptoms are observed. There 
 are loss of appetite, headache, general weakness or indisposition to 
 exertion. The patient then has a chill. Sometimes this is hardly 
 noticed, except as a slight feeling of chilliness, or it may be so 
 severe as, in rare cases, to cause the death of the patient before he 
 can react. This is soon followed by fever, accompanied with a 
 rapid, weak pulse, harsh, burning skin, violent pain in the head, 
 constipation of the bowels, the tongue covered with a whitish or 
 yellowish coat. The hearing soon becomes dull, or even deafness 
 ensues ; the mind wanders, particularly at night ; the face becomes 
 of a dusky hue. This train of symptoms continues, generally 
 growing more profound, the patient lying in a stupor, with more or 
 less muttering delirium, but from which he can generally be 
 aroused, though speedily relapsing. When this stupor or coma 
 becomes very pronounced, it is regarded as a very unfavorable sign. 
 The urine is allowed to accumulate, and in some cases it is com- 
 pletely suppressed. The tongue, which is protruded with difficulty, 
 
Typhus Fever. 107 
 
 gradually grows darker, even of a blackish hue ; hence, the disease 
 is sometimes called black tongue fever, or black tongue typhus. As 
 this organ becomes dryer, cracks or fissures occur in it, while it and 
 the teeth are covered with an accumulation known as sordes. The 
 constipation generally continues throughout the attack, and the 
 bowels are difficult to move. Frbm the fifth to the seventh day 
 the characteristic eruption makes its appearance, although in a 
 small minority of cases it is never present. It consists in a rash of 
 small, red pimples, on the chest, abdomen and extremities, usually 
 appearing in the order named ; first on the chest, then on the abdo- 
 men, etc. They are of a mulberry, or measles-like color. At first 
 these will almost entirely disappear under pressure, and return as 
 the pressure is withdrawn. Accompanying these, on careful 
 examination, may be found a number of very small vesicles, known 
 as sudamina. Occasionally, rose-red spots are mingled with the 
 peculiar eruption. The abundance of the characteristic eruption in 
 typhus fever, as a general rule, is a good index of the malignity of 
 the attack. There is generally observed a peculiar odor emanating 
 from the patient, though this cannot be regarded as special to the 
 disease. Bleeding from the nose rarely occurs. As the attack 
 proceeds, the symptoms become more marked ; the delirium passes 
 almost completely into stupor, the patient lies upon his back in a 
 state of great prostration, and often the urine dribbles away invol- 
 untarily. 
 
 The duration of the attack is about three weeks, and hence the 
 tenth and eleventh days generally form the critical period, from 
 which time the decline of the fever and the improvement of the 
 patient may be anticipated. Complications may arise, such as 
 erysipelas; gangrene, from pressure, particularly of the extremi- 
 ties; pneumonia, or inflammation of the lungs, commencing by 
 passive congestion, the result of the position of the patient. It is 
 rare that a relapse occurs. Occasionally, convalescence commences 
 as early as the end of the second week, and may commence sud- 
 denly and unexpectedly. Generally, the progress of recovery is 
 marked by no untoward event. With the exception of the loss of 
 the hair, the health of the patient is, as a rule, better than prior to 
 the attack. 
 
108 Diseases of Adults. 
 
 The case may be regarded as tending to a favorable termination 
 when the pulse suddenly becomes less frequent and stronger ; when 
 the patient begins to exert himself, and turns to one side from the 
 position on the back, or draws up one leg, as is naturally done in 
 health; when the rash is scanty or absent; when the appetite 
 commences to reappear, and the tongue to clean and become moist ; 
 and when the face assumes a less dusky hue, and the brain is 
 aroused to a returning intelligence. 
 
 The usual average of mortality is about one death in ten cases. 
 
 How Treated. As in all forms of severe disease, good nursing 
 is a great essential. As to any method of cutting short, or arrest- 
 ing this fever, there are no reliable means, though, at various times, 
 plans and remedies have been proposed, and even highly lauded, 
 but invariably, a full and careful trial has shown their inefficacy. 
 Perhaps the best thing to commence with is a mild purgative, as it 
 must be remembered that this is a low form of fever, and will not 
 bear any more depletion or weakening of the vital powers. Any 
 of the effervescent draughts, in moderate doses, are suitable, 
 especially as it is desirable to act by cooling the heated condition 
 of the patient. 
 
 From the commencement, there are but few cases which do not 
 require, almost from the onset, nourishment in a concentrated form, 
 and stimulants. When the heat of the skin is intense, great ameli- 
 oration of all the symptoms almost always results from the use of 
 cold water. An excellent plan is to sponge the patient all over, 
 taking care not to make too great an exposure of the surface. 
 Alcohol, or citric acid, or vinegar, may be added to the water with 
 advantage. This should be repeated several times daily, the appli- 
 cations being governed by the results. Thus, if the patient does 
 not feel comfortable after the sponging, but chilliness follows, it 
 should not be repeated. But when the temperature is lessened, 
 and all the symptoms appear to improve, the indications are that 
 the sponging is beneficial, and should be repeated. 
 
 Digitalis and veratrum viride both act well to diminish the force 
 and frequency of the pulse, as well as the temperature of the body. 
 
 The best results are claimed for, and would appear to follow, the 
 use of the mineral acids, the dilute phosphoric, the sulphuric, the 
 
Typhus Fever, 109 
 
 hydrochloric, the nitro-muriatic, or the nitric. Of the first, ten 
 to fifteen drops are given every hour, or every two hours. As a 
 general rule, large doses do not seem requisite, but the acids may 
 be given at sufficiently frequent intervals, largely diluted with 
 water, and with the addition of any pleasant syrup. Few patients 
 fail to appreciate this form of medication, and generally relish it. 
 The oil of turpentine has long been a favorite form of treatment, 
 particularly when the tongue is dry, and the abdomen is swollen by 
 the presence of gas. It is best given in mucilage, say, for an adult, 
 in fifteen to twenty drop doses, repeated every two, three or four 
 hours. 
 
 As this is a zymotic disease, or one due to a fermenting poison 
 in the blood, the sulphites have been supposed to be eminently 
 applicable as a curative agent. The carbolic acid also has its 
 advocates, but neither have yet been proven as possessing great 
 value. 
 
 Special indications must be observed as the disease progresses. 
 The headache, especially at the onset, claims attention, and may be 
 mitigated, if not entirely relieved, by the application of ice water, 
 vinegar and water, cologne water, alcohol and water, and if neces- 
 sary, the cold affusion, or bladder filled with crushed ice, may be 
 used, the hair having been closely cut. Sleep is important, and to 
 procure this, recourse may be had to full doses of opiates, or per- 
 haps, what is much better, of chloral. In this connection, it must 
 be remembered, that small doses of narcotics frequently add to the 
 excited condition of the brain, while a full dose at once procures 
 that relief which is so much needed. This, too, aids in relieving 
 the delirium, quieting the incoherent talking, or attempts to leave 
 the bed, and thus prevents the consequent exhaustion so liable to 
 follow. The bromides, particularly of sodium and potassium, may 
 be usefully employed to carry out this indication. 
 
 When nausea or vomiting occur, care must be observed that the 
 articles of diet, etc., are given in small quantities. Diarrhoea or 
 dysentery must be checked by astringents and opiates, when these 
 complications appear likely to add to the exhaustion of the patient. 
 As the disease progresses, constipation may be relieved by the use 
 of enemas, or very mild laxatives. Care must always be had lest 
 10 
 
no Diseases of Adults. 
 
 urine accumulate in the bladder, and the catheter should be em- 
 ployed whenever there is reason to suspect the presence of an undue 
 quantity. When there are much swelling and tenderness of the 
 abdomen, hot mush and other poultices may be applied, turpentine 
 stupes, and turpentine in the form of enemas, and by the mouth, 
 may be used. Mechanical compression, as a binder applied over 
 the abdomen, often affords great comfort. 
 
 Should hemorrhage occur, or sudden, intense pain in the abdo- 
 men, marking the occurrence of perforation of the bowels, the 
 situation becomes extremely grave. The utmost quiet must be 
 enjoined. Astringents, as tannic acid, acetate of lead, and the sub- 
 sulphate of iron, in union with opiates, may be employed to check 
 the hemorrhage ; and these may be given both by the mouth and 
 by the rectum ; opiates and chloral in full doses, to procure relief 
 of the exhausting agony, and to give rest. 
 
 The use of alcohol as a supporting measure, and of abundance 
 of fluid, easily digested food, particularly in a highly concentrated 
 form, are essentially necessary, sometimes from the beginning, 
 always after the first few days. 
 
 Stimulation must be employed solely with reference to the condi- 
 tion of the patient. The pulse is the best guide. When the pulse 
 becomes fuller, slower, stronger, the stimulation is doing a good 
 work. Under its influence the delirium ceases, the restlessness is 
 checked, the skin grows moist, and every symptom assumes -a more 
 favorable aspect. The reverse of these symptoms shows a necessity 
 for a lessened stimulation, or its entire cessation. 
 
 As a tonic, quinine, in two-grain doses, three to four times 
 daily, is highly beneficial. 
 
 The diet should consist solely of liquids, as milk — first and best, 
 eggs, broths, meat essences, etc. These should be given whether 
 desired by the patient- or not, and at intervals of two to three 
 hours. Too frequent repetitions are hurtful, by loading the 
 stomach, and not affording time for rest to the patient. The 
 quantity given at once should be determined by the attending cir- 
 cumstances, care being had not to risk the production of nausea 
 and vomiting by the administration of too large quantities. 
 Another point is to see that these articles are alternated, so as not 
 
Bilious Remittent Fever. Ill 
 
 to tire and disgust the patient by too much sameness, and also, by 
 a want of care in their preparation. 
 
 Should the stupor become profound, a blister may be applied to 
 the nape of the neck, extending well up over the occiput ; and at 
 the same time, revulsion may be induced by sinapisms to the 
 extremities. To avoid bed sores, etc., and the induction of pneu- 
 monia, or congestion of the lungs, the position of the patient should 
 be changed frequently, and the parts properly cleansed. When 
 the lung complication ensues, dry-cups and blisters to the chest are 
 alone admissible. 
 
 How Prevented. The causes should be avoided by thorough 
 ventilation, the prevention of overcrowding, and the proper hygienic 
 measures. 
 
 Bilious Remittent Fever. This is also called bilious fever, 
 remittent fever, and malarial fever. 
 
 How Brought On. Seen most, if not entirely, in spring and fall, 
 and due to malaria arising from marshes, or other stagnant bodies 
 of water, or the draining of mill-dams, ponds, etc., or the turning 
 up of fresh, uncultivated ground, as in new settlements. 
 
 How Distinguished. This disease is ushered in by general lan- 
 guor, and depression of spirits, headache, occasional nausea, and 
 coated tongue. Presently a chill occurs ; generally not severe, but 
 of an hour or more in duration. These symptoms vary in intensity, 
 and are followed by fever, which is marked by the usual hot, dry 
 skin; the quick, forcible pulse; flushed face; severe, throbbing 
 pain in the head ; more or less inability for mental exertion ; violent 
 aching pains in the limbs ; nausea, and vomiting of bilious matters ; 
 constipation; thirst, and quick respiration. In the course of ten 
 to twenty hours, an abatement of all the symptoms occurs, the 
 patient appears to be getting better, sleep occurs, and there is 
 moisture of the skin, or even a copious sweating. Still, his condi- 
 tion does not become quite normal. The pulse remains rather full 
 and frequent, more or less headache, and general pains continue, 
 with thirst, and general uneasiness of the stomach. These symp- 
 toms continue for a period varying from eight to twenty-four hours, 
 when the former state is renewed, and every symptom becomes 
 aggravated. The tongue now becomes heavily coated with a yel- 
 
112 Diseases of Adults. 
 
 lowish matter, and the stomach is so sensitive as to reject almost 
 every ingesta. When a passage occurs from the bowels, the dejec- 
 tion is loaded with bile, but may be more or less slate-colored. In 
 extreme cases, there are delirium, and great restlessness, and the 
 skin is deeply tinged of a yellow hue. This appearance, however, 
 is present, more or less, in nearly every case. 
 
 As the attack progresses, the remissions become more irregular, 
 and less marked, and finally, unless checked, the fever becomes 
 continuous. 
 
 The duration of the attack varies, according to its violence, from 
 six days to as many weeks. Occasionally, a complete intermission 
 occurs at the end of the first week, which terminates the disease. 
 It is liable to complication by an attack of inflammation of the 
 lungs, producing pneumonia; of the brain; of the stomach or 
 bowels, when diarrhoea or dysentery follow. As a result of a 
 chronic attack, we may have inflammation of the spleen or liver. 
 Or, particularly in some abnormal constitutions, or under adverse 
 circumstances, as privation or misery, the disease assumes the 
 typhoid form. This may occur from neglect or want of proper 
 treatment, or the epidemic influence of typhoid fever. The symp- 
 toms then, more or less nearly, resemble those of typhoid. The 
 pulse becomes high, rapid, 120 to 140 in the minute, and weak; 
 the skin harsh and dry ; the face assumes a dusky hue ; the bowels 
 may either be obstinately costive, or affected by diarrhoea; delirium 
 and restlessness occur; the tongue is dry and fissured, and covered 
 with dark sordes ; the weakness is marked, and may be alarmingly 
 increased by the occurrence of hemorrhages from the stomach, 
 bowels, nose, lungs, etc. Death may at any time close the scene. 
 The critical period is often marked by the occurrence of a copious 
 perspiration, or of a sudden alvine discharge of black, offensive 
 matter, in great abundance. 
 
 How Treated. Active and positive medication are imperatively 
 demanded, in order to cut short the attack when possible, and avoid 
 the occurrence of the complications and results so liable to follow. 
 Bleeding may be regarded as proper when the attack occurs in one 
 of a robust nature, where the headache is intense, the pulse bound- 
 ing and full, and there is every evidence of a plethoric condition. 
 
Bilious Remittent Fever, 113 
 
 Generally, however, the fever may be moderated by a free, active 
 purgative, and this should be of a saline character, preceded, if 
 necessary, by blue pill or calomel. Care should be taken when 
 there is nausea, lest these articles increase the trouble, and result in 
 an attack of obstinate vomiting. To meet this indication, an effer- 
 vescent, as the citrate of magnesia, will mostly act well, or Seidlitz 
 powders, or Epsom salts. 
 
 Refrigerant diaphoretics or effervescent draughts may be given, 
 and if the headache is intense, cups, or even leeches, should be 
 applied to the back of the neck. If the nausea is very annoying, 
 the irritability of the stomach may be controlled by cups or mus- 
 tard over the stomach, hot mustard foot baths, and lime water 
 and aromatic spirits of ammonia internally. Ice may be given 
 freely, and when the stomach is quieted, cold drinks may be freely 
 employed. 
 
 Having obtained a remission, more or less complete, that is, a 
 decided lowering of the pulse, diminished heat generally, free action 
 of the bowels, etc., quinine may be administered. Small and 
 frequently repeated doses are best, unless the remission amounts 
 almost to an intermission, or where there is reason to fear a return 
 of the symptoms in increased force, like a congestive chill, then one 
 large dose may be justifiable. If, under these repeated doses, say 
 one or two grains every two or three hours, all the symptoms con- 
 tinue to improve, the remedy may be continued, and on the occasion 
 of the next remission the dose may be doubled, say two grains 
 every hour; of course, not necessarily arousing the patient from 
 sleep. 
 
 Large, and even enormous doses are indicated when the symp- 
 toms assume a grave or malignant form, with great debility. 
 
 As the convalescence progresses, the dose may be gradually 
 lessened, say two grains three or four times a day, and this may be 
 continued as a tonic until the recovery is complete. 
 
 Complications which may arise will require the usual treatment 
 as indicated. 
 
 Where the patient progresses too slowly, and there still remains 
 great derangement of the digestive apparatus, and general sallow- 
 ness, small doses of some liver tonic, as blue mass, may be used. 
 10* 
 
114 Diseases of Adults. 
 
 If signs of thinness of the blood are present, some form of iron 
 may be added to the quinine. 
 
 How Prevented. The disease can only be guarded against by 
 the avoidance of exposure to malarial influence, though it seems at 
 certain times to prevail epidemically, and to attack many who can- 
 not trace any exposure to marshes, etc. 
 
 Chills and Fever. This disease is known also as intermittent 
 fever, ague, malarial fever, paludal fever, marsh fever, swamp fever, 
 littoral fever, chills, shakes, etc. 
 
 How Brought On. This disease is caused by exposure to mala- 
 rious influence, as the air of swamps, marshes, bodies of stagnant 
 water, etc. 
 
 How Distinguished. This disease is readily recognized by its 
 three stages, which are usually well marked and distinct. First, the 
 cold stage, when the patient has a chill of greater or less severity, 
 beginning with general uneasiness, yawning, languor, chilliness, 
 finally culminating in a chill, or rigor, or shake. The skin is cold 
 and blue, the teeth chatter, the patient shakes all over, and com- 
 plains of the great coldness, even when loaded with clothing and 
 placed close to a hot fire. Along with this he has headache, de- 
 pressed spirits, thirst, sometimes nausea and vomiting. This may 
 continue from a few minutes to several hours, but the usual average 
 is about one hour or less. This passes, gradually, into the second 
 or hot stage: The circulation becomes more and more rapid, the 
 face is flushed, the skin becomes hot and dry, violent headache sets 
 in, the ' bowels are constipated, the mouth and tongue are dry, and 
 the thirst is great. The appetite is lost, and occasionally vomiting 
 adds to the trouble. This may last from one hour to twenty; 
 generally, at the end of six or eight hours, the patient gradually 
 passes into the third or sweating stage. Moisture breaks out on 
 the face and upper portions of the body, and extends to the abdo- 
 men and limbs, and generally becomes quite profuse. The nausea 
 and headache disappear, and the patient, exhausted and relieved, 
 falls into a refreshing slumber. 
 
 This is the usual course of an intermittent ; but the order of the 
 stages may be reversed, or any of them may be wanting. In place 
 of the chill, a neuralgic pain may occur, generally over the brow, 
 
Chills and Fever. 1 1 5 
 
 or, the chill being absent, it becomes what is popularly known as 
 "dumb ague." Sometimes very singular forms present; thus, the 
 whole disease may be limited to one-half the body, or to one limb, 
 while the rest of the body appears in perfect health. There may 
 be dysentery or other diseases complicating the attack, and which 
 are completely intermittent. During the intermission the only 
 symptom of disorder is more or less debility, with indigestion or 
 headache. These intervals occur almost always in the daytime, 
 and may extend over more than one day. Hence, the disease is 
 known as quotidian, with a daily paroxysm ; tertian, with a parox- 
 ysm every other day, etc. The paroxysms have been separated by 
 an interval of a week. Again, the case may be a double quotidian, 
 that is, with two paroxysms daily. If protracted, as by neglect, 
 general debility ensues, with want of red blood, enlargement of the 
 spleen and liver, and general dropsy may set in. 
 
 How Treated. When the chill is on, the system may be aided 
 te react, by heat externally, and hot drinks freely taken. The 
 fever may be moderated by the usual refrigerant diaphoretics, pur- 
 gatives to relieve constipation, and cold, acid drinks.* 
 
 As soon as the fever ceases, the patient must be placed under the 
 influence of quinine, to prevent a return of the paroxysm. One 
 or two grains every hour, being careful to give enough to obtain its 
 full effects, will generally break up the periodical tendency. At 
 least 15 or 20 grains will be necessary. The return once broken, 
 it is safest to continue this remedy in smaller doses for several days, 
 or a week, at least. There is a remarkable tendency for the parox- 
 ysm to return in seven days, or multiples thereof. Hence, prior 
 to the seventh day, a large dose, as 10 or 12 grains, should be 
 taken. In very obstinate cases, complete recovery may be insured 
 by a careful observance of each seventh day, and a renewal of the 
 dose in anticipation of each. The cinchona bark, or the othei 
 extracts from it, as quinidia, cinchonidia, sulphate of cinchona, 
 have all been of value, but the quinine is preferable, as most 
 certain. 
 
 To break or prevent the chill, opium or laudanum, in one full 
 dose, has often proven successful. Chloroform, in one full dose, say 
 
1 1 6 Diseases of Adults. 
 
 one drachm, mixed with mucilage of gum arabie, has frequently 
 aborted a chill, and prevented a return. 
 
 Various barks, particularly the dogwood; pepper, or piperin; 
 willow bark, and salicin, an extract from it; sulphate of copper; 
 arsenic; in fact, a vast number of extremely diverse articles, have 
 been greatly extolled as useful in interrupting the tendency to 
 return. Perhaps arsenic has best shown this power, but, after all, 
 unless the preparations from the cinchona or Peruvian bark cannot 
 be obtained, or for some reason are inadmissible, there can be but 
 little advantage in resorting to these substitutes. Chills have been 
 broken, and their return prevented, by fright, or some powerful 
 impression made upon the person. Hence the success of certain 
 charms and incantations, a blister, a shower bath, etc. 
 
 Should the disease be of long duration, a strong tendency to 
 relapse is observed, the patient becomes debilitated, and iron with 
 quinine may become necessary. 
 
 How Prevented. By avoiding exposure to the causes. 
 
 Break- Bone Fever. This is called Dengue, dandy fever, and 
 by some it has been regarded as a form of scarlet fever, and called 
 rheumatic scarlatina. 
 
 How Brought On. No cause save epidemic influence has yet 
 been assigned to this disease. 
 
 How Distinguished. This disease is ushered in by languor, 
 chilliness, pains in the bones and back, headache, fever, and swell- 
 ing of the joints. The pains in the bones give rise to the name, 
 as many patients express their feeling as if the bones had been 
 broken, they "ache in every joint." Dandy fever is supposed to 
 be a corruption of Dengue, or an allusion to the movements of the 
 patient, whose aches cause him to move with a certain air of stiff- 
 ness, like a dandy. By the close of the second or third day the 
 fever abates, and the pains diminish. A rash breaks out over the 
 whole body toward the sixth day, or even earlier, which is red and 
 fine, like that of scarlet-fever ; sometimes more like measles. It 
 may vary greatly in its appearance, and be mixed with erysipelas, 
 and purpura. Though the patient may be much improved by the 
 abatement of the fever, yet generally about the fifth day it returns, 
 with a renewal of all the symptoms. After the eruption appears, 
 
Catarrhal Fever. 117 
 
 the symptoms seem greatly relieved, and the complaint gradually 
 disappears, leaving the patient stiff and sore, with general debility 
 for a variable period. In many instances, at the height of the 
 attack, there is intolerance of light, restlessness, red and watery 
 eyes, swellings of the lymphatic glands, of the neck, arm pits and 
 groins, a coated tongue, and tenderness over the stomach. 
 
 How Treated, As the disease must run its course, the treat- 
 ment will consist in careful nursing, the relief of constipation, miti- 
 gation of the pains by opiates, and anodynes locally ; bathing the 
 parts, especially the swollen joints and glands, with laudanum, chlo- 
 ral solution, etc. Rest should always be procured by opium, chloral, 
 or bromide of potassium. Rubefacients to the spine have been of 
 service. After the disease has subsided, tonics may be necessary. 
 This disease has rarely been known to result fatally. It is some- 
 times followed by rheumatism of the joints, abscesses, boils, etc. 
 Hemorrhage may occur from the nose, mouth, bowels, or other 
 mucous surfaces. 
 
 How Prevented. As it attacks nearly every one in the locality 
 where it is epidemic, removal is the only means of prevention. 
 
 Catarrhal Fever. This is known as epidemic catarrh, influ- 
 enza, la grippe, and epidemic bronchitis. 
 
 How Brought On. It is wholly due to an epidemic influence. 
 
 How Distinguished. The patient complains of having taken 
 cold ; is suddenly and often alarmingly prostrated ; has more or 
 less running from the nose, red, watery eyes, little cough, headache, 
 especially of the frontal region, loss of appetite, more or less chilli- 
 ness, followed by fever. Perspiration ensues, drenching the patient ; 
 and these phenomena alternate during the attack, which may last 
 from three to six days. 
 
 Complications are extremely liable to arise, such as chronic bron- 
 chitis, and pneumonia, especially in the aged. The fatality is not 
 great, and is generally the result of the pneumonia or other compli- 
 cation. It rarely proves fatal, except in the old or those previously 
 debilitated. 
 
 How Treated. As this is a fever of great debility, depletion 
 very rarely is necessary in any form. With young, plethoric per- 
 sons, a brisk purge at the outset, the best the citrate of magnesia, 
 
1 1 8 Diseases of Adults. 
 
 or some similar effervescent aperient, is beneficial Refrigerant 
 diapheretics, hot acid drinks, mustard foot-baths at night, with 
 care and protection from the weather, will form the whole line of 
 treatment. If there are great restlessness, or want of sleep at 
 night, opiates or the bromides will be useful. Tonics, especially 
 quinine, or even stimulants, should be employed according to the 
 indications. It is claimed that cases may be cut short by the em- 
 ployment of quinine at the outset, in full doses, say five grains 
 repeated every 4 or 5 hours. Complications, as they arise, must be 
 met with appropriate remedies. 
 
 How Prevented. It would appear that no plan can avail to pre- 
 vent an attack of this disease, as those who are attacked and those 
 who escape are generally occupying the same locality, equally 
 exposed, under the same circumstances, etc. Privation and misery 
 can scarcely be said to predispose to it, as an equal number suffer 
 from it who are in every way comfortably housed, clothed, and fed. 
 Of course, these latter influences favor a light attack and a more 
 speedy recovery. 
 
 Yellow Fever. This is known as typhus icterodes, American 
 typhus, black vomit, el vomito, yellow jack, malignant typhus fever, 
 malignant bilious fever, etc. 
 
 How Brought On. This is a disease resulting from blood poison 
 generated by peculiar conditions of the locality in which it prevails. 
 It is not regarded by the best observers to be contagious, yet its 
 germs are highly capable of being transported from place to place, 
 as in the hold of a vessel, and when these germs are brought to a 
 locality where the surroundings favorable to its spread are found, it 
 rapidly enlarges its circle and increases the number of its victims. 
 It cannot be believed that it can be carried by the sick, as too 
 many instances have been known where s3ch have been removed 
 from place to place, and yet no new cases have occurred in those 
 localities. Again, comparatively few of those brought in contact 
 with the sick are found to be attacked, such as physicians, nurses, 
 other sick in the same hospital or house. It may prevail as an 
 epidemic or by single cases in certain localities. 
 
 The conditions for its rise and spread are a continued high tem- 
 perature for several weeks, say above 80° F.; a high degree of 
 
Yellow Fever. 119 
 
 moisture in the air ; that is, dry, sultry weather for some time ; 
 decaying animal or vegetable matter, particularly the latter. While 
 it is slow of transportation, yet under favorable circumstances it 
 may be spread very rapidly, as though the germs ran riot and grew 
 with great luxuriance in a suitable soil. Thus, it has been known 
 to be brought to a locality by a ship, but has failed to extend be- 
 yond that ship, for want of its proper food on which to grow. 
 
 While there have been many contrary opinions held relative to 
 this disease, it is believed the above points are regarded as accepted 
 by all calm and dispassionate observers. 
 
 How Distinguished. It generally commences rather abruptly, 
 the patient rarely exhibiting any premonitory symptoms, often 
 appearing in the best of health and spirits immediately preceding 
 the attack. There may be a slight chill or cold stage, soon followed 
 by pains in the back and limbs, almost invariably commencing in 
 the night, the patient being roused from sleep by the attack. Some, 
 however, may experience the usual languor, loss of appetite, slight 
 headache and chilliness, which precede almost any form of fever, 
 for two or three days prior to the attack. The fever soon comes ' 
 on, and varies in degree, sometimes of great severity, but generally 
 moderate, with but slight increase of heat, and a pulse ranging 
 about 100. There is moisture of the tongue, with more or less 
 coating. Nausea and vomiting may occur, but generally this is a 
 symptom which is of later appearance. There is more or less ten- 
 derness over the stomach when pressure is made, and constipation 
 is nearly always observed. Violent headache, especially over the 
 eyes, is a marked symptom. The pains in the back and limbs con- 
 tinue, and are very prominent. A point often insisted on as pecu- 
 liarly indicative of this disease is the redness of the eyes, called by 
 some a " pink eye." In addition, these organs are irritable and 
 watery. The mind is generally unaffected, though delirium does 
 occur in a sub-acute form The fever continues from a few hours 
 to three days, without remission. When it ceases the intermission 
 is complete, and often it does not return, and convalescence com- 
 mences, with rapid recovery There are generally, however, a cer- 
 tain amount of tenderness over the stomach, and a yellowness suc- 
 ceeding the flush of the skin. 
 
1 20 Diseases of Adults. 
 
 In very many instances, after an interval of a few hours, or even 
 thirty hours or more, a renewal occurs. The pulse falls far below 
 the normal condition, it is weak, thread-like, and in every way is 
 shown a depressed state of the circulatory system. The fever is 
 not renewed, for the entire surface remains cool. The debility is 
 intense, the tongue is brown, and the stomach becomes irritable, 
 and now occurs the peculiar symptom which has given one name to 
 this disease; there is a vomiting — sometimes it appears merely a 
 regurgitation — of a peculiar black, coffee-grounds matter, mixed with 
 a liquid, thin, varying in color, reddish, brownish, or blackish. 
 Hemorrhage may now occur from any or all of the mucous sur- 
 faces, as observed in all malignant forms of disease. Generally the 
 patient complains of this vomited matter, as having an acid taste ; 
 occasionally it is terribly acrid, and excoriates the surfaces over 
 which it flows. It is bilious matter mixed with blood more or less 
 disintegrated. It differs also in quantity, sometimes being in great 
 abundance, and again barely perceptible. In addition, the bowels 
 discharge quantities of a brownish or blackish matter, like tar or 
 molasses. In grave cases, a low muttering delirium now sets in, 
 there is a profuse clammy sweat, in short, all the symptoms of 
 approaching dissolution, and death closes the scene from the fourth 
 to the sixth day. In all cases the yellowness of the skin is marked. 
 
 There has been observed a great variety of difference in all these 
 symptoms. Thus, while the prostration is generally great, in some 
 instances the patient has been known to continue active to the last, 
 and would not acknowledge himself as dangerously ill. These are 
 familiarly known as " walking cases." Some show a delirium of a 
 decidedly mirthful or cheerful form, even after the black vomit has 
 made its appearance. The second stage may vary from ten hours 
 to four days. The third stage is one of exhaustion from the poison 
 of the disease, as shown by all the symptoms, great weakness, feeble 
 circulation, coldness of the surface and extremities, low delirium, 
 or apathetic indifference. In place of this latter, we may have 
 convulsions, or coma, great distress and restlessness. In non-fatal 
 cases, convalescence ensues as the third stage, but recovery has 
 occurred even after all these grave symptoms have been present. 
 
Yellow Fever. 121 
 
 Here, the progress toward health is very slow, with great tendency 
 to relapses. 
 
 The average duration of the whole attack is under one week. 
 
 The patient may react from the collapse, and proceed through a 
 typhoid condition to convalescence, or which may end in the final 
 exhaustion of the patient. The mortality is very great, averag- 
 ing two deaths for every five persons attacked. 
 
 How Treated. Perhaps no disease has been so thoroughly 
 watched and studied, with so little result as to positive treatment. 
 No special mode seems to offer any satisfactory results. To cut it 
 short, a great variety of remedies have been employed and lauded, 
 but have invariably failed when fully tested. Mild cases tend to 
 recovery, regardless of treatment. As debility in grave cases is so 
 marked, depressing or depleting treatment must be avoided. For 
 the relief of the tenderness over the stomach, and the intense head- 
 ache, cups or even leeches have often proved useful to these locali- 
 ties. A number of observers agree in recommending the use of a 
 purgative dose of calomel, about five grains, followed by an effer- 
 vescent or saline, as the citrate of magnesia, a seidlitz powder, etc. 
 The use of cinchona or some of its preparations, particularly qui- 
 nine, has been strongly recommended, and, in fact, has been employed 
 everywhere, and in nearly every epidemic. As a means of aborting 
 or cutting short the disease, it has always failed, and hence can 
 scarcely be of service in the early stages ; but later, when debility 
 is evident, as a tonic it may prove useful, but only in the ordinary 
 dose of one or two grains every hour or two. Ice is always a 
 necessity, and should be given freely. It is best used when broken 
 in small pieces, and allowed to dissolve in the mouth. To aid in 
 relieving thirst, and checking nausea and the irritability of the 
 stomach, lime water, champagne iced, mineral water, lemonade, 
 orangeade, lime juice, or an acid drink made of dilute sulphuric 
 acid, will always prove of great value. Each of these should be 
 allowed freely, but in small quantities at a time. Charcoal water, 
 hot lemonade, and hot coffee have also been of service in checking 
 the vomiting. Of course, as before, these should be given in small 
 quantities frequently repeated, and as hot as can be borne. A fur- 
 ther aid is the use of a mustard plaster or the well known spied 
 11 
 
122 * Diseases of Adults. 
 
 plaster over the stomach, and when these fail, a blister dressed with 
 morphia may check the irritation of that region. 
 
 To relieve the harsh feeling incident to the hot stage, the whole 
 surface may be carefully sponged with cold water. Too much sur- 
 face should not be exposed at once, and often this method will pro- 
 duce a free perspiration, which is eminently advantageous. 
 
 On the other hand, some propose and claim to have obtained 
 great benefit from hot baths. Again, tepid water has been employed 
 for sponging, and with apparent good results. Perhaps the best 
 guide is the patient's feeling after the sponging. When he finds 
 himself comfortable, refreshed, and relieved, the remedy has been 
 useful, and may be repeated if necessary. But, when he is left 
 chilled, depressed, and decidedly uncomfortable, the remedy has 
 not been appropriate. When the stage of collapse comes on, stimu- 
 lants become necessary, and must be employed, according to the 
 indications ; these, and concentrated food, as beef essence, milk, 
 etc., must be given in small quantities, frequently repeated, great 
 care being taken lest all is lost by the induction of exhausting 
 vomiting, and the consequent rejection of everything carried into 
 the stomach. In this case, or sometimes preferably, food and 
 stimulants may be thrown into the rectum, and will aid materi- 
 ally in preventing fatal exhaustion. In all cases, however mild, 
 great quiet, cleanliness, and good ventilation must be imperatively 
 insisted upon. 
 
 Cases which appear of the mildest form at the beginning, often 
 assume a malignant type ; additional means may be employed as 
 complications, or rather fresh symptoms, arise. For the extreme 
 nausea, and tenderness over the stomach, in some instances, chloro- 
 form, creasote, carbolic acid, prussic acid, have been successfully 
 employed. Astringents have seemed to check the black vomit, and 
 among these may be mentioned acetate of lead, the subsulphate, 
 the pernitrate, and the chloride of iron. These also are specially 
 indicated in the occurrence of hemorrhage. Inquietude, morbid 
 vigilance, call for opiates, the bromides, or chloral, and other ano- 
 dynes. 
 
 Various antiseptics have been suggested, and in some instances 
 are claimed as useful. Among these are the sulphites, carbolic 
 
Small-Pox. ; 123 
 
 acid, chlorine, particularly the latter in the form of the chlorine 
 mixture, as proposed by Prof. Watson for other analogous affec- 
 tions. This is prepared by placing eight grains of the chlorate of 
 potassa in a pint bottle, and pouring over the salt one drachm of 
 the strong hydrochloric acid. The mouth of the vessel must be 
 closed until the reaction ceases, and then an ounce of water added 
 and the whole well shaken ; add the water, ounce by ounce, until 
 the bottle is filled. The dose of this is a tablespoonful or more, 
 according to the age of the patient, and repeated at short intervals, 
 so that the whole pint may be taken in one day. 
 
 How Prevented. To prevent the formation or spread of this 
 disease, the utmost vigilance is required. The most complete sani- 
 tary measures should be taken. Everything calculated to aid it, 
 or to act as a nest for its germs, must be thoroughly eradicated. 
 Cleanliness, the avoidance of overcrowding, disinfectants for all sus- 
 picious localities, the fullest ventilation, will act most efficiently. 
 When the disease has attacked a locality, its inhabitants should be 
 scattered at once ; the germs should be destroyed by the free use of 
 disinfectants, etc., preferably superheated steam, or dry heat. Cold, 
 too, destroys these germs, and the reduction of the temperature of 
 an infected vessel, etc., below the freezing point, will effectually pre- 
 vent the spread of the disease. 
 
 The most rigid inspection of all suspected vessels, as they arrive 
 at a locality, will most certainly prevent the introduction of the 
 disease. 
 
 Small- Pox. This disease is known by the name of variola; a 
 milder form varioloid; the confluent form is often called black 
 small-pox. 
 
 How Brought On. This disease is solely due to contagion. 
 Perhaps no form of disease is so readily conveyed by contagion. 
 While it is believed that the fomites must be conveyed by contact 
 or a near approach to the seat of the disease, instances are con- 
 stantly occurring where the occurrence of the disease cannot be 
 attributed to anything else than the epidemic influence. Generally, 
 . one attack secures an immunity from the disease, but cases do 
 occur where the second, or even third attack has been seen. Occa- 
 sionally, while a second attack is less grave, now and then, the 
 
124 Diseases of Adults. 
 
 second time it will assume a malignant form. It would appear as 
 though this were due to some vice in the system, or, perhaps, an 
 exposure to a very concentrated form of the poison. Filth, want 
 of ventilation, privation, and misery, would all, seemingly, predis- 
 pose to severe attacks, though, too frequently, the reverse obtains, 
 and a malignant type will invade the homes of the most refined 
 and luxurious. 
 
 How Distinguished. The earliest symptoms are those incident 
 to nearly all fevers, languor, nausea, pains in the head, back, and 
 limbs, the pain in the small of the back being, in nearly every case, 
 a marked symptom. Chills, and feverish flushes may alternate 
 until the fever sets in, which is the primary fever, or fever of erup- 
 tion. Along with these, there is, usually, more or less perspiration, 
 nausea, vomiting, coated tongue, pain and tenderness on pressure, 
 over the stomach, generally constipation, rarely diarrhoea, often 
 slight delirium. Pains in the loins is often a special symptom, and 
 more or less debility. When an epidemic of this disease is present, 
 the disease may be anticipated with great certainty, in all cases 
 where great complaint is made of pains in the loins, the small of 
 the back, and intense headache. Occasionally, the symptoms are 
 very extreme, the fever high, and the delirium great ; and convul- 
 sions sometimes ensue, or even usher in the attack. Nor is this 
 always a criterion of the gravity of the case, as in many cases 
 these symptoms speedily vanish as the eruption appears, and the 
 disease runs a mild course to its termination. Generally, however, 
 the variety known as the confluent form may be anticipated when 
 the chill, etc., are marked, and great fever results. 
 
 This stage generally lasts two days, and on the third day the 
 eruption begins to make its appearance. In rare instances, the 
 eruption is delayed, even to the fifth day, or may not appear at all, 
 which is often observed when the disease is epidemic; many per- 
 sons who have been exposed will have the fever of small-pox well 
 marked, but not followed by any eruption. When it appears very 
 early, as the second day, it is more apt to be in the confluent form, 
 that is, where the pustules are close or large, and run into each 
 other. The discrete, or separate variety, generally may be expected 
 when the eruption is slow to appear. Along with the peculiar 
 
Small-Pox. 125 
 
 eruption, in many cases, there is a rash, or efflorescence, resembling 
 that seen in scarlet fever, and frequently this leads to an error as 
 to what disease is under treatment, or it is believed to be a mix- 
 ture of the two diseases. As in nearly all cases of fever, the 
 sudamina, or sweat vesicles, are generally present, particularly on 
 the chest and abdomen. This efflorescence may make its appear- 
 ance first, and as the small-pox eruption appears, the other fades 
 away. In grave cases, or those liable to become malignant, another 
 eruption appears, known as petechiae, or ecchymoses, that is, blood 
 effused under the skin, in small patches or blotches. When small, 
 and limited in number, these are not so very significant, though 
 they show a broken down condition of the blood, but when large, 
 or very numerous, they are a very unfavorable sign, and are 
 extremely liable to be the forerunners of alarming hemorrhages. 
 The eruption proper of the disease appears, as a rule, first on the 
 face, neck, and wrists, the exposed portions of the body, next on 
 the chest and arms, then they extend over the whole body, and 
 lastly, on the lower extremities. This takes about three days. The 
 first appearance is a small, red spot, slightly raised above the sur- 
 face; sometimes these are livid or purplish. Gradually, it rises 
 and forms a vesicle, then a pustule filled with a whitish-yellow 
 fluid, and with the centre of the pustule depressed, forming a ring 
 of fluid. This is the characteristic form, but not all of the pustules 
 are thus depressed, or umbilicated. At first, the eruption may be 
 taken for that of measles, but the pimples are smaller, rounder, and 
 harder, than those of measles. They give to the touch a feeling as 
 of a small, hard body, just beneath the skin. It occupies about 
 five or six days for the eruption to be completed, and to fill up. 
 This is the separate or discrete form, but in the confluent form, as 
 they fill, the vesicles run together, and form large sacs, as it were, 
 filled with the peculiar fluid. In this form a redness over the skin 
 is mostly seen, prior to the appearance of the pustules. After the 
 sixth day the centre disappears, the fluid assumes a darker color; 
 this is called the stage of suppuration, for the fluid is pus or matter, 
 and gives rise to other symptoms. The eruption is not confined to 
 the skin, but is found in the mouth, the throat, within the nostrils, 
 even on the balls of the eyes, which often cause ulcers and irrepar- 
 - 11* 
 
126 Diseases of Adults. 
 
 able injury to the sight. No doubt the eruption occurs, also, down 
 the bronchial tubes to a certain extent, and along the oesophagus. 
 Laryngitis, or inflammation of the larynx, has been often caused by 
 the eruption, and resulted fatally. 
 
 As the eruption appears, the fever and accompanying symptoms 
 generally disappear, or are decidedly lessened, although the fever 
 and delirium may continue for a time, and especially is this the 
 case in the confluent form. When the suppuration commences, 
 say about the sixth day, the fever returns, and is known as the 
 secondary fever. Now, the perspirations do not appear as before, 
 but the skin is dry and harsh. This fever continues in proportion 
 to the gravity of the disease, in mild cases, for three or four days ; 
 in the more severe or confluent, much longer. At this time the 
 patient is very uncomfortable ; the face, hands, and feet are much 
 swollen ; the eyelids often are closed completely ; there is redness in 
 all the spaces between the pustules, which is generally accompanied 
 with a burning pain. This swelling is regarded as a favorable 
 symptom, and when it does not occur in the confluent form, is apt 
 to be followed by death. Salivation often occurs, and even to a 
 profuse degree, with great swelling of all the glands of the jaw. 
 This is so marked, that patients often insist that medicine has been 
 given them to cause salivation. At this period, the delirium again 
 occurs, especially in severe attacks, and may become maniacal, but 
 is generally of a low, muttering form. If, in addition to this, there 
 are twitchings, known as subsultus tendinum, coma, diarrhoea, the 
 situation becomes one of great danger or vigilance. This stage 
 commonly lasts for four or five days. 
 
 About the twelfth or thirteenth day from the inception of the 
 attack, the third or dying stage commences, the stage of desiccation. 
 The swelling and redness diminish, the pustules break, and the 
 contained fluid exudes and forms a thick, disgusting, brown or 
 blackish scab or crust. When the pustules are close, these scabs 
 unite and form large crusts, glueing up the eyes, the nostrils, cover- 
 ing the face like a mask, and giving forth from the whole body a 
 most intensely disagreeable odor. This smell is peculiar, and char- 
 acteristic of the disease. Once recognized, it is always known as 
 the odor of small-pox. The drying of the pustules occurs in the 
 
Small-Pox. 127 
 
 same order as their appearance, and occupies about four or five 
 days. In mild cases, the patient now is convalescent, and rapidly 
 improves. Gradually the crusts fall off, leaving beneath a discol- 
 oration of the skin, which is slow to disappear. These are 
 specially observable in cold weather, and in persons of dark com- 
 plexion. If the scabs are forcibly removed, and in severe cases, 
 they are renewed again and again, and may lead to ulcerations dim- 
 cult to heal. There is more or less pitting left to mark the site of 
 each pustule. In the mild cases these soon disappear, but the " pock 
 marks" remain as cicatrices, in nearly every case, for a length of 
 time. 
 
 In the course of an attack, the patient is liable to a variety of 
 complications, as inflammation of the larynx and pharynx, bron- 
 chitis, pneumonia, pleurisy, etc. Eiysipelas occasionally occurs 
 with the eruption. Boils and abscesses very often follow its disap- 
 pearance, and greatly prolong the period of recovery. Sloughing 
 or mortification has been observed, especially on those parts much 
 pressed upon. Inflammation of the eyes may result, and produce 
 more or less impairment of vision. The same may occur by exten- 
 sion of the disease to the inner ear, and cause deafness. 
 
 In all cases, the occurrence of hemorrhage, bloody urine, and 
 petechiae, are very alarming symptoms. It is believed that, in the 
 confluent cases, the matter, or pus, is often carried into the circula- 
 tion, causing pyaemia, or blood poisoning. Since the knowledge of 
 vaccination, much of the mortality of this disease is lessened, and 
 unless complicated or malignant, nearly all recover under proper 
 care and treatment. 
 
 How Treated. As the disease cannot be cut short, the sole 
 effort of the physician must be directed to the mitigation of the 
 symptoms, and the prevention of complications. Therefore, he 
 must watch the progress, and meet every thiDg as it arises. The 
 bowels should be unloaded, but not too freely purged. The fever 
 may be lessened by the usual remedies — cool acid drinks ; sponging 
 the surface with cold or tepid water, as found most grateful to the 
 patient; refrigerant diaphoretics, or the solution of acetate of am- 
 monia, or the citrate of potassa; the usual methods of relieving 
 nausea, etc. Perhaps for this latter indication, the carbonic acid 
 
128 * Diseases of Adults. 
 
 water now obtainable in syphons, at the shops, will prove best; it 
 rarely fails to quiet all irritability of the stomach. A number of 
 observers have employed articles with a view of lessening the 
 amount of matter, or pus formed, and for this purpose have sug- 
 gested the free use of the sulphites, or the sulpho-carbolates, in full 
 and frequent doses. For this purpose, also, much praise has been 
 given to the pitcher plant (Saracenia purpurea), but it has failed 
 to yield any advantages, and is now generally abandoned. Of 
 course, the utmost attention must be paid to cleanliness, ventilation, 
 etc., as in all diseases of this character. To prevent the great 
 exhaustion which is generally the cause of death, the diet should 
 be supporting from the moment of departure of the first febrile 
 symptoms, and the appearance of the eruption. All food should 
 be of the concentrated liquid form, soft-boiled eggs, milk, and arti- 
 cles made with it, beef tea, mutton and chicken broth. These 
 should, at first, be given in small and frequently repeated doses, to 
 coax the appetite, and to avoid increasing or bringing back the 
 nausea and vomiting. As the powers of digestion improve, and 
 the appetite returns, the amounts may be increased. Signs of 
 prostration indicate the necessity of stimulants, as wine-whey, milk- 
 punch, brandy or whisky and water, quinine, the muriated tinc- 
 ture of iron, etc. To relieve the morbid wakefulness, and induce 
 refreshing sleep, opiates, the bromides, or chloral may be used. 
 
 "A great object is to prevent pitting of the face, which so greatly 
 disfigures the individual ; some endeavor to abort the vesicles by 
 puncturing them with a fine needle, and emptying the fluid, by 
 touching each with a fine point of nitrate of silver ; then to exclude 
 air, and soothe the inflammation by covering the whole face with a 
 soft poultice of flaxseed, slippery elm, or bread and milk. A 
 variety of plans have been proposed to exclude the air, such as cov- 
 ering the face with a mask of mercurial ointment, collodion, and 
 glycerine, gold leaf, white lead paint, tincture of iodine, subnitrate 
 of bismuth and prepared chalk, poultices of various ingredients, 
 carbolic acid, gutta percha softened in chloroform. All have been 
 highly lauded as successful in a few cases, but none have succeeded 
 entirely. Perhaps the best is the careful touching of each pustule 
 with the fine point of caustic, followed by any light poultice, and 
 
Milk Sickness. 129 
 
 when the pustules have flattened, cover the entire surface with 
 collodion, mixed with a very small proportion of glycerine, to soften 
 it. This must be renewed, as it cracks from time to time, until the 
 completion of the desquamatory process. 
 
 When the parts are much heated, evaporating lotions should be 
 constantly applied. Every effort should be made to prevent the 
 pustules forming on the eyeball. For this purpose compresses wet 
 with cold water should be constantly applied ; some suggest a weak 
 solution of corrosive sublimate. 
 
 Complications must be appropriately met as they occur. Great 
 care is required, in the stage of convalescence, to avoid exposure of 
 the patient to cold or sudden changes of temperature. The patient 
 should be aided to repair the great waste incurred by profuse sup- 
 puration, by the long continuance of tonics, especially some form of 
 iron, and the best regimen. 
 
 How Prevented. Vaccination is the great preventive of this 
 disease. This must be thorough. It has been proposed that after 
 a vaccine vesicle has crusted, the patient should be re-vaccinated as 
 often as he will take, thus hoping to exhaust the susceptibility of 
 his system. Even when vaccination does not prevent the disease, 
 it modifies it markedly. Great care should be had to see that the 
 vaccination is complete, and not too old. It is safest that this opera- 
 tion should be repeated at intervals not to exceed five or six years, 
 and always when an epidemic is prevailing. To prevent diffusion 
 of the disease, the utmost cleanliness and free ventilation should 
 be rigidly enforced. Patients should not be permitted to mingle 
 with other people, until the scabs have completely disappeared, and 
 only after repeated and thorough bathings. Their clothing must 
 be thoroughly disinfected, or better, destroyed ; everything used in 
 the sick room should be subjected to a similar treatment. The 
 attendants should observe the utmost care, lest they act as trans- 
 porters of the germs of contagion. Change of dress, and the most 
 thorough washing of the hands, ought to be the very least they 
 should do. 
 
 Milk Sickness. This disease has received a variety of names, 
 as puking fever, the trembles, swamp sickness, river sickness, the 
 
130 Diseases of Adults. 
 
 slows, the tires, the stiff joints, etc., all referring to its supposed 
 cause or some of its prominent symptoms. 
 
 How Brought On. It is induced by eating the flesh or drink- 
 ing the milk of cattle affected with the disease. Cattle are supposed 
 to be attacked by it after eating certain weeds found only in pas- 
 tures not before cultivated. It is only observed in certain regions, 
 and rapidly disappears as the ground is broken up and its cause 
 thus destroyed. 
 
 How Distinguished. The symptoms are sick stomach, vomiting, 
 purging, great nervous prostration, trembling, stiffness of the joints, 
 and a feeling of tiredness, remaining long after the main symptoms 
 have disappeared. 
 
 How Treated. The treatment consists in most complete rest, 
 emetics and laxatives, if requisite, to cleanse the stomach and bowels 
 from the poisonous matter, bland fluids, for the thirst, and a diet 
 of an appropriate kind. No special mode of treatment has been 
 found beneficial. 
 
 How Prevented. By avoiding the use of the milk or flesh of 
 animals thus diseased. It is claimed that if the milk is well boiled, 
 and the flesh subjected to a high temperature, the source of the 
 disease is destroyed, and these articles may be used with impunity. 
 
 The disease is now so rapidly disappearing, that few opportunities 
 are obtained for its study, and hence but little can be said concern- 
 ing it. 
 
 II. Ailments attended with Pain as the Prominent 
 Symptom. 
 
 Neuralgia. This disease is truly a nerve-pain, and may affect 
 any portion of the body. From its location it derives a variety of 
 names, as hemicrania, when it affects one side or half of the head; 
 tic douloureux, when it attacks the face, sometimes called facial 
 neuralgia; sciatica, when it affects the great nerve of the hip; 
 pleurodynia, attacking the side, or pleura; gastrodynia, the stom- 
 ach ; angina pectoris, the heart, etc. 
 
 How Brought On. It is generally caused by a sudden exposure 
 of the part to cold ; an injury of the nerve ; weakness, as want of 
 
Neuralgia. 131 
 
 red blood; the action of some poisons, as that of lead; or by mala- 
 rious influence, when it takes the form of intermittent neuralgia. 
 
 How Distinguished. This form of pain is not associated with 
 an inflammation, but seems limited entirely to the particular nerve 
 affected. The pain is acute, shooting, sometimes expressed as a 
 stabbing pain, with great tenderness on pressure over the affected 
 part. Particularly is this shown when the pressure is made with 
 the points of the fingers, when the patient will shrink or cry out. 
 But if the pressure be more firm, the pain diminishes or disappears 
 entirely. The pain is generally intermittent, that is, not always 
 recurring at the same time, as in the form of intermittent neuralgia, 
 but it comes and goes ; there are paroxysms of acute pain, and in 
 the intervals even the tenderness on pressure may disappear. 
 Again, certain movements increase it, as a fall, or sudden concussion, 
 coughing, laughing, sneezing, the application of cold or heat to the 
 seat of the pain. It may, and often does, cause contraction of the 
 muscles of the part, cramps, etc. No fever is ever present, though 
 neighboring glands may become enlarged and painful. 
 
 How Treated. If the patient is anaemic, that is, wanting red 
 blood, the appropriate remedies should be employed. It has been 
 forcibly remarked, that "pain is the prayer of the nerve for 
 healthy blood." To meet this indication, some form of iron, and 
 preferably, the tincture of the chloride of iron, known also as the 
 muriated tincture of iron, is best, and most certain to yield good 
 results. The pain itself must be relieved, as excess of pain is 
 exhausting and demoralizing to the entire system. Opiates in 
 sufficient doses, or in the form of hypodermic injection of a solution 
 of morphia, will generally relieve the paroxysm. Preferably, how- 
 ever, is the use of some article not so liable to lead to subsequent 
 bad results, as the opium habit is most frequently formed in the 
 effort to obtain relief from pain. Belladonna has proved of great 
 value, and may be employed inwardly, and externally as a plaster, 
 or in a lotion. This article, combined with morphia, both in full 
 doses, has obtained a great reputation for the relief of neuralgia. 
 Then we have aconite, hyoscyamus, conium, Indian hemp, chloral, 
 etc. Lotions, or local applications, often speedily relieve. Thus, 
 the part is commonly bathed, and covered with cloths saturated 
 
132 Diseases of Adults. 
 
 with equal parts of laudanum and sweet oil, chloroform, liniments 
 of belladonna, aconite, etc., ointments of the same, or stramonium, 
 veratria, etc. Often, a mustard plaster will give the most prompt 
 relief. Even flannels, wrung out of hot water, applied to the part, 
 have proved useful. When anodynes are used, a full dose will 
 moderate, if not remove, the pain, and the dose should then be 
 renewed, at short intervals, and in diminished quantity, until no 
 return is observed. 
 
 An immense variety of quite diverse remedies have been pro- 
 posed, and lauded as useful, many of which are well worthy a trial. 
 Prominent among these is a mixture of equal parts of chloral and 
 camphor. When rubbed well together, these form a thick oily 
 fluid, which may be applied to the seat of pain, and renewed as 
 necessity demands ; carbolic acid dissolved in camphorated oil ; 
 painting with the tincture of aconite ; an ointment of veratria, grains 
 twenty, to lard, one ounce. Occasionally, when other means fail, a 
 blister over the seat of pain, dressed with morphia, will relieve 
 promptly. Perhaps the subcutaneous injection of this drug is the 
 most prompt means in severe or obstinate attacks. Anaesthetics, 
 as chloroform, ether, nitrous oxide or laughing gas, act to relieve 
 paroxysms, but some general treatment is required to insure perma- 
 nent benefit. Constitutional treatment will consist of quinine, 
 especially if malaria is regarded as the cause, iron, strychnia, or the 
 nux vomica. These three, in combination, act with great prompt- 
 ness. The muriate of ammonia has been recommended, and cer- 
 tainly will often prove useful. For special forms of neuralgia, we 
 have bisulphide of carbon, applied behind the ear, or to the temple; 
 oil of turpentine; phosphorus, this especially for nervous debility 
 as a cause of the pain ; creasote, carbolic acid or crystals of chloral 
 to the hollow of a tooth which is the seat of neuralgia, or some 
 form of tobacco, oil of cloves, in fact, all these oils ; brandy or 
 whisky, which act by stimulating the part above the point where 
 pain is felt. 
 
 Full diet, change of air, if possible, sea bathing, act as aids, and 
 lead to a permanent cure. Many cases of headache are a species 
 of neuralgia, and are relieved by the same treatment, as quinine, 
 iron, etc. Recently, we have had the monobromate of camphor, 
 
Headache. 133 
 
 the guarana, and the bromide of quinia, greatly lauded in this 
 affection. Each case requires a careful study of its causes, and 
 their removal, if possible. If there is associated with the headache 
 a sick stomach, with acidity, some antacid, as magnesia, particu- 
 larly the carbonate, aromatic spirits of ammonia, or if the tongue 
 indicate, podophyllin or a blue pill, will give relief, which will often 
 be the ending of that attack. In addition, the valerianate of zinc, 
 iodide of potassium, especially in a case with rheumatic tendency, 
 arsenic, the bromides, the latter in very large doses, have proved 
 especially valuable. 
 
 It is not necessary to specify the treatment for each particular 
 form of this disease. Local applications, of course, are most useful 
 when applied directly over the seat of pain, though hypodermic 
 injections will relieve when inserted at any point. 
 
 Headache. This is technically known as cephalalgia. 
 
 Generally it is only a symptom, as showing congestion or fullness of 
 the brain, dyspepsia, or some form of disorder of the intestines, etc. 
 
 How Brought On. It may result from rheumatism, neuralgia, 
 poisoning, as by alcohol, narcotics, etc., fever, disease of the brain, 
 womb disease, constipation of the bowels, overloading of the stom- 
 ach, excitement, etc. 
 
 How Distinguished. When it is due to neuralgic trouble, it is 
 generally one-sided or partial, as over the brow, and more or less 
 intermittent. There is generally pain on pressure of the scalp, etc. 
 There is also, in place of a constant pain, a darting or shooting 
 pain from temple to temple. When it is the result of rheumatism, 
 it is associated with more or less stiffness of the muscles, and rheu- 
 matic pain elsewhere. When due to congestion, fever, poison, etc., 
 the pain is accompanied with heat and throbbing. A constant 
 pain in the top of the head, often expressed by the patient as occu- 
 pying a spot the size of a finger nail, may be regarded as caused by 
 womb trouble. This form, too, is liable to result from a tumor of 
 the brain, or some other disease of that organ, or pressure on the 
 brain, from an enlargement or thickening of the skull bones. Head- 
 ache due to constipation, is generally a dull heavy pain, with a con- 
 fused feeling, increased by every effort, or even by the attempt to 
 think or talk, etc. 
 12 
 
1 34 Diseases of Adults. 
 
 How Treated. Firm pressure upon the head, even the tying up 
 of the temples with a handkerchief, will often greatly relieve the 
 intensity of the pain. Rubbing the scalp often acts in a similar 
 way. When there is nausea, and there is reason to believe that 
 the pain is the result of overloading the stomach, the presence of 
 indigestible matter, or of a poison, as alcohol, opium, etc., an emetic, 
 aided in its action by free draughts of warm water, or salt, or mus- 
 tard and water, will frequently give immediate relief, which is fol- 
 lowed by a refreshing sleep, from which the patient awakes perfectly 
 recovered. When the headache seems due to nervous exhaustion, 
 as when there is no nausea, it is known as nervous headache, and a 
 full dose of aromatic spirits of ammonia, or of the bromides, or of 
 the two remedies combined, will generally give prompt and perma- 
 nent relief. When the tongue is furred, and the bowels constipated, 
 free purgation is indicated, and preferably with blue pill, podo- 
 phyllin, or some article which will act readily upon the liver, followed 
 by a seidlitz powder, citrate of maguesia, etc. When an attack is 
 heralded by premonitory symptoms, as in some cases, it often may 
 be warded off by a full dose of some opiate preparation, the carbon- 
 ate of ammonia, a free saline purgative, one of the bromides, or 
 chloral. During a paroxysm, the anaesthetic influence of ether or 
 chloroform, partially induced, evaporating lotions to the head, as 
 alcohol, bay rum, cologne water, vinegar, ether, etc., afford great 
 relief. Cold or warm water freely applied to the head, according to 
 the feelings of the patient, often gives great comfort. A drawing 
 of the blood from the head will be effected by hot mustard foot- 
 baths. With persons predisposed to headaches, great relief is often 
 obtained by a cup of strong tea or coffee. To prevent its return, 
 the cause should be removed or avoided, and any condition of the 
 system predisposing to it should be corrected. For debility, iron, 
 quinine, nux vomica, strychnia, arsenic, and the preparations of zinc. 
 
 How Avoided. By care in hygiene, the avoidance of all causes 
 of the disease, the rem ^al of constitutional troubles. When due 
 to uterine trouble, this :hould be carefully inquired into and re- 
 moved. Rheumatic te idency may be relieved by iodide of potas- 
 sium. That due to a'.cohol, etc., should be prevented by strict 
 abstinence from these articles. 
 
Rheumatism. 135 
 
 Rheumatism. This is divided into acute and chronic ; articular, 
 or that affecting the joints and muscles. 
 
 How Brought On. This is the result of exposure to cold, and 
 particularly when the body is in a state of perspiration. The acute 
 form seems to attack, almost solely, those of what is called a rheu- 
 matic diathesis, or constitutional tendency. The chronic form 
 mostly attacks the aged, though it occurs at all ages. Again, it 
 may be the result of a blood poison, as that of syphilis or gon- 
 orrhoea. 
 
 How Distinguished. The acute form of rheumatism is marked 
 by fever of a high grade, accompanied with inflammation of the 
 joints, sometimes one or two, again several, or nearly every 
 joint will be affected. These parts are swollen, red, hot, and pain- 
 ful. Generally the shoulder joints, the elbows, the wrists, and 
 ankles, are the parts affected. While the symptoms still continue, 
 the parts are often bathed in perspiration. An attack may last for 
 months, but generally averages about three weeks. It may result 
 in incurable stiffness of one or more joints. 
 
 In frequent instances, this form has had as a sequel chorea, or 
 St. Vitus' dance. It is extremely liable to bring on heart disease, 
 which is almost never relieved. A singular incident is the sudden 
 change or transfer of the disease from its first location to another. 
 This is called metastasis, and is a dangerous complication. The 
 part affected is suddenly relieved, the symptoms entirely or almost 
 disappear, and suddenly they attack a distant joint or part; the 
 heart, the brain, the stomach, are all liable, and in such an event, 
 the situation becomes extremely grave. 
 
 The chronic form is a slow inflammation of the parts affected, and 
 the pains are generally increased at night; there is a vague, tired 
 pain of the affected part. 
 
 That resulting from the blood poison, as above mentioned, gene- 
 rally affects the long or flat bones, and rarely the joints. Along 
 with the pain are found swellings, like lumps on the bones; these 
 are called nodes, and are generally associated with inflammation of 
 the membrane which covers the bone, the periosteum. 
 
 How Treated. The acute form requires a constitutional treat- 
 ment of an active character. A variety of plans have been pro- 
 
136 Diseases of Adults. 
 
 posed, with strong advocacy, and many have been abandoned as 
 useless. Thus, the treatment by alkalies, as the carbonate or bi- 
 carbonate of potassa, in full doses, say twenty to thirty grains three 
 times daily; the nitrate of potassa; the acetate of potassa, seems 
 to have given most excellent results in very many instances. Sleep 
 must be obtained, and the best remedy for this purpose is opium, 
 as in the form of Dover's powders, which is a combination of opium, 
 ipecacuanha, and sulphate or nitrate of potassa. The bromides or 
 chloral, also, are useful to meet this indication. Locally, the pains 
 may be relieved by anodyne applications, as laudanum, etc., to the 
 affected joints. 
 
 Among the remedies, have been the free use of lemon-juice, qui- 
 nine, colchicum, calomel, alone or combined with opium. These 
 may be employed according to circumstances. Thus, quinine may 
 be used where feebleness is evident, as by the presence of profuse 
 perspirations. Lemon-juice may be allowed freely. Colchicum, 
 when there is reason to believe in a gouty tendency. This, com- 
 bined with an alkali, is a favorite remedy with many. To avoid 
 the heart affections, bromide of ammonium has been thought use- 
 ful, in fifteen to twenty grain doses. Several observers have found 
 good results from repeated small blisters, applied to the affected 
 parts. In debilitated cases, the muriated tincture of iron is espe- 
 cially valuable. 
 
 In the chronic form, the most useful remedy is the iodide of 
 potassium in full and continued doses ; guaiacum also has been of 
 great value, though objectionable by its extremely unpleasant taste. 
 Locally, liniments of various kinds may be useful, as those contain- 
 ing laudanum, turpentine, hartshorne, mixed with the soap lini- 
 ment or chloroform or aconite liniments. Some have claimed good 
 from the use of blisters to the spine, between the shoulders, when the 
 pain is in the upper extremities, or over the small of the back when 
 in the lower extremities. In the place of these, cups, cut or dry, 
 may be employed. Hot water or vapor baths are of great value, 
 particularly to relieve stiffness of the joints. Another plan is to 
 sweat the affected joint by enveloping it in cotton batting covered 
 with oiled silk. In that form due to gonorrhoea or syphilis, the long 
 continued use of iodide of potassium is the only means that will 
 
Gout. 137 
 
 give any relief. The muriate of ammonia and opiates at night have 
 also been very valuable. Some practitioners claim the best results, 
 in all forms, from full doses of opium or its preparations, on the 
 principle that the relief of the pain cures the disease, and certainly 
 their reputed success would seem to warrant this belief. Chalky 
 deposits in the joints often follow repeated attacks. 
 
 Gout. This is also known as arthritis, or podagra. 
 
 How Brought On. This disease is due to a constitutional tend- 
 ency, and is superinduced by excesses in eating and drinking. 
 
 How Distinguished. This is generally preceded, for a few days, 
 by symptoms of indigestion, acidity of the stomach, flatulence, cos- 
 tiveness, etc. Suddenly, sometimes, even without these symptoms, 
 a joint, generally of the great toe, the ankle, the wrist, becomes very 
 painful, red, and swollen. The pain is generally intense, and con- 
 tinues for several days. Some characterize it as a gnawing at the 
 bone, a tearing of the parts asunder, a burning, as by fire. It is 
 always accompanied by throbbing, and there is more or less general 
 fever and nervous irritability. When these symptoms subside, the 
 part is bathed in sweat, and the patient sleeps, from exhaustion. 
 The paroxysms return at more or less frequent intervals, and may 
 occupy the same or another joint. During a paroxysm, there is 
 great danger of metastasis to the heart, or stomach, which may 
 speedily end in death. This is known as misplaced or retrocedent 
 gout. 
 
 This disease is distinguished from rheumatism, by its location ; 
 in the former, the small joints, in the latter, the large ones are at- 
 tacked. There is great resemblance, and often the two appear com- 
 bined, and this is called rheumatic gout. 
 
 How Treated. During the paroxysm, colchicum and the 
 alkalies are most useful. Of the wine of the root or seeds of col- 
 chicum, ten to twenty drop doses may be given every three or four 
 hours. Added to this, ten to thirty grains of the carbonate of 
 potassa, or a full dose of the acetate, will generally promptly give 
 relief. Care is requisite at first, not to offend the stomach, and 
 cause nausea, and its action on the heart must also be guarded. As 
 this disease is liable to be followed by chalky deposits, as in rheuma- 
 tism, various remedies have been urged to dissolve these or hinder 
 12* 
 
138 Diseases of Adults. 
 
 their deposition. Lithia, in the form of the citrate or carbonate, 
 has been employed, with apparently good results. As the intense 
 suffering must be relieved, anodynes, as the opiates, are beneficial. 
 Locally, care must be taken lest cold to the parts cause a retroces- 
 sion of the disease, and its appearance at a less favorable point. 
 Washes containing laudanum, the alkalies, etc., may be applied on 
 rags to the part, and then covered with oiled silk. In case of a 
 retrocession to the stomach, etc., stimulants, as brandy, laudanum, 
 compound spirits of ether, chloroform, chloral, the tincture of rhu- 
 barb and senna, may be freely given at short intervals. To repro- 
 duce the attack in its original seat, place the feet in hot mustard 
 baths; and also apply mustard to the chest, over the stomach, etc. 
 
 How Prevented. Where the tendency exists, the utmost care 
 will be necessary to avoid all excesses ; not by reducing the system 
 by too great abstemiousness, but the avoidance of what is known as 
 "high living," or excesses of any kind. Full nutrition, by articles 
 easy of digestion, exercise in the open air, avoidance of constipa- 
 tion, will generally prolong the intervals between the attacks and 
 ward off fresh ones. Add to these, in obstinate cases, change of 
 air, as by traveling, the use of mineral waters and baths, and all is 
 done that can contribute to success in this particular. When the 
 system is depressed, iron and bitter tonics are very serviceable, but 
 should not be too long continued. 
 
 Lockjaw, op Locked Jaw. This is known also as tetanus, or 
 trismus. 
 
 How Brought On. This is generally the result of some injury 
 or wound, more particularly what are known as punctured or lacer- 
 ated wounds. A clean cut rarely is followed by locked-jaw. It is 
 also due to crowding, carelessness as to ventilation and cleanliness, 
 in hot climates. Cases are occasionally seen which apparently 
 result from cold. That form from wounds, is called traumatic 
 tetanus, and the other form is idiopathic. Another form, occurring 
 in the newly born infant, soon after delivery, is tetanus of the new 
 born, or trismus neonatorum. Sometimes this prevails to a great 
 extent, and was formerly extremely common among the plantation 
 hands in the Southern States of America. It generally makes its 
 appearance within the second week from birth, and results fatally in 
 
Lockjaw. 1 39 
 
 a very few days. By some, the disease is regarded as allied to 
 rheumatism. 
 
 Sow Distinguished. The attack is ushered in by a feeling of 
 stiffness of the muscles, generally of the jaws, hence the name locked- 
 jaw. It speedily extends to the muscles of the throat, the chest, 
 and the limbs. The stiffness increases to a spasm, which is parox- 
 ysmal, though it never entirely ceases. In severe cases, the spasm 
 of the muscles of the spine is so great as to cause an arching back- 
 ward of the whole frame, so that the patient lies on the bed sup- 
 ported only by the head and heels. Rarely, the reverse obtains, 
 and the body is bent forward. Still more rarely, the curvature is 
 to one side or the other. The jaw is frequently so tightly closed 
 that food cannot be taken, and it may become necessary to knock 
 out a tooth in order to open a passage for the articles of nourish- 
 ment. When the muscles of the face are attacked, the most horri- 
 ble grimaces are produced, or the mouth is drawn back at its angles, 
 giving the appearance of an ugly laugh, called the sardonic grin. 
 The spasm is often so unexpected that the tongue is caught between 
 the teeth and badly bitten. Occasionally it involves the muscles of 
 swallowing, and this becomes a matter of impossibility, the patient 
 being liable to choke in the act. The breathing is more or less 
 impeded by the stiffness of the muscles of the chest, producing 
 labored respiration. These spasms are attended with great suffering, 
 and are induced by the slightest cause, as a dash of cold water or 
 air on the surface, a sudden touch — even a mental effort will cause 
 them. Sleep is almost impossible, except from the influence of 
 some narcotic. Occasionally, delirium, though not of a high grade, 
 occurs. Thirst is usual, though it is really attributable to the diffi- 
 culty of swallowing. The mouth generally is filled with foamy 
 saliva, streaked with blood from injured parts. The teeth may be 
 broken by the force with which they are brought together. The 
 bowels are costive, but there may be involuntary passages ; as also, 
 the urine may be retained, or pass involuntarily. Death may occur 
 suddenly, from asphyxia in a spasm. Though the spasm produces 
 an increase of heat of the body, yet there are usually profuse per- 
 spirations, both in the spasms and during the intervals. A common 
 symptom is a piercing pain at the pit of the stomach, going through 
 
140 Diseases of Adtdts. 
 
 to the back. Death follows in from twenty-four hours to as many 
 days, generally in ten or twelve days. It is a very fatal disease, 
 being slightly less fatal when not due to an injury. 
 
 It may be confounded with strychnia poisoning, from the pres- 
 ence of the spasms ; but here the succession of spasms is extremely 
 rapid, the lower extremities are most affected, the legs being extended 
 and the feet drawn inward, the jaw spasm is much less, and the 
 face is rarely affected, the swallowing is easy, only the patient snaps 
 like a mad dog at what is offered, and swallows it with a gulp. 
 Also, the result is quickly fatal, and there is the history or attend- 
 ing circumstances to aid in the diagnosis. 
 
 It may be known from cerebral trouble, or spinal meningitis, by 
 the absence of inflammation, of delirium, headache, and coma or 
 stupor. From epilepsy it is known by that disease having inter- 
 vals of apparent perfect health. Occasionally, there is a slight 
 locked-jaw, with hysterical attacks, but the accompanying circum- 
 stances will define the disease. 
 
 How Treated. The treatment is generally unsuccessful. An 
 infinite variety of remedies and plans have been suggested. Some 
 powerful narcotic would seem to offer the only hope of relief. 
 Opium, combined with brandy, say a grain every two hours, or 
 even every hour, has appeared of value. Or hypodermic injections 
 of morphia might be preferable, as more easy of administration, 
 and more speedy in results. The utmost quiet must be enforced ; 
 light, noise, and draughts of air, must be excluded. As the patient 
 will die from exhaustion, unless nourished, some plan must be 
 employed to meet this indication. Food is to be given in a concen- 
 trated liquid form, and stimulants in full doses. Nutritious and 
 stimulating enemas may be thrown into the bowels. In some cases, 
 a tube has been passed between the teeth, as in the absence of a 
 tooth, and carried into the stomach, by which canal, food, etc., have 
 been thrown into that organ. Inhalations of the various anaesthet- 
 ics have been very often useless, though they may partially control 
 the spasms, and make the patient more comfortable. Among other 
 remedies, have been belladonna, Indian hemp, quinine, all in large 
 doses ; the application of irritants to the spine, ice to the spine, cold 
 affusions, etc. Of later years, a variety of new methods have been 
 
Wakefulness. 14 1 
 
 suggested, as chloral, nitrite of amyl, croton chloral, the calabar 
 bean, woorara, etc. As, in some instances, the remedial applications 
 have been carried to excess, it becomes a grave question whether 
 some deaths might not be the result of these doses. 
 
 Perhaps the best plan would be the relief of the spasms by some 
 article, as chloroform inhalations, or chloral, nutritious alimentation, 
 and quiet. Instances are related, where recovery has ensued under 
 such treatment. 
 
 How Prevented. The prevention of this disease could only be 
 attempted when it was prevailing as an epidemic, among new-born 
 children, or when an injury had occurred, and such a result was 
 feared. For the first, removal from the locality, cleanliness, and 
 care, would be all that could be done. For the latter, care, quiet, 
 relief of pain, emollient and soothing applications to the seat of 
 injury. Amputation of an injured part has been proposed when 
 the nerves of the limb are involved, as the surest method of pre- 
 venting the inception of tetanus. 
 
 III. Ailments attended with Sleeplessness as the Promi- 
 nent Symptom. 
 
 Wakefulness. Known as insomnia, morbid vigilance. 
 
 How Brought On. This symptom, for it cannot be regarded as 
 a disease, marks the presence of some form of disease of the brain ; 
 or is the result of strong mental excitement, or mental labor; or is 
 caused by excessive pain, or the inordinate use of articles, as strong 
 tea, coffee, tobacco, etc. 
 
 How Distinguished. When not the result of acute pain, the 
 patient finds himself, at the hour for retiring, wide awake, and is 
 unable by any of his usual methods to compose himself to slumber. 
 The history of the case will enable the physician to decide as to 
 whether it is the result of excitement, over-work, the use of stimu- 
 lants, etc., or a symptom of hidden brain affection. When no 
 other cause can be assigned, the gravest fears may be felt lest it re- 
 sult in insanity, inflammation of the brain, or softening, etc. 
 
 Hoiv Treated. The treatment will depend solely upon the cause. 
 
142 Diseases of Adults. 
 
 Whatever this may be, it must be removed, if removable. The 
 patient should be made fully to understand the danger he is in, and 
 to lend his entire concurrence in the efforts for his relief. Mental 
 labor should be given up ; overwork of any kind must be abandoned ; 
 articles liable to keep up the trouble must be forbidden, such as to- 
 bacco, coffee and tea. If general debility be present, the system 
 must be brought to a natural standard by tonics and a proper diet. 
 If there are symptoms of a fullness of the brain, this must be re- 
 lieved by cups, or leeches to the nape of the neck, the temples, etc., 
 or a blister to the same spot, dressed, when requisite, with morphia. 
 Occasionally, this fullness may be relieved by proper physical exer- 
 cise, as a long walk, calisthenics, etc. All excitement of any form 
 must be avoided just prior to the hour for sleep, hence, light exer- 
 cise at this time will be best, as diverting the attention from busi- 
 ness, etc. Instances are common where the patient suffers from an 
 empty stomach, and a quantity of easily digested food will satisfy 
 the craving and promote a sound, refreshing slumber. Again, 
 cold to the head, or hot foot baths, with or without mustard, or a 
 warm bath, will relieve the patient promptly. The patient should 
 examine his surroundings, as to whether any cause exists, such as 
 improper position in bed; the best is always where the head and 
 shoulders are above the level. For the relief of this symptom, 
 except where it is the result of pain, medicines should be employed 
 with caution. It is always best to obtain sleep with the mildest 
 means first. A glass of beer at bed-time, a hop pillow, or the pre- 
 parations of hops, hyoscyamus, lactucarium, bromide of potassium 
 or of sodium, will generally relieve, and preferably in the order 
 given. Some observers have found that opium or morphia, added 
 to the bromides, appear to correct the unpleasant action of the 
 opium, and aid its effects. The best remedy of all is the chloral. 
 This should be employed in positive doses, say fifteen or twenty 
 grains, repeated, when necessary, in one, two or three hours. A 
 variety of other remedies have been proposed, but those quoted will 
 answer the purposes. 
 
 Delirium Tremens. Called also mania-a-potu, alcoholism, 
 dipsomania, potomania, the horrors. 
 
 How Brought On. It is caused by the abuse of alcohol, and 
 
Delirium Tremens. 143 
 
 is generally induced by the sudden withdrawal of stimulants, or 
 their long-continued excess. 
 
 How Distinguished. The symptoms are want of appetite, wake- 
 fulness, trembling of the muscles, debility, loss of digestion, 
 unreasonable horror at slight causes, hallucinations. Want of sleep 
 is the chief and most important symptom. This relieved, recovery 
 rapidly follows. The dreams, for though he is awake, they are 
 dreams, are of monsters, enemies, unnatural objects hovering around 
 him, and endeavoring to injure or annoy him. Rarely they are of 
 an amusing form, or he may perform imaginary tasks, and hold 
 conversation with spirits, which he imagines he alone can see. 
 Death will result unless relieved by sleep, though instances have 
 been known where sleep was not obtained for two weeks. Gener- 
 ally, in three or four days, the attack yields, sleep comes on, and he 
 awakes cured, though weak. 
 
 How Treated. Upon this point much difference of opinion 
 exists, though the disease has been so fully studied, the opportuni- 
 ties being, unfortunately, very frequent. Formerly, the plan of 
 " tapering off," was regarded as best, and the patient was made to 
 gradually abandon his stimulants, while opium or some narcotic was 
 given to aid in his relief. But, at present, excellent observers agree 
 in ascribing the best results to other plans, in which the stimulants 
 are positively forbidden. Perhaps the most positively successful 
 plan, is that by giving highly nutritious food, in a concentrated 
 form, and procuring sleep by the use of large doses of chloral. In 
 a number of instances this has proved highly successful. The first 
 dose, say twenty, thirty, or even sixty grains, should be followed, 
 unless the patient sleeps, by a repetition of the remedy in one or 
 two hours, but in smaller doses, say twenty grains. When sleep is 
 induced, if prolonged, the patient may be aroused at the end of 
 some hours, and made to take of some nourishment. Generally, he 
 relapses into a sound slumber when thus aroused, without a renewal 
 of the dose. Cases are reported where convulsions had occurred, 
 and death seemed imminent, but which were speedily and perma- 
 nently relieved, by this plan of treatment. Large doses of the 
 tincture of digitalis, a tablespoonful at once, have succeeded most 
 admirably, and no bad results followed. Perhaps this would equally 
 
144 Diseases of Adults. 
 
 relieve, if employed in more reasonable doses, say one drachm, 
 repeated every two or three hours. Even half a drachm has been 
 found useful in severe cases. Chloroform, by itself, in drachm doses, 
 has been quoted as giving good results. This remedy and red pepper, in 
 thirty grain doses, would suit old drinkers, perhaps, better than those 
 who had not so long been preparing their stomachs for such pun- 
 gent articles. The bromides, in large doses, have also been reported 
 as successful. 
 
 Generally, the first attack can be cured, but each fresh attack is 
 more dangerous, either as liable to a fatal termination, or to the 
 induction of insanity or idiocy. 
 
 How Avoided. By avoiding the cause. 
 
 IV. Ailments attended with Wasting as the Prominent 
 
 Symptom. 
 
 Starvation. How Brought On. This ailment may occur as 
 the result of privation, loss of appetite, or some incurable affection 
 of the organs associated with the ingestion or digestion of food. 
 
 How Distinguished. Starvation is characterized by a wasting of 
 all the tissues ; the eyes are sunk deep in their sockets ; the cheeks 
 are lantern-jawed, being hollow, sunken, and wan; the skin becomes 
 pale, flabby, and harsh; the joints are prominent; the muscles are 
 thin, soft, and flabby ; the pulse is easily compressible, and rather 
 fast; the heat is generally below the normal temperature; the hair 
 becomes thin, and straggling; the step is slow, and tottering, and 
 everything betokens a want of vitality. 
 
 How Treated. The cause must be removed, when this is possi- 
 ble. If there is chronic incurable disease of the stomach, the 
 oesophagus, etc., the only hope is to prolong life by the employment 
 of small quantities, in frequent doses, of highly concentrated food 
 and stimulants. If these cannot be retained by the stomach, or 
 there exist an insurmountable obstacle to their entering this organ, 
 they must be used in the form of enemas. The irritability of the 
 stomach should be relieved by the appropriate remedies, mentioned 
 under the appropriate head. 
 
Scrofula. 145 
 
 But when starvation is the result of privation, as poverty, or 
 enforced abstinence by shipwreck, etc., food should be given with 
 great caution, in small quantities, of the lightest, most easily digestible 
 form. The organs must be brought back to their normal condition 
 very gradually, as the slightest excess may result in the loss of all 
 the vantage ground. Starvation is extremely liable to result in 
 scurvy, purpura, low forms of fever a and diseases of the bones. 
 
 How Prevented. Starvation may be brought on unintentionally, 
 by a systematic effort to live cheaply, or to spare food for others, 
 under circumstances of privation. Hence, much may be done to 
 prevent starvation, by enlarging the popular knowledge as to cheap, 
 yet nutritious forms of food ; as to the valuation of grains, and the 
 non-necessity of meats. Again, a patient may be starving while 
 in the midst of plenty, because of a want of variety, the system 
 becoming satiated, and refusing to assimilate what is offered it. 
 The sanitarian and the philanthropist have much yet to do in this 
 respect : the teaching of the poor how to live cheaply, and well ; the 
 proper, most healthful modes of preparing the food for the stomach ; 
 the alternation in foods, the due admixture of fish and flesh with 
 grains and roots, etc. 
 
 Scrofula. This is also known as king's evil, scrofulosis, struma, 
 tubercle of the lymphatic glands, white swelling, etc. 
 
 How Brought On. It is generally the result of inheritance, or 
 the deprivation of pure air, the insufficiency of food, cold, in short, 
 any form of privation will promote it, if not produce it. 
 
 How Distinguished. There is a peculiar vitiated condition of 
 the system, which causes the development of slow inflammations, 
 tumors ending in abscesses, ulcerations, and a variety of forms of 
 skin disease, and disorders of the mucous membranes, the glands, 
 bones, etc. It most frequently occurs in the young, and is very 
 chronic in its forms of attack, and obstinately persists, healing at 
 one point and making its appearance at another. Enlargements of 
 the glands, particularly of the neck, armpit, and groin, are constantly 
 occurring. These sometimes soften and discharge, or may disap* 
 pear without softening. In children of this constitutional taint 
 there are observed enlargement of the head, swelling of the upper 
 lip, or nose, of the abdomen, flabby muscles. They are generally 
 13 
 
146 Diseases of Adults, 
 
 of light complexion, with sandy or reddish hair, blood easy to 
 inflame, and does not heal readily. Occasionally, the reverse obtains, 
 the patient is dark-haired, sallow-skinned, but with all the other 
 symptoms well marked. 
 
 How Treated. When such a general predisposition presents, 
 every effort must be directed to the improvement of the general 
 health, and the avoidance of the causes which deprave the system. 
 The nutrition must be full ; the hygiene must be carefully regarded ; 
 cleanliness, ventilation, avoidance of damp, unhealthy localities, 
 whether for work or for a residence. The blood must be improved 
 by alterative tonics, as the iodide of potassium, and the iodide of 
 iron, etc. Iodide is inseparable from its treatment. Hence, we 
 have it offered us in the form of iodized milk, the iodide of ammo- 
 nium, and continued with a great variety of remedies. The iodized 
 milk is prepared by dissolving one part of iodine in ten of alcohol, 
 and combining it with ninety parts of milk, just fresh from the 
 cow. Locally, iodine is generally used to soften or drive away the 
 swellings, or reduce enlarged joints, etc. It is thought, by many, 
 that the best results are obtained by its use in the form of a very 
 dilute ointment, thus causing absorption and not irritation, as would 
 be the result of strong applications. As a remedy to aid in build- 
 ing up, the cod-liver oil alone, or combined with the lacto-phosphates 
 of lime, iron, potassium, etc., is very useful. Pure air and good 
 food are indispensable, hence the sea shore is the best place for a 
 residence, while under treatment. Dr. Lankester offers a dietetic 
 salt, being common salt united with phosphoric acid, sulphuric acid, 
 lime, iron, and potassium. Another preparation is a mixture of 
 iron with chocolate, forming a caramel. Both of these are proper 
 remedies, and should be employed along with the remedies indicated 
 above. 
 
 Complications, as strumous ophthalmia, etc., must be met as they 
 arise. 
 
 How Prevented. The means of prevention are indicated in the 
 above. 
 
 Poverty of the Blood. This is known as anaemia, bloodless- 
 ness, watery blood, etc. 
 
 How Brought On. Poverty of the blood may be the result 
 
Poverty of the Blood. 147 
 
 of a loss of blood from a hemorrhage, as caused by injury or disease; 
 over lactation, or suckling too long continued ; any exhausting dis- 
 charge, as diarrhoea; want of nourishing food; or privation and 
 misery of any kind ; or it may be due to the influence of poisonous 
 air, like that of a malarious neighborhood. 
 
 How Distinguished. The patient suffering from this state of 
 the blood is extremely pale, thin, weak, easily fatigued, every exer- 
 tion causing palpitation of the heart, every little excitement causing 
 great nervousness. Blood drawn, or the result of an injury, is thin, 
 pale, and watery, showing a want of the red coloring matter. In 
 young, growing persons, especially girls, these symptoms are very 
 apt to be present, showing a growth of too rapid a nature, without 
 the proper amount of fresh air, exercise, and nourishing food. 
 There is generally a depressed state of the mind; the sleep is either 
 too profound and not refreshing, or disturbed; in some, there is 
 ringing in the ears ; swelling of the feet and hands often are pres- 
 ent, and almost invariably there is more or less swelling beneath the 
 eyes, which are surrounded with a dark ring ; as a general rule, the 
 appetite is much impaired ; it may be wanting, or appear insatiable 
 and capricious, with a desire for strange food. Very many cases 
 of long standing have vague pains, and suffer greatly from neu- 
 ralgia, generally in the head and face. 
 
 How Treated. The indications for treatment are plain. Every 
 effort must be made to build up the blood. The patient should be 
 required to have plenty of fresh, pure air, light exercise, as it can 
 be taken, and highly nourishing diet. The medical treatment will 
 consist in tonics, particularly those containing iron. Among the 
 numerous iron preparations, it may be necessary to ring the changes, 
 as the patient soon appears to tire of one long continued. Again, 
 certain forms appear to agree better with some persons than with 
 others. Perhaps the muriated tincture of iron, combined with qui- 
 nine, or some preparation of cinchona, will be found most useful. 
 To this may be added, dilute phosphoric acid, or these may be com- 
 bined, in pill form, as quinine and the phosphate of iron. In 
 extreme nervousness, the valerianate of iron is useful. Strychnia, 
 or nux vomica, often greatly aids in relieving the muscular debility. 
 Where there is a scrofulous tendency, the iodide of iron, preferably 
 
148 Diseases of Adults. 
 
 the syrup of the iodide of iron, with or without some cinchona pre- 
 paration, is very beneficial. In young girls, particularly, there is apt 
 to be a want of the menstrual flow, while in all women suffering 
 with poverty of the blood there is more or less disturbance or 
 irregularity in this function. Here, the muriated tincture of iron, 
 or syrup of the iodide, with quinia, proves extremely valuable. 
 
 Of course, hemorrhage, from any source, must be stopped, and 
 the solution of the sulphate of iron, combined with some form of 
 ergot, rarely fails to meet this indication. 
 
 How Prevented. The causes, as above detailed, indicate the pre- 
 vention. Remove any drain upon the system, as suckling, 
 hemorrhage, overwork ; enforce ventilation, exercise. 
 
 Night-Sweats. This is called colliquative perspiration. 
 
 How Brought On. Night-sweats are always the result of great 
 debility, and are usually associated with consumption of the lungs, 
 hence the dread with which this symptom is regarded. 
 
 How Distinguished. Strictly speaking, profuse perspirations, 
 though often occurring at night, may occur at any time. When 
 the result of phthisis, they are preceded by the hectic fever, 
 a flushed face, etc., which commences in the evening, reaches its 
 height at midnight, and terminates in a drenching sweat. When 
 the result only of debility, they follow a serious and debilitating 
 illness, or a general languor, and are induced by the most trifling 
 exertion. Sometimes, in consumption, the sweating disappears, and 
 is replaced by an exhausting diarrhoea. 
 
 How Treated. Night sweats, or profuse perspiration, at any 
 time, when not the result of a consumptive tendency, can readily 
 be checked by the free use of the astringent tonics. In all cases, 
 every effort should be made to build up the strength, by good, 
 easily digested diet, proper ventilation and regulation of the tem- 
 perature. Occasionally, the heat of the room in which the patient 
 lives is such as greatly to contribute to the keeping up of this symp- 
 tom. The mineral astringents in full doses, given freely diluted, 
 have a marked effect in checking sweats. In some instances, the 
 position, as sleeping in a chair, in place of lying in a bed, will pre- 
 vent, at least for a time, this profuse flow. When the bowels are 
 not prone to diarrhoea, we dilute sulphuric acid, in doses of fifteen 
 
Dropsy.. 149 
 
 to thirty drops, in sweetened water, with generally a good result. 
 The body should be sponged at the hour of retiring, with vinegar 
 and water, alum dissolved in whisky, or some similar astringent 
 wash. Internally, the vegetable astringents are useful, particularly 
 when there is a tendency to looseness of the bowels. Of these, the 
 tinctures of kino, krameria, or catechu, are most valuable. The 
 muriated tincture of iron, the subsulphate of iron, the syrup of the 
 iodide of iron, the ammonio-citrate of iron, all act well in relieving 
 the sweating. 
 
 How Prevented. In consumptive cases, the only hope is the 
 careful regulation of the temperature, and the husbanding of the 
 patient's strength. As these sweats are hot only very exhausting, 
 but are liable to cause additional trouble by the "taking cold," after 
 a severe illness, every effort should be made to ward them off, by an 
 early resort to tonics, full diet, etc. 
 
 Dropsy. This is known by a variety of names, according to its 
 location, as anasarca, or general dropsy ; ovarian dropsy ; hydrocele, 
 or dropsy of the testicles ; hydrocephalus, or dropsy of the head ; 
 oedema, or dropsy of a part where the water is located just beneath 
 the skin ; etc. 
 
 How Brought On. As by the general term, dropsy, is meant 
 that form witnessed in the abdomen or feet, this form alone will be 
 discussed. It is generally due to a sudden stoppage of sweating, as 
 by cold ; thinness of the blood, as in anaemia ; or some mechanical 
 obstruction of the circulation of blood in the veins. It may result 
 from heart disease, kidney disease, liver disease, or may follow any 
 exhausting sickness. 
 
 How Distinguished. The first symptom showing the presence 
 of dropsy is a gradual, painless swelling of the part. In the abdo- 
 men it is shown by great enlargement, want of tenderness, a dull 
 sound on percussion, or gently striking the part. Striking with one 
 hand, at one side, will cause a wave of the fluid to pass to the other, 
 and strike against the hand placed on that side. Along with this, 
 there is emaciation of the whole system, the appetite is poor, the 
 patient is easily fatigued, and when the swelling is great, there is 
 more or less difficulty of breathing. The swelling is regular and 
 even, and not in lumps or irregularities, as in the case of a tumor. 
 13* 
 
150 Diseases of A dults. 
 
 If an abscess caused the swelling, there would be more or less pain 
 at the seat of inflammation, and the other characteristic symptoms 
 of that affection. As the dropsy increases, there is correspond- 
 ingly increasing inability to lie down, for the water interferes with 
 the lungs and heart more when the patient is in a recumbent 
 position. 
 
 How Treated. When it is rather sudden in its appearance, it is 
 called acute dropsy, in contradistinction to the slower or chronic 
 form. This being the result, generally, of suppression of perspira- 
 tion, or of the action of the kidneys, what are known as diuretics 
 should be used, with free purgation. Jalap and cream of tartar in 
 large doses, with plenty of water, rarely fail to act well and bring on 
 copious watery discharges from the bowels and bladder. These may 
 be given in infusion of juniper berries, or broom ; and along with 
 them, at proper intervals, the acetate of potassa, sweet spirits of 
 nitre, etc., are valuable. Free purging may generally be obtained 
 by the elaterium, say, in doses of a fourth, or a third of a grain, 
 every three or four hours, till it acts freely. Digitalis formerly was 
 thought to act favorably, but it is now falling into disfavor. When 
 it is due to debility, along with these remedies, should be given the 
 proper tonics, to bring up the blood to its proper standard. Care 
 should be had, not to further exhaust the strength by these purga- 
 tives, etc. When the parts are so swollen as to become painful, or 
 to interfere with the breathing, etc., as in the abdominal form, tap- 
 ping becomes necessary; or when it is in the lower extremities, 
 great relief may be obtained by a number of minute punctures 
 through the skin, so as to let the fluid escape. 
 
 V. Ailments attended with Insensibility as the Promi- 
 nent Symptom. 
 
 Fainting. Known, also, as syncope, a swoon, or swooning, 
 fainting fit, etc. 
 
 How Brought On. This may be the result of any sudden emo- 
 tion, debility, heart disease, an injury, etc. 
 
 How Distinguished. The patient suddenly loses consciousness, 
 
Apoplexy. 151 
 
 and falls or sinks to the ground. There is general pallor, apparent 
 or total suspension of respiration, the heart's action is so feeble that 
 it can scarcely be felt, or heard when the ear is placed over the side, 
 the limbs are relaxed and motionless. It is distinguished from 
 epilepsy by the absence of the frothing, the previous history, etc. 
 Generally, the attack soon passes off, and the patient "comes to," as 
 it is called, and gradually the functions are resumed. 
 
 How Treated. As fainting, if prolonged, may cause death, or 
 serious injury to the system, by the formation of clots in the 
 heart, it is very important that the fit should be shortened, and the 
 consciousness restored. Perhaps the most valuable means to this 
 end will be, to place the patient prone on the ground, so that the 
 head shall be on a level with or below the body, the clothes loos- 
 ened, so that no impediment may exist to the free circulation of the 
 blood. This will insure the brain being kept full of blood, which 
 serves to restore the nerve power necessary to reanimate the heart. 
 In persons liable to faint, by reason of debility, hemorrhage, etc., 
 it should be remembered that fainting cannot occur so long as the 
 brain is kept full of blood. For this purpose, the head should be 
 kept low, the pillows, etc., removed, and the feet and body elevated. 
 To aid in restoring animation, cold water may be dashed suddenly 
 in the face, stimulants may be placed in the mouth, and caused to 
 rundown the throat; hartshorne or smelling salts maybe applied to 
 the nose. In cases of fainting from emotion, where there is plenty of 
 blood, bleeding from the arm may be resorted to. In addition, the 
 limbs may be vigorously rubbed. 
 
 How Prevented. This is sufficiently indicated in the foregoing. 
 
 Apoplexy. How Brought On. This is generally the result 
 of age, though it is occasionally seen in the young or middle-aged. 
 As age advances, the blood vessels of the brain become less able to 
 retain their contents, and some sudden emotion, a full meal, over- 
 stimulation, a strain, as at stool, or in lifting, causes a rupture 
 at some point, the blood is poured out, and either causes instant 
 death, or forms a clot, by whose pressure life is hastened to a close. 
 Those predisposed to apoplexy are short, thick-necked people, of 
 indolent habits, and high-livers. Excessive mental effort also 
 superinduces such an attack. Again, the wearing of a tight cravat, 
 
152 Diseases of Adults. 
 
 which, by its pressure, hinders the return of the blood from the 
 brain. 
 
 How Distinguished. When it is the result of the rupture of a 
 blood vessel in the brain, there are rarely any premonitory symptoms. 
 Generally, it is sudden ; a stroke, as it is often called ; the patient at 
 once falls, unconscious; breathing more or less like snoring, called 
 stertorous ; the cheeks puffing out and in, the pulse slow, generally 
 full ; the face is dark, livid. This may continue from a few min- 
 utes to several hours, and is followed by more or less paralysis, with 
 affection of the mental powers. When it is caused by congestion 
 or fullness of the brain, the face, for some time previously, is flushed; 
 the eyes are red and bulging; there are heat, throbbing of the ves- 
 sels of the head, headache or vertigo, or both ; the sight is more or 
 less impaired. The patient has also been costive, dull, drowsy, and 
 complaining of a fullness of the head ; these symptoms are followed 
 by sudden stupor, with stertorous breathing, pulse labored and slow, 
 and the face flushed and livid. Generally, the total unconscious- 
 ness is brief. There might be slight convulsive movements. After 
 recovery, the paralysis is generally but of temporary duration. 
 
 The history aids much in distinguishing this effect. Thus, the 
 absence of the fumes of liquor, etc., show that it is not drunken- 
 ness, or poisoning by opium, or some similar drug. If it were the 
 result of concussion or compression, there would be the evidences 
 of injury. Fainting would be known by the presence of paleness, 
 coldness, and the loss of pulsation. 
 
 How Treated. Of course, the age of the patient will have much 
 to do with the decision as to the probabilities of entire recovery ; 
 the younger the patient, the better prospect exists. When there 
 are evidences of plethora, or an abundance of blood, bleeding may 
 be employed to relieve the tension on the vessels of the brain. 
 This operation should be performed with care, watching the effect. 
 When solely due to congestion, a free bleeding will often give com- 
 plete relief, but should be followed by rest, care in diet, free purga- 
 tion. When it is doubtful as to the use of bleeding, cups, cut or 
 dry, may be applied to the nape of the neck, and mustard plasters 
 along the spine, on the legs, and stomach. Injections into the 
 lower bowel will aid during the first of the attack, and these should 
 
Falling Sickness. 1 5 3 
 
 be followed by free purgatives, particularly those of a saline char- 
 acter. The head should be elevated, and kept cool by the use of 
 wet cloths, or a bladder filled with ice. In cases occurring in broken 
 down or aged persons still more care is required, lest the trouble be 
 rendered permanent by still further hemorrhage, or other injury to 
 the delicate organism of the brain. 
 
 How Prevented. This will be met by the avoidance of excessive 
 brain work, care as to diet and drink, in all cases where, from age 
 or other reasons, an attack is likely to occur. 
 
 VI. Ailments attended with Fits as the Prominent 
 
 Symptom. 
 
 Falling Sickness. This is known as epilepsy. It is an attack 
 of convulsions, with unconsciousness, and which recurs from time 
 to time, without any regularity. 
 
 How Brought On. This may, and often does, result from 
 parentage, intemperance, or excesses of any kind ; injuries to the 
 head, or fright. 
 
 How Distinguished. In many instances an attack is ushered in 
 by a headache, vertigo, a sudden feeling of terror, or what is called 
 the aura ; a feeling as though something were creeping up a limb, or 
 a wind were blowing on it. This extends slowly upward, and then 
 the patient screams, starts, and falls suddenly, convulsed, foaming, 
 grinding the teeth ; the face is flushed, the eyes roll wildly, respira- 
 tion is performed with difficulty, and there may be vomiting and 
 involuntary passages. This lasts usually five or ten minutes, the fit 
 passes off, the patient goes into a sleep, or a drowsy state, or may 
 arise bewildered, and stagger on his way, with more or less head- 
 ache, weakness, or even delirium and frenzy, which impels to attack 
 those around. A fresh attack may occur in a few minutes, or 
 hours ; or even months may elapse before a renewal. 
 
 How Treated. During the fit but little can be usefully attempted. 
 The patient should be cared for, and placed so that no injury may 
 result from striking his limbs or head as he tosses about. The 
 clothing should be loosened, and he should be allowed plenty of 
 fresh air. If prolonged, ether, chloroform, or nitrite of amyl may 
 
1 54 Diseases of Adults. 
 
 be given, by inhalation, to arrest its continuance. The special effort 
 will be to prevent a recurrence, and for this purpose, many and 
 diverse remedies have been proposed. Perhaps the best results have 
 been obtained from the valerianate of zinc, one grain, two or three 
 times a day ; the bromide of potassium, in full doses, and continued 
 for a long time, say 15 to 30 grains, three times a day, for months; 
 digitalis, bromide of ammonium, conium, tincture of assafoetida, 
 and chloral. The latter was given just prior to the expected par- 
 oxysm. The nitrite of amyl, also given at this time, say as the 
 aura was commencing, has been found eminently valuable. 
 
 How Prevented. This indication will be met by the careful 
 avoidance of the causes ; by living temperately, yet using nutritious 
 diet, keeping away from all excesses, avoiding all bad habits, and 
 taking regular exercise in the open air. Tobacco, especially, should 
 be avoided, as highly detrimental. The bowels should be kept as 
 regular as possible. 
 
 Hysterics — hysteria, a "fit of hysterics." This was supposed 
 to be caused by the womb, and hence its name, but it is seen also 
 in the male, occasionally, and while womb affections predispose to it, 
 it may be caused by general weakness, or excitability of the nerves. 
 
 How Brought On. Any mental emotions, fatigue, or unusual 
 effort, may cause it in those who are depressed. 
 
 How Distinguished. It is characterized by a fit or attack of 
 uncontrollable laughing, crying, or even convulsive movements, like 
 epilepsy, though without loss of consciousness. It is preceded and 
 accompanied by a choking sensation, as though something were in 
 the throat, which the patient in vain tries to swallow. Some per- 
 sons who are subject to this disease will have a variety of other 
 troubles, such as a short, hacking cough, loss of voice — yet which, 
 on occasion, is found to be only simulated — retention of urine, loss 
 of power in one or more limbs, etc. 
 
 How Treated. The paroxysm may generally be relieved by 
 soothing attentions, valerian, assafoetida, etc. In the intervals, the 
 system must be built up with a good diet, iron, quinine, strychnia, 
 etc., with bromide of potassium, valerianate of ammonia, camphor, 
 and similar remedies, and chloral, as may be found requisite to 
 relieve excitement and produce sleep. The prevention of a return 
 
St. Vitus' Dance. 155 
 
 may be guarded against by regulated exercise in the open air, the 
 avoidance of all excitement, sea bathing, traveling, and a proper 
 occupation, to prevent the mind dwelling upon any sources of 
 trouble. 
 
 St. Vitus' Dance. This is also known as chorea. 
 
 How Brought On. Chorea generally occurs in debilitated child- 
 ren, especially girls from the age of eight to fifteen, or when puberty 
 commences, the occurrence of which often appears to act as a cure 
 of the trouble. It results frequently from rheumatism in the acute 
 form, from general debility, fright, excitement, fatigue, great men- 
 tal effort. 
 
 How Distinguished. It is characterized by incessant movements 
 of the hands, the feet, the face, the tongue, in fact, of the whole 
 body. These are irregular, and appear beyond the control of the 
 patient. They interfere with walking, working, and speech, but 
 cease entirely during sleep. 
 
 How Treated, The disease may last for many months, but gen- 
 erally improves in a month or less. It may produce mental derange- 
 ment. When it follows a rheumatic attack, it is more apt to be 
 obstinate, and the appropriate treatment, iodide of iron, is best, 
 combined with nutritious diet, sea bathing, and regulated exercise 
 in the open air. In protracted cases, cimicifuga has proved very 
 useful, as well as arsenic, sulphate of zinc, and bromide of potas- 
 sium. When the attack is very distressing, chjoral will be found 
 of great service. In every instance, the patient should be guarded 
 against annoyance from the thoughtlessness of those around him ; 
 and separation will be best, both for this purpose, and lest sympa- 
 thetic imitation, or intentional mimicry, induce it in others. 
 
CHAPTER V. 
 
 AILMENTS OF PARTS OF THE BODY. 
 
 Section I.— Ailments Seated in the Air Passages.— Cold in the 
 Head — Cold in the Chest— Sore Throat— Asthma— Pleurisy— Pneumonia 
 —Consumption. 
 
 Section II.— Ailments Seated in the Food Passages.— Dyspepsia- 
 Colic — Constipation — Diarrhoea — Dysentery — Cholera — Jaundice. 
 
 Section III, — Ailments Affecting the Blood Passages. — Heart 
 Disease — Swelling of Arteries. 
 
 Section IV.— Ailments Affecting the Waste Passages.— Kidney 
 Diseases — Diseases of the Bladder — Diabetes. 
 
 Section V.— Ailments Seated in the External Covering of 
 the Body.— Diseases of the Skin— Of the Hair and Nails. 
 
 I. Ailments Seated in the Air Passages. 
 
 Cold in the Head. Under this term will come eoryza, catarrh 
 of the nose, snuffles, sneezing, rose cold, hay asthma, hay fever, 
 summer catarrh, influenza, and with symptoms extremely similar, 
 we may consider ozoena, and polyps in the nose. 
 
 How Brought On. An attack of eoryza, catarrh of the nose, 
 snuffles, or cold in the head, is the result of an exposure to a draught, 
 bareheaded, or when heated, and perspiring freely. 
 
 How Distinguished. The patient's eyes and nose run freely; at 
 first, however, the eyes are suffused and watery, but the nose dry, 
 swollen, and irritable; the air will not readily pass through it, the 
 smell is lost, and constant efforts are involuntarily made to clear the 
 passage. Sneezing occurs on every access of cold air. The distress 
 extends up to the forehead, there are pain, headache, chilliness, and 
 slight fever. As the cold seems to break, a free, watery discharge 
 commences to flow from the nose, which may be enormous in quan- 
 tity. 
 
 156 
 
Ozoena. 157 
 
 How Treated. The attack is generally readily broken up by a 
 mustard foot bath, warm drinks, and twelve grains of Dover's 
 powder at bed-time. When the fever is high, the solution of the 
 acetate of ammonia, two tablespoonfuls in a tumbler of water at 
 bed-time, will usually relieve this symptom. Many persons abort 
 such an attack by one large dose of quinine, or by a hot lemonade 
 at bed-time, and sweating it off. 
 
 Rose Cold, or June cold, hay fever, summer catarrh, autumnal 
 catarrh, hay asthma, as it is variously called, is the result, not of 
 cold, but of a peculiar source of irritation, as the odor of new-mown 
 hay, of roses, ipecacuanaha, etc. 
 
 How Brought On. It occurs only in the spring, latter part of 
 the summer, and fall, and only in those predisposed to it. Some 
 have a similar attack from sleeping upon pillows or beds of duck 
 feathers, and from a singular variety of causes. 
 
 How Distinguished. The symptoms are the same as those of a 
 cold in the head, but can generally be traced to an exciting cause, 
 as the proximity of hay, etc. 
 
 Hoxo Treated. This is still a matter of earnest consideration to 
 many. In a number of cases, the only relief that can be hoped 
 for, is to fly from the cause. Many have found the greatest benefit 
 from the application of a saturated solution of quinine to the nos- 
 trils. The tincture of lobelia is a favorite remedy ; the sulphates 
 of iron and quinine, combined, have proved very useful ; some are 
 relieved by filling the air with the vapor of chloride of lime, or 
 soda, and lately, arsenic. Three to five drops of the solution, given 
 immediately after meals, has acted in a highly favorable manner in 
 a number of cases. 
 
 Influenza having been treated of in a previous chapter, it will 
 be unnecessary to again consider it. 
 
 r Ozoena is an ulceration of the nose, originating in a scrofulous 
 system, or one tainted with syphilis. 
 
 How Distinguished. This affection is characterized by a dis- 
 charge from one or both nostrils, of a fluid of a very offensive odor, 
 thin, irritating to the surface over which it flows, and aggravated 
 by cold. In syphilitic cases, it almost invariably occurs from both 
 nostrils ; while in scrofulous cases, but one is apt to be affected. 
 14 
 
158 Diseases of Adults. 
 
 This sometimes runs down the back passage, and getting into the 
 throat or stomach, causes nausea, vomiting, loss of appetite. Occa- 
 sionally, in severe cases, thickened masses, like scabs, drop, or are 
 blown from the nose, and finally, decay of the bones takes place, 
 and causes great deformity. 
 
 How Treated, This disease, which is also often known as 
 catarrh of the nose, requires care in its treatment. When of syphi- 
 litic origin, iodide of potassium, and mercury, in full doses, are 
 requisite. In the other form, syrup of the iodide of iron, cod-liver 
 oil, good, nourishing diet, cleanliness, and fresh air, are the neces- 
 saries. Locally, to relieve the odor, etc., lotions may be used, of 
 chlorinated soda, chloride of zinc, sulphate of copper, carbolic acid, 
 permanganate of potassa, etc., by means of the nasal douche, at 
 least twice each day. 
 
 It should be remembered that similar symptoms may occur from 
 the presence of a foreign body in the passage, or even general ill 
 health. Here, iron tonics, good diet, and lotions of disinfectants to 
 the nose, are all that will be required. 
 
 Polyps in the Nose will often give rise to the belief of the 
 presence of a cold in the head. The nostril is choked, and 
 after much effort, portions of hard, bloody mucus are forcibly 
 expelled. There is generally a feeling of weight and fullness about 
 the nose ; a thin, bloody, odorous discharge often occurs. 
 
 How Treated. When small, the insufflation of an astringent, 
 the best is tincture of chloride of iron, or solution of subsulphate 
 of iron, twice or thrice a day, will relieve the symptoms, and cause 
 the polyp to shrink and fall off. When large, and in some instances 
 they become enormous, an operation is necessary. A polyp forceps 
 must be passed up, with great care, and the polyp may then be 
 seized and twisted off. 
 
 Cold in the Chest. This will include bronchitis, catarrh of 
 the chest, catarrhal fever, coughs and colds. Bronchitis or inflam- 
 mation of the bronchial tubes, or tubes which run to the lung, is 
 an affection of the lining membrane or mucous membrane of these 
 tubes. 
 
 How Brought On. This is generally the result of exposure to 
 cold, but may also occur from certain occupations, as knife or tool 
 
Cold in the Chest, 159 
 
 grinding, stone-cutting, in short, anything by which particles of irri- 
 tating matter may enter the tubes and set up inflammation. 
 
 How Distinguished. There are fever, tightness with soreness of 
 the chest, at first a tight, dry cough, which becomes loose, with ex- 
 pectoration of a white frothy matter ; or, in bad cases, filled with pus 
 or shreds of membrane. 
 
 How Treated, A cold in the chest, in its early stages, may 
 often be cut short by the same treatment indicated for a cold in the 
 head. A full dose of quinine; a hot lemonade, or ginger tea 
 at bed-time ; a hot mustard foot-bath, and a full dose, say ten grains, 
 of compound powder of ipecacuanha at bed-time. Profuse per- 
 spiration results, and the cold is broken, leaving a little debility, 
 which must be treated with generous diet and tonics. When pro- 
 longed, a free purgation with a saline is best, followed by tartar 
 emetic, grain one-eighth, every two or three hours, with liberal 
 draughts of some mild fluid, as flaxseed tea. A mustard plaster 
 over the chest, or frictions with turpentine, will aid in relieving the 
 difliculty. If there is nausea, or a tendency thereto, syrup of ipe- 
 cacuanha, one-half teaspoonful every three or four hours, will relieve 
 the cough and respiration. If very troublesome, squills and pare- 
 goric may be given, particularly to enable the patient to sleep at 
 night. Care should be observed in using opium and its prepara- 
 tions, lest the cough be made tight, and dangerous results be brought 
 on. Stimulating expectorants are often necessary when the phlegm 
 is tenacious, as the decoction or syrup of senega, chloride or car- 
 bonate of ammonia, etc. To keep up the strength, quinine, beef- 
 tea, wine-whey and spirits may be necessary. Inhalations, as of 
 steam, the infusion of hops, etc.,- often greatly relieve the air pas- 
 sages. Poultices of hops, Indian meal, and mustard, are useful, 
 particularly in children. 
 
 Should the disease become chronic, croton oil, tincture of iodine, 
 and plasters of hemlock or pitch may be applied to the chest, while 
 tonics, stimulating expectorants and alteratives are used. In these 
 cases, pure fresh air is valuable, and can do no harm, though this 
 is generally prohibited, lest they should take fresh cold. 
 
 How Prevented. Cold in the chest may be prevented by keep- 
 ing the chest and arms well protected in cold weather, and the feet 
 
160 Diseases of Adults. 
 
 from dampness. Cod-liver oil and syrup of the iodide of iron con- 
 tinued for a long time will strengthen the system of one predis- 
 posed to this affection, and secure immunity from repeated attacks. 
 
 Sore Throat will include laryngitis, tonsillitis, quinsy, hoarse- 
 ness, loss of voice, clergyman's sore throat, putrid sore throat, diph- 
 theria, and diphtheritic sore throat, throat ulcers and relaxed uvula. 
 
 Laryngitis, or inflammation of the larynx, is the most common 
 form of sore throat. Tonsillitis, or inflammation of the tonsils, 
 when very severe, is known as quinsy. Aphonia, or loss -of voice, 
 is apt to be only partial. Clergyman's or orator's sore throat is 
 generally the result of straining the voice, and does not occur so 
 frequently as formerly, now that public speakers are learning to 
 use their voices. Hoarseness may result from straining the voice, 
 slight cold, debility, etc. 
 
 How Distinguished. Laryngitis is accompanied with sore throat, 
 hoarseness, short dry cough, and more or less pain in breathing. 
 
 Tonsillitis shows, in addition to these symptoms, great swelling 
 and redness of the tonsils, producing loud, hoarse breathing, inter- 
 fering, to a degree, also, with the hearing. As it progresses, the pain 
 becomes constant and throbbing, there is great difficulty in swallow- 
 ing, and finally the abscess breaks or is opened artificially. 
 
 How Treated. In all cases of sore throat, free purgation is best 
 at the outset, and especially by the use of cooling aperients, as the 
 citrate of magnesia, etc. If the inflammation is great, leeches may 
 be applied to the throat. The inhalation of steam, by placing the 
 head over a vessel of boiling water, gives great relief. When there 
 is ulceration of the throat, the atomizer may be used, with lauda- 
 num, hops, hyoscyamus, etc., in the vapor. When the swelling, 
 etc., are great, after leeching, poultices of hops, flaxseed, etc., may 
 be applied, and the throat bathed from time to time with a stimu- 
 lating liniment, as hartshorne liniment, or painted with tincture of 
 iodine. In ordinary sore throats, gargles are useful, as alum water, 
 sage tea, honey, borax and water, and demulcent drinks, as flaxseed 
 tea, gum arabic, or slippery elm water. In children that cannot be 
 made to gargle, a good plan is to blow finely pulverized alum or 
 borax into the throat, through a quill, or a folded paper, or tube of 
 any kind. When the tonsils remain enlarged, they should be re- 
 
Diphtheria. 161 
 
 moved by the knife or scissors. Great care is necessary lest a large 
 vessel be opened, and severe hemorrhage result. Ulceration and re- 
 laxation of the uvula may be treated with a gargle of alum, 
 or rubbed with some astringent, as sulphate of zinc or copper, to 
 the ulcers. For the preparation of steaming, inhalations, and 
 gargles, see pages 346, 347, and 350. 
 
 Loss of voice may require the application of electricity, or blis- 
 tering of the back of the neck. Singers and others find great re- 
 lief by allowing a piece of borax to dissolve slowly in the mouth, 
 swallowing the solution as it forms. In all these affections, fresh 
 air and tonics are indispensable (see p. 360). 
 
 Diphtheria, diphtheritic sore throat, putrid sore throat, may vary 
 from a simple sore throat, with the formation of false membrane, to 
 the malignant form. 
 
 How Brought On. It is the result of an epidemic influence, 
 which acts with greater intensity in proportion to its being confined, 
 as in a poorly ventilated, crowded locality. It may be carried from 
 person to person, but only under the favoring influences. 
 
 How Distinguished. Prior to the appearance of the peculiar 
 symptoms of the disease, there are languor, uneasiness, sore throat, 
 and swelling of the glands of the throat. Fever sets in, headache, 
 etc., and difficulty of swallowing. Examining the throat shows the 
 parts swollen, red, and purple, followed, in a day or two, by a coat- 
 ing of a dirty, or yellow white, like wet buckskin. At the end of 
 eight or nine days, this begins to loosen, cleans off, and recovery 
 commences. In the severe cases, all these symptoms are aggra- 
 vated; in children, the membrane causes a croupy cough, and the 
 most energetic efforts to obtain breath, the patient becoming livid, 
 and evidently strangling. In what is known as the malignant form, 
 the first onset is with intense pain in the head, high fever, 
 nausea and vomiting, and even bleeding from the mucous surfaces. 
 The coating is very dark, ash-colored, leathery, and exhales an offen- 
 sive odor. Prostration rapidly ensues, followed by stupor and 
 death. 
 
 How Treated. There is a great variety of treatment proposed, 
 but none seems to be fully satisfactory. If obstinate constipation 
 be present, moderate purgation may be employed. Perhaps the 
 11* 
 
1 62 Diseases of Adults. 
 
 treatment most lauded, and which seems to have given most success, 
 is the chlorate of potassa, with the tincture of the chloride of iron, 
 say fifteen to thirty drops of the latter, in a wineglass of water, 
 with twenty to thirty grains of the former, every three or four hours. 
 Quinine may be used, and good diet, in a liquid form, eggs, milk, 
 beef-tea, punch, etc. Gargles may be used, of solution of chlorine, 
 permanganate of potassa, sulphite of soda, and carbolic acid. Or, 
 these, in more concentrated form, may be applied, mixed with honey, 
 to the parts, by means of a swab or brush ; ice is very soothing and 
 agreeable, when allowed to dissolve in the mouth, in small quanti- 
 ties. Among the internal remedies, all the above gargles may be 
 placed ; and we may also employ, with advantage, the gargle of 
 lime-water, on page 347. 
 
 Asthma. The form of this disease known as hay asthma has 
 already been considered. 
 
 How Brought On. Asthma is most frequently inherited. It is 
 brought on by exposure to irritating fumes, by indigestion, by lung 
 disease. It is really a spasm of the very small tubes of the lungs, 
 and the attacks are generally preceded by more or less irritability, 
 drowsiness, headache, etc. 
 
 How Distinguished. The attacks almost invariably occur in the 
 night, and the patient is roused by a sense of suffocation, he rushes 
 to the window and leans out, regardless of the weather, in the effort 
 to get breath. Every symptom marks the difficulty of breathing 
 and the dread of suffocation. The breathing is wheezing, the face 
 is pale, anxious, cold, or even livid ; perspiration is profuse. Relief 
 comes with a discharge of mucus in thick lumps. The attack may 
 last from a few minutes to hours. The intervals are very irregular — 
 every night, once a month, or the attack not appearing for many 
 months. 
 
 How Treated. During the spasm, relief may be obtained by 
 smoking stramonium leaves; breathing air filled with the fumes of 
 burning paper, soaked in a solution of saltpetre; inhaling ether, 
 nitrous oxide or nitrite of amyl; hypodermic injections of mor- 
 phia; by wine of ipecac, tincture of lobelia, both till nausea is 
 produced; chloral, mustard to the feet and shoulders, inhalations, 
 as Nos. 158, 159, page 351. 
 
Pneumonia. 163 
 
 In the intervals, keep the system in good order, build up, if 
 necessary ; give bromide of potassium, in quite full doses, say fifteen 
 to thirty grains, three times a day, for many weeks. Where prac- 
 ticable, change of climate is, perhaps, the surest remedy, and often 
 relieves permanently. 
 
 Pleurisy, or inflammation of the pleura, is often known as a stitch 
 in the side. It may be single or double, that is, on one or both sides. 
 It consists of an effusion of water between the lungs and the walls 
 of the chest. 
 
 How Brought On. It is the result of exposure to cold, a broken 
 rib, a wound, cancer, or consumption. 
 
 How Distinguished. It is almost always preceded by a chill or 
 chilliness, then a sharp, cutting pain in the side follows, which 
 prevents full respiration, with fever, and a short cough. The pain 
 can be located, and is increased by motion, breathing, coughing and 
 pressure. As effusion occurs, the pain, etc., are diminished, though 
 the difficulty of breathing becomes more intense. When the effu- 
 sion is great, life is placed in great jeopardy. 
 
 How Treated. The effort must be to cut short the attack, and 
 thus lessen the liability of dangerous effusion, or adhesions, which 
 limit the breathing capacity. In high fever, at the outset, a full 
 bleeding is useful, especially in young and plethoric persons. Then 
 leeches or cups to the parts. Free purgation is always necessary, 
 and, generally, great good follows the use of tartar emetic, calomel, 
 and opium, say one-eighth grain of the first, one-half grain of calo- 
 mel, and one grain of opium, repeated every three or four hours. 
 Hot fomentations (p. 346) may be applied for the pain, and hot 
 poultices to the affected side. Others suggest rest, by broad strips of 
 adhesive plaster to the side, thus preventing its motion in breathing. 
 If effusion of water occurs, blisters, and uva ursi tea (p. 348), or 
 juniper tea (p. 349), will be useful, or, in some cases, tapping, to 
 draw off the matter that may have formed, and prevent the action of 
 the lung by its presence. 
 
 Pneumonia, or inflammation of the lung, is known, also, as lung 
 fever, and as bilious or typhoid pneumonia. 
 
 How Brought On. It is caused by exposure to cold or damp ; 
 by injury, as a fractured rib; by position, as in fevers, etc., where 
 
164 Diseases of Adults. 
 
 the position favors the flow of blood to the part, and obstructs its 
 return, producing congestion, which may result in pneumonia. 
 
 How Distinguished. A chill and fever, accompanied with op- 
 pressed respiration, a dull pain in the lung, a short cough, followed 
 soon by rusty expectoration. This is the peculiar sign, the spittle 
 tinged with blood. The disease gets to its height about from the 
 seventh to the ninth day, when, in mild cases, the symptoms im- 
 prove and recovery goes on. In fatal cases, the debility increases, 
 the breathing is more oppressed, the cough is more troublesome, 
 and the expectoration is filled with pus. Death follows as early as 
 the seventh day, but may be postponed until the end of the third 
 week. Or, it may become chronic pneumonia, where, from the in- 
 flammation, the lung hardens, and becomes solid, resembling the 
 liver in its appearance. It may be complicated with pleurisy, pleuro- 
 pneumonia ; with inflammation of the liver, bilious pleurisy ; con- 
 sumption; or the prostration, etc., may be so great, from the 
 beginning, that it may be typhoid-pneumonia, called, also, " winter 
 fever.' ' 
 
 How Treated. In mild cases, by care, proper food and rest, the 
 majority will recover without any medical treatment. In those more 
 severe, except where the debility is very great, bleeding moderately, 
 at the outset, may cut short its duration, and lessen its dangers. 
 Cupping directly over the seat of disease is preferable, and always 
 useful. The bowels should be unloaded, the fever, etc., reduced 
 by syrup of ipecac, in teaspoonful doses, but this remedy should 
 be watched, lest it add to the prostration. Others prefer the solu- 
 tion of acetate of ammonia, a tablespoonful of which, in half a 
 tumbler of water, may be taken every two hours. After this, beef 
 tea, and other good food, with small doses of ipecacuanha, carry the 
 case on safely. Rest is so important, that some strap the side, as 
 for a fractured rib. Support is absolutely necessary, by the use of 
 concentrated liquid food, and stimulants must be given the moment 
 debility is present. Blisters to the part are always valuable, and 
 aid greatly in relieving the affected lung. These may be repeated, 
 or followed by dry cups, hot poultices, etc., and when solidification 
 occurs, tincture of iodine, croton oil, or other irritants (see p. 343), 
 may be applied, to induce absorption. 
 
Consumption. 165 
 
 How Prevented. By avoiding exposure, wearing flannel under- 
 garments, high in the neck, and with long sleeves, and thus protect- 
 ing the chest. 
 
 Consumption, tuberculosis, or phthisis, will include bleeding 
 from the lungs, or spitting blood, and night sweats. 
 
 How Brought On. This is almost invariably hereditary, but 
 may occur by change of climate, and at the same time, change from 
 an out-door country life to one in a large city, where the home is 
 situated in a small, ill ventilated, never too cleanly street, and where 
 the occupation almost constantly necessitates in-door life. This 
 accounts for the mortality by this disease, among the immigrants 
 from Ireland to America. 
 
 How Distinguished. The approach is rapid, or slow. It may 
 commence as a sequel to pneumonia, bronchitis, etc. A slight 
 cough, a hemorrhage, debility, a fit of indigestion, a hoarseness, 
 mark its onset. These slowly, sometimes suddenly, increase, with 
 paleness, pains in the chest, quick pulse, then hectic fever, night 
 sweats, diarrhoea, exhaustion, and death. 
 
 These symptoms are variable. Occasionally, improvement occurs, 
 or there is an arrest of the progress, and hope of recovery is cre- 
 ated, often to be lost by a renewal of the symptoms and a more 
 rapid decline. Indigestion almost invariably accompanies the whole 
 progress of the attack. Loss of menstruation often is the first 
 symptom, with the female, to excite fear. In long cases, the 
 emaciation, and all the symptoms, become painful to witness. The 
 expectoration is mucous, mixed by degrees with pus, or blood, and 
 in very many cases becomes coin-shaped, and partially floats when 
 ejected into a basin of water. 
 
 Percussion and auscultation of the lungs show the progress of 
 the disease in the lungs. Dullness, and want of proper respiration 
 commence at the apex, or top, and make their way downward. As 
 the diseased spot softens, gurgling, or crackling, as of the separation 
 of wet surfaces, is heard. When there is a cavity, known as a 
 vomica, the voice of the patient sounds just beneath the ear of the 
 listener, when applied to the spot, and there is deep breathing, or 
 cavernous respiration. 
 
 How Treated. While instances have occurred, of the arrest of 
 
1 66 Diseases of Adults. 
 
 this disease, and an apparent approach to health, these are so rare 
 that they cannot be depended upon, and the main hope is to post- 
 pone the fatal hour, which is often possible, and to make the 
 patient comfortable while life lasts. Much more depends upon 
 hygiene than medicine. Perhaps the most important point, and the 
 one least regarded, is the supply of abundance of pure, fresh air. 
 Fear is always expressed, lest the patient take cold, and thus the 
 impure air is breathed again and again, every avenue being cut off 
 by the mistaken kindness of the friends. Daily exercise in the 
 open air, properly protected, is the next consideration. This, too, 
 is systematically avoided. Proper employment, both of mind and 
 body; proper nourishment, at regular intervals, with food highly 
 nutritious and of easy digestion; cleanliness, both of the body 
 and of the surroundings; sunlight in abundance; cheerfulness of 
 the attendants; all these are eminently valuable, and contribute 
 largely to retard the progress of the disease, while their neglect as 
 fully contributes to the rapidity of the downward march. Medi- 
 cines can do but little. Cod-liver oil, in fact, all animal fats, aid 
 in maintaining the general strength, and retard its rapid decay. 
 Iron, quinine, etc., also aid in a variety of ways, as do the remedies 
 to soothe the cough and pain, procure rest, etc. Cod-liver oil has 
 been employed in a variety of ways, because of the nausea it often 
 causes, and with the hope of adding to its efficiency. Thus, it is 
 mixed with the froth of malt liquors, or ammonia or salt are added 
 to it, to disguise the taste. It is mixed with hydrate of lime, to 
 make a soap, or with the lacto-phosphate of lime, iron, etc., to make 
 an emulsion. It is combined with the tinctures of columbo, or 
 gentian, or cinchona. It is made into bread, or given in gelatin 
 capsules. Whisky, brandy, wine, etc., should be used moderately, 
 to aid digestion, and never to stimulate, otherwise they add to the 
 trouble. They may be given, with most advantage, in the form of 
 milk punch, with eggs beaten up in it. Beef and brandy will not do 
 any of the many miraculous things anticipated, and should be aban- 
 doned. Beef tea is very useful ; it is easy of digestion, and rarely 
 proves unacceptable. Milk, given in regular quantities, not so 
 much at once as to embarrass the digestive powers, is of immense 
 value. Koumiss, made by fermenting milk, is claimed, by some, 
 
Consumption. 167 
 
 to be the real cure, if that be possible, of this disease. The cough 
 may be treated by inhalations of the vapor of iodine, made by 
 pouring ten to twenty drops of the tincture of iodine in hot water ; 
 or the inhalations of cubebs and carbolic acid, and of tar, given, p. 
 351. For internal remedies, the receipts Nos. 144, and 155 (p. 
 349), will be useful. Nothing, however, which disturbs the diges- 
 tion, must be continued. If bleeding of the lungs occurs, rest, 
 with perfect quiet, and gallic acid, in ten grain doses, will generally 
 check it speedily. Ice, slowly dissolved in the mouth, will be 
 useful, though salt is generally the popular remedy. The night 
 sweats may be checked by aromatic sulphuric acid, ten drops in a 
 wineglass of water, or by bathing the body with alum, dissolved in 
 whisky. Diarrhoea may be checked by the vegetable astringents, 
 as will hereafter be mentioned. Plasters of belladonna, opium, 
 conium, irritation with iodine, croton oil, etc., will be useful for 
 the chest pains. Blisters are rarely beneficial, and often exhaust 
 the strength. Where it is possible, a change to an equable, dry 
 climate would be advisable, but this must be done early, or else it 
 is too often changing the place in which to die. 
 
 How Prevented, This is much more important to know than 
 how it is treated, for in the prevention of consumption art is strong, 
 in its cure very weak. Persons who have a hereditary or other 
 tendency to the disease should not inhale an atmosphere loaded with 
 smoke or dust. They should choose an outdoor life, and prefer- 
 ably, one in the country. Horseback exercise is especially useful to 
 them. Sydenham, the great physician, said, "in consumption the 
 best doctor is a horse, the best apothecary an ass ;" so much did he 
 believe in this exercise. Yet all violent exertion, as immoderate 
 running, dancing, singing, etc., should be avoided. Flannel should 
 be worn next the skin at all seasons, the night air generally avoided, 
 a salt bath taken every morning, followed by thorough dry-rub- 
 bing, and the food be light and nutritious. When practicable, the 
 cold winters should be avoided by a change of climate, as a long 
 sea voyage. The chest should be expanded by appropriate exer- 
 cise, and by the habit of deep and long breathing, several times a 
 day. Very much can be done by these means, and often the ten- 
 dency to the disease wholly escaped. 
 
1 68 Diseases of Adults. 
 
 II. Ailments Seated in the Food Passages. 
 
 Dyspepsia, or indigestion, will include gastritis, gastric catarrh, 
 gastric ulcer, vomiting of blood, sour stomach, water-brash, heart- 
 burn, loss of appetite, and biliousness. 
 
 How Brought On, Indigestion, with its accompanying train of 
 discomforts, is the result of haste or carelessness in eating, not 
 chewing the food, excess or deficiency of food, fatigue, excitement, 
 study, the use of tobacco, or of ardent spirits, and last, but not 
 least, the ignorant use of medicine. 
 
 How Distinguished, The most prominent symptom is a .feeling 
 of uneasiness, not exactly pain, at the stomach. Pain would be 
 indicative of ulceration. Nausea, and even vomiting, occasionally 
 occur. There is a clammy feeling in the mouth, with a bitterness, 
 or sourness. The skin is generally sallow. The bowels are gene- 
 rally costive, but this may be alternated by diarrhoea. When bil- 
 iousness is present, the stools are apt to be scanty, and of light 
 clay color. The following symptoms appear, from time to time: 
 water-brash, a running of tasteless fluid from the mouth; heart- 
 burn, caused by the presence of acid in the stomach, and extending 
 up the oesophagus; palpitation of the heart; headache; depression 
 of spirits, melancholy, or the occurrence of foolish ideas ; disorders 
 of taste, vision, etc. ; more or less vertigo in every case. Dyspepsia 
 is always an obstinate affection, but can scarcely be regarded as dan- 
 gerous. 
 
 How Treated, Medicine is less important than the regulation 
 of the quantity and quality of food, and the hours for its ingestion. 
 Plain, easily digested food, is required. The stomach should never 
 be loaded; the meals should not be at too long or too short inter- 
 vals. Beef, mutton, fowl, oysters, roasted, stewed, or panned, never 
 fried, with bread rather stale ; crackers, kiln dried ; rice ; stewed or 
 fresh fruit; and milk, as a beverage, will be the proper diet for the 
 dyspeptic, and will give a sufficient variety. Pastry must be scrupu- 
 lously avoided. Some prefer, and may have, milk tea, or milk and 
 warm water, as a drink with the meals. Some seem to require a 
 slight stimulant with dinner, and here, ginger and water, or cider, 
 or sherry wine and water, may be allowed in small quantities. 
 
Dyspepsia, 169 
 
 Where the digestion is greatly impaired, the food may be given in 
 very small quantities, at short intervals. To use the remark of a 
 distinguished authority, " sixty meals a day." Of course, this is 
 only to be enforced until the stomach will bear a larger quantity at 
 , a time, when the plan should be abandoned. Daily exercise, in the 
 open air, and bathing, are very important, as well as rest at meal- 
 time. Never eat under an excitement. At a meal, the family chat 
 aids the digestion; hence the better appetite while traveling; the 
 mind is relieved of cares, etc. 
 
 Medicines are required to stimulate the digestive powers, as gen- 
 tian, columbo, and ginger (see page 361), in cases of nervous 
 debility ; iron, when the blood is poor, as the syrup of the iodide, 
 or the potassio-tartrate (see pages 360 and 361). The bowels 
 must be kept free by mild laxatives, as the mineral waters, senna, 
 rhubarb, magnesia, sulphur; when the constipation is obstinate, 
 aloes, or May-apple, may be added. If acidity is present, the bi- 
 carbonate of soda, or potassa, the carbonate of magnesia, and the 
 aromatic spirits of ammonia, are best. The sulphites are highly 
 lauded, as also is charcoal. When the liver is torpid, small doses of 
 cream of tartar (p. 340), or dandelion tea (p. 350), will relieve it. 
 Many prefer five drops of nitro-muriatic acid, three or four times 
 daily, well diluted with water, as a stimulant both of the stomach and 
 liver. The other acids, the nitric and hydrochloric, have been 
 employed, as also bismuth, which lately seems to have obtained 
 great favor. The heart-burn and water-brash are best relieved by 
 bicarbonate of soda, ten grains, in water, before eating; when the 
 latter is very annoying, astringents may be used, as blackberry tea 
 (page 349), tincture of chloride of iron. Hiccough, which is 
 often very annoying and distressing, may be controlled by the 
 anti-spasmodics, but chloral is perhaps the best remedy for this. 
 When blood is vomited, it is not from the lung, if dark and clotted, 
 and mixed with food; this requires rest in the horizontal position, 
 ice slowly dissolved in the mouth, and when very abundant, astrin- 
 gents, as gallic acid, in ten-grain doses. 
 
 When inflammation or catarrh of the stomach is present, there 
 is great pain on pressure over the stomach, vomiting of all ingesta, 
 and fever. A bilious attack is the result of indigestion, or expos- 
 15 
 
170 . Diseases of Adults. 
 
 ure, and has the same symptoms, with vomiting of greenish fluid, 
 which is very acrid, constipation, headache, and vertigo. To relieve 
 these attacks will require rest, abstinence from food, ice in small 
 quantities, cream of tartar, and May-apple (pp. 340, 341). 
 
 Gastric ulcer, or ulcer of the stomach, is marked by a severe 
 sickening pain and tenderness at a particular point, the seat of the 
 ulcer. This is aggravated by motion, and by food, especially if it 
 be hot. Vomiting is present, and often the ejected matters are 
 mixed with blood. This is the special sign of gastric ulcer. The 
 diet must be unirritating, lime-water and milk, arrowroot, rice, 
 sago, corn starch, tapioca, fresh eggs, beef tea, or mutton broth. 
 The healing of the ulcer is aided by subnitrate of bismuth, and 
 oxide of zinc, about ten grains of the former, or three of the lat- 
 ter, three times a day. To check the incessant vomiting, hypo- 
 dermic injections are valuable. 
 
 Colic is known as belly-ache, wind in the bowels, bilious colic, 
 cramp colic, and flatulence, and may be produced also by a spasm 
 of the stomach, or the passage of gall stones. 
 
 How Brought On. As above noted, it is generally the result of wind 
 in the bowels ; or, it may be caused by cramp or spasm of the parts ; 
 congestion, produced by exposure, particularly of the feet; or the pas- 
 sage of gall stones. Wind in the bowels is the result of indigestion. 
 
 How Distinguished. There are more or less vomiting, pain, 
 with exacerbations, distention of the abdomen, constipation, fever 
 of slight degree, belching of wind. In the bilious forms, the vom- 
 iting is of a greenish-yellow fluid, and may be followed by a slight 
 jaundice. The passage of a gall stone is extremely painful; the 
 line of pain can be mapped out by the sufferer, and is chiefly in the 
 right side; sudden relief follows the escape of the stone, though the 
 tenderness may continue a while. It is also believed that one cause 
 of pain is the passage of the acrid bile. What is known as lead 
 colic, or painter's colic, or "dry belly-ache," is caused by the poison 
 of the lead carried into the system ; here the abdomen is shrunken, 
 there is no vomiting, the bowels feel as if knotted, the pain is less- 
 ened by pressure, hence there is no tenderness; there is restless- 
 ness, with extreme suffering. Generally, a blue margin is observed 
 on the gums. 
 
Colic. 171 
 
 How Treated. The bowels are to be opened, and the pain and 
 spasm relieved. When there is reason to suspect a loaded stomach, 
 an emetic will be useful, as a tablespoonful of salt, or a teaspoonful 
 of mustard, in a cup of warm water, repeated in a few minutes, if 
 required. The bowels may be relieved by warm clysters of castor 
 oil, salt, soap, molasses and water. Magnesia may be given, with 
 essence of peppermint, or ginger, as on pages 340, 341. When 
 the nausea and pain are great, we may use aromatic spirits of harts- 
 horn, spirits of camphor, about twenty drops of either, repeated 
 frequently. These failing, or the emergency being great, anodynes 
 will be necessary, as chloroform, opium, paregoric etc. (see page 
 357). Externally, mustard plasters, or flannels, wrung out of 
 hot liquor, hot foot-baths, and the immersion of the abdomen in 
 a tub of water as hot as can be borne, will often give immediate 
 relief. In many instances, massage, or kneading the abdomen, will 
 cause the wind to be dislodged, though this requires too much care 
 to be entrusted to inexperienced hands. Care, also, is necessary in 
 every case, lest there be a concealed rupture or hernia, and in every 
 instance this may be suspected, when the pain is prolonged, and the 
 vomiting is of a dark color, and offensive odor. 
 
 The colic of infants is generally readily relieved by some aro- 
 matic, as anise or fennel tea, or peppermint candy, dissolved in hot 
 water; at the same time, hot applications should be made to the 
 stomach ; the best is a flannel wrung out of hot whisky or alcohol. 
 In more urgent cases, a drop or more of chloroform, added to the 
 medicine, and repeated as required, will relieve. The bowels 
 should be keep free by mild aperients, as senna, rhubarb, manna. 
 Lime-water in the milk will correct acidity. Much of this trouble 
 is due to the carelessness of those who have charge of the infant, 
 and cram it, even with highly improper food, in place of allowing 
 it the proper nourishment, and that only. 
 
 Bilious colic may need, in addition to the remedies already given, 
 those specially acting upon the liver, as blue pill, or calomel with 
 opium ; podophyllin, taraxacum, nitro-muriatic acid, etc. If inflam- 
 matory action appears imminent, leeches or cups may be bene- 
 ficially applied over the liver. 
 
 The passage of gall stones may necessitate the use of anaesthesia, 
 
172 Diseases of Adults. 
 
 to relax the duct leading to the bowels, and to relieve the intense 
 agony. Chloroform, internally, is supposed to aid in dissolving 
 these concretions, thus supplying a double purpose. 
 
 When gout is transferred to the stomach, the treatment is simi- 
 lar, but requires more energetic measures. The doses of chloroform, 
 morphia, etc., must be greater, and more frequent. 
 
 Lead colic will require relief of the pain in the same way, and 
 antidotes for the poison. Iodide of potassium is perhaps the best, 
 ten grains, three times a day, combined with a diet exclusively of 
 milk. (See " Lead Poisoning.") 
 
 Constipation, or costiveness, will result from obstruction of the 
 bowels, a knot, congestion, and will often be accompanied by vom- 
 iting of foul matters. Under this head we may consider typhlitis, 
 or inflammation of the lower bowel. 
 
 How Brought On. This is generally the result of neglect of 
 the bowels, indigestion, want of exercise, but may occur from strict- 
 ure, or some mechanical obstruction. 
 
 How Distinguished. In the aged, or those otherwise diseased, 
 the presence of palsy of the bowels, or of stricture, etc., may be 
 feared, particularly when a hard, painful lump is felt at one point. 
 Here, the costiveness is very persistent, there is vomiting of mat- 
 ters which should pass downward, with cold skin, prostration, great 
 mental distress, and collapse. At the affected point, everything 
 stops, wind accumulates and swells the abdomen. 
 
 How Treated. Much depends upon care and diet. The latter 
 should be of a laxative nature: stewed and fresh fruit, molasses, 
 bran bread, rye mush ; with many, oat meal mush, for supper, acts 
 as a laxative. Next, a very important matter is to have a particu- 
 lar time to attend to this necessity, and soon it becomes a fixed 
 habit. Proper exercise, and kneading of the bowels, also act to aid 
 in the relief of the torpid condition. 
 
 When medicine is used, it must be as mild as will serve the pur- 
 pose: rhubarb, podophyllin, senna, and injections of warm water, 
 or of soap, molasses, salt, etc. Many are readily relieved by sup- 
 positories of soap. The natural laxative mineral waters may be 
 used with excellent results. Electricity is also useful. (See pages 
 340 and 341, for prescriptions.) 
 
Diarrhoea. 173 
 
 Typhlitis is an inflammation of a portion of the lower bowel. 
 It has all the symptoms of constipation, with fever, pain at a fixed 
 spot, swelling of the abdomen, vomiting, and shortly diarrhoea, 
 which may be mucous, bloody, or filled with matter or pus. 
 
 Bleeding will be necessary, especially in the robust. Leeches 
 should be applied to the affected spot, and their action aided by 
 poultices of flaxseed, hops, Indian meal, etc. Anodynes are about 
 the only remedies that can be useful. The food must be mild and 
 soft, or fluid, as sago, arrowroot, beef tea, etc. It may end in an 
 abscess, and death from its rupture into the cavity of the abdomen. 
 Diarrhoea, or looseness of the bowels, summer complaint, may 
 be acute, sudden, or chronic, persisting. 
 
 How Brought On. This disease may result from improper food, 
 as too much or unripe fruit, decayed vegetables, bad water, cold, etc. 
 How Distinguished. It is marked by too frequent and profuse 
 discharges from the bowels, with more or less pain ; the discharges 
 may be bilious, thin, and watery, of a dirty, ill-smelling water, mu- 
 cous, or "rice water," as in cholera. 
 
 How Treated. Rest, in the horizontal position, will, in very many 
 instances, check the disease in its incipiency. In every case this is 
 important, and greatly aids the treatment. When the symptoms are 
 not urgent, the discharge should not be checked suddenly, as it 
 often marks the crisis or passing off of a disease. It appears as 
 though the system were thus throwing off the cause, or poison. 
 Especially is this true in typhoid fever. When acidity is present, 
 antacids, as lime water, or solution of soda, are requisite. Blue 
 pill, mercury with chalk, charcoal, magnesia, these may be given in 
 the aromatic syrup of rhubarb, or with syrup of ginger, or cinna- 
 mon water. Astringents are necessary when these fail, and here 
 we have blackberry root tea, logwood tea (p. 348), white oak bark 
 tea (p. 349), and the like. For pain, and also to aid the other 
 remedies, paregoric, or calamus (p. 350), may be added. When 
 the disease is persistent, oxide of zinc, especially for children, is 
 excellent. About five grains are a dose. In chronic cases, acetate 
 of lead, or tannin with opium, say two or three grains of lead to 
 a half grain opium, or three grains of tannin, with the opium, every 
 three, four, or five hours. Enemas of the same, in solution, will 
 15* 
 
174 Diseases of Adults. 
 
 also be very efficient. The use of fruit and vegetables must be 
 prohibited, and the diet must be regulated so as to avoid any irri- 
 tation of the bowels. 
 
 Dysentery, or bloody flux, or bloody stools, is an inflammation 
 of the large bowel, the colon, hence it is also called colitis. 
 
 How Brought On. This disease appears to occur most fre- 
 quently about the last of August and September, and is due to the 
 use of unripe fruit, improper food, exposure to cold and damp after 
 the heat of the day, impure water, etc. It often prevails in a local- 
 ity as an epidemic, attacking the majority of those exposed to it. 
 
 How Distinguished. It is characterized by pain in the lower 
 part of the abdomen; tenderness on motion and on pressure; fre- 
 quent desire to evacuate the bowels; small, bloody, mucous passages; 
 great tendency to strain or bear down, which is called " tenesmus ;" 
 griping, called "tormina," and moderate fever. There may be 
 debility, generally not at first; ulceration, and purulent, shreddy 
 discharges may occur later. 
 
 How Treated. Where the strength will bear it, and the inflam- 
 mation is great, leeches may be usefully applied, at first, to the 
 abdomen, at the seat of the greatest soreness, followed by warm 
 poultices of flaxseed, hops, Indian meal. A tablespoonful of castor 
 oil, with fifteen to twenty drops of laudanum, is the usual dose 
 before anything else, and this is generally very useful. A large 
 injection of warm water is often of great service. Alteratives, as 
 blue pill with ipecacuanha, camphor, or opium, are next in order; 
 then acetate of lead and opium (as under Diarrhoea), to complete 
 the cure, if it has not already been accomplished. As in diarrhoea, 
 rest, in the horizontal position, is very important, and aids greatly in 
 the early relief of the patient. 
 
 Of course, great care should be paid to the diet, which should 
 be mainly of rice, arrowroot, chicken or beef tea ; and for the 
 thirst, iced drinks, as slippery elm water, gum arabic water,* etc. (p. 
 322). Enemas of iced water are very soothing, or of flaxseed tea, 
 with a half teaspoonful of laudanum (p. 350), or starch and laud- 
 anum, or acetate of lead and laudanum, in starch, in the same pro- 
 portion. 
 
 With great debility, quinine may be given, or other tonics (see 
 
Cholera. 175 
 
 p. 360), and even stimulants, if there is great weakness. Nitric 
 acid, in the form known as Hope's Dysentery Mixture, that is, one 
 fluid drachm nitric acid, forty drops tincture of opium, eight fluid 
 ounces camphor water, in tablespoonful doses, every three or four 
 hours. Sulphate of soda, or of magnesia, with laudanum, has 
 proved useful with some. 
 
 How Prevented. Dysentery can generally be prevented by using 
 great discretion in diet, avoiding all unripe fruit, all dishes which 
 lead to dyspepsia, all irregularities of life, and exposure to cold, wet, 
 and night air. A flannel bandage, a foot wide, should be worn 
 around the abdomen. Often a spell of constipation precedes dysen- 
 tery. Hence, in the late summer and early fall, particular attention 
 should be given to having a full passage every day. Diet is gener- 
 ally sufficient for this. If not, use cream of tartar (p. 340), some 
 laxative mineral water, a seidlitz powder (p. 341), or an injection 
 of warm water. 
 
 Cholera. Known as Asiatic cholera, or cholera asphyxia, In- 
 dian cholera, epidemic or malignant cholera, and the occasional 
 solitary cases of cholera morbus. Bilious cholera must next be con- 
 sidered. 
 
 How Brought On. Cholera morbus, or bilious cholera, occurs 
 every summer, to a greater or less extent, though in certain seasons 
 it is extremely prevalent, and is due to the use of unripe fruit, 
 improper food, excesses, cold, etc. 
 
 True cholera is the result of a certain influence which is suscep- 
 tible of change of locality, and which may affect the system and 
 produce its characteristic symptoms by inhalation, by its contami- 
 nation of the drinking water. It never has shown itself to be 
 contagious. It would appear, most frequently, to have found its 
 nest in accumulations of putrefying animal matter. 
 
 How Distinguished. It is generally preceded by a painless 
 watery diarrhoea, called cholerine, though its attack may be extremely 
 sudden, and all the worst symptoms develop with lightning-like 
 rapidity, The diarrhoea may last from a few hours to three days, 
 increasing in its frequency, and soon accompanied by vomiting and 
 pain. The fluid discharged, both from the bowels and the stomach, 
 is a colorless water, familiarly termed "rice-water discharges." 
 
176 Diseases of Adults^ 
 
 Cramps in the limbs ensue, with great prostration, cold skin, intense 
 thirst, hoarseness, or loss of voice, loss of pulse, profuse sweating, 
 blueness of the skin, the fingers become shriveled like those of a 
 "washwoman," hence the term "washerwoman's fingers," the nose 
 pinched, the breath cold, collapse comes on, and death closes the 
 scene. If reaction occurs, it may be followed by a low fever, or 
 the case may go on steadily to recovery. Cases of summer cholera 
 rarely present all these symptoms, while cholera morbus has only 
 the cramps, vomiting and purging, never the peculiar discharges, 
 and almost invariably rapidly recovers under the appropriate treat- 
 ment. 
 
 How Treated. The treatment is almost as varied as the number 
 of observers, and in malignant attacks everything fails. The treat- 
 ment undoubtedly must be greatly antispasmodic, and chloroform 
 has shown its power in this respect. The diarrhoea, which is all 
 the more dangerous, as it is painless, should be checked by the reme- 
 dies given above. Particularly should rest be enjoined. The 
 remedies, as paregoric, ginger, lavender, aromatic spirits of harts- 
 horn, act by soothing and stimulating the system. If vomiting 
 sets in, mustard to the abdomen and to the feet, or, if there is rea- 
 son to suspect the presence of any offending matter in the stomach, 
 great good has resulted from a draught of salt and hot water, a 
 teaspoonful of salt in a tumbler of hot water. In repeated instances 
 this has acted very promptly, and particularly while waiting for 
 other and more powerful means. When the cramps, etc., have 
 fully set in, the best and surest means is the administration of chloro- 
 form and aromatic spirits of ammonia, in full doses, frequently 
 repeated. An excellent formula is : two fluid drachms chloroform ; 
 one-half fluid ounce each compound tincture of cardamom and 
 paregoric; one and a half fluid ounces each syrup of ginger and 
 mucilage of gum acacia; mix well. The dose would be a teaspoon- 
 ful, followed by a lump of ice ; repeated every ten or fifteen minutes, 
 or even oftener, until relief is obtained. Of course, this will serve 
 as an example, and may be modified by additions, or change of 
 dose, as occasion demands. The use of stimulants will be necessary, 
 both by the mouth and by frictions, to promote the flow of the 
 blood, and produce reaction. In collapse, every remedy must be 
 
Cholera. 17 7 
 
 increased. A variety of remedies are offered, some of which we 
 shall enumerate: hot mustard, or salt baths (p. 337), warm baths 
 of infusion of stramonium leaves, chloral, in large doses, hot ene- 
 mas, the warm bath, with carbonate of ammonia, chloroform by 
 inhalation, etc. 
 
 Perhaps the best treatment of cholera is that known as the acid 
 treatment. In the report on the subject of cholera, by the U. S. 
 War Department, through the Surgeon General, this treatment is 
 shown to be extremely successful, both as a cure and as a prevent- 
 ive. As a preventive, and as a remedy in every stage, it is given 
 as sulphuric acid lemonade, to fill the system, as it were, with acid. 
 Twenty drops of dilute sulphuric acid are mixed with four ounces 
 of water, and sweetened. This is to be used freely, as a beverage, 
 by the patient, attendants, and all exposed. By this plan, the mor- 
 tality has been reduced to 8 deaths in 100 cases. It acts also as a 
 prophylactic, by allaying the fears, and thus those exposed are less 
 liable to an attack. Given in the same way to a patient, it relieves 
 the nausea and vomiting, and the passages are gradually checked. 
 The acid appears to act by killing the cause of the disease. 
 
 How Prevented. Cholera must be prevented by vigorous hy- 
 gienic measures. All infected goods, cloths, etc., must be destroyed 
 by burning, or thoroughly washed, dried, and disinfected, by acids 
 in some form, as acidulated water, or acid gases. No diarrhoea can 
 be regarded as harmless during a season of cholera. The ejecta 
 must all be disinfected and kept from contact with other patients, 
 their clothing, or any of their surroundings. Every vessel must 
 be treated rigorously when even one case occurs on board of it, and 
 thus render quarantine restraint unnecessary. Attention should be 
 directed to the condition of each house and its premises, that there 
 is the most thorough cleansing, ventilation, and disinfection ; to the 
 drainage of every town ; in short, cleanliness, ventilation, and disin- 
 fection, will prevent this disease, and nothing else can do it so 
 effectually ; but it must be by visitation from house to house that 
 the authorities can know that this has been effectually accomplished. 
 
 Jaundice may be called yellow, green, or black jaundice, though 
 these are quite improper, as the word jaundiced means a yellowish 
 
1 7 8 Diseases of Adults. 
 
 condition. It may be caused by liver disease, torpidity of the liver, 
 ulceration, etc. 
 
 How Brought On. It is produced by any disease or mechani- 
 cal obstruction which prevents the removal of the bile from its 
 place of formation to the bowels ; and thus it is taken up again into 
 the blood, and distributed to the skin, the eyes, etc. It may be 
 due to exposure to cold and dampness, to violent emotion, to preg- 
 nancy, to malaria, etc. 
 
 How Distinguished. It may be suddenly, or, after general lan- 
 guor, debility, etc., that the whites of the eyes are observed to be 
 tinged with yellow, the roots of the nails, the face, and gradually 
 the whole surface of the body. The urine has a more yellow 
 appearance, and stains everything yellow, but the passages from the 
 bowels are wanting in their natural appearance, being sometimes 
 of a dull white, lead color, or a very light brown. The tongue is 
 coated, and there is an acrid taste. The general system sympa- 
 thizes ; there is debility, with great depression of spirits, or melan- 
 choly. 
 
 How Treated. Unless an obstruction is known to exist, the 
 remedies should be such as act on the liver. These are known as 
 cholagogues. But moderate effects should be induced at first, 
 hence small doses of cream of tartar, or of May-apple, as given, 
 pages 340, 341. Sometimes three grains of blue pill acts very 
 well. It should be followed by a purgative. Salines are best, as 
 the citrate of magnesia, cream of tartar, etc. If the case seem 
 obstinate, the cholagogues may be repeated, in small doses, at fre- 
 quent intervals. Extract of dandelion, or dandelion tea (p. 350), 
 or nitro-muriatic acid, five drops in a wineglassful of water, are best 
 to continue the action, and promote the absorption of the effused 
 bile. Ether and chloroform are supposed to act as solvents of gall 
 stones, and hence are given in cases supposed to result from the 
 presence of such obstructions. A teaspoonful of ether, in a tum- 
 bler of water, three times a day, may be taken. 
 
 Piles, or hemorrhoids, are small tumors or pouches filled with 
 blood, at the edge of the bowel, or just within it. Hence, they 
 are outward or inward, or they are bleeding, or blind, dry piles. 
 
 How Brought On. They are caused by anything which acts to 
 
Piles. 179 
 
 cause a flow of blood to the lower bowel, or which tends to obstruct 
 its return. They are generally most frequently seen in the ple- 
 thoric, those of sedentary habits, in pregnancy, or in those much 
 troubled with diarrhoea, or dysentery, or the reverse, constipation. 
 
 How Distinguished, Back-ache is so commonly the result of 
 piles, that their presence should always be suspected when this is 
 much complained of. They are characterized by fullness and weight 
 in the lower bowel, soreness, pain after a passage, and which may 
 extend down the limbs and to the loins. When inflammation occurs, 
 the aching and throbbing are intense. At every passage, there is 
 felt the presence of something which will not come away, as though 
 the stool was not completed. When they are outward, examination 
 reveals the presence of one or more tumors, more or less painful. 
 When within, blood, and the above symptoms with the passages, 
 indicate their presence, or the piles may be forced out, and appear 
 as a hard painful mass, which often must be forced back by the 
 hands. The pain is great until it is returned, and the constriction 
 is thus removed. While the bleeding is generally small, in some 
 cases large amounts of blood are lost, and generally the patient who 
 has suffered long shows a blanched appearance, and is affected with 
 poverty of the blood. 
 
 How Treated. Special attention must be paid to the* avoidance 
 of any action of the bowels liable to cause or increase the flow of 
 ^blood to the parts. Costiveness, especially, must be relieved, while 
 diarrhoea, etc., are checked. Diet will have much to do with this, 
 and it should be of food easily digested, and not exciting. Seden- 
 tary occupation, fatigue, standing too long, whatever tends to irri- 
 tate the parts, or cause a flow of blood there, must be avoided. 
 Soothing ointments, and the same containing astringents, will act 
 well in relieving the trouble. After each stool, the parts should be 
 bathed with cold water, or cold alum water, a teaspoonful of pow- 
 dered alum to a pint, or the sal ammoniac wash (p. 355), and an- 
 ointed with tannin ointment (p. 356), or other. Mild laxatives, as 
 stewed fruit eaten freely, senna, rhubarb, sulphur, will be indicated, 
 and the careful avoidance of irritating purgatives. The parts, when 
 gorged with blood, may be unloaded by leeches, and cups to the 
 lower part of the back. When the bleeding is too free, it must be 
 
180 Diseases of Adults. 
 
 checked by subsulphate of iron, alum, cold water, ice, etc., applied 
 freely to the parts, and by carefully preserving the horizontal posi- 
 tion. When the piles extrude, as after a passage, they must be 
 carefully anointed and replaced. One of the best applications is 
 the following, A quantity, the size of a small pea, to be gently 
 applied after each stool: 
 
 PILE OINTMENT. 
 
 Dried Persulphate of Iron, half a drachm. 
 
 Powdered Opium, one scruple. 
 
 Washed Unsalted Lard, one ounce. 
 Eub them well together. 
 
 A body bandage, continually worn, often gives great relief. When 
 all fails, the tumors must be cut off. 
 
 Fistula of the Anus, or fissure, will present very similar symp- 
 toms, but examination shows a crack, or fissure, in the bowel, at 
 the opening ; or, when a fistula, there will be a false passage, or a 
 small opening, into which a portion of the stools will pass and be 
 retained. Generally, surgical treatment is necessary, but often, by 
 the use of soothing ointments, as belladonna, oxide of zinc (p. 356), 
 lead, or touching the part with nitrate of silver, will cause it to 
 heal. To relieve pain, opium, belladonna, etc., made into supposi- 
 tories with* cocoa butter, will be useful. 
 
 III. Ailments Affecting the Blood Passages. 
 
 Heart Disease will include palpitation, fluttering of the heart, 
 pain in the heart, angina, rheumatism or neuralgia, dropsy, heart- 
 break or rupture, and fatty heart. 
 
 How Brought On. Heart affections, or symptoms, may be 
 caused by dyspepsia; by inflammation; by transfer of disease, as 
 gout, or rheumatism, to the heart; by great emotion; by age, or 
 debility from any cause. 
 
 How Distinguished. Heart disease is either an affection of this 
 organ itself, directly, or by irritation by, or sympathy with, an 
 affection of another organ. When the heart itself is diseased, there 
 
 are irregularity of the pulse and of the beats of the heart, general 
 
 \ 
 \ 
 
Heart Disease. 1 8 1 
 
 uneasiness, as by sympathy of the whole system, more or less pain, 
 occasional coldness of the extremities, and lividity or suffusion of 
 the head and face, brain trouble, as vertigo, fullness, etc. On lis- 
 tening to the heart, with the ear placed over it, the sounds will be 
 unnatural, the beat will be heard irregularly, there will be a blow- 
 ing or a hissing sound, a rubbing sound, or the beats will vary by 
 being too feeble or given with too great force. These symptoms 
 will- show disease of the heart, as hypertrophy, or enlargement, 
 atrophy, or diminution, dilatation, disease of the valves. But when 
 there are palpitation, throbbing, irregular beats, without these 
 sounds, then the affection will most likely depend upon poverty of 
 the blood, or anaemia, which will be further shown by the other 
 general symptoms of that condition, as detailed in a previous chap- 
 ter ; or these symptoms will follow a full meal, an evidence of their 
 being the result of indigestion. Neuralgia, or angina pectoris, 
 rheumatism, or gout of the heart, are shown by the intense, ago- 
 nizing pain in the heart ; in the first case, this pain shoots down the 
 left arm ; in the latter, there are the general symptoms of gout or 
 rheumatism elsewhere, and a sudden cessation of the attack, and 
 its equally sudden appearance in the heart. 
 
 Heart-break, or rupture of the heart, would result in sudden 
 death after great mental emotion, and could only be known by a 
 post-mortem examination. Though rare, it has been known to 
 occur. Dropsy of the heart would be shown by the sounds of the 
 heart being muffled, and the noise of fluid around the heart. Fatty 
 heart may be surmised to exist when the patient has feeble, irregu- 
 lar action of the heart, when there is general evidence of a break- 
 ing down of the system, but can only be known by the examina- 
 tion after death. When sudden death occurs, it may be regarded 
 as most probably due to heart disease, when it has been preceded 
 by sudden difficulty of breathing, great and sudden paleness, a flut- 
 tering pulse, and pain in the region of the heart. 
 
 How Treated. Great pain in the heart, from whatever cause, 
 demands immediate relief. This may be given by opiates, chloral, 
 the inhalation of nitrite of amyl. Combined with these must be 
 the most perfect quiescence in the horizontal position, with the 
 head but slightly raised. To relieve the great debility accompany- 
 16 
 
1 82 Diseases of Adults. 
 
 ing heart disease, stimulants are requisite, but they must be given 
 with great care, lest they further excite the heart. When the 
 heart's action is too rapid, it may be controlled by digitalis, and 
 preferably, the tincture. This remedy may be given twenty or 
 thirty drops at a time, in repeated doses, every three or four hours, 
 watching its effects, and as the pulsations are reduced in force and 
 frequency, it may be lessened in dose, or omitted. Often, this fre- 
 quency of action is combined with feebleness, the irregularity being 
 due to thinness or poverty of the blood ; here, the indication is to 
 unite the digitalis with iron, as the tincture of the chloride of iron, 
 ten drops, or the potassio-tartrate of iron (p. 361). In all cases 
 of syncope, or fainting, the patient should be placed with the head 
 lower than the body, so as to cause the blood to flow into the brain, 
 and thus arouse it to its duty. Too long a faint will permit the 
 formation of a clot in the heart, which at any moment may cause 
 sudden death. Where evidences exist of inflammation of the 
 heart, this must be met by bleeding, leeches and cups over the 
 heart, free purging, and the use of the tincture of veratrum viride, 
 ten or fifteen drops, to quiet the heart's action. If of rheumatic 
 origin, the treatment appropriate to that affection must be employed. 
 If dropsy result, the fluid must be evacuated as rapidly as possible, 
 by the use of diuretics, as sweet spirits of nitre, squills, juniper 
 berry tea, brisk purgatives, etc. All emotion must be sedulously 
 avoided. The diet should be of a tonic and easily digestible nature. 
 When heart trouble is caused by indigestion, the former is relieved 
 by those remedies calculated to relieve dyspepsia, as detailed in the 
 chapter upon that subject. Exercise in the open air, when taken in 
 moderation, will always be beneficial in heart disease. 
 
 Row Prevented. All tendency to heart affections require fresh 
 air, moderate exercise, the avoidance of excitement, easily digested 
 diet. 
 
 Swelling of the Arteries, or aneurism, is the formation of a 
 tumor on a part of an artery, by reason of a rupture of one of the 
 coats of the vessel, or a general softening of the vessel, causing it 
 to give way, and swell irregularly. 
 
 Row Brought On. This is generally the result of an injury, 
 as a blow on the part, a strain, etc., or it may be due to general dis- 
 
Swelling of tlic Arteries. 183 
 
 ease of the artery, causing its coats to become softened, and lose 
 their power of resisting the force of the current of blood. Rowing, 
 boxing, and running, most frequently cause aneurisms, especially of 
 the vessels of the arms and legs, as also of the larger vessels directly 
 connected with the head. 
 
 How Distinguished. An aneurism, wherever located, is char- 
 acterized by a swelling or lump, appearing rather suddenly, without 
 any of the peculiar signs of inflammation, as redness, heat, etc. 
 The tumor is always situated on one of the arteries, which may be 
 felt extending from it on either side ; it is soft, yielding, but elastic ; 
 has but little, if any pain, and is always attended with a pulsatile 
 movement. Compression on the heart side of the tumor will cut 
 off this movement, and cause a sensible lessening of the enlarge- 
 ment. In distinction from an enlarged gland, the aneurism is fixed, 
 the gland more or less movable. Aneurism generally develops 
 slowly. When situated in the large vessel near the heart, the aorta, 
 it gradually causes a bulging of the chest, and often produces diffi- 
 culty of breathing, pain at the spot, cough, loss of voice, and even 
 interferes with swallowing. These complications are the result of 
 pressure upon the parts surrounding the tumor. When it occurs 
 lower down, as in the abdomen, there is deep-seated pain in the 
 back and abdomen, no fever, and all treatment fails to have any 
 effect. In every instance, the pulsation of the tumor is a marked 
 symptom. 
 
 How Treated. Surgical interference is necessary for the com- 
 plete cure of aneurism. In those occurring in the smaller vessels, 
 this is all, but when this affection takes place in the larger arteries, 
 as those of the chest, or abdomen, much aid and comfort may be 
 derived from hygienic measures. It should be remembered that 
 death may suddenly occur, and for this the patient should be pre- 
 pared. All excitement should be sedulously avoided. Exertion 
 should be limited to the lightest exercise. The food should be such 
 as will be easily digested, so as to avoid any troubles with the 
 stomach, etc. The stomach should not be loaded with food. The 
 surroundings should be guarded, so as to avoid the possibility of 
 annoyance, by much company, by business, or by household cares 
 and vexations. By forcibly impressing upon the minds of the 
 
184 Diseases of Adults. 
 
 attendants the vast importance of these points, much may be done 
 to prolong life and avert the fatal rupture of the tumor. The vol- 
 ume of blood may be lessened by limiting the amount of fluid taken 
 into the system, and this reduces the pressure upon the sac. 
 
 IV. Ailments Affecting the Waste Passages. 
 
 Kidney Diseases will include inflammation of these organs, 
 Bright's disease, Addison's disease, gravel, or kidney stone. 
 
 Inflammation and Congestion. How Brought On. The 
 kidneys may be congested, either from inflammation, irritating medi- 
 cines, cold, etc., which induces the active form of congestion; or, 
 as a result of obstruction which prevents the return of blood from 
 the vessels of the kidneys, which causes the passive form. 
 
 How Distinguished. This trouble is recognized by pain in the 
 lower back, and tenderness on pressure over the kidneys. The 
 urine is scanty, of high color, occasionally bloody. By boiling it 
 in a spoon over a lamp, coagulation occurs, showing the presence of 
 albumen. When inflammation is present, all these symptoms are 
 seen, but in a greatly aggravated form, and with high fever, followed 
 by the discharge of matter or pus with the urine ; before the pus 
 commences to come away, there is generally a bulging observed in 
 the region of the inflamed kidney, which disappears as the matter 
 is passed. 
 
 How Treated. The treatment must be directed to the relief of 
 the congested condition, or the subduing of the inflammation, which 
 is best met by free cupping or leeching, over the seat of pain ; pur- 
 ging actively, and the use of warm hip-baths. The diet should be 
 mild, and the drinks of a soothing nature, as slippery elm mucilage, 
 or flaxseed tea (p. 350), or tea made of quince seeds. 
 
 Bright's Disease is such a state of the kidneys as causes the 
 presence of albumen in the urine, and general dropsy. It is, to 
 some extent, a breaking down of the structure of the kidneys. 
 
 How Brought On. This disease presents in two forms: the 
 acute, or rapid, and the chronic, or slow form. Generally, it is the 
 result of exposure to cold or damp ; as after scarlet fever, or during 
 a debauch, or pregnancy. By some, it is believed to result from 
 
Bright 's Disease. 185 
 
 ague poisoning, and also from intemperance in alcoholic drinks. 
 The slow form is the result of these causes, but often follows a long 
 continuance of intemperate habits, or heart disease, and seems also 
 due to certain climates. 
 
 How Distinguished. In the quick form, the patient has a chill, 
 headache, sick stomach, backache, and pains in the limbs, dry, 
 harsh skin, and difficulty of breathing. Then fever sets in, and 
 dropsy follows, so that the face, the limbs, in fact, the whole surface 
 is puffed up. The flow of urine is almost'entirely checked; what 
 is passed is dark, and filled with blood, acid, and is found to be full 
 of albumen. The patient is constantly tormented with a desire to 
 pass the water. After a week, or even a month, recovery com- 
 mences, or the attack becomes of the chronic form, or the poisoning 
 of the blood is so great as to cause death. 
 
 In the slow or chronic form, the presence of the disease is often 
 not known until too late to check the downward career. The face 
 becomes pale, the breathing is short, the strength is easily exhausted, 
 and the bladder requires to be emptied frequently. When the urine 
 is passed, it is observed to form bubbles on the top, due to the pres- 
 ence of albumen, which may be demonstrated by boiling, as before 
 mentioned. Suddenly, a convulsion occurs, the sight fails, dropsy 
 shows itself, diarrhoea comes on, and every symptom is present of 
 the system breaking down. Generally, these symptoms appear to 
 improve occasionally, but these appearances are deceitful, and all 
 are apt to come back with increased force, ending in convulsions, 
 coma, and death. These symptoms may extend over a period of 
 years, but generally, a few months ends the scene. 
 
 How Treated. In the acute form, active medication is required. 
 The loins may be cupped or leeched, or the trouble may be relieved 
 by the use of the hot hip-bath ; by active purgation, and particu- 
 larly by the use of diuretics, as the citrate of magnesia, jalap, and 
 cream of tartar, bitter-sweet tea, uva ursi tea, etc. (see pp. 341 
 and 348). The diet, as in all these affections, must be of a liquid, 
 nourishing form. When the chronic form occurs, great care is 
 requisite. Cold and dampness must be carefully avoided; the 
 strength preserved; little exercise, for fear of fatigue; liquors of 
 all kinds must be forbidden ; the skin should be enabled to do its 
 16* 
 
1 86 Diseases of Adults. 
 
 full duty by warm bathing and dry rubbing; the bowels should be 
 kept in a moderately loose condition, constipation carefully pre- 
 vented. The diet, as before, should be of a bland nature. For 
 this reason, it has been proposed to use exclusively a diet of skimmed 
 milk, given in small quantities, frequently repeated, say two or three 
 wineglassfuls every two or three hours. As a tonic, iron in some 
 form is always best, and chiefly the muriated tincture of iron, ten 
 drops in water, after each meal. When the stomach is not too irri- 
 table, cod-liver oil is useful to help repair the waste of the system. 
 The dropsy becomes a matter of great annoyance, and its presence 
 is always alarming. To relieve this symptom, the same medication 
 will be useful as in the acute form. The cream of tartar and jalap 
 may be given freely, in infusion of juniper berries, broom, etc. ; 
 and efforts should be made to cause free perspiration, as by the hot 
 bath, or the hot air bath. Of course, other diuretics, such as 
 given in receipts Nos. 146, 147, and 157, may also be used with 
 advantage. 
 
 Addison's Disease is a singular affection, which is characterized 
 by bronzing of the skin, weakness, poverty of the blood, irregular- 
 ity of the heart, shortness of breath after the slightest exercise, 
 inability to digest the food, nausea, vomiting, and impairment of 
 vision. It is due to an affection of what are known as the supra- 
 renal capsules, small bodies situated upon the top of the kidneys. 
 It generally occurs in young men, and may last for years, always 
 ending in death. It may terminate very gradually, by diarrhoea, 
 stupor, etc., or convulsions may come on and end in death. 
 
 How Treated. The treatment is almost nothing. Care, fresh 
 air, light exercise, and mild tonics may serve to prolong life. It 
 has been thought that good has resulted from a mixture of the tinc- 
 ture of iron, chloroform, and glycerine, say fifteen drops of each of 
 the first two, with two drachms of the last, this amount to be taken 
 two or three times a day. 
 
 Gravel, op Kidney Stone, is also known as lithiasis. 
 
 How Brought On. This affection is supposed to be due almost 
 solely to the use of lime-stone water, and hence it prevails much 
 more frequently in certain localities. 
 
 How Distinguished. The urine is filled with small stones, or 
 
Inflammation of the Bladder. 187 
 
 sand ; there is pain in the back, in the region of the kidneys ; the 
 attack is generally ushered in by a chill and fever, and more or less 
 indigestion ; occasionally, there is great pain, as in the passage of the 
 larger particles. The desire to pass the mine is very annoying, and 
 there is observed a sediment or deposit at the bottom of the vessel. 
 
 How Treated. As there is always acidity of the urine, this 
 must be corrected by the free use of alkalies, and the pain and irri- 
 tation relieved by free use of soothing drinks, of flaxseed, slippery 
 elm, etc., with sweet spirits of nitre, bicarbonate of soda, etc. 
 Should the pain be very great, opium, or preferably, chloral, may 
 be given in proper quantities. 
 
 How Prevented. It is deemed possible to prevent these attacks 
 by the use of food, mostly of a vegetable form, the avoidance of 
 stimulants, the free use of water, or other diluent drinks, exercise 
 in the open air, encouraging perspiration, and the use of antacids, 
 as Saratoga or Vichy mineral waters. 
 
 Diseases of the Bladder will include inflammation, weakness, 
 stone, and bloody urine. 
 
 Inflammation of the Bladder is known as cystitis, or catarrh 
 of the bladder. 
 
 Hovj Brought On. This may result from injuries, stone or 
 gravel in the bladder, irritating medicines, foul urine long retained. 
 
 How Distinguished. There are pain in the region of the blad- 
 der, a constant desire to pass the water, burning or scalding in the 
 passage, and a tendency to bear down. More or less fever and 
 chilliness are always present. Occasionally, the tenderness on pres- 
 sure over the bladder is very great. 
 
 These symptoms may be greatly aggravated, and accompanied 
 with sick stomach, mental depression, cold sweats, and delirium. 
 The urine may be bloody, filled with matter, or horribly offensive. 
 Sometimes there is great difficulty in passing the water. 
 
 How Treated. The patient must be kept quiet in bed, and the 
 parts freely cupped or leeched; warm hip-baths will be found of 
 great value (p. 338). If necessary, mild purgation may be in- 
 duced, as by castor oil, or some similar article (p. 340). To 
 relieve the bearing down, heat and pain, pieces of ice may be passed 
 into the bowel, and this will be found a source of great comfort to 
 
1 88 Diseases of Adults. 
 
 the patient. The drinks must be soothing in form, as flaxseed, or 
 slippery elm tea. Excessive pain and restlessness may be readily 
 controlled by charcoal (p. 357), or by suppositories or enemas of 
 laudanum or opium. 
 
 Stone, or calculus in the bladder, would be indicated by sudden 
 stoppage of the stream in urinating; pain in the bladder, more or 
 less acute; but could only be positively known by the use of a 
 sound passed into the bladder and striking the foreign body. A 
 prominent symptom, especially in children, is itching or pain at the 
 end of the penis, causing the child to be constantly pulling at or 
 rubbing the organ. This sometimes causes an elongation of the 
 foreskin, and great annoyance by the collection of the secretions in 
 this part. 
 
 How Treated. The removal of the stone by an operation, 
 either cutting or crushing, is almost all that can be done. A vege- 
 table diet should be preferred, and the bowels and kidneys kept in 
 prompt action. 
 
 Bloody Urine may be the result of injuries; the presence of a 
 stone, with sharp edges or points; a strain, causing the rupture of 
 a small vessel ; or from inflammation, etc. It is seen in cancer, 
 scarlet fever, in the aged, or may result from the use of turpentine 
 or cantharides. 
 
 How Treated. When the blood is mixed with the water, it is 
 almost sure to be from the kidneys; when it appears to follow the 
 urine, it is from the bladder. When an instrument has been used, 
 and it follows either in a stream or drops, it is from the passage 
 itself, and most likely has been caused by an injury. Rest in the 
 recumbent position is of great importance; astringents must be 
 employed to check the hemorrhage, and the best is gallic acid, in 
 doses of ten grains, or the muriated tincture of iron, or powdered 
 alum, ten or fifteen grains; or some of these may be injected into 
 the bladder in free dilution. If it is from the passage, and alarm- 
 ing, this may be readily stopped by passing the catheter, and com- 
 pressing the parts around it until the hemorrhage is checked. 
 When the instrument is withdrawn, which should not be until time 
 has been allowed for the obstruction of the torn vessel by coagu- 
 lum, it should be done with great caution. 
 
Diabetes. 1 89 
 
 Diabetes, or an immoderate flow of urine, may be sugary diabetes, 
 or simple diabetes. 
 
 How Brought On. This disease is caused by injuries to the 
 head; the abuse of alcoholic liquors; exposure to cold and damp- 
 ness ; sudden checking of the perspiration ; emotion ; fevers ; diseases 
 of the brain and spine ; and in the sugary form, the inordinate use 
 of food containing sugar. 
 
 How Distinguished. The simple form, or diabetes insipidus, 
 generally comes on suddenly, and the patient finds himself con- 
 stantly passing his water, and on each occasion a large quantity, 
 amounting to many quarts each day. The thirst is intense, and 
 the patient drinks immoderately, both day and night, being compelled 
 to rise frequently to urinate, and also to quench his thirst. He 
 becomes weak and thin, with a harsh, dry skin. 
 
 The sugary form, or diabetes mellitus, usually comes on more 
 slowly, and is attended with general languor, uneasiness, emacia- 
 tion ; gradually the desire to pass the urine becomes very frequent, 
 and the amount becomes alarming, accompanied with great thirst, 
 and often with a voracious appetite. The symptoms are similar to 
 the other form, the general powers fail, hectic sets in, dropsy of the 
 limbs, diarrhoea, the lungs become involved, and death closes the 
 scene. 
 
 How Treated. The treatment of this affection is yet, to a great 
 degree, a matter of uncertainty. It is believed that the absolute 
 prohibition of sugar in the diet, or of articles prone to form sugar, 
 will aid greatly in checking this disease. Hence, the diet must be 
 composed of meats, eggs, butter, bran-bread, cabbage, onions, celery, 
 lettuce, spinach; and these must be varied by turns, lest distaste 
 occur, and thus an additional cause of debility be induced. The 
 forbidden fruits would be, all fruits, wheat bread, potatoes, beets, 
 milk, liver, sweet breads, etc. Liquors must only be allowed in 
 case of great debility, and then only in small quantities, preferring 
 whisky, or sherry or claret wine. 
 
 A great variety of medicines have been proposed, but few seem 
 especially useful. Cod-liver oil, both by the mouth and by inunc- 
 tion, may prevent the rapid progress of the debility. Perhaps the 
 best results obtained have followed the l ' skim-milk treatment . ' ' The 
 
190 Diseases of Adults. 
 
 patient is restricted to the milk, carefully skimmed, for a month at 
 least, and then allowed, in addition, two to four pints of curd made 
 by the use of rennets, gradually; as improvement occurs, lean 
 meat and green vegetables are given, then eggs, fish, fowl, etc. If 
 recovery occurs, substances containing sugar and starch should not 
 be allowed for a very long time, if at all. There is always a loss of 
 weight for the first few weeks, after which improvement commences. 
 In some instances, the "condensed milk" has been employed, this 
 being brought to the standard of pure milk by the addition of water. .. 
 It is claimed that if the disease is not very far advanced, the sugar 
 will disappear from the urine even in two weeks, and often at the 
 end of five or six weeks, and in cases of long standing, that the 
 progress of the affection will be arrested, even though a cure may 
 not result. 
 
 V. Ailments Seated in the External Coverings of 
 the Body. 
 
 Diseases of the Skin. 
 
 There are a great many names to skin diseases, but, so far as 
 treatment goes, they may be divided into but a few forms, which 
 are not very hard to recognize. The first is : — 
 
 1. Those which have a moist, weeping or watery surface. This 
 is caused by small blisters which break and discharge their contents. 
 Under this head come grocers' itch, bakers' itch, bricklayers' itch, 
 washerwomens' itch, moist tetter, salt rheum, bath itch, gum boils, 
 fever blisters, milk crust, scald head, water pox, shingles, brow 
 shingles, toothing rash, ringworm, canker sores. 
 
 Eczema, apthae, and herpes are the medical names for these 
 various complaints. 
 
 Sow Treated. This is by diet, by local measures, by internal 
 medicines. Spices, coffees, liquors of all sorts, pickles, and rich 
 food, should not be taken. Meat should be taken in small quanti- 
 ties. The bowels should be kept open by appropriate laxatives 
 (see page 348). For the local treatment, the crusts should first be 
 removed by soaking with oil and then washing with soap and warm 
 water, or poulticing, if this does not answer. When they are all 
 
Ringworm. 191 
 
 Off, cover the part with a cloth wet with tar- water, made by stewing 
 a teacupful of tar in a quart of boiling water. Or anoint the part 
 with an ointment made of equal parts of tar and unsalted lard, or 
 with oxide of zinc ointment (p. 356), an excellent application. 
 
 The internal treatment is, in weak children and feeble elderly 
 persons, a spoonful of cod-liver oil three times a day, and ten drops 
 of the tincture of iron in water, after each meal. When the patient 
 is otherwise robust, a somewhat low diet and an occasional cathartic 
 will be required. 
 
 Ringworm is quite common in children. Several different dis- 
 eases are called by this name, but the one we have reference to 
 appears as a small circle of watery pimples, which extends, and leaves 
 in its centre a dry, branny surface. When it first appears it may be 
 checked by bathing the part frequently with vinegar in which a 
 piece of blue vitriol has been dissolved, or painting it with tincture 
 of cantharides. Later, the oxide of zinc ointment is to be applied. 
 Scratching should be avoided. Attention to the general health is 
 called for when ringworms appear often. 
 
 2. Those with a dry, pimply or lumpy surface, without discharge. 
 
 This class is next common to the first one. It embraces those 
 ailments whose common names are, nettle rash, prickly heat, hives, 
 dry hives, pimples, wabash scratches, camp itch, soldier's , itch, 
 ground itch, night itch, winter itch, grubs in the face, or black 
 heads, rose, rose rash, wind pox, barbers' itch, beard itch, tetter. 
 
 The medical names it includes are, urticaria, roseola, acne, lichen, 
 prurigo, molluscum, sycosis. 
 
 Most of these complaints are characterized by more or less itch- 
 ing and prickling, and this is the symptom which the patient par- 
 ticularly wishes abated. For nettle rash, or hives, bathing the part 
 in hot mustard water is often sufficient. The "cooling sal-ammo- 
 niac wash" (p. 355) is a valuable application. Bathing with dilute 
 vinegar also gives relief. For camp or ground itch, the parts 
 should be rubbed thoroughly with common soft soap, every night, 
 for three nights, which should be well washed off the next morning, 
 and the oxide of zinc ointment (p. 356) or the lead ointment (p. 
 354) gently rubbed in. The internal treatment and diet should be 
 the same as given for the previous class of ailments. Grubs on 
 
192 Diseases of Adults. 
 
 the face may be removed by washing repeatedly with ether, or with 
 water somewhat strong with washing soda, or with a tablespoonful 
 of alum in a basinful. 
 
 Barbers' Itch is the development of pimples and pustules in 
 the beard and whiskers. Each pimple, if examined, will be found 
 to have a hair passing through it. There is but one way to set 
 about curing this troublesome and disfiguring disease, and that is as 
 follows: Remove the crusts by oil and poultices. Cut the beard 
 short with scissors. Then pull out every hair that is seen to come 
 from a yellow point or pimple. A small forceps should be used for 
 this. When this is completed, rub thoroughly with the following 
 ointment : — 
 
 Take of Flowers of Sulphur, one scruple. 
 
 White Precipitate of Mercury, one scruple. 
 
 Carbolic Acid, pure* ten drops. 
 
 Fresh Lard, - one ounce. 
 Mix well. 
 
 Repeat this treatment, plucking out the hairs, as directed, and con- 
 tinue as long as there are any yellow points. Do not sfeave for 
 at least six months after the disease has left. 
 
 3. Those which have a dry, scaly surface. 
 
 Of these, the public has familiar names for dandruff, dry tetter, 
 scaly tetter, chapped hands, cracked lips, leprosy. 
 
 The treatment in most of the cases of these diseases is by cleans- 
 ing the surface well with a wash of common soft soap and warm 
 water, and then anointing the part with some mild, slightly stimu- 
 lating ointment, one of the best of which is the camphor ointment, 
 given p. 356. 
 
 4. Those caused by insects in or under the skin. 
 
 First, we shall speak of the true itch, scabies or psora. This is 
 a very contagious disease, caused by the burrowing of the itch mite 
 under the skin. The irritation it causes gives rise to a little pustule, 
 which is soon broken by scratching, and the fluid escapes and dries 
 into a crust. 
 
 The most successful mode of dealing with an ordinary case of 
 scabies is as follows :— The patient before going to bed should soak 
 for an hour in a warm bath, and scour himself well with soap and 
 flannel; when thoroughly dry, he should rub in plenty of simple 
 
Flea Bites. 193 
 
 sulphur ointment (p. 356), all over his body, arms, legs, hands, 
 and feet, but especially between the fingers and toes, and on the 
 flexed side of the limbs. He should then put on a long pair of 
 drawers, gloves, and socks to prevent the ointment from rubbing 
 off, or a long night dress, gloves, and socks will answer the purpose 
 tolerably well. He should then go to bed for ten or twelve hours. 
 If it is important that the smell of sulphur should be removed during 
 the day ; he may take a warm bath in the morning, and then follow 
 his usual occupation. At night, the process should be repeated. 
 A third application is sometimes, but not generally necessary, pro- 
 vided the ointment has been thoroughly applied in the first instance, 
 and in sufficient quantity. A single application is usually sufficient 
 if the ointment, after being well rubbed into every part of the body, 
 is allowed to remain undisturbed for twenty-four hours. 
 
 Lice. These disgusting insects are easily transferred from one 
 person to another, and give rise to much irritation and even eruption 
 of the skin. Sometimes they breed with inconceivable rapidity, 
 especially on dirty or broken-down subjects. 
 
 The treatment is simple. The clothes should be baked, for 
 washing alone will not kill the insects ; a warm bath should be taken, 
 and the skin anointed with stavesacre ointment (one drachm to one 
 ounce). Flannel should be discontinued next the skin until the 
 eruption is well. A strong tea of tobacco and mercurial ointment 
 also destroy them. 
 
 The louse which frequents the hair differs from that found in the 
 clothing. It can be destroyed by the same measures. 
 
 The crab-louse occurs in the hair on the trunk, under the arm- 
 pits, etc. He is exceedingly tenacious of life. Mercurial ointment, 
 or calomel rubbed in, is generally sufficient, however. 
 
 Flea Bites sometimes give children and those of tender skins the 
 appearance of having a skin disease. These pests can be driven 
 away by sprinkling the under-clothes with carbolic acid, or oil of 
 peppermint. 
 
 5. Those in which the skin is permanently discolored. 
 Such are moles, mother's marks, liver spots, Saint Anthony's fire, 
 rose rash, tan, freckles, white spots, red nose, sunburn, face blotches, 
 bronzed skin, India ink marks, nitrate of silver stains, tattooing, etc. 
 
 17 
 
194 Diseases of Adults. 
 
 They arise from the various causes their names denote, and some 
 are hereditary. Though classed as diseases, they are more properly 
 disfigurements. Some of them, as mother's marks, moles, and 
 India ink marks, require careful surgery to displace. Those which 
 may be treated by simpler means will be found considered, with the 
 receipts appropriate for their removal, on pages 365, 366. 
 
 Diseases of the Hair. 
 
 The most usual diseases of the hair are falling, eczema, dandruff, 
 also seborrhoea. 
 
 Falling of the Hair, or alopecia, without obvious reason, generally 
 depends upon want of vigor in the scalp, and can be remedied by 
 stimulating applications. We give, later in this work, the recipes 
 for a number of well-tried hair tonics, which are appropriate in 
 these cases (pp. 363, 364). 
 
 Eczema of the Scalp. This is shown by a moist, watery dis- 
 charge on the scalp. It dries up, forms scabs, and mats the hairs 
 together. One form of scald head, in children, is of this nature. 
 Its treatment should be that given under the first class of skin dis- 
 eases, to which it belongs. 
 
 Dandruff is the well-known dry, branny scurf, which many per- 
 sons show on their coats and in their hair. Its cure can usually be 
 accomplished by washing with soap and warm water, and then, when 
 dry, rubbing in the ointment No. 188, p. 356. 
 
 Seborrhoea has thicker, more solid, and coarser scales than dand- 
 ruff. It is a frequent cause of early baldness in adult life. Often, 
 the scalp itches considerably and is sore to the touch. The treat- 
 ment is to rub well with oil, and wash with soap, to remove the 
 crusts, which will have to be done more than once, as a rule ; then, 
 to rub the scalp three times a week with a wash of soft water, con- 
 taining a teaspoonful of carbolic acid to the pint ; and finally, anoint 
 the roots of the hairs carefully with a mixture of equal parts of zinc 
 ointment and white precipitate ointment, which can be had from 
 any druggist. 
 
 Scald Head. This, called by physicians tinea, is a contagious 
 disease, found chiefly on the heads of children, and is caused by 
 the growth of a vegetable fungus. In its early stages, it is charac- 
 
Blisters. 195 
 
 terized by the formation of little sulphur-colored and cupped crusts; 
 these coalesce, and form yellow masses of a honey-comb appearance, 
 and having a peculiar smell, as of mice. The disease is of a very 
 chronic character. 
 
 The treatment consists in destroying the vegetable parasite. For 
 this purpose, a strong sulphurous acid lotion, of one part of the 
 acid to one or two of water, should be continuously applied, under 
 oiled silk, to the diseased surface, and kept constantly moist; the 
 crusts, when softened by this application, should be from time to 
 time removed ; this constitutes the first part of the treatment. The 
 second consists in pulling out the hairs of the affected part, and 
 using the ointment given for barbers' itch. 
 
 Diseases of the Kails. 
 
 Hang-nails. The loose fragments of nails which bear this 
 name should always be carefully removed, as they may, by their 
 irritation, produce felons, and other inflammatory troubles. 
 
 Ingrown Nails. These usually are found on the toes, especially 
 the big toe. They are very painful and obstinate. To heal them, 
 the middle of the nail should be scraped with a piece of glass until 
 it is quite thin. Then the edge which has grown under the flesh 
 should be gently but firmly pressed upward by inserting under it a 
 roll of lint or soft cotton. The raw edge of the flesh should be 
 fastened down, away from the nail, with narrow strips of adhesive 
 plaster, and a loose shoe be worn. Perseverance in this plan will 
 effect a cure. 
 
 Miscellaneous External Affections. 
 
 We now throw together, under an alphabetical arrangement, the 
 treatment of several external ailments, in addition to those men- 
 tioned above, which will be looked for under this heading. 
 
 Blisters, or blebs on the skin, are sometimes raised by han- 
 dling irritating substances, animal or vegetable, as Spanish flies, 
 potato bugs, parsnip leaves, poison oak, and from burns, quick lime, 
 the sun's rays, and so on. The rule is not to open them, but to 
 pass a needle through them, carrying a white woolen or loose cotton 
 
196 Diseases of Adults. 
 
 thread. Then cut off the thread each side of the blister, leaving 
 the part between the cuts in the bleb. The fluid will drain out, 
 and the surface skin promptly unite with that below it. 
 
 In blisters of the feet, from walking, and of the hands, from 
 rowing, the same method is employed. 
 
 Blood Blisters rise on the skin when one of the small skin 
 blood-vessels is broken. If not the result of an accident, they are 
 often the sign of bad health, and point to the necessity of a good 
 diet, tonics, cod-liver oil, and change of air. 
 
 Boils or Furuncles. These are great pests to some people, and 
 many ways are suggested to "backen" them. The best is to apply 
 heat as soon as there is any sign of one. Hot water, long con- 
 tinued, will often succeed. When matter has once formed, warm 
 poultices should be applied, and the boil opened with a sharp knife, 
 so that the core can loosen. 
 
 When a person has crop after crop of boils, it is a sign of en- 
 feebled health. Peruvian bark or quinine should be taken with 
 iron (see pp. 360, 361). 
 
 For a blind boil, which is a dull, obstinate sore, opening with a 
 knife, and poulticing, is the proper treatment. 
 
 Bunions are hard, tender swellings, which appear on the ball, 
 the outer portion of the second joint of the big toe, or on the 
 insteps. Tight or short shoes produce them. A loose, but well- 
 fitting and flexible shoe must be worn, and the swelling painted, 
 several times a week, with tincture of iodine or a weak solution of 
 carbolic acid. 
 
 Carbuncle. This is a large and malignant boil, very painful, 
 and even dangerous, as it indicates a low state of health. It is flat 
 and firm, with a crust with several imperfect openings, from which 
 the matter passes out. This, and its size, and the intense pain 
 accompanying, distinguishes it from a common boil. At times it 
 is infectious, induced by the reception of an animal poison (from 
 cattle) into the system. This is called "malignant pustule." 
 
 How Treated. The only efficient plan of treating a carbuncle 
 is to divide it crosswise, with a sharp surgical knife, early in its 
 course, and then poultice it steadily. The system should be kept 
 up with tonics, and stong, nourishing food, with ale or porter. 
 
Goitre. 197 
 
 Corns. The cure of these common annoyances is easy, but 
 troublesome. The foot should be thoroughly soaked in warm water, 
 and all of the corn removed with a dull penknife, but no pain 
 should be produced. When this is felt, it is a sign that the knife 
 is going too far. Then the little cavity should be surrounded with 
 flat rings of wash leather, or felt, or corn plaster, leaving a hollow 
 centre. A drop or two of sweet oil should be placed in this, and 
 the foot clothed in a soft stocking, and a loose, easy shoe. This 
 process, repeated twice or three times a week, for a month or two, 
 will cure a corn ; but it will return if tight, ill-fitting shoes are 
 resumed. 
 
 Felon, or Whitlow. This is a very painful inflammation of 
 the finger, arising from a bruise, from the entrance of a needle or 
 splinter, a hang-nail, or other irritant. When milder, it is called a 
 "flesh felon;" when severe, affecting the bone, a "bone felon." 
 The former begins generally at one side of the root of the nail, or 
 in the bulb of the finger end, with redness, swelling, and a throb- 
 bing, burning pain, shooting up the hand and arm. 
 
 These symptoms are very much increased in severity in the 
 second variety. The patient holds his hand up, as the pain is more 
 acute when it is dropped. The appetite suffers, and sleep is dis- 
 turbed or prevented. 
 
 At the outset, a felon may be backened, at times, by holding the 
 hand for a half-hour in water as hot as may be borne, and then 
 wrapping it in a large hot poultice. After this is done, leeches may " 
 be applied, so as to draw blood freely from the part. These meas- 
 ures failing, the next measure, which should not be delayed, is to 
 open freely the swelling, with a sharp knife, cutting, in a bone felon, 
 fully to the bone. This, alone, will prevent the danger of having 
 a stiff, mutilated, and useless finger for a lifetime. After the in- 
 cision, poultices and warm water dressing will complete the cure. 
 
 Goitre, Derbyshire neck, or swelled throat, is a deformity common 
 in mountainous countries. Its cause is not ascertained. The 
 swelling is in front and at the base of the neck. It is painless, but 
 is unsightly, and may become troublesome by pressure on the wind- 
 pipe and large blood-vessels. When of many years' standing, it 
 cannot be cured; but when comparatively recent, rubbing with the 
 
 17* 
 
198 
 
 Diseases of Adults. 
 
 following ointment, three times a week for several months, will 
 cause it to disappear. 
 
 Take of Iodide of Cadmium, - one drachm. 
 
 Fresh Lard, one ounce. 
 
 Mix. Rub in a portion the size of a small pea. 
 
 Goitre is liable to return, however, unless a change of residence 
 
 is adopted. 
 
 Sores and Ulcers. Cold sore, leg sore, or indolent ulcer. 
 
 These are names given to those obstinate sores, or issues, that come 
 
 on the legs of persons, especially those in advanced life, whose 
 
 systems are below par, and who have suffered from swollen veins, 
 
 rheumatism, frosted feet, and similar troubles. They are not very 
 
 Fig 58. painful, but are foul, debilitating, and 
 
 difficult to heal. 
 
 The treatment is local and internal. 
 
 Good hygiene, great cleanliness, pure 
 
 air, nourishing, simple diet, and iron 
 
 or cod-liver oil, daily, are essential. 
 
 Then locally apply the carbonate of 
 
 ammonia ointment, given on page 356, 
 
 taking care to wash the sore by a 
 
 stream of warm suds from castile 
 
 soap. This done, cut long strips of 
 
 sticking plaster about a half inch wide, 
 
 and long enough to go once and a 
 
 half round the limb. Applying the 
 
 middle of one of these to the opposite 
 
 side of the limb from the ulcer, the 
 
 two ends are brought forward across 
 
 this with a firm pressure, so as to bring 
 
 together, as much as may be, the edges 
 
 of the sore. A number of straps, so 
 
 applied (leaving places for the matter 
 
 to escape), completes the dressing. 
 Bandaging a Leg with Adhe- mi . , , ' & 
 
 sive Strips This should be repeated once or twice 
 
 a week. This method of bandaging a leg is shown in Figure 58. 
 
 Sweating, excessive. Persons of a stout habit occasionally suf 
 
Warts. 199 
 
 fer from excessive perspiration, which, though it may not be injuri- 
 ous, is disagreeable. It may be diminished by avoiding warm 
 baths, changing the underclothing frequently, and sponging the 
 body with a lotion consisting of two teaspoonfuls of dilute sulphuric 
 acid, in a quart of water. The skin, when dried, should be pow- 
 dered with starch or pulverized asbestos. 
 
 Fetid, OP Foul Feet, from excessive sweating, are a great annoy- 
 ance to some. Benefit in such cases will be derived from bathing 
 the feet, night and morning, with a mixture of half an ounce of 
 tannic acid in a pint of cologne water, drying, and powdering with 
 starch or dry tannic acid. 
 
 Warts. These ugly excrescences are best dispersed by rubbing 
 them, night and morning, with a piece of muriate of ammonia (sal- 
 ammoniac), moistened with water. 
 
CHAPTER VI. 
 
 ACCIDENTS, INJURIES, AND POISONS. 
 
 Genekal Directions for Treating Accidents, Bandages, Splints, 
 and Dressings.— Bed Sores. Bites: of Mad Dogs— Hydrophobia, Ra- 
 bies — of Snakes, Spiders. Bleeding or Hemorrhage : from Wounds — from 
 Nose — from Large Arteries. Blows : Wounds from. Bones : Broken — 
 Out of Joint — (fractures and dislocations). Brain: Compression and Con- 
 cussion of. Bruises: Blows — Contusions. Burns and Scalds : Scars from. 
 Cuts. Browned : To Restore. Fainting and faint Spells. Falls : Hurts 
 from. Frozen Persons: to Restore — Frozen Limbs — Chilblains — Frost 
 Bite, Railroad Injuries : Spinal Shock. Rings : to get off. Ruptures , or 
 Hernia: Trusses. Scars: from Wounds— Burns— Small-Pox. Shock: 
 Sprains and Strains— Stings of Insects. Stroke : Sun-stroke — Heat-stroke 
 Sun— Headache — Sun Pain — Lightning Stroke. Suffocation and Strangu- 
 lation: Choking, or Asphyxia, Suspended Animation— from Hanging— 
 from Fixed Air — Well Damp, or Carbonic Acid Gas — from Charcoal 
 Fumes— from Common Burning Gas — from Coal Gas and Choke Damp. 
 Teeth Knocked out. Things : in the Eye— in the Ear— in the Nose— in the 
 Throat— in the Lower Bowel— in the Flesh— Needles— Pins— Fish-Hooks. 
 Veins: Swollen— Bursting of. Wounds: How to Dress— Bandages- 
 Gunshot Wounds — Torn Wounds — Cats — Stabs and Thrusts — Cut 
 Throa1>-Scalp Wounds. Passive Movements : For Wounds and Injuries 
 — Illustrations of. 
 
 Poisons and Poisonings— General Directions: Alcohol — Aconite— Am- 
 monia —Antimony— Arsenic — Baryta— Belladonna — Bismuth — Bitter 
 Sweet — Camphor — Copper— Corrosive Sublimate — Digitalis— Iodine- 
 Iron— Lead— Mushrooms— Nitrate of Silver— Opium— Oxalic Acid— Poi- 
 son Ivy, or Vine— Prussic Acid— Phosphorus— Savine— Stramonium- 
 Strychnia— Tobacco. Laying out the Dead. 
 
 General Directions for Treating Accidents. 
 
 When a person witnesses an accident, his duty is to render imme- 
 diate assistance. And if he is not wanted for this purpose, to go about 
 
 200 
 
Bandages and Dressings. 201 
 
 his business forthwith, and not to form one of a gaping, staring crowd. 
 What a person who is hurt needs first, is plenty of air. He 
 should not be surrounded by many persons, and if in a room, the 
 windows should be opened. There should be no hurry nor rude- 
 ness in moving him. Often ill-directed attempts to do so mate- 
 rially aggravate his sufferings, and the danger from the injury. 
 
 If a person has been thrown from a carriage, injured by a fall 
 from a height, blow, or other cause ; while there may be no frac- 
 ture, or other external injury evident, the nervous system has 
 received what is called a "shock." As is commonly said, the per- 
 son is " faint." 
 
 A person situated with such symptoms, should, if possible, be 
 placed flat on the back, with the head, neck, and shoulders slightly 
 raised. The limbs, at the same time, should be straightened out, 
 if practicable, so that the heart, already feeble in action, may act at 
 as little disadvantage as possible. The cravat, collar, and every- 
 thing else calculated to in any way impede the circulation toward 
 the head, or the movements of the chest, should be loosened or 
 removed. If the injury is slight, reaction will soon come on after 
 giving the person a sip of cold water; spirits and water (teaspoon- 
 ful in tablespoonful of cold water every couple of minutes), or 
 aromatic spirits of ammonia (twenty drops in a tablespoonful of 
 cold water) every couple of minutes. Gentle frictions to the ex- 
 tremities, a few drops of cologne water on a handkerchief, to the 
 nostrils; if the weather is hot, the use of a palm-leaf fan; hot 
 flannels to the limbs and pit of the stomach, are all likewise useful 
 in assisting reaction. 
 
 Bandages and Dressings. 
 
 Every Jne should be prepared to give at least the first attention 
 to severe accidents. To do this properly, they should know some- 
 thing about roller bandages, splints, and simple dressings for 
 wounds. 
 
 A roller is made of stout white cotton cloth, about three fingers 
 wide, and of any desired length. 
 
 It is generally rolled from one end only, and is then called a 
 
202 
 
 Accidents y Injuries and Poisons. 
 
 Fig. 59. 
 
 A Roller Bandage. 
 
 single-headed roller (a). But if it be rolled from both ends, so 
 that the rolls meet in the middle, it is a double-headed roller (b) ; 
 this is not, however, often used, as it is 
 not very convenient. 
 
 For those who have the opportunity 
 of having assistance, a roller can be bet- 
 ter applied by an attendant than by them- 
 selves. But such as prefer being inde- 
 pendent may soon learn to put on their 
 roller very well. The foot as well as the 
 leg should be rolled, and the rolling should be begun at the toes 
 and finished just below, or what is much better, immediately above 
 the knee. 
 
 Sow to Bandage a Leg. Presuming the person is right-handed, 
 he will take a single-headed roller in his right hand, holding its 
 circumference between his thumb and fingers, and laying its loose 
 end on top of the foot at the root of the toes, he fixes it there with 
 the thumb of the left hand whilst the roller itself is carried beneath 
 the sole and round the foot, and twice or thrice round in the same 
 place till it get a good hold on the foot. The roller is then to be 
 turned round and round the foot towards the heel, each turn half 
 
 covering the former 
 one, and as the roller 
 passes beneath the 
 foot, it is delivered 
 from the right to 
 the left hand, and 
 then as it passes over 
 the foot, from the 
 left to the right 
 
 hand. Having ar- 
 BandagingaLeg. rived ^ ^ ingtep? 
 
 the roller is now carried round the ankle, made to descend to the 
 opposite side of the foot from which it had been brought, passed 
 beneath the sole, and then carried round the ankle again, thus form- 
 ing a figure of eight, one loop containing the foot, the other the 
 ankle-joint, and the gripe of the loops on the instep ; this figure-of- 
 
 Fig. 60. 
 
Bandages and Dressings. 
 
 203 
 
 Fig. 61. 
 
 A 4-tailed Bandage. 
 
 eight turn generally requires twice making to give the roller a good 
 start up the leg. The roller is now turned round the leg, each turn 
 half covering the former, and delivered from hand to hand alter- 
 nately, from within to without or from without to within, according 
 to which leg is being rolled. When all is wound, the end is to 
 be securely pinned. 
 
 On rounded parts of the body, as the head, buttocks, etc., it is 
 not easy to apply any sort of roller band- 
 ages. When it is desired to protect such 
 portions, a square bandage may be cut 
 into the form of a Maltese cross. Its 
 four arms will then fold down smoothly 
 one over the other, and the whole may be 
 fastened by adhesive strips. The pattern 
 of such a bandage will readily be under- 
 stood from Figure 61. 
 
 Sometimes, when a leg or thigh is broken and much injured, it 
 is desirable to renew its bandage without lifting the limb. This is 
 accomplished by a simple and ingenious device known as the many- 
 tailed, or Scultetus bandage. A number of single strips,-of the 
 width of the ordinary roller, are 
 laid adjacent, as shown in Figure 
 62, and upon these the limb is 
 laid. The ends of each strip 
 are then brought to the front of 
 the limb, folded, and fastened. 
 Any single strip can then be 
 replaced, without lifting the limb, 
 by pinning one of the same 
 length to its end and drawing it 
 under the limb. A Many-tailed Bandage. 
 
 Of all applications to a broken or much injured limb, water, hot 
 or cold, simple or medicated, stands first in importance. Everybody 
 should know how to keep a limb constantly moist, and constantly at 
 the same temperature. This is called irrigating a limb. The 
 very simple apparatus shown in Figure 63, which can be easily 
 constructed, answers the purpose admirably. A small bucket 
 
 Fig 62. 
 
 ^H! 
 
204 
 
 Accidents , Injuries and Poisons. 
 
 is suspended from the ceiling. A pipe, with a number of small 
 apertures, is fastened to its bottom. The flow is regulated by the 
 stop-cock. The bed is protected by a rubber cloth. And thus the 
 limb is constantly bathed in a gentle stream of fluid of any required 
 temperature. No treatment is more efficacious to reduce swelling, 
 prevent inflammation, and hasten recovery. The general rule is, 
 that the temperature of the fluid be that most agreeable to the 
 patient 
 
 Ffe. 63. 
 
 Irrigating a Limb. 
 
 We shall now mention, in alphabetical sequence, the most common 
 accidents and injuries, with their appropriate treatment. 
 
 Bed Sores. These sores are apt to come on projecting points 
 
Bites. 205 
 
 of the body of a patient who is long confined to bed. The following 
 directions will generally preverit their recurrence : — 
 
 1. The under sheet should be kept smooth and free from wrinkles 
 or crumbs. 
 
 2. The patient should be kept as dry as possible, all discharges 
 being cleared away frequently. 
 
 3. The position of the patient should be varied as frequently as 
 possible. 
 
 4. The back should be examined daily and washed with a strong 
 solution of spirits of wine, and, after having been thoroughly dried, 
 should be dusted with flour starch or powdered oxide of zinc. 
 
 5. When any indication of redness appears, the patient should 
 be supplied with a water or air cushion, or the part should be 
 covered with some thick felt or amadou plaster, having a circular 
 hole corresponding to the inflamed spot. 
 
 When they have come, they must be treated as we shall describe 
 under wounds. 
 
 Bites. The bite of a dog is a common accident, and always 
 deserves the most prompt and energetic attention, as there is always 
 a possibility of madness, hydrophobia or rabies. Even angry dogs 
 are said to communicate the disease sometimes by their bites, and 
 the same is asserted of the common skunk or pole-cat. The same 
 precautions should be used in every case as if we knew the dog was 
 mad. If these precautions are thoroughly and immediately applied, 
 there is not the least danger, even from the bite of a really mad dog. 
 There are four things to do, and we give them in the order in which 
 they should be done: — 
 
 1. Ligation. — Tie a string tightly between the part bitten and 
 the body. This can always be done when it is a leg or an arm 
 which is bitten, as is usually the case. It is to prevent the poison 
 from being absorbed into the system. 
 
 2. Washing.— -Wash the wound thoroughly, pouring abundance 
 of water on it from a height, or hold it under a full stream from a 
 pump or hydrant. 
 
 3. Suction. — Rinse the mouth and suck the wound as hard as 
 possible, and for fifteen or twenty minutes, spitting out the blood, 
 etc., which flows. 
 
 18 
 
206 
 
 Accidents, Injuries and Poisons. 
 
 4. Burning. — The wound should finally be cauterized or 
 burned. Carbolic acid, and nitrate of silver, or lunar caustic, are 
 the best for this purpose. But nitric or sulphuric acid will answer, 
 or a red-hot poker, or live coals. It is no time to be timid about 
 the means. • 
 
 When these are done, put a light poultice on the wound, keep 
 quiet until the slough comes off, and dismiss the matter from the 
 mind, for all danger is past. 
 
 For bites of rattlesnakes, vipers, moccasins, tarantulas, spiders, 
 and other poisonous serpents and reptiles, the same four precautions 
 are to be taken. Often the poison so exhausts and depresses the 
 system that stimulants are required. Spirits may be given, or, 
 what is better, spirits of ammonia, twenty or thirty drops in water 
 every quarter of an hour, as required. 
 
 Bleeding, op Hemorrhage. Thisalways acc'companies wounds, 
 and is generally most alarming to bystanders. There is no occasion 
 for fright, as people do not bleed to death very quickly. Retain 
 your presence of mind, and remember that three things are to be 
 done, all of which you can do at once. Take time to notice the 
 color of the blood. Blood from the arteries is a bright red color, and 
 bursts out in spurts, while venous blood is a purple red, and flows 
 in a steady stream. 
 
 The three steps you can 
 take to stop the blood are : — 
 1. Pressure. — Should an 
 artery or branch have been 
 divided (indicated by a spurt- 
 ing of a spray of bright blood 
 at each beat of the heart), the 
 firm pressure of the finger 
 for some time, to the point of 
 division, should be used, to 
 diminish the size of the ves- 
 sel at that point, until a clot 
 is formed there. 
 
 Sometimes, pressure to the 
 Pressure to Check ^Bleeding from the supposed seat f the injured 
 
 Fig. 64. 
 
Bleeding, or Hemorrhage. 
 
 207 
 
 vessel does not reach the artery. In such a case the pressure must 
 
 be used to some known trunk between the original supply of the 
 
 bloods and the injured branch. Thus, if the finger or the toe is the 
 
 seat of the arterial hemor- 
 
 Fig. 65. 
 rhage, firm pressure applied 
 
 each side of the finger, close 
 to the hand (as in the cut), 
 or toe, close to the foot, com- 
 presses the arteries passing 
 along to be distributed to 
 the extremity. If the hand 
 or foot is the seat of the in- 
 jury, pressure on the wrist, 
 over the point where the ar- 
 tery is felt for the a pulse, ,, 
 or at the inside of the ankle, 
 will materially retard the 
 passage of the blood beyond pressure to Check Bleeding from Finger, 
 those points. 
 
 2. Position. — The part from which the blood comes should be 
 raised above the rest of the body, and if the patient become faint 
 he should not be roused immediately, since faintness acts as nature's 
 remedy by lessening the force and activity of the flow of blood. 
 
 3. The Application of Cold. — This plan answers best when the 
 bleeding is from several points scattered over a large surface ; it is . 
 conveniently applied by letting cold water drip from a sponge upon 
 the bleeding points, or by the application of ice in a rubber bag, or 
 bladder. 
 
 When these immediate measures have been used, there is time 
 enough to use what physicians call hemostatics, to stop the blood. 
 Gallic acid is a cheap and convenient one. Still more handy is 
 alum. Either may be dusted on the part in powder, or poured 
 over in solution. Or the wound may be touched with nitrate of 
 silver, or tincture of iron. But these measures are needless in 
 ordinary cases. Sometimes, when a tooth is drawn, and the blood 
 will not cease running, a piece of cotton, dampened with alum 
 
208 
 
 Accidents, Injuries and Poisons. 
 
 water, or sprinkled with alum powder, and applied, will cheek it 
 promptly. 
 
 Bleeding from the Nose. Bleeding from the nose is seldom 
 serious, and may generally be controlled by the application of a lit- 
 tle cold water. The patient should be kept upright, with his head 
 thrown back and his hands raised above his head. Ice to the back 
 of the neck is useful. If very obstinate, throw up ice-water, or a 
 solution of gallic acid, with a syringe. 
 
 Bleeding from Small Arteries. This can generally be stopped 
 by firm and constant pressure on the point whence the blood spurts, 
 as above described. If a forceps is at hand, torsion may be used. 
 The end of the bleeding artery should be caught and twisted five 
 or six turns, without pulling. Even quite large vessels will cease 
 flowing if this is carefully done. 
 
 Bleeding from Large Arteries. When one of the large arteries, 
 which carry the bright red blood from the heart, is cut, there is 
 required more active treatment. This is, to compress the main 
 trunk of the artery, higher up, by the fingers, a strap and pad, or 
 a tourniquet. We shall show how this is to be done in the various 
 limbs. 
 
 If the bleeding be from a wound 
 in the arm, near the armpit, in 
 which case nothing more can for 
 the moment be done, a bystander 
 should press his thumb firmly into 
 the neck, behind the middle of the 
 collar bone, which will stop the flow 
 of blood through the great artery of 
 the arm as it is first coming out of 
 the chest. As, however, the pres- 
 sure thus made soon tires the thumb, 
 the handle of a door-key, wrapped 
 in three or four folds of linen, may 
 be pressed behind the middle of the 
 collar bone, and held without fatigue for almost any length of time, 
 till proper assistance can be obtained. 
 
 When the wound is below the armpit, about the elbow, the pres- 
 
 Fig. 66. 
 
 Pressure to Check Bleeding at 
 the Armpit. 
 
Bleeding, or Hemorrhage. 209 
 
 sure should be directed as shown in Fig. 67. The cut also shows 
 
 Fig. 67. 
 
 Pressure to Check Bleeding in Upper Arm. 
 where pressure by the thumb can be used to check bleeding near the 
 armpit. 
 
 The arm and forearm, with dotted lines, indicate the course of 
 
 Fig. 68. 
 
 Handkerchief Tourniquet on the Arm, 
 
 18* 
 
2IO 
 
 Accidents, Injuries and Poisons. 
 
 the arteries, and points at which pressure can be most judiciously 
 applied. 
 
 The arrow points the course of the current of the blood of the 
 artery, from the heart to the exttemities. 
 
 Permanent pressure is exerted by means of a temporary tourni- 
 quet to the artery of the arm. A common folded handkerchief, 
 with a firm, sharply-defined knot tied at the middle, a long strip of 
 muslin torn from a shirt sleeve, or a suspender, with a suitable knot 
 in it, is rather loosely tied around the arm, and the slack taken up 
 by twisting with a cane or stick until the knot, kept over the ves- 
 sel, exerts enough pressure to prevent the passage along it of the 
 blood. 
 
 The method of exerting pressure by the fingers along the course 
 of the artery of the thigh, between the wound and the heart, is 
 shown in Fig. 69. 
 
 Fig. 69. 
 
 Pressure on the Artery of the Thigh. 
 Sometimes it is easier to find the artery nearer the surface, at a 
 point along the dotted line, or a little higher up towards the groin. 
 The two thumbs, placed together, furnish firm resistance; and a 
 blunt stick, suitably protected, will often answer to keep up the 
 pressure until a tourniquet can be extemporized. 
 
Bones , Broken or Fractured. 
 
 211 
 
 Fig. 70 represents the tourniquet made as directed for the arm, 
 by getting a large, firm knot in a handkerchief, or anything else of 
 the kind. A small pebble has often been introduced for the pur- 
 pose, into the knot, with success. Twist the ligature with the 
 leverage obtained by passing under it a cane or stick. 
 
 Fig. 70. 
 
 Handkerchief Tourniquet on the Thigh. 
 
 Get the knot over the artery, keep the knot there, and tighten , 
 until the pressure of the knot closes the vessel. 
 
 Bones, Broken or Fractured. Splints is the name surgeons 
 give to the apparatus used to place along the broken fragments, to 
 keep them in position. They are made of wood, rubber, leather, 
 binders' board, tin, and many other materials. For general use 
 those manufactured of stiff felt are the best. They come in sets, 
 and are readily moulded, when hot, to any limb, and are firm 
 and soft when cool. 
 
 In instances of suspected fracture or dislocation of the thigh or 
 leg, the injured parts should ,be placed in a comfortable position, 
 and as well supported as possible, to prevent the twitchings of the 
 leg from the spasmodic action of the muscles of the injured extremity. 
 If necessary to remove the patient to his home or the hospital, 
 from the spot where the accident happened, the arrangement of the 
 
212 
 
 Accidents \ Injuries and Poisons. 
 
 limb should be made after lie has been placed on the stretcher or 
 substitute. 
 
 Fig. 71. 
 
 Temporary Bandage for Fractured Limb. 
 
 If found necessary to carry the injured person some distance, and 
 a litter for the purpose cannot be had, the arrangement of the frac- 
 tured limb against the other, and kept there by handkerchiefs, as 
 shown in the cut (Fig. 71), is often of great comfort to the sufferer. 
 
 By a little ingenuity a comfortable litter can be made by fasten- 
 ing four stout poles together, and tying a blanket securely to them, 
 
 Fig. 72. 
 
 A Convenient Litter. 
 
 so as to resemble the frame and sacking of a bedstead, and upon 
 this the sufferer may be laid. Hand-carriage is infinitely more 
 easy than carriage or cart, for every jolt over any irregularity in 
 the road produces motion in the broken bone, and correspondingly 
 severe pain. 
 
 This should be carried by hand, two persons at each end taking 
 hold of it, and all keeping step as they move along. 
 
 We shall now describe particular fractures, which may be either 
 simple, compound, or comminuted. 
 
Bones, Broken or Fractured. 
 
 213 
 
 Simple. When a bone is broken in one place without any ex- 
 ternal wound. 
 
 Compound. When a bone is broken in one place, and there is 
 an external wound leading down to the broken bone. 
 
 Comminuted. When a bone is broken in two or more places, as 
 when a splinter of bone is broken off. 
 
 Skull. Put the patient in bed, and let his head be shaved for 
 some distance round the seat of injury, and wet lint with gutta- 
 percha tissue applied over it. 
 
 Lower Jaw. In this fracture the parts of the bone should be 
 replaced in their natural position, the mouth closed, and the face 
 bandaged so as to retain the fragments in place. The patient should 
 be fed by a tube, which can be inserted where he has lost a tooth. 
 Broth and milk must be his diet until the bones knit. A dentist 
 can easily make a splint of rubber to fit inside the mouth, and thus 
 hold the parts in position at less discomfort. 
 
 Collar-Bone. Keep the patient in bed, without a pillow, with 
 the arm on the injured side folded across the chest. The further 
 treatment consists in placing high up in the hollow of the armpit 
 a pad, about as big as two fists, and 
 twice as wide, which must be kept in 
 place by a tape at each end, passed 
 one on the back, and the other on 
 the front of the chest, and tied on a 
 pad (to prevent galling) on the oppo- 
 site side of the neck. A bandage 
 is next to be turned once or twice 
 round the arm, immediately above 
 the elbow, and its two ends carried 
 round the chest, one before the other 
 behind, and tied so as to keep the 
 elbow close to the side. The elbow 
 
 and forearm are then put into a short Bandage and Sling for Colla 7_ 
 sling, which lifts up the shoulder, and Bone Fracture, 
 
 should be tied on the neck on the sound side. This done, all de- 
 formity disappears, and the bone is set. The bandages thus put 
 on must be worn about a month. 
 
 Fig. 73, 
 
214 
 
 Accidents, Injuries and Poisons. 
 
 Ribs. The patient should remain in bed, and a special rib 
 bandage or flannel roller, six yards long and six or eight inches 
 wide, be put round his chest ; a spittoon should be placed within 
 his reach, and the character of the expectoration noticed. 
 
 Broken Arm Above the Elbow. The pads and splints must be 
 fitted on the sound arm before they are placed on the injured limb, 
 and four of each will be required; The splints should be about three 
 fingers' breadth wide ; one should reach from the shoulder to the 
 bend of the elbow ; one behind, from the shoulder to the point of 
 the elbow; one from the armpit to the jutting inside of the elbow; 
 and one from the shoulder to the jutting outside of the elbow. 
 The pads should be a little wider than the splints, and about two 
 inches longer, so that they may be turned over each end of the 
 splint, and tacked to prevent them slipping out. Two long rollers 
 are also needful. The immediate swelling after the accident having 
 subsided, the limb must be placed with the forearm bent at a right 
 angle with the upper. The hand and arm are to be lightly swathed 
 Flo . 74 in the roller, the turns of which 
 
 should overlap each other, and 
 be continued a little above the 
 elbow. The object of this is to 
 prevent the swelling which 
 generally follows the appliance 
 of the splints. The second roller 
 is now to be wound round the 
 arm twice or three times, above 
 the elbow; then the first splint 
 is to be placed on the front of 
 the upper arm, but not quite 
 Bandage and Splints for Fracture of down to the bend of the elbow, 
 pper rm. ^^ ^ wo ^ three turns of the 
 
 roller made round it ; next the back splint from the shoulder to 
 the elbow placed against the arm, and the roller carried round it 
 twice or thrice; the third splint is now put on at the inside, its 
 upper end being pushed up into the armpit, not so high, how- 
 ever, as to rub against and gall it; and the fourth on the outside; 
 around these the roller is now to be wound, and continued till 
 
Bones, Broken or Fractured. 
 
 215 
 
 the whole arm, with the splints, has been swathed from the arm- 
 pit to the bend of the elbow. A short sling is then put round 
 the neck, which must only support the hand and wrist. By thus 
 doing, the weight of the elbow drags down the lower end of the 
 bone, and keeps the broken portions in place. The splints rarely 
 require being touched for ten days or a fortnight, and must then 
 be again applied in the same manner. They must be worn a 
 month or five weeks. There is no need of keeping the person in 
 bed, and indeed it is advisable he should be up, as the broken bone 
 keeps its position better than when in bed. 
 
 Broken arm Below the Elbow. There are two bones in the fore- 
 arm, and when both are broken there is little difficulty in discov- 
 ering the nature of the accident. But if only one be broken, it is 
 not so easy for an unpracticed person to distinguish it; but this is 
 of less consequence, as the sound bone serves for a splint to keep 
 the broken one pretty nearly in its place, even though no splints be 
 put on. 
 
 If both bones be broken, two padded splints are required, 
 
 extending from the tips of the fingers to the bend of the elbow in 
 
 front, and to the point of the 
 
 . . Fig. 75. 
 
 elbow behind. The forearm is 
 
 now to be bent on the elbow; 
 the splints applied, one before 
 and the other behind, and both 
 bound firmly to the arm with a 
 roller from the fingers up to the 
 bend of the elbow. The arm 
 then, resting on its back, is to be 
 put in a sling, which shall sup- 
 port it from the elbow to the 
 finger ends. The splints must 
 be kept on about a month. 
 
 Broken Fingers, If the first or second joint of either of the 
 fingers be broken, it is readily discovered ; but not so easily if it be 
 the third joint, which, however, is but rarely broken without more 
 serious mischief. 
 
 A piece of thin wood or stiff pasteboard, as wide and as long as 
 
 Bandage and Splints for Fracture of 
 Lower Arm, 
 
216 Accidents , Injuries and Poisons. 
 
 the finger, is to be placed on its front, or same side as the palm of 
 the hand. Upon this, the finger being laid straight, it is to be 
 bound with a roller an inch wide from end to end. It is best to 
 keep the hand in a sling for three weeks or a month, and not to 
 attempt using it till after that time. The broken finger often 
 remains stiff a long while after it has become well knit together ; 
 it is therefore a good plan to render the joints supple by thrusting 
 the hand for half an hour daily into warm grains ; but if these 
 cannot be procured, soaking it for the same time in warm water, 
 and afterward to bend the finger gently forward and backward, as 
 far as it can be moved without pain. 
 
 Brdken Thigh. If this accident occur in any part a little distant 
 from the hip or knee-joint, it is easily ascertained by the unnatural 
 bending at the seat of injury, and by the person being unable to lift 
 up the leg below the broken part, as well as by his not liking to 
 attempt it on account of the pain produced by the ends of the bone 
 pushing into the flesh. This is a much more serious accident than 
 either of those already mentioned, and is managed with difficulty 
 by any but an expert surgeon. When none is near, the limb should 
 be gently, but firmly, drawn down, so that the bones are restored to 
 their natural position. The simplest plan is then to lay narrow bags, 
 eighteen inches long and six inches in diameter, loosely filled with 
 sand, along the outer course of the limb. Keep it constantly irri- 
 gated, and if it tends to become displaced by contraction of the 
 muscles, a brick should be suspended to a rope passing over a pulley 
 at the foot of the bed, and fastened by a string around the ankle. 
 In nearly every case, no matter how well treated, there remains 
 slight shortening of the limb and a limp in the walk. 
 
 Fig. 76. In fracture of the leg, below 
 
 he knee, we also have either 
 one or two bones, as in the arm 
 below the elbow. Here, too,, 
 one may serve as a splint to the 
 other. When the accident oc- 
 curs, the patient should be put 
 
 Box for Broken Leg. in bed, the limb gently brought 
 
Bones Out of Joint, or Dislocated. 
 
 217 
 
 to its natural shape by the hands of the attendant, and then placed 
 in a box, as shown in Fig. 76. 
 
 Between the sides of the box and the limb, sand bags can be laid, 
 or, if there is an outer wound, bran or sawdust. A sling can be 
 placed around the ankle, and passing through two holes in the foot- 
 board, may be used to keep the leg in a firm and natural position. 
 This fracture usually lays the patient up for six weeks. 
 
 Bones Out of Joint, op Dislocated. On pages 51 and 52 
 of this book, the reader has seen the different ways in which nature 
 has connected the bones of the body. When this connection is 
 violently separated, the bone is said to be "out of joint," or "dislo- 
 cated." The signs of this accident are, first, a deformity, seen and 
 felt, caused by the presence of the end of the bone in its new place ; 
 second, inability to use the limb which is dislocated ; third, pain and 
 swelling about the joint injured. Often, the limb has quite an 
 unusual turn or twist, which at once reveals the trouble. 
 
 The general rules for treating a person with dislocation are, to 
 convey them promptly to their homes, give some aromatic spirits 
 of ammonia, or spirits, if there is much shock, place them in the 
 most comfortable position, and then proceed, with due deliberation, 
 to the setting or reduction of the bone. There is no hurry about 
 this, and a day or two's delay, if the Fig. 77. 
 
 joint is protected and irrigated by 
 cold water, is often more of a benefit 
 than otherwise. Hence, if by such 
 delay experienced help can be sum- 
 moned, it should be sent for. When 
 this help cannot be obtained, careful 
 observance of the following methods, 
 applicable to the more common dis- 
 locations, will be in order. 
 
 Dislocation of the Jaw. The re- 
 duction or replacing of a dislocated 
 jaw, either on one or both sides, is very 
 easily managed. The patient being Reducing a Jaw out of Joint, 
 seated on the floor, and his head resting against the operator's 
 knees, who stands behind him, a couple of fork handles, or two 
 19 
 
218 
 
 Accidents, Injuries and Poisons. 
 
 Fig. 78. 
 
 pieces of hard wood, about the same size, are to be passed into the 
 mouth, one at each corner, and to be pressed back as far as they 
 will go, between the back teeth on each side, and there held by 
 another person. The operator then, bending over the patient, and 
 passing his own fingers between one another so as to make a loop 
 of both hands, places them under the chin, and pulls it up so as 
 to close the mouth. As this is doing, the joint-ends of the jaw- 
 bone are made to descend, and as soon as they reach the edge of 
 their sockets, are pulled into place, and the dislocation is reduced. 
 Care must be taken that the pulling up of the chin be made level, 
 and that the forkhandles both retain their place. 
 
 Dislocation of the Collar-Bone. This is a troublesome and 
 rather common accident. The head of the bone forms a protrusion 
 over the upper part of the breast-bone. To restore it, the shoulder 
 should be pressed upward, outward, and backward, and the end of 
 
 the bone pressed up- 
 ward, with the finger 
 and thumb, into its 
 place. To retain it 
 there, a bandage should 
 be applied across both 
 shoulders, and around 
 the chest, the applica- 
 tion of which will be 
 more apparent from the 
 opposite figure than from 
 a verbal description. 
 
 This should be worn 
 night and day, for five 
 or six weeks. . This 
 accident is very apt to 
 leave a deformity after 
 it, in spite of every 
 care. 
 Bandage for a Collar-Bone out of Joint. Dislocation of the 
 
 Arm at the Armpit This is also a very common accident, and with 
 some persons it occurs over and over again, with slight provocation. 
 
Bones Out of Joint, or Dislocated. 
 
 219 
 
 The patient and the person who is to pull the arm into place 
 
 both lie down on a sofa, or still better, 
 upon the floor, on their backs, side by 
 side, but in contrary directions, so that 
 the feet of the one are at the shoulder of 
 the other, on the side where the displace- 
 ment is. The operator then, having taken 
 off his shoe, and put a folded towel in 
 the patient's armpit, puts his foot upon 
 it, between the chest and the arm, using 
 the right foot if the right shoulder be 
 dislocated, and the left if the left shoulder. 
 He then grasps the patient's wrist with 
 both hands, and pulls the arm down 
 steadily. At the same time he tells the 
 patient to make some little change in his 
 position, and thus inducing him to call 
 some other muscles into action, the 
 resistance to the reduction, which the 
 muscles of the dislocated shoulder had 
 been previously offering, is for a moment 
 suspended, and at that moment the opera- 
 tor pulls a little more vigorously, and 
 generally the bone immediately returns to 
 its socket with a more or less loud snap. 
 
 A person who has repeat- 
 edly dislocated his shoulder, 
 may, if he have courage to 
 bear a little pain for a few 
 minutes, even manage, him- 
 self, to reduce it, if the acci- 
 dent have happened whilst he 
 is out in the fields, and there 
 be a five-barred gate at hand. 
 All he has to do is to get his 
 arm over the top rail, and 
 then, having grasped the low- 
 
 Fig. 79. 
 
 Reducing an Arm out of 
 Joint. 
 
 Fig. 80. 
 
 Reducing an Arm out of Joint with- 
 out Assistance. 
 
220 
 
 Accidents , Injuries and Poisons. 
 
 est rail he can reach, hold fast, and let the whole weight of his 
 body hang on the other side of the gate ; and then, if he make 
 some little attempt to change the position of his body, still, however, 
 letting its weight tell on the top of the gate, the bone will probably 
 slip into its place. The principle on which this is done is exactly 
 the same as when the heel is put in the armpit and the arm pulled, 
 Fig. 81. that is, to move the head or top of the 
 
 arm-bone to the edge of its socket, 
 below which, when dislocated, it had 
 dropped, and this done, the muscles of 
 their own accord pull it into place. 
 
 Dislocation of the Thigh at the Hip- 
 joint does not so frequently recur after 
 one displacement as the dislocation of 
 the shoulder, just mentioned. Persons 
 who have had dislocation of the hip 
 two or three times are pretty much as 
 well aware of it as those whose shoul- 
 der has been put out. 
 
 If there be tolerable reason for be- 
 lieving that the thigh is really dislocated, 
 its reduction may be attempted in the 
 same way as dislocation of the shoulder. 
 At any rate, an attempt is worth trial. 
 The patient and the operator both lie 
 down on their backs, and assistants hold 
 the hips of the former steady, so that 
 they shall not sway about. The opera- 
 tor then puts his leg between the pa- 
 tient's legs and presses his foot close 
 up to the fork, which must be pro- 
 tected with a towel ; he then grasps the 
 patient's ankle with both hands, and 
 Reducing a Thigh out of Joint. p U n Sj m \j s the patient change his posi- 
 tion a little, and, whilst he is thus engaged, pulls a little more 
 briskly, and probably succeeds in replacing the bone, which goes 
 in with a snap. 
 
Bones Out of Joint, or Dislocated. 
 
 221 
 
 Dislocation of the Fingers and Toes. These smaller bones are 
 readily recognized when they are put out of place. But it is not 
 so easy to restore them as might be imagined. The figure given 
 below shows very clearly how the index finger appears when dislo- 
 cated at its third joint. Firm, strong pulling in the line indicated 
 
 Fig. 82. 
 
 The Index Finger out of Joint, 
 will sometimes reduce it. But generally, to obtain a better " pur- 
 chase," one has to use what sailors Fig. 83. 
 call the "clove hitch." A tape is 
 folded as shown in Figure 83. 
 This is slipped over the finger, 
 the two ends are grasped with 
 one hand by the assistant, while 
 with the other he steadies the 
 wrist of the patient and makes 
 traction in the natural line of the 
 finger. This method is further 
 
 shown in . The Clove Hitch. 
 
 Figure 84. 
 
 Reducing a Finger out of Joint. 
 In Dislocation of the Toes the bone can be restored to its place by 
 the same means. 
 19* 
 
222 Accide7tts y Injuries and Poisons. 
 
 Reduction of fractures, that is, " bone-setting," as it is popularly 
 called, is always easier when the patient is under the influence of 
 ether or chloroform. After it has been accomplished, rest and 
 cold irrigation for a few days should be observed, and subsequently 
 "passive motion" of the limb, which will be explained further on. 
 Brain, Concussion and Compression of. These are two varieties 
 of injury to the brain, the latter more severe, and marked by the 
 patient being perfectly insensible, and labored, snoring breathing. 
 The former is a stun, the patient can be partially aroused, and his 
 skin is cool. 
 
 In both cases, the injured person should be put to bed, cold 
 applied to the head by ice bags, or cold compresses, the room kept 
 quiet and dark, visitors excluded, and if he is much prostrated, hot 
 bricks to his feet. So long as the pulse is steady, and the breath- 
 ing natural, there is no danger. Do not give stimulants, or excite 
 him in any way. 
 
 Fig. 85. In cases of compression of brain, there is 
 
 much more danger to life than when it is merely 
 concussed. Treatment, therefore, should be 
 more active, and in its line, nothing yields bet- 
 ter results than to take some blood at the back 
 of the neck by cups, either wet, that is, those 
 
 that are used to draw the blood externally, or 
 Cupping back of _ . . . . 
 
 Neck. dry, that is, where no cutting instrument is 
 
 employed (see page 344). The location of the cups is shown in 
 
 the above figure. 
 
 Bruises, Blows, or Contusions, are flesh injuries where neither 
 
 skin nor bone is broken. Cold and rest are the applications for 
 
 them at first. For the former, see p. 342. To forestall a " black 
 
 eye," as soon as the blow is received, keep the part constantly wet 
 
 with the spirit wash, p. 355, or the arnica lotion, p. 356. For 
 
 jammed toes, or fingers caught in a window or door, the most 
 
 speedy mode of procuring relief, immediately after the occurrence, 
 
 is to plunge the finger into as hot water as can be borne. By so 
 
 doing the nail is softened, and yields, or accommodates itself to the 
 
 blogd poured out beneath it, so that the agony is soon diminished. 
 
Burns and Scalds. 223 
 
 The finger may then be advantageously wrapped up in a bread-and- 
 water poultice. 
 
 After the first pain and swelling of the bruise disappear, the 
 discoloration which remains may be dispersed by gentle and long 
 rubbing with camphor liniment (p. 353). 
 
 When a person is shaken and bruised all over, by a fall from a 
 horse, or the like, a warm bath gives great relief, if he is not faint. 
 
 Burns and Scalds. These common accidents, by receiving 
 early and suitable attention, are often deprived of much of their 
 inconvenience. Of course, the first thing is to put the fire out, 
 and then, if the injured parts require it, the clothing should be cut 
 away, so as to get at the entire extent of the injury with as little 
 trouble to the patient as possible. Should any fragment of gar- 
 ment appear adherent to the burned surface, the sticking part 
 should be left, as the violence required to remove it must necessarily 
 increase the damage to the injured part. 
 
 Fig. 86. 
 
 Extinguishing Flames on Clothing. 
 
 When the clothing catches fire, throw the person down on the 
 ground, as the flames will tend less to rise toward the mouth and 
 nostrils. Then, without a moment's delay, roll the person in the 
 carpet or hearth-rug, so as to stifle the flames, leaving only the head 
 out for breathing. If no carpet or rug can be had, then take off 
 your coat and use it instead. Keep the flame as much as possible 
 from the face, so as to prevent the entrance of the hot air into the 
 lungs. This can be done by beginning at the neck and shoulders 
 with the wrapping. 
 
 If the burn or scald involves considerable surface, symptoms of 
 
224 Accidents , Injuries and Poisons. 
 
 shock are observed, from the extreme of mere weakness to that of 
 utter prostration. This at once requires prompt attention, and a 
 few drops of aromatic spirits of ammonia in water, or a little 
 brandy, should be given every few moments until a return of 
 the strength is seen. A burn, superficial, as far as depth is con- 
 cerned, but covering a large surface, especially in the case of small 
 children and aged people, is usually considered more dangerous, as 
 far as life is concerned, than a burn smaller in extent, but deeper 
 and more complete. 
 
 If the burn or scald is slight in character, one of the best appli- 
 cations is cold water dressing, keeping the linens used constantly 
 wet with cold water. In a short time after the pain shall have 
 moderated, one of the best things for use, and readily procured, is 
 a dressing of pure hog's lard. 
 
 If the burn or scald, particularly the latter, is superficial in char- 
 acter, a simple and useful dressing is the application, by a brush or 
 a soft wisp of old muslin, of the white of egg to the injury. As 
 soon as the first layer dries, another should be used. 
 
 A lather of soap, from the shaving cup, applied by the brush in 
 the same way, is often followed by immediate relief. These sub- 
 stances appear to protect from the action of the air the irritated 
 nerves beneath. Do not apply cotton to the injury, as sooner or 
 later it increases the pain, and without having done any special 
 good. 
 
 Where the effects of the burn or scald extend deeper, involving 
 the subcutaneous tissue, or even the parts beneath that, as the mus- 
 cle, other considerations must not be overlooked. There probably 
 will be more shock. The portion whose vitality has been destroyed 
 by the burn cannot do otherwise than become detached from the 
 uninjured parts beneath, and thrown off in the shape of shreds or 
 larger masses, during the process of sloughing. After water dress- 
 ing has given a degree of relief to the part, poulticing must be 
 commenced. After being used for a short time, a mark of well- 
 defined separation is seen at the junction of the burned and the 
 unburned parts. 
 
 If the arm, at the elbow, is burned or scalded, so that a scar 
 results, the contraction of this tissue will often draw up the forearm 
 
Drowning. 225 
 
 to a right angle, from which it cannot be straightened. A burn or 
 scald at the front of the neck is often followed by a dense white 
 scar, which, contracting, draws the chin down toward the chest, 
 and the lower lip down toward the chin, ending in the greatest 
 deformity. 
 
 Burns and scalds practically differ but little from each other. 
 Scalds are usually more confined to the outer cuticle, unless the 
 substance containing the heat is viscid in character, as oil, pitch, 
 etc., and does not rapidly run off the part with which it came in 
 contact. As far as treatment is concerned, the two may be regarded 
 as presenting no essential difference. 
 
 Burns by lime, caustic potash and other alkalies. Lime rapidly 
 destroys the parts with which it comes in contact. It is useless 
 to attempt to pick it off, for the fingers remove no more than they 
 get hold of, so an application should at once be made of something 
 to unite with the alkali, to form a comparatively harmless prepara- 
 tion ; vinegar diluted with water, the acid in lemon-juice, or any 
 other dilute acid, will answer. What has been said about the 
 alkali known as lime may be said about the other alkalies, potash, 
 soda, ammonia, etc. 
 
 Burns by adds — sulphuric acid {oil of vitriol), nitric acid 
 (aquafortis), etc. In these cases, applications of water will dilute 
 them beyond their capacity to injure. Alkalies applied neutralize 
 acids into harmless preparations. Common earth, gathered almost 
 anywhere, applied in handfuls, contains alkali enough of one kind 
 or another to entitle it to the consideration of being one of the best 
 (and at the same time most easily secured) applications in cases of 
 burns by acids. 
 
 Cuts. These will be spoken of under wounds. 
 
 Drowning. This frequent accident every one should learn how 
 to treat. 
 
 The body should be recovered as soon as possible from the water ; 
 the face turned downward for a moment, with the forefinger of a 
 bystander slightly curved and thrust backward to depress the 
 tongue, to favor the escape of a small quantity of water, or mucus, 
 or other substances, often collected at the base of the tongue, over 
 the entrance to the windpipe, which tend to obstruct the entrance 
 
226 
 
 Accidents , Injuries and Poisons. 
 
 of air to the lungs. The practice of rolling a person over a barrel, 
 or hanging him head downward, to permit the escape of water 
 from the lungs, is of no use. The body should be conveyed to the 
 nearest house, a messenger having been previously dispatched to 
 make the arrangements involved in the following: — As soon as the 
 body arrives it should be stripped of the clothing, rapidly dried, 
 placed on a bed previously warmed, the head, neck, and shoulders, 
 raised a very little, if any ; frictions with the dry hands used to the 
 extremities, and heated flannels kept applied to the rest of the body. 
 
 If artificial breathing can now be carried out for some time, it 
 may be that the natural respiration can take place. Two methods 
 are usually employed for the purpose, the first known as "Silvester's 
 Ready Method." 
 
 This consists, after the above suggestions have been carried out, in 
 pulling the tongue forward, which better favors the passage of air 
 along the base of the tongue into the trachea (windpipe), and then 
 drawing the arms away from the sides of the body and upward, so 
 as to meet over the head, by means of which the ribs are raised 
 
 Fig. 87. 
 
 Artificial Respiration, 
 (expansion of the chest) by the muscles (pectoral) running from 
 them to the arms near the shoulder. A vacuum is thus created in 
 the lungs, the air rushes in, and the blood then is purified by the 
 passage of the impure gases in the blood vessels to the air, and by 
 
Drowning. 227 
 
 the giving up by the air of a portion of its oxygen to the blood. 
 The arms are now brought down to the sides, and the elbows made 
 to almost meet over what is called the "pit of the stomach." This 
 produces contraction of the walls of the chest, and expulsion of the 
 impure air from the lungs. 
 
 These two movements constitute an act of respiration, and should 
 be persisted in, without interruption, at the rate of about sixteen to 
 the minute. In other words, each complete movement should 
 occupy about four seconds, which is about the natural rate of respi- 
 ration in health. 
 
 The second " Ready Method," as it is called, is that of Marshall 
 Hall. 
 
 The person whose breathing is to be restored is placed flat on 
 the face, gentle pressure is then made on the back, the pressure 
 removed, the body turned on its side, or a little beyond that. The 
 body is then turned again on the face, gentle pressure again used 
 to the back, then turned on the side. This should be done about 
 sixteen times in a minute. 
 
 Both of these methods have the same object in view; either may 
 be exclusively used, or one may be alternated with the other. 
 Most physicians express a preference for the first described (" Ready 
 Method of Silvester)". Both of these procedures might be prac- 
 ticed in advance by the reader, because such practice might be 
 more easily remembered than a concise rule. 
 
 In speaking of the restoration of persons drowned, it is often 
 said that he was a good swimmer, and must have been attacked 
 with "cramp." This is a spasmodic contraction of the muscles 
 beyond the control of the individual, and occurs after exhaustion 
 of the muscles from over-exertion. Persons suffering from debility, 
 especially the debility peculiarly affecting the nervous system, 
 should never be induced to go beyond depth in the water, or out of 
 reach of immediate assistance. There is no warning in advance of 
 the seizure, and the person sinks at once. Many lives are lost each 
 season, in shallow as well as in deep water, from these seizures, 
 which could have been avoided had the bather, perhaps just recov- 
 ering from an attack of sickness, or even of indisposition, not 
 neglected the precautions stated. 
 
228 
 
 Accidents, Injuries and Poisons. 
 
 Recovery from drowning can scarcely be expected to take place 
 after an immersion of five or six minutes, although there are well 
 authenticated cases where restoration has taken place after an 
 immersion of as much as twenty minutes. The efforts ought to be 
 made, and persisted in, for at least a couple of hours. As soon 
 as returning vitality permits, a few drops of brandy, in a little 
 water, may be given; and as the strength of the person is usually 
 completely exhausted, from muscular efforts of the most violent and 
 continued character, to save himself from drowning, some beef tea, 
 or other easily digested nourishment, should be given. 
 
 The accident of drowning is so frequent that we go still further 
 into the treatment of it, and copy into our pages the detailed rules 
 published by the Life Saving Society, of New York. At the risk 
 of repetition, we show their method. Three steps are to be taken : 
 
 Fig. 88. 
 
 The First Movement. 
 1. Remove all obstructions to breathing. Instantly loosen or 
 cut apart all neck and waist bands ; turn the patient on his face, 
 with the head down hill ; stand astride the hips with your face 
 toward his head, and locking your fingers together under his belly, 
 raise the body as high as you can without lifting the forehead off 
 the ground (Fig. 88), and give the body a smart jerk to remove 
 mucus from the throat, and water from the windpipe ; hold the 
 body suspended long enough to slowly count one, two, three, four, 
 five, repeating the jerk more gently two or three times. 
 
Drowning. 229 
 
 2. Place the patient on the ground, face downward, and main- 
 taining all the while your position astride the body, grasp the points 
 of the shoulders by the clothing, or, if the body is naked, thrust 
 
 Fig. 89. 
 
 The Second Movement, 
 your fingers into the armpits, clasping your thumbs over the points 
 of the shoulders, and raise the chest as high as you can (Fig. 89), 
 without lifting the head quite off the ground, and hold it long 
 
 Fig. 90. 
 
 The Third Movement, 
 enough to slowly count one, two, three. Keplace him on the 
 ground, with his forehead on his flexed arm, the neck straightened 
 20 
 
230 Accidents, Injuries and Poisons. 
 
 out, and the mouth and nose free. Place your elbows against your 
 knees, and your hands upon the sides of his chest (Fig. 90), over 
 the lower ribs, and press downward and inward with increasing 
 force, long enough to slowly count one, two. Then suddenly let 
 go, grasp the shoulders as before, and raise the chest (Fig. 89) ; 
 then press upon the ribs, etc. (Fig. 90). These alternate move- 
 ments should be repeated ten to fifteen times a minute for an hour 
 at least, unless breathing is restored sooner. Use the same regular- 
 ity as in natural breathing. 
 
 3. After breathing has commenced, restore the animal heat. 
 Wrap him in warm blankets, apply bottles of hot water, hot bricks, 
 or anything to restore heat. Warm the head nearly as fast as the 
 body, lest convulsions come on. Kubbing the body with warm cloths 
 or the hand, and slapping the fleshy parts, may assist to restore warmth, 
 and the breathing also. If the patient can surely swallow, give hot 
 coffee, tea, milk, or a little hot sling. Give spirits sparingly, lest 
 they produce depression. Place the patient in a warm bed, and 
 give him plenty of fresh air ; keep him quiet. 
 
 Faintness. In any case of faintness, the patient should be at 
 once placed in a recumbent position, the head lower than the rest 
 of the body, all tight clothing about the neck and chest loosened, 
 and a supply of fresh, cold air secured. 
 
 Water dashed on the face, or applied by means of a wet towel, 
 is the best restorative. 
 
 If smelling salts or any preparation of ammonia be used, care 
 must be taken that they are not used too persistently, as serious 
 injury may be thereby caused to the lining membrane of the breath- 
 ing passages. 
 
 Falls, Hurts from. These are generally bruises or broken 
 bones, to which headings the reader is referred. 
 
 Frozen Limbs, Frost-bite, op Chilblains. When the circu- 
 lation of any part begins to succumb to the influence of the cold, it 
 becomes puffy, bluish, and smarting. This is because the blood 
 moves more slowly than natural through the vessels exposed near 
 the surface. Soon this blueness disappears, and the part becomes 
 pallid, as if the influence of the cold had contracted the vessels to 
 an extent incompatible with the passage of blood through them. 
 
Frozen Limbs. 231 
 
 The pain at this point ceases ; indeed, until he meets a friend, he 
 often does not know of his mishap. At this stage the injury has 
 become so great that, unless proper means are taken to restore cir- 
 culation, complete death of the part ensues, and in due time sloughs 
 away, and is detached from the line of living tissue. 
 
 What takes place in a part of the body, known as frost-bite, may 
 take place in the whole of it, which is known as " frozen to death." 
 There is increasing difficulty in breathing, owing to the engorged 
 state of the chest, and, what should always be remembered by one so 
 exposed to cold, an unconquerable desire to sleep. To sleep then 
 is to die. If the person exhibits such a symptom, he must, by all 
 means, be kept constantly moving. 
 
 Persons exposed like those just described must be treated 
 promptly, and with one thing never lost sight of. That is, keep 
 the frozen person away from the heat. A person taken up insensi- 
 ble, or approaching it, from exposure to the cold, should be taken 
 into a cold room, his clothing removed, and thoroughly rubbed with 
 snow, or cloths wrung out with ice water. The friction to every 
 part of the body, particularly the extremities, must be continued 
 for some time, until signs of returning animation appear. When 
 the frozen limbs show signs of life, the person should be carefully 
 dried; put into a cold bed in a cold room; artificial respiration 
 used until the natural is established ; then brandy given, also gin- 
 ger tea, and beef tea. Do not forget that the patient is to be 
 brought by degrees into rather warmer air ; and lest in some part 
 there might still be defective circulation, the person should be kept 
 away from exposure to the heat of the fire. 
 
 Milder degrees of the same condition, as suspension of life in 
 the ear, nose, finger, or toe, from exposure to cold, must be treated 
 with the same general directions in view. The part should be kept 
 away from the heat, and rubbed with handfuls of snow, or towels 
 dipped in cold water, until circulation appears re-established. Ex- 
 posure of the part to the heat before, we may say, it has been 
 almost rebuilt, is apt to be followed by sloughing. 
 
 For Chilblains. Keeping the feet warm by wearing worsted 
 stockings, and encouraging the circulation by rubbing once or twice 
 a day with soap liniment, or mustard liniment, is the best mode of 
 
232 Accidents , Injuries and Poiso?ts. 
 
 managing chilblains in their first stage. The itching may be also 
 for a time relieved by brushing over the inflamed skin with dilute 
 sulphuric acid. But when the chilblains have broken, a bread-and- 
 milk or linseed-meal poultice is the best application. 
 
 Railroad Injuries. The violent shock which the body receives 
 in the collision and crash of a railroad smash-up produces some- 
 times a peculiar internal injury, a spinal shock. The person so 
 hurt does not feel it much at the time. He may run around and 
 aid other passengers, but in a few hours or days his limbs fail and 
 he becomes partly paralyzed. 
 
 As soon as any such symptoms appear he should take to bed and 
 seek medical advice, as it may prove to be a lasting injury. 
 
 Rings, to get off. Sometimes rings remaining a long time on 
 the finger cause, by the growth of the latter, constriction, pain, and 
 swelling. To remove them, wrap the finger, commencing at its tip, 
 with fine thread, very tightly. On reaching the ring slip the end 
 of the thread under it, oil or soap the finger well, and thus work 
 the ring down. A gold ring, when this fails, can be readily broken 
 by first rubbing it with quicksilver. 
 
 Ruptures or Hernia. This is a common weakness. It is caused 
 by a portion of the bowels or their covering slipping out of their 
 natural position in the cavity of the abdomen. If happening after 
 birth, a rupture shows itself as a swelling suddenly appearing in 
 the groin after violent exertion ; remaining distinct while the person 
 stands upright, disappearing when, he lies down, and returning 
 again when he gets up. It also usually fills out when he coughs. 
 If let alone it continues increasing in size, so that instead of the 
 bowels being contained, as they should be, in the belly, the greater 
 part drop into the swelling, which may become of an enormous size. 
 
 The proper treatment for a rupture is the wearing of a well-fitting 
 truss. It should never be laid aside for a day. The bowels should 
 never be allowed to become costive. 
 
 When through neglect of precaution the bowel "comes down" 
 and will not return, the rupture is said to be " strangulated." This 
 is a dangerous condition, and one should be able to recognize it. 
 When a person has been costive two or three days, and he becomes 
 violently and frequently sick, at first throwing up stuff like coffee- 
 
Shock. 233 
 
 grounds, and after some hours like stools, and very offensive ; if 
 there be a feeling of a cord tied round the midriff, constant feeling 
 of sickness, much uneasiness and anxiety, there is great reason for 
 supposing that this has something to do with a rupture. The 
 inquiry should be made, and if there is a rupture, and it has fallen 
 down, immediate treatment is required. 
 
 The patient may be put into a warm bath up to his neck, and 
 kept there till he feel very faint; he may then attempt, according 
 to his own usual method, to put the rupture up, by pressing it 
 gently, if it be in the groin, or by lifting it up if in the purse, and 
 gently squeezing it toward the belly, but no violence must be used, 
 or the gut will burst. 
 
 If this do not succeed, cold may be applied over the swelling, 
 by filling a bladder with pounded ice and a small handful of salt, 
 or with a freezing mixture consisting of Glauber salt and sal- 
 ammoniac, to which some water must be added. Either of these, 
 after being kept on some hours, will occasionally cause the return 
 of a rupture, but they require to be used with some caution, as 
 if the skin become frosted it may mortify. If neither ice nor the 
 materials for the freezing mixture can be obtained, a wet rag may 
 be put on the part, and evaporation encouraged by a continued* 
 stream of air from a pair of bellows, repeatedly wetting the cloth 
 as it dries; by these means almost as great a degree of cold can be 
 produced as by ice. 
 
 Some surgeons have of late strongly recommended attempting 
 reduction of a rupture by reversing the position of the body ; in 
 other words, by holding the patient head downward, or nearly so, 
 and they state that in many instances this method has succeeded. 
 
 Scars, from wounds, burns, small-pox, etc. Many of these are 
 disfiguring, some painful. Repeated rubbing with some stimulat- 
 ing ointment, as that of carbonate of ammonia (p. 356), has been 
 recommended. Frequently, however, nothing but a surgical opera- 
 tion will remove them. In "webbed fingers," and wry neck, from 
 burn scars, this is always advisable. 
 
 Shock is the violent disturbance of the system after accidents, 
 which does not show itself in any special part. It is, however, 
 often dangerous. Loss of blood, bathing in cold water when heated, 
 
 20* 
 
234 Accidents, Injuries and Poisons. 
 
 or drinking it in excess, certain poisons, as tobacco and antimony, 
 burns, and falls, produce it. The patient lies in a state of utter 
 prostration. There is pallor of the whole surface, the lips are 
 bloodless and pale. The eyes have lost their lustre, and the eyeball 
 is usually partially covered by the drooping upper lid. The nos- 
 trils are usually dilated. The skin is covered with a cold, clammy 
 moisture, often gathered in beads of sweat upon the forehead. The 
 temperature is cold, and perhaps the person shivers. 
 
 The treatment consists in first placing the patient as flat on his 
 back as possible, with the head raised not over an inch. This is an 
 important point in cases of ordinary fainting, and whenever the 
 vital powers are depressed stimulants are required. A teaspoon- 
 ful of spirits, in a tablespoonful of water, every minute, until six 
 or eight have been taken, is the best way to give it. If the tem- 
 perature of the body is raised by it, and there seems a revival of 
 the action of the heart, enough brandy has been given. Twenty 
 drops of the aromatic spirits of ammonia, in a teaspoonful of water, 
 may be given every couple of minutes, until four or five doses have 
 been taken. The applications of heat to the extremities and "pit 
 of the stomach," are very useful. Flannels wrung out in hot 
 water, or bottles of hot water properly wrapped up, should not be 
 neglected. Mustard plasters to the pit of the stomach are often 
 used. Nausea and vomiting often are seen in shock, and can best 
 be allayed by getting the patient to swallow, whole, small chips of 
 ice. Ice can be easily chipped by standing the piece with the grain 
 upright, and splitting off a thin edge with the point of a pin. 
 
 Sprains and Strains. These occur when the sinews or mus- 
 cles are violently wrenched. The ankle and wrist are especially apt 
 to suffer thus. 
 
 When a joint has been sprained, it should be kept perfectly at 
 rest, and if the ankle or knee, the person should lie in bed, or on a 
 sofa. Warm, moist flannels should be repeatedly applied for some 
 hours, and a bread-and-water poultice on going to bed. These 
 should be continued for a few days, and no attempt made at using 
 the joint. If the pain be very stypre, and continue so for the first 
 or following days, leeches may b^ o^lied, and repeated once or 
 oftener. Some persons are iQnd °f putti-^ a vinegar-poultice on at 
 
Stroke. 235 
 
 once ; but this is better after the tenderness has subsided, and there 
 remain only a little pain and stiffness in the joint; then a vinegar- 
 poultice is a very good application. 
 
 When the pain has entirely ceased, the joint must not be care- 
 lessly used ; and, if it be the knee or ankle sprained, walking till 
 the joint becomes weak and aches must be most carefully avoided, 
 as irreparable mischief is thereby very often set up. Short and 
 gentle walks only, therefore, should be taken, and may be repeated 
 by degrees more frequently during the day, if they do not produce 
 pain or fatigue. 
 
 A joint often swells a long while after a sprain, under which 
 circumstance it is best to bind it up with straps of soap-plaster or a 
 roller. 
 
 Stings of hornets, wasps, and bees, are wounds, not made by the 
 
 insect to obtain food, but in anger and for Fig. 91. 
 
 its own defence; and into these wounds, 
 
 which are made by a sharp dart at the 
 
 extremity of the body, and which is hollow, 
 
 poison secreted in twisted tubes (a a), which 
 
 pour it into a little bag (6) specially formed 
 
 as a reservoir, is thrown by the sting dart (d), 
 
 which protrudes from between a sheath 
 
 formed by two side plates (c c) at the end 
 
 J , , , The Sting and Poison 
 
 of the insect s body. Bag of a Bee. 
 
 A stimulating application to the injury, as a drop of aromatic 
 spirits of ammonia, will often afford the greatest relief. A pinch 
 of common table salt, dampened with water and rubbed in, is very 
 useful for the same purpose; likewise a slice of onion rubbed on 
 gives almost instant comfort; or the application of wet clay, or 
 cosmoline. 
 
 Stroke. Sun-stroke. This is a common accident in the intense 
 heats of American summer. It does not always need the sun to 
 bring it on, as great heat in the shade may cause it. This is called 
 "heat-stroke." 
 
 Before it comes, there is pain in the head, wandering of the 
 thoughts, irritable temper, nervousness, and general ill-feeling. 
 
236 Accidents, Injuries and Poisons. 
 
 " Sun-headache " and " sun-pain" show that there is unusual danger 
 from this source. 
 
 How Prevented. — During hot weather all alcoholic drinks must 
 be avoided. A bath should be taken daily. Abundant cool, but 
 not ice-cold, water should be taken. The head should be well 
 protected by a tall straw hat, with a damp newspaper or sponge, 
 a wet handkerchief or a handful of green leaves, in the crown. 
 "When the heat is felt unpleasantly, exposure to it should cease. 
 
 Treatment. — The person attacked should at once be carried to a 
 cool, airy spot, in the shadow of a wall, or to a large room in a 
 house with a bare floor ; or, what is often better, if there is no sun, 
 he should be placed in a back yard, on the pavement. 
 
 The clothing should be at once gently removed, and the patient 
 placed on his back, with the head raised a couple of inches by a 
 folded garment. Then the entire body, particularly the head and 
 chest, dashed with cold water in profusion. While preparations are 
 being made for this, a messenger should be despatched for a good 
 supply of ice. A large fragment should be placed in a towel, and 
 struck a few times against the side of the house, to reduce it rapidly 
 to small pieces. These pieces, mixed by the hand into a bucket of 
 water, will promptly supply ice-water. Two buckets can be used, 
 each half full of the small ice, and as soon as the water of one is 
 used for* dashing against the patient, another will be ready for the 
 same purpose. The ice-water must not be sprinkled over the 
 person, but dashed against him in large bowlfuls, particularly 
 against the head and chest. While one person makes the ice- 
 water, and another uses it, a third should, in the same manner, 
 with a towel, break some ice in fragments not larger than almonds. 
 A double handful, at least, of these bits should be placed in a thin, 
 coarse towel, the ends gathered up and fastened with a string, as 
 you would a pudding. Then holding to the tied portion of the 
 collection of ice, the entire surface of the body should be rapidly 
 rubbed. 
 
 These measures are to reduce the heat of the body. WTien the 
 decline in the heat is noticed, the cold applications should be 
 abandoned, the patient carefully removed to a dry spot, and the 
 entire surface of the body dried off with toweb. Should a tendency 
 
Suspen ded A nimation. 237 
 
 to a return of the high temperature be seen, as sometimes happens, 
 even after consciousness is restored, it must be met by a renewal of 
 the cold applications. 
 
 Artificial respiration, until the natural returns, must be resorted 
 to as soon as the heated condition of the body is overcome. The 
 dashing of cold water over the chest and face is a useful means of 
 encouraging a return of the life force. 
 
 Stroke of Lightning. A person struck by lightning is usually 
 rendered more or less unconscious by it, which lasts for a longer or 
 shorter time. 
 
 The burns caused by lightning should receive the same attention 
 as burns from any other cause. 
 
 When the person exhibits little or no signs of life, the clothing 
 should be rapidly and immediately removed, the body exposed to a 
 dashing of cold water; then dried, placed in a bed, and warmth 
 applied, particularly to the "pit of the stomach," by means of 
 bottles filled with hot water, or the tin vessel kept in some house- 
 holds for such application. It is somewhat concave on one 
 surface, filled with hot water, and, if it can be had, is well adapted 
 to the purpose. 
 
 Artificial respiration should be kept up until the parts of the 
 brain and nervous system in charge of this duty shall have recovered 
 enough to attend to it. Recoveries after an hour of supposed 
 death are on record. 
 
 Some stimulant, as the aromatic spirits of ammonia, may be 
 employed. 
 
 Suspended Animation.. Thisisthe term applied by medical men 
 to apparent, but not real death, from the breathing of gases, such as 
 fixed air or carbonic acid gas, well-damp and choke-damp, charcoal 
 fumes, common burning gas, and coal gas; from strangulation, 
 hanging, or suffocation. Of course, death will result from any of 
 these causes; but frequently the sufferer is only seemingly dead 
 when discovered, and may be brought to life by appropriate means. 
 These, in all the circumstances mentioned, are pretty nearly the 
 same. 
 
 Old wells and brewers' vats very often are filled with fixed air or 
 carbonic acid gas, and are rendered very dangerous to enter by its 
 
238 Accidents , Injuries and Poisons. 
 
 presence. A person breathing it will drop insensible and die in a 
 few minutes unless rescued. 
 
 Buckets of water dashed down into the well, or masses of lighted 
 shavings or blazing paper, give enough movement to the carbonic 
 acid gas to dislodge it from its resting-place. After testing the 
 success of the effort, by again introducing the lighted candle, it can 
 soon be known whether a person may enter with impunity. 
 Freshly-slaked lime also rapidly absorbs it. 
 
 When a person appears overcome with the carbonic acid gas, he 
 is, of course, wholly unable to help himself, and he must at once 
 be removed by another. No time should be lost in descending or 
 arising, as the person lowered depends upon doing everything dur- 
 ing the interval he can hold his breath ; for, of course, should he 
 inhale the gas, his position, in this respect, would be but little bet- 
 ter than the man he attempts to succor. A large sack is sometimes 
 thrown over the head and shoulders of the person who descends. 
 It contains enough air to serve for several inhalations, while the 
 texture of the material prevents, to a hurtful degree, the admission 
 of the gas. 
 
 The person suffering from asphyxia from the gas, immediately 
 after being brought out, should be placed on his back, the neck and 
 throat bared, and any other obstacles to the breathing quickly 
 removed. His body should then be quickly stripped, and if he 
 have not fallen into water on being overpowered by the gas, his 
 head, neck, and shoulders, freely dashed with cold water. A per- 
 son should stand off some distance, with a bowl of cold water, and 
 throw its contents, with as much force as possible, against the parts. 
 Others should follow, without interval, for half a minute, while one 
 can count thirty slowly, then the dripping water be wiped away by 
 a towel. This procedure should be repeated from time to time, as 
 apparently required. Sometimes, if a brook of water is near, the 
 stripped person might be dipped again and again ; being careful, of 
 course, not to dip in his face. Artificial respiration should be 
 used with as little intermission as possible. 
 
 Should the person have fallen in the water, and become chilled, 
 the use of the cold water, in this manner, had better be avoided, as 
 the evaporation of moisture absorbs more heat than can be manu- 
 
Things in the Eye. 239 
 
 factured by the exhausted and overpowered system. In such a 
 case, the body of the person should be put into a warmed bed, with 
 hot applications, and artificial respiration at once established, as in 
 drowning. 
 
 While artificial respiration is being used, friction applied to the 
 limbs should be kept up. 
 
 Teeth Knocked Out. When this happens, the bleeding should 
 be stopped by the use of cold water, and the tooth should be imme- 
 diately replaced in its socket and fastened by a piece of silk thread. 
 It will often regain its position and usefulness by this precaution. 
 
 Things in the Eye. A great deal of pain is often suffered 
 from various substances getting in the eye. The best way to 
 remove them is by holding a knitting- Fig. 92. 
 
 needle over the upper lid, close to 
 and just under the edge of the orbit, 
 then, holding it firmly, seize the 
 lashes of that lid by the fingers of 
 the disengaged hand, and gently turn 
 the lid upward and backward over 
 the needle, or substitute used. Move- 
 ment of the eyeball by the sufferer, 
 in a strong light, usually reveals the 
 presence of the intruding body, so Removing an Object from the 
 that by means of a corner of a silk Eye * 
 
 or cambric handkerchief, it can be detached and removed. 
 
 Should the foreign body be imbedded in the membrane covering 
 the eyeball or the eyelid, a steady hand and a sharp-pointed instru- 
 ment will usually lift it out 
 
 The foreign body often cannot be seen, but the person assures us 
 he feels it. Often he does not really feel the presence of the body, 
 as much as the roughness left by it. In such a case, or even if 
 the body has been seen and removed, a soothing application to the 
 injury is as useful as the same thing applied to a wound of the 
 hand. Take a spoon or cup, heat it, and pour in a few drops of 
 laudanum. It will soon become dense and jelly-like. A few drops 
 of water added will dissolve this gummy material, and the liquid 
 thus formed may be applied by the finger to the " inside of the eye," 
 
240 
 
 Accidents y Injuries and Poisons. 
 
 Bandage for an In jury- 
 to the Eye. 
 
 as they say. The laudanum is opium dissolved in alcohol. The 
 alcohol is somewhat irritating, but is easily evaporated by the gentle 
 heat, leaving an extract of opium, which is dissolved in the water 
 afterward added. 
 
 Lime, soda, or potash, not unfrequently gains entrance into the 
 Fig. 93. eyes of those working in these substances. 
 
 A dry camel's hair brush will remove them, 
 but if not at hand, time should not be 
 wasted in trying to pick them out, but a little 
 vinegar or lemon-juice, diluted with water, 
 should be thrown into the eye, which will 
 rapidly neutralize their injurious action. 
 
 After an injury of this kind to the eye, 
 or any other which causes pain and inflamma- 
 tion, this precious organ should be bandaged, 
 and excluded from the light. The plan of 
 doing this is shown in Fig. 93. The strips 
 a a a are applied first, b b over them, and pinned or sewed where 
 they cross. 
 
 Things in the Ear. Insects sometimes get into the ear, and 
 cause much inconvenience, even if they do not sting and produce 
 further mischief. The best mode of proceeding, in such case, is to 
 fill the ear with sweet oil, which will kill the animal by stopping up 
 its breathing pores, and generally floats it out. But if it be not 
 thus dislodged, it must be washed out with a syringe and warm 
 water. 
 
 When peas, beans, pebbles, or such like are found in the ears of 
 children, attempts should never be made to get them out with a 
 knitting-needle, or a stick. The rounded end of a hair-pin may 
 sometimes be used. But the safest is to employ a syringe with a 
 narrow nozzle, which will throw a good stream of water behind the 
 object, and thus force it out. 
 
 The earwig is a small, winged insect, which has its name from 
 the frequency with which it has been the cause of trouble by entering 
 the ear. Pouring in oil will soon destroy it. In cases where this 
 means is not at hand, as in hunting, blowing tobacco smoke in the 
 ear will kill or stupefy it and similar intruders. 
 
Needles, Fish-Hooks y and Pins in the Flesh. 241 
 
 Things in the Nose. Children sometimes amuse themselves 
 with poking things with which they are at play into their noses. 
 If peas, beans, or any other seed or substance be thrust in, which 
 swell as they moisten, no time should be lost in getting them out, 
 otherwise, as they enlarge, they become more firmly fixed, and more 
 difficult to be removed, are attended with great pain and suffering, 
 and may even cause dangerous consequences. Hard substances, as 
 shells, which remain unchanged in bulk by moisture, are of less 
 consequence, and may remain some days without causing much 
 inconvenience, and often drop out of themselves. 
 
 If the pea or shell be in the nostril, the child should be made to 
 draw his breath in deeply, and then stopping the other nostril with 
 the finger, and closing the mouth firmly, to snort forcibly through 
 that side of the nose in which the substance is lodged. If this be 
 done soon after the accident, two or three efforts usually shoot the 
 unwelcome lodger out. But if this does not succeed, the nose must 
 be lightly nipped with the finger and thumb above the pea or shell, 
 so as to prevent it getting further in, and then the eyed end of a 
 bodkin or probe, having been a little bent, must be gently insinu- 
 ated between the bottom of the nose and the substance, and when 
 introduced sufficiently far, must be gently used as a hook to bring 
 it down. 
 
 Things in the Throat, Gullet, and Windpipe. Choking 
 and strangling from pieces of food or bones of fish are by no means 
 rare. The body should be bent forward, when several smart blows, 
 high up between the shoulders, will sometimes dislodge it. This 
 failing, it had better be extracted with the curved end of a long 
 hair-pin, or the loop at the end of a scissors blade, which can be 
 unriveted for the purpose. If the object is an artificial tooth or 
 other hard and pointed substance, care must be had not to injure 
 the throat in efforts to get it out. 
 
 Objects in the windpipe cause severe coughing and choking, the 
 sufferer becoming, at times, quite black in the face. A surgical 
 operation is required in desperate cases; while some have been 
 relieved by being held head downwards. This must be tried with 
 caution, however. 
 
 Needles, Fish-hooks, and Pins in the Flesh. Needles often 
 21 
 
242 Accidents, Injuries and Poisons. 
 
 enter the flesh and remain long in the body without doing much 
 harm. They travel quite through it at times. Pins can usually 
 be extracted by their heads. When a fish-hook has plunged its 
 barbed point into the flesh, it must either be cut down upon and 
 withdrawn, or else the hasp pushed forcibly , so that the barb is 
 driven out through the skin and the hook is held by the curved 
 portion. The barb can then be snapped off with a pair of steel 
 nippers, or the rest of the hook pulled through after it. 
 
 Splinters or Thorns. These should be -removed by cutting the 
 flesh above them with a sharp knife and lifting them out. If they 
 "fester," this can be hastened by poultices, and the matter let out by 
 opening soon with a sharp knife. Do not neglect these small inju- 
 ries. They have often produced lock-j aw and death. If the splinter 
 is under the finger-nail, and cannot be pulled out, do not waste the 
 outside end by picking at it. The nail immediately above should 
 be scraped as thin as possible by a piece of glass, and then the thin 
 nail overlying should be split with the blade of a knife, or an 
 incision made on each side of the splinter, and the tongue of nail 
 between the incision removed, which should expose the upper 
 surface of the splinter along its entire course. The restraining 
 pressure of the nail upon the foreign body is in this way gotten rid 
 of, and at the same time an outlet for the products of inflammation 
 is given. 
 
 A piece of lint, wet in water, to which a good deal of laudanum 
 has been added, should be applied, and kept wet with it as long as 
 may be necessary. 
 
 Veins, Swollen and Bursted. Laboring people, and especially 
 women, have what are called varicose veins, when the veins of one 
 or both legs become very large and swollen. If let alone, the whole 
 leg, and sometimes the thigh up to the groin, becomes more or less 
 completely covered with a network of these swelled vessels. After 
 long standing, about and toward evening the veins become enor- 
 mously swollen, rendering the limb heavy and painful. Very 
 commonly the skin inflames on some part of the leg, and an ulcer 
 forms. Sometimes, without any ulcer, one of the veins suddenly 
 bursts, and the person loses a large quantity of blood, and naturally 
 becomes much alarmed. 
 
Wounds. 243 
 
 How Treated. The bowels should be kept open, that is, moved 
 every day, by some of the remedies mentioned hereafter (see page 
 340). Then the limb should be swathed in a well-fitting roller 
 bandage, as described on page 202. Or, what is better, a carefully 
 adjusted lace-stocking should be worn. 
 
 When a vein bursts it may be immediately stopped by putting 
 the finger on the bleeding part, and laying the person down flat, 
 either on the ground or on a bed. A little pad of lint is then to be 
 put on, and bound fast with a roller, which should first be applied 
 upon the foot, and rolled up over the pad and above the knee, or 
 higher, according to circumstances. The person should be kept lying 
 in bed for a few days, in which time the wound heals, and the pad 
 may be removed, having first soaked it for a few hours in a wet 
 poultice. A small piece of plaster may afterward be put on, and 
 the leg rolled as before. 
 
 Wounds. The Dressing of Wounds. Wounds should never 
 be uncovered for the purpose of being dressed until everything that 
 is likely to be required during the process is close at hand. 
 
 Old dressings that have become fast to the surface of a wound 
 should never be pulled off sharply, but should be previously 
 loosened by bathing with warm water or by the application of a 
 bread poultice. 
 
 Discharges should be cleaned away from the edges of a wound, 
 and from the surrounding parts, but the surface of the wound itself 
 should be left undisturbed. The attendant should be careful to get 
 none of the discharge in his eyes. The utmost cleanliness should 
 be observed. 
 
 A soft surgical sponge should be used, or else cotton-wool or tow 
 soaked in water. When, as in burns, the wound is extensive, but 
 a part of it should be uncovered at once. 
 
 Gunpowder and Gunshot Wounds. Every fourth of July brings 
 a rich harvest of these injuries. When they are in the form of 
 burns from the flaming up of ignited gunpowder, the treatment 
 is the same as that given for other burns. Small shot and grains 
 of unburnt powder should be picked out with a small forceps or- 
 the point of a needle or penknife. The bleeding should be staunched 
 as directed under that subject, and the part wounded placed in a 
 
244 
 
 Accidents, Injuries and Poisons. 
 
 natural and easy position. If there is much shock and prostration, 
 the wounded man should not be moved for some time, and aromatic 
 spirits of ammonia (twenty or thirty drops in water) or some 
 stimulant be administered. Cold-water dressings to the part will 
 be found most comfortable. The thirst which soon sets in may be 
 freely allayed with cold water. A bone broken by a ball should be 
 treated as before described. 
 
 Torn or Lacerated Wounds. These frequently result from 
 machinery or railroad accidents, also from nails and hooks. There 
 is apt to be in them dirt and other foreign substances. They 
 should therefore be carefully cleansed. Strapping, not too tight, 
 and light bandaging are very serviceable in them. They are often 
 slow to heal. When a finger or limb has been crushed by machinery 
 or a heavy weight, an excellent mode of treatment is to keep it 
 constantly wet with tepid water, by the "irrigating" plan, which 
 has been described on an earlier page. 
 
 Some torn wounds, of not unfrequent occurrence, require modes 
 of dressing different from others. A peculiar and important acci- 
 dent is a rupture of the ham-string, or, as physicians call it, the 
 
 tendon of Achilles. This strong 
 sinew is at the back of the heel, 
 and in violent efforts at leaping, 
 as well as by direct violence, may 
 be torn across. The patient 
 must then submit to having his 
 leg placed in the splint depicted 
 in Figure 94. It usually re- 
 Dressing Ruptured Ham-string. quireg gome two mont h s to unite. 
 
 The method of applying the dressing has been so clearly shown by 
 the artist that further description is needless. 
 
 Cuts, Stabs, and Thrusts. These are known as incised and 
 punctured wounds, and form an important class of injuries. The 
 treatment is to remove all dirt, clots, and foreign matter, by the 
 free use of water, check the bleeding by some of the means 
 already described, then bring the edges of the wound smoothly 
 and evenly together, and fasten them by strips of adhesive or stick- 
 ing plaster. 
 
 Fig. 94. 
 
Cuts, Stabs and Thrusts. 
 
 245 
 
 The use of this plaster deserves special mention. It should first 
 
 be cut lengthwise into strips a quarter of an inch wide. These can 
 
 be cut asrain crosswise, so as 
 
 , , , Fig. 95. 
 
 to extend across the wound, 
 
 and far enough on each side 
 to secure a suitable hold on 
 the skin. Warm the plas- 
 ter side of the strip at the 
 fire until it becomes thor- 
 oughly and uniformly melted, 
 then, beginning at one end 
 (recollecting that the centre 
 of the strip should cross the 
 incision), rapidly and com- 
 pletely attach it to the skin, 
 as a rule, at right angles to 
 the line of the cut. As the 
 middle part approaches the 
 wound, with the fingers 
 bring up the skin towards 
 the incision, from the other side, upon which the other half of the 
 strip is to rest; then rapidly attach the rest of the strip. 
 
 If one strip will keep the edges approximated along the whole 
 length of the wound, no more is needed. If not, use others. 
 Where more than one is used, the edge of the strip should be brought 
 across a short distance from the extremity of the wound, so as to 
 permit the ready exit of blood or pus. On the scalp, the face of 
 man, and the extremities of some persons, the hairs must first be 
 shaved off the skin, or the plaster will not remain attached. 
 
 Most persons, in using adhesive plaster on a wound, apply a large 
 piece, or several small pieces, so as to completely cover it. This 
 must not be done. A few drops of blood escaping after such an 
 arrangement, even when the edges of the wound have been care- 
 fully brought together, undergoes decomposition, irritates and 
 inflames the parts, loosens the plaster, and changes what otherwise 
 should have been the result of the accident. 
 
 Stabs in the chest may penetrate the lungs. When this is the 
 21* 
 
 Applying Sticking Plaster. 
 
246 
 
 Accidents , Injuries and Poisons. 
 
 case, the patient spits blood. The great object is to check this as 
 soon as possible. We should inhale the vapor of turpentine, sprin- 
 kled on a handkerchief; swallow small pieces of ice; have cold 
 applied to the chest ; and, as soon as possible, take five to ten grains 
 of gallic acid, and repeat it every quarter of an hour. 
 
 The tongue is sometimes cut with a knife, or bitten by the teeth, 
 causing: alarming bleeding. This wound cannot be dressed with 
 much success. The best step is to wash the mouth with alum-water 
 till the bleeding ceases, and leave the wound to nature. 
 
 The throat is often cut in attempts at suicide. Usually, the 
 wound is not deep enough to accomplish this desperate purpose. 
 The treatment is peculiar. Small quantities of nourishment and 
 stimulants may be given, but the wound should not be sewed or 
 tightly strapped, as the matter accumulating in the wound might 
 press on the windpipe and choke the patient. The position of the 
 patient is the great thing to attend to. When the bleeding has 
 ceased, his shoulders should be raised by pillows, so as to make the 
 head bow forward. Hot, moist flannels should be kept to the 
 wound. 
 
 Scalp Wounds are frequent from machinery and from falls, and 
 from blows from missiles. If there is con- 
 cussion or compression of the brain, these 
 should be treated as set forth under those 
 headings. The wound should be tho- 
 roughly washed by pouring tepid water 
 upon it, the hair should be cut with scis- 
 sors close to the scalp, the bleeding stopped 
 by pressure or twisting the arteries, or 
 by holding a piece of ice to the part, 
 and the fragments of the scalp carefully 
 replaced and fastened by adhesive straps. 
 A bandage should then be applied to the 
 
 head, the pattern for which will readily 
 Bandage for a Scalp Wound. ^ geen by Kgure ^ 
 
 Passive Movements. After almost any severe surgical disease 
 or injury, the limb which has been hurt fails to regain its pliability 
 long after the immediate wound is healed. The stiffness and 
 
Passive Movements. 
 
 247 
 
 soreness, the swelling and the pain on motion, must be vigorously 
 combated, or, through indulgence, the joints will become perma- 
 nently stiff or "anchylosed," and the muscles dwindle and pass into 
 what is called "atrophy." 
 
 To prevent this, the limb should be moved 
 to and fro, its surface well rubbed with stimu- 
 lating liniment, asNos. 164, 166, or 171 (page 
 353), or with the dry hand. Warm and cold 
 water may be poured on it from a height alter- 
 nately for two or three minutes, morning and 
 evening, followed by active rubbing. Electri- 
 city and the flesh brush are also in much use in 
 obstinate cases, and also kneading and working 
 up the muscles, the process called "massage." 
 Similar procedures are often very valuable in 
 stiffness in chronic rheumatism. 
 
 For all such cases the " Swedish movement 
 cure " has been often and justly praised. Its 
 peculiarity is that the person is handled and 
 moved to and fro by an assistant, instead of moving himself. The 
 advantages are that more motion with less fatigue is ensured, and it 
 can be more accurately directed than by the patient's own volition. 
 Without entering into the subject to any great 
 extent, we illustrate it by showing a few of the 
 more prominent passive movements. 
 
 The first is when the patient grasps a bar above 
 his head, and the assistant grasps his hips and 
 moves his body around in a circle. By this 
 
 Fig. 99. 
 
 Passive Motion of 
 the Trunk. 
 
 Passive Motion of 
 the Chest and Ab- 
 
 Passive Motion of Limbs Forward, 
 the muscles of the trunk, of the back and the thighs are well 
 stretched, and the hip joints rendered more pliable. 
 
248 
 
 Accidents , Injuries and Poisons. 
 
 Fig. 100. 
 
 The second motion, displayed in Figure 98, is where an assistant 
 grasps the hands of the patient, who is upon his knees, and bend- 
 ing them backward over his head, puts the muscles of the chest 
 and abdomen on the stretch, as well as the joints of the arms and 
 the back. 
 
 In Figures 99 and 100 we illustrate the plan pursued in pas- 
 sive motion of the lower extremities. Figure 99 shows how this 
 is done by a knee and hip motion forward, during which the 
 patient can be drawn on one or the other side. Figure 100 repre- 
 sents how the muscles and 
 joints of the lower extremi- 
 ties can be put on the stretch 
 backward. 
 
 These few examples will 
 give the reader an idea of 
 the nature of passive move- 
 ments. They are extremely 
 Passive Motion of Limbs, Backward. useful after sprains, frac- 
 tures and lacerations, after rheumatic and neuralgic attacks, and 
 similar ailments which affect the power of voluntary movement. 
 Their general principles are evident from what has been written, 
 and it will be easy to extend their application as needed. 
 
 Poisons and Poisoning. 
 
 Hardly any accident is more common than poisoning, either by 
 intention or by mistake. Often, there are symptoms of poisoning 
 when the patient cannot or will not say what it is he has taken. 
 Therefore the importance of some 
 
 General Directions for the Treatment of Poisoning. 
 
 1. Make the patient vomit at once. To do this, give him a tea- 
 spoonful of ground mustard, in a teacupful of warm water, every 
 minute, until he throws up. Or a tablespoonful of common table 
 salt, in the same quantity of warm water. Or tickle the inside of 
 his throat with a feather or the finger. 
 
Poisons and Poisoning. 249 
 
 2. After he has well vomited, let him take the antidote for the 
 poison, when any one is given in the following pages. 
 
 3. Rest and quiet, a low diet, and the reclining position, should 
 be kept for several days. Barley water (p. 322), linseed tea (p. 
 323), chicken broth (p. 326), and such articles, should be the main 
 staples of food for a few days. 
 
 Proceeding now to the particular poisons which one is liable to 
 be called upon to treat, we speak of them in alphabetical order. 
 
 Acids — Mineral. These are nitric acid, or aqua fortis; sul- 
 phuric acid, or oil of vitriol ; and muriatic acid, or spirits of salt. 
 Commence with a vomit. Then, give a tablespoonful of lime-water 
 (p. 355), in a wineglassful of water, every minute, until the burn- 
 ing pain is relieved. Common soap may be made into a strong 
 suds, and a wineglassful of this given frequently. 
 
 Alcohol. This, in the form of brandy, rum, gin, whisky, or 
 other intoxicating liquors, is a dangerous poison. Persons who 
 become "dead-drunk" are liable to be dead in earnest, unless 
 restored. Give an emetic, or tickle the throat, to make them vomit. 
 Then pour cold water, from a height, on their heads. When awak- 
 ened, give five grains of carbonate of ammonia, in a wineglass of 
 water, every quarter of an hour. 
 
 Aconite. Called also markshood and wolf bane. Give emetic 
 at once, and if the patient is stupid, keep up the breathing by arti- 
 ficial respiration (p. 226). This dangerous poison is much used in 
 liniments, which are sometimes taken by mistake. 
 
 Ammonia, and other alkalies. By the latter name chemists call 
 lime, soda (washing soda), potash, lye, and similar materials. Spir- 
 its of hartshorn, or aqua ammonia, is a well-known strong irritant. 
 When taken internally, give, at once, table vinegar, by the dessert- 
 spoonful, till the pain lessens. Lemon-juice will also answer. 
 Olive oil will afterwards be beneficial. 
 
 Antimony. This is contained in tartar emetic, and antimonial 
 wine; also in "hive syrup," sometimes used for colds in children. 
 It causes violent vomiting. The antidote is tannin or tannic acid, 
 nutgalls, or powdered oak bark. A teaspoonful of tannin, in water, 
 may be given. A cup of strong green tea is also useful as an anti- 
 dote, and is readily prepared. 
 
250 Accidents , Injuries and Poisons. 
 
 Arsenic. This common poison is found in ratsbane, Paris green, 
 fly poison, Fowler's solution, and other familiar preparations. The 
 first step is to give an emetic and vomit freely (see p. 345). Then 
 the patient should drink plenty of milk, white of egg and water, or 
 flour and water. The antidote is freshly prepared hydrated per- 
 oxide of iron, which can be had of any apothecary. 
 
 Baryta. This substance, largely used to adulterate certain 
 paints, is sometimes accidentally swallowed in poisonous doses. 
 
 The antidote is water, acidulated to about the strength of lemon- 
 ade, with sulphuric acid, which converts the baryta into an insolu- 
 ble compound, which must be dislodged from the stomach by an 
 emetic. 
 
 Belladonna. Deadly Nightshade. The berries are some- 
 times eaten by children. Empty the stomach with an emetic, pour 
 cold water, from a height, upon the head, if there is stupor, and 
 give ten drops of laudanum, every quarter of an hour, for two 
 hours (to an adult, two drops to a child). 
 
 Bismuth. Often used in toilet powders. Give an emetic, and 
 when it has acted, copious draughts of milk. 
 
 Bitter- Sweet. Woody Nightshade, Dulcamara. Proceed 
 as for belladonna. 
 
 Camphor. Give an emetic, followed by draughts of warm 
 water, flaxseed tea, gum-arabic water, milk and the like. 
 
 Copper. Cooking in copper vessels, or allowing acid fruits to 
 remain in them, may poison the food. Blue vitriol is a common 
 salt of copper. After free vomiting, give milk, or white of eggs, 
 in water. Ordinary baking soda, or iron filings, a half teaspoonful 
 every five minutes, should be given, to the extent of four or five 
 doses, if the symptoms are severe. 
 
 Corrosive Sublimate. The bichloride of mercury (corrosive 
 sublimate), often used as a solution, in houses, for destroying ver- 
 min about beds, is one of the most active poisons, when taken 
 internally. The red oxide of mercury (red precipitate) is another 
 dangerous salt of the same metal. When swallowed, the white of 
 eggs should at once be given, and often repeated. In the absence 
 of this form of albumen, common milk can be used, or wheat flour 
 beaten up with water. 
 
Poisons and Poisoning. 251 
 
 Digitalis. Foxglove. Treat as for belladonna. Twenty or 
 thirty drops of aromatic spirits of ammonia,, in water, will aid in 
 restoring the strength of the heart. 
 
 Henbane. Hyoscyamus. Treat as given above for belladonna. 
 
 Iodine. The common tincture of iodine, used for external 
 application, is the usual form of this poison. Starch, in water, 
 may be freely given until vomiting is secured by an emetic. 
 
 Iron, Sulphate of. Copperas, or Green Vitriol. This is an 
 irritant poison. After vomiting, let the patient take carbonate of 
 soda (baking soda), as recommended for copper poisoning. 
 
 Lead. The form from which poisoning by this substance usu- 
 ally takes place is the acetate of lead (sugar of lead). The car- 
 bonate of lead, the "white lead" of the painters, and the red oxide 
 (red lead), are also sometimes swallowed in poisonous doses. They 
 all act as irritant poisons. 
 
 The treatment of such cases consists in giving, as an antidote, 
 water, acidulated to about the strength of lemonade, with sulphuric 
 acid (oil of vitriol). 
 
 Sulphate of magnesia (epsom-salts), or the sulphate of soda 
 (Glauber's salt), in water, are also reputed antidotes. After the 
 antidote has been given, in poisoning by lead, an emetic should be 
 given. 
 
 Lead poisoning, in the forms of painters' colic, and lead palsy, 
 follow from much exposure to the metal. Cosmetics containing 
 white lead, and hair-color restorers, containing sugar of lead, water 
 which is contaminated by lead piping, and eating food preserved in 
 leaden cans, may cause them. The free use of milk will often pre- 
 vent these bad effects. 
 
 Mushrooms. When poisoning from eating mushrooms takes 
 place, the contents of the stomach should at once be evacuated by 
 an emetic. After vomiting has commenced, it should be promoted 
 by draughts of warm water, barley water, but particularly by drink- 
 ing copiously of warm milk and water, to which sugar has been 
 added. 
 
 Nitrate of Potash. Saltpetre. In large doses, say half an 
 ounce or more, taken internally, is followed by poisonous symptoms. 
 There is pain, with heat in the stomach, vomiting, and purging of 
 
252 Accidents y Injuries and Poisons. 
 
 blood, with great prostration, and other symptoms denoting the 
 action of an irritant poison. 
 
 No antidote is known. The treatment consists in rapidly evacu- 
 ating the contents of the stomach by an emetic, and the free 
 administration of mucilaginous drinks, with some paregoric, every 
 little while. 
 
 Nitrate of Silver. Lunar Caustic. Used in hair dyes and 
 indelible ink. The antidote for this violent poison is common salt, 
 which acts promptly and efficiently. A strong brine should be 
 swallowed as soon as possible. 
 
 Opium. Laudanum, Morphia, Soothing Syrup. This is the 
 most frequently used poisonous agent. The first step is to give an 
 active emetic, like ground mustard, salt and water, or ipecac. 
 
 The narcotic effects upon the brain, at the same time, as far as 
 possible, must be attended to. If the respiration is yielding to the 
 poison, that is, falling much below the standard of about twenty to 
 the minute, it must be sustained by assistance. The exposed body 
 of the patient should be dashed with cold water, not neglecting the 
 head, face, and chest. After the cold water has been sufficiently 
 used in this way, the body should be dried, removed to a dry spot, 
 and hot applications made to the extremities and other parts. This 
 is necessary, owing to the heat-producing power of the body being 
 impaired by the suspended or diminished respiration. 
 
 If the respiration is not suspended, but is going on at a dimin- 
 ished rate, say six or eight to the minute, artificial respiration is 
 not required, unless the number of respiratory movements of the 
 chest falls below that ; but the other measures may be used. In 
 addition to these, a strong stimulant, in the shape of twenty or thirty 
 drops of aromatic spirits of ammonia in a tablespoonful of water, 
 may be given three or four times, at intervals of a couple or more 
 minutes. It is better than brandy, or anything alcoholic, because 
 the mode of the action of brandy is much the same upon the brain 
 as opium, and it might be rather adding to instead of taking from 
 the poison that is at work. The aromatic spirits of ammonia will 
 give the advantage, without the disadvantage. A few tablespoon- 
 fuls of very strong freshly made coffed is a useful thing to give in 
 such cases. 
 
Poisons and Poisoning. 253 
 
 Among measures to keep in activity the circulation and respira- 
 tion, as well as to promote the elimination (casting out) from the 
 blood of the poison acting as a narcotic, there are few things more 
 useful than muscular exercise. The patient should be walked or 
 run up and down the room constantly. 
 
 Oxalic Acid. Often taken by mistake for epsom salts — a dan- 
 gerous mistake. Give at once powdered chalk, calcined and 
 powdered magnesia, or strong lime-water. After these have been 
 administered for a time an emetic will empty the stomach. 
 
 Poison Vine. Poison Oak, Poison Sumac. These are species 
 of Rhus, and abound in many parts of the United States. The 
 juice, or even the touch of the leaf when the dew is on it, brings 
 about in many persons redness, itching, swelling, and blisters. The 
 person so affected should take a dose of epsom salts or cream of 
 tartar, to empty the bowels, and bathe the parts with lead-wash (p. 
 355). A wash of a teaspoonful of baking soda in a tumbler of 
 water immediately after exposure will prevent the eruption. When 
 the latter has appeared, painting the parts with tincture of iron will 
 usually check it. A solution of blue vitriol or sulphate of copper, 
 a teaspoonful to the pint of water, is also an efficient lotion. 
 
 Prussic Acid. This substance is so rapidly fatal that little can 
 be done to avert death. If possible, give an emetic of mustard, and 
 follow with stimulants. 
 
 Phosphorus. Sometimes taken in rat and roach poison, and 
 in matches. There is no antidote known. Some calcined mag- 
 nesia may be given in plenty of water, to be rapidly followed by an 
 emetic, and then an abundance of mucilaginous drinks. 
 
 Savine, Oil of. This substance in large doses inflames the 
 stomach and bowels. Give olive oil in tablespoonful doses, and 
 empty the stomach with emetics. 
 
 Stramonium. Usually known as thorn apple, or jimson weed; 
 belongs to the same natural order in botany as belladonna, and 
 when taken internally in improper quantities, is to be treated by 
 similar general means. Children often gather the seeds and eat 
 them. 
 
 St rye h n i n e . Nux Vomica. This dangerous substance destroys 
 life quickly, with severe convulsions. The patient should be made 
 22 
 
254 Accidents , Injuries and Poisons. 
 
 to vomit without delay. Chloroform should then be'given in tea- 
 spoonful doses, in water, every quarter of an hour. Artificial 
 respiration may be tried if apparent death has set in. 
 
 Tobacco. The oil of tobacco is a violent poison, and the leaf 
 when swallowed causes nausea and vomiting. This should be 
 encouraged with warm water, after which twenty-drop doses of 
 aromatic spirits of ammonia, in a tablespoonful of water, will be of 
 benefit. 
 
 Laying Out the Dead. 
 
 When a person dies, the eyes should be closed by gentle pres- 
 sure with the fingers for a few minutes, or a small weight — a penny 
 or similar coin — may be used to keep up the pressure. 
 
 The limbs should be straightened out carefully, and a bandage 
 applied under the lower jaw, to support it; the arms should be 
 placed by the side, and the lower extremities kept in position by 
 means of a bandage connecting the great toes. 
 
 The clothes should then all be removed, and after the body has 
 been thoroughly washed, be replaced by a clean bed-gown. 
 
PART III. 
 
 SICKNESS IN CHILDHOOD. 
 
 THE DIVISIONS OF THIS PART. 
 
 The ailments affecting children, either exclusively or with espe- 
 cial frequency, will be spoken of on the same plan as were those of 
 adults. But a less rigid adherence to the plan of Part II will be 
 adopted, as we shall have fewer maladies to study. The first chap- 
 ter of this part, the Seventh of the book, will be devoted to ailments 
 affecting the whole body of the child ; the second chapter, Eighth 
 of the book, will treat of those confined to parts of its body ; while 
 the third, the Ninth of the book, will explain the management of 
 the accidents, etc., to which the child is. particularly liable. 
 
 By the term " Childhood," in this Part, is not meant infancy, 
 that is, the first year of life. This has been already fully treated 
 in " The Physical Life of Woman," to which work the reader is 
 referred for the management of the newly born and of babes. 
 " Childhood," as here used, covers the period from the epoch of 
 weaning to that of puberty, and the doses recommended will be for 
 children about eight or ten years of age. 
 
 255 
 
CHAPTEE VII. 
 
 Diseases of Childeen — Ailments Affecting the 
 Whole Body. 
 
 Infantile Remittent Fever: (Wasting Fever — Gastric Fever — Worm Fever.) 
 Teething Fever. Scarlet Fever : (Scarlatina — Scarlet Kash — Putrid Sore 
 Throat.) Measles: (French Measles — Black Measles.) Mumps. Chicken- 
 pox, or Varicella. Small-pox, and Vaccination. Chorea, or St, Vitus' 
 Dance. Jaundice, or Yellows. Worms, and Worm Troubles. Hydro- 
 cephalus, or Water on the Brain. Marasmus: Wasting, or Decline. 
 Scrofula: Scrofulosis, or King's Evil — Management of Scrofulous Chil- 
 dren — Hygienic Treatment. Rickets, or Rachitis. Fits, or Convulsions. 
 Night Terrors, and Excessive Nervousness. 
 
 Infantile Remittent Fever. Known also as Infantile Typhoid, 
 , Wasting Fever, of children, Worm Fever, Infantile Hectic, and 
 Gastric Fever, of infants. 
 
 How Distinguished. In this affection, there is always inflam- 
 mation of the stomach and bowels. It may come on suddenly, the 
 child, though apparently well on going to bed, being attacked soon 
 afterward by fever ; the skin is hot and dry, the face flushed, the 
 eyes red, the pulse quick, the thirst constant, with dry, coated 
 tongue, but red at its point; the child is very restless, and even 
 delirious. The abdomen is tender on pressure, and hot, and there 
 may be nausea, and vomiting of a sour, greenish yellow fluid. 
 These symptoms continue until nearly daylight, when they begin 
 to lessen, though they do not disappear entirely until the day is well 
 advanced. Even then, there is languor, with great irritability, and 
 the symptoms are again observed to be present towards nightfall, and 
 the fever thus comes and goes, and may even become of a continued 
 form. Often, the child is several days complaining, with thirst, 
 hot skin, loss of appetite, fretful, etc., and gradually the disease is 
 fully developed. Generally, there is constipation, or diarrhoea may 
 
 256 
 
Infantile Remittent Fever. 257 
 
 be present, with frequent, small passages. All discharges from the 
 bowels are very offensive, dark, or clay-colored, tarry, and even 
 bloody. In the latter case, there is more or less straining and grip- 
 ing. In severe cases, the child lies upon the back, with the knees 
 drawn up, and his face shows the distress which he is suffering. In 
 protracted cases, the symptoms assume all the more marked 
 appearance of typhoid fever. Cough is often present, and from 
 this and other symptoms, as the picking of the nose, etc., worms 
 are supposed to be the cause of the affection, and hence one of its 
 names. 
 
 Worm Fever. The child rapidly emaciates, and- becomes much 
 debilitated, falls into a stupor, with the eyes half-closed, and pre- 
 sents all the appearance of disease of the brain. Or the cough 
 develops into a complete attack of bronchitis. The disease is often 
 observed to abate its force, and then a relapse occurs, with aggrava- 
 tion of all the bowel symptoms. Where there exists a tendency to 
 tubercles, these develop, and a fatal result ensues. 
 
 How Treated. It is important that the diet should be mild, 
 nutritious, and easy of digestion; the drinks of cold, mucilaginous 
 form (such as given, p. 323). The bowels may be operated on by 
 a mild laxative, as rhubarb and magnesia, followed, if necessary, by 
 clysters (p. 341), or by castor oil. It should be remembered that 
 the bowels are in an irritable condition, and, therefore, they should 
 not be unnecessarily troubled. Chalk and ipecacuanha act well in 
 small doses, two grains of the former to a quarter grain of the lat- 
 ter, and generally cause all the symptoms to improve. Should the 
 fever and pain of the abdomen be very great, leeches to the part 
 will greatly relieve these symptoms. The warm bath is of great 
 " value, or the whole surface may be sponged with warm water, much 
 to the comfort of the little patient. Applications to the abdomen 
 of fomentations, as hops, mush, etc. (p. 346), will aid in the treat- 
 ment, and in protracted cases, blisters may be employed, with good 
 results. If symptoms of brain affection occur, hot mustard foot- 
 baths, cold to the head, leeches behind the ears, become necessary. 
 When the discharge becomes offensive, with windy swelling of the 
 bowels, turpentine may be given in mucilage, say five to fifteen 
 drops, every four or five hours. If the symptoms subside, tonics 
 22* 
 
258 Diseases of Children. 
 
 may at once be employed, as those given, pp. 360, 361. The 
 utmost care must be observed as to the diet, lest indulgence lead to 
 a relapse, and every precaution should be taken to guard against 
 exposure of the body to cold and dampness. Exercise, at first of a 
 passive form, in the open air, should be taken as soon as it can be 
 borne, and gradually the patient should be brought back to its 
 accustomed habits of diet, exercise, etc. If there remain symptoms 
 of enlargement of the glands in the bowels, what are called altera- 
 tives, as the syrup of the iodide of iron, ten drops, three times a 
 day, will be useful ; and this may be aided by rubbing in iodine in 
 liniment, or the tincture of iodine may be painted freely over the 
 parts. 
 
 Teething Fever, or troubles of dentition. Few children pass 
 through the process of dentition without more or less trouble. 
 Frequently the general disturbance is out of all proportion to the 
 amount of irritation observed in the mouth. 
 
 How Brought On. Dentition is more liable to go on easily and 
 safely in cool weather than in the summer season. Coupled with 
 the exhausting heat of summer, the evolution of the teeth gives 
 rise to a variety of troubles, many of which prove fatal. More 
 especially is this to be anticipated where the child -is of delicate or 
 diseased parents, or where it is imperfectly nourished, as by a sickly 
 mother, the absence of the breast-milk, etc. 
 
 How Distinguished. The surface of the gum is hot and swollen, 
 there is more or less running of spittle, the child is fretful, its face 
 is flushed, it is constantly working with its fingers in the mouth, or 
 bites on anything, as though to relieve the annoyance ; at night the 
 sleep is much disturbed, the bowels are affected with diarrhoea, 
 generally of a mucous character, and there is more or less vomiting. 
 In other cases, the skin is hot and dry, the mouth is filled with 
 little white spots, aphthae or thrush, and the child is seen eagerly to 
 take the breast and in a moment drop it with an irritable cry. 
 Under these circumstances, inflammation of the bowels, the brain, 
 the stomach, etc., may at any time occur. Most usually, diarrhoea 
 results, with great pain of the bowels, rapid emaciation, and an 
 aggravation of all the symptoms. Convulsions are extremely liable 
 to occur. 
 
Scarlet Fever. 259 
 
 How Treated. The utmost care should be observed that the 
 mother's milk should not be vitiated by excitement, undue exertion, 
 improper food or stimulants. 
 
 If the gum is swollen, hot, painful, hard, this condition should 
 be relieved by lancing, so as to give free passage to the tooth. 
 Often every symptom is at once relieved, and under proper regimen 
 the cure is soon effected. Should the fever still persist, unless the 
 bowels are free, mild saline laxatives are useful. The thirst is best 
 relieved by the free use of cold water. This may also be freely 
 applied to the head, and the child will be greatly benefited by 
 sponging the whole surface freely, either with cold or tepid water. 
 If the diarrhoea be persistent, the astringents, as Nos. 139, 148, 162, 
 with chalk mixture, paregoric, or Dover's powder, will soon check it. 
 Applications to the abdomen of flannels wrung out of laudanum 
 and sweet oil, or hop poultices, will greatly aid in the relief. Con- 
 vulsions are best controlled by the application of cold affusions to 
 the head, mustard the whole length of the spine, or chloral, the 
 latter in a fourth of the dose recommended, page 357. Debility 
 must be met at the proper time by cream punch, nourishing diet — 
 often this may be in addition to the mother's milk — tonics, particu- 
 larly quinine, or tea of cinchona (page 349). Perhaps, than the 
 latter, there is nothing better for debility of the bowels, which often 
 occurs with or follows dentition. 
 
 How Prevented. The child should be kept almost constantly in 
 the open air, particularly that of the country ; when possible, it should 
 be removed from a city residence. The whole surface should be 
 kept scrupulously clean ; the clothing should be light and cool ; the 
 diet simple ; the bowels carefully regulated ; and the swollen gums 
 may be occasionally rubbed with the fingers, or some not too hard 
 body. 
 
 Scarlet Fever is known as scarlatina, scarlet rash, scarlatina 
 maligna, or anginosa, putrid sore throat, etc. There is no difference 
 between scarlet fever and scarlatina ; they are both names for the 
 same disease. 
 
 How Brought On. This disease is contagious in the fullest sense 
 of that word. Still, many are exposed and escape. Though it may 
 attack the same person twice, this is rare. Undoubtedly, it is 
 
260 Diseases of Children. 
 
 caused by bad drainage. Instances have often occurred where this 
 disease only attacked the inmates of a house of which the drainage 
 was imperfect, and where no possible source of contagion could be 
 found. 
 
 How Distinguished. The patient generally, though not invari- 
 ably, shows signs of loss of appetite, debility, fretfulness, headache, 
 pains in the limbs, hot fever, sore throat, and an eruption about the 
 second day. In some cases, the first symptom is a convulsion, 
 followed by high fever and delirium. The eruption is a diffused 
 redness, as if the skin had been uniformly scalded, commencing on 
 the face and upper parts, but rapidly extending in a few hours over 
 the whole body. On close examination, the eruption is found 
 to consist of fine points very closely placed. The skin is 
 swollen, extremely dry and harsh, with a burning feeling, which 
 increases to the touch as the hand is kept upon it. The sufferer 
 also feels this like a soreness or burning over the surface. The 
 pulse is always very quick; the mucous surfaces are equally impli- 
 cated, the tongue and throat being inflamed, swollen, sore, and often 
 of a dull red color; the thirst is very great, and there is almost 
 always delirium, unless the case be extremely mild. The mildest 
 cases, known as the simple form, have a moderate eruption, scarcely 
 any fever or sore throat. The anginose form is where the throat 
 receives the full force of the disease, the inflammation being very 
 great, and the part covered with a false membrane, which gives it 
 the name of putrid sore throat, because of the offensive discharge 
 from it. This form rarely fails to leave bad results, as loss of 
 hearing, etc. 
 
 The malignant form is that where the first shock of the poison 
 of the disease is so great that death frequently occurs in a few hours, 
 without reaching the stage of eruption. If the eruption occurs, it 
 is of a livid or bluish character, and recedes, followed by stupor and 
 death. Or, if protracted, there is hemorrhage, diarrhoea, and vomit- 
 ing. Death is almost certain. 
 
 How Treated. In the first or simple form, nursing is the most 
 important point, and the avoidance of cold or dampness. The thirst 
 and fever may be relieved by the free use of cold drinks, ice (see 
 p. 322), and a solution of the acetate of ammonia, with the 
 
Scarlet Fever. 261 
 
 sweet spirits of nitre, a tablespoonful of the former to a teaspoon- 
 ful of the latter, in a tumbler of water. Great comfort is procured 
 by sponging the surface with tepid or cold water. This may be 
 repeated, as indicated by the warmth of the skin, etc. A favorite 
 domestic remedy is rubbing the whole surface with lard, or a piece 
 of fat bacon. This has the advantage of preventing the intolerable 
 pain and itching from the eruption. Some prefer the use of glyce- 
 rine, as more cleanly and less offensive. Better than either is cocoa- 
 butter. When the throat is quite sore, leeches may be applied to 
 the angles of the jaw, and a variety of gargles are employed, as 
 pure cider vinegar and cold water, tincture of chloride of iron, a 
 teaspoonful to a tumbler of water, or chlorate of potassa (p. 347); 
 or the parte may be freely swabbed or brushed, every few hours, 
 with strong solutions of the tincture of chloride of iron, equal 
 parts of it and water. Care must be observed lest the debility be 
 increased by the neglect of nutrition. The food must be of a 
 liquid form, and perhaps nothing can equal milk in disease of any 
 kind. Next, beef tea, mutton broth, chicken broth, etc. The 
 tincture of chloride of iron acts as a good tonic, and may be com- 
 bined, in feeble cases, with quinine, one grain of the latter to five 
 drops of the former, in a wineglass of water. In these mild forms 
 it is extremely important that the case should be guarded against 
 cold or dampness, while at the same time proper ventilation is 
 secured. 
 
 The putrid sore throat, or malignant form, often gives no time or 
 hope to do anything. The effect of the poison of the disease is so 
 depressing, that the system is unable to react ; therefore, the prin- 
 cipal indication is to use remedies of a stimulating character, such 
 as hot baths with mustard or salt ; mustard plasters to the spine, 
 the extremities ; heat in every way, as by bags of hot sand or salt, 
 bottles of hot water (see p. 347) ; stimulation of the skin by fric- 
 tions with strong mustard water. At the same time, stimulants 
 may be given inwardly, as sweet spirits of ammonia, whisky, and 
 preparations of cinchona. In addition to these remedies, a num- 
 ber have been suggested and highly lauded as of great value : thus, 
 the sulphite of soda, in a saturated solution, given freely, is a 
 supposed antidote to the disease. One remedy requires particular 
 
262 Diseases of Children. 
 
 mention; this is digitalis. It is made into an infusion of one 
 drachm of the powdered leaves, with twelve tablespoonfuls of boiling 
 water. When cold, a teaspoonful is given every two, three or four 
 hours, according to age, and the effects produced. At first, the 
 remedy is given, including the powder itself, by stirring up the 
 grounds; as the symptoms abate, the clear liquor is given, and the 
 intervals between the doses are lengthened. The attendants should 
 be cautioned to watch the pulse, and if it flags, to suspend the 
 medicine. This remedy is well worthy of extended trial. If the 
 sulphite of soda were combined with it, its value would be greatly 
 increased. 
 
 Should dropsy occur, as often is the case after the disease has 
 abated, during the process of "skinning," as it is termed, the kidneys 
 should be well acted on. The uva ursi tea, bitter-sweet tea, juniper 
 tea (see p. 348), sweet spirits of nitre, jalap and cream of tartar, 
 lemonade freely, every remedy that will cause a free flow of water 
 to the kidneys, the bowels and the skin, is proper. To prevent 
 dropsy, the patient should be kept* in the house, and even in his 
 room, for several weeks, until the skin has had time to resume its 
 proper condition, and thus be less liable to cause the deposit of water. 
 
 How Prevented. By proper drainage, ventilation, and the avoid- 
 ance of the contagion, much may be done to prevent this disease, 
 or make it less dangerous. Three drops of tincture of belladonna, 
 three times a day, or 10 grains of the sulphite of soda, as often, 
 will lessen the liability to the attack. 
 
 Measles is known also as rubeola, French measles, black mea- 
 sles, morbili, and may be confounded with roseola or rose rash. 
 The latter has no fever or throat symptoms. 
 
 How Brought On. This is due to contagion, and is rarely seen 
 to occur a second time. 
 
 How Distinguished. The attack is ushered in by all the evidences 
 of a cold. The nose runs, the eyes are red and watery, sneezing 
 is frequent, and there is more or less cough. Along with this is 
 more or less fever and debility. About the fourth day the eruption 
 appears, first on the face, then on the chest and upper extremities, 
 finally covering the whole body. It is of a dark red color, not fine 
 pointed, and arranged in patches of a crescent shape. The fever 
 
Mumps. 263 
 
 soon declines, and the eruption fades after three days, being fol- 
 lowed by slight scaling of the skin. There is also a soreness of the 
 throat, though generally of a mild form. 
 
 French or German measles is also called "rotheln." It appears 
 like a mixture of measles and scarlet fever. On one part, the 
 eruption strongly resembles the one, while on another, it resembles 
 the other. Some regard this as an entirely separate disease, and 
 claim that it does not afford any safety against an attack of either 
 measles or scarlet fever. 
 
 Black measles is that form when typhoid symptoms occur, and 
 the attack is complicated with hemorrhages, etc., and generally 
 proves fatal. 
 
 How Treated. The bowels should be acted upon gently, by 
 some cooling saline, as Nos. 94 or 100, p. 341 ; then the solution 
 of acetate of ammonia may be given freely, with soothing and 
 cooling drinks (p. 322), and if the cough and chest symptoms are 
 severe, a half teaspoonful of ipecac syrup is well. In very many 
 cases, scarcely anything more is required than care and nursing. 
 In debilitated cases, and those of a typhoid form, quinine, stimu- 
 lants, and nutritious food are required. 
 
 The "rotheln," German or French measles, will require the same 
 treatment ; it may be followed by dropsy, like scarlet fever, though 
 it more closely resembles measles. 
 
 Mumps is also known as parotitis or inflammation of the large 
 gland back of the jaw, called the parotid. 
 
 How Caused. This is purely contagious. 
 
 How Distinguished. The patient has a slight fever and uneasi- 
 ness, and the gland swells, is red, hot, very painful to the touch. 
 The swelling may be so great as to cause difficulty of swallowing. 
 It may affect but one side, or both at the same time, or one after 
 the other, at a long interval. In the course of six or eight days 
 the disease disappears, and the gland is reduced to its proper size. 
 In very rare instances, the inflammation may go on to form matter. 
 The special point of danger is the great liability to "metastasis," 
 that is, a sudden transfer of the disease from the original seat to the 
 testicles, the breasts, or even to the brain. In the latter case it may 
 prove fatal. 
 
264 Diseases of Children. 
 
 How Treated. The greatest care must be taken to prevent 
 exposure to cold or dampness, as this is the great cause of "metas- 
 tasis." The bowels may be gently moved, a light fever mixture 
 given, as the acetate of ammonia, and the parts should be bathed 
 with a mildly stimulating liniment, as mustard liniment (p. 353), 
 and poulticed, to relieve the discomfort of the patient. Should 
 metastasis occur, the effort should be made to cause a return to the 
 original seat by stimulants over the gland, and by the same treat- 
 ment as above to the new point of inflammation. A very hot 
 Indian meal poultice is often effectual. 
 
 Chicken Pox, or varicella. This so much resembles a mild 
 attack of varioloid that frequently the two are confounded. Indeed, 
 some regard them as identical. It is the result of contagion. 
 
 How Distinguished. The fever, if any, is very slight. There 
 is no backache, nor aching of the bones. The pimples are few in 
 number and much scattered ; they fill on the second day, scab about 
 the fourth, and fall off quickly, rarely leaving any pitting. The 
 eruption is not deep-seated, is never umbilicated or depressed in the 
 centre, comes out in successive crops, and does not fill with pus 
 or matter. It cannot be propagated by inoculation, and is not in 
 the least affected by vaccination. 
 
 How Treated. This disease merely requires the bowels to be 
 kept free, the avoidance of cold or dampness, and the use of some 
 cooling medicine, as the solution of the acetate of ammonia. 
 
 Small Pox has been fully treated of on another page. It may 
 be alluded to here to show the neccessity of vaccination of children. 
 An unvaccinated child, especially an infant, if exposed to this 
 disease, is extremely apt to be attacked with the most violent form, 
 either destroying its life, terribly marking and disfiguring it forever, 
 or even causing injury of vision or blindness. Hence it becomes of 
 the utmost importance that vaccination should be performed early, 
 say at the close of the second month or the beginning of the third. 
 Should the disease be prevalent, vaccination should be insisted on 
 at once, even within a few hours of birth Care is necessary in 
 the selection of matter; only that from perfectly healthy children 
 should be employed For this reason it is better not to use a crust 
 given by the parents, as one is unable to know to a certainty all 
 
Small Pox. 265 
 
 the circumstances attending the formation of such a crust, and thus 
 may be the unwitting instrument of conveying serious disease. 
 There is no doubt that diseases are thus conveyed, and every pre- 
 caution should be taken. A crust should be rejected if the child 
 from which it is taken exhibits signs of eruptions on the skin, or 
 any other form of indisposition. To prevent positively every such 
 undesirable result, the advice is given not to use, nor to let the physi- 
 cian use, any vaccine matter which has been taken from the human 
 arm, but only that which has been derived from young and healthy 
 heifers. This can now be had from any of a number of vaccine 
 farms, at the most trifling expense. In this connection it may be 
 well to notice the fact that a person liable to cutaneous eruptions 
 is almost sure to have more or less breaking out under the excite- 
 ment of the vaccination. This should be mentioned, as, otherwise, 
 these are attributed to the use of bad matter by the vaccinator. 
 In vaccinating, the left arm is preferred, as the one least likely to 
 interfere with the pursuits of the person, and it is also preferred 
 in children, that some uniformity may be had. The virus is softened 
 with water into a creamy consistence, and inserted in the arm by 
 scratching with the point of a dull lancet, or inserting it as in a 
 pocket beneath the outer skin, or in any way, so that it may be 
 brought in contact with the absorbing surface, and thus carried into 
 the system. Too sharp an instrument will cause too free a flow of 
 blood, which will be liable to wash away the virus. The less blood 
 the more sure is the operation to be successful. The part is then 
 allowed to dry, and generally about the end of the third day it 
 begins to inflame ; a small red pimple forms, which gradually en- 
 larges, and when at its height is almost circular, depressed in the 
 centre, and surrounded with a bright red ring of inflammation. 
 About the eleventh day this ring begins to disappear, the pustule 
 dries up and forms a thick, dark brown scab, which falls off about 
 the end of the third week, leaving a honeycombed scar. During 
 this process there is more or less fever, sometimes mounting so high 
 as to cause a convulsion, or delirium. In rare instances, the process 
 is delayed beyond the third day, and commences as late as the 
 tenth or eleventh day, and runs on to a proper termination. Occa^ 
 sionally, the inflammation begins at once, and aborts, or fails to 
 
 23 
 
266 Diseases of Children. 
 
 form a vesicle, a thin scab forms and drops off in a few days. 
 This is known as spurious vaccination, and is of no value as a 
 preventive. In such cases the operation should be repeated, even 
 several times, until the physician is satisfied of the impossibility of 
 success. In these instances, it is believed that the patient is not so 
 liable to be attacked with small pox, or would be most likely to have 
 it in a very slight or modified form. 
 
 Revaccination should always be practiced when small pox is 
 prevalent, as the susceptibility appears, in some people, to be renewed 
 after a lapse of years, say five or seven years, on the average. 
 
 Chorea, or St. Vitus' Dance, or the Shakes, has been treated 
 of on a former page. 
 
 Jaundice, or Yellows, in children, or infantile icterus, is fre- 
 quently seen a few days after birth, and generally disappears of its 
 own accord, in the course of a week. It appears mostly in feeble, 
 delicate infants, and is perhaps due to want of cleanliness, prevent- 
 ing the proper action of the skin, imperfect action of the lungs, 
 or exposure to cold. In obstinate cases, it may be due to obstruc- 
 tion of the bile passages, or even to malformation of these parts. 
 
 How Distinguished. The whole surface of the skin- is of a yel- 
 low hue, the urine is of a saffron color, and the passages are of a 
 light clay color, or even white. 
 
 How Treated. In ordinary cases, a mild laxative, as white wal- 
 nut tea, p. 349, with pure air of a proper temperature, and cleanli- 
 ness, will be all that is needed, and the coloring will speedily 
 disappear. If the case is obstinate, and evidently due to obstruc- 
 tion by thickened bile or gall stones, hot baths, fomentations to the 
 region of the liver, hot drinks, purgatives, such as No. 94, will 
 relieve the case, by removing the obstruction. In the event of 
 failure, dandelion tea (p. 350), and nitro-muriatic acid, one drop in 
 water, thrice daily, will aid in giving relief. These latter, especi- 
 ally the acid, act also to cause the removal of the yellowness, after 
 the cause of the affection is removed. 
 
 Worm Troubles are not so common as generally supposed. Al- 
 most every irritation or abnormal condition of a child is attributed 
 by the parents, and others, to the presence of worms, and the little 
 sufferer is often made worse by the resulting medication. With- 
 
Worm Troubles. 267 
 
 out giving all the varieties of worms, it will be sufficient to allude 
 to three kinds : intestinal worms, seat or thread worms, and round 
 worms. 
 
 How Caused. In very many instances these are due to improper 
 or unhealthy food. Thus, meat of any kind, eaten too raw, may 
 deposit the larvae of worms, and thus lead to the production of 
 these parasites in the system. Especially is this true of pork, which, 
 made into sausage, half cooked, or ham, imperfectly cured, eaten 
 raw, is often much diseased, and forms an appropriate nest for the 
 deposit of the eggs of worms. Want of cleanliness, as of the re- 
 gions near the anus, is generally the cause of seat worms, which 
 often pass forward into the vagina, and set up an irritation there, 
 causing symptoms of an alarming character. 
 
 How Distinguished. A child is generally supposed to have 
 worms when it picks its nose constantly, loses its appetite, or eats 
 voraciously; is generally irritable and peevish; is restless at night; 
 groaning ; grinding the teeth ; complains of great itching about the 
 opening of the bowels. Often there is an irritable, spasmodic 
 cough ; and occasionally, convulsions come on, which can be traced 
 to no other apparent cause. 
 
 Diarrhoea occurs, of an irregular form, better one day, worse the 
 next; the stools are offensive, slimy, and occasionally contain one 
 or more worms. Vomiting, also, is often present. Add to this, 
 the child constantly losing flesh, having dark rings around the eyes, 
 indigestion, sleeping with the eyes half shut, and there is good 
 reason to suspect the presence of worms, even when none are 
 passed. The thread or seat worms cause a most intolerable irrita- 
 tion about the orifice of the bowel, even tenesmus, when a stool 
 occurs; often a white discharge occurs from the vagina, in girls, 
 which is due to the presence of seat worms. In the evening and 
 at night, more or less fever is present, in severe cases. When the 
 tapeworm is present, the most marked emaciation occurs, causing 
 the patient to become literally " skin and bone." 
 
 How Treated. First, the worms must be expelled from the 
 bowels. This done, the system may be enabled to regain its usual 
 tone by the appropriate remedies. Seat worms, and those occupy- 
 ing the lower bowel, are generally readily killed and expelled by 
 
268 Diseases of Children. 
 
 the free use of clysters of salt and water, an ounce to a pint, thrown 
 in warm, morning and evening; or of an infusion of quassia; or 
 of a solution of the tincture of the chloride of iron, say four 
 drachms to a pint of water; or of lime water. All these, when 
 employed, should be thrown into the bowel freely.' Their effect 
 may be greatly aided by a brisk purgative, as cream of tartar and 
 jalap, or seidlitz powder. Of internal remedies, for the other 
 forms, a variety are used, and highly praised: as, wormwood tea, (p. 
 350); oil of turpentine, ten drops in molasses; pumpkin seed tea; 
 and santonine. The latter is of great value, and is given in three 
 grain doses, to a child of five to seven years, two or three times a 
 day. Recently, the oil of male fern appears to have obtained great 
 favor, in this affection. The patient is first purged moderately, and 
 kept on low diet; thus preparing the worms for the full effect of 
 the medicine ; then, in the morning, the oil is given in a dose of 
 ten to twenty drops, according to the age, mixed with syrup and 
 mucilage. This is followed, in six or eight hours, by a full dose 
 of some purgative. One or two doses generally remove all the 
 worms, and the cure is completed by the use of tincture of chloride 
 of iron, with aloes ; or five drops of muriatic acid, with infusion of 
 quassia. Pumpkin seeds, also, should be taken on an empty 
 stomach, and as they are harmless, they may be used very freely. 
 Salt, eaten freely with the food, is also an excellent remedy for 
 worms, being both preventive and curative. Iron and cod-liver 
 oil will aid in building up the system, and are supposed to act as a 
 means of prevention. In no case, however, ought the child to be 
 purged and medicated for worms, unless it is quite positive that 
 such are present. Rarely do they exist without some evidence 
 being shown in the discharges; hence these should be carefully 
 examined. 
 
 Hydrocephalus, or Water on the Brain, may be either acute, 
 or sudden, or chronic, or gradual in its formation. This is also 
 known as dropsy of the brain. Sometimes children are born with 
 this affection ; or it may cause their premature delivery, and conse- 
 quent death. 
 
 How Brought On. This may be due to brain disease, to general 
 
Marasmus. 269 
 
 dropsy, to injuries of the head, or it may follow other affections, as 
 scarlet fever. 
 
 How Distinguished. The chronic form is often very insidious 
 in its approach ; often the brain becomes so tolerant of the pressure, 
 that scarcely any impairment of the bodily functions is observed. 
 Even, in some, the mental powers seem but little disturbed, though 
 generally it results in idiocy long before a fatal termination. Gen- 
 erally, convulsions occur, a slight fit each day, with a little twitch- 
 ing, etc. The enlargement of the head is scarcely noticed until 
 the disease has existed for some time. The child wastes, in spite 
 of all the nourishment, which it greedily takes ; it finds the head 
 too heavy, and therefore avoids the erect posture ; the bowels are 
 irregular; the vision is impaired or lost; crossing of the eyes often 
 is early noticed; there may be paralysis, especially of the lower 
 extremities, or one-half of the body is affected. 
 
 In the acute form, the symptoms progress with great rapidity ; 
 the head rapidly enlarges, the moulds of the head expand and the 
 skin bulges out, the child suddenly becomes cross-eyed, stupid, 
 lethargic, comatose, and dies, generally, in a convulsion. 
 
 How Treated. But little can be done. The only hope would 
 be the evacuation of the water by causing every avenue to carry it 
 off. Purging would cause watery stools, but might, if carried too 
 far, complete the case by rapidly increasing the debility. The food 
 should be of a liquid, highly nutritious form. Absorption may be 
 promoted by rubbing iodide of potassa ointment over the whole 
 scalp, previously shaven, or by blisters to the back of the neck, or 
 to the scalp. Medicines to act on the kidneys may be given, as 
 receipts Nos. 137, 147, etc., combined with a tonic. So soon as 
 imprqvement is observed, quinine and iron should be given. 
 
 Marasmus is well known as wasting or decline; its technical 
 names are infantile atrophy and tabes mesenterica. 
 
 How Brought On. Many children, especially those who are at 
 the nursing age, are observed to lose flesh and pine away without 
 any apparent cause. Unfortunately, in too many instances, without 
 a careful inquiry, the little sufferers are still further injured by 
 dosing with the thousand and one nostrums for children, and thus 
 the stomach and bowels are permanently disordered, and digestion 
 23* 
 
270 Diseases of Children. 
 
 is impaired, so that the food which is necessary for the improvement 
 of the child only serves to act as a foreign body. 
 
 How Distinguished. Marasmus, to whatever cause it may be 
 due, is marked by a slow, constant wasting ; the sufferer loses flesh, 
 becomes pale, requires a great deal of rest, exhibits no desire to join 
 in the usual infantile sports, and, as the disease advances, it comes 
 to look like a little old man, with a wrinkled brow, a head apparently 
 too large for the body, limbs that have dwindled away to skin and 
 bone. The skin becomes harsh and dry, the appetite is capricious, 
 often being so voracious as to cause the attendants to believe in the 
 presence of worms, which they think are devouring the food 
 intended for the nourishment of the child. When this affection is 
 dependent upon wasting disease of the lungs, really a consumption, 
 there is more or less cough, expectoration, fever from the middle of 
 the afternoon or at night, derangement of the bowels, generally 
 constipation. When dependent upon disease or consumption of the 
 bowels, the tabes mesenterica, the bowels are tender upon pressure, 
 there are eructations of wind and food, sour stomach, constipation 
 and diarrhoea alternately, fever, but no cough. When dependent 
 upon insufficient or improper food, the child is constantly desiring 
 the breast, or bottle, as the case may be ; it takes the food eagerly 
 and ejects it but little altered. 
 
 How Treated. The food should first claim the attention. If 
 the child is at the breast, the mother's milk should be carefully 
 examined, first, as to its quantity ; second, as to its quality. If the 
 supply is small and the child seems never satisfied, it should be 
 supplemented by the administration of cow's milk properly prepared. 
 Frequently the mode of preparation is by diluting it with water to 
 the extent of one-half, or even two-thirds, and thus the child gets 
 one pint of milk while taking three times that quantity of fluid, 
 filling the stomach and getting but little nourishment. In quite 
 young children, the dilution should be one part of water to two 
 parts of milk, with sufficient white loaf-sugar to make it rather 
 sweet. In older children, the pure milk should be used ; and where 
 it is difficult to procure pure milk, the condensed milk may be 
 employed. Especially is this form valuable in the summer, when 
 it is difficult to procure fresh, pure milk, or where the supply is 
 
Scrofula, 2j\ 
 
 liable to be vitiated by keeping. To examine the mother's milk a 
 portion should be drawn and allowed to stand for some hours, when 
 its quality may be judged by the amount of cream formed, and the 
 general appearance of the fluid. Milk should always be the nutri- 
 ment for the child until the teeth are sufficiently formed to enable it 
 properly to masticate the food. Starchy articles may be added to 
 the milk, soft-boiled eggs, beef broths, etc., as may seem necessary 
 to bring the child up to the normal standard. 
 
 When the stomach is in an acid condition, lime-water, or a little 
 bicarbonate of soda, added to the milk, will correct this condition. 
 As a tonic and appetizer, some of the bitter infusions are excellent, 
 say Nos. 141, 142; or one grain of quinine, three times a day; 
 or the elixir of cinchona bark. Where the necessity for an altera- 
 tive is apparent, the syrup of the iodide of iron, ten drops, three 
 times a day, will give the best results. When the tenderness over 
 the bowels shows the presence of intestinal trouble, rubbing the 
 abdomen with ointment of iodine, or painting with the tincture, 
 will aid in changing this condition. Every day, the whole surface 
 should be sponged with tepid salt water ; the skin should be excited to 
 its full duty, by brisk frictions with a coarse towel, or a towel dipped 
 in salt water, and allowed to dry. Fresh air is of great importance, 
 and, when practicable, the child should be removed to the country, 
 or to the sea shore. 
 
 Scrofula, or Scrofulosis, is commonly known as the King's evil, 
 because it was believed, in ancient times, that the disease could be 
 cured by the touch of the king. 
 
 How Brought On. This disease, which is almost solely due to 
 hereditary tendency, may be excited to full action by want of 
 cleanliness, foul air, deficient or improper nutrition, cold and damp- 
 ness. 
 
 How Distinguished. Scrofulous children are generally of a 
 pale, flabby appearance, about the face and hands; with light, 
 coarse hair; dull in expression; heavy and stolid; thick lips; 
 teeth early decayed; large, clammy nose, with wide, open nostrils; 
 a tendency to enlargement of the glands, especially, of the neck. 
 The eyes are weak, easily inflamed, with frequent attacks of in- 
 flammation of the lids, and the formation of what are called " styes." 
 
272 Diseases of Children, 
 
 There is also a great liability to discharges from the nose, and to a 
 diarrhoea of a mucous form. Generally, however, constipation is 
 an accompaniment. Every sickness occurs in an aggravated form, 
 with slow recovery, often becoming chronic. Digestion is extremely 
 apt to be impaired by the slightest causes. Extremes of tempera- 
 ture are borne with difficulty. Slight injuries produce ulceration, 
 with slow or difficult healing. The bones are easily affected, and 
 soften or die from trifling causes. Frequently, enlargement of the 
 joints takes place, which is with great difficulty reduced. De- 
 formities occur, as bending or shortening of the bones, curvature 
 of the spine, flattening of the ribs, projection of the breast-bone. 
 In short, the whole system evinces a diseased condition, with but 
 little recuperative power. Hence, we have scrofulous ophthalmia; 
 tabes mesenterica, or marasmus; slow enlargement of the glands; 
 deafness caused by inflammation of the ear, and the destruction of 
 its bones; discharges from the vagina of a thin, unhealthy fluid; 
 diseases of the bones; white swelling or scrofulous inflammation 
 of the joints; hip disease; spine disease, etc. In all these affec- 
 tions, there is a marked similarity in the accompanying symptoms. 
 The child becomes listless, languid ; is disinclined to play, especially 
 at anything requiring much motion ; swelling is observed at the 
 point at which the disease is about to make its outbreak. The part 
 is weak, tender, especially to the touch ; soon, a dull, heavy pain 
 commences, an aching pain, increased by motion of the part, and 
 also at night, when the patient is in bed. If it is an aperture, as 
 the nose or ear, a discharge occurs, of a thin, dirty, yellowish fluid, 
 of a very unpleasant odor, generally due to decay and consequent 
 discharge of portions of the bony structure. In the joints, great 
 enlargement is seen, the ends of the bones forming knobs, and 
 consequent deformity, and difficulty of motion. In every instance 
 the neighboring glands are early affected, and are felt like hard 
 peas beneath the surface. "When the nose or throat is affected 
 there is more or less coughing, with expectoration of a foul mucus, 
 which causes nausea, loss of appetite, even vomiting. An exami- 
 nation shows the tonsils greatly enlarged, filling up the throat, 
 interfering with the aperture of the inner ear, and thus causing 
 more or less deafness. In these cases the child is observed to suf- 
 
Scrofula. 273 
 
 fer from deafness and difficulty of swallowing in every spell of 
 dump weather. 
 
 Scrofulous children are also extremely liable to be affected with 
 eruptions of all kinds, particularly during the progress of teething, 
 and if they are caused to dry up suddenly, the disease breaks out 
 elsewhere, in a nmre dangerous form. 
 
 When a discharge occurs from the vagina, in a child, it is very 
 apt to be regarded as the result of something else, as of an attempt 
 at rape; for this reason great care should be observed, lest a wrong 
 be done, and an innocent person suffer. The history of the child 
 should be carefully learned, its predisposition, its tendencies, if any, 
 to such discharges elsewhere. In this connection, it should not be 
 forgotten, as intimated on a previous page, that the presence of 
 seat worms in the rectum, or their transfer to the vagina, will often 
 cause discharges from the vagina. 
 
 "When a child begins to fail, without apparent cause, the abdo- 
 men should be carefully examined, and if found swelled, tender on 
 pressure, the limbs emaciated, the glands of the groin and those 
 of the abdomen enlarged, as may be ascertained by careful manipu- 
 lation, scrofulous disease of the mesenteric glands may be known 
 as the cause of the trouble. 
 
 In scrofulous disease of the spine, almost the earliest symptoms 
 are a tendency to stumble, a clumsiness, frequent falling, a tendency 
 to cross the limbs involuntarily, both in walking and lying down. 
 The power of walking is soon lost, especially if the diseased bones 
 be low down in the spinal column. When high up, as about the 
 ' neck, the child is observed to support its head on the hand, or on a 
 table or other convenient support, and the head begins to sink between 
 the shoulders. The bones project, and are tender on pressure, the 
 muscles of the spine are wasted, and speedily curvature is observed, 
 the affected bones being the point of departure from the true line. 
 This may produce pressure upon the cord and paralysis of the 
 corresponding parts, or it may result in what is known as anchylosis, 
 or stiffening of the joints at the seat of the disease, leaving the 
 patient more or less crippled. 
 
 How Treated. A patient of a scrofulous tendency requires con- 
 stant care. It must be placed under the best possible influences 
 
274 Diseases of Children. 
 
 as to pure, fresh air. cleanliness, sunlight, food, exercise, clothing. 
 A child properly protected by warm clothing, kept in the open 
 air as much as possible, and properly nourished, will often be 
 enabled to recover from such a tendency, and escape the results of 
 its constitutional taint. Fresh air and sunlight are of great im- 
 portance, and are sure to prove valuable factors in improving the 
 general health of a scrofulous patient. Nourishment, in proper 
 quantity and form, forms an additional and valuable aid. For 
 the young child, milk, and especially that of a good, healthy 
 nurse, is the first and best form of food. Later, to cow's milk may 
 be added vegetables of easy digestion, and animal food. Soft- 
 boiled eggs are generally acceptable to the stomach, and materially 
 aid in the nutrition. Much depends upon the cooking, as the best 
 food is not easily digested when either too much or too little cooked. 
 As indigestion is a frequent accompaniment, the food preparation 
 often increases the trouble. In addition to this, care should be 
 observed lest the food be taken in too large quantities, and this is 
 too often the case as convalescence occurs, and thus the progress to 
 health is retarded or prevented. 
 
 A point frequently lost sight of is the drinking-water. In the 
 vicinity of large cities, and particularly in their crowded streets, the 
 water used is often very impure, and frequently is itself a carrier of 
 disease. This is at the present time attracting the attention it deserves, 
 and it is hoped will soon lead to an improvement which has long 
 been needed, and which will greatly aid in the prevention of disease. 
 
 It cannot be too forcibly impressed upon the attention that those 
 who are weak and delicate require pure, fresh air as a necessity, 
 even more than the healthy. It has so long been the rule to confine 
 such persons to the house, as though the outer air were poisonous, 
 that it often requires the most earnest injunctions on the part of the 
 physician to obtain obedience to his orders. House ventilation is 
 avoided, from the mistaken idea of giving the child cold. It should 
 be thoroughly known that fresh air can do no harm, so long as it is 
 supplied without a draught. This may be accomplished in a variety 
 of ways, as by partially opening a window, and interposing a screen, 
 as a chair with a shawl thrown over it, to prevent the direct current 
 of air. Overcrowded apartments must be strictly interdicted, 
 
Scrofula. 275 
 
 whether by night or day, in the dwelling or the workroom. When 
 possible, the patient should be removed to a healthy locality, an 
 atmosphere of a dry and elevated situation, in the country or at the 
 sea-side. Exercise in the open air must be regular, and never 
 omitted except in the most inclement weather. This may be on 
 horseback, in an easy carriage, walking, etc. If so arranged as to 
 be combined with pleasant recreation, so as to aid in the develop- 
 ment of the muscles, greater benefit will be obtained. Fatigue 
 should not be allowed, hence the sports, etc., must be watched and 
 controlled, to prevent excesses. 
 
 Bathing is a valuable adjunct, keeping the skin in proper condi- 
 tion, and thus enabling it to throw off disease. If the patient is 
 easily chilled, warm bathing is preferable, and promotes the 
 circulation. Otherwise, the tepid bath may be employed. Sponging, 
 followed by friction with coarse towels, or towels dipped in salt- 
 water and allowed to dry, is very useful. When at the sea-shore, 
 bathing must be practiced, but its results must be watched, lest a 
 chill follow, and thus undo all the good accomplished. 
 
 Rarely is the cold bath of service. Almost always it is followed 
 by a want of reaction, causing more or less congestion of the more 
 delicate organs, and hence it proves positively hurtful. With 
 some, a cold bath daily, to an infant, is regarded as a means of 
 invigoration, a hardening process, which too often results in the 
 death of its victim. 
 
 It is pleasant to know that fashion is at last becoming more 
 reasonable, and permits her votaries to dress their children according 
 to the dictates of good sense and propriety. The child should be fully 
 protected against chilliness, especially in a climate liable to sudden 
 changes. In summer, the clothing should be light, avoiding either 
 extreme, as often a child is kept in a state of perspiration in warm 
 weather for want of a little attention. Flannel next the skin, pro- 
 tecting the chest and bowels, should be worn until the warm weather 
 has fully set in, and then should be substituted by some of the finer 
 textures until all danger of sudden changes are past, or these may 
 be continued during the balance of the year. 
 
 As to medicine, this must be a last resort, and at first should be 
 of the mildest nature. The bowels should be regulated by mild 
 
276 Diseases of Children, 
 
 aperients, or, when indicated by clay- colored passages, those which 
 arouse the liver may be employed, such as small doses of rhubarb, 
 magnesia, calomel, blue pill, senna, or jalap. 
 
 To improve the digestion, the blood, etc., some form of iron will 
 be of value, and here it will be important to find, by observation, 
 which preparation is most appropriate — the syrup of the iodide, ten 
 drops, three times a day, the tincture of the chloride, five drops, 
 three times a day, the potassio tartrate (p. 361), or the pure pow- 
 der of iron. Either of these may be combined with quinine, or 
 cinchona, as in its agreeable , form of elixir, which is most readily 
 taken by children. Symptoms must be met as they arise. If the 
 bowels are loose, the solution of the logwood tea (p. 348) will be 
 an excellent remedy, aided, when required, by paregoric, etc., and 
 fluid nutrition in proper amounts. 
 
 If the bowels are much affected, a special point will be the 
 avoidance of exercise and the upright position; rest, in bed, is of 
 the utmost value in the treatment of all forms of diarrhoea. But 
 frictions to the entire surface, once or twice each day, should not be 
 omitted. 
 
 The appetite may be restored by the use of mild bitter infusions, 
 as chamomile, columba, or cinchona. Animal fats are highly useful 
 in such cases. Hence the value of cod-liver oil ; and if to this we 
 add the syrup of iodide of iron, or some other of the preparations 
 now so happily prepared by the skill of the chemist, the results 
 will be still more beneficial. Such remedies require many months 
 to obtain their full and lasting effects. 
 
 In enlargements of the glands of the abdomen, added to the above 
 treatment should be the application of iodine to the surface ; this 
 may be by the use of the tincture, or of the ointment. 
 
 The same may be said of enlarged joints, with the addition of 
 perfect rest of the part. 
 
 Recently a variety of remedies have been introduced, as iodized 
 milk, made by dissolving one part of iodine in ten of alcohol, and 
 mixed with ninety of fresh cow's milk. 
 
 All enlargements of glands may be painted with the tincture of 
 iodine, or coated with the iodine ointment. In inflammation of 
 the bones, an ointment of carbonate of lead, freely applied over the 
 
Rickets. 2J7 
 
 seat of disease, often acts to arrest its progress. Burdock tea (p. 
 349) is an old and valuable domestic remedy in this complaint. 
 
 Rickets, technically known as Rachitis, is a want of nutrition 
 of the bones and muscles, causing bending or breaking of the bones 
 from slight injuries; muscular weakness ; crooked limbs; curvature 
 of the spine ; nervous irritability ; general tenderness, etc. 
 
 How Brought On. Perhaps the usual cause of this disease is 
 want of food, or food of improper kind. It would also appear to 
 be the result of bad ventilation, and want of sunlight. A distin- 
 guished observer declares "that wherever the rachitic child is 
 dependent upon the mother's milk, the mother will be found to 
 have menstruated during lactation, regularly, for several months, 
 and the degree of rachitis to be in direct ratio to the frequency, 
 duration, and amount of the menstrual flow." In short, the dis- 
 ease is the result of anything which impairs nutrition. 
 
 How Distinguished. Children with a tendency to rickets 
 exhibit in their whole bony structure unmistakable evidences of 
 the disease. The face is broad and square ; the head is large and 
 flat; the moulds or openings in the skull do not close until late; 
 the veins are prominent ; the spine is curved ; the limbs, especially 
 the lower extremities, are bowed, shortening the child so as to give 
 it a squat appearance ; the muscles are feeble ; the child is generally 
 deficient in vigor, mental as well as physical ; the skin is thick, and 
 of a dirty appearance; the teeth are late in appearing, and the 
 child rarely can walk, or even stand, until long after the usual time. 
 The child is spiritless, dull, languid ; the appetite is poor ; the flesh 
 is flabby ; the passages from the bowels are loose, dirty-looking, and 
 offensive; perspiration occurs at night, and often this is excessive; 
 the child gains no power over its muscles, and requires help in all 
 its movements, though at first the muscles do not seem wasted, and 
 preserve their contour. As the disease advances, the mental and 
 physical powers retrograde, and a glance at the child, with its defi- 
 cient mental powers, its crooked limbs, unsightly joints, and the 
 shape of its chest, shows the whole trouble. 
 
 The glands often become enlarged, as in its congener, scrofula, 
 but are softer, much larger, and not so easily moved as in scrofu- 
 lous cases. The disease may last from one to three years, and 
 24 
 
278 Diseases of Children. 
 
 under proper treatment, and surrounding circumstances favoring, 
 may be completely cured; though, when brought under treatment 
 at a late period, deformity, to a certain extent, is liable to remain, 
 particularly curvature of the spine, etc. Death occurs from 
 exhaustion, the powers of vitality being unable to carry the system 
 to a favorable termination ; or death may ensue from some compli- 
 cation, as hydrocephalus, diarrhoea, convulsions, incurable changes 
 in the larger glands, as the liver, spleen, etc. 
 
 How Treated. With a full knowledge of the causes inducing 
 this affection, and of the nature of its changes, it is easily under- 
 stood what would be the special line of treatment. In the early 
 stages, when the patient is so fortunate as to come under the proper 
 observation, much may be done to prevent its full development, and 
 ward off the possible complications. The nourishment must be 
 positive, and easy of digestion. The greatest care must be observed, 
 to see that food is given at proper intervals, and in sufficient quan- 
 tity, as well as of a proper kind. Too much stress cannot be laid 
 upon the value of pure cow's milk for children, after weaning, or 
 in the event of a failure of the breast-milk. Of course, the 
 mother's milk, or that of a healthy young person, is to be preferred 
 in all cases where it is possible to be obtained. 
 
 Combined with milk, other articles are valuable, as eggs, in the 
 form of custard, or soft-boiled, rice, farina, corn starch, roasted 
 potatoes, meats, etc. The same observations apply here as in re- 
 gard to scrofula, as the great point is to remedy the difficulty by 
 properly nourishing the bones, etc. 
 
 All exhausting discharges, as diarrhoea, etc. ; all complications, as 
 indigestion, constipation, etc., must be met as they arise, with the 
 appropriate remedies heretofore indicated. The constitution must 
 be toned up, strengthened, by tepid baths, sea-bathing, fresh air, 
 always that of the country or seashore, if obtainable; tonics, as 
 the preparations of iron, particularly those mentioned under that 
 head, in Part IV ; cod-liver oil ; bone itself, as fine filings of fresh 
 bones, in milk or rice-milk. Blackberry root tea (p. 349), or mag- 
 nesia and rhubarb (p. 348), or chalk mixture, will generally relieve 
 the diarrhoea; and if the stools are very offensive, castor oil may 
 be given to cleanse the bowels, and then the vegetable astringents 
 
Fits, or Convulsions. 279 
 
 mentioned (p. 348). A valuable aid in changing the character of 
 the evacuations, is the addition of a few drops of the solution of 
 chlorinated soda to each dose of the diarrhoea mixture. Quinine, 
 in combination with iron, as the potassio-tartrate of iron, in cin- 
 chona tea (pp. 361, 349), or the tincture of the chloride of iron, 
 acts well as a tonic. In many instances, the dilute acids combined 
 with a bitter, act well in toning up the muscular system. Thus, 
 the dilute nitro-muriatic acid, two to five drops, in gentian, columba, 
 cascarilla, or cinchona tea, checks the excessive perspiration, 
 strengthens the digestion, and, in fact, improves the whole system. 
 
 Occasionally, when the treatment is commenced at a late period, 
 rest will become necessary, to prevent curvature of the limbs 
 becoming greater, or great deformity of the spine, resulting from 
 the softened condition of the small bo»es comprising the spinal 
 column. This rest must be in a recumbent position, but must be 
 combined with daily excursions into the open air. Or some form 
 of apparatus may be employed to support the part until the bones 
 have acquired sufficient hardness. Thus, when the seat of the 
 affection is at the bones of the neck, the weight of the head may 
 be taken from the bones by means of an appropriate sling, suspend- 
 ing the head from a bowed piece connected with an apparatus 
 placed around the chest. Each deformity, or tendency thereto, will 
 require its own apparatus, varied to meet the indications. 
 
 How Prevented. A child manifesting a tendency to rickets 
 should be kept from an erect position, or the early use of its feet, 
 until the bones have assumed a proper degree of hardness. Vio- 
 lent exercise, in older children, should be interdicted. Cleanliness, 
 ventilation, full nutrition, are the prerequisites for the prevention 
 of this affection, as well as the aids in its cure when it is estab- 
 lished. Sunlight deprivation is too often a main exciting cause of 
 this, as well as other diseases of children. Hence, our legislators 
 would show their wisdom by prohibiting the building of houses, as 
 dwellings, in the rear of tall factories, as well as upon streets of 
 such narrowness as to preclude the entrance of the sun's rays, if at 
 all, but for a short period of each clear day. 
 
 Fits, OP Convulsions, Spasms, as they are often called, are 
 always symptoms of some other affections. 
 
280 Diseases of Children. 
 
 How Brought On. Fits are very frequently the result of a 
 loaded stomach, or a stomach containing articles either of difficult 
 digestion, or wholly inappropriate for the action of the stomach's 
 powers. Thus, hard-boiled eggs, heavy fruit-cake, minced pies, 
 sour milk, nuts of all kinds, raisins, seeds and rind of fruits, sweet- 
 meats, food in lumps or imperfectly chewed ; in short, anything 
 which, by its imperfect solubility, taxes the powers of the stomach, 
 is apt to create so much irritation, by its presence, as to cause a 
 reflex excitement of the brain, and the production of convulsions. 
 
 Again, in the beginning of some diseases, as measles, scarlet 
 fever, small-pox, the first blow of the poison of the disease may be 
 so overwhelming as to cause a convulsion. 
 
 Again, the progress of teething may be so difficult, and accom- 
 panied by so much nervous excitement, that convulsions result. 
 Worms in the bowels are often regarded as the cause of convulsions, 
 but these parasites are more frequently developed by the causes of 
 decline in health which are themselves the exciters of the convul- 
 sive tendency. Impure air, air loaded with gas from a broken 
 stove, or filled with emanations from a foul well, may be the excit- 
 ing cause of disease, which is first manifested by a convulsion. 
 Cold and dampness, by driving the blood from the surface and the 
 extremities, and thus causing congestion of the spine and brain, 
 may cause spasms. Fright, great mental emotion, suckling during 
 a fit of passion, or other emotion, of the mother, may cause an 
 attack of convulsions. 
 
 In some children there is observed a tendency to be attacked 
 with convulsions from the slightest causes. In such cases, every 
 form of disease is attended with fits. Some seem to inherit this 
 tendency from an epileptic parent. Such cases, sooner or later, suc- 
 cumb to brain trouble, or grow up deficient in mental capacity. 
 
 How Distinguished. An advantage is gained in the treatment 
 when it is possible to learn the cause of the convulsion, by the 
 removal of which the attack may be relieved, or its recurrence 
 prevented. The history and surroundings of each case will lead to 
 a full understanding. Thus, convulsions occurring at holiday times, 
 or on festive occasions, or soon after eating, will generally tell their 
 own story. Here, the face is flushed, the head throbs, and there is 
 
Fits, or Convulsions. 281 
 
 every indication of a loaded stomach. The child has been eating 
 freely of a mixture of indigestible food, has been complaining of 
 sick stomach, has shown signs of irritability and peevishness, per- 
 haps has been sleeping in a disturbed way, when suddenly the con- 
 vulsion occurred. 
 
 When due to teething, the state of the gums readily aid in ascer- 
 taining the cause, these being puffy, swollen, red, tender to the touch. 
 
 A convulsion occurring without any, or scarcely any, premonitory 
 symptoms, would lead to the anticipation of an attack of some 
 disease, as measles, scarlet fever, small-pox, especially when such 
 diseases are prevalent and are occurring in the vicinity. 
 
 How Treated. The treatment must be directed, during a con- 
 vulsion, to the shortening of it, and care in preventing injury to 
 the head or limbs by the struggles. All tight clothing should be 
 loosened, or better, entirely removed. The child should then be 
 placed in a warm bath, to which mustard may be added ; during this 
 time cold should be applied to the head, either by cloths saturated, 
 or by the douche, or by the use of a bladder filled with crushed ice. 
 Should this fail to relieve the spasm, the child should be placed 
 upon a couch, and a mustard plaster placed the whole length of the 
 spine, extending on either side for an inch or two. A decided 
 impression must be made before this is removed. If there is reason 
 to believe that foreign matters in the stomach are acting to prolong 
 the attack, a brisk emetic, ipecacuanha, tartar emetic, sulphate of 
 zinc, should be given, and its effect encouraged by the use of 
 draughts of hot water with salt or mustard. Injections should be 
 •thrown into the bowel, of salt and hot water, castor oil, oil of tur- 
 pentine, to stimulate the action of the bowel, and act as a revulsive 
 to draw the blood from the brain. In obstinate cases, convulsions 
 may be broken up by inhalation of ether or chloroform. In rare 
 cases, with a strong tendency to a return of the convulsions, the 
 effect of these drugs may be continued until all such symptoms 
 disappear. Of course, it would scarcely be necessary to make the 
 artificial sleep very complete, only sufficient to control the convul- 
 sion. Chloral, by injection into the bowel, certainly has proved 
 of value in these cases ; a teaspoonful in a pint of water, of which 
 a gill may be thrown up in a child of ten. 
 24* 
 
282 Diseases of Children. 
 
 In the interval, or after the spasm has gone off, the indication 
 will be to prevent its return and relieve any accompanying symptoms, 
 or treat whatever disease may be thus ushered in. The bowels 
 should be freely moved ; the stomach thoroughly emptied, the teeth 
 lanced, if necessary ; restlessness subdued by narcotics, as, above all, 
 chloral. Worms may be expelled by the appropriate medication ; 
 fever lessened by sponging with tepid water, and cold applications 
 to- the head ; the force of the circulation diminished by small drafts 
 of digitalis tea, a teaspoonful of the leaves to a quart of water. If 
 there are marked evidences of a fullness of blood in the brain, 
 leeches behind the ears, to the nape of the neck, or temples, will 
 rarely fail to give great relief. In obstinate cases, a blister to the 
 back of the neck, extending up and down, and allowed to draw well, 
 will prove of great benefit. 
 
 Other complications should be met as they occur, and treated in 
 accordance with the principles laid down. 
 
 Night Terrors, and excessive nervousness, are of frequent 
 occurrence in childhood. Frights to children often terminate in 
 convulsions, imbecility, or death. Those who have the care of 
 children should be especially on their guard to use every endeavor 
 to prevent frights, and to protect against the foolish habit of 
 working on the fears of a child to make it behave properly. Not 
 only is this very injurious, but it is liable to make children deceivers 
 and liars, and its evil results often cling to them* when grown to 
 adult age. On the contrary, children should be kindly encouraged, 
 and made to feel the protecting care of those around them. They 
 should be constantly shown the absence of all danger. 
 
 A child will often suddenly awake in the night, with a frightened 
 cry, and evidently impressed with a vague fear of something, and 
 fail to recognize the presence of its protectors. This may last for 
 several minutes, terminating in a fit of weeping, or it may again 
 quietly fall asleep. Such attacks may occur nightly, or at irregular 
 intervals. Rarely is it observed to return the same night. These 
 are almost invariably the result of some irritation of the stomach or 
 bowels, and are generally associated with constipation. 
 
 There is no reason to regard these symptoms as indicative of 
 
Night Terrors. 283 
 
 brain disease, though a continuance might eventually lead to serious 
 results. 
 
 How Treated. On the occurrence of such an attack, the child 
 should be at once attended to, and in no case is it justifiable to seek 
 to quiet it by harsh words or treatment. Its position should always 
 be changed by turning it from the back, which is mostly its 
 position during such an attack, to the side, or better, by raising it 
 in the arms, and thus endeavoring to soothe and comfort it. Or it 
 may be roused by washing its face with cold water, and a sup of 
 cold water will generally be desired and prove refreshing. The 
 child should not be allowed to nurse, which is the usual panacea of 
 all infantile troubles, until it is thoroughly roused and quieted. 
 
 To prevent a recurrence of these attacks, the bowels should be 
 carefully regulated. All excitement, particularly near the hour of 
 sleep, should be carefully avoided. Exercise of a violent nature is 
 never otherwise than hurtful, particularly, as is too often the case, 
 about the bed-hour. A light in the room, and better still, the 
 presence of an attendant, at least for some time after it retires, will 
 greatly conduce to the prevention of these alarms. Care should 
 always be had not to rudely waken a child from its rest, but in 
 every way to promote sleep. This great restorer is needed by the 
 child, who plays and labors with all its powers during its waking 
 moments, and hence requires plenty of quiet sleep. 
 
 Perhaps the bromide of potassium may prove of value should an 
 attack continue obstinate. Opiates, or the so-called soothing syrups, 
 should be avoided, as sure to prove hurtful. The dose of the 
 bromide of potassium for this purpose should be five or ten grains. 
 Eating a raw onion just before bed-time will, with many persons, 
 induce refreshing sleep. A glass of hot water (not warm, but hot), 
 flavored with lemon or orange peel, has the same effect. Hop tea 
 is another pleasant and efficient remedy for sleeplessness. Any of 
 these may be tried, and where one fails another will be a success. 
 
CHAPTER VIII. 
 
 Ailments Affecting Parts of the Body. 
 
 Snuffles— Stomatitis— Thrush— Sore Throat— Croup— Diphtheria— Whoop- 
 ing Cough— Coughs and Colds in Children — Infantile Pneumonia— Colic 
 —Summer Complaint— Falling of Bowel — Bed- Wetting —Weaning 
 Brash — Milk Crust. 
 
 Snuffles, Catarrh of the Nose, Chronic and Acute Ozaena. 
 
 How Brought On. This affection is of quite frequent occur- 
 rence in children, infants particularly, and is the result of careless 
 exposure to draughts; dampness; imperfect drying after washing; 
 want of care as to the clothing, as the exposure of the arms to the 
 shoulder, by the foolish fashion of short sleeves, or the equally 
 senseless and careless action of standing at a door with the little 
 one's head uncovered. 
 
 How Distinguished. The attack commences by a constant sneez- 
 ing ; soon a little fever comes on, with watery eyes, and a thin dis- 
 charge from the nose. The nostrils are more or less obstructed, and 
 hence the peculiar noise in breathing which originates the name. 
 Generally, when sleeping, the child lies with the mouth open, in 
 order to breathe. In severe cases, the nostrils are so much ob- 
 structed as to interfere with the operation of sucking, and the child 
 grasps the nipple, draws, and lets go in order to breathe. Hunger 
 incites it to seize the nipple again, and again it is compelled to de- 
 sist, and gives vent to its irritation in angry screams. Indeed, this 
 may be carried so far as to cause debility and exhaustion. 
 
 Ozsena occurs in children of scrofulous or syphilitic taint, and is 
 characterized by all the above symptoms, with the addition of a 
 highly offensive and dirty discharge from the nostrils. 
 
 How Treated. In mild cases, care as to clothing, and a proper 
 
 284 
 
Stomatitis. 285 
 
 degree of heat, will generally be followed by a complete cure in a 
 few days. 
 
 In severe cases, debility must be prevented by spoon-feeding, the 
 use of tonics, as quinine, iron, and even stimulants. The nostrils 
 may be much relieved by the application, with a brush, of soothing 
 articles, as cold cream, lard, glycerine; and if false membranes 
 form, injections of alum, ten grains to the ounce of water; or 
 nitrate of silver, two grains to the ounce, will aid in destroying 
 them. 
 
 Where a scrofulous taint exists, the appropriate treatment must 
 be used, as the syrup of the iodide of iron, the mercurials, in very 
 small doses, etc. 
 
 Stomatitis, Nursing Sore mouth, or Inflammation of the Mucous 
 or Lining Membrane of the Mouth, is of quite frequent occurrence 
 in childhood. The mild form is most frequent, but occasionally 
 ulceration takes place, and rapidly runs into gangrene. This affec- 
 tion is generally the result of a weak condition, as in delicate or 
 scrofulous children. 
 
 How Distinguished. Generally, the trouble is first observed by 
 the child having a difficulty in sucking ; the saliva flows freely ; as 
 the nurses say, the child is " constantly slobbering;" the glands 
 under the jaw are apt to be tender and swollen. There is more or 
 less fever and restlessness ; the appetite is poor ; and there is pain 
 on swallowing. Diarrhoea often accompanies this affection. An 
 inspection of the mouth shows the presence of many small, white 
 spots on the tongue, the whole of the mouth, and even the throat. 
 Ulcerations soon occur at these points, and they are coated with a 
 dirty, yellow covering. * The points may remain separate, or they 
 may run together, in which case it becomes a serious matter. In 
 the severe cases, the gums are so ulcerated as to fall away from the 
 teeth, and expose them ; the mouth is hot, the breath highly offen- 
 sive; the lips swollen. Should it continue, the parts assume a 
 dark, livid color, the teeth fall out, the inside of the cheeks ulcer- 
 ate through, exposing the cavity of the mouth, and the child gene- 
 rally dies from exhaustion. 
 
 Ho J " Treated. In mild cases, by securing cleanliness, ventilation, 
 pure,' lon h air in abundance, and proper food, no other treatment is 
 
286 Diseases of Children. 
 
 required. Many believe that the diarrhoea is due to the same condi- 
 tion occurring in the whole of the intestinal tract. No medicinal 
 treatment is so directly useful as the chlorate of potassa. This is given 
 in doses of two or three grains in sweetened gum water every four or 
 five hours, say for a child of one year, and may be mixed with 
 sugar and water. The mouth should be carefully kept clean by the 
 use of washes of slippery elm infusion, or flaxseed; acidity should 
 be corrected by lime water, soda, or magnesia. Sometimes, it is 
 requisite to employ locally an astringent solution, as the acetate of 
 lead, two to four grains to the ounce of water, and this is best 
 applied by means of a brush. Occasionally, the nitrate of silver, 
 two or three grains to the ounce, or the sulphate of copper in the 
 same strength, are required, to stimulate the ulcers to heal. Should 
 similar ones appear at the verge of the bowel, as sometimes is seen, 
 the same remedies will prove beneficial. The diet must be carefully 
 attended to, and the nurse changed, if requisite. Quinine and iron 
 should be given if great debility exists, the best forms of which 
 have already been mentioned, and the breast milk supplemented by 
 broths, milk, and lime water, wine whey, etc. 
 
 When gangrene occurs, it is called " canker," or cancer of the 
 mouth; this is generally only seen in children of a broken down 
 constitution and of depressed vitality. It often follows low forms of 
 fever, scarlet fever, measles, small pox, and is invariably attributed 
 to the use of mercury by the physicians. 
 
 But little hope can be indulged as to a favorable result. The 
 ulcerative process must be checked by the application of a powerful 
 caustic; the best is the pure hydrochloric acid, carefully touched to 
 the surface of the slough or canker by means of a brush, and again 
 applied after an interval of twelve or fifteen hours, unless the progress 
 is checked. The offensive condition of the mouth may be remedied 
 by frequent washings with a proper strength of the solution of the 
 chlorinated soda, one part to twelve of water, or a solution of the 
 hydrochloric acid, two or three drachms to half a pint of water. 
 Of course, the chlorate of potassa must be freely administered, with 
 quinine or cinchona in some form, and full nutrition and stimula- 
 tion, as needed. 
 
 Thrush, or " aphthae," is also the result of impaired nutrition 
 
Sore Throat. 287 
 
 and want of vitality, and is most commonly met with in children 
 which are hand-fed or suckled by an unhealthy nurse. 
 
 How Distinguished. The child is fretful, attempts to feed, but 
 leaves off as if in pain. The bowels are generally disordered. The 
 mouth is covered with minute white spots, like specks of curdled 
 milk. The whole lining of the mouth is dry, hot, and red. There 
 are fever, depression, and in rare instances, swelling of the glands 
 and offensive discharges from the bowels, followed by death. 
 
 How Treated. The first point will be the improvement of the 
 food, which alone will, in many instances, suffice to cause a cure, if 
 continued, with careful attention to the hygiene. The mouth may 
 be carefully sponged with pure, cold water, after each taking of 
 food, followed by the use of a solution of borax, twenty to thirty 
 grains to the ounce of water. Some prefer the sulphite of soda, 
 sixty grains to the ounce of water, and claim for it the very best 
 results. Others use gargles and mouth washes of chlorate of po- 
 tassa, alum, acetate of lead, and in severe cases, the nitrate of 
 silver (see pp. 362, 363). Rhubarb and magnesia will act altera- 
 tively, and when there is weakness, tonics, as quinine, and some of 
 the mineral acids, are valuable. 
 
 Sore- Throat, or Swelled Tonsils, generally occurs in children 
 of relaxed and scrofulous tendency, and is the result of exposure 
 to cold and dampness, or may become chronic. 
 
 How Distinguished. The child swallows as if the act were pain- 
 ful, and if old enough, complains of having a sore throat. The 
 throat, on examination, is red, and one or both of the tonsils are 
 swollen, so as to materially encroach upon the passage. There is 
 more or less fever. If not relieved, the symptoms are aggravated, 
 the pain is intense and throbbing, the throat seems about to close 
 up, when the abscess which has formed either, breaks, or is opened 
 by the physician. When it assumes a chronic form, the child is 
 more or less deaf, from the obstruction of the inner ear by the 
 enlarged tonsil ; the child has a certain peculiar tone of voice, and 
 the tonsils are seen to be greatly swollen. This state is increased 
 on the occasion of damp weather. 
 
 How Treated. A cooling aperient should be given, to promote 
 the action of the bowels, and aid in reducing the fever. Sooth- 
 
288 Diseases of Children, 
 
 ing drinks, as flaxseed or slippery elm tea, may be used with wine 
 of ipecac, say twenty to thirty drops, every four or five hours, ac- 
 cording to the urgency of the symptoms. Gargling with chlorate 
 of potassa, and tincture of the chloride of iron (teaspoonful to a 
 pint of water), will generally be found of service (see p. 347 for 
 gargles). When the pain and swelling are great, leeches may be 
 applied to the throat, or poultices of Indian meal mush, flaxseed, 
 etc., may be employed. Some prefer the free use, to the outside 
 of the throat, of hartshorn liniment, tincture of iodine, or even a 
 blister. But if, from the throbbing, swelling, and pain, there can 
 be no doubt of the formation of an abscess, poultices, as given, • 
 page 358, should be freely employed, until the abscess breaks, or is 
 opened. In performing this operation, care is required to avoid 
 severe, even fatal bleeding, which might occur if a large vessel 
 were cut. 
 
 When swelling of the tonsils becomes chronic, gargles of an 
 astringent character may be used, as alum, teaspoonful to half a 
 pint, tincture of iron, the same quantity, etc., or touching them 
 each day with the nitrate of silver will cause them to contract. 
 This failing, the excess must be removed by the use of a cutting 
 instrument. 
 
 Croup. This scourge of childhood is divided into two varieties, 
 true croup, or pseudo-membranous, and false, or spasm of the larynx. 
 True or membranous croup *s regarded by some as identical with 
 diphtheria, inasmuch as both are characterized by the formation of 
 a false membrane in the throat. A discussion of this point would 
 be foreign to the purpose of the present work, though it may be 
 mentioned that in croup the membrane is formed on the surface, 
 while that in diphtheria dips down, as it were, and forms beneath 
 the surface of the mucous lining of the throat. 
 
 How Distinguished. In membranous or true croup, the child is 
 attacked during the night, often without any previous symptoms, or, 
 perhaps, a slight hoarseness and cough before retiring, by a sharp, 
 shrill cough, which sounds exactly like the bark of a small dog. 
 There is a sense of suffocation, hurried breathing; every movement' 
 shows the earnest desire for breath, and the fear of strangling. 
 Generally, the cough is in distinctive paroxysms, and relief occurs 
 
Croup. 289 
 
 toward morning, or is the result of the remedies employed. 
 Should, however, the disease continue, the inflammation goes on, 
 the fever is greater, the voice is hoarse, the sense of suffocation be- 
 comes intense, the cough is constant, the child grasps at its throat 
 as though to tear something away, the breathing is panting, and 
 the tongue is thickly furred. The attacks occur at night, with an 
 abatement of the symptoms in the morning ; there is no expectora- 
 tion ; talking increases the pain, and the thirst is constant. This 
 goes on, with shortening of the intervals ; the cough becomes fee- 
 ble; the voice is lost; drowsiness comes on, and the child sleeps 
 and starts in terror, grasping wildly at those around, as if for relief. 
 In fifteen or twenty hours, unless relief is obtained, coma or stupor 
 comes on, and the child dies exhausted. 
 
 How Treated. No ailment requires such prompt, unremitting 
 attention as this. Early medication, even where the disease is only 
 apprehended, will often prevent further progress, and ward off dan- 
 gerous results. A catarrh, with a suspicious ringing, barking 
 cough, should be carefully watched. A warm bath for a quarter 
 of an hour will relieve the spasmodic inflammatory tendency ; then 
 the little patient should be kept in a room, preferably in bed, with 
 an atmosphere kept moist by the vapor of boiling water, and the 
 full emetic effect produced by the administration of powdered 
 alum. A teaspoonful may be mixed with double as much honey, 
 and given at once (p. 345). Some regard this article as having a 
 specific effect in relieving croup. Others prefer ipecac, as the 
 syrup or wine, or mustard water. The warm bath may be repeated, 
 if necessary, in a few hours, and the fever and inflammatory symp- 
 toms kept down by salines, with ipecacuanha, or tartar emetic. 
 Should these fail, and inflammation fully set in, the most active 
 exertions will be required. Wine of ipecacuanha may be given, 
 say one to two drachms, according to age, every ten or fifteen min- 
 utes, until free vomiting results, and then its effects kept up until 
 complete relief is obtained. Then it may be followed by the solu- 
 tion of acetate of potassa, with ipecacuanha. Alum is preferable, 
 as less exhausting; and if debility is coming on, senega tea (p. 
 349), containing in each dose five grains of carbonate of ammonia, 
 may be employed. When the advance still continues, the throat 
 25 
 
290 Diseases of Children. 
 
 must be painted with tincture of iodine, being careful not to allow 
 it to cause a blister, while the powers are sustained with beef tea, 
 milk punch, wine whey, etc. 
 
 A variety of other remedies have been found of use, as muriate 
 of ammonia, three or four grains, and the gargle of lime-water given (p. 
 347). Other local remedies are the tincture of chloride of iron, 
 with glycerine; or carbolic acid and glycerine. 
 
 Very excellent results have often been secured by causing the 
 child to inhale the vapor of slaking lime, on the principle that it 
 acts to soften and loosen the membrane. This may be employed, 
 with care, at any period of the disease. Water should be poured on 
 a piece of quick-lime the size of an orange, and the child held so as 
 to breathe freely the vapors arising from it. 
 
 Tracheotomy, or opening the windpipe to permit the entrance of 
 air, rarely succeeds, perhaps because it is rarely performed until too 
 late to be of service. It is, moreover, an operation none but a 
 skilled surgeon can perform, so we need not discuss it. 
 
 Spasmodic Croup, Spurious or False Croup, never has any false 
 membrane or inflammation to occur. It is very mild, comparatively 
 speaking, and yet resembles true croup in many particulars. 
 
 Sow Distinguished, The attack commences with a slight cold, 
 followed at night by difficulty of breathing, slight fever, and the 
 singular barking cough. All the symptoms of inflammation are 
 absent, though there may be increased heat, great hoarseness, thirst, 
 and a peculiar crowing respiration. Occasionally, these symptoms 
 result in convulsions, or congestion of the brain. Or there may be 
 along with it spasms of the extremities, clenching of the hands, etc. 
 
 How Treated. The emetic effects of powdered alum, given as 
 recommended for true croup, are of especial value. Turpentine 
 liniment or stupes may be applied to the throat (see page 346), or 
 poultices of various kinds. Ipecacuanha, teaspoonful doses of the 
 syrup, until vomiting is produced, is of great avail. The strength 
 must be carefully kept up by nourishing food, and stimulants, if 
 necessary, and after the subsidence of the attack iron and quinine 
 will be useful. 
 
 Diphtheria. The treatment of this disease, and, in fact, every- 
 thing relative to it, have been very carefully given on a previous 
 
Whooping Cough. 291 
 
 page. When the disease occurs in children, the symptoms are 
 identical, though not so easily recognized. Many regard it as the same 
 with membranous croup, though there is yet room to believe that 
 diphtheria is the result of a special poison, with a tendency to the 
 throat. 
 
 How Distinguished. Diphtheria is ushered in by symptoms of sore 
 throat, high fever, marked debility, soon followed by acute soreness 
 of the whole of the throat, which is of a deep red or livid color, and 
 covered with a coating like dirty chamois leather. This may extend 
 all over the inside of the mouth, down the throat, into the nostrils, 
 etc. When it extends into the larynx there is a cough like croup, 
 harsh breathing, like a hissing or whistling. In very many cases, 
 death results from exhaustion, or stupor, the effects of the poison 
 upon the system. 
 
 How Treated. If seen early, the free use of the chlorate of 
 potassa gargle (p. 347), generally relieves the attack and prevents 
 the extension of the disease. Combined with this, the tincture of 
 the chloride of iron is of great benefit. Quinine, good nourishment, 
 stimulation, all must be employed to aid in the treatment. 
 
 Gargles or swabbings with solutions of tincture of iron, carbolic 
 acid, permanganate of potassa, and of lime-water (p. 347), may be 
 used from time to time, though care- should be taken lest, by rough- 
 ness to the diseased parts, injury be done and bad results follow. 
 
 Whooping Cough, or "Pertussis," is rarely seen except in 
 children. It is caused wholly by contagion, and generally occurs 
 but once. 
 
 How Distinguished. The premonitory symptoms are those of 
 bronchitis, which is followed by a cough returning in spasms. In 
 the intervals, the child exhibits but little appearance of anything 
 untoward, when suddenly a paroxysm occurs, which lasts even for 
 several minutes. The whoop is so peculiar that it is quite easy of 
 recognition. The cough commences and continues as a series of 
 short, violent efforts to relieve the throat, and at times results in 
 bleeding at the nose, eyes and mouth. The face becomes suffused, 
 the eyes are injected, the head aches, and the child ceases, and 
 falls back exhausted. All cases do not have the peculiar whoop. 
 The matter brought up is thick, ropy ; sometimes mixed with blood 
 
292 Diseases of Children. 
 
 and pus. Or the efforts may bring on vomiting, when the food 
 recently taken will be mingled with the expectoration. 
 
 The duration is about six or eight weeks, rarely less, often much 
 longer, even for months. 
 
 It may be complicated with congestion of the brain, of the lungs, 
 deafness, pneumonia, and convulsions. 
 
 How Treated. Care and avoidance of exposure to cold and 
 dampness are required, even in the mildest cases, to avoid the 
 setting in of other allied diseases. But it is not advantageous to 
 keep the patient constantly in the house. The next point is to 
 moderate, if possible, the force and frequency of the paroxysms. 
 If the cough is tight, expectoration may be aided by squills, ipe- 
 cacuanha, or other similar remedies. (See Nos. 144, 145, 155, 
 pp. 349, 350.) Fever, when present, is relieved by the solution of 
 acetate of ammonia. For the moderation of the spasms, an almost 
 endless variety of remedies have been tried. Of these the best 
 are the bromide of ammonium, coffee, tea of chestnut leaves, or of 
 clover, hay tea, cinchona tea, and chloral. 
 
 Almost any one of these articles will modify the attack, often, 
 will shorten it. Quinine in small doses, or chloral in the same 
 way, have been highly lauded. Inhalations, as of the common 
 illuminating gas well diluted, steam from boiling water, or the same 
 containing tar, cubebs, and carbolic acid, have been found of service 
 (see page 351). Perhaps the best plan to relieve the force of a 
 paroxysm, when prolonged, is the inhalation of chloroform, one or 
 two drops at a time. The general health should be regarded, and 
 tonics, especially iron, cinchona tea, or quinine, should be em- 
 ployed when required. 
 
 Strangulation has been known to occur by a sudden commence- 
 ment of a paroxysm during eating. Therefore, children thus 
 suffering should be watched at their meals, and be required to have 
 their food cut fine previous to placing it in the mouth. 
 
 As an efficient formula in this disease, we give the following: — 
 
 WHOOPING COUGH MIXTURE. 
 
 Take Bromide of Potash, two drachms 
 
 Tincture of Belladonna, two drachms 
 
 Syrup of Wild Cherry Bark, three ounces. 
 
 Mix, and give a teaspoonful every two or four hours, as required. 
 
Bronchitis. 293 
 
 Coughs and Colds, in children, are constantly occurring as the 
 result of exposure to cold and dampness, and the neglect to which 
 so many are subjected. 
 
 These should never be neglected, but at the outset should be 
 subjected to appropriate treatment. Early care might thus prevent 
 a dangerous catarrh, pneumonia, croup, etc. Proper clothing, 
 protecting the arms to the wrist, and the feet and legs, and parti- 
 cularly the chest, will act as a preventive of many of these affections, 
 which, while not fatal in childhood, may lay the foundation of 
 serious diseases in after-life. A mild expectorant, with proper 
 tonic treatment, will often speedily relieve these incipient symptoms. 
 
 Bronchitis is known by its commencing as a common catarrh, 
 which rapidly becomes aggravated, with light fever, hurried respi- 
 ration, quick pulse, light dry cough, hoarseness. As it increases, 
 the breathing is labored and wheezing, the cough is painful, with 
 more or less rattling in the chest, the appearance is languid, and 
 debility rapidly ensues. Choking up of the smaller tubes with the 
 free mucous discharge may occur, and lead to a collapse of that part 
 of the lungs. Or the smaller tubes may be attacked by the bron- 
 chitis ; the inflammation is then very high, and pus is soon formed, 
 and death is almost sure to follow. 
 
 Row Treated. Slight cases will only need care, a warm atmos- 
 phere, good, nourishing diet, and soothing drinks. If necessary, a 
 saline mixture may be given, to act on the bowels, as No. 101, p. 
 341. When the case is severe, with high fever, some emetic, as 
 mustard or syrup of ipecacuanha, will be needed, warm baths, and 
 the promotion of free perspiration by warm drinks. The carbon- 
 ate of ammonia, in three-grain doses, will prove of value, combined 
 with senega, to promote free secretion. The following prescription 
 is a useful one: — 
 
 COUGH MIXTURE. 
 
 Take Carbonate of Ammonia, one drachm 
 
 Syrup of Senega, half an ounce 
 
 Paregoric, half an ounce 
 
 Balsam of Tolu, one ounce. 
 
 Half a teaspoonful, three or four times a day, to a child ten years old. 
 
 A good treatment for an ordinary "hard cold" in children is, 
 25* 
 
294 Diseases of Children. 
 
 as soon as it commences, to give the child a warm "hip-bath," in 
 Fig. 101. salt water, or mustard water. For this pur- 
 
 pose, the form of tub exhibited in Fig. 101 is 
 most useful. 
 
 The hip-bath also furnishes a very conve- 
 nient and powerful means of acting upon the 
 lower part of the spinal marrow and the pelvic 
 organs. It may be very well taken in the ves- 
 sel of which the annexed drawing illustrates 
 a "Hip-bath" Tub for^ f° rm ) ^ nas tne important advantage of 
 Children. we n supporting the back, while the patient is 
 
 in the sitting posture. 
 
 When there is a large family, such a one comes frequently into 
 use. After the bath, which should last ten minutes, the child 
 should be well dried, and put to bed between blankets, and given 
 freely to drink of a solution of acetate of potassa, a teaspoonful to a 
 wineglassful of water, or else " cream of tartar water," made by 
 pouring a pint of boiling water on an ounce of cream of tartar. 
 Either may be sweetened to the taste. The next day the child may 
 take half a teaspoonful of syrup of ipecac every three or four hours. 
 This will generally break a cold in two or three days. 
 
 When the first symptoms are over, and a cough remains, one of 
 the prescriptions, Nos. 144, 145, or 155, may be given; the last 
 mentioned, well sweetened, is especially appropriate for children. 
 
 When the symptoms subside, tonics, good diet, and stimulants 
 should be administered. 
 
 In all such cases, remedies containing much opium, or any of its 
 preparations, must be used with caution. Many persons think if 
 they quiet the cough the disease is cured, but they often thus, as 
 it were, merely check the expression of the trouble which is endan- 
 gering the child. The dose should always be small, and the result 
 carefully watched. 
 
 Pneumonia, Lung Fever, or Inflammation of the Lungs, is 
 another result of cold and exposure. Fortunately, it is not of very 
 frequent occurrence in children, since it is a very fatal one. 
 
 Row Distinguished. The disease commences rather suddenly,- 
 often in the night, with chills, cough, quick breathing, great heat 
 
Colic. 295 
 
 of the skin, rapid pulse, thirst, and general fever. Sometimes, it 
 may even commence with a convulsion. As children almost always 
 swallow the spittle, the characteristic sign of rust-colored saliva is 
 lost. As the symptoms so much resemble those of acute bronchitis, 
 the distinction is made out by the greater severity of the symptoms, 
 the intense heat of the chest, the quick, feeble pulse, the panting 
 breathing, and the lung sounds on placing the ear to the chest. A 
 marked symptom is the wide expansion of the nostrils, and their 
 rapid movement. 
 
 How Treated. The bowels should be kept open by mild purga- 
 tives. Expectoration may be aided by emetics, as recommended 
 above, and the fever checked by the solution of the acetate of am- 
 monia. The diet should at first be light. The chest may be 
 occasionally irritated by mustard plasters, or the application of tur- 
 pentine in stupes or fomentations (p. 346). Blisters are rarely 
 beneficial, and are best omitted. To relieve restlessness, bromide 
 of potassium, in five-grain doses, and the warm bath, will prove of 
 service. If debility come on, beef tea, wine whey, and stimulants 
 are necessary, though this tendency must always be borne in mind, 
 and the strength carefully guarded throughout. 
 
 Iron, and cinchona preparations are requisite to aid the conva- 
 lescence. The cough which is often left behind must be managed 
 as above directed under that heading. 
 
 Colic, or Gripes, in children, is a disease of constant occurrence. 
 It is also regarded as a neuralgia of the bowel. 
 
 How Brought On. This affection is the result of indigestion, as 
 brought on by improper food, overloaded stomach, etc., or it seems 
 to have an intermittent tendency, recurring at a certain hour, gene- 
 rally late in the afternoon, day after day. Or it may be brought 
 on by cold and dampness to the feet. Often, carelessness, and want 
 of proper changing of a wet diaper, will cause such an attack. 
 
 How Distinguished. Generally, there is more or less wind in 
 the bowels, as shown by the distention of the abdomen, and the 
 drum sound on percussion. Again, very little wind may be pres- 
 ent. The child becomes fretful, draws its knees up to its chest, 
 cries suddenly, and becomes quiet. These actions may be repeated 
 at intervals, often very short, sometimes of greater duration, but 
 
296 Diseases of Children, 
 
 rarely disappear until wind has passed from the bowels, or perhaps 
 a thin and frothy discharge occurs. All these symptoms may be 
 exaggerated, the screams are piercing, the contractions of the* limbs 
 are almost spasmodic, the face exhibits great suffering, the child is 
 bathed in perspiration, and yet, when the attack passes off, the child 
 appears as well as usual. These attacks are often observed in the 
 cases of children otherwise remarkably healthy. 
 
 In rare cases, the attack becomes convulsive, almost epileptic, 
 though the intervals are marked by apparent health. 
 
 How Treated. The paroxysms are so distressing that the earnest 
 desire is to give the child immediate relief. This wish is met by 
 the warm bath, hot fomentations to the abdomen, particularly flan- 
 nel wrung out of hot mustard water (p. 347); poultices of hops; 
 mustard plasters, not too long continued; spice poultices, etc. At 
 the same time may be given by the mouth, camphor in water, as 
 No. 193, p. 357, or oil of turpentine dropped on sugar, say three 
 to five drops every two or three hours. A favorite and highly 
 useful mixture is chloroform, one drop, syrup of gum arabic, and 
 mint -water or anise water, of each half a teaspoonful, repeated 
 every fifteen minutes, until complete relief is obtained. The bowels 
 should be well opened by stimulating enemas, as of castor oil with 
 a few drops of turpentine, or that given, No. 102, p. 341, repeated 
 as necessary. A few drops of laudanum, or a half teaspoonful of 
 paregoric, may be considered as safe and useful. Other remedies, 
 as bromide of potassium, and chloral, may* be employed, both by> 
 the mouth and by enemas, as necessity may require. In all cases, 
 constipation must be relieved, and acidity corrected, by the appro- 
 priate remedies, as heretofore mentioned. In some cases, mustard 
 plasters to the whole length of the spine, or stimulating frictions 
 over it and the stomach, prove of great service. 
 
 How Prevented. By avoiding constipation, and the consequent 
 accumulation of wind in the bowels, much may be done to prevent 
 attacks of colic. Thus, occasional enemas of molasses, salt and 
 milk, or the administration of magnesia, with belladonna, or hyoscya- 
 mus and ipecacuanha, will generally keep the bowels in a relaxed 
 condition. Then the feet should always be kept dry and warm, and 
 the linen changed when wet, lest its coldness induce an attack. 
 
Summer Complaint. 297 
 
 Summer Complaint, and Cholera Infantum, are almost wholly 
 confined to the hottest parts of the summer months. By some, 
 these are regarded as names of the same disease. By others, the 
 former is considered as the ordinary diarrhoea of children, occurring 
 during the entire summer. 
 
 How Brought On. Diarrhoea, in children, is the result of indi- 
 gestion, eating improper food, as unripe fruit, or fruit partly decayed, 
 difficult teething, exposure to cold and dampness, especially wet 
 feet. Still, at certain times, the disease prevails much more exten- 
 sively, appearing to attack almost every infant in certain localities. 
 
 Cholera Infantum almost never has been met with beyond the 
 limits of the United States, and generally prevails extensively, dur- 
 ing the hottest months, all over the country, but particularly in large 
 cities, though by no means being confined to the poorest and filthiest 
 localities, but as often attacking children placed under the best provi- 
 sions for light, air, cleanliness, etc. This disease rarely attacks child- 
 ren above two years of age, mostly during the first teething, and for 
 this reason the second summer is always regarded with fear and 
 anxiety. It is one of the most fatal diseases of childhood. Any 
 cause impairing the vitality, as general constitutional disorder, depri- 
 vation of the breast, etc., is sure to induce an attack. For this 
 reason, weaning is often postponed until after the second summer. 
 Yet. in many instances, when the breast milk is becoming impover- 
 ished, and unsuitable for the child, it would be far better to wean 
 the child, and commence a proper diet with it some weeks previous 
 to the setting in of hot weather, rather than attempt to carry it 
 through the heated term on nourishment manifestly improper. 
 These remarks would apply where pregnancy has again commenced ; 
 where the teeth are well out, and the child is prepared for other 
 food ; where, for any cause, the breast milk is impoverished, or its 
 supply insufficient. 
 
 Again, when the child is so situated as to rely wholly upon cow's 
 milk, or other artificial feeding, the milk furnished should be care- 
 fully examined, to be sure that it is pure, fresh, and not weakened 
 by water or other adulteration. 
 
 How Distinguished. Summer complaint and cholera infantum 
 will be considered as synonymous terms, as the same principles for 
 
298 Diseases of Children. 
 
 the treatment of the ordinary diarrhoea of childhood will apply in 
 every instance, guided by that common sense which is so eminently 
 necessary for the treatment of all disease. 
 
 In some cases the attack is quite sudden ; the child is seized 
 with vomiting, purging, slight fever, great desire for drinks, rest- 
 lessness; the stomach and bowels being emptied, the discharges 
 become watery, whitish, ill-smelling, or even odorless. The stomach 
 is very irritable, rejecting suddenly and forcibly everything that is 
 taken into it. The progress is rapid ; in a few days, or even a few 
 hours, the child comes to resemble a wilted, aged person. The 
 pulse is quick, small, like a thread under the finger ; the tongue is white 
 and slimy ; the skin is dry, dirty-looking and harsh ; the feet and hands 
 are apt to be cold. Generally, the feverish symptoms increase late in 
 the afternoon. The child may express great suffering, as if in 
 pain, or may lie prostrate and uncomplaining ; generally, there is great 
 restlessness, with drawing up of the knees and moaning ; constant 
 tossing and changing of the position, and often sharp, shrill screams. 
 The abdomen is more or less swollen, and tender to the touch. 
 Frequently, the vomiting ceases early, though the diarrhoea con- 
 tinues, or increases in violence; everything seems to pass through 
 the bowels without any effort at digestion, in a very short time 
 after it is taken. Delirium or other symptoms simulating cerebral 
 affection come on, and the attendants, even the physician, are led to 
 believe that the brain is inflamed, though these symptoms are solely 
 the result of the great exhaustion, and deprivation of the brain of 
 its proper supply of blood. 
 
 Very many cases succumb within twenty-four hours, though the 
 majority are slower in reaching a fatal termination. Here, the 
 emaciation is extreme, the eyes sink in, the whole face is pale, the 
 nose is sharp, the lips are thin and dry, the skin is drawn over the 
 cheek bones and forehead so tightly as to be smooth and glistening. 
 The child is but half conscious, lies with the eyes partially closed, 
 and permits the dust and even insects to settle on its eye-balls 
 without noticing them. Every symptom betokens the approach of 
 death, which, singularly, is often long in coming, giving hope of a 
 recovery, long after the child is really in the agonies of death. The 
 
Summer Complaint. 299 
 
 child generally dies in an unconscious state ; occasionally it is attacked 
 with convulsions. 
 
 Favorable symptoms are, a decided change in the character and 
 frequency of the passages, desire for food, quiet slumber, reduction 
 of the pulse, moisture of the skin. 
 
 How Treated. The first and most important measure is the 
 removal of the child to a cooler atmosphere, of the sea-shore, best 
 of all ; the pure country air ; or taking it out early in the morning, 
 beyond the built-up portions of the city, where it can breathe a 
 purer air. Excursions on the water, as in the ferry-boats of our 
 large cities, will aid greatly in inducing a favorable change. Under 
 any circumstances, the air of the apartment occupied by the child 
 must be completely purified by free ventilation, the most positive 
 cleanliness, the avoidance of many persons in the room. The air 
 of the room must be kept dry, and free from anything that will 
 vitiate it, as cooking, tobacco smoke, etc. The clothing must be 
 light, clean, and dry, . and sufficient to protect the child from 
 atmospheric changes, but not to keep it too warm. The bed 
 should be cool, hence feathers should be avoided ; a mattress, or a 
 blanket only, thick enough to make the couch comfortable. 
 
 When there is reason to suspect teething as a cause, the gums 
 should be cut, if necessary, as will hereafter be described, and if 
 they are hot, swollen, and tender, rubbing them with a piece of ice 
 will greatly relieve their irritability. The whole surface of the 
 body should he bathed night and morning with tepid salt water, and 
 then the skin should be excited to action by frictions with a soft 
 towel or the hand. The diet should be restricted to the breast-milk, 
 or, in older children, to pure cow's milk, properly prepared, not too 
 much diluted; "condensed milk" is highly esteemed by many as 
 the very best food for these cases. Overloading of the stomach 
 must be very carefully guarded against. Cold demulcent drinks 
 or ice may be allowed. 
 
 The diarrhoea in its beginning may often be speedily checked by 
 a slight astringent, as acetate of lead, one-fourth to one-half a grain, 
 and three or four grains of prepared chalk every two, three, or four 
 hours, according to the urgency of the symptoms. The irritability 
 of the stomach can often be relieved by a few grains of magnesia, 
 
3<X) Diseases of Children. 
 
 rubbed up with white sugar, and placed upon the tongue ; or by 
 three or four drops of dilute sulphuric acid in syrup and spearmint 
 water every hour. Other remedies for the vomiting are camphor 
 one fluidounce to ether one fluiddrachm, given in doses of two or 
 three drops at short intervals ; or a few drops of turpentine, or 
 creasote, in a solution of acetate of lead, say, acetate of lead five 
 grains, dilute acetic acid three to five drops, sugar two to three 
 teaspoonfuls, and water one ounce, given in teaspoonful doses every 
 hour till relieved. When all else fails, a blister may be placed 
 over the stomach, followed by a poultice of bread and milk, or of 
 flaxseed, etc. When there is great pain of the bowels, leeches may 
 be applied, and followed by hop or other soothing poultices. 
 
 Should brain symptoms appear, leeches may be applied behind 
 the ears, to the temples, cold lotions or the ice-bag to the whole of 
 the scalp, stimulants to the lower extremities. 
 
 One of the most valuable remedial agents is the application of 
 stimulating liniments to the whole length of the spine, and the 
 abdomen. This is done in the belief that the counter-irritation 
 will act to draw away the irritation from the stomach and bowels. 
 Such liniments are mentioned, Nos. 164, 166, and 171 (p. 353). 
 When the symptoms begin to improve, the diarrhoea may be 
 checked by a continuance of the acetate of lead, etc., combined with 
 small doses of ipecacuanha; or the vegetable astringents, as men- 
 tioned on pages 348, 349. 
 
 Should the disease tend to become chronic, perhaps the best 
 remedy will be the tincture of the chloride of iron given in syrup 
 and water, in doses of three to five drops every two, three, or four 
 hours, according to age. Laudanum pr paregoric, in appropriate 
 doses, may be used cautiously, if required by pain. A decoction 
 of blackberry root (p. 349) has been found of especial service. 
 What is commonly known as "thickened milk," milk boiled and 
 thickened with flour, or rice flour, enjoys a high reputation in these 
 
 cases. 
 
 Quinine in small and frequent doses will act as an efficient tonic. 
 The aromatic spirits of ammonia, in doses often to fifteen drops, in 
 syrup and water, often proves an excellent stimulant, and quiets the 
 irritability of the system. 
 
Falling of the Bowel. 301 
 
 In closing this important subject, we append the following list 
 of things to be done when a child is suddenly attacked, in summer, 
 with vomiting, purging, and prostration: — 
 
 1. Put the child for a few minutes in a hot bath, then carefully 
 wipe it dry with a warm towel, and wrap it in warm blankets. If 
 its hands and feet are cold, fill bottles with hot water, wrap them in 
 flannel, and lay against them. 
 
 2. Place over the belly a mush poultice, or one made of flaxseed 
 meal, to which one-quarter part of mustard flour has been added, 
 or flannels wrung out of hot vinegar and water. 
 
 3. Give five drops of brandy in a teaspoonful of water every 
 ten or fifteen minutes ; if the vomiting persists, give this brandy in 
 the same quantity of milk and lime-water. 
 
 4. If the diarrhoea has just begun, give a teaspoonful of castor- 
 oil, or of the spiced syrup of rhubarb. 
 
 5. If the child has been fed partly on the breast and partly on 
 other food, the mother's milk alone must now be used. If the 
 child has been weaned, it should have its milk-food diluted 
 with lime-water, or should have weak beef tea, or chicken water. 
 
 6. Give the child cold water to drink, freely. 
 
 7. Have the soiled diapers or the discharges at once removed 
 from the room. ■ 
 
 Falling of the Bowel, or Prolapse of the Anus, is generally 
 observed in debilitated children, or after protracted diarrhoea. On 
 the other hand, it may come on from constipation and the constant 
 straining to extrude the hardened stools. In some, it occurs after 
 every passage, or even if the child stands for a long time. 
 
 How Distinguished. The child is observed to suffer greatly, and 
 examination reveals the presence of a red tumor at the opening, 
 which is generally easily pushed back. If allowed to remain down 
 long, it becomes strangulated, and gorged with blood, inflames, and 
 may even ulcerate or become mortified. 
 
 How Treated. The reduction should be performed at once, by 
 anointing the parts with sweet oil, lard, etc., and then gently press- 
 ing it back, and being sure to see that it is completely returned, 
 and no portion allowed to remain grasped by the sphincter or lower 
 muscle controlling the opening of the bowel. If it is constantly 
 26 
 
302 Diseases of Children, 
 
 recurring, an injection may be thrown into the bowel^ consisting of 
 bismuth and catechu, No. 103 (p. 341). In cases where the 
 part is much engorged and difficult to return, the free use of cold 
 water to the part will relieve it, or a few leeches may be applied 
 before any effort is made to return it. The parts may then be 
 washed frequently with astringent lotions, as strong alum water ; 
 a decoction of white oak bark ; or the two may be combined ; or a 
 decoction of galls may be used. 
 
 The accident must be prevented by keeping the bowels relaxed 
 by proper food, fruit, etc., and by careful attention at the time of 
 having an operation of the bowels. In severe cases, it becomes 
 , necessary to retain the bowel in place by a pad or compress, held on 
 by a bandage. It is proposed to reduce the size of the opening, 
 and thus retain the bowel, by removing a portion of the projecting 
 folds. This has proved successful in some cases, but of course 
 requires the hand of a competent surgeon. 
 
 Polypus of the Rectum is often mistaken for falling of the 
 bowel, which it may closely resemble. It is not of common occur- 
 rence. 
 
 Sow Distinguished, A polypus may exist in the lower bowel 
 for some time before its presence is recognized. It is generally 
 marked by tenesmus at each evacuation, mucous or bloody dis- 
 charges, and as it becomes larger, it acts as a foreign body, and 
 annoys the child greatly. Finally, after one of these efforts, it is 
 extruded, and shows like a lump or tumor of a dark red color, some- 
 times of a dirty yellowish appearance, and often covered with mu- 
 cus, more or less bloody. 
 
 The red form generally bleeds freely from slight causes. 
 
 It is known not to be a falling of the bowel, because it is in the 
 centre, and the finger can be passed all around it, and up to its root. 
 In some cases, it does not protrude, and is only detected by an 
 examination for the cause of the difficulty experienced by the child. 
 Often, it drains away the blood and 'causes great prostration, etc. 
 
 Sow Treated. The only proper treatment is removal, if small, 
 by twisting the polypus off by means of a pair of forceps ; if large, 
 by strangling it with a ligature, and thus cutting off the entire 
 tumor. The lump is pulled down with a pair of forceps, and then 
 
Weaning Brash. 303 
 
 a waxed ligature is placed around the stem or root, and drawn 
 tight. If troublesome bleeding follows, the sulphate of iron, freely 
 applied to the point, will readily control it. 
 
 Bed -Wetting, or Incontinence of Urine, is a most annoying 
 affection of children, and, singularly, is most frequent in colored 
 children. This is often the result of habit; want of proper teach- 
 ing; a lack of mental capacity; or it may result from a partial 
 paralysis of the retaining muscle of the bladder. It most com- 
 monly occurs at night, while in bed, and hence its name. Espe- 
 cially is this likely to occur when care is not taken to have the 
 child pass its water before going to bed. It may be the result of 
 the urine containing irritating salts, and thus causing the child so 
 much distress that it half consciously allows the urine to escape. 
 In these instances, the child is observed to use the vessel very fre- 
 quently during the waking hours. Some assert that the discharge 
 of the water only occurs when the child turns on its back, and 
 hence propose and insist on the good results of a blister to the 
 back, to prevent the child from assuming that position. 
 
 How Treated. When the urine is being constantly passed, its 
 irritating nature may be corrected by daily exercise in the air; 
 avoiding exposure to cold and damp ; alkalies, as lime water and 
 bicarbonate of soda, five grains thrice daily, with mild, bitter 
 tonics, as cinchona tea (p. 349), keeping the bowels free, improv- 
 ing the digestion, etc. Often, under this plan, the trouble will 
 quickly disappear, and recovery be permanent. 
 
 In all cases, the child should have a light supper; be allowed to 
 drink but little of fluids toward night, and empty his bladder the 
 last act before retiring. As a medicine, the tincture of cantharides, 
 say three to five or ten drops, three times a day, gradually increas- 
 ing the dose, will eventually relieve the difficulty. Care should be 
 taken to stop this remedy at once if painful and difficult urination 
 is complained of. Belladonna, in repeated doses long continued, 
 has acquired a great reputation. Two to five drops of the tincture 
 of belladonna should be given in sweetened water every night. 
 
 Weaning Brash, or diarrhoea, or looseness of the bowels at 
 the time of weaning, most frequently occurs during the summer, 
 and is often the result of negligence as to the food. The utmost 
 
304 • Diseases of Children. 
 
 care is necessary to see thajt the milk given the child is pure, fresh, 
 and not too much, if at all, diluted. Generally, the diarrhoea is 
 checked by these attentions, and the use of prepared chalk, and 
 calomel, followed by a mild astringent. When protracted, the same 
 principles will apply as given under similar headings heretofore. 
 
 Galling, or Rubbing, is most generally seen in fat children, and 
 those of a scrofulous or flabby predisposition. Such cases require 
 care as to cleanliness, and the avoidance of much friction, or soap 
 and water in removing any soiling that may occur. Hence some 
 mothers are said to be too cleanly, and clean the skin off their 
 children. The parts should be dried by swabbing or patting with 
 a soft cloth, in place of rubbing with a rough, coarse towel. After 
 which, they should be dusted with fine starch, prepared chalk, 
 oxide of zinc, lycopodium, etc. An excellent application is the 
 oxide of zinc ointment, page 356,- with care to prevent the parts 
 from coming into contact. Some children are greatly relieved by 
 bathing the parts with tepid water frequently, or with slippery elm 
 or flaxseed mucilage. 
 
 Milk Crust generally occurs during teething, and while the child is 
 yet nursing, hence its name ; and it is commonly thought to be incur- 
 able until all the teeth are cut or weaning takes place. It usually 
 appears in children of scrofulous tendency, and is, by its disgusting 
 appearance, a great source of annoyance. 
 
 How Distinguished. Milk crust is an eruption, upon the face 
 or head, of a number of red blotches, soon covered with pustules ; 
 these, itching and breaking, exude a whitish-yellow or greenish 
 discharge, which hardens and forms a thick brown crust, beneath 
 which the discharge continues to ooze, and constantly adds to the 
 crusts. These crusts may appear only on the cheeks or chin, over a 
 small space, or they may cover the whole scalp and face, forming a 
 mask of hideous appearance. In the course of three or four weeks 
 the discharge ceases, the crusts fall off, leaving a red, shining sur- 
 face, very irritable, and liable to renew the pustules and discharge 
 as before. This matter seems to act as a source of conveyance of 
 the disease, as, wherever it is brought in contact with the skin, it 
 produces more or less of a similar irritation. Fortunately, the 
 disease leaves no scar or marks after healing. 
 
Milk Crust. 305 
 
 How Treated. In the early stages, it will often speedily yield 
 to proper regulation of the diet, mild laxatives, and soothing lotions. 
 Small doses of magnesia and ipecacuanha, warm baths, pure, fresh 
 air, are invaluable adjuncts in the treatment. Occasionally, it 
 becomes necessary to add tonics, as potassio-tartrate, or syrup of the 
 iodide of iron (p. 361), infusions of cinchona, dogwood, goose grass, 
 etc. (p. 349). As local applications to kill the itching and cause the 
 eruption to disappear, the ointment of nitrate of mercury, say one 
 part to three of clean lard; or oxide of zinc ointment (p. 356); 
 or camphor and chloral, equal parts, rubbed up till they melt, and 
 added to glycerine or simple cerate, in the proportion of half a 
 drachm to the ounce, or stronger, as may be required. 
 
 In very greatly protracted cases, the solution of the arseniate of 
 potassa, or "Fowler's solution," in two-drop doses three times a day, 
 will generally effect a cure, if persisted in. 
 
 26* 
 
CHAPTER IX. 
 
 Accidents, Injuries, and Surgical Ailments of 
 Children. 
 
 Lancing the Gums— Tongue Tie— Hare Lip— Wry Neck— Sore Eyes- 
 Cross Eyes— Ingrowing Eyelashes— Styes— Running, or Catarrh of the 
 Ears — Earache— Crushed Fingers— Hip Disease— Spinal Diseases : Cur- 
 vature of the Spine, Inflammation of the Spine, Dropsy of the Spine — 
 Club Foot — Weak Ankles — Knock-Knee — Rupture, or Hernia — Cancer 
 — Swellings of the Glands of the Neck. 
 
 Of course, children are exposed to many of the same accidents 
 to which adults are liable, and the treatment is generally the same. 
 What it is, has already been described in Chapter VII. But child- 
 ren are also particularly subject to certain injuries and surgical 
 diseases to which parents should be prepared to give early and 
 intelligent attention. Frequently, years of misery or permanent 
 disfigurement can be avoided by correcting a bad habit in a child, 
 or by giving some apparently trifling symptom prompt care. There- 
 fore the present chapter should be read by every parent with close 
 study. 
 
 Lancing the Gums. The first teeth commence to appear sev- 
 eral months after birth, and are usually accompanied by a flow of 
 saliva ; redness and swelling of the gums ; heat and tenderness of 
 the inside of the mouth ; sometimes, general fever ; more or less 
 diarrhoea, and even fits or convulsions, as we have described more 
 at length on a previous page. When these symptoms commence to 
 threaten the general health of the child, the proper step is to lance 
 the gums with a gum lancet. 
 
 To perform this operation, an assistant should hold the child 
 firmly on his lap, fixing its head so that it cannot move it. The 
 
 306 
 
Wry Neck. 
 
 307 
 
 operator then depresses the lower jaw with his left hand, holding 
 
 in his right a gum lancet, or, if that is Fig. 102. 
 
 not at hand, a sharp penknife, the blade 
 
 of which is wrapped in linen in such 
 
 a way that the point is only uncovered 
 
 for rather less than half an inch. At 
 
 first, one cut should be made lengthways 
 
 of the gum, and then a second one 
 
 across it at right angles. 
 
 Figure 102 indicates the method of 
 holding the child's mouth and making 
 
 the first incision. When, as rarely Lancing a Child's Gums 
 happens, there is excessive bleeding after the operation, the gums 
 may be bathed with alum water, or powdered galls may be sprin- 
 kled upon them. 
 
 Tongue Tie. This is brought about by the tongue being fast- 
 ened to the floor of the mouth by what is called the "fcenum," 
 which is the thin membrane seen running beneath the tongue when 
 we elevate it. In tongue tie this extends nearly, or quite, to the 
 tip of the tongue, and fastens it down. The deformity can easily 
 be remedied by nipping a very small notch, with the scissors, in the 
 middle of the free edge of the foenum, and then, for several days 
 after the operation, passing the little finger beneath the tongue two 
 or three times, so as to tear the cut a little larger and prevent its 
 edges uniting. 
 
 Hare Lip. The distressing deformity so called receives its name 
 because the child's upper lip is divided by a cleft, as it is in the hare 
 or rabbit. There are many opinions as to its cause, which need not 
 detain us now. The only remedy for it is a surgical operation, and 
 why we mention it here is to urge upon parents to have this per- 
 formed within the first few months, or, at least, in the first year 
 of life. Too many delay, out of timidity, and thus, when the ope- 
 ration is submitted to, a scar is sure to be left, which could be 
 avoided by an earlier recourse to the knife. 
 
 Wry Neck sometimes arises from feeble muscular power on one 
 side of the body. The child's head is drawn to the stronger side 
 by the greater contractile power of the muscles-, and after a time 
 
308 Diseases of Children. 
 
 he actually loses the ability to keep it in an erect position. As 
 soon as the least tendency to this is noticed, the child should be 
 encouraged to resist it; his general health should be strengthened 
 by tonics, as quinine or iron ; nourishing food ; salt water baths ; 
 frictions with a coarse towel ; open air exercise, and light gymnas- 
 tics. The side of the neck opposite the inclination should be 
 thoroughly rubbed with stimulating liniments or ointments, such as 
 given in Part IV. 
 
 Erysipelas, a boil, a burn, or similar injury, or rheumatism, may 
 either weaken the muscles of one side of the neck, or, by rendering 
 their exterior painful, lead to " favoring" them by holding the head 
 bent toward that shoulder. Therefore, whenever a child has such 
 an injury in that locality, he should be watched, and this tendency 
 prevented by prompt admonition, or by bandages and mechanical 
 appliances. The latter, together with the surgical operation of 
 dividing the muscles, is the resort of the physician in cases where 
 the milder means we have mentioned fail. 
 
 Sore Eyes, or Ophthalmia. Not a few children, especially those 
 who have in their constitutions a somewhat scrofulous taint, suffer 
 from soreness, redness, and weakness of the eyes. In the morning 
 they complain that the lids are "stuck together;" in the evening 
 that they smart and burn. A bright light is painful to them, and 
 they are frequently seen rubbing the eye, as if there was something 
 irritating in it. On separating the lids, we can see that an unnatu- 
 ral redness is present, both on the edges of the lids and over the 
 white of the eye. Small, red veins may be seen winding through 
 the latter, and the lids often look thicker than is natural. 
 
 How Treated. Having satisfied ourselves by a careful examina- 
 tion, as directed on a previous page, that these symptoms do not 
 arise from the presence of some foreign body in the organ, in which 
 case its removal will cause the symptoms to disappear, we proceed 
 to treat the eye locally, by an appropriate eye-wash. Clear, cool 
 water is one of the best; water which contains a tablespoonful of 
 salt to the quart, and mucilage water made by soaking an ounce of 
 sassafras pith to the pint, are all simple and efficient eye-washes. 
 Care should be taken that they freely run over the ball of the eye. 
 The lids should be held apart, and the wash applied in a gentle 
 
Cross Eyes. 309 
 
 stream several times a day. When there is a scrofulous taint, re- 
 course must be had to internal remedies and more active lotions. 
 What we have said under Scrofula, in a previous chapter, will 
 answer for the first. For the second, the eye-washes, Nos. 122, 
 123, 124, 125, page 346, will be found of great value. Salt water 
 or mustard foot-baths often yield good service by drawing the in- 
 flammation from the eye. The bowels must be kept somewhat 
 loose. The child should be warned not to use the eyes in any 
 manner which causes pain. If light becomes quite painful, he must 
 be kept in a darkened room. By such precautions he will be re- 
 stored early, and avoid one of the saddest accidents to which man is 
 liable — the loss of sight. 
 
 Cross Eye, Squint, Squinting, Strabismus. These names are 
 given to a turning or deviation of one eye from the line of vision 
 of the other. It is readily seen by an observer, and casts an 
 unpleasant expression on the face of the sufferer; more than that, 
 it is sure, sooner or later, to weaken the eyesight. It may arise 
 from injury, but much more frequently it is caused by the bad 
 habit contracted in early childhood of using only one eye, closing 
 the other, or not fixing it on the object. An infant frequently 
 laid on a bed on the one side of which is a blank wall and on the 
 other a window, will use the eye toward the latter and not that 
 toward the former, and thus may contract a permanent squint. 
 Babes should always be placed in such a position toward the light 
 that they shall use both eyes equally. 
 
 Older children, if the one eye becomes inflamed from a foreign 
 body or other cause, very easily acquire the same habit, and must 
 be closely watched in consequence. Violent mental emotions in 
 nervous temperaments have the same tendency to cause squinting. 
 
 How Treated. Much can be done in early childhood to check 
 cross-eye, by means of certain exercises, with the view of restoring 
 the crooked eyes, consisting in directing the sight along different 
 lines of vision, inward, outward, upward, and downward; by 
 urging the child to be on his guard against using one and not the 
 other organ. These means failing, an operation is the only recourse ; 
 the proper age at which it should be done is from twelve to fourteen 
 years. 
 
3 io Diseases of Children, 
 
 Ingrowing Eyelashes. Children who have suffered from 
 inflammation of the eyes, and others who have not, are occasionally 
 much annoyed by the tendency of some of the hairs which form the 
 eyelashes to turn inwardly and thus irritate the ball of the eye. It 
 leads to a sense of pricking and an irritable and watery state of the 
 eye. To remedy this, the offending hairs must be carefully plucked 
 out from time to time. This seems a simple and trifling matter, 
 but, in fact, few manipulations require more care. The hair must 
 not be broken, as its stif£ stump will cause far more distress than 
 its natural fine point. A pair of delicate forceps should be used, 
 the hair grasped firmly between their points, and never be sharply 
 jerked out, but removed with a slow, steady pull. 
 
 Styes, to which we have already referred, are peculiarly prone 
 to appear on scrofulous and delicate children. They are minute 
 boils which appear on the very edge of the lid, as small, red, tense 
 swellings, with a sense of itching and stiffness. Sometimes, the 
 inflammation excited entirely closes the eye, and considerable pain 
 follows. 
 
 A stye should never be rubbed or squeezed ; no incision is neces- 
 sary; all that is required is a warm water dressing, applied by 
 means of the bandage shown in Figure 93, page 240. The bowels 
 should be kept regular by some of the many means we have 
 recommended, the diet carefully regulated, and tonics, as of iron or 
 quinine, be given for some time. 
 
 Running from, or Catarrh of the Ears. The inside of the 
 ear has a natural secretion of wax, which serves to protect it in a 
 variety of ways. In children, especially feeble and scrofulous ones, 
 that secretion is liable to become increased in quantity, fluid or 
 watery, and offensive to sight and smell. A great deal of injury is 
 done by attentive mothers and nurses, who think the ears of children 
 require to be cleaned out, by inserting into them the screwed-up 
 corner of a towel. Dr. Hinton, of London, who has given much 
 attention to diseases of the ear, says, " This practice may rank next 
 to scarlatina among the causes of disease of the ear in children." 
 
 Local applications in such cases must be very carefully employed. 
 Astringent injections are liable to do more harm than good. Atten- 
 
Crushed Fingers. 311 
 
 tion to the general health, and a few drops of sweet oil poured in 
 the ear, from time to time, are sufficient. 
 
 Another form of running from the ears arises from inflammation 
 of the lining membrane of the canal of the ear. Poor and neglected 
 children have this very commonly, and it may follow scarlatina in all 
 classes. It is distinguished from the former by being preceded by 
 uneasiness and pain in the passage, frequent spells of " earache," a 
 sensation of itching, which leads the little patient to run his fingers 
 and other objects in his ears, and the swollen appearance of the 
 inside of the ear when examined in a strong light. The hearing is 
 not generally impaired. The general health is almost always 
 deranged. The discharge is not thin and waxy, as in the preceding 
 variety, but is semi-purulent or mattery, often with a foul odor. 
 
 In this form, washing out the ear with a gentle astringent lotion 
 is needed. The use of the syringe requires considerable care, on 
 account of the tenderness of the parts, especially in children ; it is 
 best not to employ it. The child should lie down on the side 
 opposite the diseased ear, and this should then be filled with the 
 lotion by simply pouring it in. After it has remained in for two 
 or three minutes, the child may turn and let it run out. As an 
 appropriate lotion, use may be made of white oak bark tea, cold or 
 warm; or, of water one pint, powdered alum one teaspoonful; or, 
 of water one tumbler, sugar of lead ten grains. These lotions 
 should be used three or four times a day, in the manner prescribed, 
 and attention given to the general health of the child. 
 
 For the attacks of earache which accompany this disease, or 
 precede it, the best application is heat. This can be applied in any 
 of the ways mentioned on page 347 ; or, what we think a most 
 excellent and convenient means, wrap a hot roasted onion in a 
 flannel wrung out in laudanum, and bind it over the ear. 
 
 Crushed Fingers. The very common accident here mentioned 
 may vary from a mere pinch to a crush which will leave one or 
 more fingers or the whole hand a shapeless mass. No matter how 
 severe it may be, the attendants must not despair. The hand, that 
 "divine tool," as it has been called, is too important a member to 
 be given up without the most strenuous exertions. Moreover, the 
 experience of the last ten years has proven over and over again 
 
312 Diseases of Children. 
 
 that the most hopeless-looking crushings have been successfully 
 treated by simple measures. That which should be employed 
 beyond all else is water. Constant irrigation (as explained in 
 chapter VI) should at once be commenced, using cold water in 
 warm seasons and moderately warm water in cold seasons, taking 
 care not to cease it abruptly, but at the end of three days dimin- 
 ishing gradually. The hand and fingers should be placed in a 
 splint that will keep them motionless, and may be dressed with 
 linen spread with clean lard, fresh, unsalted butter, or cerate. 
 After the first inflammation has subsided, cloths wet with alcohol 
 and water, carbolic acid and water (teaspoonful of carbolic acid to 
 the quart), or the like stimulating lotions, may be employed. If 
 proud flesh (" fungous granulation," as it is called by surgeons) 
 appears, it may be checked by touching with burnt alum. Great 
 cleanliness is essential. The strength should be kept up by nour- 
 ishing broths and milk, and by stimulants, if the former do not 
 suffice. Sleep should be secured by some of the means already 
 mentioned, and the little sufferer placed in as comfortable a 
 position as possible. 
 
 Hip Disease. The painful affection commonly known by this 
 name is an inflammation of the hip-joint, passing into suppuration 
 and a destruction of the head of the bone. It is essentially a dis- 
 ease of childhood, rarely commencing before the age of four years, 
 and equally rarely after fourteen. The sufferers are most commonly 
 of scrofulous constitutions, and generally feeble health; but the 
 affection may arise in healthy children, in which case it can gene- 
 rally be traced to a blow, fall, or strain. The progress of the dis- 
 ease is usually slow, lasting for many years, and when a cure is 
 obtained it is rarely accomplished until the age of puberty. Dur- 
 ing the earlier stages of the disease the patient may retain nearly 
 all the appearances of perfect health, hence it is important that 
 parents should learn to recognize what its first signs are. These 
 are a slight lameness or limping, often amounting to nothing more 
 than " favoring " one leg more than another, as in standing with the 
 weight thrown on one in preference to the other ; some little pain 
 in the limb, which, however, is more frequently referred to the 
 knee or its vicinity than to the hip ; an appearance, when stripped, 
 
Spinal Diseases, 3 1 3 
 
 of having one leg a little shorter or longer than the other, and a 
 slight difference in the contour of the buttocks. In sleeping, the 
 child is observed to take, in preference, a position which avoids 
 throwing the weight on the affected joint, and if turned so as to 
 rest upon it, will unconsciously throw himself back in order to re- 
 move the pressure. These symptoms, coming very gradually, 
 may justly cause alarm, and the child should be submitted to the 
 examination of a competent surgeon without delay. 
 
 Of the treatment, it need only be said that it must be directed to 
 remove all pressure from the affected joint, that is, the child must 
 be put into splints that will maintain its leg and thigh motionless 
 for a long time. The apparatus to secure this end is complicated, 
 and can only be applied by a professional man. We therefore omit 
 its description. 
 
 Spinal Diseases. These nearly always commence in childhood, 
 and as they are insidious and slow in progress, often progress be- 
 yond remedy before attention is directed to them. 
 
 Curvature of the spine is easily caused by occupations or pos- 
 tures that tax one side of the body more than the other, especially 
 if at the same time the child is subjected to want of exercise. Sit- 
 ting in school at too high or too low desks, and working in factories 
 in constrained positions, are common causes of it. The first thing 
 that attracts attention is a projection of one shoulder-blade or the 
 other, or an elevation of one shoulder above the other, or of one 
 side of the bosom, which is popularly said to be " growing out." 
 The age at which it is generally noticed is from ten to sixteen. If 
 the back be now exposed and the spine examined, it will be found 
 to be curved from a straight line into one like the italic letter /, 
 which will be seen to be the reason of the projection of the shoul- 
 der blade, etc. 
 
 The cure will depend chiefly upon removing the habit or neces- 
 sity of using one side more than the other, giving the body rest, 
 and on maintaining good general health. The child should sleep 
 with a single pillow, so that the body be not bent ; gentle and regu- 
 lar exercise in the open air should be practiced every day ; standing 
 or sitting in one position, for any great length of time, must be 
 avoided; and the back should be rubbed every morning with a 
 27 
 
3 14 Diseases of Children. 
 
 coarse towel or horse-hair gloves. The clothes should be supported 
 in some easy and natural manner. The many "braces" and stays 
 which are advertised should be avoided, as generally they do more 
 harm than good. 
 
 Inflammation of the spine is a disease which generally affects 
 scrofulous children, but may arise from a blow upon the backbone, or 
 a fall upon it. It begins with a feeling of languor, weakness, and 
 coldness in the legs ; inability to stand erect for any length of time ; 
 weakness and shuffling in the gait ; disturbed sleep ; costive bowels ; 
 and soreness in the back. If now the latter be examined by press- 
 ing with the finger on each process or vertebra of the backbone 
 (see p. 49), one or two of them will be found tender on pressure, 
 and perhaps a little more prominent than the others. 
 
 The treatment which is required is rest in bed in a horizontal 
 position, and keeping the strength up with tonics, iron, etc. The 
 sooner this is commenced and rigidly enforced, the better prospect 
 is there of a cure. 
 
 Dropsy of the spine, or "spina bifida," is an affection with which 
 some infants are born. There is a watery tumor on the backbone, 
 at some point of its course, tender on pressure, and causing a loss 
 of power of movement. Such children occasionally survive to 
 adult life, but the complaint is incurable, and the probabilities of 
 early death very strong. 
 
 Club Foot. This affection consists in a deformity of the foot, 
 by which the part that touches the ground is not the sole, but the 
 side of the ball or the heel. Generally, children come into the 
 world with this malformation, but sometimes it is a consequence of 
 fever, of long confinement and inactivity, of attacks of rheumatism, 
 and even of irritation of the bowels or of the foreskin. Slight 
 cases may generally be remedied, if taken at their very commence- 
 ment, by daily extension with the hands, and frictions of stimulat- 
 ing liniments, together with tonics, electricity, and sea bathing. 
 When these measures do not succeed, a surgical operation is neces- 
 sary, which, by cutting the muscles which retain the foot in its 
 false position, allows it to be righted. 
 
 Weak Ankles. This affection depends upon a weakness or 
 relaxation of the bones and ligaments of the ankles, rendering the 
 
Rupture. 3 1 5 
 
 internal border of the foot convex or concave, so that the child 
 walks on one or other side of it. It is almost sure to be brought 
 on if children are put upon their legs too soon, and persuaded to 
 try and walk before their lower limbs have the requisite strength. 
 In its treatment, the patient should wear shoes or boots with high 
 heels, and with the inner edge of the sole much thicker than the 
 outer. In severe cases, he must wear a tight-fitting boot, with a 
 piece of whalebone or a frame of steel passing up to the middle of 
 the leg, thus firmly fixing his foot in its natural position. This 
 will have to be worn continuously, from six to eighteen months, 
 before the cure is permanent. 
 
 Knock-Knee, OP In-Knee. This frequent deformity, not con- 
 fined to childhood, but most frequent then, consists of an inward 
 yielding of the knee-joint, in consequence of the weakness of the 
 ligaments and muscles destined to keep it in its proper place. It 
 may be constitutional, arise from strains and such-like accidents, or 
 be caused by insufficient nutrition. Putting an infant on a watery, 
 floury diet, when it ought to have breast-milk, is a common link in 
 the chain of causes to which it may be traced. It may proceed 
 to such an extent that the child, at the age of eight or ten, is pre- 
 vented from walking altogether without the use of crutches. 
 
 In a small proportion of cases, children recover from this deform- 
 ity without any treatment. The probabilities of this fortunate 
 result are much increased if the exciting cause of the complaint is 
 removed, and the child placed under favorable hygienic surround- 
 ings. When this fails, mechanical support must be given. For 
 this purpose simple padded wooden splints may suffice, a short one 
 behind the knee, to prevent its flexion or bending backward, and a 
 long one, reaching from the hip to the ankle, on the outer surface 
 of the limb. They must be firmly, but not too tightly bandaged. 
 Care should be taken to employ daily friction, and passive motion 
 (p. 247), to prevent the joint from becoming stiff. In still more 
 severe cases, a somewhat complicated apparatus of iron or steel is 
 used, which it is needless to describe. 
 
 Rupture, or Hernia, may occur in children from the time of 
 birth, or may be developed at any age, in those predisposed, after 
 unusually violent exercise, as leaping, wrestling, or riding. When- 
 
3 1 6 Diseases of Children. 
 
 ever a child is observed to have a slight tumor or swelling at the 
 navel, or in the groin, enlarging on coughing or straining, he should 
 be warned of the risk of violent effort, and the first opportunity 
 embraced to consult a competent surgeon. The permanent cure of 
 a rupture, by means of a properly fitting truss, is more likely to be 
 brought about in a child than in grown persons. 
 
 In very young children a rupture at the navel is not uncommon. 
 It may appear a few days after birth. When a child presents this 
 infirmity, it must be removed by compression. This is accom- 
 plished by a well-fitting bandage around the waist, containing a coin 
 or similar body immediately over the navel, thus retaining the parts 
 in their natural positions. 
 
 When they occur elsewhere, ruptures must be treated on the 
 principles laid down, p. 232. 
 
 Cancer, although not specially an affection of childhood, is li- 
 able to occur at that time, and moreover, as a disease generally here- 
 ditary, may be appropriately spoken of in this connection. Cancers 
 are of various kinds, and may occur in all parts of the body, and 
 appear at any age. They have been described as hard, soft, open or 
 bleeding, black, skin and bone cancers. They usually commence 
 with a swelling and pain, followed by a breaking of the skin, and 
 the formation of an external running sore. The pain is a. very 
 variable symptom. At the outset it is rarely very severe, and may 
 not be continuous. At times, it is described to be of an aching or 
 rheumatic character; at others, and more commonly, it is an occa- 
 sional dart of pain through the part, as if a needle had suddenly 
 been thrust into it. Later in the disease, the suffering becomes 
 severe and constant, even excruciating, and can only be relieved by 
 heavy doses of opiates. 
 
 What makes cancers so dangerous, is their tendency to recur 
 after removal, and penetrate into and poison the tissues of all the 
 organs of the body. Hence the only hope is to treat them early, 
 before this has come to pass. Although generally hereditary, they 
 are, in their outbreak, entirely local, and many instances are on 
 record where early and complete removal has saved the patient from 
 any recurrence of the cancerous growth. 
 
 One of the most common forms of cancer is epithelial, or skin 
 
Swellings of the Glands of the Neck, 317 
 
 cancer. It is frequently seen on the lips and face. Its surface may 
 be dry and warty, or watery and ulcerating. The edges are thick 
 and a little elevated, and the discharge thin. It is usually slow in 
 progress, lasting for years before causing such serious inconvenience 
 as to lead the sufferer to a surgeon. 
 
 The treatment of a cancer, whether in a child or in an adult, is 
 always and only by removal, and the earlier and more completely 
 this is done, the greater safety has the patient for his life. Removal 
 may be accomplished either by the knife or by caustics. Of the 
 first of these methods, we shall only say that in the majority of 
 cases it is the least painful, the most prompt, and the most effica- 
 cious. Whenever it is possible, the advice of a good surgeon 
 should be sought early, and his intervention solicited. 
 
 But many people have a great dread of the knife. They prefer 
 to suffer indefinite agonies from strolling quacks who advertise can- 
 cer salves, and it is of these we would speak. Whatever secrets 
 such quacks pretend to have, they are all deceptions, and unscrupu- 
 lous frauds. The caustics which are of use in cancer are all well 
 known to the regular medical profession, and appear in the text- 
 books of surgery. The two principal ones are the chloride of zinc 
 and arsenic. The former, made into a paste with two parts of flour 
 and a small quantity of morphia, is as efficient a cancer salve as 
 any, but it is dangerous and unjustifiable for persons ignorant of 
 surgery to employ it. Of the internal remedies given to prevent 
 the return of cancer, the best are arsenic, in small doses, long con- 
 tinued, and poke root. The latter vegetable preparation, given as a 
 tea or extract, seems to have really valuable properties. 
 
 Swellings of the Glands of the Neck are often treated at 
 home, without the aid of the physician or surgeon, until they 
 suppurate, and are likely to leave scars. When such domestic 
 management, however, is determined upon, the invalid should be 
 allowed a nutritious animal diet, his bowels kept free by exercise 
 on foot, whilst mild purgatives should be given, and the solution of 
 iodide of iron, in doses of from ten to sixty drops, or, the syrup of 
 the iodide, in doses of a teaspoonful (a fluid drachm, which contains 
 three grains of the iodide), should be internally administered, in a 
 glass of water, twice a day. The tumors should be treated with 
 27* 
 
3i8 
 
 Diseases of Children. 
 
 fomentations of salt or sea water, and friction employed twice daily, 
 for half an hour each time. If suppuration cannot be arrested, 
 under the improved state of health, then surgical advice must not 
 be delayed until the abscess bursts spontaneously, for an ugly scar 
 is likely to be the result; an event always to be regretted, especially 
 in females. 
 
PART IV. 
 
 SPECIAL RECEIPTS FOR CARE OF THE SICK. 
 
 THE DIVISIONS OF THIS PART. 
 
 In this, the last of the four parts into which we have divided our 
 book, we have grouped nearly three hundred new and approved 
 special receipts for the care of the sick. The first chapter of this 
 part, Chapter Eleventh of the book, contains choice dietetic receipts 
 for the sick-room ; the second chapter of this part, Chapter Twelfth 
 of the book, contains efficient medical receipts for the sick-room. 
 Most of these receipts have been referred to by their numbers, in 
 the treatment recommended for the various ailments discussed on 
 the previous pages. By grouping them, as is here done, the 
 various ways for accomplishing the same or a similar object are 
 shown, and the reader can readily choose among them, in accordance 
 with the purpose in view or the resources at hand. Thus, if a poul- 
 tice is wanted, by turning to the section on poultices, in Chapter 
 Twelfth, there will be exposed at one view, under the eye, a large 
 number of receipts for making poultices, from which to select one 
 appropriate to the needs of the case, or to the means of treatment 
 at command. 
 
 319 
 
CHAPTER X 
 
 Dietetic Receipts for, the Sick Room. 
 
 Importance of the subject — Rules for preparing and serving food for the 
 sick — Nutritious, cooling, and soothing drinks: Lemonade — Effervescing 
 lemonade — Barley water — Linseed tea — Arrowroot drink — Milk punch — 
 Wine whey — Egg and sherry — Ice — Toast and water — Nutritious coffee — 
 Milk and Isinglass — A soothing drink — Milk and cinnamon drink — 
 Caudle — Apple water — Chocolate — Chocolate milk — The Invalid's tea — 
 Rose tea — Sage tea — Oatmeal tea. Gruels : Water gruel — Milk gruel — 
 Flour gruel — Rice gruel — Barley gruel. Broths and soups: Chicken 
 broth— Mutton broth — Whole beef tea — Quickly-made beef tea — Veget- 
 able soup — Bread soup — Spinach soup — Beef and hen broth. Meats and 
 Vegetables for Invalids: Table, in order of digestibility, of some articles 
 of animal food — Boiled pigeon or partridge — Bread sauce — Relish for 
 fish — Minced fowl and egg — Fowl and rice — Stewed oysters — The inva- 
 lid's cutlet — The invalid's mashed potato — Potato surprise Jellies for 
 Invalids: Isinglass jelly — Strengthening jelly — Mutton jelly — Bread 
 jelly— Rice blanc-mange — Arrowroot blanc-mange — Sago jelly — Tapioca 
 jelly — Panada — Calves' feet jelly — Currant jelly — Irish moss blanc- 
 mange — Gelatine blanc-mange. Puddings for Invalids: Rice pudding — 
 Bread pudding — Batter pudding — Milk for puddings or stewed fruit — 
 Rice and apple — Vermicelli pudding. 
 
 In many, if not in all diseases, the choice and the preparation of 
 the articles for the patient's table are of the utmost importance. 
 Food is often the best medicine, and the cook may frequently be 
 of more service than the druggist. But not uncommonly, the dishes 
 served the invalid, like the drugs administered to him, fail of their 
 effect because of their faulty preparation. Those who cook for the 
 sick share the responsibility of treatment with the physician and 
 pharmacist. 
 
 The character and amount of the food required by the sick 
 vary, of course, with the nature and stage of the illness. Those 
 sick of a fever need to be nourished by frequent supplies of nutri- 
 
 320 
 
Rides for Waiting on the Sick. 321 
 
 tious, easily digested food, in a fluid form, for solid food is, ordina- 
 rily, then rejected by the stomach, because of the loathing it 
 excites. The weakest stomach, in such case, will take a small 
 wineglassful of milk or beef-tea, every hour or two. If the milk 
 clot in the stomach, and cheesy lumps be thrown up, this can be 
 readily guarded against by adding a tablespoonful of lime water to 
 each wineglassful of milk. As no regular meals can be taken, they 
 should not be attempted. Small quantities of fluid food at short 
 intervals, will furnish, during the twenty-four hours, a large amount 
 of nourishment, which the irritable stomach, when thus approached, 
 will absorb unconsciously. In inflammatory rheumatism, meat in 
 any form, solid or fluid, is injurious; the patient must be put upon 
 preparations of rice, potatoes, bread, arrowroot, gruel, vegetable or 
 meatless soups, and jellies. In dyspepsia and weak digestion, the 
 invalid requires frequent, small meals, at which he should drink 
 very sparingly, and not at all at the beginning of the repast. 
 Persons subject to hysterics need a generous meat diet, and must 
 avoid all spirituous or fermented liquors. An excellent drink for 
 them is a mixture of equal parts of soda water and milk. For 
 consumptives, milk and suet are excellent articles of diet, but the 
 best of all is cod-liver oil, which is the most readily digested fat of 
 which we have any knowledge. In disease of the heart, a dry diet 
 is most conducive to the comfort of the invalid, as liquids are 
 absorbed very slowly by the stomach ; the table should be generous, 
 from which stimulants, however, are to be excluded, as they readily 
 excite the heart's action. 
 
 We cannot better preface the varied receipts of this chapter, 
 than by quoting the words of one whose eminence in the profession, 
 and whose large and long experience, give them the weight of author- 
 ity. Professor Gross says : " The diet of the sick room has slain its 
 thousands and tens of thousands. Broths, and slops, and jellies, 
 and custards, and ptisans, are usually as disgusting as they are 
 pernicious. Men worn out by disease and injury must have 
 nutritious and concentrated food. The ordinary preparations for 
 the sick are, in general, not only not nutritious, but insipid and 
 flatulent. Animal soups are among the most efficient supporters 
 of the exhausted system, and every medical man should know how to 
 
322 Special Receipts for the Care of the Sick. 
 
 give directions for their preparation. The life of a man is his food. 
 Solid articles are, of course, withheld in acute diseases, in their 
 earlier stages ; but when the patient begins to convalesce, they are 
 frequently borne with impunity, and greatly promote recovery. All 
 animal soups should be made of lean meat; and their nutritious 
 properties, as well as their flavor, may be much increased by the 
 addition of some vegetable substance, as rice or barley. If the 
 stomach is very weak, they, may be diluted, or seasoned with 
 pepper." 
 
 The following rules must be observed in preparing, cooking, and 
 serving food for the sick: — 
 
 All the utensils employed should be scrupulously clean. 
 
 Never make a large quantity of one thing at a time. 
 
 Serve everything in as tempting and elegant a form as possible. 
 
 Put only a small quantity of an article on a dish at a time. 
 
 Keep milk and other delicacies on ice in warm weather. 
 
 Never leave food about a sick room. 
 
 Never offer beef tea or broth with the smallest particle of fat or 
 grease on it, nor milk that is sour, nor meat or soup that is turned, 
 nor an egg that is bad, nor vegetables that are underdone. 
 
 NUTRITIOUS, COOLING AND SOOTHING DRINKS. 
 
 1. Lemonade. 
 Take of 
 
 Sugar, two or three lumps. 
 
 Lemon, one. 
 
 Well rub the sugar on the rind of 
 the lemon, squeeze out the juice, and 
 add to it half a pint or a pint of 
 cold or iced water ; or, better still, 
 one or two bottles of soda water. 
 
 2. Another Lemonade. 
 Pare the rind of three lemons as 
 thin as possible, add a quart of boil- 
 ing water and a quarter of an ounce 
 of isinglass. Let them stand till 
 next day, covered, then squeeze the 
 juice of eight lemons upon half a 
 pound of lump sugar; when the 
 
 sugar is dissolved, pour the lemon 
 and water upon it, mix all well to- 
 gether, strain it, and it is ready for 
 use. 
 
 3. Effervescing Lemonade. 
 
 Squeeze two large lemons, and add 
 a pint of spring water to the juice, 
 and then four or five lumps of white 
 sugar. When required for use, pour 
 half of it into a tumbler, and add 
 half a teaspoonful of baking soda; 
 stir and drink while foaming. 
 
 4. Barley Water. 
 Take of 
 Pearl barley, half a quarter of a 
 pound. 
 
Nutritions , Cooling and Soothing Drinks. 323 
 
 Wash with cold water. Boil for 
 five minutes in some fresh water, 
 and then throw both waters away. 
 Then pour on two quarts of boiling 
 water, and boil it down to a quart. 
 Flavor with thinly-cut lemon rind, 
 and sugar to taste, but do not strain, 
 unless at the sick person's special 
 request. 
 
 This is an excellent receipt for 
 making hard water more digestible. 
 
 5. Linseed Tea. 
 
 Take of 
 
 Whole linseed, 
 
 White sugar, each one ounce. 
 
 Liquorice root, half an ounce. 
 
 Lemon juice, four tablespoonfuls. 
 
 Pour on the materials two pints of 
 boiling water, let them stand in a hot 
 place four hours, and then strain off 
 the liquor. 
 
 This makes an admirable soothing 
 drink, which acts also upon the kid- 
 neys. 
 
 6. Arrowroot Drink. 
 Take of 
 
 Arrowroot, two teaspoonfuls. 
 
 Cold water, three tablespoonfuls. 
 
 Mix together and pour in about 
 half a pint of boiling water. When 
 well mixed, add, by degrees, half a 
 pint of cold water, stirring all the 
 time, so as to make it perfectly 
 smooth. It should be about the 
 consistence of cream ; if too thick, a 
 little more ^water may be added. 
 Then pour in two wineglassfuls of 
 sherry, or one of brandy, add sugar 
 to taste, and give it to the invalid in 
 a tumbler. A lump of ice may be 
 added. 
 
 7. Milk-Punch. 
 Take of 
 
 Good brandy, two tablespoonfuls. 
 
 Cold, fresh milk, one tumblerful. 
 
 Mix with sugar and nutmeg to 
 taste. 
 
 This is a useful drink when a 
 stimulant is required in conjunction 
 with a nutrient. It is a medicinal 
 drink, and must not be given indis- 
 criminately. 
 
 8. Wine Whey. 
 Take of 
 
 Fresh milk, one pint. 
 
 Boil it, and so soon as the boiling 
 
 point is reached add as much good 
 Madeira or sherry as will coagulate 
 it. Strain, and sweeten or flavor 
 for use. 
 
 This preparation, when nicely 
 made, renders great service to the 
 sick in proper cases. 
 
 9. Egg and Sherry. 
 
 Beat up, with a fork, an egg till it 
 froths, add a lump of sugar and two 
 tablespoonfuls of water. Mix well. 
 Then pour in a wineglassful of 
 sherry, and serve before it gets flat. 
 Half the quantity of brandy may be 
 used instead of sherry. 
 
 This is a valuable preparation in 
 cases of great prostration, when 
 stimulants and concentrated nutri- 
 ment are required. 
 
 10. Ice. 
 
 It has been found by experiments 
 on the gastric juice that low tempera- 
 ture does not exercise any deleterious 
 influence upon it, though it is quite 
 spoiled by heat. The supply of the 
 juices necessary to digestion is ar- 
 rested by feverish ness of the system 
 and in hot weather and in hot rooms. 
 It cannot, therefore, but be benefi- 
 cial to the stomach to reduce the 
 unusual temperature to which it has 
 been brought by the overheated 
 blood. Hence, ice makes a most 
 valuable addition to the tables of 
 both sick and well. It is very inju- 
 rious during the exhaustion follow- 
 ing violent exercise, or the real cool- 
 ing attending excessive perspiration. 
 Lake ice is much superior to pond 
 ice or snow. 
 
 11. Toast and Water. 
 
 Take of 
 
 Bread, one slice, from a stale loaf. 
 
 Boiling water, one quart, 
 
 Toast the slice of stale bread (a 
 piece of hard crust is better than 
 anything else for the purpose) to a 
 nice brown on each side, but do not 
 allow it to burn or blacken. Put it 
 into a jug, pour the boiling water 
 over it, cover it closely, and let it 
 remain until cold. When strained 
 it will be ready for use. 
 
 Toast and water should always be 
 made a short time before it is re- 
 
324 Special Receipts for the Care of the Sick. 
 
 quired, to enable it to get cold ; if 
 drank in a tepid or lukewarm state, 
 it is an exceedingly disagreeable 
 beverage. If, as is sometimes the 
 case, this drink is wanted in a hurry, 
 put the toasted bread into a jug, and 
 only just cover it with the boiling 
 water ; when this is cool, cold water 
 may be added in the proportion re- 
 quired, and the toast and water 
 strained. It will then be ready for 
 Use, and is more expeditiously pre- 
 pared than by the above method. 
 
 12. Nutritious Coffee. 
 
 Dissolve a little isinglass in water, 
 then put half an ounce of freshly- 
 ground coffee into a saucepan, with 
 one pint of new milk, which should 
 be nearly boiling before the coffee is 
 added. Boil both together for three 
 minutes. Clear it by pouring some 
 of it in a cup and dashing it back 
 again. Add the isinglass and leave 
 it to settle before the fire for a few 
 minutes. Beat up an egg in a break- 
 fast cup and pour the coffee into it ; 
 or, if preferred, drink without the 
 egg- 
 
 13. Milk and Isinglass. 
 Take of 
 
 Isinglass, a pinch or two. 
 Milk, a tumblerful. 
 Mix well and boil. Serve with or 
 without sugar, as preferred. 
 
 14. A Soothing Drink, 
 Take of 
 
 Isinglass, a pinch. 
 New milk, a tumblerful. 
 Bruised sweet almonds, half a 
 
 dozen. 
 Sugar, three lumps. 
 Boil together. 
 
 15. Milk and Cinnamon Drink. 
 
 Boil, in a pint of new milk, suffi- 
 cient cinnamon to flavor it pleasant- 
 ly, and sweeten with white sugar. 
 
 This may be taken cold, with a 
 teaspoonful of brandy, and is very 
 good in cases of diarrhoea. Children 
 may take it milk-warm, without the 
 brandy. 
 
 16. Caudle. 
 Beat up an egg to a froth, add a 
 wineglassful of sherry, and half a 
 pint of gruel ; flavor with lemon-peel 
 and nutmeg, and sweeten to taste. 
 
 17. Apple Water. 
 
 Slice two or three ripe apples, 
 without paring, into a pitcher, pour 
 on a quart of scalding water, let it 
 stand till cool, and sweeten with 
 sugar. 
 
 18, Chocolate. 
 
 Put milk and water on to boil. 
 Scrape the chocolate fine, one or two 
 squares to a pint, as will best suit 
 the stomach. When the mixture of 
 milk and water boils, take it off the 
 fire, throw the chocolate into it, mix 
 it well, and serve it up with the froth. 
 The sugar may be mixed with the 
 scraped chocolate, or added after- 
 wards. It should never be made 
 before it is wanted, as heating it 
 again injures the flavor, and causes 
 a separation of the oil, 
 
 19. Chocolate Milk. 
 
 Dissolve an ounce of scraped choco- 
 late in a pint of boiling new milk. 
 
 20. The Invalid's Tea. 
 Pour into a small china or earthen 
 ware teapot a cup of quite boiling 
 water ; empty it out, and while the 
 teapot is still hot and steaming, put 
 in the tea. Add enough boiling wa- 
 ter to wet the tea thoroughly, and set 
 it close to the fire to steam, for five or 
 six minutes. Then pour in the quan- 
 tity of boiling water required, from 
 the kettle, and it is ready for use. 
 
 21. Rose Tea. 
 Take of 
 Bed rose-buds (the white heels 
 being taken off), half an ounce. 
 White wine vinegar, three table- 
 spoonfuls. 
 White sugar candy, one ounce. 
 Put them in two pints of boiling 
 water, and let them stand near a fire 
 for two hours, then strain. 
 
 Similar sour drinks may be made 
 of apple jelly, guava jelly, syrup of 
 gooseberries, etc. A variety is 
 always agreeable. 
 
Gruels for Invalids. 
 
 325 
 
 22. Sage Tea. 
 
 Take of 
 Green sage leaves, plucked from 
 the stalks and washed clean, half 
 an ounce. 
 Sugar, one ounce. 
 Outer rind of lemon-peel, finely 
 pared from the white, quarter of 
 an ounce. 
 Put them in two pints of boiling 
 water, let them stand near the fire 
 half an hour, then strain. 
 
 When the sage is dried, it must be 
 used in rather less quantity than 
 above mentioned. 
 In the same manner, teas may be 
 
 made of rosemary, balm, southern 
 wood, etc., and are convenient to 
 prevent a thirsty invalid taking too 
 much tea and coffee when not good 
 for him. 
 
 23. Oatmeal Tea. 
 Take of 
 
 Oatmeal, a handful. 
 
 Barley water, a gallon. 
 
 Mix in a deep vessel. Let the 
 oatmeal subside, which it does in 
 half an hour, and pour off the tea. 
 Hard water may be made digestible 
 in this manner. 
 
 GKUELS. 
 
 Gruels should be thick, but not too thick ; thin, but not too 
 thin. Served in a tumbler they are more appetizing than when 
 served in a basin or cup and saucer. 
 
 24. Water Gruel. 
 Take of 
 
 Fine oatmeal, a dessertspoonful. 
 
 Cold water, a tablespoonful. 
 
 Mix. Add a pint of boiling water, 
 and boil it ten minutes, keeping it 
 stirred. 
 
 25. Milk Gruel. 
 Take of 
 
 Fine oatmeal, four tablespoonfuls. 
 
 Milk, a quart. 
 
 Stir the oatmeal smoothly into the 
 milk. Then stir it quickly into a 
 quart of boiling water, and boil up a 
 few minutes, till it is thickened. 
 Sweeten with sugar. 
 
 26. Flour Gruel. 
 Take of 
 
 Flour, a tablespoonful. 
 
 Water, half a tumblerful. 
 
 Mix smoothly. Set on the fire, in 
 a saucepan, haif a tumblerful of new 
 milk, sweeten it, and, when it boils, 
 add the flour and water. Simmer 
 and stir them together for a quarter 
 of an hour. 
 
 27. Rice Gruel. 
 Take of 
 
 Fine rice, two tablespoonfuls. 
 
 28 
 
 Soak for half an hour in cold 
 water. Pour off the water, and to 
 the rice add a pint, or rather more, 
 of new milk. Simmer gently till the 
 rice is tender, then press through a 
 sieve and mix with the milk. Heat 
 over the fire, add a little more milk 
 gradually, pour off to cool, and 
 flavor with salt or sugar. 
 
 28. Barley Gruel 
 
 Take of 
 
 Pearl barley, two ounces. 
 
 Port wine, a tumblerful. 
 
 Rind of lemon, one. 
 
 Water, one quart and a pint. 
 
 Sugar, to taste. 
 
 After well washing the barley, boil 
 it in a tumblerful of water for fif- 
 teen minutes. Then pour this water 
 away. Put to the barley the quart 
 of fresh boiling water, and let it 
 boil until the liquid is reduced to 
 half; then strain it off. Add the 
 wine, sugar and lemon peel. Sim- 
 mer for five minutes and put it away 
 in a clean jug. It can be warmed 
 from time to time, as required. 
 
326 Special Receipts for the Care of the Sick, 
 
 BROTHS AND SOUPS. 
 
 Broths, soups and beef tea should not be kept hot, but heated 
 up as required. Neither should they ever be made in the sick 
 room. 
 
 29. Chicken Broth. 
 
 Skin, and chop up small, a small 
 chicken, or half a large fowl, and 
 boil it, bones and all, with a blade 
 of mace or sprig of parsley, and a 
 crust of bread, in a quart of water, 
 for an hour, skimming it from time 
 to time. Strain through a coarse 
 cullender. 
 
 Chicken broth, poured on thin 
 pieces of bread laid on the bottom 
 of the dish, makes a good sauce for 
 boiled chicken or partridge, when 
 the invalid is well enough to be 
 allowed solid food. 
 
 30. Mutton Broth. 
 Take of 
 
 Lean loin of mutton, one pound, 
 exclusive of bone. 
 
 Water, three pints. 
 
 Boil gently till very tender, throw- 
 ing in a little salt and onion, accord- 
 ing to taste. Pour out the broth 
 into a basin, and, when it is cold, 
 skim off all the fat. It can be 
 warmed up as wanted. 
 
 If barley or rice is added, as is 
 desirable during recovery from sick- 
 ness, it must be boiled first, sepa- 
 rately, till quite soft, and put in 
 when the broth is heated for use. 
 
 31. Whole Beef Tea. 
 
 The virtue of beef tea is to con- 
 tain all the contents and flavors of 
 lean beef in a liquid form. Its vices 
 are, to be sticky and strong, and to 
 set in a hard jelly when cold. 
 
 Take half, a pound of fresh-killed 
 beef for every pint of tea required, 
 and remove all fat, sinew, veins and 
 bones. Cut up into pieces under 
 half an inch square, and soak for 
 twelve hours, in one-third of the 
 water. Take it out and simmer for 
 two hours in the remaining two- 
 thirds of the water, the quantity 
 lost by evaporation being replaced 
 from time to time. Then pour the 
 
 boiling liquor on the cold liquor in 
 which the meat was soaked. Dry 
 the solid meat, pound it in a mortar, 
 freed from all stringy parts, and mix 
 with the rest. 
 
 When the beef tea is made daily, 
 it is convenient to use one day's 
 boiled meat for the next day's tea, 
 as thus it has time to dry and is 
 easier pounded. 
 
 A wholesome flavoring for beef 
 tea is fresh tomato. A piece of green 
 celery stalk, or a small onion and a 
 few cloves, may also be boiled in it. 
 Leeks give it a fusty flavor, and 
 mushroom ketchup, sometimes in- 
 troduced, is of doubtful composi- 
 tion. 
 
 While this is cooking, some more 
 hastily prepared, in the following 
 way, may be used. 
 
 32. Quickly-made Beef Tea. 
 Take one pound of raw beef, 
 minced, for each pint of water. 
 Stir up cold and let it stand for one 
 hour. Then place the vessel in 
 which they are mixed in a pan of 
 water, and heat for another hour, 
 over a slow fire, being careful not to 
 boil, as then the preparation becomes 
 gluey, and is not equally nutritious 
 or digestible. Run the tea through 
 a coarse strainer, and flavor at dis- 
 cretion. 
 
 33. Vegetable Soup. 
 
 Take of butter, half a pound. Put 
 it in a deep stew-pan, place it on a 
 gentle fire till it melts, shake it 
 about, and let it stand till it has done 
 making a noise. Have ready six 
 medium-sized onions, peeled and cut 
 small ; throw them in and shake them 
 about. Take a bunch of celery, cut 
 in pieces about an inch long, a large 
 handful of spinach, cut small, and 
 a little bundle of parsley, chopped 
 fine; sprinkle these into the pan, 
 and shake them about for a quarter 
 
Meats and Vegetables for Invalids. 
 
 327 
 
 of an hour ; then sprinkle in a little 
 flour and stir it up. Pour into the 
 pan two quarts of boiling water, and 
 add a handful of dry bread-crust, 
 broken in pieces, a teaspoonful of 
 pepper, three blades of mace, beaten 
 fine ; boil gently another half hour. 
 Then beat up the yolks of two eggs, 
 with a teaspoonful of vinegar, and 
 stir them in, and the soup is ready. 
 
 The order in which the ingredients 
 are added is very important. 
 
 34. Bread Soup. 
 
 Take the crust of a stale roll, cut it 
 in pieces, and boil it well in a pint 
 of water, with a piece of butter as big 
 as a walnut, stirring and beating 
 them till the bread is raised. Season 
 with celery and salt, 
 
 35. Spinach Soup. 
 Pick all the stalks from one and 
 a half pounds of fresh spinach ; wash 
 
 it and clip it ; put it in a three-quart 
 stew-pan, with a quarter of a pound 
 of butter ; stir it over the fire for five 
 minutes ; add an ounce of flour, and 
 stir again for three or four minutes, 
 then stir in two quarts of chicken 
 broth till it boils. Simmer it on a 
 cool stove for half an hour, and add 
 a small teaspoonful of cream. Serve 
 with it some fried or baked bread. 
 
 Endive or lettuce soup may be pre- 
 pared in the same way. 
 
 36. Beef and Hen Broth. 
 
 Take of 
 
 Lean beef, one pound. 
 
 Hen, one-half, boned. 
 
 Pound together in a mortar ; add 
 salt ; put in a stew-pan with two and 
 a half pints of water, and stir over 
 the fire till boiling. Then add car- 
 rots, onions, leeks, and celery, cut 
 fine. Boil for half an hour. Strain 
 and serve. 
 
 MEATS AND VEGETABLES FOR INVALIDS. 
 
 Table, in Order of Digestibility, of 
 Some Articles of Animal Food. 
 
 Sweet bread. 
 
 Boiled chicken. 
 
 Venison. 
 
 Lightly boiled eggs, new toasted 
 
 cheese. 
 Boast fowl, turkey, partridge and 
 
 pheasant. 
 Lamb, wild duck. 
 Oysters. 
 
 Boiled haddock, trout, perch. 
 Roast beef. 
 Boiled beef. 
 Rump steak. 
 Roast veal. 
 Boiled veal, rabbit. 
 Salmon, mackerel, herring. 
 Hard-boiled and fried eggs. 
 Wood pigeon, hare. 
 Tame pigeon, tame duck, geese. 
 Fried fish. 
 
 Roast and boiled pork. 
 Heart, liver, lights and kidneys of 
 
 ox, swine and sheep. 
 
 Lobsters. 
 
 Smoked, dried, salt and pickled fish. 
 
 Crab. 
 
 Ripe old cheese. 
 
 37. Boiled Pigeon or Partridge. 
 
 Clean and season, inclose it in a 
 puff paste, and boil. Serve in its 
 own gravy, supplemented by the 
 liver rubbed up with some stock, 
 and do not forget the bread sauce. 
 
 38. Bread Sauce. 
 Take of 
 
 The crumbs of a French roll. 
 
 Water, a tumblerful. 
 
 Black pepper, six to eight corns. 
 
 Onion, a small piece. 
 
 Salt, to taste. 
 
 Boil till smooth ; then add a piece 
 of butter about as big as a walnut, 
 and mix for use. It is good, hot, 
 with hot birds, cold, with cold birds, 
 and is an excellent food for the sick. 
 
328 Special Receipts for the Care of the Sick. 
 
 39. Relish for Fish. 
 Fish is made more digestible, and 
 has its flavor brought out, by a few 
 drops of lemon juice squeezed over 
 it. 
 
 40. Minced Fowl and Egg. 
 
 Take of 
 
 Cold roast fowl, one. 
 
 Hard-boiled egg, one. 
 
 New milk or cream, three table- 
 spoonfuls. 
 
 Butter, half an ounce. 
 
 Flour, one tablespoonful. 
 
 Salt, pepper, or cayenne, to taste. 
 
 Lemon juice, one teaspoonful. 
 
 Mince the fowl and remove all 
 skin and bones. Put the bones, 
 skin and trimmings into a stewpan, 
 with one small onion, if agreeable to 
 the patient, and nearly half a pint 
 of water. Let this stir for an hour, 
 then strain the liquor, chop the egg 
 small, mince with the fowl, add salt 
 and pepper, put in the other ingre- 
 dients, let the whole just boil, and 
 serve with thin slices of toasted 
 bread. 
 
 41. Fowl and Rice. 
 
 Take of 
 
 Rice, one quarter of a pound 
 
 Broth, one pint. 
 
 Butter, one ounce and a half. 
 
 Minced fowl, egg and bread 
 crumbs. 
 
 Put the rice into the broth, let it 
 boil very gently for half an hour, 
 then add the butter, and simmer it 
 till quite dry and soft. When cold, 
 make it into balls, hollow out the 
 inside, and fill them with mince 
 made according to the foregoing re- 
 ceipt, but a little stiffer. Cover with 
 rice, dip the balls into egg, sprinkle 
 with bread crumbs, and fry a nice 
 brown. A little cream stirred into 
 the rice bei'ore it cools improves it 
 very much. 
 
 42. Stewed Oysters. 
 Take of 
 
 Oysters, half a pint. 
 
 Butter, half an ounce. 
 
 Cream, one-third of a pint. 
 
 Flour, cayenne and salt, to taste. 
 
 Scald the oysters in their own 
 liquor. Take them out, beard them, 
 and strain the liquor. Put the but- 
 
 ter into a stewpan, dredge in suffi- 
 cient flour to dry it up, add the 
 oyster liquor, and stir it over a 
 sharp fire with a wooden spoon. 
 When it boils, add the cream, oysters 
 and seasoning, and simmer for one 
 or two minutes, but not longer, or 
 the oysters will harden. Serve on a 
 hot dish, with thin slices of toasted 
 bread. A quarter of a pint of 
 oysters, the other ingredients being 
 in proportion, makes a dish large 
 enough for one person. 
 
 43. The Invalid's Cutlet. 
 Take of 
 
 Nice cutlet, from loin or neck of 
 mutton, one. 
 
 Water, two teacupfuls. 
 
 Celery, one very small stick. 
 
 Pepper and salt, to taste. 
 
 Have the cutlet cut from a very 
 nice loin or neck of mutton. Take 
 off all the fat, put it into a stewpan, 
 with the other ingredients; stew 
 very gently indeed for nearly two 
 hours, and skim off every particle 
 of fat that may rise to the surface 
 from time to time. The celery 
 should be cut into thin slices before 
 it is added to the meat, and care 
 must be taken not to put in too much 
 of this ingredient, or the dish will 
 not be good. If the water is allowed 
 to boil fast the cutlet will be hard. 
 Time, two hours, very gentle stew- 
 ing. 
 
 44. The Invalid's Mashed Potato. 
 Boil one pound of potatoes with 
 their skins on, till they are tender or 
 brittle. Peel them and rub them 
 through a fine sieve. When cool, 
 add a small teacupful of fresh cream 
 and a little salt, beating up lightly 
 until the whole is quite smooth. 
 Warm up gently for use. 
 
 45. Potato Surprise. 
 Scoop out the inside of a sound 
 potato, leaving the skin attached, on 
 one side, to the hole, as a lid. Mince 
 up fine the lean of a juicy mutton 
 chop, with a little salt and pepper ; 
 put it in the potato, pin down the 
 lid, and bake or roast. Before serv- 
 ing (in the skin) add a little hot 
 gravy, if the mince seems too dry. 
 
Jellies for Invalids. 
 JELLIES FOE INVALIDS. 
 
 329 
 
 46. Isinglass Jelly. 
 
 Boil an ounce of isinglass and a 
 dozen cloves (if liked), in a quart of 
 water, down to a pint. Strain, hot, 
 through a flannel bag, on two ounces 
 of sugar-candy, and flavor. 
 
 47. Strengthening Jelly. 
 
 Simmer, in two quarts of soft 
 water, one ounce of pearl barley, one 
 ounce of sago, one ounce of rice, till 
 reduced to one quart. Take a tea- 
 cupful, in milk, morning, noon and 
 night. 
 
 48. Mutton Jelly. 
 Take of 
 
 Shanks of mutton, six. 
 
 Lean beef, half a pound. 
 
 Water, three pints. 
 
 Crust of bread, toasted brown. 
 
 Pepper and salt, to taste. 
 
 Soak the shanks in water several 
 hours, and scrub them well. Put 
 the shanks, the beef and other ingre- 
 dients into a saucepan, with the 
 water, and let them simmer, say, 
 gently, for five hours. Strain it, 
 and, when cold, take off" the fat. 
 Warm up as much as is wanted at a 
 time. 
 
 49. Bread Jelly. 
 
 Take the crumb of a loaf, break 
 it up, pour boiling water over it, and 
 leave it to soak for three hours. 
 Then strain off the water containing 
 all the noxious matters with which 
 the bread may be adulterated, and 
 add fresh. Place the mixture on the 
 fire and let it boil till it is perfectly 
 smooth. Take it off, and, after pour- 
 ing out the water, flavor with any- 
 thing agreeable. Put it into a mould, 
 and turn it out when required for 
 use. 
 
 50. Rice Blanc-mange. 
 Take of 
 
 Ground rice, one-quarter of a 
 
 pound. 
 Loaf sugar, two ounces. 
 Butter, one ounce. 
 Milk, one quart. 
 Flavoring, of lemon peel. 
 
 28* 
 
 Mix the rice to a smooth batter, 
 with a little milk, and put the re- 
 mainder into a saucepan, with the 
 butter, sugar and lemon peel. Bring 
 the milk to boiling point, stir in the 
 rice. Let it boil for ten minutes, or 
 till it comes away from the saucepan. 
 Grease a mould with salad oil, pour 
 in the rice, let it get perfectly cold, 
 and turn out, 
 
 51. Arrowroot Blanc-mange. 
 
 Take of 
 
 Arrowroot, two tablespoonfuls. 
 
 Milk, three-quarters of a pint. 
 
 Lemon and sugar, to taste. 
 
 Mix the arrowroot, with a little 
 milk, to a smooth batter; put the 
 rest of the milk on the fire and let 
 it boil. Sweeten and flavor it, stir- 
 ring all the time, till it thickens 
 sufficiently to come from the sauce- 
 pan. Put it into a mould till quite 
 cold. 
 
 52. Sago Jelly. 
 
 Take of 
 
 Sago, two tablespoonfuls. 
 
 Water, one pint. 
 
 Boil gently, until it thickens, fre- 
 quently stirring. Wine, sugar and 
 water may be added, according to 
 circumstances. 
 
 53. Tapioca Jelly. 
 
 Take of 
 
 Tapioca, two tablespoonfuls. 
 
 Water, one pint. 
 
 Boil it gently for an hour, or until 
 it assumes a jelly-like appearance. 
 Add sugar, wine and nutmeg, with 
 lemon juice to suit the taste of the 
 patient and the character of the ail- 
 ment. 
 
 54. Panada. 
 
 Take of 
 
 Bread crumbs, one ounce. 
 
 Mace, one blade. 
 
 Water, one pint. 
 
 Boil, without stirring, till they 
 mix and turn smooth. Then add a 
 grate of nutmeg, a small piece of 
 butter, sugar according to taste. 
 
330 Special Receipts for the Care of the Sick. 
 
 55. Calves'-Feet Jelly. 
 
 Take two calves 1 feet and add to 
 them one gallon of water, and boil 
 down to one quart. Strain, and, 
 when cold, remove all fat. Then 
 add the whites of six or eight eggs, 
 well beaten (a pint of urine, if desi- 
 rable), half a pound of loaf sugar, 
 and the juice of four lemons, and 
 mix well. Boil for a few minutes, 
 constantly stirring. Then strain 
 through a flannel bag. 
 
 56. Currant Jelly. 
 
 Boil together equal weights of 
 white sugar and the juice of ripe 
 currants, until the mixture solidifies 
 by cooling, as shown by dropping a 
 few drops on a cold plate. Bemove 
 the scum, and form the jelly in suit- 
 able vessels. 
 
 A tablespoonful of this jelly in a 
 tumbler of cold water makes a de- 
 
 lightful acid drink, very grateful to 
 many invalids. 
 
 57. Irish Moss Blanc-mange. 
 
 Take of 
 
 Irish moss, half an ounce. 
 
 Fresh milk, one pint and a half. 
 
 Boil these down to such a consis- 
 tency as to retain a form when cold. 
 Remove any sediment by filtering, 
 and then add the requisite quantity 
 of sugar, with lemon juice or peach 
 water, to give an agreeable flavor. 
 
 The moss, before being used, must 
 be well washed in cold water, to re- 
 move its saltish taste. 
 
 58. Gelatine Blanc-mange. 
 
 Boil one ounce of shred gelatine 
 in a quart of milk for ten minutes, 
 stirring constantly. Sweeten to the 
 taste, flavor with peach water or 
 essence of vanilla, and strain into a 
 mould. 
 
 PUDDINGS FOR INVALIDS 
 
 59. Rice Pudding. 
 Boil two ounces of rice in a pint 
 of milk, assiduously stirring till it 
 thickens. Take it off and let it cool. 
 Then well mix in two ounces of 
 butter, a quarter of a nutmeg, grated, 
 and sugar in moderation, according 
 to taste. Pour it into a buttered 
 dish and bake. 
 
 60. Bread Pudding. 
 Pour over a French roll half a 
 pint of boiling milk, cover it close, 
 and let it stand till it has soaked up 
 the milk. Tie it up tightly in a 
 cloth, and let it boil for a quarter of 
 an hour. Turn it out on a plate and 
 sprinkle a little white sugar over it. 
 The addition of burnt sugar or tinc- 
 ture of saffron, will give it the estab- 
 lished yellow color. 
 
 61. Batter Pudding. 
 Take of 
 
 Flour, three teaspoonfuls. 
 
 Milk, one pint. 
 
 Salt, a pinch. 
 
 Powdered ginger. 
 
 Nutmeg. 
 
 Tincture of saffron, each a tea- 
 spoonful. 
 
 Boil, 
 
 It will be observed in these three 
 receipts eggs are avoided, as when 
 baked, or even when boiled, so long 
 as it is necessary to boil puddings, 
 they are quite insoluble in a weak 
 stomach. 
 
 62. Milk for Puddings or Stewed 
 Fruit. 
 Boil a strip of lemon and two cloves 
 in a pint of milk. Mix half a tea- 
 
Counsels on Giving Food to the Sick. 
 
 331 
 
 spoonful of arroivroot in a little cold 
 milk, and add it to the boiling milk. 
 Stir it till about the consistency of 
 cream. Have ready the yolks of 
 three eggs, beaten up well in a little 
 milk. Take the hot milk off the 
 fire, and as it cools, add the eggs and 
 atablespoonful of orange flower water, 
 stirring it constantly till quite cool. 
 Keep it in a very cool place till 
 required for use. 
 
 63. Bice and Apple. 
 
 Boil about three tablespoonfuls of 
 rice in a pint and a half of new milk, 
 and simmer, stirring it from time to 
 time, till the rice is quite tender. 
 Have ready some apples, peeled, 
 cored, and stewed to a pulp, and 
 
 sweetened with a very little loaf 
 sugar. Put the rice round a plate, 
 and the apple in the middle, and 
 serve with a little of the above prep- 
 aration of milk, if liked. 
 
 64. Vermicelli Pudding. 
 Take of 
 
 Vermicelli, two ounces. 
 
 Milk, three-quarters of a pint. 
 
 Cream, one-quarter of a pint. 
 
 Butter, one ounce and a half. 
 
 Eggs, two. 
 
 Sugar, one ounce and a half. 
 
 Boil the vermicelli in the milk till 
 it is tender, then stir in the remain- 
 ing ingredients (omitting the cream 
 if that be not obtainable). Butter 
 a small tart dish, line with puff paste, 
 put in the pudding, and bake. 
 
 We conclude this chapter with the following judicious counsels 
 from the pen of Prof. Chambers, of London: "When a patient 
 cannot be raised in bed without risk of exhaustion, a crockery or 
 glass feeder is a convenience, but the same vessel, or even one of 
 the same appearance, should not be used for food and for medicine. 
 If the patient's mouth be foul, as in small-pox or putrid fever, it 
 should be cleansed when he is fed. The administration of nutri- 
 ment should then be so frequent that it is not allowed to become 
 again foul. Food should, as a rule, be as near the natural tempera- 
 ture of the body as possible. But when the febrile heat is very 
 high, or there is much nausea, some of it may be iced, with 
 advantage. When life seems passing away under their eyes, the 
 friends will often shrink from tormenting (as it seems to them) the 
 sick man with food. Let them not despair; many a one has 
 recovered after the doctor has taken his leave with a sad shake of 
 the head, and without making a fresh appointment. And let them 
 also be stimulated by this fact, namely, that the pains of death are 
 aggravated, if not mainly caused, by the failure of nutrition. 
 Even when apparently insensible, the dying suffer much increased 
 distress from want of food, though they cannot express their 
 sufferings." 
 
CHAPTEE XI 
 
 Medical Receipts for the Sick Room. 
 
 Baths and Douches. The hygienic importance of bathing— Rules for 
 the use of the bath in health — Division of baths according to their 
 warmth — The cold bath and directions for its employment — Warm and 
 hot baths, when useful — Medicated water baths — Soap bath — Bran bath — 
 Starch bath — Oil bath — Alkaline bath — Valerian bath — Gelatine bath — 
 Bark bath— Iron bath — Mustard bath— Salt water bath — Liver of sul- 
 phur bath — Turpentine bath — Vapor baths: Simple vapor bath— Medi- 
 cated vapor bath — Warm air bath — Turkish bath — Russian and Roman 
 baths — Fumigations— Shower baths — Douche baths — Sand and mud 
 baths — Hip baths or sitz baths— Foot baths — Shallow baths — Cold affu- 
 sion— Wet-sheet packing— The dripping sheet— The wet compress— The 
 sponge bath— Blisters— Cathartics or Purgatives. Remarks in 
 regard to their use — Receipts for Effervescing cream of tartar — Mag- 
 nesia and rhubarb— Rhubarb and epsom salts— May apple— Jalap and 
 cream of tartar— Calcined magnesia — Seidlitz powders— Purgative mine- 
 ral water — Clysters or Injections : A purgative injection — An as- 
 tringent injection — Nutritive injections — Cold, mode of applying — 
 Counter-irritants — Cupping — Disinfectants — Emetics — Eye 
 Waters— Fomentations, or Stupes and Steaming— Gargles- 
 Heat, mode of applying— Herb and other Medicinal Teas, Re- 
 ceipts for — Inhalations Directions for Administering — Leeching 
 — Liniments — Lotions or Washes — Ointments or Salves — Pain 
 Removers, or Anodynes — Plasters— Poultices: Bread and water 
 poultice — Flaxseed meal poultice— Bran poultice — Stimulating poultices 
 — Yeast poultice— Molasses poultice — Starch poultice — Charcoal poul- 
 tice—Carrot poultice — Alum poultice — Mush poultice — Slippery elm 
 poultice — Arrow-root poultice — Onion poultice — Mustard poultice — 
 Bread and Milk Poultice — Tonics — Receipts for the hygiene of the person: 
 — Tooth powders — Mouth washes — Washes for foul breath — Hair tonics 
 — Ointments and washes for dandruff — Lip salves and lotions — Ointments 
 and washes for chapped hands — Ointment for fetid feet — Lotions for the 
 face — Washes for removing freckles — Ointment for sunburn. 
 
 For convenience of reference we have arranged the various 
 classes under which the receipts are grouped in alphabetical order, 
 and shall, therefore, commence with 
 
 332 
 
Baths and Douches. 
 Baths and Douches. 
 
 333 
 
 Bathing, in its various forms, is an important item, not only in 
 hygiene, or for the preservation of health, but in the treatment of 
 many ailments, or, for the restoration of health. Baths may be 
 divided into simple baths and medicated baths. 
 
 In health, and during the summer particularly, washing the 
 whole body in a bath tub, or a running stream, several times a 
 week, is of the utmost importance. For this purpose the water 
 should not *be too cold. Very cold spring water is, therefore, 
 unfitted for bathing. If there be no bath in the house a wash tub 
 does very well. Or, a bath may be readily constructed of the kind 
 shown in the accompanying Figure. It consists of a hammock (a) 
 of rubber cloth, extended upon two long poles (6), passed through 
 a broad seam on each side of the hammock, and kept asunder by 
 the cross pieces (c), which are attached to the cross pieces by thumb 
 screws (d). By the flexible tube (/) the water may be drawn off. 
 When the poles are fixed as in the figure, and the open end of the 
 flexible tube twisted around one of the thumb screws, the bath is 
 ready to receive the water. It may be supported upon two chairs, 
 or upon the trestles (ee). 
 
 Fig. 103. 
 
 A Home-made Bath Tub. 
 A shower bath is an excellent thing on getting out of bed in the 
 morning. A very good make-shift for a regularly constructed 
 shower-bath apparatus exists in every house, in the shape of a 
 colander. The use of this needs an assistant, however, to pour 
 water through it. The accompanying figure shows a hollow tin 
 vessel with a perforated bottom. To make a shower bath of it, 
 sink it in a bucket of water, put the thumb at the orifice (c) of the 
 
334 Special Receipts for the Care of the Sick. 
 
 hollow tube (6) and raise the vessel from the bucket of water. 
 Fig. 104. The pressure of air keeps the water 
 
 in so long as the thumb is kept on 
 the orifice; on removing it, the 
 water is thrown in a shower on the 
 patient, over whose head it is held 
 by an attendant. This is especially 
 convenient for children. 
 
 After bathing, the skin should 
 be rubbed with a hard dry towel, 
 or with a flesh-brush, until it is in 
 a glow. 
 
 When a bath cannot be con- 
 veniently taken, it is always possi- 
 ble to sponge the chest and arms 
 A Home made Shower Bath. with water in the morning on 
 rising. This, if made a daily practice, with or without the addition 
 of a little vinegar to the water, will be found to be, when cold water 
 is employed, an excellent preventive of colds. 
 
 According to their temperature, baths are divided as follows: 
 
 The cold bath, from 33° to 60° of the ordinary (Pah.) thermometer. 
 The cool " 60° to 75° " " " 
 
 The temperate" 75° to 85° « " « 
 
 The tepid " 85° to 92° •< " " 
 
 The warm " 92° to 98° " " " 
 
 The hot " 98° to 112° " " " 
 
 The Cold Bath is mainly employed for the purpose of producing 
 the powerful reaction which should always follow its use. 
 
 Rules for the Use of the Cold Bath. — 1. The morning is the 
 best time. 2. It should never be taken when the body is in a pro- 
 fuse sweat. 3. Never immediately after a full meal. 4. The head 
 should be immersed first. 5. It should never be prolonged so as 
 to cause shivering, blueness of the nails, etc. Five minutes is 
 ordinarily a sufficient time. 6. If it cause disagreeable effects, the 
 temperature, on another occasion, should be raised, and the time 
 
The Cold and the Warm Bath. 335 
 
 shortened. 7. So soon as the bath is over, the body must be 
 quickly dried, and gentle exercise taken. 
 
 Cautions in Regard to the Use of the Cold Bath. — It should 
 never be taken very cold by persons with disease of the heart, nor by 
 those suffering from active inflammation of any of the organs of the 
 body. In skin diseases it is usually inadmissible, particularly in 
 those where a sudden driving in of the eruption may cause internal 
 affections. Persons very much debilitated, or those who do not 
 possess sufficient powers of reaction, must employ it with great cau- 
 tion, if at all. In infancy and old age it is of less benefit than in 
 youth and middle life. 
 
 The cold bath is particularly useful where there is a general 
 relaxation of the system and a deranged state of the nervous system 
 resulting from disease or a too close application to business or study. 
 It is a valuable tonic in all cases where no disease of the internal 
 organs exists. Like all powerful agents, it must be resorted to with 
 judgment, and its effects carefully watched. 
 
 Ailments in which the Cold Bath is Especially Beneficial. — In 
 asthma a cold bath in the morning has been found to be of great 
 service in many cases. Some prefer sponging the body in a mixture 
 of salt and cold water (two or three tablespoonfuls of salt to the 
 pint of water). The body should be well rubbed afterwards with 
 coarse towels. In persistent whooping cough the cold bath or the 
 shower bath has given good results in numerous instances. In St. 
 Vitus 1 dance cold baths and shower baths are often excellent in 
 connection with other treatment. Hysterical ailments of all kinds 
 are greatly benefited by them. 
 
 The Warm Bath is useful in soothing the nervous system, in 
 equalizing the temperature of the body, in modifying the action of 
 the skin, in reducing the frequency and force of the heart's action, 
 in relaxing the muscular system, in allaying restlessness, in relieving 
 pain, and often in inducing quiet sleep. It should be employed 
 with caution, if at all, by persons of very gross habits, and by those 
 predisposed to apoplexy or to dropsy. On coming out of a warm 
 bath, care should be taken to avoid exposure to a current of air and 
 so checking the perspiration. 
 
 Ailments in which the Warm and Hot Baths are Useful. — In 
 
336 Special Receipts for the Care of the Sick. 
 
 the jits, or convulsions of children, the warm bath (98° of the ther- 
 mometer) is a remedy of the utmost importance, and one which 
 should never be overlooked. The trunk of the body should be kept 
 in the water during ten or fifteen minutes. The hot bath is of ser- 
 vice in mild forms of dysentery. In most diseases of the skin a 
 daily employment of tepid or temperate baths is of much benefit. 
 
 Besides plain water baths, medicated baths are of frequent service 
 in the treatment of many ailments. We shall, therefore, give a 
 number of receipts for their preparation and use. 
 
 MEDICATED WATER BATHS. 
 
 65. Soap Bath, 
 
 Cut up two pounds of white soap, 
 and dissolve in live or six quarts of 
 warm water. Add this solution to 
 the water of the bath. 
 
 Useful in softening the skin, and 
 preparing it for the action of reme- 
 dies in many skin affections. 
 
 66. Bran Bath. 
 
 Boil in water, half an ounce of 
 bran, for a quarter of an hour. Add 
 this to the bath. 
 
 This makes an excellent soothing 
 bath. 
 
 67. Starch Bath. 
 
 Mix one pound and a half of grated 
 potatoes with five or six quarts of 
 water, and gently warm it. Then 
 heat to the boiling point, the same 
 quantity of water, and add slowly to 
 the potato and water mixture in 
 stirring. To be added to the bath. 
 
 This is also an admirable soothing 
 bath. 
 
 68. Oil Bath. 
 
 Add a pound of carbonate of soda, 
 to the warm water of the bath. Dis- 
 solve and leave in repose for half an 
 hour. Then add half a pint of al- 
 mond or cod-liver oil, and mix. 
 
 The preliminary solution of car- 
 
 bonate of soda is indispensable in 
 order to precipitate the salts of lime 
 contained in ordinary water ; without 
 this precaution, no thorough mixing 
 could be obtained. 
 
 This bath, frequently repeated, in- 
 creases the flesh of the sick and con- 
 valescent. 
 
 69. Alkaline Bath. 
 
 Add a quarter of a pound of car- 
 bonate of soda, or of ordinary baking- 
 powder, to the water of the bath. 
 
 This is useful in many skin affec- 
 tions. 
 
 70. Valerian Bath. 
 
 Mix one drachm of bruised valerian 
 root with a tumblerful of boiling 
 water, and add to the bath. 
 
 This is a useful bath in fits and 
 nervous affections. 
 
 71. Gelatine Bath. 
 
 Steep a pound and a half of pow- 
 dered gelatine in two quarts of cold 
 water, during an hour ; complete the 
 solution by heating. Add to the 
 bath. 
 
 A good soothing bath. 
 
 72. Bark Bath. 
 Boil, for half an hour, half a pound 
 
Medicated Baths. 
 
 337 
 
 of cinchona bark with a pint of 
 water, and strain. Add to the water 
 of the bath. 
 A useful tonic bath. 
 
 73. Iron Bath. 
 
 Add one ounce of the sulphate of 
 iron (green vitriol) to the water of 
 the bath. 
 
 This bath is recommended for 
 scrofulous and rickety children. 
 
 74, Mustard Bath. 
 
 Add two ounces of mustard to the 
 water of the bath. 
 
 This makes an effective stimulant 
 bath. Often of service in the ex- 
 haustion of children ; the child to be 
 immersed, all but its head. 
 
 75. Salt- Water Bath. 
 
 Add half a pound of salt to the 
 water of the bath, which may be 
 cold or warm, according to the sea- 
 son. 
 
 Very useful in scrofula and general 
 debility. 
 
 76. Liver of Sulphur Bath. 
 
 Add two ounces of liver of sulphur 
 to the water of the bath. 
 
 Frequently of great benefit in St. 
 Vitus' Dance. Also of much service 
 in itch. 
 
 77. Turpentine Bath. 
 Take of 
 
 Baking soda, two pounds. 
 
 Turpentine, a tumblerful. 
 
 Oil of rosemary, a tablespoonful. 
 
 Add to the water of the bath. 
 
 This bath calms the pulse, softens 
 the skin, and renders the respiration 
 easy. 
 
 78. Simple Vapor Bath. 
 A vapor bath may readily be given 
 by placing the unclothed patient on 
 a cane-bottomed chair, with a large 
 blanket fastened round his neck, 
 reaching to the ground. Under the 
 chair put a spirit lamp or a hot 
 brick and a dish containing wa- 
 ter. So soon as the water boils it 
 surrounds the body with an atmos- 
 phere of vapor. Or, the patient 
 may remain in bed, and the vapor 
 
 29 
 
 be introduced under the covers by 
 means of a rubber tube fastened 
 over the spout of an ordinary tea 
 kettle in which water is kept boiling. 
 
 79. Medicated Vapor Bath. 
 
 The water to be evaporated may 
 be readily medicated by throwing in 
 dried herbs, such as rosemary, thyme, 
 lavender flowers, or any others which 
 it may be desirable to employ. 
 
 In many chest and throat affec- 
 tions watery vapor, either simple or 
 medicated, may be diffused, with 
 advantage, through the air of the 
 sick room, by means of a small open 
 boiler placed over the fire, a gas, or 
 a spirit lamp. 
 
 80. Warm Air Bath. 
 This consists in exposing, for a 
 short time, the naked body to the 
 air of a common chamber which has 
 been made very warm. It acts pow- 
 erfully upon the skin, and induces 
 perspiration very quickly. 
 
 81. Turkish Baths. 
 
 This bath is essentially a hot air 
 bath, alternated with shampooing 
 and cold douches. It can only, of 
 course, be taken in large cities, 
 where establishments for the pur- 
 pose exist. The same remark ap- 
 plies to Russian and Roman baths. 
 
 These baths are dangerous when 
 any heart disease exists, and should 
 never be taken by the sick or en- 
 feebled, except upon competent medi- 
 cal advice. 
 
 82. Fumigations. 
 These are vapors or gases obtained 
 by heating various substances, for 
 the purpose of masking unpleasant 
 odors in the sick room, for modify- 
 ing the air in it, or for producing an 
 effect upon portions of the body with 
 which they are brought in contact. 
 They are frequently very improperly 
 employed for concealing odors the 
 cause of which should be removed 
 by cleanliness and ventilation. They 
 are generally made by burning cam- 
 phor y sugar, juniper berries or ben- 
 zoin, or by heating vinegar in the 
 
338 Special Receipts for the Care of the Sick. 
 
 83. Shower Bath. 
 
 The shower bath resembles, in its 
 effects, the cold bath, but the shock it 
 gives, with its thousand little blows, 
 is more violent, particularly if the 
 water be very cold, its quantity great, 
 and its fall considerable. Its uses are 
 the same as those of the cold bath. 
 
 84. Douche Bath. 
 
 This consists of a stream of water 
 let fall or thrown, by means of a tube 
 or otherwise, upon some portion of 
 the body. Its power varies with the 
 temperature of the water, the volume 
 of the stream, and the force with 
 which it is projected. A stream of 
 an inch diameter, falling five or ten 
 feet, is sufficient, borne for half a 
 minute. It must be used with care. 
 
 In fainting, the cold douche, sud- 
 denly applied to the spine, some- 
 times suddenly restores conscious- 
 ness. Stiff joints, after injuries or 
 rheumatic attacks, are often bene- 
 fited by cold douches of water upon 
 them. A thin stream of cold water 
 directed, for a few moments, from 
 an elevation of two or three feet, 
 upon the top of the head, is fre- 
 quently useful in fits or convulsions 
 of full-blooded children. 
 
 85. Sand and Mud Baths. 
 Warm sand baths are sometimes 
 useful in the treatment of rheumatic 
 joint affections. They are made by 
 heaping up warm sand about the 
 limb. At some mineral springs, and 
 
 at the seaside, patients affected with 
 gout, rheumatism, or general dropsy, 
 are treated by being buried to the 
 neck in sand, mud, or gravel, satu- 
 rated with the warm mineral water. 
 
 86. Hip Baths or Sitz Baths. 
 These consist simply of any conve- 
 nient vessel, containing warm water, 
 in which the patient can sit, so that 
 the hips will be completely immersed. 
 They are of use in gravel and kidney 
 
 87. Foot Baths. 
 These are very useful in drawing 
 away the blood from the brain, lungs 
 or other organs which are congested, 
 or the seat of pain. They also, if 
 their temperature be not above 100°, 
 excite perspiration and persuade 
 sleep. Salt or mustard may be 
 added to the water, which should 
 rise as high as the calves of the legs. 
 The foot bath may be prolonged for 
 fifteen or thirty minutes, a blanket 
 being thrown over the limbs, so as 
 to enclose, also, the foot tub. 
 
 88. Shallow Baths. 
 A shallow bath is taken by sitting 
 the patient in a bath tub, five or six 
 feet long, and pouring in sufficient 
 water to rise eight or ten inches. At 
 the same time the body and limbs 
 should be well rubbed by an attend- 
 ant, and water poured over the head. 
 The water should be cold and the 
 stay in it very short. It is useful in 
 many cases of nervous irritability. 
 
 COLD AFFUSION. 
 
 Manner of applying cold affusion. The patient, being unclothed, 
 is to have from three to five gallons of water, at 50° F. or 60° F., 
 in the winter, and 60° or 70° in the summer, poured over him. 
 Simple water, or vinegar and water, or salt and water may be used. 
 The safest time for the application during fever is, when the exacer- 
 bation is at its height, or immediately after its declination has 
 
Blisters. 
 
 339 
 
 begun. From six to nine o'clock in the evening is the hour usually 
 chosen. 
 
 Cautmns in the use of cold affusion. 1. It should never be 
 employed when there is any sense of chilliness, although the ther- 
 mometer in the armpit indicate a high degree of heat. 2. It should 
 never be employed in the cold stage of fever, nor when the heat, 
 measured by the thermometer in the armpit, is less than, or equal 
 to, the natural heat (96° F.), even though the patient is not chilly. 
 
 3. It should never be employed when the body is in a profuse per- 
 spiration ; nor, in fever complicated with any visceral inflammation, 
 
 4. The patient should always immerse his hands for a few moments 
 in the water, before it is applied to any other part of the body; this 
 prevents the shock from being too violent. 
 
 The earlier in the disease it is resorted to the better the effects 
 of cold affusion ; but in the more advanced stages it will be found 
 to moderate the symptoms. It is useful in sleeplessness and in 
 fevers. 
 
 90. Wet-Sheet Packing. 
 
 A sheet, dipped in cold or warm 
 water, and well wrung ont, is wrapped 
 aronnd the patient, and covered with 
 three or more blankets. The patient 
 should lie upon his side,thus wrapped 
 up, for half an hour or an hour. 
 Perspiration, ordinarily not very 
 profuse, is produced, and a sedative 
 effect upon the system obtained. 
 
 91. The Dripping Sheet. 
 
 A dripping wet sheet is suddenly 
 thrown over the patient while stand- 
 ing, the- skin briskly rubbed by the 
 hands of an assistant, a dry sheet 
 thrown on in the place of the wet 
 one, the rubbing briskly kept up, 
 
 and the entire operation finished in 
 five minutes. 
 
 92. The Wet Compress. 
 
 A piece of flannel or muslin, wrung 
 out in cold water, is put around the 
 seat of pain, and covered over by. a 
 piece of oiled silk or muslin. 
 
 93. The Sponge Bath. 
 Sponging the body once or twice a 
 
 day in fevers, with cold water, alone 
 or mixed with vinegar, is very grate- 
 ful and refreshing to the hot and 
 restless patient, and may be employed 
 with safety, if care be taken not to 
 expose the moist skin to a current of 
 air. 
 
 BLISTERS. 
 
 A blister is best made by spreading the ointment of Spanish flies 
 over an adhesive plaster, so as to leave a margin for attaching it to 
 
340 Special Receipts for the Care of the Sick. 
 
 the skin. It should be removed so soon as it causes decided pain, 
 or so soon as the skin is well reddened, and the operation completed 
 by means of a soft, soothing poultice. An extremely thin piece of 
 muslin or paper, moistened with spirits of turpentine, inserted 
 between the blister and the skin, will prevent that annoying irrita- 
 tion of the bladder which sometimes follow the use of a blister. 
 In dressing a blister the bladders should be pierced with a large 
 needle, and not cut, unless it is desired to keep up an open sore. 
 
 CATHARTICS OR PURQATIVES. 
 
 Cathartics or purgatives are medicines which loosen the bowels. 
 Those which act violently are called drastics, those which act 
 mildly, aperients or laxatives. 
 
 Remarks in regard to their use. The habitual employment of 
 purgatives is a practice productive of great injury, causing dyspepsia 
 and many other troubles of the stomach and bowels. Purgatives 
 should not be given so that their operation will interfere with the 
 regular hours of rest. They should not be taken immediately after 
 a full meal. The action of every purgative is followed by a greater 
 or less amount of costiveness. This is especially true of rhubarb, 
 least so of castor oil. In cases of great debility catharties should 
 be avoided. 
 
 94. Effervescing Cream of Tartar. 
 
 Take of 
 
 Cream of tartar, 
 
 Carbonate of soda, each three 
 drachms. 
 
 Water, a tumblerful. 
 
 Put the whole into a stone jug or 
 bottle, and attach the cork firmly. 
 To be taken in the morning, before 
 eating. 
 
 95. Magnesia and Rhubarb. 
 
 Take of 
 Magnesia, one ounce. 
 Rhubarb, two drachms and a half. 
 Powdered ginger, two scruples. 
 
 Mix and divide into eight powders. 
 Take one or two in the evening, at 
 bed-time, to obtain a laxative effect 
 in the morning. 
 
 96. Rhubarb and Epsom Salts. 
 Take of 
 
 Powdered rhubarb, one drachm. 
 
 Epsom salts, one ounce. 
 
 Spirit of peppermint, two drops. 
 
 Water, a tumblerful. 
 
 One or two tablespoonfuls will 
 produce a laxative effect. 
 
Clysters and Injections. 
 
 341 
 
 97. May Apple, or Mandrake. 
 Take of 
 
 Powdered resin of May apple 
 (Podophyllin), one grain. 
 
 Powdered hyoscyamus leaves, eight 
 grains. 
 
 Powdered ginger, twelve grains. 
 
 Mix and divide into four powders. 
 One or two at bedtime in torpor of 
 the liver and bilious disorders. A 
 much better and safer pill than blue 
 mass or other mercurials, so fre- 
 quently employed indiscriminately 
 in these cases, 
 
 98. Jalap and Cream of Tartar. 
 
 Take of 
 
 Powdered jalap, one drachm. 
 
 Cream of tartar, six drachms. 
 
 Mix and divide into six powders. 
 Dose, one, in molasses. 
 
 99. Calcined Magnesia. 
 
 Take of 
 Husbands' or Ellis , magnesia, 
 thirty grains, 
 And dissolve it in a little milk or 
 water for one dose. This is an ex- 
 
 cellent cooling laxative. Its opera- 
 tion is promoted by the drinking of 
 lemonade. 
 
 100. Seidlitz Powders. 
 These are to be obtained of any 
 druggist. Two powders are given 
 together, a white and a blue one; 
 each of which is to be dissolved, 
 separately, in a tumbler one-third 
 full of water, and the two solutions 
 then mixed and drank while foam- 
 ing, in the morning, before break- 
 fast. This is a very popular, gentle 
 laxative, and well borne by the 
 stomach when other medicines of 
 the kind disagree. 
 
 101. Purgative Mineral Water. 
 
 Take from a bottle of the solution 
 of the citrate of magnesia, to be had 
 of any druggist, a teacupful every 
 two hours, until it operates. For a 
 child five years old, a wineglassful 
 is the proper dose. This prepara- 
 tion, which tastes like lemonade, is 
 one of the most agreeable of laxa- 
 tives. 
 
 CLYSTERS OH INJECTIONS. 
 
 Clysters or injections are solutions thrown into the lower bowel, 
 in order to act as purgatives, as astringents to check diarrhoea, or 
 stop bleeding, or as nutrients to nourish the patient in those ex- 
 hausted conditions when food cannot be given by the mouth. 
 
 102. A Purgative Injection. 
 
 Take of 
 
 Epsom salts, one ounce. 
 
 Sweet oil, two tablespoonfuls. 
 
 Starch water, one pint. 
 
 To be given when a purgative is 
 required. 
 
 Common salt and molasses also 
 make an excellent purgative injec- 
 tion ; a tablespoonful of each in a 
 pint of water, with or without the 
 addition of a little soap. 
 
 29* 
 
 103. An Astringent Injection. 
 
 Take of 
 Subnitrate of bismuth, twenty- 
 grains. 
 Tincture of catechu, a teaspoonful. 
 Milk, a wineglassful. 
 
 For one injection, to be repeated 
 in twelve hours. Useful in checking 
 the purging of consumption, fevers, 
 etc. 
 
34 2 Special Receipts for the Care of the Sick. 
 
 104. Nutritive Injections. 
 Life can be prolonged, and even, 
 in many cases, preserved, by the 
 persistent use of nutritive injections 
 when, in ailments like ulceration 
 of the stomach, it is impossible to 
 
 give food by the mouth, as it is at 
 once rejected by the stomach. Nu- 
 tritive injections are made of strong 
 beef tea, milk, raw eggs, cod-liver 
 oil, and, even in extreme cases, of di- 
 luted brandy. 
 
 COLD, MODE OP APPLYING. 
 
 Cold has been employed in the treatment of disease from the 
 earliest times. It is applied in various ways, by cold baths, by 
 streams of cold water, by cold moist sponges and cloths, by bladders 
 filled with ice, and by the evaporation of ether. 
 
 105. Cold Application. 
 
 Take of 
 
 Nitre, half an ounce, 
 
 Sal ammoniac, two drachms. 
 
 Vinegar, three tablespoonfuls. 
 
 Water, a pint. 
 
 Mix. This solution, applied, by 
 means of sponges or cloths, to the 
 head, and elsewhere, where intense 
 cold is ^desired, produces a more 
 powerful effect than cold water or 
 pounded ice. 
 
 106. Cold without Moisture. 
 
 When it is desired to apply a 
 freezing mixture to a small portion 
 of the skin, it may be readily done 
 by putting a mixture of ice and 
 salt in a bladder, or a tumbler, or a 
 
 lamp glass covered with a piece of 
 bladder. 
 
 107. Hydropathic Belts. 
 A hydropathic belt consists of a 
 bandage, five or six inches wide and 
 long enough to pass two or three 
 times around the body It is dipped 
 into cold water, carefully wrung out, 
 wound around the trunk, and cov- 
 ered by a wider and longer dry band. 
 About every hour, or as often as it 
 becomes dry, it is to be changed. A 
 bandage may be applied in the same 
 manner upon various parts of the 
 body, and particularly over the joints 
 attacked by rheumatism. An erup- 
 tion of the skin is usually produced 
 by this application, which is fre- 
 quently of service. 
 
 COUNTER-IRRITANTS. 
 
 Counter-irritants are applications intended to irritate the parts to 
 which they are applied, and by exciting artificial congestion or 
 inflammation, to modify disease existing in a distant part. How 
 this curative power is exerted, it is difficult to say. Professor 
 Stille remarks: " It is a familiar fact .that the body is an assem- 
 blage of organs, which are constantly exerting a reciprocal influence 
 
Counter- Irritants. 
 
 343 
 
 upon one another, so that all are more or less involved in the 
 derangements of each. Examples of sympathy between remote 
 parts, and exerted through the organ of the mind, are innumerable. 
 Emotions of pleasure or shame suffuse the face with blushes ; while 
 fear and the depressing passions blanch the cheeks, chill the 
 extremities, and bedew the skin with a cold sweat. So, emotions 
 of pity or tenderness make the tears flow ; the odor or sight of 
 agreeable food, or even the thought of it, makes the mouth water ; 
 while disgusting objects turn the stomach, and alarming ones 
 suspend digestion or destroy the appetite. Obstinate constipation 
 has been overcome by causing the patient to stand upon a wet 
 marble pavement; consumption has often supervened upon the 
 suppression of an issue or other habitual discharge ; and still more 
 frequently, apoplexy and other internal congestions have followed 
 the same causes. The translation of gout and rheumatism to the 
 brain, heart, stomach, etc., when suppressed in the extremities, is 
 familiar to every practitioner. The coryzas, and sore throats, and 
 pulmonary catarrhs, diarrhoeas, and other affections which arise 
 from merely getting the feet wet, are matters of daily experience, 
 whose reality cannot be denied nor explained away. They are 
 neither more nor less intelligible than the effects of counter-irrita- 
 tion, and both must be accepted because they are facts." 
 
 Shakspeare, whose wonderful acquaintance with the actions of 
 the body has furnished us with more than one illustration, speaks, 
 in "Romeo and Juliet," of the principle of counter-irritants, as 
 
 follows : — 
 
 "Tut, man, one fir% burns out another's burning, 
 One pain is lessened by another's anguish. . , . 
 Take thou some new infection to thy eye, 
 And the rank poison of the old will die." 
 
 Counter-irritation is affected by the application of various sub- 
 stances which redden or blister the skin 
 
 108. Croton-Oil Liniment. 
 
 Take of 
 
 Croton oil, thirty drops. 
 Sweet oil, two tablespoonfuls. 
 Mix. Produces, when rubbed on, 
 
 redness and eruption of the skin. 
 
 A useful application to the chest in 
 
 beginning consumption. 
 
 109. Iodine Paint. 
 
 Take of 
 
 Tincture of iodine, 
 
 Alcohol, equal parts. 
 
 To be applied with a camel's-hair 
 brush. Useful in many cases of 
 persistent pains in the joints and 
 limbs (See, also, Blisters and Cups). 
 
344 Special Receipts for the Care of the Sick. 
 
 CUPPING. 
 
 Physicians employ two sorts of cups, known as wet cups and 
 dry cups. The former are for the purpose of extracting blood, the 
 latter for counter-irritation by reddening the skin. A dry cup can 
 be readily applied by any one. All that is necessary is a tumbler 
 or wine-glass, and a little piece of cotton or paper, which is to be 
 wet with spirits of wine, set on fire, thrown into the glass, which 
 should then at once be firmly pressed down over the skin, when the 
 fire will be quickly extinguished (without causing any pain), and 
 the skin drawn up forcibly into the glass. The same object may be 
 accomplished by holding the tumbler over a light until the air within 
 is well heated, and then applying it quickly and closely to the skin 
 
 Cupping is of benefit in rheumatic ailments, and in many affec- 
 tions of the chest and of the large joints. 
 
 DISINFECTANTS. 
 
 Disinfectants are substances which possess the power of destroying 
 poisons capable of producing disease, and of removing disagreeable 
 odors and gases by decomposing both them and the bodies from 
 which they proceed. 
 
 The principal disinfectants are carbolic acid, coal tar, creosote, 
 charcoal, chlorine, permanganate of potash, quicklime, sulphate of 
 iron (copperas or green vitriol), sulphur, and fresh earth. 
 
 110. Carbolic Acid as a Disinfectant. 
 
 Take of 
 
 Impure carbolic acid, one ounce. 
 
 Water, one gallon. 
 
 Mix. Sprinkle over the floors of 
 privies, about sinks, etc. 
 
 HI. Charcoal as a Disinfectant. 
 
 Powder some wood charcoal and 
 expose it, in open pans, in the place 
 to be disinfected. It has the advan- 
 tage over lime preparations, of being 
 without odor. 
 
 112. Chlorine as a Disinfectant. 
 
 Chlorine water, to be obtained 
 from any druggist, is a useful agent 
 for correcting stenches, and, diluted 
 with water, for washing foul sores. 
 
 113. Permanganate of Potash. 
 
 Take of 
 
 Permanganate of potash, a tea- 
 spoonful. 
 
 Water, a quart. 
 
 Expose, in saucers, in the sick 
 room. Useful for musty closets and 
 foul cellars. It has no odor itself. 
 
Emetics. 
 
 345 
 
 114. Green Vitriol. 
 Sulphate of iron, commonly called 
 green vitriol, or copperas, in powder, 
 alone, or mixed with lime, is an ex- 
 cellent disinfectant for privy-wells, 
 slaughter-houses, ditches, etc. 
 
 115. Fresh Earth. 
 Fine dry earth, sprinkled over 
 offensive matters, is an admirable 
 disinfectant. A knowledge of this 
 fact has led to the construction of 
 earth closets. A box of dust from the 
 road, and a tin cup, kept at the side 
 of the closet or chamber vessel, so 
 that the earth may be thrown imme- 
 diately upon the dejection, will serve 
 as a complete deodorizer, and answer 
 the purpose almost as well as the 
 
 elaborately-constructed patent earth 
 closets now in the market. 
 
 116. Snlphur. 
 Take of 
 
 Milk of sulphur, a teaspoonful. 
 
 Water, 6ne pint. 
 
 Mix. Sprinkle over clothes to be 
 disinfected, and iron with a hot flat- 
 iron. 
 
 The fumes of burning sulphur 
 may be employed for disinfecting 
 out-houses, closets, carriages, etc. 
 
 117. To Quickly Kemove a Bad Smell. 
 An unpleasant odor may be quickly 
 removed from the sick room by burn- 
 ing in it dried lavender or cascarilla 
 bark, with the window open. 
 
 EMETICS. * 
 
 Emetics are medicines which cause vomiting. They are used to 
 remove from the stomach poisons or crude indigestible matters, to 
 dislodge things lodged in the throat or air-passages, and to excite 
 the action of the skin and of the liver. They are not, except, of 
 course, in cases of poisoning, to be given when there is disease of 
 the heart, great irritability of the stomach, or much general debil- 
 ity. They are well borne by children, and of much service in many 
 of the ailments of infancy and childhood. Their action is promoted 
 by drinking plentifully of warm water, and by tickling the throat 
 with a feather. When the vomiting produced is too violent or too 
 long continued, it may be checked by a few drops of laudanum, or 
 by applying a mustard plaster over the pit of the stomach. 
 
 118. Mustard Emetic. 
 
 Take a teaspoonful of mustard in 
 a teacupful of warm water, every ten 
 minutes, until vomiting is produced. 
 
 This is an efficient, quick, and 
 safe emetic. 
 
 119. Alum Emetic. 
 Take a teaspoonful of powdered 
 
 120. Common Salt Emetic. 
 Add one or two teaspoonfuls of 
 salt to a teacupful of warm water. 
 Take every ten or fifteen minutes, 
 till vomiting is produced. 
 
 121. Salt and Mustard Emetic. 
 Mix a teaspoonful each of salt 
 
 alum in a little honey, syrup, or and mustard in a teacupful of warm 
 molasses, every fifteen minutes, until water. Repeat every ten minutes, 
 vomiting is produced. until free vomiting is brought on. 
 
346 Special Receipts for the Care of the Sick. 
 
 EYE-WASHES OR WATERS. 
 
 Eye-waters, or collyria, as they are called by physicians, are 
 solutions applied directly to the eye or eyelids. 
 
 122. Alum Eye-wash. 
 Take of 
 
 Alum, one grain. 
 
 Pure water, two tablespoonfuls. 
 
 Mix. A useful wash, night and 
 morning, for inflamed eyes. 
 
 123. Brandy Eye-wash. 
 A teaspoonful of brandy to two 
 tablespoonfuls of water makes a 
 serviceable eye- water when a stimu- 
 lant is wanted. 
 
 124. Arnica Eye-wash. 
 Take of 
 
 Tincture of arnica, five drops. 
 
 Pure water, two tablespoonfuls. 
 
 Mix. Often of benefit in weak or 
 sore eyes. 
 
 125. Tea Eye-wash. 
 Ordinary tea, when cold, makes a 
 valuable eye-water in many cases. 
 
 FOMENTATIONS, OR STUPES AND STEAMING. 
 
 Fomentation is the application of warmth and moisture to the 
 surface of the body by means of a flannel or soft cloth. Steaming 
 consists in exposing a part to the vapors arising from a piece of 
 flannel wrung out in boiling water; it is often employed in affec- 
 tions of the eyes. 
 
 126. An Ordinary Fomentation. 
 
 Immerse a piece of flannel in boil- 
 ing water, remove it and put it in a 
 wringer made by attaching stout 
 toweling to two rods. The wringer 
 is twisted around the flannel very 
 strongly, till as much as possible of 
 the water is pressed away. The 
 wringer is useful, as the flannel is 
 too hot, when first removed from the 
 boiling water, to be grasped by the 
 hand. When wrung as dry as possi- 
 ble, fomentations prepared in this 
 way may be applied very hot, with- 
 out fear of scalding or blistering the 
 skin. The flannel, when applied to 
 the part, should be covered with a 
 piece of oiled silk or rubber cloth, 
 and changed before it becomes cold. 
 On the removal of the fomentation 
 
 the skin should be at once gently 
 dried and covered with a piece of 
 dry flannel. 
 
 If the precaution of covering the 
 fomentation with oiled silk, muslin, 
 or paper, or a rubber cloth, be neg- 
 lected, the warm, comforting flannels 
 will be converted, in a few minutes, 
 into cold, clammy, wet ones, disa- 
 greeable and hurtful to the patient. 
 
 127. Turpentine Fomentation. 
 
 Steep a piece of lint or linen in 
 oil of turpentine, place it over the 
 part, and immediately apply over it 
 flannel, heated as hot as it can be 
 borne. 
 
 This is, frequently, more effectual 
 than a mustard plaster. 
 
Heat, Mode of Applying. 
 
 347 
 
 128. Another Turpentine Fomenta- 
 tion. 
 
 Sprinkle the flannel, wrung out of 
 hot water in the manner described, 
 with a tablespoonful of turpentine. 
 
 This will act as a counter-irritant, 
 rapidly reddening the skin and re- 
 lieving pain in many cases. 
 
 129. Opium Fomentation. 
 Instead of turpentine, employ 
 
 laudanum, as directed in the preced- 
 ing receipt. Used to relieve pain. 
 
 130. Mustard Fomentation. 
 
 Add a quarter of a pound of mus- 
 tard to a pint of boiling water. 
 Wring the flannel cloths out in this 
 solution, in the manner above di- 
 rected. 
 
 This fomentation quickly reddens 
 the skin, and is frequently useful in 
 allaying pain. 
 
 GAKGLES. 
 
 Gargles, to be of benefit, must be frequently repeated, and their 
 use persevered in. 
 
 131. Gargle of Brandy. 
 A mixture of equal parts of brandy 
 and water makes a useful gargle in 
 some cases of sore throat. 
 
 132. Gargle of Alum. 
 Take of 
 
 Alum, two tea spoonfuls. 
 
 Water, a tumblerful. 
 
 Mix. Used to remove offensive 
 breath depending upon inflamed 
 throat. 
 
 133. Gargle of Lime-Water. 
 
 Pour upon a quarter of a pound 
 
 of fresh unslackened lime two quarts 
 
 of hot water. After standing several 
 
 hours carefully decant the clear 
 
 liquid, without shaking up the lime. 
 This is a valuable gargle in diph- 
 theria and croup, 
 
 134. Gargle of Chlorate of Potash. 
 Take of 
 
 Chlorate of potash, a teaspoonful. 
 Water, a tumblerful. 
 Mix. An excellent gargle for 
 ordinary sore throat, 
 
 135. Gargle of Sage and Linseed. 
 
 Take of 
 
 Sage, two ounces. 
 
 Linseed, one ounce. 
 
 Boiling water, one pint. 
 
 Mix. To be used cold in the early 
 stages of inflamed throat. 
 
 HEAT, MODE OF APPLYING. 
 
 Moist heat is applied by means of fomentations and poultices, 
 which see. Dry heat may J)e applied in various ways. Flannel, 
 highly heated in an oven, or before the fire, may be employed, but 
 
348 Special Receipts for the Care of the Sick. 
 
 it cools quickly. Hot sand, though heavy, and, therefore, for 
 many purposes improper, retains its heat for a long time. It 
 should be heated over the fire in an iron pan, and put in a warm 
 linen bag of the proper shape for the object in view. Chamomile 
 flowers are lighter than sand, but more quickly lose their warmth. 
 They are to be heated, and placed in a linen bag, in the same 
 manner as the sand. Hot salt, in a bag, is a ready method of 
 applying heat in many cases, as, for instance, to the back of the 
 neck, at night, to relieve headache. A thin piece of flat-tile, 
 when it can be procured, can often be used with advantage. It is 
 lighter than sand, and, when heated in an oven, and wrapped in a 
 flannel, retains its warmth for a considerable time. A heated 
 dinner-plate, or a hot brick, wrapped in flannel, may sometimes be 
 employed, as may also bottles of hot water, well corked. 
 
 HERB, AND OTHER MEDICINAL TEAS. 
 
 Of any of the following teas the dose is a wineglassful every 
 two or three hours. 
 
 136. Fipsissewa Tea. 
 Take of 
 
 Pipsissewa, bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water, through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful to act upon the skin, pro- 
 duce perspiration, etc. 
 
 137. TJva Ursi (Bearberry) Tea. 
 Take of 
 
 Bearberry leaves, one ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water, through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful to act upon the kidneys. 
 
 138. Bittersweet Tea. 
 Take of 
 Bittersweet, bruised, one ounce. 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water, through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful to act upon the skin and 
 kidneys. „ 
 
 139. Logwood Tea. 
 
 Take of 
 
 Logwood, rasped, one ounce. 
 
 Water, one quart. 
 
 Boil down to a pint, and strain. 
 
 Useful in diarrhoea and dysen- 
 tery. 
 
Herb j and Other Medicinal Teas, 
 
 349 
 
 140. White Oak Bark Tea. 
 Take of 
 
 White oak, bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for half an hour, strain, and 
 add sufficient water through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful in persistent diarrhoea, 
 
 141. Yellow Cinchona Tea. 
 Take of 
 
 Yellow cinchona, bruised, one 
 ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water to make the tea 
 measure a pint. 
 
 142. Bed Cinchona Tea. 
 Take of 
 
 Red Cinchona, bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water, through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful as a tonic. 
 
 143. Dogwood Tea. 
 Take of 
 
 Dogwood, bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water, through the 
 strainer, to make the tea measure a 
 pint. 
 
 Useful to give appetite and strength 
 after sickness. Also, to break an at- 
 tack of fever and ague. 
 
 144. Seneka Tea. 
 Take of 
 
 Seneka, bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, and 
 add sufficient water through the 
 strainer to make the tea measure a 
 pint. 
 
 Useful as an expectorant. 
 
 145. Iceland Moss Tea 
 Take of 
 
 Iceland moss, half an ounce. 
 
 Water, one pint. 
 
 Boil for fifteen minutes, strain, 
 with squeezing, and add sufficient 
 water through the strainer to make 
 the tea measure a pint. 
 
 Useful for coughs and colds. 
 
 30 
 
 146. Black Elder Tea. 
 Take of 
 Inner bark of black elder, one 
 
 ounce. 
 Water, one quart. 
 Boil down to one pint. A wine- 
 glassful, or more, is a useful purga- 
 tive in dropsy. 
 
 147. Juniper Tea. 
 Take of 
 
 Juniper berries, bruised, a table- 
 spoonful. 
 
 Boiling water, one pint. 
 
 Pour the boiling water on the 
 bruised berries, and, when cool, 
 drink the whole in the course of the 
 day. 
 
 Useful in dropsical affections. 
 
 148. Blackberry Root Tea. 
 Take of 
 
 Small blackberry roots, a large 
 tablespoonful. 
 
 Water, one pint and a half. 
 
 Boil down to a pint. Instead of 
 the small roots the bark of the 
 larger roots may be employed. The 
 dose is a tablespoonful, four or five 
 times a day, in diarrhoea and dys- 
 entery. 
 
 149. Goose Grass Tea. 
 Take of 
 
 Goose grass, a handful. 
 
 Water, a quart. 
 
 Boil for twenty minutes. Dose, a 
 tumblerful, thrice daily, in skin dis- 
 eases and in gravel. 
 
 150. White Walnut Tea. 
 Take of 
 
 White walnut bark, one ounce. 
 
 Water, a quart. 
 
 Boil for half an hour. Dose, a 
 wineglassful, as a mild purgative. 
 
 151. Burdock Tea. 
 Take of 
 
 Burdock root, freshly bruised, a 
 handful. 
 
 Water, three pints. 
 
 Boil down to a quart, A pint to 
 be taken, in divided doses, during the 
 day. 
 
 Useful in persistent skin affections 
 and scrofulous ailments. It acts de- 
 cidedly upon the skin, slightly upon 
 the bowels. 
 
350 Special Receipts for the Care of the Sick. 
 
 162. Calamus Tea. 
 Take of 
 
 Calamus root, one ounce. 
 
 Boiling water, one pint. 
 
 Pour the water on the calamus, 
 and, when cool, give in doses of a 
 wineglassful for the relief of colicky 
 pains in the bowels. Especially use- 
 ful for children. 
 
 153. Dandelion Tea. 
 Take of 
 
 Dried dandelion root, sliced and 
 bruised, one ounce. 
 
 Water, one pint. 
 
 Boil for ten minutes in a covered 
 vessel, then strain, and pour as much 
 water over the contents of the 
 strainer as will make the strained 
 product measure a pint. Dose, a 
 wineglassful several times a day in 
 biliousness and dropsy. 
 
 154, Wormseed Tea. 
 Take of 
 
 Fresh wormseed leaves, one ounce. 
 
 Milk, one pint. 
 
 Boil with a little orange peel. 
 Dose, a wineglassful, morning and 
 evening, for the expulsion of worms 
 from the bowels. 
 
 155. Seneka and Liquorice Tea. 
 Take of 
 
 Seneka snakeroot, 
 
 Liquorice root, each a andful. 
 
 Water, two quarts. 
 
 Boil for half an hour and strain. 
 Dose, a wineglassful several times a 
 day in obstinate coughs and colds. 
 
 156. Flaxseed Tea. 
 
 Take three tablespoonfuls of flax- 
 seed, put in a small linen bag, sus- - 
 pend in a quart of water, and boil 
 for twenty minutes. Flavor with a 
 little lemon. 
 
 A soothing drink in ailments of 
 the chest and bowels. 
 
 For a tea of flaxseed and liquorice 
 see receipt No. 5, among the dietetic 
 preparations on page 323. 
 
 157. Parsley Tea. 
 Take of 
 
 Parsley root, one ounce. 
 
 Boiling water, one pint. 
 
 Pour the boiling water over the 
 parsley root, and strain. A teacup- 
 ful alone, or with a teaspoonful of 
 sweet spirits of nitre, every four 
 hours, is an excellent remedy in 
 dropsy. 
 
 INHALATIONS. 
 
 By means of inhalation, remedies are made to enter, in the form 
 of vapor, the air passages, and so come immediately in contact with 
 the affected surfaces they are designed to treat. A funnel, turned 
 over a bowl of hot water, medicated as required, makes a simple 
 inhaler, the patient drawing the vapor through the neck of the 
 funnel. An ordinary teapot may be readily made to serve the 
 same purpose. An excellent inhaler may be easily made in any 
 house, from a large and wide-mouthed bottle. Fit a cork into it 
 accurately, bore two holes in the cork, through which pass two 
 glass tubes, one' straight, extending to the bottom nearly, the other 
 
Inhalations. 
 
 351 
 
 Fig. 105. 
 
 curved, extending only a slight distance below the cork, and not far 
 
 enough to touch the liquid for inhalation, to be placed in the bottle. 
 
 The accompanying illustration shows, at a glance, 
 
 how to make such an inhaler. The end of the 
 
 bent portion of the tube is the mouth-piece. The 
 
 solution for inhalation is to be placed in the 
 
 inhaler, filling it only about one-third full, and 
 
 the inhaler then set in a vessel of hot water, to 
 
 generate the vapor. When ready for use, take 
 
 the extremity of the bent tube in the mouth, 
 
 and draw the vapor into the lungs. Various 
 
 substances are used for inhalation. The simplest 
 
 of all is the steam of hot water, which is very 
 
 beneficial in many throat and chest ailments. 
 
 Another simple but effective inhalation in 
 
 many cases, is obtained by pouring vinegar into 
 
 boiling water. Bottle. 
 
 158. Balsam of Tolu Inhalation. 
 Take of 
 
 Balsam of tolu, one ounce. 
 
 Boiling water, one pint. 
 
 Put in a bowl, cover with an in- 
 verted funnel, and inhale the vapor. 
 
 159. 
 
 Acid 
 
 Cubebs and Carbolic 
 Inhalation. 
 
 Take of 
 
 Tincture of cubebs, a tablespoon- 
 ful, 
 
 Fluid carbolic acid, twenty drops. 
 
 Mix. Add to half a tumblerful of 
 water in the inhaling bottle, and use 
 every three or four hours until tired. 
 Very efficient in relieving the dry 
 cough and pain of consumptive 
 patients. 
 
 160. Inhalation of Tar. 
 Take of 
 
 Tar, one pint. 
 
 Solution of potassa (to be obtained 
 
 of the druggist), two tablespoon- 
 
 fuls. 
 
 Mix these two ingredients, and boil 
 
 for a few minutes in the open air, in 
 
 order to disengage any impurities. 
 
 Then keep them simmering in the 
 sick room, in an iron vessel, over a 
 spirit lamp or other fire. In this 
 way, not only the chamber, but the 
 entire house is quickly pervaded by 
 an agreeable vapor, which, although 
 it may at first excite an inclination 
 to cough, both in healthy and sick 
 persons, very soon, in most cases, 
 allays this symptom, and with it a 
 great portion of a consumptive 
 patient's distress. 
 
 161. Carbolic Acid Inhalation. 
 Take of 
 
 Fluid carbolic acid, ten drops. 
 
 Boiling water, a tumblerful. 
 
 Place in inhaling bottle, and. use 
 three or four times a day, in catarrh 
 and offensive secretions from the air 
 tubes. 
 
 162. Creosote Inhalation. 
 
 Take of 
 
 Creosote, thirty drops. 
 
 Boiling water, a tumblerful. 
 
 Put in inhaler,, and use several 
 times a day, in chronic catarrh. 
 
352 Special Receipts for the Care of the Sick. 
 
 LEECHING. 
 
 Leeching is a mode of removing blood from a part, and is much 
 employed in the treatment of many affections. 
 
 Leeches are best kept in rain water, in a stone or glass jar, in a 
 damp cellar or other cool place. It is better not to change the 
 water oftener than once a week. 
 
 How to get the leeches to fix. Clear the skin carefully of all 
 perspiration, and, if they do not readily take hold, moisten it with 
 a little sweetened water or milk, or sweet beer. If a number are 
 to be applied on one spot, put them in a tumbler, or small wine- 
 glass, or pill-box, and turn it down on the part. When they are to 
 be spread over a large surface, they have to be applied one by one, 
 with the hand, over which a towel or handkerchief may be fastened. 
 When applied, the leeches should be let alone, and allowed to drop 
 off of their own accord. When detached, the part should be 
 powdered with a little dry starch, and covered with a soft cloth. 
 
 If it be desired to continue the bleeding after the leeches come 
 off, it can readily be done by sponging away the clotted blood and 
 applying a warm bread and milk poultice, to be changed every half 
 hour, or by covering the part with hot, moist flannels. To check 
 the bleeding, a piece of lint wet with a mixture of vinegar and 
 water, or a strong solution of alum in water, may be bound over 
 the part. If this should fail, and the loss of blood become excess- 
 ive, send to the drug store for a little of MonselFs solution of iron, 
 and apply it on a piece of lint. 
 
 Children bear leeches badly. Leeches, if employed at all, should 
 be used with great caution, only one or two at a time in infantile 
 ailments. Adults will readily bear fifteen to twenty leeches at a 
 time. A good foreign leech will take about a tablespoonful of 
 blood; an American leech only about a teaspoonful. 
 
 Leeches must never be put to the eyelids, and rarely upon the 
 face, as they may leave scars. 
 
Receipts for Liniments. 
 
 353 
 
 LINIMENTS. 
 
 Liniments are used for the double purpose of causing the removal 
 of swellings and for reddening the skin, and so act as counter-irri- 
 tants. They are applied by rubbing, either with the bare hand or 
 with the hand covered by a piece of flannel, oiled silk or muslin, or 
 a piece of bladder. 
 
 163. Camphor Liniment. 
 Take of 
 Camphor, one ounce. 
 Olive oil, four ounces. 
 Rub up the camphor in the oil. 
 
 164. Hartshorne and Oil. 
 Take one part of hartshorne to two 
 parts of oil; mix. 
 
 Useful for stiff neck and lumbago. 
 
 165. Opodeldoc. 
 Take of 
 
 Hard white soap, three ounces. 
 
 Camphor, one ounce. 
 
 Put them in a bottle, and add a 
 tumblerful of spirits of wine, or 
 brandy, or any other spirit, and as 
 much water. Shake the bottle from 
 day to day, till the soap and camphor 
 are dissolved, when the liniment is 
 ready for use. 
 
 A mixture of two tablespoon fuls of 
 this liniment with a teaspoonful of 
 laudanum, is very valuable to lull 
 violent rheumatic pain. 
 
 166. Mustard Liniment 
 Is. for stimulating the surface, e 
 of the best, as it is very manageable, 
 and may be made to act either very 
 slightly, or so severely as to take the 
 skin off, according to the quantity 
 used and the time the rubbing is 
 kept up. The best guide as to the 
 quantity required is the feelings of 
 the person rubbed. At first, there is 
 a pleasant sensation of heat, then a 
 little pricking, and next a positive 
 smarting; when this is produced, 
 leave off, for if the rubbing be con- 
 tinued, it will soon flay the skin, and, 
 as a consequence, prevents its being 
 rubbed again for three or four days. 
 
 30* 
 
 An ounce of fresh flour of mustard 
 put into a bottle with a pint of spirits 
 of turpentine, and shaken daily for 
 two or three days, make this lini- 
 ment. The mustard will settle to 
 the bottom, and the clear fluid should 
 be then poured off. Do not leave the 
 mustard in and shake the bottle up 
 before using; if so, it will give the 
 skin a coating of mustard, and render 
 the application unnecessarily severe. 
 It is excellent for lumbago and chil- 
 blains. 
 
 Sometimes it is necessary to keep 
 up irritation on the skin for a length 
 of time without disturbing the con- 
 stitution, which some irritants will 
 do. The best application for this 
 purpose is — 
 
 167. Croton Oil, 
 Of which ten or a dozen drops are 
 to be rubbed in lightly with the fin- 
 gers, guarded with a piece of oiled 
 silk, for two or three nights. Gene- 
 rally, on the second day the surface 
 is red and puffy, and on the third 
 day a large crop of little blisters, 
 about the size of hempseed, cover the 
 skin. When these appear, the rub- 
 bing must be stopped. In the course 
 of a few hours, the fluid in the blis- 
 ters changes to matter, and these 
 pustules begin to tingle and itch 
 furiously. As soon as this happens, 
 prick each with the point of a needle, 
 and press out the matter with a 
 handkerchief. In the course of a 
 week the skin has been completely 
 reproduced, and then the croton oil 
 may be used again ; but it does not 
 blister quite so quickly as when first 
 applied. The croton may be used 
 for months, and is a most excellent 
 mild irritant. 
 
354 Special Receipts for the Care of the Sick. 
 
 168. Lime Liniment. 
 Take of 
 Lime water, 
 
 Flaxseed oil, each a tumblerful 
 Mix them. 
 
 169. Chloroform Liniment. 
 Take of 
 
 Pure chloroform, a wineglassful. 
 
 Olive oil, two wineglassfuls. 
 
 Mix them. 
 
 A useful liniment in many painful 
 rheumatic and neuralgic affections. 
 
 170. Lead Ointment. 
 Take of 
 Solution of sugar of lead, two 
 
 ounces. 
 Olive oil, two wineglassfuls. 
 Mix them. 
 
 171. Turpentine Liniment. 
 Take of 
 Rosin cerate (to be had of the 
 druggist), three-quarters of a 
 pound. 
 Oil of turpentine, a tumblerful. 
 Add the oil to the cerate, pre- 
 viously melted, and mix them. 
 
 LOTIONS OR WASHES. 
 
 Washes are employed either for soothing and cooling inflamed 
 parts, for stimulating sluggish sores to heal, or for drying and 
 absorbing discharges. 
 
 In applying a cooling lotion or wash, a single piece of linen 
 should be wet with it and laid on the part, which should not be 
 wrapped up nor covered with the bed-clothes. So soon as the cloth 
 dries it should be again dipped in the lotion, or wet by squeezing a 
 spongeful of the wash over it. 
 
 A stimulating lotion is applied by dipping lint or rag into it, 
 putting it on the sore and confining it by a bandage. 
 
 Lint, for use for this and so many other purposes, in dressing 
 wounds and sores, is made by unraveling old linen, soft from use 
 and washing. It may be prepared by scraping tightly-stretched 
 linen with a sharp knife. A "patent lint" is sold at all the drug- 
 stores, in rolls or sheets, which is more compact than loose lint, one 
 side being fleecy and the other smooth. Charpie is an excellent 
 sort of lint, much employed. It is made as follows: Cut a piece 
 of lint into small pieces, a few inches square, and completely un- 
 ravel it, thread by thread. The coarser kind may be made of old 
 tablecloths. Old linen is much better than new for making 
 charpie. 
 
Lotions or Washes. 
 
 355 
 
 Drying lotions are applied, by means of lint or rag, to cracked 
 skin, and to scalds, burns, and sores which weep or discharge very 
 freely. 
 
 172. Cold Water Wash 
 Is as good a wash as any, to pro- 
 duce evaporation, if care be taken 
 to have the wet linen well exposed 
 to the air; and it has the further 
 advantage of being almost always at 
 hand. 
 
 173. Spirit Wash. 
 
 Half a quarter of a pint of spirits 
 of wine, or a quarter of a pint of 
 brandy, or any other good spirit, 
 added to a pint of water, make this 
 wash. 
 
 174. Vinegar Wash 
 Is made by mixing one-fourth of 
 vinegar to three-fourths of water. 
 
 To a pint of either of the former 
 washes half a tablespoonful of lauda- 
 num may be added, if the pain 
 suffered be very severe. 
 
 175. Lead Wash, or Goulard- Water 
 
 or White Wash, 
 As it is often called, for common 
 purposes, may be made by dissolving 
 one drachm of sugar of lead in a 
 pint of soft water. Some persons 
 are very fond of using this wash, 
 With the addition of spirits of wine, 
 as an evaporant. 
 
 176. Lime Water Wash r 
 A very simple application; is one 
 of the best, and very easily made. 
 Take half a pound of unslaked lime, 
 and three-quarters of a pint of water. 
 Put the lime into an earthen pot, 
 and pour a little of the water upon 
 it, and as the lime slakes pour the 
 water on bv little and little, and 
 stir up with a stick. The water 
 must be added very slowly, other- 
 wise the lime will fly about in all 
 directions, and the great heat sud- 
 denly produced will crack or break 
 the vessel which contains it. After 
 three or four hours, when the slaked 
 lime has sunk to the bottom, the 
 clear fluid may be poured off, and 
 put in a stoppled bottle, away from 
 the light. 
 
 177. Oxide of Zinc Wash 
 Is made by putting four drachms of 
 oxide of zinc into a pint of lime water, 
 which does not, however, dissolve, 
 but merely suspends it. It is, there- 
 fore, always necessary to shake the 
 bottle well up, so that the linen may 
 entangle the proper quantity of the 
 oxide. 
 
 178. Sal Ammoniac Wash. 
 
 Take of 
 
 Sal ammoniac, one drachm. 
 
 Water, a tumblerful. 
 
 Mix, with or without the addition 
 of a teaspoonful of laudanum, 
 
 Useful for painful, sluggish sores. 
 
 179. A Cooling Sal Ammoniac 
 Wash. 
 Take of 
 
 Sal ammoniac, one drachm. 
 
 Nitre, two drachms. 
 
 Vinegar, two tablespoonfuls. 
 
 Water, a tumblerful. 
 
 Mix, apply by means of one layer 
 only of linen, without any covering, 
 to heated inflamed surfaces. 
 
 180. Another Sal Ammoniac Wash. 
 Take of 
 
 Sal ammoniac, ■ 
 
 Nitre, 
 
 Common salt, each two teaspoon- 
 fuls. 
 
 Water, one pint. 
 
 Apply as above. 
 
 181. Chlorate of Potash Wash. 
 
 Take of 
 
 Chlorate of potash, a teaspoonful. 
 
 Water, a tumblerful. 
 
 A useful application to bad sores, 
 and for chapped or cracked hands. 
 
 182. Borax Wash. 
 
 Take of 
 
 Borax, a teaspoonful. 
 Glycerine, a tablespoonful. 
 Water, a tumblerful. 
 Mix. An agreeable soothing lotion. 
 
356 Special Receipts for the Care of the Sick. 
 
 184. Arnica Lotion. 
 
 183. An Absorbent Wash. 
 Take of 
 Oxide of zinc, two drachms. 
 Water, a tumblerful. 
 
 Mix. 
 
 Take of 
 
 Tincture of arnica, a tablespoon- 
 ful. 
 
 Water, a tumblerful. 
 
 Mix. A useful lotion for sprains, 
 bruises and burns. 
 
 OINTMENTS OR SALVES. 
 
 Ointments or salves are usually prepared by rubbing of a medi- 
 cine with lard. They should not be kept on hand too long, as they 
 become rancid and unfit for use. 
 
 185. Sulphur Ointment. 
 Take of 
 
 Flowers of sulphur, half a pound. 
 
 Lard, one pound. 
 
 Oil of bergamot, two teaspoonfuls. 
 
 Mix up together. A curative 
 ointment for itch. 
 
 186. Carbonate of Ammonia Oint- 
 ment. 
 Take of 
 Carbonate of ammonia, half a 
 
 drachm. 
 Lard, half an ounce. 
 Mix. A useful appli cation to 
 sluggish, scrofulous sores. 
 
 187. Common Ointment. 
 
 Take of 
 Yellow wax, one ounce. 
 Olive oil, four ounces. 
 Lard, one ounce. 
 Mix. A soothing salve. 
 
 188. Tannin Ointment. 
 Take of 
 
 Tannin, one drachm. 
 
 Lard, one ounce. 
 
 Mix. An excellent astringent 
 salve. 
 
 189. Camphor Ointment. 
 Take of 
 
 Camphor, ten grains. 
 
 Spirits of wine, a few drops. 
 
 Lard, one ounce. 
 
 Mix. Useful in some skin dis- 
 eases. 
 
 190. Oxide of Zinc Ointment. 
 
 Take of 
 
 Oxide of zinc, one drachm. 
 
 Lard, two ounces. 
 
 Mix. Useful for chapped skin 
 and sores. 
 
 PAIN REMOVERS, OR ANODYNES. 
 
 The boldest doubter, he who, in rude health, is a most defiant 
 and sarcastic skeptic of the power of medicine, is forced, by the 
 
Pain Removers, or Anodynes. 
 
 357 
 
 terror and victory of pain, to confess the beneficence of the sub- 
 stances given us by a merciful Creator for the subduing and the 
 destroying of that pain. 
 
 " Pain is perfect misery, the worst 
 Of evils, and, excessive, overturns 
 All patience." 
 
 The most powerful means for relieving pain, such as opium by 
 the mouth, morphia injected under the skin, and chloroform by 
 inhalation, are such potent agents for evil, as well as good, that 
 their use can only be trusted to those trained to employ them. 
 But there are other means which can be handled, with greater or 
 less success, by non-medical persons. Many of them we have 
 mentioned in speaking of painful ailments, but we group, in this 
 place, a number of receipts for the relief of pain, which are of no 
 little value, and which can be employed, with the exercise of ordi- 
 nary care and judgment, without the risk of doing harm. 
 
 191. Quinine Powders. 
 Take of quinine, twenty grains, 
 and divide it into eight powders. 
 One of them twice a day is an excel- 
 lent remedy in many forms of neu- 
 ralgia (particularly in that occurring 
 in persons living in districts where 
 chills and fever prevail) and sick 
 headache. 
 
 192. Sal Ammoniac. 
 Take of sal ammoniac, twenty 
 grains, for one dose, in half a tum- 
 bler of water. Repeat the dose at 
 the end of every hour, until four 
 doses are taken, when, if no relief is 
 had, the medicine is not appropriate 
 to the case, and it is needless to con- 
 tinue. If it afford relief, as it does 
 frequently, in an almost magical 
 manner, in neuralgia of the face, 
 and other parts, it should be taken 
 three times a day, for a week or two, 
 after the attack. 
 
 193. Camphor. 
 
 Half a teaspoonful of the spirits of 
 camphor in water, is an excellent 
 remedy for the pains of colic and 
 diarrhoea. 
 
 Painful joints are also relieved by 
 
 the rubbing in over them of spirits 
 of camphor, by itself or mixed with 
 a little laudanum. 
 
 194. Chloral. 
 
 Take of 
 
 Chloral, two drachms. 
 
 Sweetened water, half a tumbler- 
 ful. 
 
 Take a tablespoonful for a dose. 
 Useful to procure ease and sleep in 
 many ailments, particularly rheu- 
 matic pains and pains arising from 
 burns. 
 
 195. Coffee. 
 
 Squeeze the juice of a lemon in a 
 small cup of strong black coffee. 
 This will often afford immediate 
 relief in neuralgic headache. 
 
 Tea ordinarily increases neuralgic 
 pain, and ought not to be used by 
 persons affected with it. 
 
 196. Iodide of Potassium. 
 
 Take of 
 
 Iodide of potassium, one drachm. 
 
 Sweetened water, half a tumbler- 
 ful. 
 
 Mix. Take a tablespoonful three 
 times a day, in pains of the joints 
 and bones that are worse at night. 
 
358 Special Receipts for the Care of the Sick. 
 
 197. External Applications. 
 
 Warm and hot baths are admirable 
 remedies for pain. So, also, are 
 poultices and hot fomentations , for 
 which receipts are given under their 
 heads in this chapter. 
 
 198. Hygienic Means. 
 Whatever improves the general 
 health, saves and relieves pain. 
 Pure air is, therefore, an anodyne. 
 
 "Ye, who amid this feverish world 
 
 would wear 
 A body free from pain, of cares a 
 
 mind, 
 Fly the rank city, shun its turbid 
 
 air." 
 
 Light- rooms; warm clothing; 
 regulated gymnastic exercise, such 
 as described in the first chapter of 
 this book, page 37 ; out-door recrea- 
 tion; proper amount of sleep; the 
 avoidance of fatigue of body and 
 mind ; and of intemperance in alco- 
 hol and tobacco, and in everything 
 else which impairs the nervous force ; 
 together with change of air and cli- 
 mate as restoratives, are all means 
 by which pain may be escaped or its 
 edge blunted. 
 
 Many forms of neuralgia are re- 
 lieved by change of air, as well as 
 various constitutional disorders caus- 
 ing pain. Sea air is particularly use- 
 ful in numerous instances 
 
 POULTICES. 
 
 " Poultices are blessings or curses, as they are well or ill made," 
 was a saying of the celebrated Dr. Abernethy. They should be 
 spread thickly, as a general rule, otherwise they dry quickly, and 
 irritate the part they are intended to soothe. 
 
 All poultices should be covered over by a piece of oiled silk, 
 muslin, or paper, to retain the heat and moisture. 
 
 199, Bread and Water Poultice. 
 
 Scald out a basin, for, in order to 
 make a good poultice perfectly, boil- 
 ing water is necessary ; then, having 
 put in some hot water, throw in 
 coarsely-crumbled bread, and cover 
 it with a plate. When the bread has 
 soaked up as much water as it will 
 imbibe, drain off the remaining 
 water, and there will be left a light 
 pulp. Spread it, a third of an inch 
 thick, on folded linen, and apply it 
 when of the temperature of a warm 
 bath. 
 
 Or, carefully pare away the hard, 
 brown crust from a slice around the 
 loaf of stale bread, dip it into hot 
 water, lift it out at once, and apply 
 immediately, if not too hot. 
 
 200. Flaxseed Meal Poultice. 
 
 The celebrated Dr. Abernethy gave 
 the following directions for making 
 this poultice : — 
 
 " Get some linseed powder, not the 
 common stuff full of grit and sand. 
 Scald out a basin ; pour in some per- 
 fectly boiling water ; throw in the 
 powder, stir it round with a stick, 
 till well incorporated ; add a little 
 more water and a little more meal ; 
 stir again, and when it is about two- 
 thirds the consistence you wish it to 
 be, beat it up with the blade of a 
 knife till all the lumps are removed. 
 If properly made, it is so well 
 worked together, that you might 
 throw it up to the ceiling, and it 
 would come down again without 
 
Poultices. 
 
 359 
 
 felling to pieces ; it is, in fact, like a 
 pan-cake. Then take it out, lay it 
 on a piece of soft linen, spread it the 
 fourth of an inch thick, and as wide 
 as will cover the whole inflamed 
 part ; put a bit of hog's lard in the 
 centre of it, and when it begins to 
 melt, draw the edge of the knife 
 lightly over and grease the surface 
 of the poultice. When made in this 
 way, oh ! it is beautifully smooth ; 
 it is delightfully soft ; it is warm and 
 comfortable to the feelings of the 
 patient." 
 
 201. The Bran Poultice 
 
 Is a sort of u entire," or half-and 
 half, partlv poultice, partly fomen- 
 tation, and is a very good applica- 
 tion for setting up and keeping up 
 perspiration on a part; but it re- 
 quires to be often changed, for it 
 very quickly becomes sour, and then 
 has not the most agreeable smell. 
 It merely consists of bran moistened, 
 but not made wet, with hot water ; 
 and enough of it should be put into 
 a flannel bag, sufficiently large to 
 cover the part, to fill it about one- 
 third; if more bran be put in the 
 bag becomes unpleasantly heavy. 
 It must then be held before the fire, 
 and the bran turned about again and 
 again, till it is thoroughly heated. 
 Thus warmed, it must be quickly 
 applied, and the bran should be 
 gently spread, so as to cover the 
 whole extent of the bag. 
 
 202. Stimulating Poultices 
 
 Are required for two purposes: 
 either to hasten the separation of a 
 dead part or slough, or, as it is 
 called in common language, "a set- 
 fast," or "core;" or to irritate the 
 skin where it is inconvenient to ap- 
 ply a blister, or for the purpose of 
 rendering the operation of a blister 
 more speedy. For the first of these 
 objects, yeast, stale beer-grounds, or 
 molasses, is used for the second, 
 mustard. 
 
 203. Yeast Poultice 
 Is made by mixing a pound of flour, 
 or linseed-meal, or oat-meal, with 
 half a pint of yeast or beer-grounds. 
 
 The mixture is to be heated in a pot, 
 carefully stirred, to prevent burning, 
 and, when sufficiently warm, must 
 be spread on linen, like any other 
 poultice. 
 
 204. Molasses Poultice 
 
 May be made according to the same 
 proportions, heated and applied in 
 the same way. 
 
 205. Starch Poultice. 
 
 Add a little cold water to the 
 starch, and blend the two into a 
 pap; then add sufficient boiling 
 water to make a poultice of the re- 
 quired consistence, which must be 
 spread on linen. 
 
 Useful in skin eruptions attended 
 with much heat and pain, and, in 
 general, when a soothing application 
 is required. 
 
 206. Charcoal Poultice. 
 
 The charcoal may either be mixed 
 with the ingredients of the poultice 
 or sprinkled over the part and cov- 
 ered with a simple poultice, or the 
 following receipt may be used : 
 Take of 
 
 Wood charcoal, in powder, a table- 
 spoonful. 
 
 Bread, three or four slices. 
 
 Flaxseed-meal, three tablespoon- 
 fuls. 
 
 Boiling water, one tumblerful. 
 
 Mix. A useful application to offen- 
 sive wounds and sores, 
 
 207. Carrot Poultice. 
 
 Boil the carrots till they become 
 quite soft, mash them with a fork, 
 and spread the pulp on linen, in the 
 ordinary way, 
 
 A turnip poultice may be made in 
 the same manner. 
 
 208. Alum Poultice. 
 Composed of the whites of two 
 
 eggs and a teaspoonful of powdered 
 alum. An excellent astringent. 
 
 209. Mush Poultice. 
 
 Stir Indian-meal, in small quanti- 
 ties, into water kept boiling in a 
 pan, until the whole has acquired 
 the proper degree of thickness. 
 
360 Special Receipts for the Care of the Sick. 
 
 210. Slippery Elm Poultice. 
 
 Made by moistening, with hot 
 water, the inner bark of slippery 
 elm, ground into a fine powder. 
 
 211. Arrowroot Poultice. 
 
 Add enough boiling water to 
 arrowroot, previously mixed with 
 cold water into a smooth paste, as 
 will make it of the required thick- 
 ness for spreading, A pleasant 
 soothing poultice. 
 
 212. Onion Poultice. 
 
 Mash some partially roasted 
 onions, and spread them upon folds 
 of muslin. Applied to the chest, 
 useful in the croup and catarrh of 
 children; applied to the arms and 
 legs, useful to prevent the fits of 
 children. 
 
 213. Mustard Poultice. 
 
 For a mustard poultice, a sufficient 
 quantity of powdered mustard should 
 be taken to make a thin paste the 
 required size. This should be mixed 
 with boiling water, with a small 
 quantity of vinegar added, if a very 
 strong poultice is required, and 
 spread on brown paper, with a piece 
 of thin muslin over it. 
 
 A mustard poultice should gener- 
 ally be kept on from ten to twenty 
 minutes, but some skins will bear it 
 much longer than others. If the 
 skin is very irritable afterwards, a 
 little flour should be sprinkled over 
 it. This will remove the burning 
 sensation. 
 
 214. Bread and Milk Poultice. 
 
 Upon the crumbs of stale wheat 
 bread, in a basin, pour boiling milk, 
 stirring with the back of a spoon 
 until the mixture has the thickness 
 of mush. Spread and apply. 
 
 TONICS. 
 
 Tonic medicines are those which give strength to the system. 
 They act slowly, and must be persevered in to obtain their full 
 effects. Excellent results are frequently obtained by changing from 
 one to another, when the first tried fails, or has ceased to do good. 
 
 215. Quinine in Powder. 
 Take of 
 
 Quinine, two scruples. 
 
 Divide into twenty powders. Take 
 one three times a day, well covered 
 in a little scraped apple. The apple 
 disguises, completely, the bitter taste 
 of the medicine. 
 
 This is an admirable tonic in ner- 
 vous and other forms of debility, and 
 in loss of appetite. 
 
 216. Quinine in Solution 
 Take of 
 
 Quinine, eight grains. 
 
 Syrup of gum arabic, 
 
 Ammonia water, each two table- 
 spoonfuls. 
 
 Mix. As the quinine is not dis- 
 solved, but merely suspended in this 
 solution, the bottle must be well 
 shaken before giving a dose. 
 
 This is a useful preparation for 
 
Receipts for the Hygiene of the Person. 
 
 361 
 
 children, the proper dose for them 
 being a teaspoonful, containing one- 
 half a grain of quinine. 
 
 The gum masks, somewhat, the 
 bitter taste of the medicine. Used 
 for the same purposes as the preced- 
 ing receipt. 
 
 217. Iron Powder. 
 
 Take of 
 
 Keduced iron, two scruples. 
 
 White sugar, in powder, two tea- 
 spoonfuls. 
 
 Mix, and divide into twenty pow- 
 ders. Dose, one powder, in molasses, 
 syrup, or preserves, three times a 
 day. 
 
 Reduced iron, which is a tasteless 
 powder of an iron gray color, may be 
 obtained from any druggist, and is 
 one of the very best preparations of 
 iron which can be taken by pale, 
 thin-blooded people. 
 
 In using this, as well as the other 
 preparations of iron, it is necessary 
 to persevere for several months, to 
 reap the fullest results. 
 
 218. Potassio- tartrate of Iron. 
 
 Take of > 
 Potassio-tartrate of iron, one 
 drachm. 
 
 Divide into twelve powders. Take 
 one, in syrup or preserves, three 
 times a day. An admirable tonic in 
 dyspepsia, and loss of appetite, and 
 debility. It has the advantage over 
 many other preparations of iron, of 
 not constipating the bowels, and of 
 being rapidly digested. 
 
 Half an ounce of the potassio-tar- 
 trate of iron, added to a pint of 
 sherry after solution, may be used 
 instead of the powders, in tablespoon- 
 ful doses. 
 
 The best time for taking this,' and 
 other preparations of iron, is with 
 the meals, and not on an empty 
 stomach. The juice in the stomach 
 during digestion readily dissolves 
 the iron, which, if taken while fast- 
 ing, may cause pain and uneasiness. 
 
 219. Columbo and Ginger. 
 
 Take of 
 
 Bruised columbo, one ounce. 
 
 Bruised ginger, a quarter of an 
 ounce. 
 
 Boiling water, one pint. 
 
 Mix and strain. 
 
 A wineglassful four or five times a 
 day is a useful tonic in persistent 
 diarrhoea. 
 
 RECEIPTS FOR THE HYGIENE OF THE PERSON. 
 
 Under this head we group a variety of useful receipts for the 
 care of the hair, the skin, and the teeth. They are all harmless, 
 as well as efficient, which, too frequently, is not the case with the 
 many perilous compounds widely advertised, and sold as tooth 
 powders, hair tonics, mouth and skin washes, and lip salves, under 
 high-sounding names. Any druggist can put them up, and at a 
 less price than is asked for the dangerous secret preparations they 
 are designed to replace. 
 31 
 
362 Special Receipts for the Care of the Sick. 
 
 TOOTH POWDERS. 
 
 220. 
 
 Take of 
 
 , Powdered camphor, 
 
 Powdered orris root, each, two 
 drachms. 
 
 Precipitated chalk, half an ounce. 
 
 Mix thoroughly. The chalk em- 
 ployed should be the " precipitated," 
 and not the " prepared " chalk of the 
 druggist. 
 
 Another excellent tooth powder is 
 the following : — 
 
 221. 
 
 Take of 
 Freshly-prepared willow charcoal, 
 
 or, 
 Freshly-prepared areca-nut char- 
 coal, one ounce. 
 Keep in a tightly-corked bottle. 
 Another powder, especially valu- 
 able when the teeth have been 
 stained by taking iron : — 
 
 222. 
 
 Take of 
 
 Tannic acid, quarter of an ounce. 
 
 Sugar of milk, two ounces. 
 
 Red lake, half a drachm. 
 
 Oil of teaberry, or cloves, a few 
 drops. 
 
 Mix with care. 
 
 A tooth paste, of use occasionally, 
 is the following : — 
 
 223. 
 
 Take of 
 
 Finely-powdered white, dried Cas* 
 tile soap, 
 
 Sepia, in powder, each a quarter 
 of an ounce. 
 
 Mix, to the thickness of a paste, 
 with fresh, clarified honey, and per- 
 fume with a few drops of teaberry. 
 
 As the " sepia" wears the enamel 
 if often used, this powder is for occa- 
 sional employment only. 
 
 The following tooth powder is of 
 benefit when the gums are sore and 
 spongy :— 
 
 224. 
 
 Take of 
 
 Powdered myrrh, quarter of an 
 ounce. 
 
 Powdered borax, half an ounce. 
 
 Precipitated chalk, one ounce. 
 
 Powdered orris root, quarter of an 
 ounce. 
 
 Mix. 
 
 The following tooth powder is 
 excellent when the saliva is acrid 
 and the breath sour : — 
 
 225. 
 
 Take of 
 Bicarbo ate of soda, 
 Powdered talc, each half an ounce. 
 Oil of anise, a few drops. 
 
 Improper tooth pow'dcrs are powdered pumice stone, which 
 rapidly wears off the enamel, the protecting cover of the teeth 
 (pumice stone is a frequent ingredient in secret tooth powders), 
 cigar ashes, cream of tartar, or any other acid. 
 
 MOUTH WASHES. 
 
 These are useful when the gums are tender, or the breath 
 offensive, or the teeth rapidly decaying. 
 
 226. Camphor Mouth Wash. 227. Honey Mouth Wash. 
 
 Take of Take of 
 
 Spirits of camphor, half a teaspoon- Honey of rose, half a teaspoonful. 
 
 fill. Milk-warm water, a wineglassful. 
 
 Milk-warm water, a wineglassful. Mix, and use as above directed. 
 To be used several times a day, 
 and at bedtime. 
 
Receipts for the Hygiene of the Person. 
 
 3 6 3 
 
 228. Myrrh and Cinchona Mouth 
 
 Wash. 
 Take of 
 Tincture of myrrh, 
 Compound tincture of cinchona, 
 
 each half a teaspoonful. 
 Milk- warm water, a wineglassful. 
 Mix, and use as above directed. 
 
 229. Brandy Month Wash. 
 Take of 
 Pure French brandy, a teaspoon- 
 ful. 
 Milk- warm water, a wineglassful. 
 Mix, and use as above directed. 
 
 230. Permanganate of Potash 
 Mouth Wash. 
 Take of 
 
 Permanganate of potash, four 
 grains. 
 
 Rose water, four fluid ounces. 
 
 Oil of peppermint, a few drops. 
 
 This is an excellent mouth wash 
 for foul breath, caused by bad teeth 
 or disordered secretions of the 
 mouth. It slightly stains the teeth, 
 but does them no injury; on the 
 contrary, being an excellent pre- 
 servative, and a valuable remedy for 
 preventing and curing toothache. 
 
 The discoloration may- be easily 
 taken off by a tooth brush or sponge. 
 
 231. Chlorate of Potash Mouth 
 
 Wash. 
 Take of 
 Chlorate of potash, two or three 
 
 teaspoonfuls. 
 Water a tumblerful. 
 Oil of teaberry, a few drops. 
 To be used several times a day. 
 
 232. 
 
 When offensive breath comes from 
 a foul stomach, twenty grains of 
 bisulphite of soda, in half a tumbler 
 of water, with a little essence of 
 peppermint, twice a day, is an ex- 
 cellent remedy. Or, three grains of 
 chlorinated limey known also as chlo- 
 ride of lime, in a wineglassful of 
 water, several times a day, may be 
 taken. Charcoal, internally, is also 
 of use in such cases. 
 
 233. 
 
 For masking the scent of onions, 
 and other disagreeable acquired 
 odors, freshly-roasted coffee grains 
 are useful, or a small portion of 
 Canada snakeroot, chewed. 
 
 HAIR TONICS 
 
 234. 
 
 Take of 
 
 Pure glycerine, three drachms. 
 
 Lime water, four ounces. 
 
 To be applied to the scalp, night 
 and morning, with a soft tooth 
 brush, after the head has been 
 cleaned by gently washing with 
 Castile or sulphur soap and warm 
 water. 
 
 This is an excellent treatment to 
 commence with for slight scurfiness 
 of the head, and falling of the hair, 
 and baldness. 
 
 After several weeks' use the pre- 
 paration may be changed to the fol- 
 lowing : 
 
 Take of 
 
 Tincture of cantharides, half an 
 ounce. 
 
 Pure glycerine, three drachms. 
 
 Lime water, four ounces. 
 
 To be rubbed into the skin, briskly, 
 twice a day. 
 
 The following hair tonic is also 
 often of service for scurf and com- 
 mencing baldness : — 
 
 236. 
 
 Take of 
 Rock salt, as much as will dissolve. 
 Pure glycerine, a tablespoonful. 
 Flour of sulphur, a teaspoonful. 
 Old whiskey, a tumblerful. 
 Mix. 
 
364 Special Receipts for the Care of the Sick. 
 
 237. Bark Hair Tonic 
 Take of 
 Red cinchona tea (see receipt No. 
 
 142), a tumblerful. 
 Brandy, a wineglassful. 
 Pure glycerine, a tablespoonful. 
 Mix. Apply, night and morning, 
 for scurf and, falling of the hair. 
 
 238. Ammonia Hair Tonic. 
 Take of 
 
 Stronger water of ammonia, 
 
 Castor oil, each one ounce. 
 
 Old brandy, two ounces. 
 
 Rose water, six ounces. 
 
 Mix. This mixture must not be 
 employed oftener than every other 
 day. 
 
 239. Ointment for Dandruff. 
 Take of 
 
 Powdered borax, twenty grains. 
 
 Lead water (diluted solution of 
 subacetate of lead), two drachms. 
 
 Fresh lard, one ounce. 
 
 Attar of roses, a few drops. 
 
 Mix. To be rubbed on the scaly 
 patches on the scalp every morning, 
 after the skin has been cleaned by 
 soap and water. 
 
 Or, the same ingredients may be 
 used in a wash as follows : — 
 
 240. Wash for Dandruff. 
 
 Take of 
 Powdered borax, twenty grains. 
 Lead water, two drachms. 
 Rain water, half a tumblerful. 
 Pure glycerine, a tablespoonful. 
 Mix. Use once or twice a day. 
 
 LIP SALVES, LOTIONS, ETC. 
 
 241. Lip Salve. 
 Take of 
 
 Oxide of zinc, thirty grains. 
 
 Spermaceti ointment, half an 
 ounce. 
 
 Attar of roses, one drop. 
 
 Mix. To be applied, night and 
 morning, for irritated and cracked 
 lips, after bathing the parts with the 
 following : — 
 
 242. Lotion for the Lips. 
 
 Take of 
 
 Alum, a teaspoonful. 
 
 Water, a tumblerful. 
 
 Instead of alum, borax may be 
 often used, with advantage. 
 
 243. Solution for Fever-Blisters. 
 Take of 
 
 Carbolic acid, ten drops. 
 
 Pure glycerine, a teaspoonful. 
 
 Attar of roses, two drops. 
 
 Cautiously touch the sore part 
 with this preparation several times a 
 day. Or, wet the little blisters with 
 a solution of permanganate of potash 
 (one grain to a tablespoonful of 
 water) and dust with fine starch or 
 French chalk. 
 
 244. Lotions for the Hands. 
 
 Add a tablespoonful of pure gly- 
 cerine to a pint of water. This, 
 well rubbed in, but not wiped off, 
 will soften and whiten the hands, 
 and protect them from the air. 
 
 Another simple, but effectual, 
 wash for this purpose is the follow- 
 ing :— 
 
 245. 
 
 Take of 
 
 Horse-chestnuts, a sufficient quan- 
 tity. 
 
 Peel them, and dry thoroughly in 
 the oven. Then pound or grind into 
 a fine powder, and add a tablespoon- 
 ful of the powder to the water in the 
 hand-basin each time the hands are 
 rinsed. 
 
 For chapped hands nothing is bet- 
 ter than pure glycerine, well rubbed 
 in, several times a day. A little 
 tincture of benzoin may be added, 
 with benefit, to the glycerine. 
 
 246. 
 
 Take of 
 Sal ammoniac, a teaspoonful. 
 Aromatic vinegar, a tablespoonful. 
 Warm soft water, a quart. 
 
Receipts for the Hygiene of the Person. 
 
 365 
 
 This solution, used for soaking the 
 hands, during ten or fifteen minutes, 
 morning and evening, is recom- 
 mended for improving the skin, 
 preventing redness, and destroying 
 warts. 
 
 It is also of service for clammy 
 moisture of the hands. 
 
 Clammy hands are also benefited 
 by adding half a teaspoonful of 
 alum to the wash- water. 
 
 247. Ointment for Fetid Feet. 
 
 Take of 
 Crystallized carbolic acid, five 
 
 grains. 
 Ointment of oxide of zinc, one 
 
 ounce. 
 
 Mix. Apply, morning and even- 
 ing, after washing the feet in cold 
 water, with which a few teaspoon- 
 fuls of alum have been mixed. In 
 such cases, the wearing of a thin 
 sole of felt inside the shoe, which 
 should be removed several times a 
 week, wet in a solution of permanga- 
 nate of potash (twenty grains to the 
 ounce of water), dried, and rein- 
 serted, is of benefit. The stockings 
 should be of wool, and changed 
 once a day, and the same pair of 
 shoes should not be worn on two 
 consecutive days. 
 
 WASHES FOR THE FACE. 
 
 248. 
 
 Take of 
 
 Powdered borax, half an ounce. 
 
 Pure glycerine, one ounce. 
 
 Camphor water, one quart. 
 
 Mix. Wet the face with this, 
 morning and evening, allow it to 
 remain for several minutes, and wash 
 in rain water. An excellent lotion 
 to prevent chapped skin, to remove 
 sunburn, and cleanse the pores of 
 the skin, 
 
 249. 
 
 Take of 
 
 Fresh lemon juice, a wineglassful. 
 
 Rain water, one pint. 
 
 Attar of roses, a few drops. 
 
 Mix, and put in a well-corked 
 bottle. Wash the face and hands 
 with this several times a day (letting 
 it stay on for several minutes before 
 drying with the towel). This prepa- 
 ration is highly recommended by the 
 celebrated Dr. Wilson, of London, 
 for clearing the complexion of 
 " muddiness." 
 
 250. 
 
 Take of 
 
 Juice of cucumber, pressed from 
 the fruit, a sufficient quantity. 
 
 Boil it over a quick fire, cool 
 rapidly, and bottle. Apply a table- 
 
 31* 
 
 spoonful, diluted with two table- 
 spoonfuls of water, night and morn- 
 ing. This preparation is much em- 
 ployed in France for clearing the 
 complexion. 
 
 In some parts of England the 
 following wash is much employed 
 for removing sunburn and whitening 
 the skin : — 
 
 251. 
 Take of 
 
 Fresh horseradish root, one ounce. 
 
 Cold buttermilk, one pint. 
 
 Put aside for four hours. 
 
 Or, 
 
 252. 
 Take of 
 
 The juice of horseradish, one part. 
 
 Cider vinegar, two parts. 
 
 Mix. Has the same uses as the 
 above receipt, and is also recom- 
 mended for removing freckles. 
 
 Take of 
 
 Benzoin, two ounces. 
 
 Pure alcohol, one pint. 
 
 Mix. A tablespoonful of this, 
 added to a tumbler of water, turns 
 it white, and makes a most agree- 
 able wash for clearing the com- 
 plexion. 
 
366 Receipts for the Hygiene of the Person. 
 
 254. Ointment for Sunburn. 
 Take of 
 
 Spermaceti, 
 
 Oil of almond, each two ounces. 
 
 Honey, one teaspoonful. 
 
 Attar of roses (or any scent), a few 
 drops. 
 
 Melt the spermaceti in a pipkin, 
 then add the oil of almonds, and, 
 when they are thoroughly mixed, 
 
 stir in the honey. Take the pipkin 
 off the fire, and stir constantly, until 
 it is cool, adding the scent. 
 
 Apply at night, after washing the 
 skin, and allow it to remain until 
 morning. It relieves the irritated 
 burning skin, and lessens the red- 
 ness. Cold, fresh cream smeared 
 over the affected parts sometimes 
 does good. 
 
 As lunar caustic and tincture of iodine are medicines in common 
 use, and stain the skin and body linen, the following directions for 
 removing these stains will be found useful : 
 
 255. To Remove Stains of Lunar 
 Caustic (Nitrate of Silver) from 
 the Skin. 
 
 Wash the parts discolored by hand- 
 ling a stick or solution of lunar 
 caustic in a solution of iodide of 
 potassium in water. The washing 
 will turn the discolorations from 
 brown to dead white. Then wash 
 in a solution of spirits of hartshorn. 
 
 256. To Remove Stains of Lunar 
 
 Caustic from Linen. 
 The best way to remove stains of 
 nitrate of silver from linen is to 
 moisten the stain with a few drops 
 of a solution of one drachm of cyan- 
 ide of potassium in a wineglassful of 
 water, to which a few drops of tinc- 
 ture of iodine has been added imme- 
 ately before using the solution. The 
 linen should then be well rinsed in 
 
 clear water. This plan removes even 
 the oldest stains of nitrate of silver, 
 provided the operation be carried on 
 in a moderately lighted room. The 
 cyanide of potassium may be ob- 
 tained of the druggist, but is a vio- 
 lent poison, which should be kept 
 and handled with great care. 
 
 257. Another Way of Removing Ni- 
 trate of Silver Stains from the 
 Fingers. 
 
 Moisten the part with tincture of 
 iodine ; immediately apply spirits of 
 hartshorn, and wash off. 
 
 258. To Remove Iodine Stains from 
 
 Linen. 
 Dissolve two drachms of the hypo- 
 sulphite of soda in half a tumbler of 
 water, and soak the stains in the 
 solution, then wash in water. 
 
CONCLUSION. 
 
 Charity to the Poor and Sick. 
 
 In closing this review of the afflictions to which the human body 
 is exposed, and this enumeration of the resources which science and 
 experience have at command to alleviate them, were it not well to 
 reflect how many there are, within reach of every one of us, who 
 stand in great need of such alleviations, and who have no means to 
 procure them? By the expenditure of but a little time, and a 
 small outlay, it is in our power to soothe many an aching brain and 
 fevered body. "The poor always ye have with you," said One 
 whose words do not fail, and there is no benevolence more practical, 
 more immediately a duty, than to aid the poor who are sick. 
 
 Poor and sick ! How much misery in those three monosyllables, 
 which the poet might have called { The saddest words of tongue or 
 pen." 
 
 Hospitals and almshouses do not supply the need, and it is but 
 an excuse for heartlessness and selfishness to say so. Very many 
 cases are not suited for admission to them, and they never equal the 
 requirements of a community. In no sense do they relieve the 
 individual of the command which has been laid upon him, to " visit 
 the sick in their affliction." 
 
 Nor is the spirit of that command complied with when we merely 
 supply the actual wants of the invalid, furnish him food and fuel, 
 clothing and medicines. The charity that stops here is cold indeed, 
 and the thoughtfulness which extends no further, takes little note of 
 the deeper needs of the human heart. Our civilization has created 
 for us necessities none the less real because they are artificial. As a 
 gifted woman once remarked, " Poverty does not consist so much in 
 
 367 
 
368 Conclusion. 
 
 not having enough to eat, as in not having the food one desires." 
 Doubly true is this in sickness. The coarse fare which is the 
 ordinary food of the poor is then loathed, and it is physiologically 
 true that it often will not nourish if taken, and the monotony of 
 diet actually starves the body. Delicacies, "tidbits," little surprises 
 in diet, such as we have given numerous receipts for in the foregoing 
 pages, are then not merely most grateful, but really necessary. It 
 is, moreover, a curious fact, one constantly observed, and which we 
 can interpret as a standing admonition to mutual kindly offices, that 
 the palate of the sick is nearly always better pleased with a dish 
 sent in by a neighbor than with the same prepared at home. The 
 little peculiarities in its preparation which every housekeeper has, 
 give it an agreeable diversity in flavor. 
 
 But the sick ask more at our hands than food and shelter. The 
 long, weary days, the longer, more weary, sleepless nights: how 
 grateful to the worn and disturbed senses at such times, is the fresh 
 fragrance of a bouquet of flowers, the cool scent of an aromatic 
 water, such as bay water, cologne, or diluted vinegar, the sight of a 
 few pretty prints, or the soothing sound of a gentle hymn. In one 
 sad case we remember, that of a fair young girl, a long time tossing 
 in the low delirium of typhoid fever, nothing gave her quiet till 
 two or three of her schoolmates stood round her bed and united 
 their voices in a soft hymn, when she sank into a peaceful slumber. 
 
 In this connection, we would recommend for imitation an 
 admirable society in Philadelphia, organized by a number of charit- 
 able ladies, the "Philadelphia Flower Mission," the chief purpose 
 of which is to distribute bouquets and baskets of flowers, pot plants 
 and fresh fruits, through hospitals and charitable institutions, and in 
 the dwellings of the poor throughout the city. It gives away in 
 this manner from eight to ten thousand bouquets annually, all of 
 them contributed by the members and their friends, who have flower 
 gardens and conservatories. Let such use as this be made of surplus 
 wealth, and we shall hear no longer of " the war between labor and 
 capital." Such charity is dictated by no monkish sentimentality, 
 but is directed by the truest of physiological principles, and is 
 inspired by the very spirit of Him who painted the lilies of the 
 field with tones of beauty such as no earthly artist can approach. 
 
Charity to the Poor and Sick. 369 
 
 Especially would we call the attention of the charitable to the 
 condition of the children of the poor in our large cities. There 
 are, in the first place, those waifs of humanity, the foundlings. 
 About a fourth of all the children of the poor die in the first year 
 of their life; but of those deserted little ones, hardly a fourth 
 survive that year. The mortality of foundling hospitals, no matter 
 how well cared for, is simply appalling ; but a very small fraction of 
 the infants admitted to them live to come out again. Hence an 
 eminent physician of New York city condemns them altogether, 
 and recommends in their stead that arrangements shall be made 
 with small farmers, and others living in country places, to take 
 and care for the foundlings. This plan, adopted with gratifying 
 success in certain European cities, is not more expensive, and should 
 be introduced with us. 
 
 Next to these the older children of poor parents claim our 
 attention. Think of the child shut up the long, hot summer, in 
 the foul alleys of the city, never seeing the green fields, its natural 
 home, nor culling flowers, or chasing butterflies, its brightest of 
 dreams. Shall we not give those little ones, at least once in a while, 
 a breath of pure, fresh, country air, a brief escape from crowded 
 tenement houses and dusty streets? With this object in view, 
 charitable individuals in some of our cities have for several years 
 subscribed to a fund to provide excursions for the children of the 
 city poor. This is well ; but it is not necessary to wait for such 
 organizations. Any one can readily — too readily! — find a child 
 suffering and pining for country air, and at a small expense arrange 
 with a farmer's family to keep it a few weeks during the summer. 
 Then give another its turn, and at no more cost than a week for 
 ourselves at the seaside, health and happiness can be distributed for 
 a whole summer, on half a dozen little lives. 
 
 Dr. Toner, of Washington, has also suggested the establishment 
 of large camps, with abundance of shade and pure water near them, 
 for the accommodation of poor families in the summer, a most 
 benevolent suggestion, which, it is to be hoped, will not be forgotten. 
 
 We would add one more word to the recommendations which we 
 have here written, and a word which, if the reader pass on unmindful 
 of it, will frustrate his best attempts to help those who need his 
 
37° Conclusion. 
 
 help. It is this : show your sympathy as well as feel it. Show it 
 in word and in look, as well as in acts ; show it in your softened 
 tones, in tender inquiry, in patient listening to complaints, in 
 consideration for the feelings of the humblest, in a demeanor as 
 respectful in dreariest garrets as in most luxurious sick chambers. 
 Without this, your deeds of mercy will neither bless you who give, 
 nor those who receive. 
 
 We add another and a final reflection. Sickness is to man a 
 warning that this life is not his only one; that he is but a so- 
 journer in the land, and must seek his true home beyond. There- 
 fore, it is eminently proper at such times, when the condition of the 
 invalid permits it, to recall to his mind the promises of religion and 
 the loving kindness of Him who holds our destinies in His hand. 
 It is not the time to excite religious fears or strong emotions, nor 
 to discuss differences in religious opinions. It is not for us to 
 pronounce judgment on our fellows, nor can we measure the good 
 and evil of any man's life; but every Christian, whatever opinions 
 he may individually prefer, can always draw from the inexhaustible 
 fund of God's promises, words of consolation and comfort for the 
 sick and the wretched, which will cheer their minds, lighten their 
 sufferings, and fit them better for the passage to the world beyond. 
 
APPENDIX. 
 THE FAMILY HEALTH RECORD. 
 
 THE OBJECT OF THE HEALTH RECORD. 
 
 By means of the following schedules for a " Family Health Re- 
 cord" any mother can, with very little labor, keep the health annals 
 of each of her children. The jotting down in place of a word or 
 two, or of an initial, every few months, will, in time, furnish orderly 
 notes, extending from infancy over the whole life, always at hand 
 for instant reference. The value to a family of such health archives 
 can scarcely be over-estimated. No random, straggling memoranda, 
 like those sometimes kept, compare in utility with these regularly 
 noted facts, arranged upon a uniform plan. 
 
 Every mother can and should be the historian of her children's 
 health, and put upon permanent record her solicitude for their wel- 
 fare. No careful housekeeper is ignorant of the usefulness of exact 
 expense accounts ; few can fail to see the great importance of pre- 
 serving exact health accounts, instead of trusting, as is usually 
 done, such details to the memory, a guardian often at fault, and 
 never fully competent. Who can recollect and give at once, and 
 with accuracy, to a new physician, one, therefore, unacquainted 
 with the family history and peculiarities, the prominent events in 
 regard to the early life, the growth and the ailments of each mem- 
 ber of the family, his or her susceptibilities to this or that disease, 
 
 371 
 
37 2 The Family Health Record. 
 
 to the effects of this or that food, medicine or mode of life? Yet 
 such information throws that light upon the constitution of the 
 invalid which is often the most needed, the most difficult to obtain, 
 and the want of which often leads to the most lamentable errors of 
 treatment. The register which we here give will enable any 
 mother, at the trouble only of noting a word, a date, or a single 
 letter, at long intervals of time, to treasure up, always ready for con- 
 sultation, all the important facts relating to the temperament, pre- 
 disposition, and ailments of her children. 
 
 With the aid of this Family Health Record, properly kept, many 
 a connection, which would otherwise remain unsuspected, will be 
 observed between sicknesses remote from each other, but united by 
 a chain of cause and effect, a common nature, or a similar origin. 
 Family peculiarities and hereditary tendencies will, by it, be brought 
 to light, which would otherwise escape attention. Predispositions 
 to certain ailments frequently lurk in individuals and in families, 
 unseen by all but the old family physician, whose knowledge of 
 them cannot always be made available ; these records will make 
 them apparent to every ordinary intelligence. 
 
 In order that the nature of each serious ailment may be correctly 
 stated, the mother should question the attending physician at the 
 close of the illness, and at once make her notes. The precise facts 
 only are wanted ; all theories and suppositions are useless. 
 
 We need not enlarge upon the importance of a Family Health 
 Record to every individual, family and community ; a moment's 
 reflection will show what precious light would be thrown upon 
 public as well as private hygiene if such a register, on a uniform 
 plan, were kept for generations by every family of the land. 
 
 It will be observed that the following register is arranged under 
 eight heads, and that it presents, therefore, eight separate tables, in 
 blank, for filling up. They are all within the range of the mother's 
 powers of observation. The first is devoted to descent, and gives 
 the health and tendencies to disease of the immediate living relatives, 
 and the age and cause of death of those deceased. Initials for filling 
 up the columns of this table are furnished in the foot-note to it. 
 On the blank page opposite, any additional particulars bearing on the 
 subject may be recorded. The second table is for the purpose of record- 
 
The Family Health Record. 373 
 
 ing the weight at different ages. These comparative weights are of the 
 greatest importance, and are not difficult to take. The average 
 weight of a new-born child is seven pounds ; the extremes are from 
 four to eleven pounds. The third table affords the means of noting 
 the growth, particulars in regard to school life, and the diseases 
 which manifest themselves during the period of active growth. 
 The notes in reference to vaccination called for by this table should 
 not be overlooked. A new-born child is easily measured by stretch- 
 ing it upon a table, keeping its legs out straight, and drawing 
 two lines, one touching the soles of the feet, the other the top of 
 the head. Subsequent measurements are readily taken by having 
 the child stand in stocking feet beside the case of the door, and 
 resting a square on the top of the head. If a small four-sided 
 post be prepared, two inches square and six feet and a half high, 
 on its four faces may be inscribed the growth of four children of 
 the same family, one face for each child. This, if kept, and carried 
 from house to house, enables comparisons to be made at a glance. 
 The fourth table is for the noting of ailments. Quite a number of 
 the most common and the most important for recording are printed, 
 and blanks left for others. The defects and diseases in the senses 
 of sight and hearing are to be noted in the blanks provided for 
 them by table fifth. The sixth and seventh tables are for facts 
 in regard to Accidents and Operations, and Hygienic Habits. 
 An obituary record ends the Register. 
 
 PRACTICAL DIRECTIONS FOR KEEPING THE FAMILY HEALTH 
 
 RECORD. 
 
 Make the entries very brief; employ the initials as often as 
 possible, in the place of writing out the words. 
 
 Observe that there is ample space for keeping the health records 
 of four children, that of one being upon the left-hand page and 
 those of the other three on the right-hand page facing it. The full 
 form, given on the left-hand pages, for the first child, is not repeated 
 on the right-hand pages for the second, third and fourth child, 
 as it is' unnecessary to do so, it being easy to put down in the blank 
 space there given to each child all the details that need be noted, 
 if care be taken to record them in the same order as that called for 
 by the ruled form on the opposite page. 
 32 
 
The Family Health Record. 
 
 DESCENT. 
 
 i 
 
 o 
 ■8 
 
 fa. Grandfather, 
 I. Paternal. < 
 
 (b. Grandmother 
 
 S3 
 < 
 
 < 
 
 fa. Grandfather, 
 II. Maternal. < 
 
 ' (b. Grandmother 
 
 B. Father 
 
 C. Mother. ..... 
 
 
 1 
 
 D. Brothers. < 
 
 2. . . . 
 
 
 Z 
 
 
 1 
 
 E. Sisters. 
 
 2 
 
 F. 
 
 ' Uncles 
 and • 
 Aunts. 
 
 r ri. 
 
 Paternal. •< 
 
 1 2. 
 
 fl. 
 
 Maternal. < 
 I 12. . 
 
 Living. 
 
 Dead. 
 
 Age 
 
 Causes of Death. 
 
 * Fill up this column by the use of the following initials : Very- 
 good (V.G.); good(G.); tolerably good (T.G.) ; delicate (D.) ; feeble 
 (F.); confirmed invalid (I.). 
 
 f Fill up this column by the use of the following initials : Tendency 
 to brain disease (B.) ; to nervous affections (N.) ; to coughs, colds, and 
 chest affections (C); to rheumatism (B.). 
 
 374 
 
The Family Health Record. 
 ADDITIONAL PARTICULARS. 
 
 \hz 
 
 o/o 
 

 The Family Health Record, 
 
 
 
 
 WEIGHT. 
 
 
 
 Age. 
 
 
 Age. 
 
 2 
 
 Age 
 
 +5 
 
 Age. 
 
 
 
 ft)S. 
 
 
 £ 
 
 
 £ 
 
 
 $ 
 
 
 ft)S. 
 
 
 lbs. 
 
 
 lbs. 
 
 At birth, 
 
 
 2 years, 
 
 
 12 years, 
 
 
 25 years, 
 
 
 1 month, 
 
 
 3 years, 
 
 
 13 years, 
 
 
 30 years, 
 
 
 2 months, 
 
 
 4 years, 
 
 
 14 years, 
 
 
 35 years, 
 
 
 3 months, 
 
 
 5 years, 
 
 
 15 years, 
 
 
 40 years, 
 
 
 4 months, 
 
 
 6 years, 
 
 
 16 years, 
 
 
 45 years, 
 
 
 5 months, 
 
 
 7 years, 
 
 
 17 years, 
 
 
 50 years, 
 
 
 6 months, 
 
 
 8 years, 
 
 
 18 years, 
 
 
 55 years, 
 
 
 9 months, 
 
 
 9 years, 
 
 
 19 years, 
 
 
 60 years, 
 
 
 12 months, 
 
 
 10 years, 
 
 
 20 years, 
 
 
 65 years, 
 
 
 18 months. 
 
 
 11 years, 
 
 
 21 years, 
 
 
 70 years, 
 
 
 Ages at ' 
 
 WHICH 
 
 the Weight has Dimie 
 
 ISHED : 
 
 
 
 
 
 Hygienic Causes : -J 2 
 
 . Bodily fatigue 
 
 
 
 
 
 . Mental fatigue 
 
 
 Causes of Di 
 
 minishi 
 
 3d 
 
 [3 
 
 . Rapid growth : 
 
 
 Weigl 
 
 it: 
 
 
 Morbid Causes : - 
 
 ' 1 
 
 2 
 
 . 3 
 
 . Bad habits : 
 . Indispositions: 
 . Sickness: 
 
 
 376 
 
The Family Health Record. 
 OTHER CHILDREN. 
 
 ;77 
 
The Family Health Record. 
 GEOWTH. 
 
 Age. 
 
 Height. 
 
 Age. 
 
 Height. 
 
 Age. 
 
 Height. 
 
 
 Ft. 
 
 In. 
 
 
 Ft. 
 
 In. 
 
 
 Ft. 
 
 In. 
 
 At birth, 
 
 
 
 7 years, 
 
 
 
 14 years, 
 
 
 
 1 year, 
 
 
 
 8 years, 
 
 
 
 15 years, 
 
 
 
 2 years, 
 
 
 
 9 years, 
 
 
 
 16 years, 
 
 
 
 3 years, 
 
 
 
 10 years, 
 
 
 
 17 years, 
 
 
 
 4 years, 
 
 
 
 11 years, 
 
 
 
 18 years, 
 
 
 
 5 years, 
 
 
 
 12 years, 
 
 
 
 19 years, 
 
 
 
 6 years, 
 
 
 
 13 years, 
 
 
 
 20 years, 
 
 
 
 Irregularities : 
 
 A. Retarded growth : 
 
 B. Premature growth : 
 
 C. Growth by leaps : 
 
 D. Excessive growth : 
 
 SCHOOL LIFE. 
 
 
 Primary 
 School. 
 
 Grammar School. 
 
 High Sch'l 
 or other. 
 
 
 Lower 
 Classes. 
 
 Upper 
 Classes. 
 
 Age when entering, . . 
 Age when leaving, , . 
 Interruption from Indispo- 
 sition or Sickness, . . 
 
 
 
 
 
 DISEASES IN GROWING. 
 
 
 d 
 
 rS 
 
 
 o 
 
 -u» tX 
 
 
 
 fl P 
 
 
 08 
 
 t» O 
 
 
 c3 
 
 an 
 
 
 B 
 
 
 
 w 
 
 Ph 
 
 Age, . . . 
 Duration, 
 
 
 
 Severity, . . 
 
 
 
 ■a 
 
 .So 
 
 gS 
 
 -1-3 
 
 m 
 
 o 
 
 When vaccinated : 
 
 Did it take? 
 
 Date of vaccination : 
 
 378 
 
The Family Health Record. 
 OTHER CHILDREN. 
 
 379 
 
The Family Health Record. 
 
 AILMENTS, 
 
 Disease. Date. Season. Age Duration. 
 
 Consequences. 
 
 Constipation, . . 
 Dyspepsia, . . . 
 Diarrhcea, . . . 
 Colds in the head, 
 Colds in the chest, 
 Sore eyes, . . . 
 Running at the ears 
 Boils, .... 
 Eruptions on the skin, 
 Nose-bleed, . . 
 Neuralgia, . . . 
 Rheumatism, . . 
 Persistent cough, 
 Spitting of blood, 
 Night sweats, . . 
 Vomiting of blood, 
 
 380 
 
The Family Health Record. 
 OTHER CHILDREN. 
 
 381 
 
The Family Health Record. 
 
 SIGHT AND HEARING. 
 
 I. Sight. 
 
 A. Cross-eye: 
 
 B. Near sight, 
 
 C. Far-sight. 
 
 ■ Father : 
 
 1. Inherited. -J Mother: 
 
 Brother or sister : 
 
 2. Time of appearing : 
 
 1. Inherited: 
 
 2. Time of appearing : 
 D. Diseases of the eyes : 
 
 II. Hearing. 
 
 A. Diseases of the ear : 
 
 1. Of long standing : 
 
 Be Deafness. 
 
 2. Nervous: 
 
 382 
 
The Family Health Record. 
 OTHER CHILDREN. 
 
 383 
 

 The Family Health Record. 
 
 
 ACCIDENTS AND OPEKATIONS. 
 
 A. 
 
 Falls: 
 
 B. 
 
 Blows and contusions : 
 
 C. 
 
 Bruises and scalds : 
 
 
 
 ' 1. Age: 
 
 
 
 2. Side: 
 
 D. 
 
 Kuptures. 
 
 3. Causes: 
 
 
 » 
 
 r A. Date of application : 
 k 4. Trusses. \ 
 
 1 B. Date of leaving off: 
 
 
 
 1. In the stomach : 
 
 E. 
 
 Foreign bodies. • • 
 
 2. In the eye : 
 
 3. In the ear : 
 
 4. In the throat : 
 
 
 f 1. Date: 
 
 F. 
 
 Poisoning. . . , \ 2. Substance: 
 
 
 [ 3. Consequences. 
 
 G. 
 
 Injuries of the bones 
 
 ' 1. Fractures: 
 2. Dislocations: 
 
 
 or joints. 
 
 3. Sprains: 
 
 H, 
 
 Surgical operations : 
 
 
 • 
 
 384 
 
The Family Health Record. 
 
 OTHER CHILDREN. 
 
 385 
 

 The Family Health Record. 
 
 
 HYGIENIC HABITS. 
 
 
 
 ■ 
 
 r 1. Fat : 
 
 
 
 
 2. Lean: 
 
 I 
 
 Food : - 
 
 A. Food badly digested : ■ 
 
 3. Milk: 
 
 4. Vegetables: 
 ^5. Fruit: 
 
 
 
 L B. Peculiar tastes in eating . 
 
 
 
 ' A, Common duration : 
 
 c rising : 
 B. Hours of < 
 
 ( retiring : 
 
 
 
 
 ' 1. Peaceful sleep: 
 
 II. 
 
 Sleep : ■ 
 
 
 2. Continuous sleep : 
 
 3. Interrupted sleep : 
 
 
 
 C. Condition: - 
 
 4. Dreams: 
 
 5. Nightmare: 
 
 6. Grinding of the teeth : 
 
 
 
 „ 
 
 7. Habit of talking aloud : 
 
 
 
 ' A. Activity or sluggishness : 
 
 III. 
 
 Exercise : - 
 
 B. Agility or address : 
 
 C. Endurance of fatigue : 
 
 
 f A, Date of beginning : 
 
 IV. 
 
 Gymnastics: \ B. Total duration. 
 
 
 [ C. Principal exercises: 
 
 V. 
 
 r A. Warm and thick: 
 Clothing: \ 
 
 IB. Light: 
 
 
 C A. Warm: 
 Bathing: \ B. Cold: 
 
 VI. 
 
 
 [c Sea: 
 
 VII. 
 
 rA. Active: 
 Kind of Life : \ 
 
 LB. Sedentary: 
 
 386 
 
The Family Health Record. 
 OTHER CHILDREN. 
 
 3. 
 
 387 
 
Obituary Record. 
 
 NAME. 
 
 Date 
 of Death. 
 
 Age. 
 
 Disease. 
 
 • 
 • 
 
 
 
 
 388 
 
CLASSIFIED LIST OF ILLUSTRATIONS. 
 
 Illustrations of the Structure of the Body.— The Teeth (2)— 
 The Different Kinds of Bones (4)— The Framework of the Body (4)— 
 The Muscles and Skin (5) — The Lungs and Means of Ventilation (3) — 
 The Heart (3)— The Sense of Touch (1)— The Ear (3)— The Eye (2)— The 
 Nervous System (1). Total, 28 engravings. 
 
 Illustrations of Health Movements.— Home Gymnastic Exercises 
 without Apparatus (28)— Movement Cure (4). Total, 32 engravings. 
 
 Illustrations of Bandages and Dressings.— Bandages and Modes 
 of Applying (5) — Irrigating a limb (1) — Surgical Cradles (1) — To Check 
 Bleeding (7) — Dressings for Broken Bones (5) — A Handy Stretcher (1) 
 — To Reduce Dislocations (8). Total, 28 Engravings. 
 
 Illustrations of the Treatment for Drowned Persons, 4 en- 
 gravings. 
 
 Illustrations of the Treatment of Sundry Accidents, 8 engrav- 
 ings. 
 
 Illustrations of Baths and Inhalations, 4 engravings. 
 
 The Permanent Teeth. For Description, see p. 53. 
 
 The Inside of a Grinder, For Description, see p. 53. 
 
 389 
 
39° 
 
 Illustrations of the Bones. 
 
 Example of the Long Bones- 
 The Thigh, p. 47— fig. 35. 
 
 Example of the Flat Bones— The 
 Shoulder Blade, p. 48— fig. 37. 
 
 Example of the Short Bones— Example of the Irregular Bones— 
 
 The-Wnst. p. 48— fig. 36. A Vertebra, p. 48— fig. 38. 
 
Illustrations of the Bony Framework of the Body. 391 
 
 The Chest Cage. p. 50— fig. 40. 
 
 The Spinal Column, 
 p. 49— fig. 39. 
 
 The Bones of the Abdomen, 
 p. 50-fig. 41. 
 
 The Skeleton, p. 50— fig. 42. 
 
39 2 
 
 Illustrations of the Muscles. 
 
 Knee-pan and Muscles, 
 p. 35-fig. 6. 
 
 Section of Skin. 
 p. 27-fig. 1. 
 
Illustrations of Health Movements. 393 
 
 Home Gymnastic Exercises without Apparatus. 
 
 Movement 1. 
 
 p. 37— fig. 7. 
 
 Movement 2. 
 p. 37— fig. 8. 
 
 Movement 3. 
 p. 37-fig. 9. 
 
 Movement 4. 
 p. 38— fig. 10. 
 
 Movement 5. 
 p. 38— fig. 11. 
 
 Movement 6. 
 p. 38— fig. 12. 
 
 Movement8. 
 p. 39-fig. 14. 
 
 &:: 
 
 rjs& 
 
 Movement 9. 
 p. 39— fig. 15. 
 
394 
 
 Illustrations of Health Movements. 
 
 M 
 
 C^S: 
 
 Movement 10. Movement 11. Movement 12. 
 p. 39— fig. 16. p. 39— fig. 17. p. 40— fig. 18. 
 
 Movement 13. 
 p. 40-fig. 19. 
 
 Movement 14. 
 p. 40— fig. 20. 
 
 Movement 15. 
 p. 41— fig. 21. 
 
 Movement 16. 
 p. 41— fig. 22. 
 
 i ...:-x~p 
 
 # 
 
 Movement 17. 
 p. 41— fig. 23. 
 
 Movement 18. 
 p. 41— fig. 24. 
 
 Movement 19. 
 p. 42-fig. 25. 
 
Illustrations of Health Movements. 
 
 395 
 
 Movement 20. 
 p. 42— fig. 26. 
 
 V"*** 
 
 Movement 21. 
 p. 42— fig. 27. 
 
 Movement 22. 
 p 43— fig. 28. 
 
 S?:::;;^u Cr::::::::: 
 
 Movement 23. 
 p. 43— fig. 29. 
 
 Movement 24. 
 p. 43— fig. 30. 
 
 Movement 25. 
 p. 44-fig. 31. 
 
 Movement 26. 
 p. 44— fig. 32. 
 
 Movement 27. 
 p. 44— fig. 33. 
 
 Movement 28. 
 p. 45-fig. 34. 
 
396 Illustrations of Bandages and Dressings. 
 
 Bandages and Dressings. 
 
 A Roller Bandage, p. 202— fig. 59. 
 
 Applying a Roller, p. 202— fig. 
 
 A 4-tailed Bandage, p. 203— fig. 61. 
 
fflustrations of Bandages and Dressings. 397 
 
 A Many-tailed Bandage, p. 203— fig. 62. 
 
 34 
 
 Irrigating a Limb. p. 204— fig, 63. 
 
398 Illustrations of Bandages and Dressings. 
 
 Surgical Cradles, p. 92— fig. 57. 
 
 Bandage for Leg Sores, p. 198— fig. 58. 
 
Illustrations of Bleeding. 
 
 399 
 
 Bleeding and its Treatment. 
 
 Bleeding from Forearm, p. 206 —fig; 64. 
 
 Bleeding from Finger, 
 p. 207— fig. 65. 
 
 The Use of a Key to Stop Blood, 
 p. 208— fig. 66. 
 
400 
 
 Illustrations of Bleeding, 
 
 Pressure on Armpit, p. 209— fig. ( 
 
 
 Tourniquet on Arm. p. 209 —fig. 68. 
 
Illustrations of Bleeding. 
 
 401 
 
 Pressure 011 Leg. p. 210— fig, 
 
 Tourniquet on Leg. p. 211— fig. 70. 
 
 34* 
 
402 Illustrations of Broken Bones. 
 
 Broken Bones and their Treatment. 
 
 MiiiiiiiiiliiiiiliilllillllillillllllM 
 
 Tying Legs for Transportation, p. 212— fig. 71. 
 
 A Handy Stretcher, p. 212— fig. 72. 
 
 Dressing in Broken Collar Bone. p. 213— fig. 73. 
 
Illustrations of Broken Bones. 
 
 403 
 
 Dressing for Broken Upper Arm. p. 214— fig. 74. 
 
 Dressing for Broken Lower Arm. p. 215— fig, 75. 
 
 Box for Broken Leg. p. 216— fig. 76. 
 
404 Illustrations of Bones Out of Joint. 
 
 Bones Out of Joint and their Treatment. 
 
 Reducing a Lower Jaw Out of Joint, p. 217— fig. 77. 
 
 Dressing for a Collar Bone Out of Joint, p. 218— fig. 78. 
 
Illustrations of Bones Out of Joint. 405 
 
 Reducing an Arm Out of Joint, p. 219— fig. 79. 
 
 Reducing a Dislocated Arm without Assistance, p. 219— fig. 
 
 A Finger Out of Joint, p. 221— fig. 82 
 
406 Illustrations of Bones Out of Joint. 
 
 Reducing a Finger Out of Joint, p. 221— fig. 84. 
 
 The Clove Hitch, 
 p. 221— fig. 83. 
 
 Reducing a Thigrh Out of Joint, 
 p. 220— fig. 83. 
 
Illustrations of Drowning. 
 
 407 
 
 Drowning and its Treatment. 
 
 Artificial Respiration, p. 226— fig. 87. 
 
 The First Movement, p. 228— fig. 
 
4°8 Illustrations of Drowning. 
 
 The Second Movement, p. 229— fig. 
 
 The Third Movement, p. 229— fig. 90. 
 
Illustrations of Sundry Accidents. 409 
 
 Sundry Accidents. 
 
 Cupping Back of Neck, 
 p. 222^-fig. 85. 
 
 %sfs> 
 
 Poison Bag of a Bee. 
 p. 235-fig. 91. 
 
 Extinguishing Flames on Clothing, p. 223— fig. 86. 
 
 Removing an Objpct from the Eye. Dressing for an Injury to the Eye. 
 p. 239— fig. 92. p. 240-fig. 93. 
 
 35 
 
4io 
 
 Illustrations of Sundry Accidents. 
 
 Dressing a Clean Cut. p. 245— fig. 95. 
 
 Dressing for Lacerated Ham String, 
 p. 244— fig. 94. 
 
 Dressing for Wounds of Scalp, 
 p. 246— fig. 96. 
 
Illustrations of Passive Movements. 41 1 
 
 Passive Movements. 
 
 Arm and Body Movement, 
 p. 247— fig. 97. 
 
 Body Movement, 
 p. 247— fig. 98. 
 
 The Hip Movement, p. 247— fig, 
 
 Leg Movements, p. 248— fig. 100. 
 
412 Illustrations of Lungs and Heart. 
 
 The Lungs and Blood. 
 W 
 
 4§r 
 
 The Lungs, p. 57-fig. 45. 
 
 Inside of the Heart, p. 66— fig. 47. 
 
Illustrations of Circulation and Capillary Vessels \ 4 1 3 
 
 Pl:tn of the Circulation of the Blood, p. 68— fig. 48. 
 
 Magnified Capillary Vessels, p. 69— fig. 49. 
 
414 
 
 Illustrations of Nerves. 
 The Blood and Nerves. 
 
 The Feelers of the Skin. p. 77— fig. 50. 
 
 The Brain, Spinal Cord and Nerves, p. 86— flg. 56. 
 
Illustrations of the Eye. 
 
 Eye and Ear. 
 
 The Eyeball and its Muscles, p. 81— fig. 54. 
 
 The Chamber of the Eye. p 83-fig 55. 
 
4i6 
 
 Illustrations of the Ear. 
 
 Section of the Ear. p. 79— fig. 51. 
 
 The Little Bones in the 
 Ear. p. 80— fig. 52. 
 
 The Outer, Middle and Inner Ear. p. 80-fig. 
 
 58. 
 
Illustrations of Room and Windozv Sash. 
 Ventilation. 
 
 417 
 
 14 CUBIC 
 FEET 
 
 , 5 FEET __„>* 
 
 Dimension s of a Room. p. 32— fig. 3. 
 
 Window Sash Ventilator, p. 60— fig. 46. 
 
4X8 Mirations of Bathing Apparatus, etc. 
 
 Baths, Etc. 
 
 A Home-Made Bath Tub. p. 333-fig. 
 
 103. 
 
 ;»;;>!!'•• 
 
 :ii!:!:;i:!:i!ii: 
 
 Home-made Shower Bath, 
 p. 334-fig. 104. 
 
 An Inhaling Bottle, 
 p. 351-fig. 105. 
 
 A Hip-Bath Tub for Children, 
 p. 294— fig. 101. 
 
 Lancing a Child's Gums, 
 p. 307-fig. 102. 
 
INDEX. 
 
 PAGE 
 
 ABDOMEN, the, . 50 
 
 Accidents, .... 200 
 
 Acid, carbolic, " 344 
 
 oxalic, .... 253 
 
 prussic, .... 253 
 
 treatment, in cholera, . 177 
 
 burns by, .... 225 
 
 poisoning by, ♦ . . 249 
 
 Acne, . . . . . 191 
 
 Aconite, poisoning by, . . 249 
 
 Addison's disease of kidneys, . 186 
 
 Adhesive plaster, how to use, . 245 
 
 Affusion, cold, .... 338 
 
 Ague, 114 
 
 Air, amount used in respiration, 58 
 
 foul, in sick-room, . . 94 
 
 how changed in the lungs, 59 
 
 of sick-room, . . 93 
 
 pure, as an anodyne, . . 358 
 
 fresh, as a tonic, . . 88, 274 
 
 in consumption, . . . 166 
 
 size of rooms, ... 32 
 
 the medium of sound, . 80 
 
 Air-bath, warm, . ♦ . 337 
 
 Alcoholic poisoning, . . 249 
 
 Alcohol? sm, .... 142 
 
 Alkalies, burns by, . . . 225 
 
 poisoning by, . . . 249 
 
 Alopecia, 194 
 
 Alum emetic, .... 345 
 
 poultice, .... 359 
 
 Ammonia, .... 101 
 
 poisoning by, . . . 249 
 
 Ansemia, or poverty of the 
 
 blood, . . . .146 
 
 Anasarca, or general dropsy, . 149 
 
 Aneurisms, . , . < 182 
 
 PAGE 
 
 Angina, .... 180 
 
 pectoris, .... 130 
 
 Animal foods, table of, . . 327 
 
 Ankles, weak, in children, . 314 
 
 Anodynes, ... * 356 
 
 six receipts, . . . 357 
 Antidotes (under poisons), 248-254 
 
 Antimony, poisoning by, . . 249 
 
 Aorta, the, . . . ♦ 70 
 
 Aperients, .... 340 
 
 Apoplexy, .... 151 
 
 Appetite, 65 
 
 loss of, .... 168 
 
 Apple water, receipt, ' . . 324 
 
 Applying cold, . 342 
 
 cold affusions, . . . 338 
 
 heat, 347 
 
 Apthae, 190 
 
 of infants, .... 286 
 
 Arm, broken above elbow, . 214 
 
 broken below elbow, . . 215 
 
 out of joint, reducing, . 218 
 
 Arnica lotion, . . . .356 
 
 Arrowroot blanc-mange, . 329 
 
 drink, receipt, . . . 323 
 
 poultice, .... 360 
 
 Arsenic, 250 
 
 Arteries, the, .... 70 
 
 bleeding from, . . . 206 
 
 swelling of, . . .182 
 
 Arthritis, or gout, . . .137 
 
 Asphyxia, .... 237 
 
 cholera, .... 175 
 
 Asthma, 162 
 
 cold baths for, . . . 335 
 
 hay, 157 
 
 Auscultation in consumption, 165 
 
 419 
 
420 
 
 Index. 
 
 
 PAGE 
 
 I 
 
 >AGE 
 
 BACK-ACHE, in piles, , 
 
 . 179 
 
 Bath, warm, .... 
 
 335 
 
 Backening boils, 
 
 . 196 
 
 warm air, • • 
 
 337 
 
 felons, 
 
 . 197 
 
 Bathing, ..... 
 
 333 
 
 Baldness, 
 
 . 194 
 
 for delicate children, 
 
 275 
 
 receipts, 
 
 . 363 
 
 Baths, kinds, uses, etc., . 
 
 333 
 
 Bandage for scalp wound , 
 
 . 246 
 
 medicated, .... 
 
 336 
 
 for the eye, 
 
 . 240 
 
 temperature, . . • 
 
 334 
 
 four-tailed, * 
 
 . 203 
 
 Bath-tub, home-made, 
 
 333 
 
 many-tailed, 
 
 . 203 
 
 Batter pudding, receipt, . 
 
 330 
 
 roller, 
 
 . 201 
 
 Bed-clothing, .... 
 
 31 
 
 temporary, 
 
 . 212 
 
 for the sick, 
 
 92 
 
 Bantingism, 
 
 . 64 
 
 Bed-sores, .... 
 
 204 
 
 Barbers' itch, . 
 
 . 192 
 
 in typhoid fever, 
 
 105 
 
 Barley gruel, receipt, 
 
 . 325 
 
 Bed- wetting of children, . 
 
 303 
 
 water, receipt, . 
 
 . 322 
 
 Beef and hen broth, receipt, . 
 
 327 
 
 Baryta, poisoning by, 
 
 . 250 
 
 tea, two receipts, 
 
 326 
 
 Bath, alkaline, . 
 
 . 336 
 
 Belladonna, poisoning by, • 
 
 250 
 
 bark, . 
 
 . 336 
 
 Belly-ache, .... 
 
 170 
 
 bran, . 
 
 . 336 
 
 dry, 
 
 170 
 
 eold, . 
 
 . 334 
 
 Belts, hydropathic, . 
 
 342 
 
 douche, 
 
 . 338 
 
 Bile, the 
 
 62 
 
 foot, . 
 
 . 338 
 
 retention of, or jaundice, . 
 
 178 
 
 gelatine,. . 
 
 . 336 
 
 Bilious cholera, 
 
 175 
 
 hip, 
 
 . 338 
 
 colic, 
 
 170 
 
 hip, for children, 
 
 . 294 
 
 diseases, powder for, . 
 
 341 
 
 iron, . 
 
 . 337 
 
 diseases, dandelion tea for, . 
 
 350 
 
 liver of sulphur, 
 
 . 337 
 
 pneumonia, 
 
 163 
 
 mud, . 
 
 . 338 
 
 Biliousness, .... 
 
 168 
 
 mustard, 
 
 . 337 
 
 Bismuth, poisoning by, . . 
 
 250 
 
 oil, . . 
 
 . . 336 
 
 Bite of a dog, . . ^ . 
 
 205 
 
 Koman, 
 
 . 337 
 
 Bites of insects, serpents, spi- 
 
 
 Bussian, 
 
 . 337 
 
 ders, etc., . . . 
 
 206 
 
 salt water, . 
 
 . 337 
 
 Bitter-sweet, poisoning by, 
 
 250 
 
 sand, . 
 
 . 338 
 
 Black heads, .... 
 
 191 
 
 shallow, . . 
 
 . 338 
 
 Black vomit, or yellow fever, . 
 
 118 
 
 shower, 
 
 333, 338 
 
 Bladder, disease of, . 
 
 187 
 
 sitz, . 
 
 . 338 
 
 inflammation or catarrh, . 
 
 187 
 
 soap, . 
 
 . 336 
 
 stone or calculus, 
 
 188 
 
 sponge, 
 
 . 339 
 
 weakness, 
 
 187 
 
 starch, 
 
 . 336 
 
 Blanc-manges, four receipts, . 
 
 329 
 
 Turkish, . 
 
 . 337 
 
 Blebs on the skin, . 
 
 195 
 
 turpentine, 
 
 . 337 
 
 Bleeding after tooth-drawing, . 
 
 207 
 
 valerian, . 
 
 . 336 
 
 from arteries, . . 206 
 
 ,208 
 
 vapor, medicated, 
 
 . 337 
 
 leech-bites, 
 
 352 
 
 vapor, simple, . 
 
 . 337 
 
 the lungs, .... 
 
 165 
 
Index. 
 
 421 
 
 
 PAGE 
 
 
 PAGE 
 
 Bleeding from the nose, . 
 
 208 
 
 Bowels, the, 
 
 . 63 
 
 wounds, to check, 
 
 206 
 
 looseness of, . 17 
 
 3, 297, 303 
 
 piles, 
 
 178 
 
 palsy of, . 
 
 . 172 
 
 to check, wound in arm, . 
 
 209 
 
 stricture of, 
 
 . 172 
 
 to check, wound in leg, 
 
 210 
 
 wind in, . 
 
 . 170 
 
 Blisters, blood . 
 
 196 
 
 Bow-legs, .... 
 
 . 52 
 
 from poison vine, 
 
 253 
 
 Boxing as exercise, . 
 
 . 45 
 
 of the skin, . . • 
 
 195 
 
 Brain, the, 
 
 . 85 
 
 of the feet, 
 
 196 
 
 compression of, . 
 
 . 222 
 
 to make and use, 
 
 339 
 
 concussion of, 
 
 . 222 
 
 Blood, the . 
 
 66 
 
 the seat of sensation, . 
 
 . 87 
 
 arterial, . 
 
 71 
 
 of voluntary motion, , 
 
 . 87 
 
 course in circulation, , 
 
 68 
 
 water on, in children, 
 
 . 268 
 
 changes in circulation, 
 
 71 
 
 Bran poultice, . 
 
 . 359 
 
 its two-fold office, 
 
 71 
 
 Brash, weaning, of infants, . 303 
 
 poverty of . 
 
 146 
 
 Bread and milk poultice, 
 
 . 360 
 
 spitting, . 
 
 165 
 
 and water poultice , 
 
 . 358 
 
 venous, 
 
 71 
 
 jelly, receipt, . 
 
 . 329 
 
 vomiting of 
 
 168 
 
 pudding, receipt, 
 
 . 330 
 
 watery, 
 
 146 
 
 sauce, receipt, . 
 
 . 327 
 
 Bloodlessness, or poverty of tht 
 
 
 soup, receipt, 
 
 . 327 
 
 blood, 
 
 . 146 
 
 Breath, foul, mouth- washe 
 
 s for, 363 
 
 Bloody flux, or stools, 
 
 . 174 
 
 Breathing, 
 
 . 58 
 
 urine, 
 
 . 188 
 
 in consumption, 
 
 . 165 
 
 Blotches, face, . 
 
 . 193 
 
 through the nose, 
 
 ."» 75 
 
 Blows, .... 
 
 . 222 
 
 through the skin, 
 
 28,59 
 
 Blue mass, substitute for, . 
 
 . 341 
 
 B right's disease, 
 
 . . 184 
 
 Blushing, .... 
 
 . 29 
 
 Broken bones (see also 
 
 Frac- 
 
 Body, like steam-engine, . 
 
 . 64 
 
 ture), 
 
 . 211 
 
 three divisions of, 
 
 . 49 
 
 heart, . 
 
 . 181 
 
 waste and repair of, . 
 
 . 72 
 
 limb, irrigating, 
 
 . 203 
 
 Boils, .... 
 
 . 196 
 
 ribs, . 
 
 . 214 
 
 blind, .... 
 
 . 196 
 
 Bromides, the, . 
 
 . 101 
 
 Bones, the, 
 
 . 47 
 
 Bronchial tubes, 
 
 . 57 
 
 broken, 
 
 . 211 
 
 Bronchitis, 
 
 . 158 
 
 number of, in body, . 
 
 . 48 
 
 epidemic, . 
 
 . 117 
 
 of the extremities, 
 
 . 50 
 
 of children, 
 
 . 293 
 
 head, .... 
 
 . 49 
 
 Bronzed skin, . 
 
 . 193 
 
 trunk, 
 
 . 49 
 
 Broths, receipts, 
 
 . 326 
 
 out of joint (see Dislocatic 
 
 >n). 
 
 Bruises, . . . 
 
 . 222 
 
 Bone-setting, ... 21 
 
 L7, 222 
 
 Bunions, . . . 
 
 . 196 
 
 Borax wash, 
 
 . 355 
 
 Burns, 
 
 . 223 
 
 Bowel, falling of, in children, 
 
 . 301 
 
 by acids, 
 
 . 225 
 
 inflammation of large, 
 
 . 174 
 
 from gunpowder, 
 
 . 243 
 
 inflammation of lower, 
 
 . 172 
 
 lime, potash, etc., 
 
 . 225 
 
422 
 
 Index* 
 
 PAGE 
 
 
 PAGE 
 
 CALCULUS in the bladder . 
 
 188 
 
 Charpie lint, . . . 
 
 . 354 
 
 Calves'-feet jelly, . . 
 
 330 
 
 Chest diseases, vapor baths for, 337 
 
 Camphor, for pain, . 
 
 357 
 
 pains in, in consumpt] 
 
 Lon, . 165 
 
 liniment, .... 
 
 353 
 
 stabs in, 
 
 . 245 
 
 ointment .... 
 
 356 
 
 Chewing the food, . 
 
 . 61 
 
 poisoning by, 
 
 250 
 
 Chicken broth, . . « 
 
 . 326 
 
 Cancers 
 
 316 
 
 pox, . 
 
 . 264 
 
 skin, . 
 
 316 
 
 Chilblains, 
 
 . 231 
 
 Canker of mouth, in infants, . 
 
 286 
 
 liniment for, 
 
 . 353 
 
 sores, 
 
 190 
 
 Children, bones not easily 
 
 • bro- 
 
 Capillaries, the 
 
 69 
 
 ken, . . -v . 
 
 . 47 
 
 Carbolic acid, .... 
 
 344 
 
 breathing through mouth, . 74 
 
 Carbonic acid gas, in breathing, 
 
 59 
 
 cross-eyes, . 
 
 82, 309 
 
 Carbuncle, .... 
 
 196 
 
 deformities, 
 
 . 52 
 
 Carriage-riding, 
 
 45 
 
 delicate, 
 
 . 274 
 
 Carrot poultice, 
 
 359 
 
 doses, in this work, . 
 
 . 255 
 
 Castor oil, .... 
 
 340 
 
 emetics, . 
 
 . 345 
 
 Catarrhal fever, or cold in the 
 
 
 eruptions from scrofula, 273 304 
 
 chest, .... 
 
 158 
 
 frightening, 
 
 . 282 
 
 Catarrh, autumnal, . 
 
 157 
 
 galling, or rubbing, . 
 
 . 304 
 
 epidemic, .... 
 
 117 
 
 hip-bath, . 
 
 . 294 
 
 gastric, 
 
 168 
 
 itching, etc., from calculus, 188 
 
 inhalations for, 
 
 351 
 
 leeches, 
 
 . 352 
 
 nasal, .... 
 
 156 
 
 measuring, 
 
 . 373 
 
 of the chest, . . ' . 
 
 158 
 
 mistaken care of ears 
 
 , . 310 
 
 of the ears, 
 
 310 
 
 of the poor, . 
 
 . 369 
 
 of nose, or ozsena, 
 
 157 
 
 picking the ear, . 
 
 . 78 
 
 children's, .... 
 
 284 
 
 picking the nose, 
 
 , . 74 
 
 summer, .... 
 
 157 
 
 scrofulous symptoms. 
 
 . 271 
 
 Cathartics, cautions, etc. . 
 
 340 
 
 short sight, 
 
 . 84 
 
 eight receipts, . 
 
 340 
 
 things in ear, 
 
 . 240 
 
 Caudle, receipt, 
 
 324 
 
 things in nose, . 
 
 . 241 
 
 Caustics for cancers, 
 
 317 
 
 vaccination, 
 
 264, 266 
 
 Cellars, foul, to disinfect, 
 
 344 
 
 wetting the bed, 
 
 . 303 
 
 Chamber utensil in sick-room, . 
 
 95 
 
 See also various diseases, etc. 
 
 Chambers, Prof., on food for 
 
 
 Chills, or chills and fever 
 
 . 114 
 
 sick, .... 
 
 331 
 
 and fever, dogwood tea for, 349 
 
 Change of air in convalescence, 
 
 99 
 
 Chloral, for pain, 
 
 . 357 
 
 of climate, in consumption, 
 
 167 
 
 Chlorine as disinfectant, 
 
 . 344 
 
 Chapped hands, 
 
 192 
 
 Chloroform liniment, 
 
 . 354 
 
 skin, salve for, . 
 
 356 
 
 Chocolate milk, receipt, 
 
 . 324 
 
 receipts, .... 
 
 364 
 
 receipt for making, 
 
 . 324 
 
 to prevent, .... 
 
 365 
 
 Choke-damp, . 
 
 . 237 
 
 Charcoal fumes, apparent death 
 
 237 
 
 Choking, in eating, etc., 
 
 . 241 
 
 poultice, .... 
 
 359 
 
 Cholera, Asiatic, 
 
 . 175 
 
Index. 
 
 423 
 
 52. 
 
 PAGE 
 
 Cholera, asphyxia, . . . 175 
 
 bilious, .... 175 
 
 epidemic, .... 175 
 
 Indian, .... 175 
 
 infantum, . 297 
 
 malignant, . . . .175 
 
 morbus, .... 175 
 
 Chorea, 155 
 
 Chronic diarrhoea, . . . 173 
 Chyle and chyme, ... 62 
 Circulation of the blood, . 66 
 
 Cleanliness about dwellings, . 31 
 
 of sick room, ... 96 
 
 of persons of sick, 
 Clothing, . 
 
 on fire, 
 
 to disinfect, 
 Club-foot, . 
 Clysters, . 
 Cod-liver oil, . 
 Coffee as an anodyne, 
 
 for the sick, receipt, 
 Cold affusions, . 
 
 bath, . 
 
 excessive, effects of, 
 
 in the chest, 
 
 in the head, 
 
 June, . 
 
 modes of applying, 
 
 rose, . 
 
 sore, . 
 
 to prevent sick from taking, 
 Colds, medicines for, receipts, 
 
 of children, 
 Colic, 
 
 calamus tea for, 
 
 camphor for, 
 
 lead, or painters', 
 
 of children, 
 
 of infants, . 
 Collapse, in cholera, 
 Collar-bone, dislocation of, 
 
 fracture of, 
 Colitis, or dysentery, 
 Columbo and ginger tonic, 
 
 30 
 223 
 345 
 314 
 341 
 166 
 357 
 324 
 338 
 334 
 231 
 158 
 156 
 157 
 342 
 157 
 198 
 
 94 
 
 . 293 
 
 . 170 
 
 . 350 
 
 . 357 
 170, 172 
 
 . 295 
 
 . 171 
 
 . 176 
 
 . 218 
 
 . 213 
 
 . 174 
 
 . 361 
 
 PAGE 
 
 Complexion, .... 29 
 
 to improve, . . • 365 
 
 Compress, wet, .... 339 
 
 Concussion of brain, . . 222 
 
 Constipation, .... 172 
 
 Consumption, . . . .165 
 
 drugs of small value, . 166 
 
 croton oil liniment for, . 344 
 
 Consumptives, inhalations for, 351 
 
 diet for, .... 321 
 
 Contagion, danger increased in 
 
 close rooms, ... 94 
 small-pox, .... 123 
 Contagious diseases. See Small- 
 pox, Measles, Whooping 
 Cough, Scarlet Fever, etc.. 
 Contusions, . . . .222 
 Convalescence, .... 99 
 Convulsions, or epilepsy, . 153 
 
 of children, . . . 279 
 cold douches for children's, 338 
 warm bath for, . . 336 
 
 Cooking, etc., for the sick, . 320 
 Copper, poisoning from, . . 250 
 Copperas, as a disinfectant, . 345 
 poisoning by, . . . 251 
 
 Corns, 197 
 
 Corpulency, to reduce, . . 64 
 Corrosive sublimate, . . 250 
 Coryza, or cold in the head, . 156 
 Costiveness, .... 172 
 Cough medicines, receipts, . 349 
 whooping, .... 291 
 whooping, cold baths for, . 335 
 
 Coughs, 158 
 
 of children, . . .293 
 
 Counter-irritants, . . . 342 
 
 Cramp colic, .... 170 
 
 in swimming, . . . 227 
 
 Cramps in cholera, . • . 176 
 
 Cream of tartar, effervescing, . 340 
 
 jalap and, .... 341 
 
 Croquet-playing, ... 45 
 
 Cross eyes, .... 82 
 
 in children, . . . 309 
 
424 
 
 Index. 
 
 
 PAGE 
 
 Croton oil as an irritant, . 
 
 . 353 
 
 liniment, . • 
 
 . 343 
 
 Croup, onion poultice for, 
 
 . 360 
 
 spurious, or spasmodic, 
 
 . 290 
 
 true, or membranous, 
 
 . 288 
 
 Crushed hand or fingers, . 
 
 . 311 
 
 limb, .... 
 
 . 244 
 
 Cushions, air and water, . 
 
 . 92 
 
 Cupping, .... 
 
 . 344 
 
 dry, .... 
 
 . 344 
 
 wet, .... 
 
 . 344 
 
 Currant jelly, . 
 
 . 330 
 
 Curvature of the spine, . 
 
 . 313 
 
 Cutlet, invalid's, 
 
 . 328 
 
 Cuts, 
 
 . 244 
 
 Cystitis, .... 
 
 . 187 
 
 DEAD, laying out, . . .254 
 
 Death, apparent, from gas, etc., 237 
 
 strychnine, . . . 254 
 
 sudden, from aneurism, . 183 
 
 heart disease, . . .181 
 
 Dancing as exercise, . . 45 
 
 Dandruff, 194 
 
 receipts, .... 364 
 Debility forbids cold baths, . 335 
 forbids emetics, . . . 345 
 Decline (marasmus) in child- 
 ren, . . . .269 
 Deformities, from burns, etc., . 225 
 in bones, .... 52 
 muscular, and cure, . . 46 
 spinal curvature, . . 313 
 Delicate children, . . . 274 
 Delirious patients, ... 98 
 Delirium tremens, . . .142 
 Dengue, or break-bone fever, . 116 
 Dentition, troubles of, . . 258 
 Deodorizers, .... 344 
 Derbyshire neck, . . . 197 
 Diabetes, . . . /. .189 
 
 Diarrhoea, 173 
 
 medicinal teas for, . . 349 
 of children, . . 297, 303 
 " rice water," in cholera, . 175 
 
 PAGE 
 
 Diarrhoea, tonic preparation for, 361 
 
 Diet, after starvation, . . 145 
 
 for corpulency, ... 64 
 
 dyspeptics, . . .168 
 
 thinness of flesh, . . 64 
 
 in diabetes, . . .189 
 
 diarrhoea, .... 173 
 
 dysentery, .... 174 
 
 sickness, its importance, . 320 
 
 various diseases, . . 320 
 
 See also Food. 
 
 Digestion, . . # .61 
 
 ice as an aid to, . . . 323 
 
 of animal foods, . . 327 
 
 weak, diet for, . . . 321 
 
 Digitalis, poisoning, . . . 251 
 
 Dipsomania, .... 142 
 
 Diphtheria, . . . .161 
 
 of children, . . .290 
 
 Disinfectant, fresh earth as, . 345 
 
 Disinfectants, principal, . . 344 
 
 Dislocation of bones, . . 217 
 
 collar-bone, . . . 218 
 
 fingers, . . . . 221 
 
 hip, ..... 220 
 
 jaw, 217 
 
 shoulder, . . * . 218 
 
 toes, 221 
 
 Dislocations, reducing, . 217, 222 
 Dog, bite of, 205 
 
 Douches, 338 
 
 Draughts, causing cold, . . 156 
 
 Dressing blisters, . . . 340 
 
 burns and scalds, . . 224 
 
 delicate children, . . 275 
 
 wounds, .... 243 
 
 wounds and sores, list for, . 354 
 
 Drink, a soothing, . . .324 
 
 milk and cinnamon, . . 324 
 
 Drinks, for the sick, receipts, . 322 
 
 Dripping sheet, the, . . 339 
 
 Dropsy, 149 
 
 after scarlet fever, . . 262 
 hydrocele, . . . 149 
 
 in Bright's disease, . .186 
 
Index. 
 
 425 
 
 PAGE 
 
 PAGE 
 
 Dropsy in oedema, . 
 
 149 
 
 Exercise, 
 
 36 
 
 of brain in children, 
 
 268 
 
 for consumption, . 166 
 
 , 167 
 
 of head, .... 
 
 149 
 
 arious kinds, . 
 
 45 
 
 of heart, .... 
 
 180 
 
 violent, and aneurisms, 
 
 182 
 
 of ovaries, . 
 
 149 
 
 Expectorant, receipt for, . 
 
 349 
 
 teas for, . 
 
 349 
 
 Extinguishing flames on cloth- 
 
 
 Drowning, , 
 
 225 
 
 ing, 
 
 223 
 
 Marshall Hall's Method, . 
 
 227 
 
 Extremities, the, 
 
 50 
 
 Rules of Life Saving So- 
 
 
 Eye, the, 
 
 81 
 
 ciety, .... 
 
 228 
 
 bandage for, 
 
 240 
 
 Silvester's Method, . 
 
 226 
 
 black, to prevent, 
 
 222 
 
 Drugs, action, selection, etc., . 
 
 100 
 
 defective action, 
 
 84 
 
 great variety needless, 
 
 100 
 
 lime, soda, or potash in, . 
 
 240 
 
 Dysentery, • 
 
 174 
 
 things in, to remove, 
 
 239 
 
 medicinal teas for, 
 
 349 
 
 Eyelashes, ingrowing, 
 
 310 
 
 Dyspepsia, .... 
 
 168 
 
 Eyes, sore, of children, . 
 
 308 
 
 diet in, ... 
 
 321 
 
 weak, \ 
 
 85 
 
 drugs of minor value, 
 
 168 
 
 Eye-wash, alum, 
 
 346 
 
 Dwellings, .... 
 
 31 
 
 arnica, . . # . 
 
 346 
 
 
 
 brandy, .... 
 
 346 
 
 EAR, the, 
 
 77 
 
 tea, 
 
 346 
 
 practices that injure, 
 
 78 
 
 
 
 running from, . 
 
 310 
 
 FACE blotches, 
 
 193 
 
 things in, . . . 
 
 240 
 
 grubs in, 
 
 191 
 
 to remove wax in, J 
 
 78 
 
 washes for, . 
 
 365 
 
 Earache, 
 
 311 
 
 Fainting, ... .150 
 
 , 182 
 
 Earth closets, .... 
 
 345 
 
 cold douche for, 
 
 338 
 
 fresh, as disinfectant, 
 
 345 
 
 Shakspeare quoted, . 
 
 70 
 
 Earwig, to remove, . 
 
 240 
 
 Faintness, .... 
 
 230 
 
 Eczema, 
 
 190 
 
 from hemorrhages after 
 
 
 of the scalp, 
 
 194 
 
 wounds, .... 
 
 207 
 
 Egg and sherry, receipt, . 
 
 323 
 
 from " shock," . . . 
 
 200 
 
 Electricity for stiff joints, etc., 
 
 247 
 
 Falling sickness, or epilepsy, . 
 
 153 
 
 Elm, slippery, poultice, . 
 
 360 
 
 Falls from horse, scaffolding, 
 
 
 Emetic, alum, .... 
 
 345 
 
 etc, 
 
 223 
 
 mustard, .... 
 
 345 
 
 injuries from, 
 
 230 
 
 salt and water, . 
 
 345 
 
 Family gymnastics, 
 
 36 
 
 salt, common, . 
 
 345 
 
 medicine chests, 
 
 101 
 
 Emetics, 
 
 345 
 
 thermometers, . 
 
 102 
 
 Epidemics. See Catarrh, Cho- 
 
 
 health record, . 
 
 371 
 
 lera, Diphtheria, Dysen- 
 
 
 Fatty degeneration of heart, . 
 
 180 
 
 tery, Fever, Small-pox," 
 
 
 Feet, blisters of, 
 
 196 
 
 etc. 
 
 
 fetid, 
 
 198 
 
 Epilepsy, or falling sickness, . 
 
 153 
 
 ointment for fetid, 
 
 365 
 
 Epsom salts, rhubarb and, 
 
 340 
 
 Felon, bone, .... 
 
 197 
 
 36* 
 
 
 
 
426 
 
 Index. 
 
 
 PAGE 
 
 
 Felon, flesh, • • • 
 
 . 197 
 
 Fever, ship or typhus, 
 
 Festering from splinters, < 
 
 3tc, . 242 
 
 slow nervous, 
 
 Fever and agne, . , 
 
 . 114 
 
 sponging body in, 
 
 and ague, dogwood te 
 
 a, for, 349 
 
 spotted or typhus, 
 
 autumnal, . 
 
 . 103 
 
 swamp, or chills and, 
 
 bilious, • 
 
 . Ill 
 
 teething, of infants, . 
 
 " or typhus, 
 
 . 106 
 
 typhoid, 
 
 " remittent, 
 
 , . Ill 
 
 typhus, . . • 
 
 blisters, 
 
 . 190 
 
 wasting, of children, . 
 
 " receipt, 
 
 . 364 
 
 winter, . 
 
 brain or typhus, 
 
 . 106 
 
 worm, of children, . 
 
 breakbone, 
 
 . 116 
 
 yellow, . . '. 
 
 camp or typhus, 
 
 . 106 
 
 Fingers, broken, 
 
 catarrhal, or influenz. 
 
 i, . 117 
 
 crushed, . . . 
 
 " or cold in < 
 
 mest, 158 
 
 dislocation, 
 
 chills and, 
 
 . 114 
 
 jammed, 
 
 chills and, cold affusio 
 
 nfor, 338 
 
 webbed, , 
 
 common continued, 
 
 . 103 
 
 Fire, clothing on, 
 
 dandy, . . « 
 
 . 116 
 
 Fish-hooks in flesh, . 
 
 diet in, 
 
 . 320 
 
 Fistula of the anus, . 
 
 fall or typhoid, . 
 
 . 103 
 
 Fit, apoplectic, 
 
 gastric, of infants, 
 
 . 256 
 
 epileptic, . 
 
 hay, . 
 
 . .157 
 
 fainting, 
 
 hospital or typhus, 
 
 . .106 
 
 of hysterics, . 
 
 infantile remittent, 
 
 . 256 
 
 Fits of children, 
 
 infantile typhoid, 
 
 . ' . 256 
 
 cold douche for, 
 
 intermittent, 
 
 . 114 
 
 onion poultice for, 
 
 jail or typhus, . 
 
 . 106 
 
 warm bath for, 
 
 littoral, . ; 
 
 . 114 
 
 Flannel underclothing, . 
 
 low or typhus, . 
 
 . 106 
 
 Flannels, hot, 
 
 lung, . 
 
 . 163 
 
 Flatulence, 
 
 " of children, 
 
 . 294 
 
 Flaxseed meal poultice, . 
 
 malarial or bilious, 
 
 . Ill 
 
 Fleabites, 
 
 " or chills anc 
 
 L, . 114 
 
 Flesh, the, 
 
 malignant bilious, 
 
 . 118 
 
 pins, needles, etc., in, 
 
 " typhus, 
 
 . 118 
 
 splinters, etc.. in, 
 
 marsh, or chills and, 
 
 . 114 
 
 Flour gruel, receipt, 
 
 nightsoil or typhoid, 
 
 . 103 
 
 Fluttering of the heart, . 
 
 paludal, 
 
 . 114 
 
 Flux, bloody, 
 
 petechial, . 
 
 . 106 
 
 Fly poison (under arsenic), 
 
 puking, 
 
 . 129 
 
 Fomentation, . ... 
 
 putrid or typhoid, 
 
 . 103 
 
 mustard, . 
 
 " or typhus, 
 
 . 106 
 
 opium, ... 
 
 remittent, . 
 
 . Ill 
 
 ordinary, . 
 
 scarlet, 
 
 . 259 
 
 turpentine, 
 
Index. 
 
 427 
 
 
 PAGE 
 
 
 PAGE 
 
 Fomentation, turpentine, a: 
 
 a- 
 
 Gargle of alum, 
 
 . 347 
 
 other, . 
 
 . 347 
 
 brandy, 
 
 . 347 
 
 Food, animal, different kinds 
 
 , 327 
 
 chlorate of potash, . 
 
 . 347 
 
 best when enjoyed, . 
 
 . 76 
 
 lime water, 
 
 . 347 
 
 for the sick, rules, 
 
 . 322 
 
 sage and linseed, 
 
 . 347 
 
 forming and warming, 
 
 . 64 
 
 Gases, apparent deaths from, 
 
 . 237 
 
 giving it to the sick, 
 
 . 331 
 
 Gastric catarrh, 
 
 . 168 
 
 starved, caution 
 
 s, 145 
 
 fever, of infants, 
 
 . 256 
 
 variety necessary, 
 
 . 65 
 
 juice, .... 
 
 . 62 
 
 want of, 
 
 . 65 
 
 ulcer, 
 
 . 168 
 
 why necessary, . | . 
 
 61,64 
 
 Gastritis, .... 
 
 . 168 
 
 See also Diet. 
 
 
 Gelatine blanc-mange, 
 
 . 330 
 
 Footbaths, 
 
 . 338 
 
 Glands of neck, swellings of, 
 
 . 317 
 
 warmer for the sick, . 
 
 . 92 
 
 Goitre, .... 
 
 . 197 
 
 Foul breath, mouth washes f 
 
 or, 363 
 
 Goulard-water wash, 
 
 . 355 
 
 Fowl and egg } minced, receif 
 
 t, 328 
 
 Gout, .... 
 
 . 137 
 
 and rice, receipt, 
 
 . 328 
 
 in stomach, 
 
 . 172 
 
 Fowlers solution (arsenic), 
 
 . 250 
 
 Gravel, or kidney stone, . 
 
 . 186 
 
 Foxglove or digitalis, 
 
 . 251 
 
 goose-grass tea for, . 
 
 . 349 
 
 Fracture of arm, above elbov 
 
 r, 214 
 
 hip-bath for, 
 
 . 338 
 
 arm, below elbow, , 
 
 . 215 
 
 Gripes of children, . . 
 
 . 295 
 
 bones, 
 
 . 211 
 
 Grippe la, or catarrhal fever, 
 
 . 117 
 
 comminuted, 
 
 . 213 
 
 Gross, Prof., on diet for sick, 
 
 . 321 
 
 compound, 
 
 . 213 
 
 Grubs in the face, 
 
 . 191 
 
 simple, 
 
 . 213 
 
 Gruels, receipts, 
 
 . 325 
 
 collar-bone, 
 
 . 213 
 
 Gum boils, 
 
 . 190 
 
 fingers, 
 
 . 215 
 
 Gunpowder burns, etc., . 
 
 . 243 
 
 jaw, lower, 
 
 . 213 
 
 Gunshot wounds, 
 
 . 243 
 
 leg, .... 
 
 . 216 
 
 Gymnastics, 
 
 . 36 
 
 ribs, .... 
 
 . 214 
 
 
 
 skull, 
 
 . 213 
 
 HAIK, diseases of, . 
 
 . 194 
 
 thigh, 
 
 . 216 
 
 falling of, . 
 
 . 194 
 
 Freckles, .... 
 
 . 193 
 
 tonics, 
 
 . 363 
 
 to remove, . 
 
 . 365 
 
 Hairs, .... 
 
 . 29 
 
 Freezing mixtures, . 
 
 . 342 
 
 gray, from fear, etc., . 
 
 . 30 
 
 Frights to children, . 
 
 . 282 
 
 Ham-string, rupture of, . 
 
 . 244 
 
 Frontispiece described, . 
 
 . 63 
 
 Hand, crushed, 
 
 . 311 
 
 Frost bites, 
 
 . 230 
 
 Hands, chapped, . • 
 
 . 192 
 
 Frozen limbs, . 
 
 . 230 
 
 receipts, . 
 
 . 364 
 
 Fumigations, . 
 
 . 337 
 
 clammy, receipt, 
 
 . 365 
 
 Furniture of the sick-room, 
 
 . 91 
 
 lotion for, . 
 
 . 364 
 
 Furuncles, . . 
 
 . 196 
 
 Hanging, apparent death from, 237 
 
 
 
 Hang-nails, 
 
 . 195 
 
 GALL stones, . 
 
 . 170 
 
 Hare lip, .... 
 
 . 307 
 
 Galling in children, 
 
 . 304 
 
 Hay asthma, 
 
 . 157 
 
428- 
 
 Index, 
 
 
 
 PAGE 
 
 
 PAGE 
 
 Hay fever, 
 
 . 157 
 
 Hernia, vomiting in, 
 
 , 171 
 
 Hartshorn, 
 
 . 101 
 
 Herpes, ..... 
 
 190 
 
 and oil liniment, 
 
 . 353 
 
 Hives, 
 
 191 
 
 Head, the, 
 
 . 49 
 
 dry, .... 
 
 . 191 
 
 dropsy of, . 
 
 . 149 
 
 Hoarseness, . . . « 
 
 160 
 
 Headache, 
 
 . 133 
 
 Horrors, the, 
 
 . 142 
 
 bag of hot salt for, 
 
 . 348 
 
 Horseback-riding, . 
 
 45 
 
 neuralgic, . 
 
 . 132 
 
 Hot bricks, sand, bottles, etc., 
 
 . 348 
 
 quinine for, 
 
 . 357 
 
 Household remedies, 
 
 99 
 
 Health, means of promoti 
 
 ng, . 358 
 
 Hunger, .... 
 
 65 
 
 mental, how promote< 
 
 i, . SS 
 
 Hydrocele, 
 
 . 149 
 
 record, family, . 
 
 . 371 
 
 Hydrocephalus, 
 
 , 149 
 
 Hearing, sense of, 
 
 . 77 
 
 in children, 
 
 268 
 
 and sound waves, 
 
 . 80 
 
 Hygienic directions, 
 
 , 358 
 
 Heart, the, 
 
 . 66 
 
 receipts, personal, 
 
 . 361 
 
 diseases, 
 
 . 180 
 
 Hysterical ailments, cold bath 
 
 forbid cold ba 
 
 tths, . 335 
 
 for, . 
 
 . 335 
 
 forbid emetic 
 
 3, . 345 
 
 persons, diet, 
 
 . 321 
 
 dropsy of, . 
 
 . 180 
 
 Hysterics, .... 
 
 . 154 
 
 fatty, 
 
 
 . 180 
 
 
 
 fluttering of, 
 
 
 . 180 
 
 
 
 neuralgia of, 
 
 
 . 180 
 
 ICE, for the sick, . 
 
 . 323 
 
 palpitation of, 
 
 
 . 180 
 
 India ink marks, 
 
 . 193 
 
 rheumatism of, 
 
 
 . 180 
 
 Indigestion, 
 
 . 168 
 
 Heart-break, 
 
 
 . 180 
 
 in consumption 
 
 . 165 
 
 Heart-burn, 
 
 
 . 168 
 
 Infantile atrophy, 
 
 . 269 
 
 Heat, applying, 
 
 
 . 347 
 
 hectic, 
 
 . 256 
 
 endurable, if dry, 
 
 . 27 
 
 icterus, 
 
 . 266 
 
 moist, applying, 
 
 . 347 
 
 remittent fever, . 
 
 . 256 
 
 prickly, 
 
 . 191 
 
 typhoid, 
 
 . 256 
 
 Heat-stroke, 
 
 . 235 
 
 Infants, canker of mouth, 
 
 . 286 
 
 Hemorrhage, see Bleeding 
 
 r. 
 
 clothing, 
 
 . 31 
 
 Hemorrhoids, . 
 
 ! . 178 
 
 colic, .... 1 
 
 71,295 
 
 Hereditary diseases. See 
 
 Asth- 
 
 dropsy of spine, . 
 
 . 314 
 
 ma, Consumption, { 
 
 Scrof- 
 
 lancing the gums, 
 
 . 306 
 
 ula, St. Vitus' Dane 
 
 e, etc. 
 
 looseness of bowels, . 
 
 . 303 
 
 Hiccough, in dyspepsia, 
 
 . 169 
 
 measuring, . . . 
 
 . 373 
 
 Hip-baths, 
 
 . 338 
 
 milk crust, . 
 
 . 304 
 
 for children, 
 
 . 294 
 
 nursing sore mouth, . 
 
 . 285 
 
 Hip disease of children, 
 
 • 312 
 
 rupture, 
 
 . 316 
 
 dislocation of, . 
 
 . 220 
 
 snuffles, . . 
 
 . 284 
 
 Henbane poisoning, . 
 
 . 251 
 
 squinting, . 
 
 , 309 
 
 Herb teas, 
 
 . 348 
 
 teething, 
 
 . 258 
 
 Hernia, ♦ 
 
 . 232 
 
 weaning, . » 
 
 . 297 
 
 in children, 
 
 
 . 315 
 
 weaning brash, . 
 
 303 
 
Index. 
 
 429 
 
 PAGE 
 
 
 
 PAGE 
 
 (See also Children and various 
 
 
 Itch, barbers', . 
 
 192 
 
 diseases.) 
 
 
 bath, . 
 
 
 . 190 
 
 Infection, to destroy, 
 
 95 
 
 beard, 
 
 
 192 
 
 Inflammation, active, forbids 
 
 
 bricklayers', 
 
 
 190 
 
 cold baths, 
 
 335 
 
 camp, 
 
 
 191 
 
 artificial, .... 
 
 342 
 
 grocers', 
 
 
 190 
 
 of bladder, .... 
 
 187 
 
 ground, 
 
 
 191 
 
 bronchial tubes, . 
 
 158 
 
 night, 
 
 
 , 191 
 
 kidneys, .... 
 
 184 
 
 soldiers', . 
 
 
 . 191 
 
 large bowel, . . 
 
 174 
 
 washerwomen's, 
 
 190 
 
 larynx . . 
 
 160 
 
 winter, 
 
 191 
 
 lower bowel, 
 
 172 
 
 Itching from poison vine, 
 
 253 
 
 of lungs, .... 
 
 163 
 
 of parts in children, . 188, 257 
 
 of lungs, in children, . 
 
 294 
 
 
 
 parotid, .... 
 
 263 
 
 JALAP and cream of tartar, 
 
 . 341 
 
 pleura, .... 
 
 163 
 
 Jaundice, .... 
 
 ■ 177 
 
 stomach, .... 
 
 169 
 
 in children, 
 
 , 266 
 
 tonsils, .... 
 
 160 
 
 Jaw, dislocation of, . 
 
 , 217 
 
 Influenza or catarrhal fever, . 
 
 117 
 
 lower, fracture of, 
 
 213 
 
 or cold in the head, . 
 
 157 
 
 Jellies for invalids, receipts, 
 
 . 329 
 
 Injection, astringent, 
 
 341 
 
 Jimson weed, poisoning, . 
 
 , 253 
 
 purgative .... 
 
 341 
 
 Joints, the, 
 
 , 51 
 
 Injections, .... 
 
 341 
 
 stiff, passive movements, 
 
 246 
 
 nutritious, .... 
 
 342 
 
 cold douche for, 
 
 338 
 
 Inhalations, .... 
 
 350 
 
 
 
 balsam of tolu, . 
 
 351 
 
 KIDNEYS, . ' . 
 
 , 72 
 
 carbolic acid, 
 
 351 
 
 Addison's disease of, . 
 
 . 186 
 
 creasote, .... 
 
 351 
 
 Bright's disease, 
 
 . 184 
 
 cubebs and carbolic acid, . 
 
 351 
 
 congestion of, 
 
 . 184 
 
 tar, 
 
 351 
 
 diseases of, . 
 
 . 184 
 
 Inhaler, a simple, 
 
 350 
 
 hip-bath for, 
 
 338 
 
 In-knee, 
 
 315 
 
 inflammation of, 
 
 . 184 
 
 Insects, bites of, 
 
 206 
 
 stone or gravel, . 
 
 . 186 
 
 Iodide of potassium, for pain, . 
 
 357 
 
 King's evil, or scrofula, . 
 
 . 145 
 
 Iodine, 
 
 102 
 
 in children, 
 
 . 271 
 
 paint, 
 
 334 
 
 Knee-pan, 
 
 . 34 
 
 poisoning by, 
 
 251 
 
 Knock -knee, 
 
 . 315 
 
 stains, to remove, 
 
 366 
 
 
 
 Irish moss blanc-mange, . 
 
 330 
 
 LACTEALS, the . 
 
 . 62 
 
 Iron, tonic preparations of, 
 
 361 
 
 Lancing the gums of infants, 
 
 306 
 
 Irrigating a limb, 
 
 203 
 
 Laudanum, poisoning by, 
 
 , 252 
 
 Irritants for the skin, 
 
 353 
 
 Laxatives, 
 
 . 340 
 
 Isinglass jelly, .... 
 
 329 
 
 Laying out the dead, 
 
 . 254 
 
 Itch, 
 
 192 
 
 Lead colic, ... 17 
 
 0,172 
 
 bakers', .... 
 
 190 
 
 poisoning, . 
 
 . 
 
 . 251 
 
430 
 
 Index. 
 
 
 PAGE 
 
 
 PAGE 
 
 Lead wash, . • 
 
 . 355 
 
 Lotions for lips and hands, 
 
 . 364 
 
 Leeches and leeching, 
 
 . 352 
 
 Lumbago, mustard liniment for, 353 
 
 Leg, broken, 
 
 . 216 
 
 Lunar caustic, poisoning by, 
 
 . 252 
 
 bandaging, 
 
 • 203 
 
 stains, to remove, 
 
 . 366 
 
 sore, . 
 
 . 198 
 
 Lung fever, 
 
 . 163 
 
 Lemonade, two receipts, 
 
 . 322 
 
 of children, 
 
 . 294 
 
 effervescing, 
 
 . 322 
 
 Lungs, the, 
 
 . 57 
 
 Leprosy . 
 
 . 192 
 
 bleeding from, . . 
 
 . 165 
 
 Lice, body, 
 
 . 193 
 
 inflammation of, 
 
 . 163 
 
 crab, . 
 
 . 193 
 
 offices in circulation, 
 
 . 71 
 
 head, . 
 
 . 193 
 
 penetrated by stab, . 
 
 . 245 
 
 Lichen, . 
 
 . 191 
 
 
 
 Light of the sick-room, 
 
 . 96 
 
 MAGNESIA and rhubarb, . 
 
 . 340 
 
 Lightning, stroke of, 
 
 . 237 
 
 calcined, 
 
 . 341 
 
 Limb, broken, irrigating, 
 
 . 203 
 
 Malignant pustule, . 
 
 . 196 
 
 Lime, burns by, 
 
 . 225 
 
 Mandrake powders, ■ 
 
 . 341 
 
 Lime-water wash, 
 
 . 355 
 
 Mania-a-potu, . 
 
 . 142 
 
 Liniment, camphor, 
 
 . 353 
 
 Marasmus, in children, . 
 
 . 269 
 
 chloroform, 
 
 . 354 
 
 Markshood or aconite, 
 
 . 249 
 
 croton oil, . 
 
 343, 353 
 
 Massage for stiff joints, etc., 
 
 . 247 
 
 hartshorn and oil, 
 
 . 353 
 
 Mastication of food, 
 
 . 61 
 
 lead ointment, . 
 
 . 354 
 
 May apple powders, . 
 
 . 341 
 
 lime, . 
 
 . 354 
 
 Measles, .... 
 
 . 262 
 
 mustard, 
 
 . 353 
 
 black, 
 
 . 262 
 
 opodeldoc, 
 
 . 353 
 
 French, 
 
 . 262 
 
 turpentine, 
 
 . 354 
 
 Meats for invalids, receipts, 
 
 . 327 
 
 Liniments, 
 
 .. 353 
 
 Medical kit, the travelers, 
 
 . 101 
 
 Linseed tea, receipt, 
 
 . 323 
 
 receipts for sick-room, 
 
 . 332 
 
 Lint, 
 
 . 354 
 
 Medicated baths, 
 
 . 336 
 
 Lip, hare, . 
 
 . 307 
 
 Medicinal teas, . 
 
 . 348 
 
 salve, . 
 
 . 364 
 
 Medicine chests, family, . 
 
 . 101 
 
 Lips, cracked, . 
 
 . 192 
 
 to take without tasting, 
 
 . 75 
 
 lotion for, . 
 
 . 364 
 
 Medicines in this work, . 
 
 . 100 
 
 Liquor, alcoholic, poisoni 
 
 Qg by 249 
 
 Milk and cinnamon drink, 
 
 . 324 
 
 Lithiasis, or kidney stone 
 
 . 186 
 
 crust, .... 
 
 . 190 
 
 Litter, blanket, 
 
 . 212 
 
 of children, 
 
 . 304 
 
 Liver complaints, powder 
 
 for, . 341 
 
 and isinglass, receipt, 
 
 . 324 
 
 diseases of, . 
 
 . . .178 
 
 for puddings, etc, 
 
 . 330 
 
 Long sight, 
 
 . 84 
 
 gruel, receipt, . 
 
 . 325 
 
 Lockjaw, . 
 
 . 138 
 
 punch, receipt, . 
 
 . 323 
 
 Looseness of the Dowels, 
 
 . 173 
 
 sickness, 
 
 . 129 
 
 in children, 
 
 . 297,303 
 
 Mineral water, purgative, 
 
 . 341 
 
 Loss of appetite, 
 
 . 168 
 
 Molasses poultice, 
 
 . 359 
 
 of voice, 
 
 . 160 
 
 Moles, .... 
 
 . 193 
 
 Lotions and washes, 
 
 . 354 
 
 Molluflcum, 
 
 . 191 
 
Index. 
 
 431 
 
 PAGE 
 
 PAGE 
 
 Morbili, 
 
 262 
 
 Nightingale, Florence, quoted, 
 
 95 
 
 Morphia, poisoning by, . 
 
 252 
 
 Nightshade or belladonna, 
 
 250 
 
 Mother's marks, 
 
 193 
 
 or bitter-sweet, . 
 
 250 
 
 Motion, the power of, 
 
 86 
 
 Night-sweats, .... 
 
 148 
 
 Mouth, canker of, in children, 
 
 286 
 
 Night-sweats, in consumption, 
 
 165 
 
 sore, in infants, . 
 
 285 
 
 Nitrate of potash, poisoning, . 
 
 251 
 
 washes and receipts, . 
 
 362 
 
 silver, poisoning, 
 
 252 
 
 Movement cure, . . 46 
 
 ,247 
 
 stains, 
 
 193 
 
 Movements, passive, 
 
 246 
 
 Night terrors of children, 
 
 282 
 
 series of, . . 28-37 
 
 Nose, the, 
 
 74 
 
 Muscles, the, .... 
 
 32 
 
 bleeding, .... 
 
 208 
 
 development of, 
 
 36 
 
 catarrh of, or ozsena, 
 
 157 
 
 their perfection, . , 
 
 34 
 
 polyps in, . 
 
 158 
 
 rapid action, 
 
 35 
 
 red, 
 
 193 
 
 voluntary, .... 
 
 34 
 
 things in, . 
 
 241 
 
 Mud baths, .... 
 
 338 
 
 ulceration of, in ozsena, 
 
 157 
 
 Mumps, 
 
 263 
 
 Nurse, the, in sick room, 
 
 96 
 
 Mush poultice, .... 
 
 359 
 
 in small-pox, 
 
 129 
 
 Mushrooms, poisoning by, 
 
 251 
 
 Nursing sore mouth, 
 
 285 
 
 Mustard bath, .... 
 
 337 
 
 Nutritive injections, 
 
 342 
 
 emetic, .... 
 
 345 
 
 Nux vomica, poisoning by, 
 
 253 
 
 liniment, .... 
 
 353 
 
 
 
 poultice, .... 
 
 360 
 
 OATMEAL tea, 
 
 325 
 
 Mutton broth, .... 
 
 326 
 
 (Edema, 
 
 149 
 
 jelly, receipt, 
 
 329 
 
 Oil, castor, .... 
 
 340 
 
 
 
 cod-liver, .... 
 
 166 
 
 NAILS, the, .... 
 
 30 
 
 croton, .... 
 
 343 
 
 ingrown, .... 
 
 195 
 
 of tobacco, poisoning by, . 
 
 254 
 
 Neck, Derbyshire, . 
 
 197 
 
 Ointment, Camphor, . \ . 
 
 356 
 
 glands of, swelling, . 
 
 317 
 
 carbonate of ammonia, 
 
 356 
 
 wry, 
 
 233 
 
 common, • • • • 
 
 356 
 
 in children, 
 
 307 
 
 for barber's itch, 
 
 192 
 
 Needles in flesh, 
 
 241 
 
 fetid feet, .... 
 
 365 
 
 Nerves, the, .... 
 
 86 
 
 goitre, .... 
 
 198 
 
 Nervous affections, cold bath 
 
 
 sunburn, • 
 
 366 
 
 for, 
 
 335 
 
 oxide of zinc, . . 
 
 356 
 
 shallow bath for, 
 
 338 
 
 pile, . 
 
 180 
 
 system, the, 
 
 85 
 
 sulphur, .... 
 
 356 
 
 natural tonics for, 
 
 88 
 
 tannin, .... 
 
 356 
 
 Nervousness in children, . 
 
 282 
 
 Old persons, care of teeth, 
 
 55 
 
 Nettle rash, .... 
 
 191 
 
 clothing, .... 
 
 31 
 
 Neuralgia, .... 
 
 130 
 
 constipation, 
 
 172 
 
 chloroform liniment for, . 
 
 354 
 
 why prone to apoplexy, . 
 
 151 
 
 of the heart, 
 
 180 
 
 Onion poultice, 
 
 • 360 
 
 remedies for, 
 
 357 
 
 Opium, 
 
 102 
 
432 
 
 Index. 
 
 
 PAGE 
 
 
 PAGE 
 
 Opium, poisoning by, 
 
 . 252 
 
 Poison oak, sumac, or vine, . 253 
 
 Opodeldoc liniment, . 
 
 . 354 
 
 Poisons and poisoning, . 248-252 
 
 Ophthalmia, in children, 
 
 . 308 
 
 Poor and sick, charity to, . 367 
 
 Ovarian dropsy, 
 
 . 149 
 
 Polyps in the nose, 
 
 . 158 
 
 Oxalic acid, poisoning by 
 
 . 253 
 
 Polypus of rectum, in children, 302 
 
 Oxygen, in breathing, 
 
 . 59 
 
 Potash, caustic, burns by, . 225 
 
 Oysters, stewed, receipt, 
 
 . 328 
 
 Potato, invalid's, mashed, . 328 
 
 Ozaena, or ulceration of nose, .. 157 
 
 surprise, receipt, 
 
 . 328 
 
 in children, 
 
 . 284 
 
 Potomania, 
 
 . 142 
 
 
 
 Poultice, alum, . 
 
 . 359 
 
 PACKING, wet-sheet, 
 
 . 359 
 
 arrowroot, . 
 
 . 360 
 
 Pads for fractured limbs, 
 
 . 214 
 
 bran, . 
 
 . 359 
 
 Pain, hot baths, poultice 
 
 , etc., 
 
 bread and milk, 
 
 . 360 
 
 for, . 
 
 . 358 
 
 bread and water 
 
 , . .358 
 
 hygienic remedies for 
 
 , . 358 
 
 carrot, * 
 
 . . 359 
 
 removers, . 
 
 . 356 
 
 charcoal, . 
 
 . 359 
 
 six receipts, 
 
 . 357 
 
 flaxseed meal, 
 
 . 358 
 
 Painter's colic, 
 
 . 170, 172 
 
 molasses, . 
 
 .. .359 
 
 Palpitation of the heart, 
 
 . 180 
 
 mush, 
 
 . 359 
 
 Panada, receipt, 
 
 . 329 
 
 mustard, 
 
 . 360 
 
 Paralysis, from injury to spine, 87 
 
 onion, 
 
 . . 360 
 
 Paris green (under Arsenic), . 250 
 
 slippery elm, 
 
 . 360 
 
 Parotitis, . 
 
 . 263 
 
 starch, 
 
 .359 
 
 Partridge, boiled, receipt, 
 
 . 327 
 
 turnip, 
 
 . 359 
 
 Passive movements, . 
 
 . 246 
 
 yeast, . 
 
 . 359 
 
 Percussion, in consumption, . 165 
 
 Poultices, 
 
 . 358 
 
 Perspiration, by what affected, . 28 
 
 stimulating, 
 
 . 359 
 
 excessive, . 
 
 . 148 
 
 Pox, chicken, . 
 
 . 264 
 
 how reduces heat, 
 
 . 27 
 
 small, 
 
 . 123, 264 
 
 Phosphorus, poisoning by 
 
 . 253 
 
 water, 
 
 .190 
 
 Phthisis, or consumption. 
 
 . 165 
 
 wind, 
 
 . 191 
 
 Pigeon, boiled, receipt, 
 
 . 327 
 
 Prickly heat, . 
 
 . 191 
 
 Piles, . 
 
 . 178 
 
 Prolapse of the anus 
 
 in children, 301 
 
 Pimples, . 
 
 . 191 
 
 Proud flesh, burnt ali 
 
 am for, . 312 
 
 Pins in flesh, 
 
 . 241 
 
 Prurigo, . 
 
 . 191 
 
 Pitting in small-pox, to prevent, 128 
 
 Prussic acid, poisonii 
 
 igby, . 253 
 
 Plaster, sticking, how to use, . 245 
 
 Psora, 
 
 . 192 
 
 Pleurisy, . 
 
 . 163 
 
 Puddings for invalids 
 
 , receipts, 330 
 
 Pleuro-pneumonia, . 
 
 . 163 
 
 Pulsations of aneuris 
 
 ms, . 182 
 
 Podagra, or gout, 
 
 . 137 
 
 the heart, 
 
 67, 70 
 
 Pneumonia, 
 
 . 163 
 
 Purgative injection, 
 
 . 341 
 
 bilious, 
 
 . 163 
 
 white walnut tea 
 
 , . . 349 
 
 typhoid, 
 
 . 163 
 
 Purgatives, cautions, 
 
 etc., . 340 
 
 chronic, 
 
 . 164 
 
 eight receipts, . 
 
 . 340 
 
 of children, 
 
 . 294 
 
 Pustule, malignant, 
 
 . 196 
 
Index. 
 
 433 
 
 PAGE 
 
 Putrid sore throat, or diphtheria, 161 
 or scarlet fever, . . 259 
 
 QUININE as tonic, receipts, . 360 
 
 powders, .... 357 
 
 Quinsy, 160 
 
 Quoit playing, as exercise, . 45 
 
 RACHITIS, .... 277 
 
 Railroad injuries, . . . 232 
 
 Rash, nettle; .... 191 
 
 rose, .... 191, 193 
 
 scarlet, .... 259 
 
 teething, . . . .190 
 
 Ratsbane (under Arsenic), . 250 
 
 Receipts, dietetic, . . 322-331 
 
 medical, . . . 336-361 
 
 personal hygieue, . 362-366 
 
 Recovery, management during, 99 
 
 Recreation necessary, . . 46 
 
 Rectum, polypus of, in children, 302 
 
 Red lead, poisoning by, . . 251 
 
 nose, 193 
 
 Reducing dislocations, . . 217 
 ruptures, .... 233 
 Relish for fish, receipt, . . 328 
 Removal of cancers, . .317 
 
 Respiration, 58 
 
 Revaccination, importance of, 266 
 Reviving vital powers in shock,' 233 
 Rheumatic affections, sand and 
 
 mud baths for, . . 338 
 
 pains, remedies, . . 357 
 
 scarlatina, . . . 116 
 
 Rheumatism, .... 135 
 
 chloroform liniment for, . 354 
 
 diet in, ... 321 
 
 hydropathic belts for, . 342 
 
 of the heart, . . .180 
 
 opodeldoc liniment for, . 353 
 
 Rhubarb and epsom salts, . 340 
 
 magnesia and, . . . 340 
 
 Ribs, broken, .... 214 
 
 Rice and apple, receipt, . . 331 
 
 blanc-mange, receipt, . 329 
 
 37 
 
 
 PAGE 
 
 Rice gruel, receipt, . 
 
 . 325 
 
 pudding, receipt, 
 
 . 330 
 
 Rickets, .... 
 
 . 277 
 
 Ringworm, 
 
 1 191 
 
 Rings, to remove, 
 
 . 232 
 
 River, or milk sickness, . 
 
 . 129 
 
 Rooms, proper size of, 
 
 . 32 
 
 Rose, or rose rash, 
 
 191, 193 
 
 rash, to tell, 
 
 . 262 
 
 Roseola, 
 
 . 191 
 
 to tell, 
 
 . 262 
 
 Rose tea, .... 
 
 . 324 
 
 "Rotheln," 
 
 . 263 
 
 Rowing as exercise, 
 
 . 45 
 
 Rubbing, in children, 
 
 . 304 
 
 Rubeola, .... 
 
 . 262 
 
 Rupture, or hernia, . 
 
 . 232 
 
 in children, 
 
 . 315 
 
 in infants, 
 
 . 316 
 
 vomiting in, 
 
 . 171 
 
 SAGE tea, . . ; . 
 
 . 325 
 
 Sago jelly, receipt, . 
 
 . 329 
 
 Saint Anthony's fire, 
 
 . 193 
 
 Saint Vitus' dance, . 
 
 . 155 
 
 cold baths for, . 
 
 . 335 
 
 Sal ammoniac, for pain, . 
 
 . 357 
 
 Salt and mustard emetic, . 
 
 . 345 
 
 common, as an emetic, 
 
 . 345 
 
 hot, .... 
 
 . 348 
 
 rheum, 
 
 . 190 
 
 Saltpetre (nitrate of potash), 
 
 . 251 
 
 Salve for lips, . 
 
 . 364 
 
 Salves, six receipts for, 
 
 . 356 
 
 Sand baths, 
 
 . 338 
 
 hot, .... 
 
 . 348 
 
 Sanitary precautions, cholera 
 
 . 177 
 
 dwellings, . 
 
 31,105 
 
 small-pox, . 
 
 . 129 
 
 yellow fever, 
 
 . 123 
 
 (See also Disinfectants.) 
 
 
 Sauce, bread, receipt, 
 
 . 327 
 
 Savine, oil of, poisoning, . 
 
 . 253 
 
 Scabies, .... 
 
 . 192 
 
 Scald head, 
 
 . 194 
 
434 
 
 Index. 
 
 PAGE 
 
 PAGE 
 
 Scalds and burns, 
 
 223 
 
 Sick room, nurse, . . 
 
 96 
 
 chloral in, . 
 
 357 
 
 temperature, 
 
 90 
 
 Scalp, eczema of, 
 
 194 
 
 useful articles, . 
 
 92 
 
 wounds, .... 
 
 246 
 
 waiting on, 
 
 332 
 
 Scarlatina 
 
 259 
 
 Sight, 
 
 81 
 
 anginosa, .... 
 
 259 
 
 defective, .... 
 
 84 
 
 after-effects oh ear, . 
 
 311 
 
 old, . . . 
 
 85 
 
 maligna, .... 
 
 259 
 
 philosophy of . 
 
 83 
 
 rheumatic, .... 
 
 116 
 
 short, 
 
 84 
 
 Scarlet fever, .... 
 
 259 
 
 weak, 
 
 85 
 
 rash, "... 
 
 259 
 
 Sitz bath, 
 
 338 
 
 Scars, to remove, 
 
 233 
 
 Skeleton, the human, 
 
 48 
 
 Sciatica, 
 
 130 
 
 Skin, the, 
 
 26 
 
 Scrofula, or scrofulosis, . 
 
 145 
 
 and sense of touch, . 
 
 76 
 
 in children, 
 
 271 
 
 blisters of, . 
 
 195 
 
 Scrofulous affections, burdock 
 
 
 bronzed, .... 
 
 193 
 
 tea for, 
 
 349 
 
 cancer, .... 
 
 316 
 
 Scurf and baldness, receipts, . 
 
 363 
 
 chapped, salve, etc., for, 356, 364 
 
 Seborrhoea, .... 
 
 194 
 
 to prevent, .... 
 
 365 
 
 Seidlitz powders, . . 
 
 341 
 
 diseases, .... 
 
 190 
 
 Sensation, i>h.:losophy of, . 
 
 86 
 
 forbid cold baths, 
 
 335 
 
 Senses, the five, 
 
 73 
 
 medicinal teas for, 
 
 349 
 
 Setting bones, . . . 217 
 
 ,222 
 
 warm bath for, 
 
 336 
 
 Shakes, or chills and fever, 
 
 114 
 
 irritants for, 
 
 353 
 
 or Saint Vitus' dance, 
 
 155 
 
 pores and tubes of, 
 
 28 
 
 Shingles, .... 
 
 190 
 
 spots on, . 
 
 193 
 
 brow, 
 
 190 
 
 Skull, fracture of, 
 
 213 
 
 Shock of nervous system, 200 
 
 ,233 
 
 Sleep, 
 
 46 
 
 from burns and scalds, 
 
 224 
 
 to induce, .... 
 
 142 
 
 railroad injuries, 
 
 232 
 
 Sleeplessness, or insomnia, 
 
 141 
 
 
 84 
 
 Sling for broken arm, etc., 
 
 213 
 
 Shortening of limb from frac- 
 
 
 " Slows/ ' the, or milk sickness, 
 
 129 
 
 ture, .... 
 
 216 
 
 Small-pox, . . .123 
 
 ,264 
 
 Shoulder, dislocation of, . 
 
 218 
 
 black, .... 
 
 123 
 
 growing out of, . 
 
 313 
 
 Smell, sense of, ... 
 
 74 
 
 Shower bath, . . .333 
 
 ,338 
 
 bad, to quickly remove, . 
 
 345 
 
 Sick, charity to poor and, 
 
 367 
 
 Snakes, bites of poisonous, 
 
 206 
 
 food and diet of, . 320 
 
 ,331 
 
 Sneezing, or cold in the head, . 
 
 156 
 
 personal attentions, . 
 
 98 
 
 Snuffles, or cold in the head, . 
 
 156 
 
 room, 
 
 90 
 
 of children, 
 
 284 
 
 air and ventilation, . 
 
 93 
 
 Soothing syrup, poisoning by, . 
 
 252 
 
 bad smell, removing, 
 
 345 
 
 Sound, philosophy ot, 
 
 81 
 
 cleanliness, 
 
 96 
 
 Sore, cold, .... 
 
 198 
 
 furniture, . 
 
 91 
 
 eyes of children, 
 
 308 
 
 light, . . 
 
 96 
 
 leg, 
 
 198 
 
Index. 
 
 435 
 
 PAGE 
 
 . 285 
 
 . 160 
 
 . 160 
 
 . 161 
 
 . 287 
 
 Sore mouth, nursing, 
 throat, 
 
 clergyman's, . 
 diphtheritic, 
 of children, 
 putrid, or diphthe- 
 ria, . . . 161 
 putrid, or scarlet fe- 
 ver, . . . 259 
 Sores and ulcers, . . . 198 
 
 bed, 204 
 
 canker, , 190 
 
 charcoal poultice for, . 359 
 
 foul, wash for, . . . 344 
 
 lint for dressing, . . 354 
 
 salves for, .... 356 
 
 Soups, receipts for, . . . 326 
 
 Sour stomach, .... 168 
 
 Spasms in asthma, . . . 162 
 
 false croup, . . . 290 
 
 lockjaw, .... 139 
 
 strychnia poisoning, . . 140 
 
 of children, . . . 279 
 
 See, also, Fits of children. 
 
 of the bowels, . . . 170 
 
 Spectacles, hints on using, . 84 
 
 Spiders, bites of, . . .206 
 
 Spinach soup, receipt, . . 327 
 
 Spinal cord, the, 85 
 
 effects of injury, . . 87 
 
 vital functions through, . 88 
 
 Spinal diseases of children, 273, 313 
 
 curvature, . . . .313 
 
 inflammation, . . . 314 
 
 dropsy, .... 314 
 
 Spine, the, .... 49 
 
 Spirit wash, .... 350 
 
 Spitting blood, .... 165 
 
 Splinters in flesh, . . . 242 
 
 Splints, .... 211,214 
 
 Sponging, in lieu of bathing, . 334 
 
 in fevers, . 339 
 
 Spots on the skin, . . . 193 
 
 Sprains, 234 
 
 Squinting, .... 82 
 
 
 PAGE 
 
 Squinting in children, 
 
 309 
 
 Stabs, 
 
 244 
 
 in the chest, 
 
 245 
 
 Stains, iodine, to remove, 
 
 366 
 
 nitrate of silver, 
 
 193 
 
 " u to remove, 
 
 366 
 
 Starch poultice, 
 
 359 
 
 Starvation, 65 
 
 , 144 
 
 Steaming, 
 
 346 
 
 Sticking plaster, how to apply, 
 
 245 
 
 " Stitch " in the side, or pleu- 
 
 
 risy, .... 
 
 163 
 
 Stiffjoints or limbs, cold douche 
 
 
 for, 
 
 338 
 
 passive movements for, 
 
 246 
 
 the, or milk sickness, 
 
 129 
 
 Stille, Prof., counter-irritants, . 
 
 342 
 
 Stings of bees, wasps, etc., 
 
 235 
 
 Stomach , the, . 
 
 , 
 
 61 
 
 sour, , 
 
 , . 
 
 168 
 
 warmer for the sick, 
 
 , , 
 
 92 
 
 Stomatitis of children, 
 
 , 
 
 285 
 
 Stone in the bladder, 
 
 . 
 
 188 
 
 Stools, bloody, . 
 
 . 
 
 174 
 
 Strabismus, in children, 
 
 , . 
 
 309 
 
 Strains, 
 
 , . 
 
 234 
 
 Stramonium, poisoning by, 
 
 253 
 
 Strangulation, treatment, 
 
 237 
 
 Strength not health, 
 
 36 
 
 Strengthening jelly, . 
 
 , 
 
 329 
 
 Stricture of the bowels, 
 
 . 
 
 172 
 
 " Stroke " of apoplexy, 
 
 . 
 
 151 
 
 lightning, 
 
 . 
 
 237 
 
 sun or heat, 
 
 . 
 
 235 
 
 Struma, or scrofula, . 
 
 . 
 
 145 
 
 Strychnine poisoning, 
 
 • 
 
 253 
 
 Stun, treatment of, . 
 
 . 
 
 222 
 
 Stupes, . 
 
 . 
 
 346 
 
 Styes, 
 
 
 310 
 
 Suffocation, treatment, . 
 
 . 
 
 237 
 
 Sugar of lead, poisoning, 
 
 251 
 
 Suicide, attempted, by poison, 
 
 248 
 
 cutting throat, * 
 
 246 
 
 See also Suspended Animation. 
 
 
 Sulphate of iron, or cop] 
 
 :>eras, 
 
 251 
 
436 
 
 Index. 
 
 PAGE 
 
 
 PAGE 
 
 Sulphur as disinfectant, • 
 
 345 
 
 Tea, oatmeal, . 
 
 . 325 
 
 ointment, .... 
 
 356 
 
 parsley, 
 
 . 350 
 
 Summer complaint, . 
 
 173 
 
 pipsissewa, 
 
 . 348 
 
 of children, 
 
 297 
 
 rose, . 
 
 . 324 
 
 Sunburn, 
 
 193 
 
 sage, . 
 
 . 325 
 
 ointment for, 
 
 366 
 
 seneka, 
 
 . 349 
 
 to remove, . 
 
 365 
 
 seneka and liquorice, 
 
 . 350 
 
 Sunlight in sick room, 
 
 96 
 
 the invalid's, 
 
 . 324 
 
 Sunstroke, . . 
 
 235 
 
 walnut, white, . 
 
 . 349 
 
 Suspended animation, 
 
 237 
 
 wormseed, . 
 
 . 350 
 
 Swamp or milk sickness, 
 
 129 
 
 Teeth, the, 
 
 . 53 
 
 Sweating, excessive, 
 
 198 
 
 artificial, . 
 
 . 55 
 
 Swelled throat, or goitre, 
 
 197 
 
 causes of decay, 
 
 . 54 
 
 Swelling from poison vine, 
 
 1 253 
 
 knocked out, 
 
 . 239 
 
 of glands of neck, 
 
 317 
 
 periods of appearing, 
 
 . 54 
 
 Swimming as exercise, 
 
 45 
 
 their care, „ 
 
 . 55 
 
 precautions, 
 
 227 
 
 Teething fever, 
 
 . 258 
 
 Swooning, .... 
 
 150 
 
 Tetanus, or lockjaw, 
 
 . 138 
 
 Sycosis, , . 
 
 191 
 
 of the new-born, 
 
 . 138 
 
 Symptoms, etc., writing down, 
 
 97 
 
 Tetter, . . . 
 
 . 191 
 
 Syncope, . . . . , 
 
 150 
 
 dry, . 
 
 . 192 
 
 
 
 moist, . 
 
 . 190 
 
 TAN, . . . . 
 
 193 
 
 scaly, . 
 
 . 192 
 
 " Tapering off," not best mode, 
 
 143 
 
 Thermometer in sick roon 
 
 l, 92, 102 
 
 Tapioca jelly, receipt, 
 
 329 
 
 Thigh, broken, . 
 
 . 216 
 
 Taste, sense of, . . . _ . 
 
 75 
 
 bandaging 
 
 , . 203 
 
 Tattooing, . .25 
 
 ,193 
 
 out of joint, 
 
 . 220 
 
 Tea, bearberry, 
 
 348 
 
 Thoracic duct, . 
 
 . 62 
 
 beef, two receipts, 
 
 326 
 
 Thorn-apple, poisoning b} 
 
 r, , 253. 
 
 bitter-sweet, 
 
 348 
 
 Thorns in flesh, 
 
 . 242 
 
 blackberry root, 
 
 349 
 
 Throat, cut, treatment, 
 
 . 246 
 
 burdock, .... 
 
 349 
 
 diseases, vapor baths 3 
 
 for, . 337 
 
 calamus, .... 
 
 350 
 
 Throat, sore, 
 
 . 160 
 
 cinchona, red, . 
 
 349 
 
 clergyman's, 
 
 . 160 
 
 cinchona, yellow, 
 
 349 
 
 diphtheritic, 
 
 . 161 
 
 dandelion, .... 
 
 350 
 
 of children, . 
 
 . 2S7 
 
 dogwood, .... 
 
 349 
 
 putrid, or dip 
 
 hthe- 
 
 elder, black, . . 
 
 349 
 
 ria, . 
 
 . 161 
 
 flaxseed, .... 
 
 350 
 
 or scarlet fev< 
 
 3r, . 259 
 
 goose grass, . . . 
 
 349 
 
 swelled, or goitre, 
 
 . 197 
 
 Iceland moss, 
 
 349 
 
 things in, , 
 
 . 241 
 
 juniper, . 
 
 349 
 
 ulcers, 
 
 . 160 
 
 linseed, . . 
 
 323 
 
 Thrush, . . . 
 
 . 190 
 
 logwood, .... 
 
 348 
 
 of infants, . 
 
 . 286 
 
 oak-bark, white, 
 
 349 
 
 Thrusts, wounds from, 
 
 . 244 
 
Index. 
 
 437 
 
 
 
 PAGE 
 
 PAGE 
 
 Toast and water, receipt, . 
 
 . 323 
 
 Urine, stone in the bladder, 
 
 188 
 
 Tobacco, oil of, poisoning, 
 
 . 254 
 
 incontinence of, in children 
 
 , 303 
 
 Toes, dislocation of, 
 
 . 221 
 
 Urticaria, ..... 
 
 191 
 
 jammed, treatment, 
 
 
 . 222 
 
 Uvula, relaxed, 
 
 160 
 
 Tongue, cut or bitten, 
 
 
 . 246 
 
 
 
 tie, . 
 
 
 . 307 
 
 VACCINATION, . . 12S 
 
 >, 264 
 
 Tonic, cold bath as, . 
 
 
 . 335 
 
 Vapor-bath, simple, . 
 
 337 
 
 Tonics, . 
 
 
 . 360 
 
 medicated, .... 
 
 337 
 
 medicinal teas for, 
 
 
 . 349 
 
 Varicella, 
 
 264 
 
 natural, 
 
 
 . 88 
 
 Varicose veins, 
 
 242 
 
 Tonsils, swelled, of children, 
 
 . 287 
 
 Variola, 
 
 123 
 
 Tonsilitis, or sore throat, 
 
 . 160 
 
 Varioloid, .... 
 
 123 
 
 Tooth drawing, bleeding after, 
 
 207 
 
 Vegetables for sick, receipts, . 
 
 327 
 
 Tooth powders, receipts, . 
 
 . 362 
 
 Veins, the, .... 
 
 70 
 
 Tooth-ache, 
 
 . 363 
 
 swollen and bursted, 
 
 242 
 
 Toothing rash, . 
 
 . 190 
 
 Ventilation, .... 
 
 60 
 
 Tooth-sponge, the, . 
 
 . 55 
 
 and pure air in rooms, 
 
 32 
 
 Torsion, to check hemorrhage, 
 
 208 
 
 of sick room, 
 
 93 
 
 Touch, sense of, 
 
 . 76 
 
 Ventilator, home-made, . 
 
 60 
 
 Tourniquet, temporary, . 
 
 . 209 
 
 Vermicelli pudding, receipt, , 
 
 331 
 
 Tic-douloureux, 
 
 . 130 
 
 Vertebrse, the, .... 
 
 49 
 
 "Tires," the, or milk-sickness. 
 
 129 
 
 Vigilance, morbid, . 
 
 141 
 
 "Trembles," or milk sickness, 
 
 129 
 
 Vinegar wash, , 
 
 355 
 
 Trismus, or lockjaw, 
 
 . 138 
 
 Vision, defective, 
 
 84 
 
 Trunk of the body, . 
 
 . 49 
 
 Vital functions, how carried on, 
 
 88 
 
 Truss for rupture, 
 
 . 232 
 
 involuntary, 
 
 33 
 
 Tubercle of the lymphatic 
 
 
 Vitriol, green, or copperas, 
 
 251 
 
 glands, or scrofula, 
 
 . 145 
 
 as disinfectant, . 
 
 345 
 
 Tuberculosis, or consumption, 
 
 . 165 
 
 Voice, loss of, .... 
 
 160 
 
 Turpentine liniment, 
 
 . 354 
 
 Vomiting and emetics, 
 
 345 
 
 Typhlitis, 
 
 . 173 
 
 in cholera, etc., . 
 
 175 
 
 Typhoid pneumonia, 
 
 . 163 
 
 in constipation, 
 
 172 
 
 Typhus, American, . 
 
 . 118 
 
 in colic, .... 
 
 170 
 
 icterodes, . 
 
 . 118 
 
 in gastric ulcer, 
 
 170 
 
 
 
 in hernia, .... 
 
 171 
 
 ULCERS,. 
 
 , 198 
 
 of blood, .... 
 
 168 
 
 gastric, 
 
 168 
 
 Vomito, el, or yellow fever, 
 
 118 
 
 indolent, . 
 
 198 
 
 
 
 Urine, bloody, . 
 
 188 
 
 WABASH scratches, 
 
 191 
 
 immoderate flow of, . 
 
 189 
 
 Waiting on the sick, 
 
 320 
 
 in Bright's disease, . 
 
 185 
 
 Wakefulness, or insomnia, 
 
 141 
 
 diabetes, . 
 
 189 
 
 Walking as exercise, 
 
 45 
 
 inflammation of bladder, , 
 
 187 
 
 Warm air bath, 
 
 337 
 
 inflammation of kidneys, , 
 
 184 
 
 bath, 
 
 335 
 
 kidney stone , 
 
 186 
 
 Warts, ..... 
 
 198 
 
 37* 
 
 
 
 
 
438 
 
 Index. 
 
 
 PAGE 
 
 
 PAGE 
 
 Warts, receipt, . 
 
 . 365 
 
 Wet-sheet packing, . 
 
 . 339 
 
 Wash, absorbent, 
 
 . 356 
 
 White lead, poisoning by 
 
 . 251 
 
 borax, 
 
 . 355 
 
 Whitlow, 
 
 . 197 
 
 chlorate of potash, 
 
 . 355 
 
 White swelling, or scrofula, . 145 
 
 cold water, 
 
 . 355 
 
 Whooping cough, 
 
 . 291 
 
 Goulard, . 
 
 . 355 
 
 cold baths for, . 
 
 . 335 
 
 lead, • 
 
 . 355 
 
 Wind in the bowels, 
 
 . 170 
 
 lime water, 
 
 . 355 
 
 Windows as ventilators, 
 
 . 60 
 
 oxide of zinc, . 
 
 . 355 
 
 Windpipe, the, , 
 
 . 57 
 
 spirit, 
 
 . 355 
 
 things in, . 
 
 . 241 
 
 vinegar, 
 
 . 355 
 
 Wind pox, . i 
 
 . 191 
 
 white, 
 
 . 355 
 
 Wine whey, receipt, . 
 
 . 323 
 
 Washes, . 
 
 . 354 
 
 Wolfsbane, or aconite, 
 
 . 249 
 
 face, . 
 
 . 365 
 
 Woolen best for clothing, 
 
 . 31 
 
 for the eye, 
 
 . 346 
 
 Worm fever, 
 
 . 256 
 
 mouth, 
 
 . 362 
 
 troubles of children, 
 
 . 266 
 
 three sal ammoniac, 
 
 . 355 
 
 Worms, marasmus often 
 
 mis- 
 
 Waste of body, how carri< 
 
 3d off, 72 
 
 taken for, 
 
 . 269 
 
 Wasting fever of children 
 
 . 256 
 
 wormseed tea for, 
 
 . 350 
 
 or marasmus in child 
 
 ren, . 269 
 
 Wounds, bleeding from, 
 
 . 207 
 
 Water, barley, 
 
 . 322 
 
 charcoal poultice for, 
 
 . 359 
 
 brash, 
 
 . 168 
 
 dressing, . 
 
 . 243 
 
 cold, wash, 
 
 . 355 
 
 lint for, 
 
 . 354 
 
 gruel, receipt, • 
 
 . 325 
 
 gunshot, 
 
 . 243 
 
 limestone, and lithias 
 
 is, . 186 
 
 lockjaw from, . 
 
 . 138 
 
 on the brain, in child 
 
 ren, . 268 
 
 scalp, . 
 
 . 246 
 
 pox, 
 
 . 190 
 
 sticking-plaster on, 
 
 . 245 
 
 purgative mineral, . 
 
 . 341 
 
 throat cut, 
 
 . 246 
 
 toast and, . 
 
 . 323 
 
 torn or lacerated, 
 
 . 243 
 
 Wax in the ear, 
 
 . 78 
 
 See also Stabs. 
 
 
 Weak ankles, in children 
 
 . 314 
 
 Wry neck, 
 
 . 233 
 
 digestion, diet for, 
 
 . 321 
 
 in children, 
 
 . 307 
 
 eyes, . 
 
 . 85 
 
 
 
 Weaning brash, 
 
 . 303 
 
 
 
 of infants, • • « 
 
 . 297 
 
 YEAST poultice, . 
 
 . 359 
 
 Well-damp, 
 
 . 237 
 
 "Yellow Jack," 
 
 . 118 
 
 Wet compress, . 
 
 . 339 
 
 Yellows, in children, 
 
 . 266 
 
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