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Medical Handbook 
 
 FOR 
 
 Missionaries in Cold Climates. 
 
 BY 
 
 ' 
 
 J. H. ROMIO, M. I): ■"> 
 
 > " 3 * 3 > > ) > 
 
 PHILADELPHIA. 
 
 BOERICKE & TAFEL. 
 
 1904. 
 

 LIBRARY ^CONGRESS 
 Two Conlfts Received 
 APR 28 1904 
 Copyright Entry 
 
 CLASS ^ 
 
 S *f ") » o 
 
 COPY B 
 
 XXc No. 
 
 COPYRIGHT : 
 J. H. ROMIG, M. D. 
 
 1904. 
 
TO 
 THE MEMORY OF 
 
 MARGARET (RICKSECKBR) ROMIG 
 
 THIS TREATISE IS 
 
 AFFECTIONATELY DEDICATED 
 
 BY HER SON, 
 
 (REV.) J. H. ROMIG, M. D., 
 
 MEDICAL MISSIONARY 
 
 FOR THE 
 
 MORAVIAN CHURCH 
 
 IN 
 
 ALASKA, U. S. A. 
 
PREFACE. 
 
 The demand for medical literature is so well 
 supplied that we would hesitate before offer- 
 ing the public any contribution were it not 
 that a peculiar need prompts the preparation 
 of this small treatise. Missionaries laboring 
 in foreign fields often find the texts prepared 
 for the use of the general practitioner too 
 lengthy and difficult of understanding, and are 
 bewildered by the multitude of difficult words, 
 when medical works are consulted. 
 
 With a hope to supply a need, existing espe- 
 cially in missions in Alaska, the treatise thus 
 produced is intended for the use of mission- 
 aries where medical attendants are not to be 
 secured, because of the isolated locations of 
 many missions. 
 
 We are indebted to the following authors, 
 whose works have furnished valuable sugges- 
 tions in the preparation of this treatise : JDrs. 
 Rotch, Johnson, Goodno, Osier, Dewey, 
 Stevens, Van Harlingen, and especially to 
 Dr. H. S. Weaver, for valuable assistance on 
 the therapeutics of nose and throat affections. 
 
 This treatise is submitted with a hope that 
 the years of experience we have had in treat- 
 ing the diseases prevalent in Alaska may make 
 the work of service to those in such climates. 
 
 J. H. ROMIG, M. D. 
 
 Bethlehem, Pa., March, 1904. 
 
DOSE AND INDICATIONS FOR DRUGS. 
 
 DOSE FOR A CHILD. 
 
 "Young's rule :" Use the age of the child 
 as the numerator of a fraction and the age of 
 the child plus 12 as the denominator, reduce 
 the fraction and you have the dose for a child. 
 
 Example. 
 
 -L _— — or - the dose of an adult. 
 
 2 years + 12 14 7 
 
 Children are much more susceptible to opi- 
 ates than an adult and the dose of opiates 
 should be only one-half as much as this rule 
 indicates. Children require larger doses of 
 cathartics than this rule indicates, usually dou- 
 ble the amount of cathartics should be given. 
 The Homoeopathic dosage cannot be given by 
 this rule, but a little study will enable . any- 
 one to so modify the dose as to get the best 
 results. 
 
 The mark indicates the tincture of the 
 drug or strongest preparation. 
 
 ix indicates 1 / w as much drug as is found in 
 the 6. 
 
 2x is 1 / 10 as strong as the ix. 
 
 The larger the number in front of the x the 
 weaker the preparation. 
 
 The stronger preparations are best used for 
 acute affections and the weaker preparations 
 
8 DOSE AND INDICATIONS FOR DRUGS. 
 
 for chronic diseases, where the drug is given 
 daily for a long period of time. 
 
 Of the many symptoms given indicating a 
 Homoeopathic drug there should be present at 
 least three well defined symptoms before the 
 drug is selected as a remedy. Do not think all 
 the symptoms are necessary, but look for three 
 or more prominent symptoms in selecting the 
 remedy. 
 
ABSCESS. 
 
 Abscesses are circumscribed areas filled with 
 pus. There are two varieties, the acute and 
 the cold, abscess. 
 
 The symptoms of an acute abscess are pain, 
 swelling, chill and fever. The acute abscess 
 is filled with the ordinary pus germ. The loca- 
 tion may be in any part of the body. An ab- 
 scess works toward the surface of the body or 
 in the line of least resistance, which is usually 
 outward, but not always so. Deep abscesses of 
 the neck or along the course of a muscle may 
 burrow for some distance and rupture on the 
 surface at a remote locality from the seat of 
 a pus formation. An abscess always destroys 
 tissue to a greater or less extent, and if allow- 
 ed to take its own course will usually rupture 
 spontaneously and discharge a thick, creamy 
 pus and shreds of sloughed tissue. 
 
 The treatment of an acute abscess is for the 
 greater part surgical. 
 
 When an abscess is expected to form, at 
 times it may be dispelled by painting the part 
 with Tr. Belladonna, and giving internally 
 Ferrum phos. 2x, one tablet every 3 hours. 
 Or giving Hepar sulphur 4X, one tablet three 
 times a day. 
 
 When the medical measures fail, which they 
 will usually do, there remains but one thing to 
 
10 MKDICAL. HANDBOOK. 
 
 be done, and that is to hasten the formation of 
 pus and its liberation. Best accomplished by 
 giving Hepar sulphur ix, one tablet every two 
 or three hours. Applying warm poultices to 
 the point where it is desired or expected that 
 the abscess will break or be opened. Some 
 drawing ointment as boil salve may be used 
 to hasten the formation of a head or pointing 
 spot in the abscess. When once the pus can 
 be clearly located much pain and scarring may 
 be prevented by lancing the abscess and thor- 
 oughly cleansing the cavity. Carbuncle cavi- 
 ties should be cleansed and cauterized. 
 
 COLD ABSCESS. 
 
 Glands and joints are often the seat of ab- 
 scess formation of a tubercular or scrofulous 
 nature. The real cause, however, is the pres- 
 ence of the tubercle bacilli. Abscesses formed 
 in this way and caused by this particular germ 
 are slow in growth and attended with few- 
 systematic disturbances. Pain, chill and fever 
 are either absent or very mild. Because of the 
 nature of the abscess and the few symptoms 
 produced the name of cold abscess has been 
 given. 
 
 All cold abscesses are apt to rupture in 
 time, and after rupturing the abscess cavity is 
 apt to become infected with the ordinary pus 
 germs, which, when they enter the cavity, set 
 up all the symptoms, for the time, of acute in- 
 fection or acute abscess. 
 
AMPUTATIONS. II 
 
 The treatment of cold abscess is that of in- 
 cision before the time of rupture, using the 
 most rigid precaution to prevent infection. 
 Drain the cavity of pus and sloughing tissue 
 and pack with iodoform gauze to stimulate 
 rapid granulation or healing of the cavity. 
 
 AMPUTATIONS. 
 
 The conditions calling for amputation are so 
 varied that an exact rule cannot be given. 
 Where from injury the circulation to any part 
 has become injured to such an extent as to 
 make the life of the part impossible, then 
 amputation is at once the wisest thing. 
 
 Where gangrene or blood poison threatens 
 the life of the individual from poison from a 
 given locality, and the poison cannot be re- 
 moved, there remains but one thing to do, and 
 that is to remove the poisoned extremity. 
 
 After frost bites, if the bone has been frozen 
 and amputation has become necessary, always 
 go well above the line of demarkation for the 
 point of severing the bone, for bones regain 
 their vitality very poorly after a frost bite, and 
 if the amputation is not performed well above 
 the line of demarkation on the surface it will 
 become necessary later to open the wound and 
 remove more of the bone. 
 
 Before operating always cleanse the seat of 
 
12 MEDICAI, HANDBOOK. 
 
 the operation well and cover the part to be re- 
 moved with a wet dressing of Bichloride of 
 Mercury. See to it that no poison remains oh 
 the surface that is to be operated upon, or that 
 none be carried from other sources into the 
 new wound. Bathe the part to be operated 
 upon in Bichloride of Mercury solution and 
 keep the part to be removed covered with an 
 antiseptic dressing. Finally, the hands of the 
 operator and his assistants must be thoroughly 
 scrubbed and soaked in the i-iooo solution of 
 Bichloride of Mercury. The instruments and 
 thread must have been boiled for at least fifteen 
 minutes to insure their carrying no germs that 
 will poison the wound. The success of the 
 operation depends on the detail of cleanliness 
 observed and no one should be carel< 
 
 AMPUTATION OF A FINGER OR TOE. 
 
 All the preparatory steps having been taken, 
 of cleanliness and of disinfection, tie firmly 
 some cord or preferably a narrow bandage 
 around the toe or finger back of the locality to 
 be operated on, to control the circulation. Re- 
 member the arteries of the fingers and toes are 
 to the side and not above or below the finger. 
 Bend ' the finger or toe at the joint to be 
 severed. Cut across the back one-half inch in 
 front of the flexed joint. Press the skin back 
 and then cut through the joint. Follow the 
 under surface of the bone for nearly an inch 
 and then cut through to the palmar surface. 
 
IMPUTATIONS. 13 
 
 Pick up and tie any spurting arteries. Loosen 
 the cord or bandage that has been tied around 
 the finger or toe. Scratch the end of the joint 
 a little with the knife so that the joint surface 
 may enter into the healing. Bring up the flap 
 from below and sew it over the end of the joint 
 to the tissues and skin above. It is desired 
 that the flap of skin come from below as the 
 palmar surface is less sensitive and affords a 
 better cushion for the end of the bone and is 
 better supplied with the nerves of touch than 
 would be a dorsal flap. 
 
 Cleanse and dress the wound when necessary. 
 
 AMPUTATIONS AT THE HAND OR FOOT. 
 
 The preliminary steps for the operation 
 should be performed as for the removal of a 
 toe or finger at the joint. A tourniquet may be 
 used on the leg to control the bleeding or the 
 spurting artery may be picked up with an 
 artery clip as soon as divided. Begin the in- 
 cision one-half inch back of the joint and cut 
 on the back or dorsal surface to a point one 
 inch below the joint. Encircle the finger or 
 toe, cutting everything to the bone. Dissect 
 back all the tissues to the joint and remove 
 the bone at the joint. Scarify the end of the 
 joint. Tie the spurting arteries. Bring the 
 flaps together and sew, making the line of 
 union up and down over the end of the bone. 
 Dress and care for as occasion may demand. 
 
14 MKDICAL. HANDBOOK. 
 
 AMPUTATIONS OF A LEG OR ARM. 
 
 Amputations of a leg or arm can be done by 
 anyone who will keep his head cool and re- 
 member the following points : 
 
 Before operating, see that the location to be 
 operated upon has been cleansed and rendered 
 thoroughly aseptic. 
 
 Apply a rubber band tourniquet to the limb 
 above the seat of operation. 
 
 Remember that all the large arteries are to 
 be found in the protected sides of the limbs. 
 
 Make the flaps from both sides horizontal 
 or vertical as will best cover the end of the 
 bone, with a soft cushion of tissue. 
 
 Cut the bone far enough back of the flesh to 
 make no difficulty in covering the end of the 
 bone. 
 
 Tie all the bleeding arteries firmly. Then 
 remove the tourniquet and tie any that may 
 throb or spurt. 
 
 Sew the flaps together evenly, but do not 
 make the stitches too tight. 
 
 Dress firmly and renew the dressing as oc- 
 casion may demand. 
 
 If the wound should open up, remove with 
 very gentle traction any stitches that must 
 come away. 
 
 If bleeding should occur after the operation 
 that firm pressure cannot control, it may be 
 necessary to open up the wound and tie the 
 artery that is bleeding. 
 
ASPHYXIA. 15 
 
 If the wound should open during the time 
 of healing, keep the edges of the flaps in as 
 close proximity as possible by bands of ad- 
 hesive plaster. 
 
 ASPHYXIA AND ARTIFICIAL 
 RESPIRATION. 
 
 Artificial respiration or breathing is called 
 for in drowning cases, for persons choking 
 from ether, or accident where the breathing 
 has ceased and the heart still beats. In 
 drowning cases the heart may beat so feebly 
 as not to be easily heard and yet recovery may 
 follow diligent effort to resuscitate. 
 
 If drowning has occurred, stand over the pa- 
 tient and catch the arms around the body just 
 below the ribs. Raise the body partially from 
 the ground with the face down. Have some 
 one open the mouth and draw down the ton- 
 gue. When the water has run out of the lungs 
 place the body on the back with the head 
 lowered slightly. Have some one hold the 
 lower jaw up and open as in giving ether. 
 Then grasp the arms at the elbow and carry 
 the arms outward and upward until they al- 
 most meet over the head. Bring the arms 
 down to the side and make firm pressure on 
 the chest. Repeat the movements of the arms 
 not more than eighteen times a minute. Most 
 persons get in a hurry and work too fast. 
 
l6 MEDICAL HANDBOOK. 
 
 Rub the legs and arms towards the heart. 
 Dash hot or cold water on the chest. Slip a 
 piece of ice into the rectum or forcibly dilate 
 the rectum with the fingers or a dilator. 
 
 The last two procedures are of especial 
 value where there is a cessation from breath- 
 ing, due to taking ether. 
 
 Do not give up the efforts too soon. 
 
 Give hypodermic injections of brandy or 
 Strychnine as soon as the circulation can take 
 it up, in drowning cases ; or at once, if there is 
 any apparent circulation, as in asphyxia from 
 ether. 
 
 BURNS. 
 
 Burns, Scalds and Superficial Frost 
 Bites all demand about the same treatment. 
 A burn may be only such as to redden the 
 skin ; or more intense and cause blistering ; so 
 severe as to destroy the superficial tissues. A 
 simple reddening of two-thirds of the body is 
 very apt to cause death. Blistering of one- 
 third of the body is very serious and usually 
 fatal. Deep burns of small areas may prov« 
 fatal to children or the enfeebled. 
 
 The scars of burns contract after healing 
 and horrible distort inn may result. Infection 
 of burned areas may occur and death result 
 from blood poison. Waste matter that should 
 
BURNS. 17 
 
 be eliminated by the skin may be forced upon 
 the lungs, kidneys and intestines and cause 
 serious complication to the recovery. 
 
 Treatment. — For slight burns where there 
 is reddening of the tissue or blistering,- noth- 
 ing relieves the pain so much as a saturated 
 solution of Baking Soda (as much Soda as 
 the water will take up). Large blisters should 
 be punctured with a needle, but do not remove 
 the skin, as the air causes intense pain when it 
 comes in contact with the exposed nerves. 
 Superficial burns are the most painful and re- 
 quire a dressing that w r ill exclude the air. 
 Carbolized vaseline is a very good dressing 
 spread on lint. 
 
 Antiseptic dressings are to be used with cau- 
 tion lest from so great a surface enough of 
 the drug may be absorbed as to produce 
 poisoning. Plain boiled water or Boric acid 
 solution is to be preferred. Remove all sloughs 
 and keep the dressings renewed lest blood- 
 poison result from the absorption of pus. Keep 
 the limbs extended or in a little more than the 
 angle desired after healing, for there will 
 likely be contraction that is very hard to over- 
 come and had better be prevented. 
 
BRUISES. 
 
 Bruises are injuries of the tissues beneath 
 the skin. Usually produced by a fall or blow 
 from some blunt instrument. There is more or 
 less effusion of blood into the tissues, with 
 heat, pain and swelling. If the injury is a 
 deep one the discoloration w T ill be slow in 
 reaching the surface, if shallow or in soft 
 tissue, such as the eye, discoloration or ecchy- 
 mosis soon follows. 
 
 Treatment. — There has been an injury to 
 the bloodvessels beneath the surface and bleed- 
 ing is in progress. The object of first import is 
 to stop the bleeding, which is best accom- 
 plished by firm bandaging, by cold compresses 
 or very hot applications, and by astringent 
 lotions, such as Leadwater and Laudanum. 
 Later there is much benefit derived from the 
 use of soothing lotions, of which Tr. Arnica 
 and water in equal parts is the most frequently 
 employed. Arnica should not be used if the 
 skin has been broken, as it has been known to 
 cause erysipelas when used on open surfaces. 
 The Fluid Extract of Hamamelis is to be pre- 
 ferred where the skin has been injured. Ap- 
 ply the Arnica or Hamamelis with gentle fric- 
 tion or on wet compresses. 
 
 When once the bleeding has ceased and ab- 
 sorption has begun hot applications and gentle 
 
BOIXS. 19 
 
 massage or rubbing will aid much 111 dispelling 
 the blood from the tissues and hastening the 
 disappearance of the color, which is often the 
 most urgent part of the treatment. 
 
 BOILS. 
 
 Boils are caused by microbic infection of the 
 deeper structures, resulting in one or many 
 circumscribed painful areas or localized spots 
 of inflammation. The microbe travels down 
 the canal of a hair or through the opening of a 
 sweat gland and first produces a circumscribed, 
 painful area, later a small pustule and finally 
 enters the deeper structures of the skin and 
 connective tissue. As a result of the inflam- 
 mation a central core perishes and is sloughed 
 away. 
 
 A boil may be of the blind variety, where 
 there is only pain and swelling, but true pus 
 formation does not occur. The common form of 
 boils goes on to the formation of pus, and 
 opens with the discharge of pus and the 
 sloughing aw r ay of a central core. A boil runs 
 its course in a week or ten days. There may 
 be successive crops of boils, but each one is 
 independent of the other. Unhealthy condi- 
 tions of the skin and impurities of the blood, 
 as well as the change of seasons and over- 
 work or exhaustion, all predispose to the 
 formation of boils. The neck and back, the 
 
20 MEDICAI, HANDBOOK. 
 
 face and margins of the scalp and ears, and 
 the axilla and groin and perineum are all 
 favorite localities for the development of boils. 
 Treatment. — When there is simply pain 
 and swelling a threatened boil may be pre- 
 vented by pulling out the hair in the centre of 
 the inflamed area and painting the part first 
 with a very strong solution of Carbolic acid, 
 and later with the Fl. Ext. of Belladonna. 
 When once an abscess has formed hot applica- 
 tions, such as poultices, will hasten the head- 
 ing or opening of the boil. Boil salve may be 
 applied to soften the tissues and draw or 
 hasten the heading of the abscess. Incision and 
 drainage would be the ideal measures, but 
 most persons prefer to allow the boil to open 
 and discharge, after which rapid healing 
 follows. 
 
 BLOOD SPITTING. 
 
 The causes of blood spitting may be direct 
 injury to the mouth, throat or lungs. Inflam- 
 matory affections of the respiratory system. 
 Obstruction to the venous circulation, as is 
 common in heart and liver diseases. In scurvy, 
 in consumption of the lungs, where the de- 
 structive process causes some artery-wall to 
 break down, and in kidney diseases, where the 
 general blood pressure is raised to such an ex- 
 
BLOOD-SPITTING. 21 
 
 tent that the arteries of the lungs may rupture 
 from high arterial tension. 
 
 Symptoms. — Usually a slight cough, a warm 
 sensation beneath the breast bone, followed by 
 a warm, salty fluid in the mouth. Sometimes 
 the presence of the blood in the mouth is the 
 first symptom the patient has. The blood is 
 generally raised by coughing and is bright red 
 and frothy, and is intimately mixed with air 
 and mucus. Associated with this may be heard 
 rales or a bubbling in the region of the chest 
 from which the blood comes. Blood from the 
 stomach is always dark in color and is clotted 
 and not mixed with air and mucus, but is 
 mixed with food. 
 
 Treatment. — Absolute rest of mind and 
 body is necessary. For adults give a teaspoon- 
 ful dose of a strong salt solution, often re- 
 peated, and have the patient rest in bed, or 
 give 10 to 15 drops of the Tr. of Arnica, or 
 Y^ to 1 teaspoonful of the Fluid Extract of 
 Hamamelis, every 20 to 30 minutes, until the 
 blood spitting is better. For adults who are 
 well and strong: 
 
 J^. Morphine sulphate %. gr. 
 
 Atropine sulphate, V100 gr ' 
 
 If the patient is weak give about one-half of 
 this dose and repeat in three or four hours, if 
 necessary. 
 
NORMAL BREATHING. 
 
 The normal breathing of infants is about 
 thirty-five per minute for the first year, 
 twenty-five for the second year, about twenty 
 at the fourteenth year, and eighteen per 
 minute for adult respiration. Age, sex, ex- 
 citement, work, and disease all modify the 
 number of respirations per minute. Febrile 
 and nervous disorders tend to increase the 
 number of breaths in the minute. In fainting 
 and brain injuries and depressed nervous con- 
 ditions the respiration is slowed. 
 
 BED-WETTING OR ENURESIS. 
 
 Bed- wetting is more a symptom than a dis- 
 ease. There is always the nervous condition 
 of the patient to be taken into consideration. 
 The mechanism of micturition is a complicat- 
 ed one, and only under the control of the will 
 after the child has reached an age and period 
 where the inhibitory centers hold in abeyance 
 the reflex nerve action. Punishing a child for 
 bed-wetting or for the involuntary discharge 
 of urine is, as a rule, cruel and ignorant prac- 
 tice. The reflex nerve fibers governing the 
 muscular walls of the neck of the bladder 
 
ENURESIS. 23 
 
 respond to the irritation caused by distension 
 of the bladder. The reflex irritation travels 
 up to the inhibitory centers in the back where 
 the impulse to relax the sphincter of the blad- 
 der and expel the contents is stimulated. In 
 early childhood the emptying of the bladder 
 is accomplished by the reflex and inhibitory 
 nerves and the act requires little or no work 
 on the part of the will. 
 
 About the second year in life the will is 
 brought into play and the child assumes con- 
 trol of the function. Some children may be 
 subject to periodical attacks of enuresis. 
 Some are troubled only at night when the 
 sleep is so sound that they lose control of the 
 mechanism of the bladder. 
 
 Hyperacidity of the urine or anything that 
 will irritate the bladder may cause bed-wet- 
 ting. Pin-worms either of the rectum or 
 after traveling into the genital tract, as is 
 often the case with girls, may, by their irri- 
 tant action in the rectum or genitals, cause 
 irritability of the bladder and involuntary 
 urination. 
 
 A tight and adherent prepuce may excite 
 the reflex nerves so as to be the cause of 
 enuresis. When this is the case circumcision 
 will very likely relieve the nervous irritation 
 and cure the enuresis. Remember that, dur- 
 ing childhood, there is a lack of development 
 of the inhibitory centers, and that the will 
 has not the control of the bladder as is re- 
 
24 MEDICAI, HANDBOOK. 
 
 quired in after life. We hope, if nothing 
 more, to ask mothers to remember the child 
 is undeveloped and punishing is a cruelty in 
 many instances. 
 
 Treatment. — There is little use to give 
 drugs when the cause is to be found in the 
 rectum or genital tract. If pin-worms exist 
 treat that cause. If the genital tract is ex- 
 coriated, or there is phymosis, relieve the ir- 
 ritating cause. Bathing the back with cold 
 water at bed-time is sometimes beneficial. 
 Quite hot water may be used in place of cold 
 water. Simple friction or massage of the 
 back just above the hips may be employed 
 where no water is used. Elevating the foot 
 of the bed a little may do some good. 
 
 Internally give Belladonna ix, i tablet 
 morning and evening. 
 
 Cimicifuga ix, tablet three times a day may 
 be tried. 
 
 Do not give much liquid for supper. Try to 
 remove any local irritation and have patience 
 and all cases will recover. Some even do not 
 obtain full control of the urinary apparatus 
 until ten or twelve years of age. Children 
 otherwise healthy may be thus troubled much 
 to their own chagrin and taunts are cruel. 
 
BLOOD-POISON. 
 
 Blood-poisoning is due to the absorption of 
 the products of infected areas. The putrefac- 
 tive germs may enter the circulation or the 
 poison of these germs may produce changes in 
 the blood that are very serious and often fatal. 
 Abscesses. Injuries resulting in infection and 
 child-bed infection are the most frequent 
 causes of blood-poison. 
 
 The symptoms of blood-poison are a con- 
 tinued high fever ; headache ; weak, rapid 
 pulse ; nausea or want of appetite ; slight 
 jaundice; diarrhoea as the poison becomes 
 more intense, and finally a typhoid, dull, list- 
 less appearance marks the coming fatality. A 
 cold, clammy sweat may also be present in the 
 later stages of blood-poison. In some cases, 
 particularly where the infection is in the ab- 
 domen, the temperature may be subnormal as 
 the end is approached. 
 
 Treatment. — Where there is an area that is 
 continually giving off poison and charging the 
 system with something the blood cannot resist, 
 the only thing to do is to remove the source of 
 infection. If gangrene is the cause, remove 
 the part. If an abscess, empty the pus cavity, 
 and thoroughly cleanse the part. If a womb, 
 as in child-bed fever, the uterus should be 
 washed out with an antiseptic solution. This 
 
26 MEDICAI, HANDBOOK. 
 
 not every one can do, but anyone can give 
 a hot antiseptic vaginal injection and elevate 
 the patient's head and try to get better drain- 
 age of the womb. Try, from whatever source 
 the infection comes, to remove the cause; this 
 may require an amputation, be that as it may, 
 remove the cause. 
 
 'Internally give stimulants. Quinine, five 
 grains every four hours, acts well on the stom- 
 ach and in the blood. Alcoholic stimulation 
 should be resorted to, and it is wonderful how 
 much alcoholic stimulation can be borne by 
 one suffering with blood-poison. Quinine and 
 whiskey are almost indispensable remedies in 
 blood-poison. Strychnine, 1 / part of a grain, 
 may be given every three to six hours. Try to 
 keep up the heart. 
 
 The food should be light, but nourishing. 
 Eggnogs, beef-tea and similar liquid foods are 
 of much value. 
 
 COLD IN THE HEAD, CORYZA. 
 
 A cold in the head is an acute inflammation 
 of the upper air passages. Exposure is the 
 chief cause. At the onset the patient is lan- 
 guid and chilly. The nose may seem dry and 
 breathing difficult. Soon there is a watery 
 discharge from the nose and the nostril feels 
 raw and sore. The mucous membrane of the 
 
COI,D IN THE HEAD. 27 
 
 eyes may share in the inflammation and the 
 eyes water. The throat may become involved 
 and painful, and the voice husky or lost. Taste 
 and smell may be absent. Usually in a few 
 days the symptoms subside and recovery fol- 
 lows. 
 
 Treatment. — In the early stage where 
 there is chill and fever with rapid pulse give 
 Aconite ix, one tablet every hour. When the 
 eyes begin to water and the nose runs and the 
 urine becomes free and almost colorless, as is 
 often the case, and the patient feels drowsy, 
 languid and sore all over the body, give Gel- 
 semium 0, one tablet every hour, until the pro- 
 fuse running of the nose ceases. Later for the 
 cold in the head, where the discharge is bland, 
 Pulsatilla 0, one tablet every two hours, is 
 often very beneficial. At the onset of a cold in 
 the head, or cold on the chest, a prompt purge 
 will assist greatly other methods of treatment. 
 The old mother's remedy of fried onions for 
 supper is by no means inefficient, and for those 
 who like onions not unpleasant treatment. 
 
BRONCHITIS. OR COLD ON THE CHEST. 
 
 The symptoms of acute cold on the chest 
 may mark the onset of measles, whooping 
 cough or la grippe. Irritant vapors may 
 also cause the symptoms of a cold on the 
 chest. The usual cause is exp jsure to cold 
 or damp atmosphere, after the body has been 
 over-heated. The skin is very active in 
 eliminating waste material from the body. 
 When all the pores of the skin are open and 
 perspiration is present, a sudden change of 
 the temperature or a draught may cause the 
 pores to close and temporarily cease to act. 
 The waste matter that should have been 
 thrown off by the skin is forced back on the 
 lungs, bowels and kidneys. As a result from 
 over-work and congestion a cold on the chest 
 may ensue with cough and expectoration. 
 The bowels may be irritated and congested 
 and a diarrhoea result, or the kidneys may 
 suffer in like manner and be forced to do extra 
 work. 
 
 Treatment. — When from exposure a cold 
 on the chest is developed, much good may be 
 accomplished by relieving the lungs of some of 
 the strain by asking more of the bowels, for 
 which purpose a prompt purge should be 
 given. Soaking the feet in hot water will 
 often help to relieve the congestion of the 
 
BRONCHITIS. 29 
 
 chest, as it does the head in headache, by 
 drawing some of the blood elsewhere. 
 
 Chill, fever and rapid pulse are to be ex- 
 pected in the early stage, and call for Aconite 
 0, 1 tablet every hour for five or six doses. 
 When cough and rattling of the chest from 
 mucus begins to develop, or following the 
 Aconite, one of the best remedies is Ipecac y 
 1 tablet every hour until the expectoration is 
 free. Ipecac, besides stimulating the lungs, 
 causes the skin to do more work and aids in 
 restoring the equilibrium of the excretory 
 functions. The various cough medicines given 
 to hasten expectoration and quiet the irrita- 
 bility of the mucous membranes of the bron- 
 chial tubes are very good, but care should be 
 observed in giving cough syrup to children 
 because many contain opiates that are poorly 
 borne by children. 
 
 For an irritating cough at night that pre- 
 vents sleep wring out a cloth in quite hot 
 water and place on the chest next to the skin. 
 Bathing in hot water and brisk rubbing with 
 a coarse towel will help to start the skin to 
 action. Avoid a chill or exposure to draught 
 during the bath. 
 
CHRONIC COUGH OR CHRONIC 
 BRONCHITIS. 
 
 The causes of chronic cough may be repeat- 
 ed colds or repeated attacks of acute bron- 
 chitis. Chronic heart, lung and kidney dis- 
 eases are often the cause of chronic cough. 
 Old people are apt to have a chronic cough. 
 
 The symptoms are shortness of breath on 
 exertion, and soreness behind the breast bone, 
 associated with chronic cough and expectora- 
 tion. 
 
 Treatment. — If due to any chronic lesion 
 of the heart, or kidneys, or lungs. Treat the 
 cause. Improve the general health. Avoid 
 exposure. Give any good expectorant cough 
 medicine. 
 
 CARBUNCLE. 
 
 Carbuncles differ from boils in being deep- 
 er seated, longer in duration and more dan- 
 gerous and destructive in nature. The cause 
 of carbuncles is much the same as that of 
 boils, however certain diseases such as 
 B right's disease, predispose to carbuncles. 
 The favored locality for the formation of a 
 carbuncle is on the back of the neck, or on 
 the back and on the buttox. When a car- 
 buncle forms there is much disturbance of 
 
CARBUNCLE. 31 
 
 the system, resembling that of acute abscess. 
 There is chill, fever and burning pain. At 
 first there is a darkened, painful area, not 
 localized as in the case of a boil, but flattened 
 and extensive ; the skin is hot and has a 
 dough-like feel. In about two weeks the car- 
 buncle begins to head and several points be- 
 come white and finally break down, discharg- 
 ing at first a watery pus ; later there may be 
 seen in each of the openings white shreds 
 and masses of tissue that are sloughing away, 
 and finally all the openings will coalesce and 
 one large sloughing cavity be formed. When 
 all is done and the cavity free of sloughs heal- 
 ing takes place rapidly. A carbuncle lasts 
 from four to six weeks and is a very serious 
 disease when attacking the very young or 
 very old, or those reduced in health by dis- 
 ease. 
 
 Treatment. — The early free incision and 
 opening the cavity to its extent, and thorough 
 cauterizing with caustic or pure Carbolic acid, 
 is the best and safest procedure. Poultices 
 do more harm than good. To allow a car- 
 buncle to form and open is at times a great 
 risk, particularly in the enfeebled, as blood- 
 poison may easily result from so large a pus 
 cavity. 
 
 Those suffering from a carbuncle should 
 have the best of nourishing food and be given 
 Quinine 3 grains three times a day after 
 meals. Or Tr. Nux vomica 3 drops three 
 
32 MKDICAI, HANDBOOK. 
 
 times a day after meals, and at times alco- 
 holic stimulants. Keep up the strength of 
 the patient if possible. There are two reme- 
 dies that are of value for either carbuncles 
 or boils : 
 
 Ferrum phos. ix strength, i tablet every 
 four hours, or Hepar sulphur 4X, i tablet 
 every three hours. Either of the foregoing 
 may be used where inflammation' is present 
 and a boil or a carbuncle is threatened, with 
 a hope to avert pus formation. When once 
 pus forms and it is desired to hasten the 
 heading of a boil or carbuncle given Hepar 
 sulphur ix, 2 tablets every three hours. 
 
 CONVULSIONS. 
 
 Convulsions may be of several varieties : 
 Epilepsy, puerperal or child-bed convulsions, 
 and infantile convulsions. 
 
 The cause of convulsions may be in the 
 brain, as is shown in epilepsy, or excited by 
 nervous stimuli from any part of the system, 
 as is shown by the convulsions common to 
 children. 
 
 Convulsions originating in the brain, from 
 tumor or lesion of the brain, are apt to be 
 only partial, attacking first a hand or one side 
 of the body, and finally becoming general, 
 though the movements may only be seen on 
 the affected side. 
 
CONVULSIONS. 33 
 
 Convulsions caused by irritation from with- 
 out or reflex nervous irritation are of both 
 sides of the body during the convulsion, and 
 after the convulsion one side is not more af- 
 fected than the other, as is apt to be the case 
 where the lesion is in the brain structures. 
 Convulsions of childhood are apt to result 
 from indigestion, teething, worms in the in- 
 testines, and precede the onset of the erup- 
 tive fevers, meningitis, measles, whooping 
 cough, etc. 
 
 If the pulse is rapid and the temperature 
 high and the head congested, as is shown by 
 the throbbing fontanelle, the convulsion may 
 precede some of the eruptive fevers. If the 
 temperature is normal and the pulse not much 
 accelerated, the cause may be something in 
 the nose or ear. Sometimes convulsions re- 
 sult from an exhausted condition, such as the 
 loss of blood or continued diarrhoea. The on- 
 set of a convulsion is usually preceded by a 
 period of uneasiness. Then there is rigidity 
 and a choking noise, the eyes roll up, the 
 lips are blue and the hand clenched. Twitch- 
 ing of the arms and feet, foaming at the 
 mouth, rigidity of the body and possibly invol- 
 untary urination are present during a convul- 
 sive spasm. Then follows relaxation and sleep. 
 
 Treatment. — There is little to be done for 
 epileptic convulsions except to put something 
 between the teeth that the tongue be not 
 bitten. 
 
34 MEDICAI, HANDBOOK. 
 
 Child-bed convulsions are very difficult to 
 treat. Give 5 drops of the Tr. Veratrum 
 viride every fifteen minutes until the pulse is 
 reduced to about sixty per minute, not below 
 sixty per minute. Bromide of Potash may be 
 given in thirty-grain doses, with fifteen grains 
 of Chloral hydrate; give per rectum as an 
 injection in 1 ounce of water; repeat in a 
 half hour, if necessary. Ether is of much ser- 
 vice and should not be forgotten. Give enough 
 to quiet the patient. If Chloral has not been 
 given, give Chloroform until the nervous ex- 
 citability has lessened. 
 
 Infantile convulsions should receive the 
 most consideration, as they are the most fre- 
 quent encountered. The first thing usually 
 done is to put the child in a warm bath (ioo° 
 F.), which relieves the nervous excitement to 
 a marked degree. Ether may be given until 
 the convulsions cease. Bromide of Potash 
 may be given before the convulsion begins, 
 from 5 to 10 grains in water for two or three 
 doses, about thirty minutes apart. The drug 
 may be given per rectum if the child is in 
 convulsions, 10 grains to y 2 ounce of water. 
 
 If the convulsion is due to a foreign body 
 in the nose or ear, or to exhaustion from loss 
 of blood or diarrhoea, the hot bath is not ad- 
 visable. Remove the foreign body. If from 
 exhaustion give brandy and water, 1 to 2 tea- 
 spoonfuls to the same amount of water, as 
 an injection. If teething is the cause lance 
 
CONSTIPATION. 35 
 
 the offending gum. If the stomach, empty 
 the stomach and given an enema, and later a 
 cathartic. Try to remove the cause and to 
 prevent a recurrence. 
 
 CONSTIPATION. 
 
 Causes. — More cases are traceable to a want 
 of regularity of habit than to any other cause. 
 Torpidity of the liver and inactivity of the 
 bowels, sedentary habits or want of proper 
 physical exercise play an important role as 
 causative factors. Dark complected people are 
 more often constipated than fair ones. Preg- 
 nancy, tumors, stricture of the bowel, old 
 age and drug habits are all causative factors. 
 
 Symptoms of constipation are headache, 
 loss of appetite, furred tongue, the absence 
 of an evacuation for several days. Nausea or 
 vomiting and diarrhcea following an interval 
 of constipation should lead one to suspect im- 
 paction and should be treated accordingly. 
 Piles, ulcers of the rectum and pelvic distress 
 are all caused or encouraged by constipation. 
 
 Treatment. — Attend regularly to the call 
 of nature at a set hour of the day and allow 
 nothing to postpone this obligation. If this 
 one vow is faithfully kept it is better than 
 many drugs in the treatment of the trouble. A 
 cup of cold water before retiring and one soon 
 after rising are of much service. Fruits, such 
 as prunes and figs, or fruits in general, are of 
 
36 MEDICAI, HANDBOOK. 
 
 much benefit to the habitually constipated, es- 
 pecially so if made part of the regular diet. 
 The coarser muscles and foods all have a lax- 
 ative action on the bowel. If the abdomen is 
 flabby a fifteen minutes' massage and the 
 wearing of an abdominal support will be of 
 much service, especially so in the case of the 
 aged. 
 
 A glycerine suppository or a simple enema 
 at a regular hour is to be recommended to es- 
 tablish a regular habit, but not continued when 
 the habit is formed. All of the many cathartics 
 will give relief for the time, but few, if any, 
 there are that do not constipate the more 
 firmly when their action ceases, leaving the 
 patient in a worse state than before. The 
 continued use of drugs aggravates a consti- 
 pated habit and their use is only a method of 
 temporizing and the confession of laziness on 
 the part of the habitually constipated. The 
 constipation of pregnancy should be relieved 
 by enema, of the aged by enema and massage 
 and the abdominal support ; that from torpor 
 of the liver or atony of the bowel, by taking 
 more regular exercise, the use of coarse mush 
 for breakfast, and to start up the liver : 
 
 IJ. Calomel 1 / lo grain. 
 
 Soda Bicarb., ...i grain. 
 
 Pill. 
 
 Take i pill every three hours for a day or 
 two. 
 
 Where there is impaction of the bowel it 
 
croup. 37 
 
 may be necessary to use the finger or the 
 small end of a spoon to remove a portion of 
 the hardened mass ; but, if possible, induce 
 the bowels to move by giving slowly an 
 enema of soap water ; do not stop until the 
 bowel is thoroughly empty. 
 
 CONSTIPATION IN INFANTS. 
 
 Constipation in infants is common, and 
 often the cause is hard to ascertain. It is 
 thought by some to be due to a lack of fat 
 in the food, and the supply of this in the form 
 of olive oil or any good fat is often suffi- 
 cient to relieve the trouble. Small supposi- 
 tories of cocoa butter or soap suppositories 
 are very effective to bring about a movement. 
 Soap water enemas are also very successful. 
 
 To move the bowels : 
 
 IJ, . Olive oil, Yz drachm. 
 
 Castor oil, Y* drachm. 
 
 Mix well and give one dose. Repeat this 
 every six hours until a movement is produced. 
 
 Cream may be added to the milk of bottle- 
 fed babies, or olive oil may be given with the 
 food of infants, which alone may be enough to 
 relieve the constipation. 
 
 CROUP. 
 
 Exposure to cold and damp and acute ca- 
 tarrhal conditions of the larynx may cause a 
 train of symptoms known as croup. 
 
38 MEDICAI, HANDBOOK. 
 
 Symptoms. — The symptoms of croup are 
 high temperature, hoarseness of the voice, and 
 a metallic cough, following exposure to cold 
 and damp; this may continue for a few days 
 and then pass off without more marked symp- 
 toms. The child may have been playing about 
 all day and have no more symptoms than a 
 slight cough. In the night, after a restless 
 period of sleep, the child suddenly springs up 
 in the bed and with a wild, frightened ap- 
 pearance clutches at its throat. The voice, 
 which was only hoarse during the day, is 
 now loud and harsh, the cough has a decided 
 metallic ring, which, when once heard, can 
 always be recognized in succeeding cases. The 
 nostrils are dilated. There is much effort in 
 breathing and the chest walls may be seen 
 heaving up and down as the child struggles 
 for breath. The face may be congested and 
 even bluish, the skin hot and the pulse tense 
 and rapid ; suffocation may seem near at hand. 
 The attack usually passes off in an hour or 
 two, and the child seems as well as usual the 
 following day. Usually an attack occurs on 
 the following night and is more severe than 
 the first. One attack predisposes to subse- 
 quent attacks throughout childhood. 
 
 Treatment. — From the time the child 
 shows hoarseness and a tendency to the 
 metallic ringing cough, which is a character- 
 istic of croup, he should be confined to the 
 house, in a warm room, where the atmosphere 
 
DIPHTHERIA. 39 
 
 is kept damp by steam. Give Wine of Ipecac, 
 4 drops at noon, again at 3 o'clock and again 
 at bed time. Should an attack of the croup 
 occur, give from 10 to 20 drops of the Wine 
 or Syrup of Ipecac, and, if necessary, give 
 even enough to cause vomiting, which will 
 usually dislodge the mucus from the throat 
 and give prompt relief. In addition to this, 
 place the child in an atmosphere of steam, the 
 temperature of the room being raised to 75 
 degrees F. Moist heat to the throat or hot 
 baths are also beneficial. 
 
 The succeeding treatment is to keep the 
 child in a warm room and give Ipecac in 
 small doses in the afternoon and evening for 
 a few days until all the symptoms disappear. 
 
 DIPHTHERIA. 
 
 Diphtheria is an acute contagious disease, 
 caused by a bacillus which attacks the mem- 
 brane of the throat. 
 
 The disease is more common during early 
 childhood than in later years, though no one 
 is immune. Diphtheria may be severe or mild ; 
 but if mild in one case it may be severe in 
 another. Pharyngitis or sore throat predis- 
 poses to diphtheria. There is a period of in- 
 cubation from two to ten days after exposure. 
 Diphtheria usually begins with chills, fever, 
 languor and sore throat. The child complains 
 of pain on swallowing. The muscles of the 
 
40 MEDICAL HANDBOOK. 
 
 neck are stiff. The glands under the jaw are 
 swollen and tender. The pulse is rapid and 
 weak. The fever is not regular and never 
 very high. There is a grayish-white mem- 
 brane found on the tonsils that extends around 
 the sides of the throat and up over the sides of 
 the soft palate. The posterior wall of the 
 throat may have patches or be covered with 
 the same membrane. The membrane of diph- 
 theria, when stripped off, leaves a raw and 
 bleeding surface. Which surface is soon cov- 
 ered again with the same kind of membrane. 
 
 The membrane of diphtheria may extend 
 into the larynx or indeed may begin there and 
 form what is commonly called membraneous 
 croup. 
 
 The symptoms of diphtheria of the larynx 
 or membraneous croup are the same as given 
 for diphtheria, with the addition of hoarse- 
 ness, croupy cough and difficult breathing. 
 
 Diphtheria lasts from a few days to two 
 weeks. 
 
 The danger from diphtheria seems to be 
 from the amount of poison secreted by the 
 germs and absorbed by the blood. 
 
 Following diphtheria there may be para- 
 lysis of the throat and swallowing becomes 
 very difficult for a long time. Drooping of 
 the eyelids, or squints, or cross-eye may re- 
 sult from the disease. Rarely the extremities 
 are paralyzed. 
 
 Treatment. — One suffering from diphtheria 
 
DIPHTHERIA. 41 
 
 should be isolated that others may not be in- 
 fected. Keep the patient quiet. Give good 
 nourishing food. Liquid food will be prefer- 
 able, such as eggs, milk, beef tea and gruels. 
 Whisky or brandy should be added to the 
 food as soon as the pulse weakens or becomes 
 soft. 
 
 The air of the room should be kept moist 
 by evaporating water over a spirit lamp, or, if 
 that is not to be had, over the stove. To the 
 water that is to be evaporated a little oil of 
 Turpentine or oil of Eucalyptus may well be 
 added. The cresoline lamp may be used. 
 
 The throat should be kept clean with some 
 antiseptic solution. Listerine diluted with 
 water, one to ten parts of water may be used. 
 Peroxide of Hydrogen may be employed pure 
 or dilute used on a mop to remove the mem- 
 brane and cleanse the walls of the throat. 
 
 Borax may be used as directed, for sore 
 mouth, as a mop to cleanse the throat and re- 
 move the membrane. 
 
 The germs in the membranes secrete a 
 poison, which, when it becomes abundant 
 enough, acts as a poison to the diphtheria 
 germ itself, and the bacillus dies poisoned 
 by its own toxine. The question is, will the 
 poison secreted by the diphtheria germ kill 
 the child or the germ first? If the child has 
 sufficient strength the germ will be the first 
 to perish. With this object in view Anti- 
 toxine is administered, that while the child 
 
42 MEDICAL HANDBOOK. 
 
 is yet strong by adding to the poison the diph- 
 theria germs are secreting, the same poison 
 obtained elsewhere, the two combined will de- 
 stroy the germs of diphtheria before the 
 child becomes so weak as to succumb itself. 
 Antitoxine is strongly to be advised early in 
 the disease, but not after the child is very 
 weak. 
 
 DROPSY. 
 
 Dropsy is the collection of more than the 
 normal amount of water in the tissues of the 
 body. Dropsy may affect the hands and feet, 
 the abdomen or the whole body. 
 
 The cause of dropsy may be found in the 
 circulation ; when the heart is weak, water es- 
 capes through the small blood vessels into the 
 tissues. In kidney disease the water is not 
 thrown off in sufficient quantities and is held 
 back in the system. Liver disease may cause 
 dropsy of the abdomen by obstructing the cir- 
 culation of the abdomen and causing the 
 watery elements of the blood to escape into 
 the abdomen, where the resistance is not as 
 great as it is to pass the liver. 
 
 Treatment. — It may be necessary to remove 
 some of the water to give comfort to th/e 
 patient. This may be done by sweat-baths in 
 the sweating cabinet or by purgation, remov- 
 ing much of the water by the bowels. To re- 
 
DIARRHOEA. 43 
 
 move dropsical effusions by purgation no pur- 
 gative is superior to Epsom Salts, y 2 ounce, 
 two or three times a day. The kidneys may 
 be called upon for extra work, if the dropsy is 
 not caused by the kidney. Cream of Tartar, 
 often found in the household, in 15 grain 
 doses repeated three times a day will often 
 assist in securing more work from the kid- 
 neys. Diuretin or other drugs prepared with 
 a view to act on the kidneys may be given. 
 Gin or the Spiritus Juniperi U. S. P. are both 
 valuable diuretics. One to 4 teaspoonfuls of 
 the gin, and ^ to 1 teaspoonful of the Juniper 
 Spirits may be given at a dose and repeated 
 every three hours. 
 
 It is important after doing something to re- 
 lieve the dropsical condition to do something 
 to remove the cause. Heart tonics are very 
 frequently called for to restore the circulation 
 to its normal condition. 
 
 DTARRH(EA. 
 
 Diarrhoea is a symptom of many diseased 
 conditions and is recognized by the passage of 
 frequent liquid or semi-liquid stools. It is a 
 symptom of many diseases at the time of their 
 onset, and a later symptom of other affections. 
 It may result from mental excitement or from 
 purgative drugs, a change in the temperature 
 
44 MEDICAL HANDBOOK. 
 
 or the ingestion of unwholesome food, such as 
 unripe fruit or dishes that are tainted by de- 
 composition. 
 
 The acute form of diarrhoea is nature's ef- 
 fort to throw off an offensive burden on the 
 digestive tract. Much undigested food in the 
 movements indicates that the trouble is in 
 the upper bowel, and much mucus points to 
 the lower bowel as the seat of trouble. 
 
 Treatment. — The food should be withheld 
 for a meal or two, and it is good practice to 
 give : 
 
 1$. Calomel, 3 grains, and an enema of 
 salt water. 
 
 If there is much undigested food the Calo- 
 mel alone may suffice ; but if the lower bowel 
 is affected and there is much mucus the 
 enema should also be given. After six or 
 eight hours, when the bowel is thoroughly 
 empty of its irritating contents : 
 
 JJ. Bismuth Subnitrate, 10 grains. Powder. 
 
 Give one powder every three hours until 
 four doses have been taken. Or 
 
 R. Laudanum, 10 drops, in water. 
 
 Give the Laudanum at intervals of three 
 hours, and if necessary give three or four of 
 the 10-drop doses ; but in no instance should 
 the Laudanum be given to babes or children, 
 as they are very susceptible to the drug. 
 
 A liquid diet of boiled milk is the best food 
 to be given until the bowels are back to their 
 
DIARRHOEA. 45 
 
 normal condition. On resuming solid food 
 avoid fruits. 
 
 DISCHARGES FROM THE BOWELS. 
 
 The bowel movements of a child at birth are 
 as a rule green. In a babe that is nursing the 
 movement is light yellow and soft. During 
 dentition the stools are apt to be frothy or 
 greenish as a result of disturbed digestion. 
 Some drugs color the stool. Much undigested 
 food in the bowel movement indicates that the 
 stomach and small intestines are not working 
 right. If there is much mucus in the move- 
 ments the trouble is in the lower bowel. Very 
 light colored movements indicate that there is 
 a lack of bile, and much dark coloring of the 
 faeces would lead one to think there is an ex- 
 cess of bile. Frothy or offensive movements* 
 indicate fermentive indigestion and irritation 
 of the small intestines. Flattened faeces indi- 
 cate some obstruction of the rectum usually 
 from pressure from surrounding structures. 
 Small stools may indicate stricture of the rec- 
 tum. 
 
DENTITION OR TEETHING. 
 
 "The teeth appear in the following order : 
 6th to 8th month, the two lower middle incisors ; 
 8th to ioth month, the four upper incisors ; 
 1 2th to 14th month, the two lateral lower in- 
 cisors, and the four first molars ; 18th to 20th 
 month, the four canines ; the 28th to 32d 
 month, the four second molars." — Rotch. 
 
 The appearance of the teeth is influenced 
 by the health of the child and is delayed by 
 rachitis. Much variation in the date of the 
 appearance of the teeth often occurs, with no 
 diseased condition of the child as an explana- 
 tion. Difficult teething may be accompanied 
 by convulsions. For the convulsions give the 
 child a hot bath and afterward remove the 
 cause by incising or lancing the gum above 
 the troublesome tooth. Disturbances of diges- 
 tion are very common during teething, possi- 
 bly influenced by the appearance of the teeth, 
 and in many cases simply due to improper 
 feeding and a lack of care as to what the child 
 bites on or chews at to press the gums upon. 
 Diarrhoea is the most common trouble, and 
 when of a foul, foetid odor should not be 
 stopped too soon, as the poisonous contents of 
 the bowel may be retained to the injury of the 
 child. If not dangerously severe the diar- 
 rhoea is not to be looked upon with alarm; 
 
DISTURBANCES OF DIGESTION. 47 
 
 often a thorough emptying of the bowel by a 
 dose of Castor oil, followed by from two to 
 four grains of Subnitrate of Bismuth, every 
 three hours, may stop the diarrhoea. The food 
 should be discontinued for six hours and when 
 resumed let it be of boiled milk, and for older 
 children brown flour gruel may be added to 
 the milk diet. Gradually go back to a mixed 
 diet. 
 
 DISTURBANCES OF DIGESTION. 
 
 Furring of the tongue is looked upon as a 
 sign of disturbed digestion. Low fevers and 
 general atonic conditions of the system are 
 generally accompanied by a furred tongue. A 
 gray-coated tongue which is flabby and coated 
 only on the edges is said to indicate gastric 
 or intestinal catarrh. Sleeping with the mouth 
 open will cause furring of the tongue. In some 
 forms of sore throat the tongue is furred. In 
 the malignant fevers the tongue is coated dark 
 brown to almost black and is often very dry. 
 A thick swollen tongue, showing the imprints 
 of the teeth and coated white, is seen in ab- 
 dominal affections and in appendicitis. 
 
 VOMITING. 
 
 In babes vomiting, unless prolonged, is not 
 of much consequence and may be due to rapid 
 
48 MEDICAI, HANDBOOK. 
 
 feeding or some slight gastric disturbance. If 
 there is vomiting associated with colic, with- 
 hold the food for a short time and give a dose 
 of Castor oil. Vomiting in older children and 
 adults may be due to nauseating food, tepid 
 drinks, worms, biliary colic and pregnancy. 
 Vomiting without previous nausea and which 
 expels the food as if thrown from the patient 
 is indicative of brain trouble and may follow 
 injuries to the head or accompany brain dis- 
 eases. 
 
 Treatment. — The treatment of vomiting is 
 rest of the stomach and occasionally mild 
 stimulants. The stimulants best given are hot 
 water or bits of ice, coffee, brandy and acid 
 drinks. 
 
 HICCOUGH. 
 
 Hiccough is, as a rule, of minor importance, 
 but to the weak and enfeebled it is often very 
 distressing and sometimes injurious. Hic- 
 cough is frequently caused by too rapid eating 
 of hot food, and in such cases a few sips of 
 water will usually suffice for a cure. When 
 associated with abdominal affections and low 
 forms of disease, it is no minor complication to 
 treat. For such cases allow the patient to 
 suck ice. A teaspoonful of salt in vinegar 
 makes a good solution to give for hiccough; 
 
coivic. 49 
 
 give small quantities, but do not repeat too 
 often. Morphine, %. grain for an adult, may be 
 required in some cases, and even small amounts 
 of Chloroform may have to be given. When 
 the patient is strong, if sips of water fail to 
 cure, have him hold his breath for a little 
 while, and if this fails have him tickle his nose 
 with something; the sneezing which follows 
 usually stops the hiccough. 
 
 COLIC. 
 
 Colic is usually a result of irritant food, of 
 flatulence, of faecal accumulations and of lead 
 poisonings. The symptoms are paroxysms of 
 twisting pain around the navel which is tern 
 porarily relieved by pressure, and permanently 
 relieved by the expulsion of the faeces or 
 flatus. In lead colic there are blue lines 
 around the teeth on the gums. Infantile colic 
 is usually a result of indigestion. 
 
 Tteatment. — To remove the cause it is 
 clear that the offending contents of the stom- 
 ach and bowels should be removed. In some 
 instances an emetic and in others a prompt 
 purge are the most advisable treatment. While 
 the purge is acting it may be necessary to 
 temporarily relieve the pain by a dose of Mor- 
 phine from Y% to % grain, or Laudanum, ten 
 to twenty drops. Do not give Laudanum or 
 Morphine to children for colic. One or two 
 
50 MKDICAI, HANDBOOK. 
 
 drops of the Oil of Peppermint, with or with- 
 out the same amount of Tr. Colocynthis, may 
 be given every fifteen minutes until relief is 
 experienced, or two or three doses have been 
 given. Heat or pressure to the abdomen is 
 very soothing and beneficial. For the colic of 
 babies, rest the stomach against the hot water 
 bottle and internally give hot Chamomile tea 
 or a few drops of hot brandy in hot water, or 
 a few drops of the Oil of Peppermint in hot 
 water, give about ~%. drop of Peppermint at a 
 dose for three or four doses. Give the child a 
 dose of Castor oil and guard the feeding that 
 the attack is not repeated. 
 
 Hot compresses wrung out of hot water, on 
 which a little Turpentine may be sprinkled, 
 often give prompt relief when applied to trie 
 abdomen. 
 
 DIGESTIVE SYSTEM. 
 
 DYSPEPSIA. 
 
 There are several varieties of dyspepsia. The 
 disease is common at all ages and in all cli- 
 mates. 
 
 Acute Dyspepsia. — The causes of acute dys- 
 pepsia if well understood will assist much in 
 the proper care of those suffering from the 
 same. Rapid eating, or eating more than the 
 
DYSPEPSIA. 5 1 
 
 digestion can care for, are common causes. 
 Foods that have undergone fermentative 
 changes, alcoholic drinks and mental and 
 physical exhaustion are also important in 
 causing dyspepsia. 
 
 Symptoms. — Coated tongue, fulness and dis- 
 tress in the abdomen, eructation or belching, 
 dizziness, nausea and often vomiting, flatu- 
 lence and colicky pains. In children fever and 
 diarrhoea are common. 
 
 Treatment. — Recovery usually occurs in 
 twenty-four hours, even if no medicine is 
 given ; but much can be done for the comfort 
 of the patient. If there is nausea or vomiting, 
 a glass of warm water will assist the stomach 
 to rid itself of the offending burden. For chil- 
 dren a dose of Castor oil should be given, and 
 adults should take some prompt cathartic. If 
 there is much acidity of the stomach : 
 
 If . Soda i teaspoonful. 
 
 Water Y / 2 cup. 
 
 Stir, and take two or three teaspoonfuls 
 and repeat in a short time if necessary, or 
 
 I£. Tincture of Nux vomica, i to 3 
 drops, taken on sugar. Sometimes, 
 
 Tfy. Quinine sulphate, 3 grs. 
 is given instead of the Nux vomica. 
 
 Food should be withheld for one or two 
 meals. The error in diet sought for and cor- 
 rected, and food selected that will not irritate 
 the stomach. 
 
ERYSIPELAS. 
 
 Erysipelas is an acute contagious disease. 
 After exposure the disease may develop in 
 from two to seven days. 
 
 Those suffering with erysipelas should be 
 careful not to infect others by the use of the 
 same towels, wash basins or any article that 
 touch or come in contact with those not in- 
 fected. No one should go from the room of 
 an erysipelas patient into the lying-in cham- 
 ber, as the mother is very apt to become in- 
 fected, and the most dire results follow. 
 
 The eruption of erysipelas is preceded by 
 slight constitutional disturbances ; languor, 
 chilliness and tingling of the affected part are 
 apt to be present. The pulse quickens. The 
 tongue is coated. The appetite lost and the 
 urine scant and high colored. 
 
 The eruption usually begins on the face, is 
 bright red, swollen. Tense and has sharply 
 defined edges. The surface is first smooth 
 and glossy; but later is covered with vesicles. 
 There is swelling of the surrounding parts. 
 The disease spreads from the edges. 
 
 Erysipelas seldom lasts longer than a week 
 or ten days, half of which time the disease re- 
 quires to fully develop, the other half to grad- 
 ually disappear. There is scaling of the af- 
 fected areas after recovery is well advanced. 
 
ECZEMA. 53 
 
 Relapses are common, and one attack predis- 
 poses to another. 
 
 Treatment. — Isolate the patient. Require 
 complete rest, give nourishing food, and some 
 tonic, such as Nux vomica, three tablets three 
 times a day, or five grains of Quinine three 
 times a day. Keep the bowels moving freely. 
 Antiseptic application may be applied to the 
 part, of which the Bichloride of Mercury 
 V4000 * s as £°°d as any. Iodine is at times 
 painted around the infected area with a hope 
 to stop the spreading. Lead Water and Laud- 
 anum may be used as an application. The 
 salve given as a healing salve may be spread 
 on lint and applied to the affected area. 
 
 ECZEMA, OR TETTER. 
 
 Eczema is not a contagious disease, but is 
 more a constitutional affection. Eczema is 
 characterized by papules, vesicles, pustules, 
 scales and crust. More or less watery dis- 
 charge and. continuous itching. 
 
 The causes of eczema are anything that 
 lowers the vitality. External irritants like 
 hard soap often provoke eczema among in- 
 fants and babes. Heat and cold may cause an 
 eczematous eruption. Dyspepsia may be an 
 exciting cause. In nursing babes or bottle-fed 
 infants eczema may result from improper con- 
 
54 MEDICAI, HANDBOOK. 
 
 stituents of the food. An infant suffering 
 from eczema as a result of improper diet will 
 usually show signs of indigestion, or be 
 chronically constipated. Where the food is at 
 fault there must be a change of diet before 
 remedies will act. 
 
 Eczema may be in irregular patches on the 
 face, or vesicle or papules on the extremities. 
 There may be poorly defined patches sur- 
 rounded by many vesicles that break and leave 
 a raw surface. There may be pustules that 
 rupture and form crusts. In the scalp there 
 are usually patches covered by crusts or scales. 
 
 Eczema has for the one and ever present 
 symptom itching, no matter if the eruption is 
 vesicular, pustular or crusting. No matter 
 where the location is the itching is always 
 present. 
 
 Treatment. — Improve the health. Avoid 
 salt meats, pickles, pastries, cheese. Irritant 
 soaps. Leave no part moist after washing and, 
 indeed, too frequent washing is to be avoided. 
 The digestion should be favored in every way. 
 The bowels kept moving regularly, and exer- 
 cise in the open air should be encouraged. 
 
 Bottle-fed babies should have a change of 
 food and if constipated see that more cream is 
 added to the milk or give a teaspoonful of 
 Olive oil twice a day with the milk that the 
 bowels be kept moving more freely. 
 
EARACHE. 55 
 
 For the itching: 
 
 J$ . Salicylic acid 5 grains. 
 
 Olive oil i ounce. 
 
 Shake well and rub on the itching surface. 
 Or, 
 
 ^. Carbolic acid i drachm. 
 
 Glycerine 2 drachms. 
 
 Water 8 ounces. 
 
 Shake well and bathe the itching surface. 
 Zinc oxide may be applied to the crusts or 
 itching parts and left as a covering or oint- 
 ment. It is well at times to remove the scales 
 and cleanse the parts. It is not necessary to 
 use water, as one of the above preparations 
 may be used to soften the scales and then by 
 carefully rubbing the part may be cleansed. 
 
 EARACHE. 
 
 Earache may be due to some foreign body in 
 the ear. To the accumulation of ear wax, and 
 to inflammation of the middle ear. 
 
 There is very often an abscess to open and 
 discharge. At times following exposure to 
 cold, severe earache may result without the 
 formation of any abscess or discharge. 
 
 The pain is intense and very fatiguing. 
 The child will all of a sudden start and scream 
 and be in intense agony. Presently the pain 
 will cease and sleep may follow, only to be 
 aroused again by the intense pain of another 
 
56 MEDICAL HANDBOOK. 
 
 paroxysm. Finally, if an abscess be present, 
 rupture will take place and permanent relief 
 be afforded. 
 
 Earache may last from one to two hours, to 
 one or two days. 
 
 Treatment. — Hot applications held to the 
 side of the head often give prompt relief. 
 
 Place a few drops of Chloroform on a little 
 cotton and place the cotton in the bowl of a 
 pipe. Blow the Chloroform into the ear 
 through the stem of the pipe. 
 
 In the same way blowing tobacco smoke 
 into the ear often gives relief. 
 
 Laudanum, Glycerine and Olive oil mixed 
 in equal parts may be dropped into the ear. 
 Drop a few drops into the ear and allow to 
 remain a short time and then let run out. 
 
 Middle ear disease is so serious an affection 
 that if repeated attacks of earache are 
 followed by an offensive discharge from the 
 ear the time for home remedies ceases and 
 medical attention is strongly to be advised. 
 
 CONJUNCTIVITIS, OR SORE EYES. 
 
 The eyes may become sore from several 
 causes. Infection of the mucous membrane of 
 the eyes with some of the pus forming germs 
 is common. Infants may suffer from a severe 
 form of sore eye contracted from a diseased 
 genital tract of the mother. 
 
CONJUNCTIVITIS. 57 
 
 Raw, cold wind of spring often acts as an 
 exciting cause, producing inflammation of the 
 conjunctiva or mucous membrane of the eye. 
 xA.ssociated with snow-blindness is always con- 
 junctivitis. Some of the deeper and more 
 serious affections of the eye have an accom- 
 panying inflammation of the conjunctiva. 
 
 The symptoms are watering of the eye. A 
 sensation of sand in the eye, pain and dread of 
 light. 
 
 Treatment. — Cleanliness is of prime im- 
 portance. Some antiseptic solution should be 
 dropped in the eye every three to six hours. 
 
 The Sulphate of Copper one per cent, solu- 
 tion, or one grain to one and a half teaspoon- 
 fuls of water, is a very safe and reliable reme- 
 dy, Drop a few drops in the eye three or four 
 times a day. 
 
 Boracic acid solution as much as the water 
 will absorb, is also a safe and reliable remedy. 
 Place a few drops in the eye four or five times 
 a day. 
 
 Keep the eye cleansed by bathing the lids 
 in warm soap water. And w r ash out the eye 
 at short intervals (every two hours) with the 
 Boric acid solution if there is pus or a puru- 
 lent discharge. 
 
FACE AND EYES. 
 
 The colors of the face vary in health. Nor- 
 mal darkening is found after exposure to the 
 wind and sun, and normal bleaching of color 
 after continued housing. A yellowness of the 
 white of the eye indicates jaundice before the 
 skin appears yellow. The white of the eye may 
 become quite red from the straining during a 
 paroxysm of whooping cough. Dark lines un- 
 der the eyes may indicate a disturbance of the 
 digestion, worms in children, a disturbance of 
 the sexual functions, and the result of late 
 hours and little sleep. Puffiness under the eyes 
 is met with in some forms of kidney disease 
 and from exposure to cold and wind, also 
 from crying and from sleeping long in a poorly 
 ventilated room. Yellow coloring of the 
 face may be due to jaundice, or, in a slight 
 degree, to biliousness. Waxy paleness of the 
 face is met with in consumption and almost all 
 of the constitutional diseases that are of a 
 chronic character. A bright red spot on one 
 of the cheeks over the cheek-bone is common 
 in advanced stages of consumption. This is 
 not the bright rosy flush so common in health 
 during youth and early adolescence. Flush- 
 ing of the face is met with in fevers. Transi- 
 tory flushes are common at the climacteric. 
 Blueness of the lips may be due to poor cir- 
 culation. 
 
COLD, FROST-BITE, CHILBLAIN. 
 
 On going into intense cold there is a sensa- 
 tion of obstructed breathing, as if the passages 
 of the nose were narrowed, simultaneously 
 also is a slight rawness and fulness of the 
 chest. Reaction in the nose soon follows, and 
 a watery discharge is very common as a result 
 of the hyperemia of the mucous membrane. 
 Slight cough and expectoration is noted in 
 some. The breathing then becomes free, and 
 remains so during the exposure to the cold. 
 Localities exposed to the cold at first tingle 
 and show a lack of blood. The setting of the 
 blood inward congests the brain and frontal 
 headache follows ; with the reaction and return 
 of blood to the parts the headache subsides and 
 a sense of faintness and nausea is often felt, 
 which again rapidly subsides as the circulation 
 becomes full and strong under the stimulating 
 influence of the cold. For a time all of the 
 natural powers combine to combat the inroads 
 of cold, and the individual is alert to every 
 pain and pang from without and within. 
 There may even be anxiety. Finally the head- 
 ache is again felt, there are chilly spells, one 
 part after another tingles from cold; finally 
 the tingling lessens and numbness and weight 
 of the limbs follow. The mind is prone to 
 reverie and to a sense of security; the cold 
 is noted, but the desire to ward it off is gone, 
 
60 MEDICAI, HANDBOOK. 
 
 and there is a strong desire to sit or recline 
 and allow the mind to continue its thoughts. 
 Drowsiness follows and an almost irresistible 
 desire comes to sleep, and at the same time the 
 sensation in the limbs is lost. The individual 
 may know that he is freezing, but the will is 
 too weak to rouse the body to action. Unless 
 aid soon comes to such a one death is immi- 
 nent. Nature has exhausted her vital power 
 and with the exhaustion the heart slows, and 
 so does the respiration, and life's fire goes 
 out. Those rescued, or even those suffering 
 from cold and returning to a warm place, must 
 observe care lest the congestion of the internal 
 organs be relieved too quickly, and fainting or 
 even death follow the setting of the blood to 
 the surface, caused by the return of the cir- 
 culation of the surface, leaving the heart, in- 
 ternal organs and brain with too little blood. 
 To stimulate the lungs and heart, and retain 
 part of the circulation in the internal organs, 
 nothing surpasses hot drinks, and of these hot 
 tea is to be given preference. 
 
 FROST-BITE. 
 
 The sensation of cold is followed by tingling 
 and aching of the part affected. Numbness 
 and a sense of weight is noted and then all 
 sensation is lost. On examination the part is 
 white, stiff and frozen. So insidious is the in- 
 road of cold that a frosted area may remain 
 frozen for hours and the individual have not 
 
FROST bite;. 6i 
 
 the slightest knowledge of cold, pain or dis- 
 comfort. The action of frost is, first, by direct 
 injury to the tissues, and second and more 
 noteworthy, the injury to the nerves that con- 
 trol the local circulation of the frosted area. 
 Rapid restoration to the normal temperature is 
 followed by inflammation, slough and gan- 
 grene. An individual with a frozen finger, toe 
 or extremity should first be taken into a room 
 that is scarcely above the freezing point, bund- 
 ling with clothing sufficient to keep the body 
 warm ; the frozen part should then be rubbed 
 with snow or immersed in ice water and gent- 
 ly rubbed while the frost is coming out. Gen- 
 tle friction is necessary as the circulation re- 
 turns ; the least engorgement and stasis of the 
 blood result in death of the part or gangrene. 
 For a short time after the frost is out the 
 rubbing should continue. After this first step 
 the patient may be put to bed in a cool room. 
 The frosted member should be elevated so that 
 the arterial circulation is retarded and the 
 venous circulation is assisted from the part by 
 gravity. The limb should be left in an elevated 
 position for several days, open to the air with 
 neither cover nor dressings. The room must 
 be kept cool (40 to 50 degrees F.). Allow the 
 patient plenty of bedding that the room need 
 not be kept warm. If the frost-bite has been 
 superficial cold compresses of Lead-water 
 and Laudanum will be soothing and assist in 
 preventing inflammation. If the deeper struct- 
 
62 MEDICAI, HANDBOOK. 
 
 ures have suffered from the cold, the Lead- 
 water and Laudanum should not be used, but 
 at intervals of two or three hours alcohol should 
 be applied to the part, using gentle friction to 
 stimulate the circulation. For two or three 
 days the appearance may be quite normal and 
 then, without apparent cause, suddenly the 
 part may become inflamed and swollen, and 
 later blacken and become dead and gangrene 
 set in. If slough or gangrene develops the in- 
 jured locality should be covered with a light 
 dressing for a few days until the line of de 
 markation is established between the part that 
 is going to recover and the part that is hope- 
 lessly injured. The nerves are slow to recover 
 after being frosted, and for this reason do not 
 control the capillary bloodvessels, allowing of 
 local congestion and distension. Above the in- 
 jury the normal veins are not sufficient to 
 carry away the excess of blood, and in the seat 
 of injury the veins are distended, through 
 walls of which exudation easily follows ana 
 restoration is retarded, finally ceases and gan- 
 grene ensues. The line of demarkation in 
 superficial injuries is back of that in the 
 deeper structures, making the stump of healthy 
 tissue convex; but where the injur}' has been 
 deep and of some hours' duration the reverse 
 of this condition is to be found and the stump 
 is concave. The bone least of all the tissue 
 regains its vitality. Operations to remove 
 frozen fingers, toes or extremities must be per- 
 
CHILBLAINS. 63 
 
 formed well back of the line of demarkation, 
 especially is this true of the bone, lest a sec- 
 ond operation be necessary before the desired 
 result is obtained. 
 
 Frosted tissues are low in vitality and henl- 
 ing may be retarded. Primary union cannot 
 be expected as often as in operations on more 
 healthy structures. 
 
 CHILBLAIN. 
 
 Parts that have been frosted or exposed to 
 cold for some time and then rapidly warmed 
 behave in a peculiar manner and thus claim 
 separate consideration. Hyperesthesia of the 
 affected area is the prominent feature of the 
 trouble. The injury is more of the nerves than 
 of the tissues. A rapid rise of temeprature in 
 the part, with or without previous exposure to 
 cold, may cause very annoying symptoms of 
 burning and itching, with reddening and more 
 or less swelling. Moist heat (the bath), the 
 heat of heavy clothing, and sudden changes 
 in the temperature are all causes that may 
 excite the sensation of burning and itch- 
 ing. The treatment of such cases should be 
 first directed to the prevention of rapid 
 changes of temperature of the part affected. 
 When local irritation is present the itching 
 and pain may be arrested by the application of 
 cold compresses wet with Lead-water and 
 Laudanum, or by painting the part with the 
 Fl. Ext. of Belladonna. Directing the treat- 
 
64 MEDICAI, HANDBOOK. 
 
 ment to the injured nerves, massage and the 
 use of astringent liniments are of value be- 
 tween the times of irritation. All parts that 
 have been frozen are sensitive to cold for some 
 time and should be given massage to restore 
 the functional activity of the vessels, nerves 
 and tissues of the part. 
 
 FRACTURES. 
 
 Fractures may be complete or incomplete, or 
 simple or compound. Fractures may be trans- 
 verse, longitudinal, or diagonal. In the elbow 
 we may have a fracture separating the bone 
 lengthwise. The shaft of any long bone may 
 break in a transverse or cross fracture, or the 
 break may be in a diagonal direction. 
 
 The symptoms of fracture are pain, more 
 than normal mobility, shortening of the limb, 
 and a peculiar grating of the ends of the bone 
 at the seat of the fracture. The muscles of the 
 body have a continual tendency to draw to- 
 gether and are like rubber bands pulling on 
 both sides of a bone. When fracture takes 
 place the lower fragment is drawn up and 
 made to override the upper fragments, causing 
 shortening. To set a limb it will be necessary 
 to overcome the contractility of the muscles 
 and replace the fragments, coapting them in 
 their normal position. The dressing should be 
 firm but not too tight. Where the joints are 
 involved it is always best to place the limb in 
 
FRACTURES. 65 
 
 such a position that should the joint be stiff 
 on healing the utility of the limb will be im- 
 paired as little as possible. Thus the elbow if 
 involved in a fracture should be dressed with a 
 splint of such an angle that the hand can be 
 brought to the opposite shoulder. The knee, 
 if injured, should be dressed in a slightly 
 flexed position, which will be better for walk- 
 ing and sitting than a straight limb. 
 
 Fractures of the arm are common and may 
 be of one or of both bones. If of one bone, 
 draw the hand and lower fragment toward the 
 side of the sound bone and slip the ends of the 
 bone in apposition. 
 
 If there is a break of one or both bones of the 
 forearm and the break is below the middle of 
 the arm the hand may be placed against the 
 abdomen and an internal angular splint ap- 
 plied, leaving the arm at right angles and us- 
 ing a splint that has a right angle and is band- 
 aged to the arm above the elbow. Use a wide 
 splint so as not to draw the fragments of the 
 bone against the other bone by the pressure on 
 the sides of the arm. If the fracture is of the 
 upper part of the forearm, it may be necessary 
 to bandage the arm to a splint with the palm 
 of the hand up. This is occasioned when the 
 bone on the thumb side of the arm is broken 
 well to the upper end. 
 
 In breaks of the thigh it is necessary to 
 overcome the action of the muscles, and the 
 
66 MKDICAI, HANDBOOK. 
 
 thigh in particular is hard to deal with because 
 of the powerful muscles involved. For this a 
 double incline plane or a V-shaped splint should 
 be used ; the weight of the body will draw down 
 while the knee is over the angle of the splint 
 and some of the action of the muscles will be 
 overcome. In fractures of the leg the position 
 of the foot is to be borne in mind. Keep the 
 toes pointing directly up. Shortening will re- 
 sult from most fractures, but no one will for- 
 give you if the toe points in or out. 
 
 If a fractured bone breaks through the mus- 
 cles and skin, the danger is greatly increased 
 lest infection follow and serious trouble arise. 
 If such should occur use the most rigid anti- 
 septic measures in cleansing and dressing the 
 wound. Apply such a splint and dressing that, 
 if need be, the wound can be attended to or re- 
 dressed without removing the splint. 
 
 Remember, a shortened limb, if in the nor- 
 mal position, is a useful limb; that a stiff joint 
 is best if slightly bent; and that a compound 
 fracture demands extra care and cleanliness. 
 
FAINTING AND LOSS OF 
 CONSCIOUSNESS. 
 
 Dizziness and fainting are common symp- 
 toms and not diseases, due to anaemia of the 
 brain or want of blood in the brain. If the cir- 
 culation be drawn elsewhere, leaving the brain 
 deficient in blood supply, the functions of the 
 brain cannot be performed and the resulting 
 symptoms are dimming of vision, nausea, dizzi- 
 ness, intense weakness and finally fainting or 
 loss of consciousness. Besides a weak heart, 
 fear and emotional excitement may cause the 
 circulation to go elsewhere than to the head 
 and fainting results, even if the heart is strong. 
 
 Treatment. — Nature acts wisely by causing 
 a person that faints to become unconscious and 
 fall. In the erect position the blood gravitates 
 from the head and a weak heart cannot send 
 the blood to the head ; for this reason the posi- 
 tion for one who feels faint or has fainted is 
 not standing or sitting, but lying with, per- 
 haps, the head slightly lower than the body. 
 Undo the clothing about the neck and chest 
 that the breathing and circulation may be un- 
 hampered. Some stimulating drug may be in- 
 haled that, by acting on the nerves in a reflex 
 manner, it will stimulate the heart to stronger 
 action. The Aromatic Spirits of Ammonia is 
 
68 MEDICAL HANDBOOK. 
 
 one of the best stimulants of this kind. Heart 
 tonics, such as brandy or Strychnine, may be 
 used in medicinal doses. 
 
 Coma, or unconsciousness, may be caused by 
 injuries to the head, epilepsy, apoplexy, sun- 
 stroke, drug-poisoning and uraemia or kidney 
 disease. In coma there may be no lack of 
 blood to the brain. Consciousness does not 
 speedily return as it does in fainting. 
 
 The cause should be removed if possible in 
 treating cases of coma. 
 
 NORMAL HEART ACTION. 
 
 The normal pulse of an infant at birth Is 
 from 130 to 140 per minute; about the third 
 year, 90 or 100; and the fourteenth year, 80 or 
 85. The normal adult pulse is usually given as 
 72 per minute, but in the old the heart slows to 
 65 or even 60. There is quite a range between 
 the normal pulse of different persons ; thus 70 
 may be normal for one and 80 for another. 
 The pulse of women is normally about ten 
 beats quicker than that of men. The standing 
 position will raise the pulse ten or more beais 
 per minute and active exercise will take it to 
 100 or even more in the normal adult. The 
 pulse is increased by fevers, corresponding to 
 the height of the fever. A quick, hard pulse 
 indicates more the infectious fevers, and a 
 quick, full and bounding pulse accompanies in- 
 
HEART DISEASE. 69 
 
 flammation, and the febrile state of low dis- 
 ease, where there is absorption of poisonous 
 disease products. A changeable pulse is met 
 with in tobacco users and those suffering from 
 nervous disorders. A slow pulse is common 
 with fainting, brain diseases that are febrile, 
 and tumors of, on injury to the brain, A fine, a 
 scarcely perceptible, pulse is common as death 
 approaches. 
 
 HEART DISEASE. 
 
 In speaking of the diseases of the heart we 
 would divide them into two classes : First, 
 those affecting the heart itself, and second 
 those disorders that have symptoms referable 
 to the heart, but in which the heart is not the 
 seat of the disease, but is only affected through 
 the nervous system. 
 
 ORGANIC HEART TROUBLE. 
 
 Causes. — Pneumonia and rheumatism more 
 often than any other diseases cause valvular 
 disease of the heart. Other affections such as 
 typhoid fever or scarlet fever, etc., play a 
 minor role in causing this trouble. 
 
 7ne disease seldom exists except as a result 
 of some other affection. The poison, or the 
 germs themselves, of some disease acting on 
 the inner walls of the heart and its valves pro- 
 
70 MEDICAX, HANDBOOK. 
 
 duce inflammatory changes, which on healing 
 obstruct the openings of the heart, or the free 
 action of its valves. 
 
 Symptoms. — The symptoms of inflammation 
 of the inner heart walls are vague and often 
 not noticed at the time of the sickness that 
 causes the injury to the heart. After rheuma- 
 tism, pneumonia, typhoid fever or any of the 
 infectious diseases endocarditis may exist. 
 Shortness of breath on exertion and conscious- 
 ness of the heart's action should lead you to 
 suspect some involvement of the heart. If 
 such exists, care should be exercised that the 
 heart is not strained in any way until time has 
 been given it to recover, or for compensation to 
 take place. When the valves become deranged 
 the normal heart work is obstructed and a train 
 of symptoms are produced. The blood is 
 dammed back into the lungs and shortness of 
 breath ensues, cough, expectoration and even 
 blood-spitting may result, caused by the en- 
 gorgement of the lungs. Headache and dizzi- 
 ness may be caused by a lack of blood to the 
 head. Dropsy may be present and is most 
 likely to be noticed on the feet or ankles first, 
 the urine becomes scanty and high-colored, 
 and the digestion badly imparled, i. e., there 
 will be dyspeptic symptoms. 
 
 Treatment. — The first object to be sought 
 is the repair of the heart, and this must be 
 done by nature herself and the patient must 
 
HEART DISEASE. 7 1 
 
 not hinder this very important process. Avoid 
 over-exertion, such as running up stairs, heavy 
 lifting or straining caused by allowing the 
 bowels to become constipated. The patient 
 should have plenty of fresh air and sunshine. 
 Good easily digested food and lastly medicine. 
 
 There is probably no drug better than 
 
 J^. Tincture Strophanthus. One drop in 
 water, or one tablet three times a day. 
 
 Strophanthus acts on the heart, stimulating 
 the muscle itself, and is beneficial in assisting 
 the heart to gain strength. Acting on the gen- 
 eral circulation it assists much in relieving the 
 distress of the various organs secondarily af- 
 fected from an improper blood supply. 
 
 Ranking with Strophanthus and, in fact, an 
 older drug known and used for this same 
 trouble is Digitalis, which drug may be chosen 
 over the former in cases where the heart's 
 action is rapid and weak, and the urine scanty 
 and high colored. 
 
 1^. Tr. Digitalis, three drops. Give on 
 sugar, three times a day. 
 
 I prefer to give the Digitalis for only a short 
 period, say, one week, and then turn to the 
 Strophanthus. As symptoms subside stop the 
 drugs. 
 
HEADACHE. 
 
 Headache is a symptom of many affections 
 and by itself can hardly be successfully treated. 
 Pain in the head usually results from some dis- 
 turbance of the circulation to the head, from 
 tumors of the brain, from inflammatory dis- 
 eases of the brain or its meninges, and last, 
 but not least, from reflex nervous irritation, of 
 causes acting in distant parts of the body, as 
 disturbances of digestion, eye strain, nasal 
 catarrh, and disturbances of the reproductive 
 functions or organs. 
 
 Headache due to meningitis, tumor, abscess, 
 and diseases of brain substances are usually 
 associated with disturbances of vision, paraly- 
 sis and mental aberrations. 
 
 Headache due to congestion of the brain, as 
 in fevers, sun-stroke, over mental work and 
 obstruction of the return circulation of blood 
 from the brain, have, as symptoms, pain in the 
 head of an intense throbbing nature. The face 
 is hot and flushed, the eyes glossy and injected, 
 and the pain is made worse by excitement, 
 motion or stooping. There may be a headache 
 from want of blood to the brain caused by poor 
 circulation, which will be associated with 
 signs of poor circulation, such as cold ex- 
 tremities and fainting spells. A headache 
 caused by lack of blood to the brain will be as 
 
HEADACHE. 73 
 
 of a weight on the head; the face pale, the 
 pulse weak, and the inhaling of stimulating 
 drugs or the lowering of the head will be at- 
 tended with relief of pain in the head. 
 
 Headache may result from poisons in the 
 blood, from ursemic conditions and any state 
 where, from disease, there is a product that 
 should be thrown off by the system, but for 
 some reason is retained and absorbed by the 
 blood. Irritating the head and producing 
 headache, as by irritating the nerves of the 
 body, the poison may produce rheumatic 
 pains. 
 
 Headache still may be and more often is 
 produced by reflex nervous irritation than by 
 any other cause. Disturbances of digestion in 
 a reflex manner excite more headaches than 
 any other given thing. Where the digestion 
 is at fault the headache will be relieved by 
 vomiting or the administration of something 
 to stimulate the action of the stomach and 
 bowels. 
 
 Diseases of the female reproductive organs 
 may cause headache, which is worse at the 
 time of the menses. The headache of disturb- 
 ances peculiar to women will be worse on top 
 of the head. There is a feeling as if the top 
 of the head would fly off and pain is relieved 
 by pressure. 
 
 Treatment. — If the headache is due to re- 
 flex causes, such as indigestion, give Tr. Nux 
 vomica, three drops, or three tablets, for two 
 
74 M3DICAI, HANDBOOK. 
 
 or three doses. There is often very prompt 
 relief from the headache of indigestion if the 
 stomach is relieved by an emetic. A prompt 
 acting purge will often do wonders by ridding 
 the stomach and bowels of an unwelcome 
 burden. 
 
 If the headache is due to congestion of the 
 brain, cold applications to the head and a hot 
 foot bath will aid materially in the relief of 
 the pain. 
 
 If the circulation is poor and the headache 
 is due to want of blood to the brain, stimulat- 
 ing smelling salts and hot drinks or heart 
 tonics will aid materially in giving relief. 
 
 If the eyes are at fault, secure proper 
 glasses. 
 
 No treatment will afford permanent relief 
 unless it be directed at the original cause. 
 Headache powders are numerous, but are only 
 a poor excuse at treatment and will not result 
 in a cure. 
 
 HIVES, OR URTICARIA. 
 
 Hives are usually caused by gastrointesti- 
 nal disorders. Emotion and excitement pre- 
 dispose to hives. Certain foods are apt to 
 cause an eruption of wheals or hives on some 
 persons, while on others the same food may 
 cause no disturbance. 
 
 Hives appear suddenly and are as small red 
 
HEMORRHOIDS, OR PII.KS. 75 
 
 pimples, which are slightly elevated and itch 
 intensely. 
 
 Treatment. — If due to indigestion give a 
 prompt acting purge and some tonic, such as 
 Nux vomica 6, one to two tables every four 
 hours. If the stomach is acid to such an ex- 
 tent as to produce sour belching or heartburn, 
 give Soda Bicarbonate, three grains after 
 meals. Internally the Salicylate of Soda in 
 four grain doses may be given three times a 
 day. 
 
 Locally, the itching may be relieved by 
 bathing the itching areas with 
 
 Jfy. Acid Carbolic, . .y 2 drachm. 
 
 Glycerine, ^ ounce. 
 
 Alcohol, 
 
 Water, aa, 4 ounces. 
 
 Shake well and bathe the itching surface. 
 
 The itching of hives may often be relieved 
 by bathing the surface with vinegar and water 
 in equal parts. 
 
 Chloroform and Alcohol, one part of the 
 former to eight parts of Alcohol, make a very 
 good soothing application. 
 
 HEMORRHOIDS, OR PILES. 
 
 Haemorrhoids, or piles, are bloody tumors 
 of the lower end of the rectum. Piles are 
 composed of dilated veins. The veins of the 
 rectum have no valves as have the veins in 
 other parts of the body, and anything that ob- 
 
76 MKDICAI, HANDBOOK. 
 
 structs the refiow of blood predisposes to 
 haemorrhoids. Pregnancy, sedentary habits, 
 the excessive use of purgatives and constipa- 
 tion are all common causes. Haemorrhoids 
 may be internal or external. External piles 
 are due to a varicose condition of the external 
 haemorrhoidal veins, and are bluish rounded 
 tumors, which can easily be emptied by press- 
 ure. Fissues and eczema of the surrounding 
 skin are not uncommon with external piles. 
 The haemorrhoids, when inflamed, are ex- 
 tremely painful to the touch. They seldom 
 bleed, though occasionally they suppurate and 
 form an abscess. Itching of the parts is com- 
 mon. 
 
 Treatment. — Whatever that causes the ob- 
 struction of the refiow of blood when remov- 
 ed will open the way for medical and surgical 
 treatment. Constipation should be avoided. 
 The parts kept clean. Hot sponging will often 
 relieve the itching and pain. Astringent pile 
 salve may help to reduce the swelling and 
 pain. Tr. Belladonna and Glycerine may be 
 mixed in equal proportions and painted on the 
 piles, after which hot applications will assist 
 in relieving the pain. The operative treatment 
 gives rapid relief and permanent recovery. 
 Incision and emptying the clot, followed by 
 packing the cavity with gauze to control bleed- 
 ing, is the best treatment. If there is a large 
 haemorrhoidal mass excision of the entire mass 
 or bloody tumors is the only sure form of re- 
 lief. 
 
HEMORRHOIDS, OR PILKS. 77 
 
 INTERNAL PILES. 
 
 Internal piles are found within the rec- 
 tum. The appearance is the same as an ex- 
 ternal pile, only the tumor is covered with 
 mucous membrane. The pile may also seem 
 like a fold of the mucous membrane of the 
 rectum. Internal piles are easily excited to 
 bleeding by the irritation of the bowel move- 
 ment. At first the bleeding only follows the 
 passage of stool. Later in the course of time 
 the bleeding may precede as well as follow 
 the stool and may become a prolonged and 
 troublesome condition. During defecation 
 there is pain in the rectum and the pil»e 
 mass easily protrudes through the sphincter 
 ani, and if large may become strangulated 
 and very painful and if not reduced slough 
 away. 
 
 Treatment. — Constipation must be avoid- 
 ed by the use of laxatives and the regular 
 movement of the bowels. Ensemas are very 
 beneficial in some cases. After each stool 
 the patient should wash the pile or pile mass 
 and anoint them with an astringent oint- 
 ment one time and the next time by some 
 bland ointment ; after anointing the pile re- 
 place in the rectum. Vaseline is good for 
 the simple ointment, and Hamamelis and 
 ^sculus cerate mixed in equal parts is a 
 splendid astringent ointment for the alternate 
 application. 
 
78 MEDICAI, HANDBOOK. 
 
 Operative treatment or the removal of the 
 mass is the surest cure, but is only to be 
 done by the surgeon. 
 
 ITCH OR SCABIES. 
 
 The itch is due to the presence of an 
 animal parasite called the itch mite. The 
 itch is always acquired by contact in some 
 way with some one who has the itch. 
 
 The male itch mite remains on the surface 
 of the skin and may be seen by the use of 
 a strong magnifying glass- The female bur- 
 rows into the skin and lays her eggs, caus- 
 ing the intense itching and the formation 
 of vesicles and pustules. 
 
 The symptoms are intense itching asso- 
 ciated with the eruption of small papules, 
 vesicles and pustules. The itching is worse 
 at night when warm in bed. The parts first 
 affected are the hands between the fingers, 
 the« the wrists, then the genitalia, the inner 
 surface of the thighs and the chest beneath 
 the mamma. All of the body may become 
 involved except the face, which remains free. 
 
 Treatment. — The destruction of the para- 
 site is the only hope of a cure. There is 
 no seven-year itch, but a case may last that 
 long or longer unless treated. When the 
 parasite is dead the disease is cured, be the 
 time short or long. 
 
 Either of the following applications will 
 cure: 
 
INFLUENZA OR GRIPPE. 79 
 
 J^. Orphol or Beta Naphtol Bismuth, Y-z 
 drachm. Lard or Vaseline, i ounce. Mix 
 well and rub in well morning and evening. 
 
 IJ. Sulphur Praecipitate, i to 2 drachms. 
 Lard or Vaseline, i ounce. Mix and rub in 
 well morning and evening. 
 
 The patient should have a hot bath, with 
 soap and the ointment applied thoroughly. 
 Rub in the ointment well morning and even- 
 ing. Do not change the clothing or take a 
 bath for a week. At the end of a week take 
 a good bath, and if the disease is not cured 
 repeat the treatment. When the mites are all 
 dead the disease is cured. 
 
 INFLUENZA OR GRIPPE. 
 
 Influenza is an acute infectious disease, 
 characterized by catarrh of the respiratory 
 organs, pain in the head, back and limbs, 
 catarrh of the stomach and bowels and by 
 extreme prostration. The disease often ap- 
 pears in epidemics. Influenza does not often 
 kill of itself, but accompanying other dis- 
 eases it proves itself to be very serious and 
 often fatal. The disease may attack the 
 respiratory organs, causing sneezing, water- 
 ing of the eyes and nose, hoarseness and 
 cough. If the muscles and limbs are at- 
 
80 MEDICAI, HANDBOOK. 
 
 tacked there will be pain in the back of the 
 head and pain in the back and limbs, causing 
 intense discomfort and prostration. The di- 
 gestive tract is often the center of the trou- 
 ble. If this be true there will be colicky pain 
 in the stomach and bowels. Nausea and loss 
 of appetite. Indigestion after eating and 
 colicky pains. Diarrhoea will also be a com- 
 mon symptom. 
 
 The grippe usually begins in an abrupt man- 
 ner, with languor, pain in the head and back 
 and slight fever. Soon the respiratory 
 organs, the stomach and bowels or the nerves, 
 muscles or joints may one or all become much 
 affected. Complications with lung diseases, 
 kidney affections and intestinal disorders are 
 all to be regarded as unfavorable and are to 
 receive what care they may demand. 
 
 Treatment. — There is no specific for the 
 grippe or influenza. Rest in bed is to be en- 
 forced. Hot water bottles to the aching 
 localities will afford some relief. The food 
 should be liquid and such as may easily be 
 digested. Milk, eggnog and beef tea are all 
 of much service. Keep up 'the strength of 
 the patient. 
 
 Such remedies as Aconite, Gfelsemium, 
 Belladonna and Ipecac may be given as the 
 stage of the disease or symptoms may de- 
 mand. Stimulants or tonics are beneficial. 
 
JAUNDICE. 
 
 Jaundice, or yellow coloring of the skin, 
 is not a disease of itself, but a symptom of 
 some deeper acting condition. 
 
 Before ever the skin becomes yellowed the 
 coloring is to be seen in the eye. 
 
 The cause is generally an obstructive one, 
 to the outlet of the bile from the liver. 
 Biliary calculi may become clogged in the 
 common bile duct, and be the cause of the 
 jaundiced condition, for if the bile cannot be 
 thrown off it will be absorbed and carried 
 over the system by the blood and deposited 
 in the tissues. The skin and eyes give evi- 
 dence of the saturation of the body wjith 
 bile. 
 
 Catarrhal conditions of the stomach and 
 small intestines may be considered by far 
 the most common cause of jaundice. The 
 catarrh extending up the common bile duct 
 obstructs the flow of bile and the same train 
 of symptoms is produced as when a calculi 
 occludes the passage of the bile. There is 
 generally constipation, and the movements 
 are attended with much straining and the 
 passage of a clay colored stool and mucus. 
 The skin is dry and scaly. The urine high 
 colored and froths on being passed into a 
 recepticle. 
 
 6 
 
82 MKDICAI, HANDBOOK. 
 
 Treatment. — Since there is obstruction to 
 the flow of bile it is quite reasonable to re- 
 frain from eating food that will excite the 
 liver to action and require the action of the 
 bile to be digested. Sugars, fats and starches 
 should be avoided, and the patient put on 
 lean meat, eggs, toasts and tea or milk. If 
 constipation be present a dose of castor oil 
 should be given and the bowels be kept open. 
 Small doses of Bismuth Subnitrate, given 
 two hours after meals, are often of service. 
 From I to 3 drops of the Tr. Nux vomica 
 after meals, is also a good tonic. When the 
 inflammation subsides the bile will escape 
 and the jaundice disappear. 
 
 PREGNANCY. 
 
 Normal pregnancy lasts 280 days, 40 weeks 
 or a little more than 9 calendar months. 
 Quickening occurs about the 16 or 18th week. 
 
 The signs of pregnancy are the absence of 
 the flow, darkening of the zone around the 
 nipple, bluish discoloration of the genital 
 mucous membrane, enlargement and finally 
 quickening. 
 
 It is important that the health of the moth- 
 er be sustained from the very incipiency of 
 pregnancy. The clothing should be warm 
 
PREGNANCY. 83 
 
 and free about the waist and abdomen. Lac- 
 ing to hide the increasing tumor is a bad 
 practice. The food should be such as is easily 
 digested. All the products of the frying pan 
 and rich pastries are objectionable. There 
 is a tendency in the later months of preg- 
 nancy to constipation, which should be com- 
 bated by eating fruits, prunes being one of 
 the best. Oat mush is also a good diet. 
 Enemata may be required to keep the bowel 
 properly emptied. Daily exercise in the open 
 air is highly advisable. Hot and over-crowd- 
 ed places should be avoided. 
 
 MORNING SICKNESS. 
 
 There is no regularity in the degree or 
 frequency of morning sickness. The cause 
 is doubtless reflex nervous phenomena from 
 the gravid uterus. When the uterus rises out 
 of the abdominal cavity, and has more room, 
 the morning sickness becomes less severe. 
 The patient should not be allowed to miss 
 the breakfast, and, if from rising sickness oc- 
 curs, it is best to give a cup of coffee made 
 after the directions in this book and some 
 light food, and later in the forenoon she may 
 get out of bed. 
 
 FALLING. 
 
 About the end of the thirty-ninth week the 
 breathing becomes more free and the appe- 
 
84 MEDICAI, HANDBOOK. 
 
 tite is better, though frequent urination may 
 disturb the rest of the patient and constipa- 
 tion be quite marked- This condition pre- 
 cedes labor about a week. If there is a varia- 
 tion it is less and not more than a week until 
 labor. 
 
 MISCARRIAGE. 
 
 Pregnancy may be interrupted at any stage 
 or date of gestation. Before the end of the 
 third month such interruption is called a mis- 
 carriage. The symptoms are little more than 
 a severe prolonged menstruation. Miscar- 
 riage is apt to occur at either the eighth or 
 twelfth week of gestation. The patient should 
 go to bed when miscarriage is threatened and 
 there is pain in the back and abdomen. Mis- 
 carriage should be prevented if possible by 
 quiet and by rest during the eighth and 
 twelfth week, for when once the habit of 
 miscarriage is established there may be much 
 trouble to advance pregnancy beyond that 
 date. It is better for the mother to go on 
 to full term than to suffer miscarriage or 
 abortion. 
 
 ABORTION. 
 
 After the third month, and before the 
 seventh month, if . the uterus spontaneously 
 empties itself the condition is termed abor- 
 tion. Abortion is a more grave condition to 
 
PREGNANCY. 85 
 
 handle than labor. Usually there is a period 
 of heaviness in the abdomen and pain in the 
 back preceding the expulsion of the ovum. 
 If abortion is threatened the mother should 
 be put to bed and the bowels moved by an 
 enema, for often disturbances of the intes- 
 tines produce irritation of the uterus. A mild 
 purge may be given, such as 1 / 10 grain 
 of Calomel hourly, for 5 to 6 doses. The 
 same cleanliness required to be observed in 
 labor is indicated in the care of abortion. 
 
 Rest in bed is strongly to be enjoined. Do 
 not encourage the uterine pains in any way, 
 for nature wishes time to render the separa- 
 tion of the placenta less dangerous. Rapid 
 delivery of abortion cases is very apt to be 
 attended with profuse bleeding. 
 
 In abortion cases the breasts may make 
 some trouble. If enlarged they should be 
 bandaged firmly and internally, 1 / roo grain of 
 Atropine may be given for 4 to 5 doses six 
 hours apart. 
 
 LABOR. 
 
 The infant becomes viable after the seventh 
 month, and the delivery after that date is 
 called premature labor until at full term, 
 when the denomination of premature labor 
 is superfluous. 
 
 Labor at the seventh or eighth month is 
 less desirable than at full term, but the con- 
 
86 MKDICAL. HANDBOOK. 
 
 ditions and procedures are the same as at 
 full term, only there is more danger that the 
 placenta will make trouble by being slow of 
 delivery than at full term. 
 
 When labor is expected it is well to move 
 the bowels and empty the bladder that these 
 organs do not obstruct the passage of the 
 child. There may be a discharge of bloody 
 mucus called a show, which is very suggestive 
 of oncoming labor. 
 
 True labor pains generally begin in the 
 back and extend around the abdomen. 
 
 FIRST STAGE OF LABOR. 
 
 While the uterus is being dilated and the 
 pains are severe, but not of a bearing down 
 character, the period of time thus consumed 
 is termed the first stage of labor. The time 
 required to dilate the opening of the womb 
 varies greatly. From a very short while to 
 6 or 8 hours or even more. The pains are 
 at first cramp-like and not very frequent. 
 Later they become more frequent and more 
 intense. The patient need not be put to bed 
 during this stage, and may with much benefit 
 take hot sitz baths. Allow the woman to 
 walk around the room and to sit in a tub of 
 hot water when she likes. The hot water is 
 soothing and tends to relax the outlet, mak- 
 ing the second stage of labor easier. Hot 
 milk and beef tea may be given to keep up 
 
PREGNANCY. 87 
 
 the woman's strength. When the membranes 
 rupture and the waters come away or the 
 pains assume a bearing down character it is 
 time for the patient to go to bed. 
 
 SECOND STAGE OF LABOR. 
 
 From the time the pains assume an ex- 
 pelling character until the expulsion of the 
 infant the labor is said to be in the second 
 stage. The position for delivery is prefer- 
 ably on the left side, with the buttox near 
 the edge of the bed. It is not necessary for 
 the woman to lie on the left side during the 
 second stage of labor, but to turn on the left 
 side before delivery. 
 
 If the second stage is protracted and the 
 pains seem to have little effect remember that 
 in two ways this is the best. First, the out- 
 let is given time to dilate and tearing is not 
 near so apt to occur, and, second, the con- 
 dition of the uterus will be better for the 
 prompt expulsion of the placenta in the last 
 stage of labor. 
 
 An assistant may place one hand on the 
 abdomen and another hand on the small of 
 the back. and materially assist and relieve the 
 efforts of the mother. The mother will often 
 do better if she may hold some one's hands 
 or have something to pull on. 
 
 The second stage of labor is usually much 
 shorter than the first. When the pains are 
 
88 MEDICAL HANDBOOK. 
 
 producing the final results and the uterus is 
 contracting after the child the hand of an as- 
 sistant should follow and hold the uterus 
 until the placenta is delivered. 
 
 THIRD STAGE OF LABOR. 
 
 Following the expulsion of the infant there 
 is apt to be a short period of rest for the 
 mother, and she may sleep. The hand of 
 the assistant must not lose the uterus dur- 
 ing this time, and if there is any tendency for 
 the womb to get large the hand should knead 
 or rub the uterus through the abdominal walls, 
 and if this does not suffice to produce a con- 
 traction of the womb cold water may be ap- 
 plied with the hand to the abdomen while 
 kneading is continued. The third stage lasts 
 until the placenta is delivered, but the hold- 
 ing of the womb through the abdomen and 
 the kneading to keep the uterus hard is not 
 to cease until an hour has elapsed after labor. 
 This precaution to prevent flooding should 
 not be neglected under any circumstances or 
 in no case. 
 
 When the placenta is delivered some one 
 should grasp it gently and roll the mass over 
 and over, and by gentle traction withdraw 
 the membranes. Use no force, for if the 
 membranes are broken and remain they may 
 cause after pains or become offensive and 
 most objectionable. 
 
PREGNANCY. 89 
 
 FLOODING. 
 
 Should the expulsion of much blood and 
 rapid sinking of the patient occur give a hot 
 injection of boiled water; give as hot as can 
 be borne and not burn the mother. Powdered 
 Alum may be added to the water, 1 teaspoon- 
 ful to the pint. Hot compresses may be ap- 
 plied to the abdomen. Do not burn, but 
 make them as hot as can be borne. Keep 
 on kneading the uterus. Smelling salts and 
 brandy may be given the mother. Flooding 
 is not the rule and an accident that will sel- 
 dom occur if the uterus has been watched and 
 kneading after the expulsion of the placenta. 
 
 THE CHILD. 
 
 There should be some saturated Boracic 
 Acid solution ready to wash the eyes and 
 mouth and nose with. The eye should be 
 washed out lest some of the discharges of 
 the genital canal may have entered the eye 
 and set up sore eyes that may be very hard 
 to treat. The mouth and nose may be 
 cleansed with gauze from the same solution, 
 but the solution is immaterial. Simply wash 
 the eyes first and then with the same or 
 another sponge cleanse the nose and mouth. 
 
 The child should be placed on the right 
 side as soon as born, and for the first few 
 days following birth, that the heart may be 
 
90 MKDICAI, HANDBOOK. 
 
 given a chance to become strong. Always 
 follow this rule, for the child's heart at birth 
 undergoes changes which this position will 
 assist. The severing of the cord should be 
 done as soon as the cord ceases to pulsate. 
 Tie the cord about I inch from the abdomen. 
 Tie firmly with a small bit of braid, and be 
 sure that no bleeding occurs, for the life of 
 the infant may be endangered by a bleeding 
 cord. The cord should be tied also on the 
 mother's end, lest bleeding from that end 
 endanger the life of a possible twin. Never 
 fail to tie firmly, and tie twice before cut- 
 ting the cord. 
 
 There is no rush about the bathing of 
 the infant. A little oil applied will later 
 make the bath the more easy. The child has 
 come to a colder clime than what he is ac- 
 customed to, and it should not be bathed at 
 once, for there is already a tendency to a re- 
 duced temperature from without. A little 
 time for the supply of warmth from within 
 is advisable. 
 
 The child may rest as well as the mother 
 for several hours before there is any need 
 of nursing. Unless there is a tendency for 
 the womb to relax then the nursing of the 
 child is to be advised, for that act is apt to 
 produce contraction of the womb, and aid, if 
 needed, in the keeping of the womb small 
 until all danger of flooding is over. 
 
PREGNANCY. 91 
 
 Dress the cord with some absorbent cotton 
 and Boracic Acid dusting powder. 
 
 LYING-IN PERIOD. 
 
 During the first three days the mother 
 should not be fed on heavy foods or given 
 much tea to drink, lest the digestion be dis- 
 turbed or the milk come too soon and too much 
 for the child. 
 
 A binder is customary among some people, 
 but the good done is very limited indeed. 
 
 On the third day there is apt to be a rise 
 of temperature at the time of the filling of 
 the breasts with milk, but this temperature 
 does not last long and is soon back to normal. 
 
 If the bowels have not moved by the third 
 day give 1 / 10 grain doses of Calomel for 6 
 or 8 doses and an enema if necessary. 
 
 The mother should be bathed daily, but do 
 not expose so as to catch a cold. The posi- 
 tion of the mother is not important. On the 
 back or side, as she may desire. One con- 
 tinual position is apt to be followed by a 
 sagging of the womb to that side, and so 
 the position should be changed from the 
 back to either side. There may be an extra 
 pillow allowed by the end of the third day. 
 but the patient is not to sit up or get out of 
 bed until the uterus can no longer be felt 
 back of the pubic bone. There is a rule to 
 get up on the ninth day, which rule is 
 
92 MEDICAI, HANDBOOK. 
 
 erroneous ; no patient should get up until the 
 womb is back to what it was before preg- 
 nancy. It is safe not to get up before the 
 ninth day, but many should remain in bed 
 longer. 
 
 The flow, which is at first bloody, later be- 
 comes more clear and finally ceases about the 
 ninth or tenth day, but usually lasts a little 
 longer if the person is on the feet. 
 
 After the fifth day the danger of child- 
 bed fever is much lessened, and practically 
 over by the end of the first week. 
 
 When the mother is delivered there is in 
 the uterus no covering membrane and the 
 womb is as a large surface anywhere with- 
 out a covering to protect it. Infection may 
 occur as of any wound, but the infection 
 must come as in other wounds, for the most 
 part from without. For this reason meddle- 
 some mid wives' fingers in the genital tract 
 during labor or the use of some unsterile 
 household syringe may prove not only useless, 
 but absolutely dangerous. 
 
 No one coming from a house where ery- 
 sipelas, scarlet fever or any of the infectious 
 diseases are existing should be admitted to 
 the lying-in chamber. Should the tempera- 
 ture go up, the pulse become rapid and the 
 abdomen tender during the first week of the 
 lying-in period you would be justified in 
 thinking the womb was infected. It is then 
 
PREGNANCY. 93 
 
 necessary to give one or repeated hot vaginal 
 injections. Boracic Acid may be used in a 
 saturated solution, or, if the case be urgent, 
 the Bichloride of Mercury i to 5,000 may be 
 employed. The patient's head may be elevat- 
 ed in order to increase the drainage from the 
 womb. 
 
 Aconite may be given, 0, 1 tablet every two 
 hours. 
 
 Quinine and whisky or brandy should be 
 given freely if needed as a tonic. 
 
 If the Bichloride of Mercury injection is 
 used, do not use too frequently, but between 
 times use the Boracic Acid solution. 
 
 Be careful that the syringe and hands and 
 all else are sterile, as you should have been 
 during the whole course of the lying-in 
 period, lest more infection be introduced. 
 The syringe and its nozzle should be always 
 a sterile one, rendered so by boiling or anti- 
 septics. 
 
 Always call a physician if possible where 
 there is danger in the lying-in period. 
 
MUMPS. 
 
 Mumps usually appears in epidemics. It 
 is an acute infectious disease, involving the 
 glands of the cheek and the glands below the 
 tongue. Children are more frequently af- 
 fected than adults, but no age or sex is 
 immune until once they have had the dis- 
 ease, after which, if both cheeks have been 
 attacked, there is little danger of subsequent 
 attacks. After exposure there elapses from 
 one to two weeks before the disease de- 
 velops. The duration of mumps varies from 
 five to seven days. The disease begins with 
 chilliness, languor and moderate fever. The 
 swelling of the parotid gland is seen below 
 and in front of the ear. The tissues sur- 
 rounding the gland are also swollen and the 
 cheek has a doughy feel. The glands below 
 the tongue are swollen and the action of 
 the lower jaw is made difficult and painful. 
 There may be an excess of saliva or the 
 amount may be diminished. Sweet things 
 or pickles or anything that will excite the 
 activity of the salivary glands causes pain. 
 The swelling and all the symptoms usually 
 disappear on the fifth day, or they may dis- 
 appear from face and reappear in the tes- 
 ticle of the male or the mamma in the 
 female, or the disease may go to the ovaries 
 of the female. 
 
MEASLES. 95 
 
 Treatment. — There is nothing to be done 
 that will cure mumps. It is best to remain 
 indoors and avoid exposure to drafts. The 
 taking of a cold or exposure may cause the 
 metastasis of the disease, to the testicle, the 
 mamma or the ovary. Should the mamma 
 or testicle become swollen and painful it is 
 best to bandage and support them in some 
 warm covering. Lead water and Laudanum 
 may be used as a hot, wet dressing to relieve 
 the pain. Should a high fever complicate 
 mumps treat the fever as any other fever. 
 
 MEASLES. 
 
 Measles is a disease of an acute contagious 
 nature. Has been known for centuries. 
 Children are most apt to have measles, but 
 neither age nor sex renders a person im- 
 mune. One attack usually prevents a sec- 
 ond occurrence of the disease, but does not 
 always render the individual immune. The 
 disease is characterized by watering of the 
 eye, dread of light, running of the nose, 
 cough and a papular eruption and slight des- 
 quamation or scaling. 
 
 Measles are highly contagious. The period 
 of incubation is about two weeks, usually a 
 few days less, but there may be a few days 
 
96 MEDICAI, HANDBOOK. 
 
 more than two weeks elapse before the dis- 
 ease develops. 
 
 The first symptoms are watering of the eye, 
 running of the nose and much irritation of 
 the upper air passages, resulting in cough. 
 During the first twenty-four hours the tem- 
 perature rises to a little over 100 F. If the 
 temperature is very high at the end of the 
 first day the attack will probably be a severe 
 one. If the temperature is only moderate the 
 disease may not be severe. After the first 
 rise in temperature, or on the second day, the 
 fever may go down to near normal and the 
 child seem better and have a better appetite, 
 but the cough and running of the nose and 
 watering of the eyes increase until about the 
 end of the third day or the beginning of the 
 fourth day, when the temperature rapidly 
 goes up again and the eruption appears on 
 the face. The eruption appears as an efflor- 
 escence or reddened patches or papules of 
 irregular shape. The eruption extends to 
 the neck and chest, and thence all over the 
 body, being fully developed in about thirty- 
 six hours. On the face the eruption is the 
 most marked, and it is not uncommon to 
 have the eyes swollen and partially closed. 
 While the eruption is appearing all the symp- 
 toms are apt to be increased. 
 
 The watering of the eyes and dread of light 
 is worse, the running of the nose and cough 
 
MKASIvKS. 97 
 
 is more pronounced, and the temperature is 
 higher than in the beginning of the disease. 
 There may be disturbances of digestion, with 
 nausea and vomiting, and also there is often 
 a diarrhoea of frequent watery movements. 
 
 The eruption becomes fully developed and 
 all the other symptoms reach their height in a 
 few days, the temperature rapidly falls and all 
 of the symptoms improve, and the epithelium 
 is cast off in fine flakes, beginning first on 
 the face and extending over the body in the 
 same order as the eruption appeared. 
 
 The complications of measles are of much 
 importance. There is a tendency to lung trou- 
 bles after measles and much care should be 
 observed lest colds be contracted, which may 
 result in persistent bronchitis or even pneu- 
 monia. There seems to be a peculiar weak- 
 ness of the lungs after measles, making 
 tubercular or consumptive infection very 
 easy. Very persistent middle ear disease 
 may also develop and the child should be 
 guarded from exposure for some time. 
 
 Treatment. — The patient should be isolat- 
 ed to prevent exposing others. Liquid diet 
 or easily . digested food should be given. 
 Medicines are of little service, and are only 
 to be administered where there are some 
 particular symptoms requiring relief. The 
 choice of remedies must depend on the con- 
 dition calling for drugs. When desquama- 
 
98 MKDICAI, HANDBOOK. 
 
 tion begins it is often soothing to oil the sur- 
 face of the body with some simple oil. 
 
 SORE MOUTH. 
 
 Sore mouth may be due to injury to the 
 membranes of the mouth or to the presence 
 of bacteria that cause ulcers in the mouth. 
 The symptoms of sore mouth in general are 
 heat and pain in the mouth and an increase 
 in the flow of saliva. The breath may smell 
 and the child be languid and refuse to nurse, 
 and in severe forms fever may be present. 
 
 1. The simple form of this affection is char- 
 acterized by redness of the mouth, and is 
 usually due to a burn or some irritant taken 
 into the mouth. Cleanness is all that is re- 
 quired for its treatment. 
 
 2. The second form of sore mouth, called 
 aphthous stomatitis, is characterized by small 
 blisters over the tongue, lips and cheeks. 
 These little blisters soon break and form 
 ulcers. 
 
 The treatment is simply cleanliness by wash- 
 ing out the mouth with the following solution : 
 
 1^. Chlorate of potash, 20 grains. Gly- 
 cerine, one-half ounce. Water, one and one- 
 half ounces. Mix. 
 
 With a piece of cotton or gauze saturated in 
 
SORE MOUTH. 99 
 
 the above solution wash out the mouth. As 
 indigestion figures in the cause of this affec- 
 tion, feed the child at regular intervals, and 
 thoroughly empty the bowels by a dose of 
 Castor oil. 
 
 3. Parasitic form from sore mouth or 
 thrush. This form of sore mouth is due to a 
 specific fungus, and on inspection may be seen 
 elevated patches, which, when removed, leave 
 the raw surface ; the patches are found on 
 the tongue and cheeks, and may spread over 
 the entire mouth, and into the throat. There 
 is much soreness of the mouth. The saliva 
 runs from the mouth, and eating is attended 
 by pain. 
 
 Treatment. — Cleanse the mouth (Several 
 times a day, and by applying a pledget of cot- 
 ton to each spot or ulcer the following solu- 
 tion : 
 
 1^. Borax, one dram. Glycerine, two 
 ounces. Water, six ounces. Mix. 
 
 t 
 
 G. 
 
MENSTRUATION AND THE DIS- 
 ORDERS OF MENSTRUATION. 
 
 MENSTRUATION. 
 
 Normal menstruation is a periodical dis- 
 charge of blood from the uterine cavity, re- 
 curring at regular intervals. 
 
 In the majority of cases the period begins 
 every twenty-eight days. A few vary from 
 this rule a day, more or less, but if the period 
 is regular on the twenty-sixth or thirtieth day 
 there is no deviation from health. Menstrua- 
 tion begins at puberty or about the twelfth 
 year of life, and continues until the meno- 
 pause, or about the forty-fifth year of age. 
 A cold climate tends to delay the appearance 
 of the flow, which may not appear before the 
 sixteenth year. 
 
 The symptoms of normal menstruation are 
 more objective than subjective, though few 
 women escape a full, heavy feeling in the 
 pelvic organs previous to the advent of the 
 flow. 
 
 The normal period continues from two to 
 eight days, and the quantity of blood lost 
 varies from two to nine ounces. The average 
 period is about four days, and the quantity 
 of blood lost about five ounces. Unless there 
 is a profuse flow there is no clotting. 
 
MENSTRUATION. IOI 
 
 Young girls should be forewarned by their 
 mothers as to the appearance of the menses, 
 as they may be very much alarmed and re- 
 sort to rash measures to stop the supposed 
 haemorrhage; or the scare may result in the 
 disappearance of the flow, or derangement of 
 what should become a regular function. 
 When girls and boys arrive at puberty they 
 should be counseled as to the advent of natural 
 functions and passions, which, if normal and 
 kept in proper limits, insure the physical and 
 mental and the moral development of a man or 
 woman, while on the other hand, if the sexual 
 hygiene be neglected, health and happiness 
 may be sacrificed. 
 
 AMENORRHEA, OR WANT OF FLOW. 
 
 The flow may not appear at puberty, caused 
 by a poorly nourished condition of the sys- 
 tem. At times the flow may be absent because 
 of obstruction to the outlet. When the flow 
 is absent as a result of an impoverished con- 
 dition of the system, the blood will be greatly 
 lacking in the red blood corpuscles, and the 
 patient will have a waxy, greenish, white 
 complexion. There are frequent outbursts of 
 nervousness and hysteria. Mental and physi- 
 cal effort are followed by physical prostration. 
 There will be a desire for sour foods, such as 
 pickles and vinegar, and at time for the 
 earthy substances, such as chalk or charcoal, 
 
102 MEDICAI, HANDBOOK. 
 
 while meats will be rejected. The heart is 
 poorly nourished. The pulse is weak, and 
 running up stairs or climbing a hill causes 
 palpitation and faintness. Emotions will also 
 cause palpitation. Headache is common, 
 worse from motion. Pain around the heart is 
 not uncommon. Instead of the flow there 
 may be only a watery discharge, and in some 
 cases there is a watery discharge almost all 
 the time. 
 
 Treatment. — Improve the general health by 
 giving plenty of fresh air and sufficient ex- 
 ercise; but do not exhaust the patient. 
 
 Tonics are often beneficial, such as 
 
 R. Nux vomica, three drops, three times a 
 day. 
 
 ]^. Potassium iodide, three grains, well 
 diluted in water, three times a day. 
 
 R. Blaud's Iron Pills, one twice a day. 
 
 Locally, warm sitz baths with enough 
 brown mustard in the water to make the skin 
 red are very helpful. 
 
 The hot douche is the most reliable help. 
 Use two quarts of hot water (no° F.). Have 
 the patient lie on the back and flex the legs ; 
 retain the hot water as much and as long as 
 possible. Such a douche should last for a half 
 hour. Keep the water hot. 
 
 Amenorrhcea may be due to exposure, to 
 cold and wet just before the courses should 
 appear. Sometimes fear or sorrow will pre- 
 
MENSTRUATION. I03 
 
 vent the appearance of the flow. Pregnancy is 
 usually associated with a non-appearance of 
 the flow. But in health some even menstruate 
 when pregnant, (such cases are not the rule). 
 Change of climate, as a long sea voyage, may 
 cause the disappearance of the flow for a few 
 months. Serious depleting diseases are fol- 
 lowed by absence of the flow. It is evident 
 that when the system is run down and the 
 blood is poor and scant that the flow would be 
 an added drain to the system. In such cases 
 do not try to bring on the flow, but improve 
 the health and blood with tonics. 
 
 Where from fear, exposure or accident the 
 flow has not appeared or has stopped too soon, 
 the hot sitz bath, the douche, and the internal 
 use of Actea racemosa, Pulsatilla or Sepia 
 should be tried. 
 
 DYSMENORRHEA, OR PAINFUL MENSTRUATION. 
 
 This term implies menstruation that is per- 
 formed with difficulty. Pain is a troublesome 
 symptom of such patients. The cause of dis- 
 menorrhcea may be misplacements of the 
 uterus, an imperfect outlet, and as a natural 
 result of age on a uterus that has never suffer- 
 ed any other changes than menstruation such 
 is often the case in maiden ladies of advanced 
 years. 
 
 The treatment is to remove the cause, which 
 is usually a natural or mechanical one. Medi- 
 
104 MEDICAL HANDBOOK. 
 
 cal assistance may help, and the drugs that 
 should be thought of would be Actea race- 
 mosa, Sepia and Asafcetida. Hot sitz baths 
 may be beneficial. This as well as many other 
 female complaints often finds permanent relief 
 after pregnancy. As not all cases are subject 
 to the same causes it is well to place such 
 cases in the hands of competent medical at- 
 tendants. 
 
 MENOPAUSE, OR CHANGE OF LIFE. 
 
 The sensation of the menses is as important 
 as the establishment of the function, and as 
 much care and consideration is as necessary 
 as in early life when the catamenia began. 
 
 For a period of about thirty or thirty-three 
 years the pelvis has been subject to repeated 
 engorgement and nervous centralization, and 
 when change of life comes there is a call for 
 a change of outlet for the local activity of the 
 circulation and nerves. The symptoms of this 
 period of change in a woman's life are very 
 marked and greatly varied. There is scarcely 
 a limit to the symptoms that may arise at this 
 time, and the patient should be prepared for 
 many things that in young womanhood do not 
 occur. The courses become irregular in period 
 as well as in amount. Flushes of heat to the 
 head and face or to different parts of the 
 body are common. Headache, vertigo, dis- 
 turbances of digestion and haemorrhages from 
 
MENSTRUATION. I05 
 
 the uterus and nose are common. Mental de- 
 pression, loss of memory and loss of power of 
 attention are also common symptoms. The 
 period of change and disturbed nervous and 
 functional symptoms caused by the cessation 
 of sexual life last for a period of from one to 
 two years ; but the most marked symptoms oc- 
 cur during a period of about six months in the 
 middle of this time. 
 
 There is no need of alarm when this period 
 is reached. The haemorrhage or loss of blood 
 from the uterus or the nose-bleed that may 
 occur, and at times bleeding from the rectum, 
 all give relief to nature, and the habit that for 
 so long a period has existed, and are more 
 beneficial than detrimental, unless too severe 
 or too prolonged. The care of an experienced 
 physician is to be desired and secured, if pos- 
 sible. If the change is passed successfully the 
 lease on life is extended indefinitely. 
 
 Treatment. — While the nerves and circula- 
 tion are struggling with a habit that for years 
 has affected the system so profoundly, and a 
 state of uncertainty seems to prevail, it is but 
 logical that the best of hygienic methods of 
 life should be observed. Keep the skin active 
 by frequent bathing and rubbing with a rough 
 towel. Avoid excitement! or over physical 
 strain. Sleep should be encouraged. A warm 
 bath before retiring is a very good way to pro- 
 mote sleep. Regulate the diet to wholesome 
 
106 MEDICAI, HANDBOOK. 
 
 easily digested food. Do not be afraid of 
 fresh air and sunshine. 
 
 Avoid all alcoholic stimulants. Do not re- 
 sort to nerve sedative medication, as it often 
 does more harm than good, and may result in 
 a drug habit, fastening itself on the patient. 
 Candies and pastries are to be eaten in 
 moderation. 
 
 Sepia, Actea racemosa, Pulsatilla, Asafoetida 
 and other remedies named in this treatise 
 should be studied as possible remedies for 
 some of the nervous and physical phenomena. 
 
 NEURALGIA. 
 
 Pain radiating along the course of a nerve 
 trunk is called neuralgia. The causes are 
 numerous. Nervous temperament and hered- 
 ity, overwork and general exhaustion are pre- 
 disposing to neuralgia. 
 
 Rheumatism, gout, lead poison and disease 
 of the nerve trunks or nerve ganglia are per- 
 sistent causes. Exposure to sudden changes 
 of temperature often excite an attack. 
 
 Depression of spirits and tingling in the part 
 affected often precede an attack. Sharp stab- 
 bing pain in the part with tenderness along 
 the course of the nerves are always prominent 
 symptoms. The attack may last from a few 
 hours to a few days. 
 
NKURAIvGIA. 107 
 
 Following an attack of neuralgia there is apt 
 to be profuse urination of clear or pale urine. 
 
 Neuralgia of the nerves of the face is very 
 common, and may be caused by decaying teeth, 
 or disease of the nerves, or of the ganglia 
 from which the nerve springs. 
 
 Intercostal neuralgia is a common affection 
 of the chest. Has a tender spot near the spinal 
 colunmn where the nerve is given off, and a 
 line of tenderness under the rib along which 
 the nerve lies. Sciatica is but a form of 
 neuralgia, and has for the prominent symp- 
 tom pain along the course of the sciatic nerve. 
 
 Ttreatment. — The treatment of neuralgia 
 will of necessity be directed to the cause. 
 Locally, much relief may follow the use of hot 
 applications, and liniments that have an irri- 
 tant action to the skin. Tr. aconite and Tr. 
 arnica may be used in equal parts and painted 
 along the course of the painful nerve. Tr. 
 iodine may be used as an application to the 
 painful area. Belladonna plasters at times 
 afford relief. Avoid opiates, as there is the 
 greatest danger of forming the opium habit 
 
NOSE-BLEED. 
 
 Nose-bleed may be caused by injury, and by 
 obstruction of the circulation such as chronic 
 heart and lung disease. Certain affections of 
 the blood and the onset of some of the fevers 
 have nose-bleed as a symptom. In crossing 
 mountains where the atmosphere is light 
 nose-bleed occurs. At times without any ap- 
 parent cause bleeding may develop. When 
 nose-bleed is associated with a blow or in- 
 jury to the head it may be an indication of 
 fracture of the skull, if the nose was not in- 
 jured by the blow. 
 
 Treatment. — Apply ice cold water to the 
 back of the neck and to the nose. Snuffing 
 up into the nose alum solution, of one drachm 
 of alum to four ounces of water, is very effect- 
 ual where there has been direct injury to the 
 nose, or a pledget of cotton saturated in this 
 solution may be applied or packed closely into 
 the bleeding nostrils. 
 
 Adrenalin, Chlorid, used as a spray, is often 
 very effectual. 
 
 At times nothing will stop the flow of blood 
 from the nose except careful packing of the 
 nasal passage with gauze or cotton. 
 
 Association with headache or congestion of 
 the head and face, nose-bleed is often bene- 
 ficial unless too profuse. 
 
PALPITATION OF THE HEART. 
 
 Causes. — Palpitation is a symptom of 
 organic heart disease, of dyspepsia and the 
 result of certain drugs in their action on the 
 system. Palpitation is also associated with 
 anything that will for the time unbalance the 
 nervous equilibrium, such as joy, fear or 
 anxiety. Disturbances of the reproductive 
 organs often cause palpitation ; this is more 
 frequently noticed in girls than among boys. 
 
 Symptoms. — A violent action of the heart 
 perceptible to the patient, and noticeable to 
 any who may examine the pulse or listen to 
 the heart. There is no rule as to frequency of 
 the heart beats, as different cases differ in this 
 particular. 
 
 Treatment. — If the palpitation is aggravat- 
 ed by the use of tobacco, tea or coffee, stop 
 their use. If tobacco, tea or coffee disturb the 
 harmony of the functions or organs of the 
 body, they are drugs to that individual and 
 should not be used in health. Where the 
 digestion is at fault or the heart diseased, be- 
 sides the treatment of these ailments, the fol- 
 lowing has been of value: 
 
 1^. Tr. nux vomica, one drop, three times a 
 day; give on sugar or tablet; also, I£. Tr. 
 aconite, one drop, three times a day, has been 
 of service for many nervous cases ; give on 
 
110 MKDICAI, HANDBOOK. 
 
 sugar or in tablet; also, I£. Asafoetida, three 
 grains ; Ext. nux vomica, one-fourth grain 
 pill. One in the morning and one in the 
 evening. 
 
 This latter prescription is especially of 
 value for nervous girls or women. For the 
 Eskimo women of Alaska who are troubled 
 with the heart symptoms and fainting spells, 
 or hysterical seizures, this is probably the 
 best medicine to give them, as it quiets the 
 nerves and at the same time assists the heart 
 and the digestion. 
 
 Pulsatilla in the homoeopathic preparation 
 given in the tincture ranks as one of the first 
 drugs for girls about the time of puberty who 
 are troubled with palpitation. Give one or 
 two drops three times a day. There are various 
 drugs given according to Homoeopathy for 
 this trouble, but to give them in a proper 
 manner consult the indications given for the 
 drugs. 
 
 PNEUMONIA. 
 
 The lung may become inflamed from a 
 variety of causes, but the most common as 
 well as most dangerous is that form called 
 croupous pneumonia. This form is some- 
 times spoken of as the natural end of the old 
 man, as so many of the aged die from it. 
 
PNEUMONIA. Ill 
 
 CROUPOUS PNEUMONIA. 
 
 Croupous pneumonia is an acute specific 
 disease, due to a special organism, and is 
 characterized by an inflammation of the lungs. 
 High fever, cough, "rust" colored sputa, 
 shortness of breath and pain on breathing. 
 
 Causes. — A specific organism which thrives 
 only when the vitality is lowered by pre-exist- 
 ing disease or any strain that reduces the 
 general health. Exposure to cold and wet 
 frequently brings on the attack. One attack 
 predisposes to subsequent attacks. 
 
 PATHOLOGY OR COURSE OF THE DISEASE. 
 
 The disease has three stages. The first stage 
 is one of congestion of the lung. The small 
 blood vessels called capillaries are distended 
 and permit a slight exudate, and the lung is 
 hardened. 
 
 In the second stage the hardened lung be- 
 comes infiltrated with blood and is of a deep 
 red color, and so heavy it sinks in water. 
 
 The third stage is one of resolution by ah- 
 sorbtion of the part of the exudate and ex- 
 pectoration of the balance, or the lung may 
 change from red to gray; that is, the exudate 
 changes from blood to pus ; the lung becomes 
 inltrated with pus and the patient dies prac- 
 tically from blood poisoning. Or early in the 
 disease death may be caused by diminished 
 air space. 
 
112 MEJDICAIy HANDBOOK. 
 
 The two extremes of life succumb to this 
 disease readily. The consolidation of the dis- 
 ease usually begins in the lower lobe of the 
 right lung at its base and spreads upwards. 
 The pleural membrane and the adjacent bron- 
 chial tubes share the inflammation of the 
 lung. 
 
 Symptoms. — The disease generally begins 
 with a decided chill and a sharp pain in the 
 side. The temperature within the next twenty- 
 four hours reaches a maximum of 104 or 105 
 degrees F., at which point with slight daily re- 
 missions it remains until the crisis, which 
 usually occurs about the ninth day. The fall 
 of the temperature is so rapid that on the 
 tenth day it may be normal. In atypical cases 
 the temperature may gradually go back to 
 normal. Breathing is difficult. The respira- 
 tions are shallow and rapid, advancing from 
 the normal of 18 per minute, to 40 and even 
 60 to a minute. The pulse is raised to 120 per 
 minute or more, but not in proportion to the 
 breathing. Normally the heart beats 4 times 
 to 1 act of respiration, but in pneumonia the 
 ratio may be reduced as low as 2 to 1. Cough 
 is a prominent symptom, which at first is 
 short and dry, but later the sputa has a rusty 
 appearance from the blood it contains. The 
 sputa may be very tenacious, stringy and ex- 
 ceedingly hard to expectorate. The face is 
 flushed, the lips dark blue and frequently 
 
PNEUMONIA. 113 
 
 there are fever blisters on the lips. The 
 tongue is furred, the bowels constipated, the 
 urine scant and high colored, and when test- 
 ed with Nitrate of Silver solution does not 
 throw down a white precipitate; this shows a 
 lack of the chlorides, and when the precipi- 
 tates begin to appear a change for the bet- 
 ter is usually at hand. 
 
 Delirium is also a common symptom. Dur- 
 ing 'the course of the disease the chief sound 
 that can be heard on listening to the chest is 
 bronchial breathing or the sound of the air as 
 h rushes back and forth in the larger air 
 passages. If the patient speaks over the area 
 affected the sound is increased and near to 
 the ear; later in the disease or in the third 
 stage fine, moist rales can be heard. 
 
 In the aged the symptoms of pneumonia are 
 not typical. The temperature may not be high 
 at first; delirium, however, is common and 
 prostration very marked. In children the on- 
 set may be marked by convulsions, headache, 
 delirium, drowsiness and very high tempera- 
 ture. Expectoration is absent at first. 
 
 8 
 
PLEURISY. 
 
 Stimulates pneumonia, but does not have 
 the rusty expectoration. The chill is less 
 marked and the temperature not so high and 
 the breathing is distant and weak. Severe 
 pain in the side is the most marked symptom 
 of pleurisy. The fall of temperature is not 
 as marked in pleurisy as in pneumonia. The 
 prognosis of pneumonia is grave at either ex- 
 treme of life. In the young and strong the 
 prognosis is usually good. The average ratio 
 of death is one case out of five. 
 
 Treatment. — Absolute rest in bed. The 
 diet should be liquid and such articles as 
 eggs and milk or broth of meat or game may 
 be given. The chest should be enveloped in 
 some warm material. The disease is self- 
 limiting and runs a course that no remedy 
 can cut short. The object would be to sus- 
 tain the strength of the patient until the dis- 
 ease has had time to run its course. When 
 the crisis of the disease comes the tempera- 
 ture falls at once and the patient should be 
 watched well lest the fall in temperature be 
 so great as to cause the patient to die from 
 the exhaustion at this most critical time. At 
 about 2 o'clock in the morning there is a 
 natural fall of temperature, and should the 
 crisis occur at this hour the danger is in- 
 
PLEURISY. 115 
 
 creased. During the course of the disease 
 there may be need of Alcoholic stimulation, 
 but at the time of the crisis there is a great 
 probability that stimulation will be called for, 
 especially if the fall in temperature occurs 
 early in the morning. Should the temperature 
 fall at any time, and it will surely fall about 
 the ninth day, and collapse seem near, there 
 is urgent need of Alcoholic stimulation. 
 
 During the disease constipation should be 
 overcome by mild cathartics or by ensemata. 
 
 Baths if given must be performed under a 
 blanket and every care and caution taken not 
 to expose the patient lest a cold be taken. 
 
 While pneumonia is regarded as not con- 
 tagious it is by far the safer policy not to 
 allow those suffering from a cold on the chest 
 to spend too much time in the room. The 
 sputa, of course, should be burned or properly 
 disposed of. The germs are in the sputa and 
 perhaps in the air, and undue exposure of 
 those suffering with a cold or bronchitis is to 
 be guarded against. 
 
RING WORM. 
 
 Ring worm is caused by a vegetable para- 
 site affecting the skin. Ring worm may de- 
 velop on the scalp, face or any part of the 
 body. The disease may be transmitted from 
 man to man or from the lower animals to man. 
 
 The disease begins with one or more round- 
 ed elevated gray scaly patches, through the 
 center of which project dry, brittle or broken 
 hairs. The center may heal, but on the margin 
 the disease spreads in a rounded or circular 
 manner. 
 
 Eczema may resemble ring worm, but the 
 hair is not broken off, nor are the scales 
 round. Eczema does not heal in the center 
 and spread on the edges, and eczema has in- 
 tense itching, while ring worm has not. 
 
 Treatment. — Remove all scales. Pull out 
 the hair on the face or body, or if on the 
 scalp shave the affected area. Rub in well 
 twice a day one of the following ointments : 
 
 ]^. Acid Salicylic, 30 grains. Sulphur 
 Prsecip., 1 drachm. Vaseline, 1 ounce. Mix 
 well and rub in well twice daily. 
 
 1^. Ammoniated Mercury, 20 grains. 
 Vaseline, 1 ounce. Mix well and rub in 
 twice a day. 
 
 f$. Blue Ointment. Rub in well twice a 
 day. 
 
RICKETS. 117 
 
 The parasite of ring worm lives at the root 
 of the hairs and the disease is sure to last 
 until the germs are all destroyed. 
 
 RICKETS. 
 
 Rickets or rachitis is a disease of early 
 childhood, and is characterized by poor nutri- 
 tion and defective development of the bony 
 structures of the body. The symptoms arc 
 restlessness and fever at night, tenderness and 
 soreness of the body and especially is there 
 soreness and tenderness about the joints. 
 Profuse perspiration about the head. The 
 fontanelles or natural unclosed parts of the 
 skull are long in closing. The teeth slow In 
 coming, and the teeth may be unnaturally 
 formed. There is apt to be knock-knees or 
 bow-legs. There may be curvature of the 
 spine. The chest is apt to be distorted and the 
 condition known as chicken-breasted often 
 exists. 
 
 This diseased condition is due to improper 
 nutrition and a lack of the lime salts. 
 
 Treatment. — The health of the child must 
 be improved and the digestion encouraged 
 Eggs, milk and meat should be given freely 
 in sufficient quantities. Fresh air and sunshine 
 are two very advisable additions to good 
 feeding. 
 
Il8 MEDICAL HANDBOOK. 
 
 There is much good derived from the ad- 
 ministration of tonics. Calcarea carbonica is a 
 very good remedy, and will do much for such 
 patients. Lime water as is ordinarily secured 
 from the drug store may be given with the 
 milk. 
 
 RHEUMATISM. 
 
 Acute articular rheumatism is an acute dis- 
 ease of the system and is characterized by a 
 fever that is not regular, inflammation of the 
 joints and acid perspiration. The heart may 
 be involved and chronic heart disease result 
 from rheumatism. 
 
 The cause is probably an impurity in the 
 blood. The decomposition and removal of 
 waste matter from the body may be impair- 
 ed and the substances absorbed by the blood 
 act as the exciting cause. There seems to 
 be less likelihood of the germ theory being 
 applied to rheumatism as a cause of the symp- 
 toms than to other affections, but even this 
 may be true. 
 
 The symptoms may follow a spell of chilli- 
 ness, languor and sore throat, or appear 
 abruptly, with swelling of any of the joints 
 and intense pain. The knee, shoulder, elbow 
 and wrists are most frequently attacked. The 
 pain may disappear in one joint and reappear 
 
RHEUMATISM. II9 
 
 in another. There is apt to be moderate fever 
 and at times very high fever may complicate 
 the disease. The sweating is often profuse 
 and of a sour odor. The tongue is coated and 
 the appetite lost, and the bowels constipated. 
 The urine high colored and throws down an 
 abundant sediment. 
 
 Treatment. — Rest is of first importance in 
 treating rheumatism. Cover the affected part 
 with a woollen dressing. Allow plenty of fresh 
 air in the room, but do not expose the patient 
 to a draft. Liquid diet is preferable to the 
 heavier foods. Encourage digestion, avoid 
 meats, and pastries. 
 
 Lithia tablets or drinks are of value. Sali- 
 cylate of Sodium, in 10 grain doses, three 
 times a day, will often reduce the pain. Ap- 
 plications of hot water with a little oil of 
 gaultheria or oil of turpentine may be applied. 
 Lead water and Laudanum may relieve if 
 used locally. 
 
 There is often a painful affection of the 
 muscles, and known as muscular rheumatism. 
 Exposure to wet and cold is usually the direct 
 cause. Those with a rheumatic tendency are 
 apt to have muscular rheumatism. Muscular 
 rheumatism may affect the neck and produce 
 twisting of the head to one side ; there will be 
 much pain in the muscles of the neck on mo- 
 tion. Rheumatism of the muscles of the back 
 is usually called lumbago, and is greatly ag- 
 
120 MKDICAI, HANDBOOK. 
 
 gravated by motion. Rheumatism of the mus- 
 cles of the chest has severe pain accompany- 
 ing the act of breathing. 
 
 Treatment. — Rest is of first importance. 
 Belladonna and Camphor liniments may be 
 rubbed well into the parts. There are many 
 liniments that are of value for muscular rheu- 
 matism. Any counter irritant will usually af- 
 ford relief for a time at least. Porous plasters 
 have won quite a reputation for relieving the 
 pain of rheumatism. Internally Dulcamara, 
 Gelsemium, Bryonia, Arnica and Chamomilla 
 may be given, as the indications may call for 
 these remedies. 
 
 SCARLET FEVER. 
 
 Scarlet fever is an acute contagious disease 
 characterized by high fever, rapid pulse, sore 
 throat and a scarlet rash of the body. After 
 exposure the disease may develop within a few 
 hours, or in a few days, usually within the 
 first week. The poison of scarlet fever is hard 
 to destroy and clothing may transmit the dis- 
 ease after years of disuse. One attack does 
 not render the patient immune, but those who 
 have had the disease are less liable to acquire 
 the affection than those who have never had 
 it. 
 
 The disease begins suddenly. The child 
 
SCARLET FEVER. 121 
 
 feels sick, looks pale, is nauseated and may 
 vomit. The throat is sore and the pulse is 
 rapid, and the temperature is usually high 
 (105 F.). Convulsions often are present at the 
 onset of scarlet fever. If the temperature is 
 high at once and all the symptoms are very 
 marked the case will likely be a severe one. 
 
 The temperature continues to rise from the 
 beginning for about twenty-four hours or until 
 the eruption appears. The eruption appears 
 on the neck first and looks like little spots 
 sprinkled over a bright red skin surface. From 
 the neck the rash extends over the chest, and 
 then over the entire body, as well as upward 
 over the face. The rash of scarlet fever dis- 
 appears on pressure and slowly regains its 
 color after the finger has been removed, and 
 a line drawn by the fingernail remains white 
 for a short time. The throat is painful and 
 swallowing is difficult. The glands below the 
 tongue are swollen. The tonsils and soft 
 palate and walls of the throat are deeply in- 
 jected and red, and may even be covered with 
 a membrane. The tongue at first is coated, 
 while the edges and tip remain clear and red. 
 In a few days the coating of the tongue disap- 
 pears and the little papilla of the tongue are 
 seen to be prominent, making a strawberry 
 appearance. 
 
 The fever of scarlet fever rises abruptly for 
 the first twenty-four hours and continues high 
 
122 MEDICAL HANDBOOK. 
 
 for three or four days, and then gradually 
 falls to normal. The pulse and breathing are 
 both much increased, more than the severity 
 of the other symptoms would indicate. The 
 appetite is lost and the patient is restless, un- 
 able to sleep and often delirious. Headache 
 is usually present. There is a great tendency 
 in the latter stages of scarlet fever to involve- 
 ment of the kidney. The urine is scant and 
 high colored. 
 
 In acute sore throat there are many symp- 
 toms resembling scarlet fever, but the fever 
 is not so high and the pulse and breathing 
 not much increased. In measles the throat is 
 not to severely attacked; the rash of measles 
 appears later and begins on the face instead 
 of the neck and the fever falls after the first 
 day, to rise on the third or fourth day. In 
 diphtheria the symptoms do not appear as 
 rapidly as in scarlet fever and there is great 
 prostration ; a false membrane is always pres- 
 ent and there is no skin eruption in diphtheria. 
 
 Treatment. — The patient should be isolat- 
 ed. Rest in bed is imperative. The surface 
 of the body should be anointed daily with 
 some pure oil or cold cream or carbolized 
 vaseline. The food should be liquid and the 
 throat should be kept clean by a spray of lis- 
 terine, diluted in water ; or Permanganate of 
 Potash may be used, y* grain to a half glass 
 of water, as a gargle. 
 
SMAU>POX. 123 
 
 If there is high fever it is best to reduce it 
 by giving a sponge bath, using gradually 
 cooler water as the bath is given. This bath 
 to be under blankets and free from all ex- 
 posure. Aconite, Belladonna and Lachesis 
 may be given internally as symptoms may re- 
 quire. The bowels should be kept moving or 
 not allowed to become constipated. Water 
 may be given freely. 
 
 SMALL-POX. 
 
 Small-pox is an acute contagious disease 
 characterized by an eruption, which is at first 
 papular or of pimples, then vesicular or small 
 blisters, and finally pustules. Intense pain in the 
 lumbar region of the back is always present. 
 The fever subsides partially on the fourth day 
 and again reappears on the seventh or eighth 
 day, and lasts with intermissions during the 
 pustular stage. The more the pustules, the 
 more marked the fever. 
 
 The germ of small-pox is very hard to de- 
 stroy and remains virulent for many months 
 on clothing and other places where it may 
 have been deposited from the body of one 
 affected unless disinfection has been very 
 thorough. No age or sex is immune unless 
 protected by a previous attack. Vaccination 
 may not render a person immune, yet those 
 
124 MEDICAL HANDBOOK. 
 
 who have been vaccinated do not contract the 
 disease as readily as unvaccinated persons, 
 and if they do contract the disease the dan- 
 gers and course of the disease are reduced and 
 the symptoms are much more mild than 
 among unprotected persons. 
 
 After exposure the period of incubation is 
 about twelve days before the disease appears. 
 
 Small-pox usually begins with a chill or 
 with chills, vomiting and intense pain in the 
 lumbar or lower region of the back. The 
 temperature goes to 104 F. in the first twenty- 
 four hours and remains high for three or four 
 days. The pulse is quick and full. In chil- 
 dren the disease and fever is apt to begin with 
 a convulsion. 
 
 Chills followed by vomiting and intense pain 
 in the back should lead one to suspect small- 
 pox. 
 
 The temperature, which has been high for 
 three or four days, lessens and is not a prom- 
 inent feature of the disease until about the 
 eighth day, for after the eruption is all out 
 and the vesicles are turning into pustules then 
 the temperature again rises in proportion to 
 the number of pustules. After pustulation 
 the fever fluctuates for a few days and gradu- 
 ally disappears. 
 
 The eruption of small-pox appears about 
 the third or fourth day in the form of red 
 
SMAU>POX. 125 
 
 spots on the forehead and along the margins 
 of the hair and also on the wrists. The red 
 spots rapidly change into smooth, round 
 pimples, which feel like shot under the skin. 
 Within twenty-four hours the eruption ap- 
 pears on other parts of the face, on the limbs 
 and on the trunk. As the eruption appears 
 the fever subsides and the patient is more 
 comfortable. About the sixth cr seventh day 
 of the disease, or about three days after the 
 appearance of the shot-like pimples, the erup- 
 tion changes into vesicles or small, clear blis- 
 ters that are depressed in the center or umbili- 
 cated. On the eighth day, or one or two 
 days after the vesiculation or blistering, the 
 vesicles change into pustules. They first be- 
 come milky in appearance and then lose the 
 umbilicated appearance. The fluid finally be- 
 comes more turbid and is changed into pus. 
 Between the pustules there is apt to be swell- 
 ing and the features may be greatly changed. 
 The fever becomes high again with the de- 
 velopment of pustules. In about three days 
 after pustulation the pustules break and emit 
 an offensive odor and form soft yellow crusts, 
 which adhere to the skin for six or eight days 
 and then fall off, leaving permanent pock 
 marks where the- pustules were developed. 
 
 In some cases the eruption may be scatter- 
 ed and in others the eruption may run to- 
 gether and form large crusts and sores. The 
 
126 MEDICAL HANDBOOK. 
 
 larger and deeper the pustules the more se- 
 vere the case. 
 
 There may be a fetor of the breath and 
 cough due to the development of the lesions 
 within the air passages. 
 
 VARIOLOID. 
 
 Those who have been vaccinated develop 
 only a mild form of small-pox, to which the 
 name of A^arioloid has been given. One who 
 has not been vaccinated may contract small- 
 pox in its severest form from a mild case of 
 varioloid. 
 
 The protection guaranteed by vaccination is 
 more in the lessening of the severity of an 
 attack than the rendering of the individual 
 immune to the disease, though vaccinated 
 persons are less liable to contract the disease 
 than unvaccinated ones. 
 
 The symptoms of varioloid are the same as 
 those of small-pox, but much more mild in de- 
 gree. 
 
 Treatment. — Preventive treatment in the 
 form of vaccination is to be recommended for 
 every person young and old. When a case 
 develops in a house every member of the 
 household should be vaccinated at once. The 
 patient should be isolated in a room that is 
 cool and well ventilated. The diet should be 
 of easily digested food, or be of liquid food. 
 Plenty of water or acid drinks should be al- 
 
SCURVY. 127 
 
 lowed the patient or encouraged if necessary. 
 If the stomach is irritable Bismuth may be 
 given 5 to 10 grain doses. The nose and 
 throat should be kept clean by sprays and 
 gargles. If the pulse becomes weak give 
 stimulants. Cleanse the eyes several times a 
 day with a saturated solution of Boracic Acid. 
 If the fever becomes dangerously high there 
 may be need of cold sponging to reduce the 
 fever. Sponge under cover and gradually 
 reduce the temperature of the water. 
 
 When the pustulation takes place the room 
 should be kept darkened and cool. Cloths 
 wrung out of a mild Carbolic Acid solution 
 will be soothing to the face, or carbolized 
 vaseline may be used as a dressing to pre- 
 vent deep pitting of the face. 
 
 SCURVY. 
 
 The essential cause seems to be due to an 
 insufficient diet of fresh fruit and vegetables. 
 Scurvy has been known from the earliest times 
 and has prevailed particularly in mining and 
 army camps and among sailors. The disease 
 develops among those who have subsisted for 
 a prolonged period on a diet which is lacking 
 in fresh vegetables or their substitutes. The 
 blood is changed to a dark red and has a 
 tendency to infiltrate the various tissues and 
 
128 MEDICAI, HANDBOOK. 
 
 organs of the body. Haemorrhages occur into 
 the internal organs, the mucous membranes 
 and the skin. 
 
 Symptoms. — Early there is pallor and pro- 
 gressive weakness. The gums become swollen 
 and bleed easily and the teeth become loose or 
 fall out. The tongue becomes swollen and 
 coated and the breath is very offensive. The 
 mucous membrane of the mouth may have 
 blood blisters varying in number and size. 
 The skin is dry and harsh. Blood spots ap- 
 pear on the legs and then on the arms and 
 body, and resemble the bites of a flea, only 
 that the spots begin around the roots of the 
 hair. When the extravasation of blood is 
 marked there may be some swelling due to 
 these blood spots. Swelling or dropsy about 
 the ankles or knees is quite common. Nose 
 bleed is frequent, and at times blood may be 
 passed from the bowels. Constipation or 
 diarrhoea may either one be present, the ap- 
 petite lost, the mind become depressed and 
 gloomy; headache and delirium are not un- 
 common symptoms. 
 
 Treatment.' — The object in treating scurvy 
 is to supply the system with the articles of 
 food that have been lacking in the diet of 
 those affected. Fresh vegetables, the acid 
 fruits, such as lemons and oranges and ber- 
 ries, may be given first place. The tender 
 grass roots from the marshes have been used 
 
SCURVY. 129 
 
 with marked benefit and a tea made from the 
 bark or needles of the spruce tree has helped 
 many a miner and Eskimo. Willow buds 
 have been used with much benefit by some. 
 Fresh meats are very much to be desired, as 
 well as fresh vegetables. Lime water should 
 be given if obtainable, and may be given with 
 milk or as the patient prefers, 2 or 3 table- 
 spoonfuls with each meal. The mouth of all 
 patients suffering with scurvy should be kept 
 clean. The various mouth washes given for 
 sore mouth may be used or the mouth cleans- 
 ed with a cherry red solution of Permanganate 
 of Potash. 
 
 INFANTILE SCURVY. 
 
 Bottle fed infants or nursing babes where 
 the mother has been deprived of fresh vege- 
 tables for a continued season are predis- 
 posed to scurvy. 
 
 Symptoms. — Progressive pallor, loss of ap- 
 petite, profuse sweating, especially about the 
 head; slight fever attacks at times, and a sen- 
 sitive condition in the bones, especially about 
 the joints. The child cries when the affected 
 limb is touched. The pain in the limb may be 
 mistaken for paralysis. The child is afraid to 
 be handled on account of the pain. If the 
 child has teeth the gums will have the char- 
 acteristic symptoms. Slight blood spots may 
 be seen on the forehead and in the mouth. 
 
 9 
 
I30 MKDICAI, HANDBOOK. 
 
 Treatment. — The change of food to fresh 
 milk and the juice of one orange a day is all 
 that is necessary to bring about rapid recovery. 
 Where fruit cannot be had fresh berries may 
 be substituted, and if the babe is nursing any 
 fresh vegetable given to the mother will supply 
 all that is needed in the milk. 
 
 THE SKIN. 
 
 The skin of the body protects the tender 
 structures beneath from injury and prevents 
 the entrance of poisonous substances from 
 without when brought in contact with the 
 body. The skin will absorb medicines or 
 poisonous substances if applied in the right 
 form as ointments, salves, etc. The skin ex- 
 cretes much waste matter from the body and 
 should be kept active and clean. The sweat 
 ducts may become clogged and give rise to 
 pimples and comedones. When freely perspir- 
 ing one should not go at once into the open 
 air or into a draught, as chill is likely to 
 stop the action of the sweat glands and send 
 back the waste matter that should have been, 
 thrown of! by the skin onto the other ex- 
 cretory organs to dispose of, thus making 
 extra work for the lung, kidneys and bowels. 
 A condition of disturbed excretion of the 
 skin, associated with irritation of the lungs 
 
TONSII^ITIS OR OUINSY. I3I 
 
 and bronchial membranes, constitutes what is 
 commonly known as a cold. 
 
 TONSILLITIS OR QUINSY. 
 
 Quinsy occurs at all ages, but is most com- 
 mon during young adolescence. Exposure to 
 cold and damp usually brings on an attack. 
 After exposure the throat becomes sore, there 
 is pain at the angles of the jaw, which is 
 aggravated by chewing, talking and swallow- 
 ing. Chills, fever, headache and a general 
 tired ache of the whole body is often present. 
 The tonsils become swollen, and the crypts 
 are filled with a creamy exudate, and the ton- 
 sil presents a spotted appearance. In diph- 
 theria the tonsils are covered with a gray 
 membrane, which is uniform and not dotted 
 over the tonsil. The diphtheritic membrane 
 creeps up along the walls of the throat to the 
 soft palate, while the spots of tonsillitis re- 
 main on the tonsils. The patches of tonsillitis 
 leave no raw surface when removed as does 
 the membrane of diphtheria. In tonsillitis the 
 tongue is furred and the breath has a foul 
 odor. The urine is scant and high colored. 
 
 Treatment. — Early where there is chill 
 give Aconite, 1 tablet every half hour for 
 five or six doses. 
 
 Where the throat is very sore and the con- 
 
I32 MEJDICAI, HANDBOOK. 
 
 stittitional symptoms are few give Guaiacum, 
 1 tablet every one to two hours for a day or 
 two. Painting the tonsil with baking soda or 
 Soda bicarbonate will often afford relief. 
 Paint every two or three hours. 
 
 Gargle the throat three or four times a day 
 with the following: 
 
 1^. Borax, 1 drachm. Glycerine, two 
 drachms. Water, eight ounces. 
 
 A simple and efficacious gargle may be made 
 by adding one-half grain of Potassium Per- 
 manganate to a glass of water. Gargle the 
 throat frequently. 
 
 QUINSY. 
 
 The neck may be painted with Tr. Iodine 
 once or twice a day with some benefit. 
 
 When in tonsillitis or quinsy the tonsil is 
 much swollen and chill and fever is present 
 with difficult swallowing, ix Hepar sulphur, 
 1 tablet every hour, will hasten the opening of 
 the abscess which is forming in the tonsil. 
 Plot poultices will be very grateful to the pa- 
 tient, relieving much of the pain. 
 
 throat remedies and indications (dr. h. s. 
 weaver). 
 
 In catarrhal conditions of the nose, where 
 there is discharge or crusts, cleanse by spray- 
 
SORE THROAT. 133 
 
 ing or drawing into the nose from the hand a 
 solution of salt in water, one-half drachm to 
 one-half glass of water. Follow the cleans- 
 ing of the nose with an oily spray such as : 
 1^. Menthol, ten grains. Acid carbolic, 
 five grains. Oil Eucalyptus, one-half drachm. 
 Fluid Alboline, two ounces. 
 
 SORE THROAT. 
 
 Belladonna is indicated where the throat is 
 red and inflamed, the skin dry and hot, head- 
 ache and the face is flushed or red. Give 
 Belladonna ix, one tablet every two hours. 
 
 Guaiacum is indicated where the throat is 
 sore, red and inflamed, but the patient is not 
 feverish as he is when Belladonna is needed. 
 There may be some rheumatic symptoms. 
 Give Guaiacum 0, one tablet every two hours 
 for one or two days. 
 
 Mercurius iodatum rubrum is indicated 
 when the tonsils are full of patches, showing 
 a distinct tonsillitis. 
 
 Give 2x, Merc. iod. rub., one tablet every 
 hour, alternating with Belladonna as indicated 
 above, which is to be given every two hours. 
 
 Hepar sulphur is indicated in quinsy when 
 the tonsil is red and swollen, with sticking 
 pain on swallowing. 
 
 Give Hepar sulphur ix, one tablet every 
 alternate hour with Guaiacum as indicated 
 above. Early in quinsy these two drugs may 
 abort an attack of quinsy. 
 
134 MEDICAI, HANDBOOK. 
 
 Aconite is indicated where there is cold in 
 the head with rapid pulse and chilliness of the 
 body. The skin is hot and dry. There is 
 fever and restlessness. 
 
 Give Aconite, one tablet every hour for 
 five doses. 
 
 Gelsemium is indicated where there is chilli- 
 ness alternating with fever. A great deal of 
 sneezing and headache in the back of the head 
 or pain in the eyeballs. Gelsemium is espe- 
 cially good when the cold is beginning. Give 
 Gelsemium, one tablet every hour. 
 
 Arsenicum album is indicated where there is 
 much watery discharge from the nose, which 
 excoriates the nostrils and makes the nose 
 burn and look red. There is also sneezing and 
 great thirst with dryness of the lips. 
 
 Give 3x Arsenicum alb., one tablet every 
 two hours. 
 
 Euphrasia is indicated where the eyes water 
 and burn, along with other symptoms of cold 
 in the head. Give 2x Euphrasia, one tablet 
 every hour. 
 
 Pulsatilla is a prime remedy when the dis- 
 charge from the nose has become thick and is 
 of a greenish color. 
 
 Give Pulsatilla, one tablet every two 
 hours. 
 
CATARRH OF NOSE AND THROAT. I35 
 
 GARGLES. 
 
 Potassium permanganate, one-half grain to a 
 tumbler full of water, makes one of the best 
 gargles for tonsillitis and diphtheria. 
 
 For simple inflammation of the throat or 
 tonsils and pharynx use — 
 
 Ji. Alcohol, Glycerine, Hamamelis fl. ext, 
 Water, aa, equal parts. Used as a gargle is 
 very soothing. 
 
 APPLICATIONS. 
 
 In chronic catarrh or sore throat the throat 
 may be painted with the following : 
 
 1^. Glycerine, one ounce. Tr. Iodine, five 
 grains. Mix, and apply with brush. 
 
 CATARRH OF NOSE AND THROAT. 
 
 Chronic catarrh of the nose and throat is 
 very often the result of repeated attacks of 
 acute nasal catarrh. Mouth breathing is very 
 apt to set up a chronic catarrh of the throat. 
 There is apt to be clogging of the nasal pass- 
 ages. Crusting of the discharges in the nose. 
 Hypertrophy of the mucous membrane of the 
 nose. Persistent discharge that is tenacious 
 and perhaps offensive. There may be in- 
 volvement of the vocal cords when the catarrh 
 travels down the air passages. 
 
I36 MEDICAI, HANDBOOK. 
 
 Treatment. — The nose should be cleansed 
 by drawing into the nostrils a solution of 
 soda water or salt water, one drachm or one 
 teaspoonful to a pint of water. Cleanse the nose 
 thoroughly but do not blow the nose for some 
 time after drawing the solution into the nos- 
 tril. The tendency is to blow the nose, but 
 the danger is to force the solution into the 
 tubes leading to the ears if the nose be blown. 
 Nasal sprays that will reduce the inflammation 
 are valuable. 
 
 Internal medication is of much value. 
 Hydrastis Canadensis 0, one tablet, three 
 times a day. Where the discharge is stringy 
 and tenacious and yellow in color. Hepar 
 sulphur 4X, one tablet three times a day, may 
 be serviceable where the discharge is purulent 
 and the breathing is obstructed. 
 
 It is well to look up the different remedies 
 and choose the one that is most indicated. 
 
 Avoid mouth breathing, and if possible con- 
 sult some good physician. 
 
 PHARYNGITIS, OR SORE THROAT. 
 
 The causes of sore throat are much the 
 same as those of quinsy, exposure to damp 
 and cold usually causing an attack. The on- 
 set is often accompanied by chills and fever 
 and a red, swollen and painful throat. There 
 
CHRONIC SORE THROAT. I37 
 
 is tickling and dryness of the throat and sore- 
 ness on swallowing. There is a constant de- 
 sire to cough or cleanse the throat. Hoarse- 
 ness, loss of voice and impaired hearing are 
 apt to be present. 
 
 Treatment. — The same local treatment as 
 that used in quinsy is applicable. The bowels 
 are often constipated and should be moved. 
 Aconite, one tablet every hour for six 
 doses, where there are chills and fever, ix 
 Belladonna, one tablet every hour where the 
 throat is red and inflamed and the skin dry 
 and hot. Guaiacum, one tablet every two 
 hours, where the throat is sore and there is 
 little else of which the patient complains. 
 
 Painting the neck with Tr. Iodine is often 
 good in sore throat and in quinsy. A little 
 coal oil sprinkled on a cloth and tied around 
 the neck until the skin is red but not blistered 
 will often help. 
 
 CHRONIC SORE THROAT. 
 
 For chronic sore throat the throat may be 
 painted every few days with the following: 
 
 ]^. Iodine, five grains. Glycerine, one 
 ounce. Paint with brush or swab with a little 
 cotton in a forceps. 
 
 The following may be used instead of the 
 Iodine preparation: 
 
I38 MEDICAL HANDBOOK. 
 
 ]^. Acid, tannic, ten grains. Glycerine, 
 one ounce. Paint the throat every three days 
 with brush or swab. 
 
 In acute sore throat use Zinc chloride, ten 
 grains, to one ounce of Glycerine. Paint the 
 throat daily for four or five days. 
 
 TYPHOID FEVER. 
 
 Typhoid fever is an acute infectious dis- 
 ease, caused by the presence and action of a 
 bacillus in the intestines. The characteristic 
 symptoms are fever and headache, stupor and 
 dull, heavy expression of the face, abdominal 
 distension with spots that develop on the ab- 
 domen about one week after the onset of the 
 disease. Diarrhoea of a yellow color is very 
 common. The period of incubation is from 
 two to three weeks. The disease lasts from 
 three to six weeks. 
 
 There are always ulcers of the small intes- 
 tines no matter how mild the attack. The 
 mildest case is in danger, and there is hope of 
 the most severe to recover. 
 
 The disease begins with vague pains over 
 the body, languor and weakness, headache, 
 nose-bleed, bad taste in the mouth and furred 
 tongue and diarrhoea. 
 
 The temperature rises a little higher each 
 day until the seventh day in some cases, and in 
 
TYPHOID FKVKR. 139 
 
 others gradually rising until the fourteenth 
 day. One-third of the time is consumed until 
 the fever reaches its height, or about 105 ° 
 F. One-third of the duration of the attack the 
 fever remains high, and the remaining third is 
 marked by a gradual lessening of the daily 
 fever height. The daily variation in the fever 
 is from two to three degrees. In the after- 
 noon and evening the fever is higher than In 
 the morning. In protracted cases the daily 
 variations or remissions are not very marked. 
 A marked and rapid fall in the temperature 
 may indicate intestinal haemorrhage or rupture 
 of the intestine into the abdominal cavity. 
 The face of a typhoid patient is dull and 
 heavy, the cheeks often flushed and the pupils 
 dilated. There is slowness of thought, and an- 
 swers come slow and often as if the patient 
 had forgotten the question. Headaches and 
 stupor with impaired hearing are almost al- 
 ways present. Sleeping with the eyes open, 
 muttering delirium and picking at the bed- 
 clothing or at imaginary objects may develop 
 during the disease. The breathing is more 
 rapid than usual, but not as frequent as would 
 be expected from the height of the fever. 
 There is apt to be present a slight cough. 
 The pulse becomes rapid and weak, but is not 
 as rapid as would be expected with a high 
 temperature. The cause of all the symptoms 
 is found in the intestines, and we should look 
 
140 MEDICAL HANDBOOK. 
 
 to the digestive organs for the confirmation 
 of our diagnosis. At first the tongue is 
 tremulous and coated white, except the edges 
 and tip, which are red and free from any 
 coating. Late in typhoid the tongue may be 
 coated dark brown and fissured, and a deposit 
 form on the teeth. The patient usually has 
 little or no appetite, though food is seldom re- 
 jected by the stomach. In some cases vomit- 
 ing may develop. The abdomen is always dis- 
 tended with gas, and may be tender. Rum- 
 bling or gurgling may be present. Diarrhoea 
 is very common, though not always present. 
 The movements are yellow, and on standing 
 separate, a scum rising to the surface and a 
 yellow sediment remaining below. If con- 
 stipated, the yellow color is apt to be present. 
 The movements are offensive whatever their 
 nature may be as to constipation or diarrhoea. 
 
 About the end of the first week from the 
 onset of the symptoms there appear on the 
 abdomen spots like flea bites, or reddened, 
 slightly elevated spots, which disappear on 
 pressure. 
 
 Always look for the enlarged abdomen and 
 the spots by the end of the first week. The 
 urine is scant and high colored. 
 
 During convalescence the hair is apt to fall 
 out. , 
 
 Irregularities. — At times all the symptoms 
 
TYPHOID FEVER. 141 
 
 disappear in a few days. Some cases are so 
 mild that the patient refuses to go to bed, 
 but the danger is there until the intestines have 
 had time to become free of the germs and 
 healed of the ulcers. 
 
 Children may have a high temperature at 
 once and violent delirium or threatened con- 
 vulsions, and, though the abdomen becomes 
 distended, the characteristic rash may be ab- 
 sent. Relapses in typhoid fever are not in- 
 frequent, and are usually not as severe as the 
 original attack. 
 
 Temporary elevations of temperature dur- 
 ing convalescence may be due to constipation 
 or improper feeding. 
 
 Treatment. — There is no disease where 
 rest in bed is more indicated. The patient is 
 not even to get out of bed to move the 
 bowels, but must use the bed-pan. The in- 
 testines are uclerated, and exertion or im- 
 proper food may cause a fatal result by 
 rupturing the bowel into the abdominal cavity. 
 The movements should be burned or disin- 
 fected by some strong antiseptic. Soiled 
 articles of dress or bedding should be 
 thoroughly boiled. The nurse and family 
 should know that it is the discharges from the 
 body that are infectious, and use every pre- 
 caution not to infect others. 
 
 No solid food can be given lest the ulcerated 
 
142 MEDICAL HANDBOOK. 
 
 intestines rupture as a result of such irrita- 
 tion. Liquid diet is indicated throughout the 
 disease, and after recovery for some time, be- 
 cause the appetite is very strong after re- 
 covery, and this caution is doubly imperative 
 lest the eating of solid food be too much for 
 the intestines that are not yet well. More 
 than one person has died from eating too 
 much and too solid food during convalescence. 
 Milk is the best food. To the milk brandy 
 may be added if the circulation and diges- 
 tion is poor. Beef tea and meat broth may be 
 given to vary the diet. Water may be given as 
 much as desired, and if not desired it is desir- 
 able to give water at any rate at regular inter- 
 vals. If constipation should be present the bow- 
 els should be moved by enemata, and by small 
 doses of Calomel. High temperature may be 
 reduced by the gradual cold sponging under 
 woolen blankets. It may be advisable to check 
 a diarrhoea by giving Bismuth subnitrate in 
 ten-grain doses, repeated two or three times a 
 day. Heart failure, constipation, high fever 
 and delirium must be met as the occasion de- 
 mands. 
 
 The drugs, Bryonia, Aconite, Hyoscyamus, 
 Baptisia, Quinine, Whiskey, Calomel, and 
 Strychnine may, one or more, be indicated 
 during the course of the disease, and should 
 be given as occasion and indications require. 
 
TOOTHACHE. 
 
 Before placing anything in an aching cavity 
 remove all particles of food and thoroughly 
 cleanse the cavity. Saturate a small piece of 
 cotton with one of the following solutions 
 and place it in the cavity; put over this a 
 small piece of dry cotton : 
 
 IJ. Tr. Aconite, one drop on cotton, apply 
 to nerve in cavity and cover, 
 
 R. Cocaine muriate, four per cent, solu- 
 tion. Laudanum, Chloroform, equal parts of 
 each of the above. 
 
 Saturate a small piece of cotton and apply 
 as before, or instead of the above, saturate the 
 cotton with Oil of Cloves or Camphor- 
 Phenique, and apply as before stated. In- 
 stead of the foregoing the cavity may be 
 cleansed and a small piece of toothache gum 
 may be placed in the cavity. 
 
 THE TONGUE. 
 
 The tongue is worthy of some study, as it Is 
 indicative of several disorders of the system. 
 A thick, flabby, gray-coated tongue that shows 
 the imprints of the teeth indicates disturb- 
 ances of digestion in general, and is also 
 noted in connection with appendicitis. In 
 
144 MEJDICAL HANDBOOK. 
 
 brain diseases the tongue may be sharp- 
 pointed, tremulous and difficult of motion, 
 and in some lesions of the brain the tongue is 
 always protruded to one side. An immobile 
 tongue or one that always protrudes to one 
 side indicates paralysis due to pressure or in- 
 jury of the nerves of the tongue or to brain 
 tumor. The sharp red tongue is common with 
 brain fever. In typhoid fever the tongue is 
 coated from gray to very dark, depending on 
 the time and state of the irritation of the in- 
 testines. Indigestion has a gray-coated tongue 
 clear on the edges. 
 
 NORMAL TEMPERATURE. 
 
 The normal temperature of the body is from 
 98 to 100 degrees F. During sleep there is a 
 slight fall of the temperature amounting to 
 1 or 1^2 degrees. Elevations of temperature 
 are common, and are associated with many 
 affections. Elevations in temperature are less 
 dangerous than marked reduction of the tem- 
 perature. The favorite localities for the tak- 
 ing of the temperature are in the mouth under 
 the tongue and in the axilla. Axillary tem- 
 perature is likely to be a degree or so lower 
 than that taken under the tongue. It is best 
 to take the temperature of infants and 
 delirious patients per rectum. This is safer 
 and more reliable, since children will not hold 
 still. 
 
TAPE-WORMS. 
 
 Tape-worms are found as an affection of 
 meat eaters. Infection ensues in the fol- 
 lowing way: The eggs of the worm are first 
 ingested by some animal called a host, where 
 the embryo worm is hatched and passes into 
 the different tissues of the body; in this con- 
 dition it remains undeveloped and forms what 
 is known as measles in the meat. There is a 
 tape-worm from the beef, the hog and from 
 fishes, any of which may develop in man, and 
 though slightly different owing to the source 
 from which the worm comes the treatment is 
 the same for any of the several varieties. 
 
 Symptoms. — The symptoms of tape- worm 
 are not to be relied upon as proof for or 
 against the presence of the worm. There may 
 be no symptoms at all, or there may be colic, 
 or a varied appetite. Itching of the nose may 
 be present, and occasionally there is vertigo. 
 The only sure symptom is the finding of seg- 
 ments of the worm in the stool. 
 
 Treatment. — Either of the following 
 methods are easy as well as reliable : 
 
 ^. Hulled pumpkin seeds, three teaspoon- 
 fuls. Bruise the seeds well and cover with 
 water and let stand for twelve hours. Take 
 at one dose, and in three hours take a prompt 
 acting purge, such as a large dose of Castor 
 oil. 
 
 10 
 
146 MKDICAL HANDBOOK. 
 
 Or the following treatment may be em- 
 ployed : 
 
 R . Oleoresin male fern, one teaspoonful. 
 Give at one dose, or give in one- fourth tea- 
 spoonful doses, fifteen minutes apart. Four 
 hours later give a prompt acting purge as 
 above stated. 
 
 The day before taking the treatment the 
 patient should take a mild purge and eat only 
 liquid diet. 
 
 When the head of the worm is removed the 
 worm is removed. If the head is not expelled 
 the worm will continue to grow and will ap- 
 pear in the stools in segments. 
 
 All excreta of one suffering from tape-worm 
 should be burned, as some animal used for 
 food may be infected. All meats should be 
 thoroughly cooked before being eaten, and 
 measly meat should be rejected. 
 
 TUBERCULOSIS OR CONSUMPTION. 
 
 Consumption is due to the tubercle bacillus, 
 and is an infectious disease. Those having 
 the disease should not expectorate where the 
 sputa afterwards may become dry and pow- 
 dered and carried in the air to the lungs of 
 others. 
 
 The germ of consumption may invade any 
 part of the body. When attacking the lungs 
 
TUBERCULOSIS OR CONSUMPTION. 147 
 
 tubercle bacillus sets up what is commonly 
 called consumption. If the brain is attacked 
 there is acute or chronic meningitis. If the 
 intestinal cavity, chronic peritonitis, and if the 
 bones be invaded the result may be curvature 
 of the spine, hip-joint disease or swelling of 
 the joints and bones elsewhere. The glands 
 may be involved, as is shown by what Is 
 usually called scrofula. 
 
 Treatment. — The locality attacked will be 
 subject to symptoms that will require treat- 
 ment as occasion demands. 
 
 There is no known cure for the tubercle 
 bacillus. Good nourishing food, plenty of air 
 and sunshine are to be strongly advised. We 
 can only assist nature by giving her all the 
 good food and fresh air she can use. In the 
 system nature tends to destroy the germs and 
 prevent their dissemination by throwing out 
 inflammatory circles or capsules around the 
 bacilli, to entomb the germs in the capsule 
 thus formed. 
 
 Tonics are of much value in causing better 
 digestion. The fat producing foods are of 
 especial value to give the circulation plenty of 
 material . to use up in the resistance that must 
 be made. Any undue strain should not be 
 put on the system, as she has enough already. 
 Maternity is especially contra-indicated to 
 those who are tubercular, the mother being 
 much endangered by pregnancy, since the dis- 
 ease is poorly resisted during pregnancy. 
 
URINE. 
 
 Healthy urine is of an amber or straw color. 
 In health the quantity passed in twenty-four 
 hours should be from 2^4 to 3 pints. Food 
 and drink and the amount of perspiration 
 modify the output of urine. If more water is 
 passed the color is usually lighter, if less, 
 darker. In fevers the urine is usually scant 
 and high colored. In nervous disorders it 
 often is profuse and very light colored. 
 Smoky, colored urine is found where there is 
 blood present from the kidneys or bladder. 
 In pregnancy the urine is often quite red and 
 leaves a brick-red sediment on the sides and 
 bottom of the urinal. Normal urine has some 
 froth that rapidly leaves it, but if the froth 
 remains for a long time some kidney or liver 
 disease may be suspected. Cloudy or turbid 
 urine is met with in inflammation and blood 
 poison. 
 
 WHOOPING-COUGH. 
 
 Whooping-cough is an infectious disease, 
 so named from the peculiar long drawn whoop 
 following a paroxysm of coughing. The dis- 
 ease is one of the respiratory organs, and in 
 
WHOOPING-COUGH. 149 
 
 many respects resembles a cold in the head 
 and chest. Children are more prone to the 
 disease than adults, but any one may acquire 
 the disease. One attack prevents or renders 
 the individual immune to the disease in after 
 years. 
 
 Whooping-cough begins as an ordinary cold 
 in the head with slight fever, sneezing, run- 
 ning at the nose and cough. In the course of 
 ten days or two weeks the cough, which 
 has resisted all treatment, becomes paroxys- 
 mal, or excited coughing spells develop. 
 During the coughing spell the face becomes 
 blue, the eyes injected with blood, and the 
 veins of the neck and face are seen to become 
 engorged. Vomiting is very apt to result from 
 the cough, and the child may become poor 
 from inability to keep food on the stomach. 
 Nose-bleed is apt to occur as a result of the 
 engorgement of the veins of the head from a 
 paroxysm of coughing. The small arteries or 
 veins in the white of the eye at times rupture, 
 and the white of the eye may be blood red, of 
 one or both eyes. When the paroxysm of 
 coughing is over there always occurs a long 
 drawn inspiration accompanied by whooping 
 or crowing sound that when once heard will 
 not be forgotten. The stage where paroxysms 
 exist may last from three to four weeks, and 
 the number of paroxysms of coughing may 
 reach thirty or forty in a single day. 
 
150 MEDICAI, HANDBOOK. 
 
 After three or four weeks of the cough 
 and whoop the paroxysms become less fre- 
 quent and finally cease. In some cases the 
 disease only lasts a few weeks, and in others 
 it may be extended over a period of two or 
 three months. 
 
 Complications affecting the lungs, haemor- 
 rhages in the eye or ear, convulsions and 
 chronic cough may follow. 
 
 Treatment. — There is little use to give the 
 expectorant cough medicines for whooping- 
 cough, for the disease will run a certain 
 course do what you will. It is of far greater 
 importance to keep up the strength of the 
 patient by careful and systematic feeding. If 
 a child vomits after a paroxysm of cough- 
 ing immediately feed the child no matter how 
 often the emptying of the stomach may make 
 feeding necessary. There will be times be- 
 tween the paroxysms that will be of sufficient 
 length for some of the food to be digested 
 and pass from the stomach into the intestines. 
 Milk or brandy and milk are well borne, 
 and also gruels or beef tea as well as the 
 liquid foods. Eggs are also a very good food, 
 and may be given beaten up with the milk; 
 eggs are preferable if given raw. Sometimes 
 a hot cloth applied to the chest will relieve 
 the paroxysms of coughing at night. A child 
 suffering from whooping-cough should not be 
 left alone, as choking may occur during a 
 
PIN WORMS OR SKAT WORMS. 1 51 
 
 coughing spell. When the child does cough 
 it is best to take it up and hold the body in 
 any position that will assist the expelling of 
 the mucus. Bend the body slightly forward 
 that the assistance that gravity gives may 
 help to remove the mucus, which is very 
 tenacious. It is often a very good practice 
 to remove with the finger, covered by a towel, 
 some of the mucus from the mouth. 
 
 The room should be kept well ventilated. 
 At night the steam lamp used in croup may be 
 of value, or Cresoline may be used as directed 
 on the lamp. 
 
 The inhalation of a drop of Amyl nitrite, 
 from a pledget of cotton, may be tried to re- 
 lieve the paroxysm. 
 
 Good food and plenty of pure air are the 
 best remedies. 
 
 PIN WORMS OR SEAT WORMS. 
 
 This small worm inhabits the large intes- 
 tine and in appearance resembles small bits 
 of white thread. 
 
 Symptoms. — The most marked symptom is 
 itching. The child is ever boring at the nose 
 with the finger. Itching of the anus is a 
 very common and persistent symptom, and is 
 worse in the evening after retiring. Nervous 
 symptoms are common. Reflex irritation may 
 
152 MEDICAL HANDBOOK. 
 
 cause bed wetting. The worms may migrate 
 from the anus to the genital tract of girls and 
 there set up irritation. Children who have 
 worms often are very fond of candy and have 
 dark rings under the eyes and around the 
 mouth. 
 
 Treatment. — Cleanliness is necessary, for 
 the child usually reinfects itself by carrying 
 the eggs, after scratching, on the finger nails 
 to the mouth in eating. The itching at night 
 can usually be relieved by applying a little 
 vaseline to the perineum and anus. The lower 
 bowel may be washed out daily with an 
 enema of salt water, I drachm to the pint. 
 If salt water cannot be borne then give an 
 ounce of olive oil and follow in a few min- 
 utes by an enema of plain water. If the 
 hands be kept clean and the worms be daily 
 washed from the lower bowel few cases will 
 last more than a week or ten days. If the 
 worms are hard to dislodge, then one-sixth 
 grain of Santonin may be given three times 
 a da}^ in addition to the local treatment. 
 These measures should cure unless the con- 
 ditions are very unusual. If the child is 
 dizzy, and there is gastric irritation, and an 
 appearance of things being yellow, the San- 
 tonin should be discontinued lest too much 
 be given. 
 
WOUNDS. 
 
 By the word wound we understand some 
 injury from without, causing a separating of 
 the structures to a more or less extent. 
 
 Wounds may be incised, punctured or 
 penetrating, as from nails, gunshot and knife 
 thrusts. The surface may be broken by bruis- 
 ing or cutting. The idea of a wound is that 
 the structures have been severed, requiring 
 repair or healing. 
 
 Wounds may be clean or aseptic, or 
 poisoned by germs that delay healing and 
 cause suppuration or sepsis. 
 
 Treatment. — Wherever the injury has oc- 
 curred there is required rest and repair of 
 the part. As there is always great danger of 
 some infectious germs being carried into a 
 wound the precaution of rendering a wound 
 free from such poisonous germs becomes a 
 routine duty. Infected wounds are cleansed 
 by removing all dirt and lifeless tissue, and 
 then by thoroughly bathing the wound sur- 
 face in some antiseptic solution, which will 
 kill all the germs that may be present. The 
 Bichloride of Mercury in the strength of 
 Viooo * s usua Hy employed for this purpose. 
 After thorough cleansing and disinfecting a 
 wound the parts should be coapted or brought 
 together by stitches or adhesive plaster. A 
 
154 MEDICAI, HANDBOOK. 
 
 stimulating dusting powder should be dusted 
 over the wound and an antiseptic dressing 
 applied. Iodoform and Boracic Acid powders, 
 in equal parts, make a good dusting powder. 
 Wounds should be cleansed if there are in- 
 fected areas that suppurate during healing. 
 If pus forms disinfection is again necessary. 
 
 Punctured wounds require opening by free 
 incision and thorough cleansing with an anti- 
 septic solution. Free bleeding is also to be 
 encouraged. Poison carried into the tissue 
 by nails or thrusts must be removed and the 
 wound made free of all poison. 
 
 ANESTHETICS AND ANESTHESIA. 
 
 ETHER. 
 
 Ether is produced by the action of Sulphuric 
 Acid on Alcohol. The properties of ether are 
 a clear, colorless liquid of a characteristic 
 odor and a sweetish taste. Ether readily 
 combines with Alcohol and all of the fixed 
 oils, is highly inflammable and its vapor is 
 highly explosive when ignited by a light or 
 fire. Evaporation is very rapid in the open 
 air and the surface on which it evaporates is 
 markedly chilled, and even freezing can be 
 produced by its evaporation. Ether should be 
 used at a remote distance from any lamp, 
 
ANESTHETICS AND ANESTHESIA. 1 55 
 
 candle or fire. When kept too long there is 
 a partial decomposition of the drug, which 
 renders it more irritating and less desirable 
 for internal use. The chief use of Ether is 
 as an anaesthetic. When introduced into the gen- 
 eral system it stimulates the heart and cir- 
 culation as long as it is given. When fatal 
 results occur from Ether it is usually due to 
 paralysis of the respiratory centers, and the 
 heart is found beating after breathing has 
 ceased. There are some subjects in which 
 there is loss of sensation, but consciousness 
 is not destroyed. Those who habitually use 
 Alcohol are often very hard to etherize. Short, 
 fleshy people are often poor breathers when 
 taking Ether. The effect of Ether is shown 
 first on the mind, then on the nerves of sen- 
 sation and finally on the nerves of motion. 
 Ether is the safest anaesthetic for general use 
 and was introduced as an anaesthetic of mark- 
 ed value for surgical work in the year 1846. 
 
 CHLOROFORM. 
 
 Chloroform was discovered about the year 
 1831, but was not successfully introduced as 
 an anaesthetic for surgical purposes until the 
 year 1847, since which time it has ranked as 
 one of the two anaesthetics of surgery. Chloro- 
 form is far more dangerous than Ether and 
 should be chosen after Ether has been found 
 to be contraindicated. Chloroform is a clear, 
 
156 MEDICAL HANDBOOK. 
 
 colorless liquid, having a characteristic odor 
 and sweetish, burning taste. Soluble in Alco- 
 hol, Ether and all fixed oils. Chloroform is 
 less inflammable than Ether, less irritant to 
 the mucous membranes when inhaled and at- 
 tended by fewer unpleasant symptoms than 
 Ether, but on the whole it is a much more 
 dangerous drug. Ether stimulates, while 
 Chloroform depresses the heart and lungs. 
 When administered to produce anaesthesia by 
 inhalation Chloroform rapidly produces un- 
 consciousness, insensibility and relaxation of 
 the muscles. The heart is quickened, but less- 
 ened in force and volume. Insensibility is 
 produced by Chloroform in a few minutes, 
 and recovery is attended with little or no 
 nausea or vomiting, but fatal results have 
 been so much more common from its use than 
 from Ether that preference should be given 
 to the Ether. 
 
 PREPARATION OF THE PATIENT FOR ANAESTHESIA. 
 
 Solid food should be withheld for one meal, 
 or from four to six hours before the opera- 
 tion, and liquid food for at least two hours 
 before anaesthesia. The bowels should be. 
 moved naturally or by enemata shortly before 
 the time for operation. False teeth or any 
 foreign body in the mouth must be removed 
 lest during the anaesthesia they fall into the 
 throat and endanger the patient from chok- 
 
ANESTHETICS AND ANESTHESIA. 157 
 
 ing (always look to this before beginning to 
 give the anaesthetic). Loosen the clothes of 
 the chest and abdomen and have the patient He 
 down before taking Ether. 
 
 THE EXAMINATION OF THE PATIENT BEFORE 
 ANAESTHESIA. 
 
 Find out if the patient is subject to fainting 
 spells, epileptic fits, chronic heart trouble, 
 acute or chronic lung trouble, kidney disease, 
 and if the patient is at the time under the in- 
 fluence of any drug, and if so, what drug; also, 
 if an habitual user of Alcoholic drinks. 
 
 INDICATIONS FOR ETHER. 
 
 Safety demands that Ether should be given 
 in all cases where it is not contraindicated. 
 
 CONTRAINDICATIONS TO THE GIVING OF ETHER. 
 
 Since Ether is irritant to the mucous mem- 
 branes it follows that it should not be given 
 where there is marked throat or lung trouble, 
 such as inflammation or narrowing of the 
 throat, chronic inflammatory affections of the 
 lungs, such as bronchitis, asthma and con- 
 sumption or tuberculosis ; also, in the acute 
 affections of the lungs whatever the cause 
 may be. 2. Ether should not be given to pa- 
 tients suffering with either acute or chronic 
 renal or kidney diseases. 3. In operations 
 about the head Ether is often contraindicated, 
 
158 MEDICAI, HANDBOOK. 
 
 especially so if the cautery is to be used, or 
 if the operation be on the nose or throat. 4. 
 In chronic alcoholism. 5. In childbed convul- 
 sions (puerperal eclampsia), where an imme- 
 diate effect is required. 6. In the very young 
 and the very old. 
 
 HOW TO ADMINISTER ETHER. 
 
 First. Try to quiet all fears of the patient 
 and then give the patient your whole and un- 
 divided attention from the time the anaes- 
 thesia is begun until the operation is over 
 and the cone removed. 
 
 Second. The anaesthetic should be given 
 slowly at the beginning and mixed with 
 plenty of air. This is safer and more pleas- 
 ant to the patient, less irritant to the mucous 
 membrane of the air passages and materially 
 lessens the struggling of the patient. 
 
 To administer the Ether the patient should 
 lie on the back; the cone is next placed over 
 the nose and held with the thumb and fore- 
 finger of the left hand. The thumb also resting 
 firmly on the bridge of the nose, the little and 
 ring finger press from behind the angle of 
 the jaw forward and upward. This is neces- 
 sary, and should not cease from the begin- 
 ning to the end of the etherization lest the 
 tongue drop back into the throat and material- 
 ly obstruct the breathing. The Ether should 
 then be dropped slowly on the cone and the 
 
ANESTHETICS AND ANESTHESIA. 1 59 
 
 patient told to take long, deep breaths, to 
 blow the Ether away, or to count up to 40 or 
 50. During the early stage of anaesthesia 
 there is liable to be some struggling and there 
 should be assistants to hold the limbs. If 
 the Ether is given too rapidly there will like- 
 ly be some spitting and trouble with mucus 
 in the throat. As the operative stage is reach- 
 ed the breathing is deeper, the face flushed 
 and moist from perspiration. The yielding 
 of the jaw, so that it may have the lower 
 teeth hooked over the upper, which lessens 
 the strain on the ring and the little finger, 
 and the absence of the reflex of the con- 
 junctiva or of the eye, are indications that 
 the operative stage is near at hand. As deep 
 narcosis approaches there is often shallow 
 breathing, followed by long drawn inspira- 
 tions, and the patient may be a little blue. 
 Such breathing is not the best, and the cone 
 should be removed until the breathing is 
 regular, as the giving of much Ether at this 
 time is very dangerous, and if any of the 
 anaesthetic be given the amount should be 
 very small until the breathing is regular 
 again, then continue the Ether and keep the 
 patient just in the operative stage. 
 
 When the stage for operation is reached 
 there will be relaxation of the muscles, ab- 
 sence of the conjunctival reflex, and the eyes 
 will be steady and the pupil small. After the 
 
l6o MEDICAL HANDBOOK. 
 
 patient is well under Ether the amount of the 
 anaesthetic needed to continue the narcosis 
 is small, and it should be given slowly and 
 with plenty of fresh air. A large pupil is 
 either a sign of returning consciousness or of 
 danger, and of itself will not tell if more or 
 less Ether is needed. The rolling of an eye 
 with a dilated pupil slowly from side to side 
 precedes the coming consciousness a short 
 time, and the anaesthetist may know by this 
 that he should give more Ether, or if the pupil 
 is large and the eye fixed or immovable the 
 patient is already too far under and the Ether 
 should be withdrawn. The anaesthetizer 
 should watch the breathing. If long and in- 
 cluding the abdominal walls it is good; if 
 short and jerky, and only of the chest, danger 
 and great danger is near, and the Ether must 
 be stopped at once. If there is stertorous or 
 noisy breathing the tongue has slipped back 
 and the jaw must be brought forward at 
 once. The pulse must be watched, and to do 
 this the middle finger can rest on the artery 
 that crosses the lower jaw between the angle 
 and the chin; also, the radial pulse should be 
 watched. A dark color of the lips and the 
 fingernail indicate that the patient is not get- 
 ting enough air, and the cone should be re- 
 moved. When the patient has received too 
 much Ether the eyes are fixed, the pupils 
 dilated and do not contract when exposed to 
 
ANESTHETICS AND ANESTHESIA. l6l 
 
 light; the breathing short and jerky, the lips 
 and fingernails are blue and breathing may 
 cease from paralysis of the respiratory nerve 
 centers. Remember, the patient deserves your 
 undivided attention. Give the Ether slowly 
 at first, and very cautiously, just as the pa- 
 tient goes into the operative stage. Keep the 
 lower jaw forward. Watch carefully the pulse, 
 the eye, the breathing and the color of the 
 lips and fingernails. 
 
 HOW TO MEET EMERGENCIES. 
 
 Have with you a short piece of wood y 2 
 by i by 6 inches to use as a pry in spasmodic 
 closing of the mouth. 
 
 A pair of forceps to grasp the tongue with 
 in case of accident. Towels to wipe out the 
 mouth w r ith in case of choking, and have 
 ready Brandy and Strychnine if needed to be 
 used as heart tonics. In asphyxia of choking 
 from swallowing the tongue, bring the jaw 
 well forward, and if necessary draw the 
 tongue out of the mouth with a pair of for- 
 ceps. Asphyxia from too much ether should 
 be met at once with artificial repsiration, as fol- 
 lows : Lower the head, hold the jaw well 
 forward and the mouth open, let two as- 
 sistants take either arm at the elbow and 
 carry them up until they meet over the head, 
 then down again until they touch the anterior 
 surface of the chest, press simultaneously and 
 
 11 
 
l62 MKDICAI, HANDBOOK. 
 
 firmly on the chest, and then repeat the 
 motion. The movements of the arms for aiti- 
 ficial respiration should be about sixteen or 
 eighteen per minute, not more. Do not stop 
 efforts at resuscitation too soon. Dash cold 
 or hot water on abdomen and chest, and rub 
 the extremities toward the heart. Ice slipped 
 into the rectum or the rectal specula will by 
 reflex action often promptly restore breath- 
 ing. As soon as swallowing returns give 
 alcoholic stimulants. Where there is choking 
 from foreign bodies in the throat, or from 
 mucus, turn the patient on his face and re- 
 move substance with the finger and towel. If 
 the patient vomits turn him on his side, face 
 down, until the mouth and throat are empty. 
 Remember last of all that any drug capable 
 of producing unconsciousness is not devoid of 
 danger, and that cases are lost occasionally 
 by the most skilled. Chloroform has more 
 than twice the mortality of ether. Ether is 
 said to be the direct cause of death of one 
 case in 26,000; but those who have not hand- 
 led this drug should not use these figures as 
 a proof that they will not have this one fatal 
 case. If ether is given at night place the 
 light well above the patient. Ether vapor is 
 heavy and falls to the floor. If explosion 
 occur cover the patient's face and set the ether 
 can aside, do not throw it lest it burn and the 
 trouble be made worse. 
 
ANESTHETICS AND ANESTHESIA. 163 
 THE ADMINISTRATION OF CHLOROFORM. 
 
 The preparation and also the examination 
 of the patient and the restrictions of food are 
 the same as for ether. 
 
 INDICATIONS FOR THE USE OF CHLOROFORM. 
 
 Chloroform is indicated where ether cannot 
 be used and anaesthesia is necessary. 1. 
 In acute and chronic affections of the throat 
 and lungs. 2. In acute and chronic renal or 
 kidney diseases. 3. In chronic alcoholism. 4. 
 In night operations where ether cannot be 
 used on account of the light or fire. 5. In 
 operations about the nose and throat. 6. In 
 convulsions of childbed fever (eclampsia). 7. 
 In nervous and mental diseases where the ex- 
 citing effects of ether cannot be borne without 
 danger to the patient. 
 
 CONTRA-INDICATIONS FOR THE USE OF CHLORO- 
 FORM. 
 
 I. Chloroform is contra-indicated wherever 
 ether can be used. 2. In faintness and weak- 
 ness from loss of blood (shock). 3. Epilepsy. 
 4. Where there is a tendency to fainting. 5. 
 In the various diseases of the heart, and 
 where Chloral hydrate has been given shortly 
 before anaesthesia. 
 
 To administer chloroform the patient should 
 be in the recumbent position. The clothing 
 
164 MKBICAI, HANDBOOK. 
 
 loosened, false teeth removed, and the fears 
 of the patient quieted as much as possible. 
 The lower jaw should receive the same care 
 as in ether. The cone should not be used, 
 but instead a single thickness of some light 
 woolen fabric stretched over a frame of suit- 
 able shape and size. It will be remembered 
 that ether is a stimulant to the heart and 
 nerves of circulation; that it is more irritant 
 than chloroform to the mucous membrane, 
 and that it kills by paralysis of the respiratory 
 centers. In ether poisoning breathing ceases 
 long before the heart refuses to act, thus giv- 
 ing more time and chance for resuscitation 
 than in chloroform. Chloroform depresses the 
 heart and nerves, and when the heart stops 
 the chances of resuscitation are few. Hold 
 the inhaler or mask for chloroform two or 
 three inches from the nose, and begin by drop- 
 ping slowly the chloroform on the mask. As 
 soon as the giving of chloroform has begun 
 never remove your eye or attention to any- 
 thing else than the patient, until the patient 
 has recovered beyond the point of danger. 
 Never be in a hurry in giving chloroform. 
 Usually there is little struggling, and the pa- 
 tient passed rapidly into the second or opera- 
 tive stage of anaesthesia. Keep the jaw well 
 forward. Sometimes in the first stage of 
 chloroform there is restlessness, short breath- 
 ing and anxiety of the patient ; if this occurs 
 
ANESTHETICS AND ANESTHESIA. 165 
 
 remove the mask and let the patient quiet a 
 little, to push chloroform at this stage is 
 dangerous. When the patient is about to pass 
 into the operative stage be very careful not 
 to give a poisonous or overdose of the drug, 
 for with the deep breaths common at this time 
 too much chloroform can easily be given. Re- 
 member there is no safety but in little chloro- 
 form and plenty of air. Watch the eye as in 
 ether, and try to keep the patient as near the 
 stage of coming out as can be, and yet be 
 fully under. It is dangerous to operate when 
 the patient is not fully under, but strive to 
 keep him just in the operative stage of an- 
 aesthesia. In the operative stage of chloro- 
 form the pupil is more contracted than in 
 ether. Adilated pupil and fixed eye with short 
 breathing indicates danger, and the drug must 
 be stopped at once. Do not let the breathing 
 become noisy, keep the jaw well front. Watch 
 the pulse, the breathing, the jaw and the 
 color of the lips and finger-tips. If the heart 
 is quick and hard there may be too little air, 
 raise the mask higher. For choking or vomit- 
 ing proceed as in ether. If the pupils become 
 dilated, the eye fixed, the respiration shallow 
 and the lips blue, stop all chloroform, lower 
 the head of the patient, apply friction of the 
 limbs towards the heart, and give hypodermic 
 injections of heart tonics and of brandy. 
 After taking an anaesthetic some one should 
 
l66 MEDICAI, HANDBOOK. 
 
 watch the patient until he is well out from 
 under the influence of the drug. There may 
 be vomiting, and some one be needed for this 
 as well as to see that from restlessness an 
 operated part be not injured. After chloro- 
 form the tendency to vomit is not so great as 
 after the ether; the patient usually passes into 
 a long sleep to awake conscious. The dangers 
 of moving are injury to the operated part, or, 
 if allowed to rise, added strain may be put 
 onto the heart that needs the time following 
 the operation to regain its strength. 
 
 LOCAL ANESTHESIA. 
 
 There are different agents used to produce 
 local anaesthesia, but for ordinary use we will 
 consider only the one drug, Cocaine hydro- 
 chlorate. Cocaine hydrochlorate can be se- 
 cured in various forms for surgical use, but is 
 best in the one-fourth grain tablet. The dose 
 is from one-fourth to one grain. The drug is 
 used on mucous surfaces by being dropped on 
 the place or line of incision about three min- 
 utes before the time of using the knife. Small 
 operations may be done under the influence 
 of cocaine, by first injecting with the hypo- 
 dermic needle a little of a one per cent, solu- 
 tion along the line of incision. In small ampu- 
 tations and incisions the time to cut is about 
 five minutes after the injection of the drug. 
 There will be no pain felt for about ten or 
 
ANESTHETICS AND ANESTHESIA. 1 67 
 
 fifteen minutes after cocaine has been injected. 
 Where cocaine is used on fingers or toes, the 
 member should have a stout ligature or string 
 tied around it to retard the flow of blood 
 from the part, as it may, if too rapidly ab- 
 sorbed, produce alarming nervous symptoms. 
 
 If the patient becomes restless, talkative and 
 pale, there has been too much drug given, or 
 it has been absorbed too quickly. 
 
 If such symptoms occur have the patient lie 
 down and give brandy or other heart tonics 
 and allow the use of smelling salts or am- 
 monia. 
 
 Overdoses of cocaine may produce pallor, 
 restlessness, tremor, syncope, weak heart ac- 
 tion, delirium and convulsive fixation of the 
 chest and organs of respiration. 
 
 In using cocaine use the drug just where 
 you wish to cut. Use as little as will thor- 
 oughly deaden the pain. Try to retain the 
 drug where it is needed and avoid large veins 
 or vascular areas when injecting it. 
 
 For small lancings and minor operations 
 cocaine is preferable to using either of the 
 stronger anaesthetics. Use the drug with care 
 and you will find it very serviceable. If the 
 patient begins to talk freely while you are 
 using the drug, look at his face, and if he is 
 a bit pale, give him at once some brandy and 
 have him lie down. Fatal results may occur 
 but are not common. Be careful of the use of 
 
l68 MEDICAL HANDBOOK. 
 
 cocaine at all times, and especially on children 
 and the very old. 
 
 ACONITUM NAPELLUS. 
 
 Aconite is usually given in the tincture. In 
 moderate doses it slows the pulse and respir- 
 ation or breathing, and lowers the tempera- 
 ture. 
 
 Use. — In febrile affections, where there is 
 a rapid pulse, rapid breathing and mental 
 anxiety. In. the early stages of a cold where 
 there is fever. Early in quinsy. Sore throat 
 and the fevers of children. The dose should 
 be i drop in water every hour until the fever 
 and pulse are lessened. For children the dose 
 should be reduced by adding water according 
 to the age of the child. 
 
 HOMCEOPATHIC PREPARATION AND INDICATIONS. 
 
 Dose. — One drop of the tincture every hour 
 for 4 or 5 doses, or i drop of the ix dilution 
 every hour until symptoms abate. 
 Symptoms for which Aconite is indicated: 
 Fear and anxiety of mind, fear of death, 
 congestion of the head and derness of the 
 face, throbbing headache, roaring in the ears, 
 nose bleed, dry mouth and continual thirst, 
 bitter taste in the mouth, watery, slimy stools, 
 small amount of urine that is high colored 
 and its passage is associated with burning in 
 the bladder. 
 
REMEDIES. 169 
 
 Aconite is good for neuralgia of the head, 
 iety. For colicky, shooting pains in the abdomen, 
 For colicky, shooting pains in the abdomen, 
 with watery, slimy stools. For fevers where 
 there is a hard, quick pulse, rapid breathing, 
 mental anxiety and unsatisfied thirst. For 
 suppression of the menses from fear or anxiety. 
 For pain in the heart that extends down the 
 left arm, with rapid pulse after exposure to 
 cold. 
 
 For neuralgia 30 drops of the Tr. Aconite 
 in an ounce of water makes a very good lotion 
 to bathe the face with. 
 
 For toothache 1 drop of Tr. Aconite will 
 afford rapid relief, applied on a little cotton, 
 and keep the saliva from the aching tooth by 
 a pledget of cotton between the tooth and the 
 cheek. Early in fevers there is no drug to 
 surpass Aconite. From 5 to 10 drops of the 
 tincture may be placed in a half glass of 
 water and a teaspoonful be given hourly until 
 the fever is reduced and the pulse slowed. 
 When the fever and pulse have been re- 
 duced it is best to stop the use of the drug. 
 At all times avoid large doses. It is not ad- 
 vised to go beyond 5 to 10 drops in the course 
 of any single day. For children make the 
 dose less. The tablets are very convenient 
 to give. The dilutions are better for the 
 chronic conditions calling for Aconite. Never 
 
I70 MEDICAL. HANDBOOK. 
 
 let the cup of medicine remain where some 
 one may drink it by mistake. 
 
 APIS MELLIFICA (HOMCEOPATHIC) . 
 
 Dose, 3x to 6x, i tablet every two hours. 
 
 Symptoms Calling for Apis. — Swelling, 
 with burning and tingling in any part of the 
 body. The mind is sluggish. Pain in the 
 head relieved by pressure. The patient is 
 restless and turns from side to side in bed, 
 and at times suddenly cries out and screams. 
 Puffiness of the eyes and dread of light, 
 swollen tongue and swollen tonsils, with diffi- 
 cult swallowing and obstructed breathing; 
 soreness of the abdomen, greenish, watery 
 stool, worse in the morning and an inability 
 to retain the movements ; the bowel as it were 
 remains open, dark, scant urine ; swelling of 
 the limbs, with a waxy, watery appearance ; 
 hive-like eruption, with sticking, itching and 
 burning pain. 
 
 ASAFOZTIDA. 
 
 Asafcetida is a gum from a Persian plant. 
 
 Dose, I to 3 grains in a pill, two or three 
 times a day. 
 
 Asafcetida is a valuable remedy for dis- 
 turbances of the nervous system. Hysteria 
 and nervous excitement of any kind. 
 
 It is a prime remedy for indigestion, with 
 much distension and a feeling of a ball rising 
 
REMEDIES. 171 
 
 in the throat. For windy rumbling of the 
 bowels, with the passage of much gas. 
 
 For nervous indigestion and the disturbed 
 digestion of the aged, associated with disten- 
 sion, wind and colic, and the belching of 
 greasy, rancid tasting food. 
 
 Asafoetida, 3 grains ; Powdered Nnx vomica, 
 Y^ grain, in pill, 1 pill after meals, is a good 
 remedy for nervous indigestion. 
 
 ASAFOETIDA (HOMCEOPATHIC) . 
 
 Dose, ix to 3x, 2 or 3 tablets, three times 
 a day. 
 
 Asafoetida is indicated for hysterical symp- 
 toms, nervous excitement, a sensation of a 
 ball rising in the throat, belching of rancid, 
 greasy tasting food, a windy condition of 
 the bowels ; for an all-gone empty feeling of 
 the stomach, with gnawing and burning and 
 a rancid, greasy taste in the mouth. 
 
 ARSENICUM ALBUM. 
 
 Arsenic is a drug much used by all schools 
 of medicine. 
 
 In regular medicine Arsenic is used for 
 nervous affections, such as St. Vitus' dance, 
 neuralgia and for diabetes, consumption, 
 rheumatism, malaria and diseases where 
 there is a chronic, warty thickening of the 
 skin. Arsenic is usually given in Fowler's 
 solution. The dose is from 1 to 5 drops 
 (given in water) three times a day. 
 
172 MEDICAL. HANDBOOK. 
 
 Begin *with a small dose and increase the 
 dose gradually from day to day. Puffy swell- 
 ing of the eyes in the morning and looseness 
 of the bowels, with colic, are signs that enough 
 of the drug has been given and its adminis- 
 tration should cease or the dose be reduced 
 to about two-thirds of what was being given 
 when the puffiness of the eyes and diarrhoea 
 appeared. 
 
 Should poisoning occur from the accidental 
 swallowing of an overdose of Arsenic give an 
 emetic. When the stomach is empty or be- 
 fore, if the emetic acts at all slow, administer 
 Ferric Hydrate and Magnesia in tablespoonful 
 doses every fifteen minutes. Arsenic is very 
 poisonous, and its administration should be 
 according to directions. 
 
 ARSENICUM ALBUM ( HOMOEOPATHIC) . 
 
 Dose, 3x to 6x, i tablet given after meals or 
 in water. 
 
 Symptoms Calling for Arsenic. — In acute 
 cases use the 3x tablet, and for chronic cases 
 use the 5x or 6x tablet. 
 
 Arsenic is indicated where there is great 
 mental anxiety, restlessness and the patient 
 cannot bear to be alone; starting and jerking 
 of limbs when asleep, frontal headache, worse 
 from heat and relieved by cold compresses ; 
 watery corroding discharge from the nose, 
 the gums are swollen and bleed easily, the face 
 
REMEDIES. 173 
 
 is pale and drawn and neuralgic pains. Food is 
 not tasted, gnawing and burning in the abdo- 
 men, with a desire for water all the time ; 
 drinks little and often ; there is cutting pain 
 in the bowels, with dark, watery stools, that 
 are followed by burning in the rectum and 
 anus. 
 
 Prostration is a marked symptom with the 
 diarrhoea. Arsenic is good in kidney disease, 
 associated with dropsy and puffiness of the face 
 and limbs. Watery appearance of the skin, and, 
 though the body is over-charged with water, 
 there is a continual thirst. Dry, hacking 
 cough and dryness of the chest before mid- 
 night. The skin is dry and harsh, w,ith 
 burning itching and biting pains. There may 
 be eruptions that crust easily and burn and 
 itch around the crusts. Ulcers that burn 
 and have a watery, offensive discharge. 
 Arsenic is good for the later stages of fevers, 
 where there is blueness of the lips, dryness 
 of the skin, dryness of mouth and cracking 
 of lips, with thirst during the fever for oft 
 repeated drinks, and diarrhoea of dark, of- 
 fensive stools. 
 
 The Arsenic patient is worse after mid- 
 night, worse from cold or cold drinks, re- 
 lieved by warmth and warm drinks and feels 
 worse from lying still. 
 
174 MEDICAL. HANDBOOK. 
 
 ALUM. 
 
 Alum may be in large, colorless crystals 
 or in a white powder. Alum is seldom used 
 for internal medication. One to 2 teaspoon- 
 fuls will usually cause vomiting. Five to 10 
 grain doses may be used to check diarrhoea, 
 but there are so many bad results from the 
 internal use of Alum that it is seldom given. 
 Irritation of the stomach and disturbed di- 
 gestion is very apt to follow the internal use 
 of the drug. 
 
 Externally burnt Alum is often used as 
 a powder for unhealthy wounds, ulcers, etc., 
 etc. Alum cleanses the wound, stimulates 
 healing and tends to remove exuberant granu- 
 lation or proud flesh. 
 
 Powdered Alum may be blown into the 
 nose to stop nose bleed. A strong solution 
 of 1 drachm or 1 teaspoonful to a pint of 
 water may be drawn from the hand into the 
 nose to stop nose bleed. The same solution 
 may be used to bathe bleeding surfaces with 
 or dressings may be applied to bleeding 
 wounds that have been saturated in the Alum 
 solution. 
 
 ANTIMONIUM CRUDUM ( HOMOEOPATH ic) . 
 
 Dose, 3x to 6x, 1 tablet every two hours. 
 Symptoms Calling for the Drug.— Morose, 
 thinking on the dark side of things. Is peev- 
 
REMEDIES. 175 
 
 ish and sentimental. Does not want to be 
 touched or looked at. Dizziness and headache, 
 worse after eating. The abdomen feels dis- 
 tended. Vomiting that is difficult to stop. 
 An urgent call to evacuate the bowels, and 
 the effort is attended with the escape of much 
 gas and finally a small movement, followed 
 by sticking, burning, deep-seated pain in the 
 rectum. 
 
 ARNICA MONTANA ( HOMOEOPATHIC) . 
 
 Dose, to 3x, 1 to 5 tablets every two or 
 three hours. 
 
 Symptoms Calling for Arnica. — Sore, 
 bruised sensation in any part of the body. 
 Stitching pain in the head following bumps 
 or blows to the head. Offensive taste in the 
 mouth, with nausea after eating. Fermental 
 diarrhoea, with slimy blood-streaked move- 
 ments that are followed with much burning 
 and tenesmus or griping. 
 
 Soreness of the abdomen after labor. Sore- 
 ness of the chest from coughing. Arnica is 
 indicated in whooping-cough when children 
 cry before coughing from the anticipation of 
 pain. Soreness of the limbs, with fear of be- 
 ing touched. The Arnica patient complains 
 that the bed is too hard and he cannot find 
 a soft place. Arnica tincture diluted with 
 twice its volume of water makes a good lotion 
 for bruises. Arnica should not be used where 
 
176 MEDICAI, HANDBOOK. 
 
 the skin has been broken, but in its stead 
 Hamamelis is to be preferred. For blood- 
 spitting give 5 tablets of the tincture every 
 hour. 
 
 ANTISEPTICS. 
 
 Antiseptics, as the name would imply, are 
 drugs opposed to septic or putrefactive condi- 
 tions. Antiseptics are used locally to cleanse 
 infected areas or to prevent infection in newly 
 injured structures. Internally these drugs 
 are usually violent poisons, and for this rea- 
 son should be well marked, labeled and 
 guarded to prevent accidental administration 
 and serious results. 
 
 BICHLORIDE OF MERCURY OR CORROSIVE SUB- 
 LIMATE. 
 
 There is no other antiseptic so generally 
 used as Corrosive Sublimate. It is a violent 
 poison when taken internally. Should poison- 
 ing occur from the accidental swallowing of 
 Corrosive Sublimate the first thing to be done 
 is to empty the stomach by a prompt emetic. 
 Then give egg or egg albumen freely and oft 
 repeated. The egg albumen combines with 
 the free or unabsorbed poison and forms a 
 non-poisonous compound. 
 
 For the disinfection of surface wounds the 
 Bichloride of Mercury may be used in the 
 strength of 1 / 1000 - This is a good strength 
 
REMEDIES. 177 
 
 for the disinfection of the hands prior to the 
 handling of wounds or the performing of 
 operations. For the continued use on wounds 
 or for wet dressings the drug is best used in 
 the strength of 1 / 2000 , as, if applied too strong, 
 there is danger of vesication or blistering of 
 the surface and perhaps absorption of too 
 much of the drug. If vesication should occur 
 discontinue the use of the Corrosive Subli- 
 mate, and dust the vesicated part with some 
 powder as Boracic Acid. The tablets are the 
 best form in which to get the Bichloride of 
 Mercury or Corrosive Sublimate for external 
 use. 
 
 N. B. — Always mark as poison and keep 
 where no mistake can arise. 
 
 CARBOLIC ACID. 
 
 Carbolic Acid is very poisonous in large 
 doses. As much as 2 grains may be taken in- 
 ternally if diluted in water and cause no 
 alarming symptoms. 
 
 Poisoning may be produced by accidental 
 swallowing of a watery solution or by the 
 application of the acid in solution over ex- 
 tended wound surfaces. 
 
 The mouth and tongue have a burnt appear- 
 ance where a strong solution has been inject- 
 ed, and the breath has the characteristic odor 
 of the drug. Where absorption from the sur- 
 face of the body has produced poisoning the 
 
 12 
 
178 MEDICAI, HANDBOOK. 
 
 symptoms are dizziness, headache, weakness 
 of the body and dark, cloudy urine. 
 
 If accidental poisoning occur wash out the 
 stomach with the stomach tube, using as a 
 wash a solution of Epsom Salts in water, y 2 
 ounce of Epsom Salts to the pint of water. 
 Alcoholic drinks should also be given in the 
 form of wine, brandy or whisky, for the alco- 
 hol in the drinks stops the caustic action of 
 the acid. It is not necessary to cause in- 
 toxication. Oil is a very good thing to be 
 given as soon as possible after the injection 
 of the acid, as it dissolves the acid and pre- 
 vents the deep burning of the drug. Epsom 
 Salts in solution acts on Carbolic Acid and 
 forms with it a non-poisonous substance. Egg 
 albumen is also of service if given at once 
 after the ingestion of the drug that the acid 
 may act on the egg and prevent deep burning 
 of the tissues. If the symptoms of chronic 
 poisoning develop from the external use of 
 Carbolic Acid stop its use in lotion or salve 
 and the poisonous symptoms will disappear. 
 
 For the hands and to cleanse offensive sores 
 and ulcers Carbolic Acid in the strength of 
 x / or 1 / 40 is an excellent wash. 
 
 Externally Carbolic Acid is used as a 
 caustic in strong solution and as a disin- 
 fectant in the weaker solutions. Carbolic 
 Acid combines with water in all strengths. 
 The 1 per cent, solution is good for ulcers, 
 
REMEDIES. 179 
 
 itch, tetter and itching areas in any part of 
 the body, and for offensive arm pits and of- 
 fensive feet. 
 
 For offensive sore throat use 8 drops to the 
 ounce of water as a gargle. For itching sur- 
 faces 16 drops to the ounce of lard or vaseline, 
 and apply as occasion demands. Also, as a 
 soothing wash the following may be used : 
 
 ^. Carbolic Acid, 2 drachms. Alcohol. 
 Glycerine aa, 1 ounce. Water, 1 pint. Use 
 as often as occasion requires as a soothing 
 wash. 
 
 If a boil or carbuncle is to be lanced paint 
 the line of incision with a strong solution 
 and in a few moments the incision can be 
 made without much pain being felt. 
 
 For toothache apply a drop of the strong 
 solution on a small pledget of cotton and 
 cover with some more cotton, or keep the 
 saliva from the tooth by a piece of cotton 
 against the cheek. The Carbolic Acid if al- 
 lowed to act is a very good remedy for tooth- 
 ache. 
 
 The cavities of carbuncles and deep, of- 
 fensive ulcers are much benefited by being fre- 
 quently cauterized to the very bottom with a 
 strong solution. 
 
 BELLADONNA. 
 
 Dose. — Tincture of Belladonna, 3 to 10 
 drops. Fluid Extract Belladonna, 1 to 2 
 
l8o MKDICAI, HANDBOOK. 
 
 drops. Atropine Sulphate, 1 / 500 to 1 / 100 
 grain. (N. B. — Part of a grain.) 
 
 Internally, Belladonna in full doses pro- 
 duces dryness of the throat, dilated pupils 
 and increased frequency of the pulse; it pro- 
 duces mental excitement and lessens all the 
 secretions from mucous surfaces. 
 
 Belladonna is used in convulsive seizures. 
 Spasms of the throat, as in croup and whoop- 
 ing cough. Incontinence of urine in children. 
 As an adjunct to other drugs in constipation. 
 As a local application in chilblains. Atropine 
 in 1 / 150 part of a grain is used for the night- 
 sweats of consumption, given at bed-time. 
 
 In child-bed conditions where the mother 
 cannot nurse the child 1 / 200 part of a grain 
 twice a day will assist in drying up the milk. 
 A Belladonna plaster is sometimes applied to 
 the breast instead of giving Atropine. 
 
 In salivation from overdoses of Mercury, 
 1 / 200 part of a grain of Atropine Sulphate is 
 beneficial to stop the excessive flow of saliva. 
 Give two or three times a day. 
 
 Never give Belladonna or Atropine Sul- 
 phate longer than to get the dilated pupil and 
 dry throat. Do not give Belladonna or 
 Atropine to light complected persons, as they 
 are very apt to be susceptible to the drug, and 
 may break out in a red rash from its effects. 
 
 Handle Belladonna and Atropine Sulphate 
 with care, as they are strong drugs, and some 
 
REMEDIES. I8l 
 
 persons are quite susceptible to even small 
 doses. 
 
 BELLADONNA (HOMCEOPATHIC) . 
 
 Dose. — ix to 6x, i to 3 tablets every two 
 to six hours. 
 
 Indications Calling for Belladonna. — 
 Flushed, bright red cheeks, injected eyes, 
 throbbing headache, dilated pupils, squinting 
 of the eyes, grinding of the teeth. Jumps 
 from sleep and cries out and tries to escape. 
 Delirium, tears at the clothing; clutches in the 
 air and starts as if falling. May lapse into a 
 stupor and awake with a scream and intense 
 fear. Bores the head into the pillow. Hot 
 skin and throbbing pulse. (Threatened con- 
 vulsions of childhood should lead you to 
 think of Belladonna.) In the ears there is 
 shooting pain that may pass from ear to ear. 
 Dry throat. Tongue red on edges and white 
 in centre, with strawberry-like appearance of 
 the tongue caused by the papillae of the tongue 
 showing through the white coating. Bleeding 
 of the nose, soreness of the throat, putrid 
 taste in the mouth. Diarrhoea of green mucus 
 with griping and bearing down. Turbid urine 
 and frequent desire to urinate. Involuntary 
 urination during sleep. Backache. Pain in the 
 neck. In women the menses are too early and 
 too profuse, with offensive discharge. When 
 the flow is established the blood is bright red. 
 
l82 MEDICAL. HANDBOOK. 
 
 Belladonna pains gradually increase and then 
 suddenly disappear, to reappear in some other 
 part of the body. The pain is worse on the 
 right side. Jarring the bed makes the pain 
 worse. Pain worse by gentle pressure, but 
 firm pressure does not annoy the patient. 
 
 Belladonna is of much service in the dis- 
 eases of children and in fevers where there 
 is a bright flushed face and delirium. 
 
 BAPTISIA TINCTORIA (HOMOEOPATHIC) . 
 
 Dose. — ix to 4x, i tablet every four hours. 
 
 Symptoms Calling for Baptisia. — Dark, 
 flushed and besotted appearance of face. Con- 
 fusion of ideas. Stupid, goes to sleep when 
 talking or forgets what he is saying. Stupefy- 
 ing headache. Feels as if scattered about in 
 the bed, and wants to get the parts together. 
 Dark brown streak in the centre of the 
 tongue. Fetid breath, offensive ulcers in the 
 mouth. Offensive diarrhoea with colic and 
 griping. Offensive perspiration. Chest seems 
 full and is short of breath. Urine dark and 
 offensive. Trembling of hands and feet. 
 
 Baptisia is a good remedy in some forms of 
 typhoid fever, and for fevers in general where 
 there is a low exhausted condition. 
 
 BISMUTH SUB NITRATE. 
 
 Dose. — From 2 to 40 grains. Usual dose, 4 
 grains for children; 10 grains for adults. 
 
REMEDIES. 183 
 
 Bismuth Subnitrate is a white powder al- 
 most tasteless, is permanent, or does not 
 change if exposed to the air. Bismuth has an 
 astringent and antiseptic action. Bismuth is a 
 very valuable remedy for acidity of the 
 stomach, catarrh of the stomach, ulcer of the 
 stomach, and acute indigestion with vomit- 
 ing. 
 
 In catarrhal diarrhoea where the bowels are 
 empty or have been emptied by a purge, Bis- 
 muth is antiseptic and sedative to the intes- 
 tinal mucous membrane. 
 
 After taking Bismuth the stool becomes 
 dark or greenish from the decomposition of 
 the drug in the intestines. 
 
 Locally, Bismuth and Starch in equal parts 
 make a good healing powder for ulcers and 
 bed-sores. One drachm of Bismuth to an 
 ounce of vaseline makes a good healing salve. 
 
 For ulcer and catarrh of the stomach give 
 10 grains of Bismuth one-half hour before 
 the meal. For diarrhoea give 10 to 15 grains 
 of Bismuth two hours after the meal, that 
 the Bismuth may not lay in the stomach while 
 digestion is going on. After two hours the 
 food passes from the stomach. If milk is the 
 food, give the drug one hour after feeding, in 
 order that, as the food leaves the stomach, the 
 Bismuth will reach the intestines in a direct 
 manner. For diarrhoea of infants give 3 or 4 
 grains of Bismuth, one hour after feeding. 
 
184 MKDICAI, HANDBOOK. 
 
 For acidity of the stomach give any time 
 when required. For the diarrhoea of adults 
 give 10 grains, two hours after meals. If 
 given with the meal the drug lies in the 
 stomach during digestion; therefore, give 
 some time after eating. 
 
 BRYONIA ALBA ( HOMOEOPATHIC ) . 
 
 Dose. — ix to 6x, one tablet four times a day. 
 
 Indications for Bryonia. — Fullness of the 
 head, splitting headache, irritable. Wants 
 things and when they are offered refuses 
 them. Mouth parched and dry. Tongue 
 coated dark brown and cracked. Great thirst for 
 much water at a time, at long intervals. Weight 
 in the stomach after meals. Sensation of a 
 lump in the stomach. Stitches in the liver. 
 Constipation, dry, dark, lumpy stool. Ten- 
 derness of the abdomen. Urine scant and red 
 in color. Menses in women too early, too 
 profuse, and attended with stitching pain in 
 the abdomen and legs. Rheumatic swelling 
 of the joints, starting on going to sleep. Dry 
 cough worse at night when in bed. Stitch- 
 like pain in the chest, the abdomen and in the 
 joints. Bryonia is good in typhoid fever 
 where the limbs are sore and motion makes 
 all the pains worse. Severe frontal head- 
 ache. Delirium where the patient wants to go 
 home or dreams of business. Nose-bleed is 
 also present in fevers where Bryonia is indi- 
 
REMEDIES. 185 
 
 cated. The Bryonia patient is worse in the 
 morning and worse from motion. 
 
 BETA NAPHTOL BISMUTH OR ORPHOL. 
 
 Orphol is a light-brown powder having no 
 odor or taste. 
 
 Orphol, y 2 drachm to 1 ounce of lard or 
 vaseline, is one of the best, quickest and least 
 irritating ointments for the cure of the itch. 
 One-half drachm to 1 ounce of vaseline is 
 quite sufficient where the surface involved is 
 large. 
 
 Apply the ointment daily for five or six 
 days, then take a bath or wash the affected 
 area. 
 
 BERBERIS VULGARIS (HOMCEOPATHIC) . 
 
 Dose. — 2x to 6x, 1 tablet three times a day. 
 
 Indications for Berberis. — Sticking pain In 
 the region of the liver or under the ribs of 
 the right side of the chest. Sticking pain in 
 the kidney, which may extend from the kid- 
 ney to the bladder. Burning, cutting pain in 
 the bladder worse on urinating and extending 
 into the urinary passage. Red sediment in the 
 urine. Biliary colic, liver spots. Is a good 
 remedy for women who have pain in the right 
 side. Liver spots (dark brown areas on the 
 face or other parts of the body). Such 
 women have headache, pain in the back that 
 extends into the legs, and pain on urinating 
 
l86 MEDICAL HANDBOOK. 
 
 that comes from the bladder and extends 
 along the urinary passages. 
 
 COLOCYNTHIS ( HOMOEOPATHIC) . 
 
 Dose. — Q to 3x, i tablet every hour until re- 
 lieved. 
 
 Indications for Colocynth. — Violent neu- 
 ralgia of the head and face, worse on the 
 right side. Very irritable. Severe colicky 
 pains in the abdomen, worse around the navel. 
 Sore feeling of the bowels. Colic relieved by 
 bending forward and by pressure. Green or 
 bloody diarrhoea, diarrhoea after emotion or 
 vexation. Colic and diarrhoea always asso- 
 ciated. Ovarian colic at menstrual period re- 
 lieved by pressure. Sciatica or pain extending 
 from the hips to the thighs and feet. Cramp- 
 like pain in any part of the body as if the part 
 were in a vise. 
 
 CATHARTICS. 
 
 Cathartics are drugs that will move the 
 bowels by their action on the muscular walls 
 of the intestines, or by causing an increased 
 amount of fluid in the intestines, excited by 
 the action of the drug on the intestinal 
 mucous membrane. Some cathartics act on 
 the large intestine and some on the small. The 
 object desired should direct in the selection of 
 the cathartic. 
 
REMEDIES. 187 
 
 U. S. P. CATHARTIC VEGETABLE PILLS. 
 
 The U. S. P. Veg. Cathartic Pills are a com- 
 bination of drugs that act on all parts of the 
 intestine, causing an increase in the watery 
 secretion of the bowel, and an increase in the 
 onward movement of the intestines. They are 
 a very efficacious remedy for the emptying of 
 the bowel. 
 
 Dose. — One to two pills, and repeat in six 
 hours if no movement has occurred. 
 
 CASTOR OIL. 
 
 Dose. — One teaspoonful for an infant and 
 ^ to 1 ounce for adults. 
 
 Castor oil is a safe and prompt cathartic, 
 moving the bowels by its irritant action on the 
 muscular coats of the intestines. The time re- 
 quired to cause a movement is from four to 
 six hours. Following the use of Castor oil 
 there is usually a reactive quiescense of the 
 muscular coats of the intestines and a ten- 
 dency to constipation ; therefore, Castor oil is 
 to be given for the simple emptying of the 
 bowel and not as a remedy for constipation. 
 Where there is acute indigestion and the 
 bowels needs emptying there is no better 
 remedy. In summer complaint or in diar- 
 rhoea that results from improper feeding, one 
 dose of Castor oil is very beneficial in assist- 
 ing the intestines to rid themselves of their 
 
l88 MEDICAL HANDBOOK. 
 
 obnoxious burden. Following Castor oil the 
 Subnitrate of Bismuth in fairly large doses 
 often affords prompt relief to the drain of 
 diarrhoea. 
 
 CROTON OIL. 
 
 Dose. — One to 2 drops, and repeat in two 
 hours if the bowels have not moved. 
 
 Croton oil is a very prompt cathartic acting 
 usually within two hours, and often within 
 one-half hour. The oil is very irritant to the 
 stomach and bowels, and produces its prompt 
 results by causing the muscular coats of the 
 bowel to act energetically. Croton oil should 
 not be given where there is inflammation or 
 disease of the intestines, as it then may do 
 much harm by its irritant action. 
 
 Do not give in larger doses than one to 
 tw r o drops. It is given best on sugar. 
 
 Locally. — Croton oil will blister if painted 
 on the skin. Applied to warts daily it will 
 cause their disappearance. 
 
 CASCARA SAGRADA. 
 
 Dose. — From 10 to 60 drops. 
 
 Give after meals or at bedtime. Cascara 
 Sagrada Aromatica is the most pleasant form 
 to take. 
 
 Cascara causes an increased action of the 
 muscular coats of the bowels and may thus 
 cause some griping. 
 
REMEDIES. 189 
 
 Where there is atony or inactivity of the 
 bowel, as is often the case in elderly people, 
 Cascara in small doses after meals or at bed- 
 time will assist much in establishing a regular 
 habit. The habit of moving the bowels at a 
 regular hour in the day is of much importance, 
 and should be acquired by all. Constipation 
 is almost a confession of laziness, and the 
 taking of cathartics is only a means of tem- 
 porizing, and, if persisted in, makes matters 
 worse. 
 
 CALCAREA CARBONICA ( HOMOEOPATHIC ) . 
 
 Dose. — ix to 3x, 3 tablets three times a day. 
 
 Indications for Calcarea carb. — Sees ob- 
 jects on closing eyes, but the objects dis- 
 appear on opening the eyes. Acidity of the 
 stomach and vomiting. Great appetite early 
 in the morning. Sour, offensive stools of un- 
 digested food. Dry cough at night. Expec- 
 toration in the day. Any wound of the skin 
 heals poorly. 
 
 In light-complected women Calcarea carb. 
 is good where the menses come too early, last 
 too long and are too profuse. 
 
 Calcarea carb. is the remedy for fat, fair, 
 flabby children who have a large head, sweat 
 easily about the head, are stupid and sluggish 
 of thought, have a large abdomen, are sub- 
 ject to sour vomiting and sour diarrhoea, have 
 cold hands and feet, swollen and enlarged 
 
I90 MEDICAL HANDBOOK. 
 
 glands. Such a child may be thin or run 
 down in flesh, though the natural tendency is 
 is be fat. Children with scrofulous taints, and 
 those of consumptive parents are often much 
 benefited by the use of this drug. 
 
 CHAMOMILLA ( HOMOEOPATHIC) . 
 
 Dose. — Q to ix, i tablet every two hours. 
 
 Chamomilla blossoms can be had at any 
 drug store, and from the blossoms a very 
 soothing tea is made for infants. Steep a 
 teaspoonful of the blossoms in a small cup of 
 water, strain, add sugar and give to the child 
 as occasion may demand. There is no danger 
 in giving Chamomile tea to cross babies, on 
 whom it has a soothing action. 
 
 Indications for Chamomilla. — There is 
 great restlessness and violent temper. Cries 
 for things and then refuses them when they 
 are offered. Child wants to be carried from 
 one place to another. Throbbing headache 
 with perspiration of the head. Twitching of 
 the eyelids. Toothache, sore throat and a 
 bitter taste in the mouth. Vomiting of bile. 
 Stools hot and burn, smell bad and look like 
 chopped spinach and egg. Hoarseness and a 
 cough that is dry even though there is rattling 
 of mucus in the chest. Cramp-like pains of 
 the hands and feet. Clinching of the hands, 
 and pain in the calves of the legs. Starts 
 during sleep with a sudden cry. Face hot and 
 
REMEDIES. 191 
 
 the breath is hot, while the hands and feet are 
 cold. Yellow appearance of the skin. 
 
 In men nocturnal emissions, pain in the 
 back and weight in the genitals. 
 
 In women the menses are preceded by 
 leucorrhcea, and the flow is profuse, dark and 
 clotted, with pain in the back and legs. 
 
 ACTEA RACEMOSA (HOMCEOPATHIC) . 
 CIMICIFUGA IS THE SAME DRUG. 
 
 Dose. — to 3X, 2 tablets every three hours. 
 
 Indications for Cimicifuga or Actea 
 racemosa. — Gloomy state of the mind, wishes 
 solitude. Head feels too large and there is 
 severe frontal headache. The top of the head 
 feels as if it would fly off. Neuralgia of the 
 scalp. Aching of the eyeballs. Fullness of the 
 throat and hawking up of mucus. 
 
 In women there is a tenderness of the 
 uterine region. The menses come too early, 
 are dark and clotted, and there is a tender- 
 ness of the abdominal organs. The patient 
 may weep from anxiety. There is leucorrhcea, 
 or what is commonly termed the "whites," 
 with a heavy sensation in the uterus. Stop- 
 page of the flow from cold or emotional ex- 
 citement. After-pains during the child-bed 
 period. Stiffness of the neck with pain on 
 motion. Pain in back and hips. Pain from 
 one hip to the other through the pelvic organs. 
 
 Cimicifuga is one of the best remedies for 
 
I92 MEDICAI, HANDBOOK. 
 
 stoppage of the flow. Painful menstruation. 
 Gloomy depression and headache during the 
 flow. For delayed menstruation. For hys- 
 terical symptoms with numbness of the body 
 and nervousness from exertion. For the many 
 and varied nervous, mental and physical 
 phenomena of the change of life. 
 
 TR. CIMICIFUGA ( ALLOPATHIC) . 
 
 In regular medicine Cimicif uga is given for 
 the nervous conditions of the change of life. 
 Sudden stoppage of the flow. For absence 
 of the flow, and where the flow comes between 
 the proper time. Hysteria, mental unrest after 
 confinement and St. Vitus' Dance. 
 
 Dose. — Ten to 30 drops of the tincture 
 three times a day. 
 
 SULPHATE OF COPPER. ELUE VITRIOL. 
 
 Internally, the Sulphate of Copper is not 
 much used. In case of Phosphorus poisoning, 
 from 4 to 10 grains may be used as an emetic, 
 also using other means to hasten vomiting. 
 With Phosphorus the Sulphate of Copper 
 forms a non-poisonous compound. If, when 
 given as an emetic, the drug should not cause 
 vomiting, then give 10 grains of Carbonate of 
 Soda and an egg or two, and some milk to 
 counteract the drug's action. If Phosphorus 
 has been taken, do not rely altogether on 
 this drug, but give Ipecac or Apomorphine in 
 addition. 
 
REMEDIES. 193 
 
 Externally, the Sulphate of Copper is a 
 very good remedy for sore eyes and snow- 
 blindness. One and one-half grains to 2 
 drachms of water, or a 1 per cent, solution, is 
 a very good remedy for sore eyes. For 
 gonorrhoea or purulent discharges from the 
 genital tract much benefit is derived from the 
 washing or irrigating of these organs with a 
 solution of 15 to 30 grains to the pint of 
 water. 
 
 CAFFEINE CITRAS. CITRATE OF CAFFEINE. 
 
 Caffeine Citrate is a white, inodorous 
 powder. The taste is acid and bitter. This is 
 the active principle of coffee. 
 
 The dose is from 2 to 5 grains. 
 
 Used with Acetanilid it makes an excellent 
 headache powder. 
 
 Caffeine Citras, '20 grains. Acetanilid, 30 
 grains. Mix, and make ten powders. 
 
 Take one for headache when occasion may 
 require. 
 
 CHINA (H0M030PATHIC). 
 
 Dose. — to 6x, 1 tablet every three to six 
 hours. 
 
 Indications for China. — Discouraged, in- 
 disposed, neuralgia over the eyes and of the 
 upper jaw. Throbbing headache, burning in the 
 eyes. Roaring in the ears, frequent nose-bleed, 
 dry lips and mouth, dry tongue, belching, poor 
 
 13 
 
194 MEDICAI, HANDBOOK. 
 
 digestion, fullness after eating, constipated, 
 difficult stools. At times diarrhoea that is 
 painless and passed with apparent difficulty. 
 Urine dark and scant. 
 
 In women the menses are early and dark, 
 clotted. Menses preceded by leucorrhcea and 
 pressure in the abdomen. 
 
 Nocturnal emissions with debility in men. 
 
 China is to be thought of in fevers where the 
 pulse is small and rapid. Chill of the body 
 preceded by thirst. Distress of the chest and 
 an inclination to take a deep breath. The pa- 
 tient that needs China is worse every other 
 day or at repeated periods. Has neuralgia of 
 the forehead, upper cheek-bone and of the 
 teeth. 
 
 China is of value where there is depression 
 from exhaustion, or where there are excessive 
 discharges from the body of any nature, and 
 where there has been loss of blood following 
 an accident. 
 
 DOSE AND ADMINISTRATION OF DRUGS. 
 
 By a drug is meant a simple or compound 
 substance, which, when introduced into the 
 system is capable of producing local or con- 
 stitutional symptoms peculiar to that drug. 
 
 Drugs may be either derived from the vege- 
 table kingdom or from the mineral or earthy 
 elements, in the natural state or as the result 
 of chemical action. 
 
DOSE AND ADMINISTRATION. I.95 
 
 Drugs are given in some substance that is 
 used to carry and keep them in solution or in 
 dilution that the size and force of the drug 
 may be regulated and brought to bear on the 
 proper diseased tissues or assimilative surfaces. 
 Such a drug carrier is called a vehicle. The 
 common substances used as vehicles are water, 
 syrup, sugar of milk and oils. 
 
 Drugs may be given by the mouth, per 
 rectum or by hypodermic injection, and by in- 
 unctions. 
 
 Drugs given by the mouth usually are ab- 
 sorbed and taken into the circulation from the 
 stomach. Drugs given on a full stomach are 
 slowly absorbed, on an empty stomach usually 
 rapidly absorbed. Where drugs are intended 
 to reach the bowels as Bismuth in diarrhoea, 
 they are best given about two hours after a 
 meal, that they may pass with the food 
 into the intestines, and not wait the delay of 
 digestion in the stomach. 
 
 Drugs given per rectum are best given in 
 suppository or in enemata. The hypodermic 
 injection of drugs is best accomplished by 
 using regularly prepared hypodermic tablets. 
 The injection should be on the arm, thigh or 
 calf of the leg. Avoid large veins and vascu- 
 lar areas, for it would be dangerous to inject 
 a drug directly into the circulation. Medi- 
 cated ointments, as a rule, are applied with 
 friction to the part with which it is desired to 
 bring the drug in contact. 
 
I96 MEDICAI, HANDBOOK. 
 
 Drugs having opposite actions should not be 
 given at the same time, as they may counter- 
 act each other in effect, and, if chemically op- 
 posite, they may produce a new and unex- 
 pected substance as the result. 
 
 In books, as a rule, the smallest dose that 
 will produce the full effects of the drug is 
 given, and also the largest dose that is safe 
 to administer to a strong man at one time, is 
 also given. The age, the vital powers ami the 
 condition of the patient with regards to the 
 effect of drugs already in the system must 
 determine the size of the dose. To find the 
 dose for a child this (Young's) rule is a good 
 guide. Use the age of the child as the 
 numerator of the fraction, and the age of the 
 child plus 12 as the denominator, and reduce 
 the fraction, the result will be the approximate 
 dose for the child. Example : 
 
 2 years 1 
 
 2+12 7 
 
 the dose of an adult. 
 
 Variations of This Rule. — Children are 
 very susceptible to the stronger narcotics, such 
 as Opium or Laudanum, and the dose must be 
 much smaller than this rule would indicate. 
 According to this rule a child of 6 months 
 would get about one-sixth the dose of Lauda- 
 num for an adult, when, in fact, he can stand 
 but about one-twentieth the dose. So also a 
 
DOSK AND ADMINISTRATION. I97 
 
 child will not be affected in a purgative man- 
 ner by one-sixth the dose of Castor Oil, but 
 requires more of the purgative drugs. Then 
 give children much less than this rule indi- 
 cates of the narcotics and opiates, and con- 
 siderably more than the dose indicated by 
 this rule of the purgatives. 
 
 Women take smaller doses than strong 
 men. Some people are very susceptible to cer- 
 tain drugs, and the use of such drugs must be 
 with caution where the patient is suscepti- 
 ble, as, for instance, Belladonna and light- 
 haired, light-complected women. 
 
 Above all things consider an unlabeled drug 
 rank poison and you will be saved trouble and 
 sorrow. 
 
 In giving homoeopathic drugs according to 
 the indications there should be at least three 
 marked symptoms calling for the drug. If 
 two or three drugs have the same symptoms 
 indicated in disease take the one that has the 
 most symptoms indicating the drug. 
 
 indicates the homoeopathic tincture, x in- 
 dicates 1 / 10 as much as is found in the tinct- 
 ure. 2x indicates 1 / as much as is found in 
 the x, or 1 / 100 part as much of the drug- as is 
 found in the tincture. For acute conditions it 
 is best to give the (tincture) or the lower 
 dilutions, as is represented by the smaller 
 figure in front of the x. For chronic conditions, 
 where the drug is to be given repeatedly for 
 
I98 MEDICAL HANDBOOK. 
 
 days, the higher dilutions, or weaker prepara- 
 tions as represented by the larger number in 
 front of the x, should be given. It is not neces- 
 sary that all the indications given under any 
 drug should be present before that drug is 
 given. Three prominent symptoms should be 
 present out of all given to make the selection 
 a good one. 
 
 DULCAMARA (HOMOEOPATHIC) . 
 
 Dose. — ix to 6x, 1 tablet every three hours. 
 
 Indications for Dulcamara. — Swelling of 
 the glands, eruption resembling hives, diar- 
 rhoea, worse in damp, cold weather. 
 
 In women an irritable disposition, sup- 
 pressed menses ; the coming of the flow is al- 
 ways preceded by the appearance of a rash on 
 the skin of the body. 
 
 Dulcamara is good for rheumatism or diar- 
 rhoea, made worse by damp, cold weather, or 
 the suppression of the flow from the same 
 cause. Affections of the skin, mucous mem- 
 branes and muscles that are made worse in 
 damp, cold weather will usually be benefited 
 by Dulcamara. 
 
 DIGITALIS. 
 
 Dose. — Tr. Digitalis, 2 to 20 drops. Fluid 
 Extract Digitalis, 1 to 2 drops. 
 
 Digitalis slows the pulse and raises the 
 blood pressure. There is an accumulative 
 
EMETICS. 199 
 
 action of Digitalis that may, when least ex- 
 pected, after the drug has been given for 
 some time, produce alarming symptoms. 
 
 Digitalis is indicated where the pulse is 
 rapid and soft, when there is shortness of 
 breath on exertion, palpitation of the heart 
 from emotional excitement, poor circulation, 
 with cold hands and cold feet. Three to 5 
 drops of the Tincture of Digitalis will often 
 relieve many of these symptoms. Give twice 
 or three times a day for not more than a 
 week at a time. 
 
 EMETICS. 
 
 Emetics are drugs or substances used to 
 produce vomiting. 
 
 Vomiting may be produced by a drug that 
 acts on the brain center, or by drugs that 
 irritate the stomach or intestines and act 
 through the nervous system to cause the 
 empt}dng of the stomach. 
 
 Drugs that act on the brain centers are 
 the most prompt and reliable. 
 
 I£. Apomorphine hydrochlorate, 1 / 10 part 
 of a grain. 
 
 Given preferably hypodermically ; but will 
 act if given internally by the mouth. Repeat 
 the dose in ten minutes if by the first dose 
 emesis is not produced. 
 
 To cause vomiting by irritation of the 
 nerves of the stomach. 
 
200 MEDICAL HANDBOOK. 
 
 Give 
 
 J£. Syrup of Ipecac, from 15 drops to 2 tea- 
 spoonfuls, according to the size of the patient. 
 Repeat the dose in fifteen minutes if neces- 
 sary. 
 
 I£. Brown Mustard, 1 teaspoonful ; stir 
 well into a cup of warm water and drink. 
 Repeat in fifteen minutes if necessary. 
 
 The stomach may be emptied by having 
 the patient drink a cup of tepid water, and 
 then irritate the throat with the finger or a 
 feather. 
 
 ENEMATA. 
 
 An enemata may be administered to relieve 
 constipation, to check haemorrhage from the 
 lower bowel, to supply food when the 
 stomach cannot retain food and to administer 
 drugs and to relieve thirst when water can- 
 not be given by the mouth. An enemata for 
 an infant is about 1 ounce; for a child of two 
 years, 2 or 3 ounces, and so on, a little more 
 than an ounce to the year. Adults should re- 
 ceive from 1 to 2 pints, and where it is de- 
 sired to reach the upper bowel more must be 
 given. In the giving of an enema the first 
 thing is the value of time. Rapid distension 
 of the bowel usually calls for an immediate 
 evacuation before the object sought can be 
 secured. Have the patient lie on the left side 
 or on the back, elevate the hips a little that 
 
ENEMATA. 20I 
 
 gravity may assist the retaining of the injec- 
 tion. Inject slowly and if necessary support 
 the parts that the fluid be retained. By stop- 
 ping the stream the bowel has time to re- 
 gain itself and the fluid to pass up further, 
 relieving the desire to stool, then more can 
 be given. An enema for the relief of con- 
 stipation is best if retained about fifteen min- 
 utes. Medicated enemas are small and fully 
 explained by the physician. Feeding or nutri- 
 tive enemas are used when the stomach for 
 some reason cannot retain food. The amount 
 is always small ; for an adult, say, Y^ of a pint, 
 and fo ra child a smaller amount in propor- 
 tion to its age. Nutritive enemata may be of 
 milk, beef tea, of broth or gruel, or enemata 
 of eggs and milk. To all nutritive enemata 
 should be added pepsin, i grain to the ounce, 
 to digest the food since the lower bowel can- 
 not digest well. From i to 4 teaspoonfuls of 
 brandy or whisky can be added to the nutri- 
 tive enema as a stimulant if desired and or- 
 dered by the physician. Wash out the bowel 
 before giving a nutritive enema, and again 
 before giving a second feeding injection. 
 
 Nutritive enemata should not be given 
 oftener than once in three hours. Injections 
 to quench thirst are of pure water and larger 
 than nutritive enemata, or about y 2 to 1 pint 
 should be given. All enematas should be of 
 a temperature of from 80 to 100 degrees F. 
 
202 MKDICAI, HANDBOOK. 
 
 unless ordered cold, as is sometimes done, to 
 stop haemorrhage from piles. 
 
 FERRUM OR IRON. 
 
 Dose. — Blaud's Iron pills, i pill after meals. 
 
 The action of Iron in the system is to 
 cause those suffering from a want of the red 
 blood corpuscles to become more rich in this 
 particular element of the blood. 
 
 Anaemic or white, bloodless persons often 
 rapidly improve under the influence of Iron. 
 
 Women and girls, who do not menstruate 
 because the system has no blood to spare, 
 menstruate when the system has become en- 
 riched and the blood is back to the normal 
 standard as a result of taking Iron. Iron is 
 not the only remedy for anaemia, but it is a 
 valuable remedy. 
 
 FERRUM METALLICUM (HOMCEOPATHIC) . 
 
 Dose. — ix to 6x, i tablet three times a day. 
 
 Indications for Ferrum. — The Ferrum pa- 
 tient is dizzy on descending a hill or crossing 
 water. The face is pale and may be yellow- 
 spotted. Excitement causes flushes of the 
 face. The stomach feels as if pressed upon 
 after eating. There is belching of sour undigest- 
 ed food. The patient may vomit the food in al- 
 most the same condition as it was when eaten. 
 In the intestines the indigestion is marked and 
 the bowel movements may contain the food 
 unacted upon. In the morning there is a 
 
FOOD FOR THE) SICK. 203 
 
 spasmodic cough, caused by tough mucus. In 
 men there may be impotence and nocturnal 
 emissions. In women the flow may be pre- 
 ceded by strings of mucus or a milky leucor- 
 rhcea. Headache and ringing in the ears. The 
 flow is too profuse, too often and lasts too 
 long. 
 
 The Ferrum patient is better from walk- 
 ing around and is subject to flushes of the 
 face as a result of excitement or from pain. 
 
 FOOD FOR THE SICK. 
 
 There is often much misunderstanding be- 
 tween friends and physicians as to what and 
 why foods should be given as they are. To 
 force onto the stomach foods that it cannot 
 handle is not to be desired. Sick people can- 
 not digest, as when well, and the giving of 
 food should be regulated that the most 
 strength be secured with as little taxation of 
 the digestive organs as is possible from the 
 food given. 
 
 BARLEY SOUP. 
 
 Wash 1 tablespoonful of barley in cold 
 water, cover with boiling water, let boil up 
 once and drain off. Cover again with boil- 
 ing water and boil slowly for two hours, drain 
 and add to meat broth or stock, and let stand 
 on back of stove for ten minutes, salt to taste 
 and serve. The stock can be made from game 
 
204 MEDICAL. HANDBOOK. 
 
 or beef. Do not add much spice to the beef 
 or game in making the stock. Use i pint 
 of stock for the barley indicated above. 
 
 BARLEY WATER. 
 
 Stir into i pint of cold water i teaspoon- 
 ful of ground barley and a pinch of salt, boil 
 for y 2 hour, strain and keep in a cool place 
 ready for use. 
 
 RICE SOUP. 
 
 Wash i tablespoonful of rice in cold water. 
 Boil slowly in i pint of water for thirty min- 
 utes, drain and add to i pint of rich meat 
 broth the same as with barley. 
 
 PEPTONIZED MILK. 
 
 Stir 5 grains of pepsin and 15 grains of 
 soda bicarbonate (baking soda) in 4 ounces 
 of water, mix well with a pint of milk and let 
 stand in a warm place for J / 2 hour, then bring 
 to a boil for two or three minutes and place 
 on ice until used, sweeten to taste. 
 
 This may be used in nutritive enemata, in 
 milk punches and where milk is used as food. 
 
 MILK PUNCH. 
 
 To a half pint of fresh milk add 2 teaspoon- 
 fuls of sugar and add from 4 to 8 teaspoon- 
 fuls of brandy, stir well. If condensed milk is 
 used no sugar need be added. 
 
FOOD FOR THE SICK. 205 
 
 EGG-NOG. 
 
 To a well beaten tgg add a teaspoonful of 
 sugar and 4 teaspoonfuls of whisky or brandy 
 and add to Ya cup of fresh milk. (If con- 
 densed milk is used omit the sugar.) 
 
 TEA. 
 
 Use to each cup of tea ( T /2 pint) a teaspoon- 
 ful of tea, put tea in the pot and add the boil- 
 ing water, set back where it will keep hot, 
 but not boil. 
 
 COFFEE. 
 
 To each pint of coffee use 2 heaping tea- 
 spoonfuls of coffee finely ground, mix the 
 ground coffee in a little cold water, place 
 in the pot and pour on it a pint of boiling 
 water. Let boil up twice and add a little cold 
 water and set back where it will remain hot, 
 but not boil, for five minutes more while it 
 settles. Put cream and sugar in the cup and 
 then pour on the coffee. 
 
 IN THE FEEDING OF THE SICK. 
 
 Avoid things prepared in the frying pan, 
 have each article well done before serving. 
 Feed the sick regularly, but not too much at 
 one time. Do not give acid fruits or foods 
 with milk, starches, puddings and gruels. 
 
206 MKDICAI, HANDBOOK. 
 
 Acid fruits or foods go with meat and the 
 albumens, and not with the starches. 
 
 POTATOES. 
 
 Baked potatoes, boiled potatoes and mash- 
 ed potatoes are all good articles of diet for 
 the sick. 
 
 EGG CUSTARD. 
 
 Beat i egg well and add a teaspoonful of 
 sugar and a little salt, and add this to i cup 
 of scalded milk, stirring well until thick; the 
 milk should be in a receptacle that is resting 
 in boiling water or a farina cooker. Pour in 
 small dishes and set aside and serve cold. 
 
 GELATINE. 
 
 Gelatine is a very agreeable and nutritious 
 food and should like beef extract be kept on 
 hand for sickness. Knox's gelatine is as good 
 as any. All have recipes on each package, 
 which, if followed, makes delicious gelatine. 
 
 BEEF TEA. 
 
 The extract in jars is very reliable and 
 good to have in the house, but the freshly 
 prepared tea is often preferable. Take a 
 pound of fresh, lean beef, slice thin and 
 pound well or grind through a sausage mill. 
 
FOOD FOR THE SICK. 207 
 
 place in a pint of cold water and bring slowly 
 to a boil, skim off, strain, season with a little 
 salt and serve. 
 
 CHICKEN, GAME OR MUTTON BROTH. 
 
 To a pound of the game or meat cut in 
 small pieces add a quart of cold water, bring 
 slowly to a boil and let simmer for two hours 
 in a closely covered kettle, strain through a 
 sieve and let stand a few moments, skim off 
 the fat, salt to taste and serve. A teaspoon- 
 ful of rice can well be added to each pound 
 of meat if desired, as well as a little pepper. 
 
 MILK. 
 
 Fresh milk is often used as food for the 
 sick; sterilized milk is very much to be de- 
 sired. Milk may be sterilized by placing the 
 bottle in a steam sterilizer for a sufficient time 
 to thoroughly cook the milk, or in a pan of 
 boiling water. Milk should boil or steam until 
 brought to the boiling temperature for several 
 minutes. 
 
 RICE PUDDING. 
 
 Wash Y^ cup of rice in cold water, add i 
 quart of cold milk, sugar to taste, and add l / 2 
 teaspoonful of salt, grate a little nutmeg over 
 it, and bake slowly for three hours in a pud- 
 ding pan ; stir occasionally while baking. 
 
208 MEDICAL HANDBOOK. 
 
 FARINA GRUEL. 
 
 Sprinkle slowly i teaspoonful of farina into 
 a pint of boiling milk, stir well to prevent 
 lumps ; boil slowly for y 2 hour ; salt to taste 
 and serve. 
 
 OATMEAL GRUEL WITH MILK. 
 
 Soak y 2 pint of oatmeal in a quart of water 
 for ten hours ; if dry add a little more water 
 and boil for an hour, strain and add I pint 
 of boiling milk ; bring this to a boil and salt to 
 taste. 
 
 BOILED FLOUR GRUEL. 
 
 Moisten I pint of flour with enough water to 
 make it into a ball and tie it up in a piece of 
 muslin, and then moisten the cloth on the out- 
 side and paint with flour, then boil the ball of 
 flour ten hours, and remove the cloth and dry 
 the flour ball in a slow oven for eighteen or ten 
 hours. When desired to make gruel, grate 
 from the ball two teaspoonfuls of this boiled 
 flour, mix to a paste in cold water, and stir 
 into y 2 pint of boiling milk, boil slowly for 
 three or four minutes and serve. If con- 
 densed milk is used no sweetening is needed, 
 but if fresh milk, sweeten to taste. 
 
 CREAM TOAST. 
 
 Use two slices of stale bread, dry wel] in 
 
REMEDIES. 209 
 
 oven, toast to even brown over fire; place in 
 dish and pour over it boiling water; let stand 
 a minute, drain off, and butter and salt a little, 
 and pour over it a little fresh cream; place 
 again in the oven for a few minutes until hot 
 and serve hot. 
 
 PLAIN TOAST. 
 
 Plain toast is made as directed above, only 
 no water is poured over it. The toast is but- 
 tered and salted and served dry while hot. 
 
 GELSEMIUM SEMPERVIRENS (HOMCEOPATHIC) . 
 
 Dose. — 6 to 3x, 2 tablets every two to four 
 hours. 
 
 Indications for Gelsemium. — Confusion of 
 the mind, fullness of the head, frontal head- 
 ache and hot face, chilliness of the body, the 
 eyes are heavy and there is drooping of the 
 eyelids, dimness of vision, with aversion to 
 light; dry lips, hot tongue and fullness of the 
 throat, running of the nose, sour belching, 
 diarrhoea from excitement or emotion, pain in 
 the chest and in the region of the heart, lassi- 
 tude, profuse urination of clear urine. In men 
 involuntary emissions, followed by debility 
 and low spirits. In women suppressed menses, 
 with headache. Labor-like pains during preg- 
 nancy. A good remedy early in colds, with 
 running of the nose. 
 
 14 
 
210 MEDICAL HANDBOOK. 
 
 GRAPHITES (HOMOEOPATHIC). 
 
 Dose. — ix to 6x, i tablet three times a day. 
 
 Indications for Graphites.* — Feeling as if 
 intoxicated, rheumatic pains of half of the 
 head, extending into the teeth; sound in the 
 ears as of the report of a gun, eruption back of 
 the ears, soreness of the eyes and aversion to 
 light, nausea after eating, with distended feel- 
 ing of the abdomen; constipation associated 
 with shreds of mucus. In women morning 
 sickness during menstruation, pain in the left 
 ovary, suppression of the menses, with heavi- 
 ness and weight of the limbs ; leucorrhcea that 
 is thin and white and excoriates the vagina, 
 disposition to delayed menstruation, symp- 
 toms worse in the evening. 
 
 GUAIACUM (HOMOEOPATHIC). 
 
 Dose. — to 3x, 2 tablets every three to six 
 hours. 
 
 Indications for Guaiacum. — Sore throat, 
 with little constitutional symptoms ; right side 
 of the throat most affected, tonsils enlarged, 
 especially the right tonsil; stinging, sticking 
 pain in the throat, worse in a warm room, 
 veins of the throat are enlarged, threatened 
 quinsy, rheumatism of the joints, with dis- 
 tension and distorsion of the joint. 
 
 Vague growing pains in children. 
 
REMEDIES. 211 
 
 HEPAR SULPHUR (HOMCEOPATHIC) . 
 
 Dose. — ix to 6x, i or 2 tablets three times 
 a day. 
 
 Indications for Hepar sulphur. — Sad- 
 ness and dejected spirits, anguish of mind, 
 dizziness on riding in the cars or from shaking 
 the head, pain in the eyes, things look too 
 large, purulent inflammation of the eyes and 
 ears, pain in the bones of the head and face, 
 soreness and roughness of the throat, with 
 pain extending into the ears on swallowing; 
 longing for acid foods, distension of the 
 stomach, stitches in the liver, swelling of the 
 glands of the neck and groin, sour undigest- 
 ed diarrhoea, burning on urinating, dark hot 
 urine excoriating the urinary passage- In 
 women between the menses there are dis- 
 charges of bloody mucus, dry, hoarse cough, 
 loss of voice, rattling in the chest in the 
 morning, wheezing during the act of breath- 
 ing. Hepar sulphur is the prime remedy 
 where suppuration is threatened, either in the 
 throat, the eyes or ears, or on the surface of 
 the body, as in abscesses, ulcers or boils. Give 
 the 4x or 6x to prevent suppuration and the 
 ix to hasten the breaking down and discharg- 
 ing of pus, as is sometimes wished in boils 
 and quinsy. Give 1 or 2 tablets three times a 
 day, or, if the case is urgent, every three 
 hours. 
 
212 MEDICAL HANDBOOK. 
 
 Ferrum phosphoricum should be mentioned- 
 ed along with Hepar sulphur, as Ferrum 
 phos. ix to 3x every three hours is a very 
 good remedy to ward off inflammation when 
 after injury or exposure inflammation is ex- 
 pected but is not yet present. 
 
 HYDRASTIS CANADENSIS ( HOMCEOPATHIc) . 
 
 Dose. — to 3x, i to 3 tablets three or four 
 times a day. 
 
 Indications for Hydrastis. — Feeling as if 
 intoxicated, irritable, forgetful, dull frontal 
 headache, eczema around the roots of the 
 hairs of the forehead, watery excoriating 
 nasal discharge, sneezing, tenacious discharge 
 into the throat from the nose, hawking, sore 
 spots on the tongue and cheek, swollen tongue, 
 showing the imprints of the teeth ; tongue 
 coated gray or yellowish, all-gone feeling in 
 the stomach, with dull, aching pain ; consti- 
 pated, stools covered with mucus, at times 
 diarrhoea of a chronic character and there is 
 an associated pain in the lower bowel, with 
 scalding and burning after movement ; urine 
 dark and has a stringy sediment, dull aching 
 in the bladder and kidneys ; the cough of 
 Hydrastis is dry and harsh, with rawness and 
 soreness of the chest ; tickling in the throat 
 that may make the eyes water, thick, tenacious 
 yellow-colored sputa. In men thick, yellow, 
 painless discharge from the penis. In wo- 
 
REMEDIES. 213 
 
 men thick, stringy, yellow discharge from 
 the genital tract. Ulceration of the genital 
 tract. 
 
 Hydrastis is a drug for chronic nose and 
 throat trouble, chronic gastric catarrh and 
 chronic catarrh of the bowels ; also, of the 
 genito -urinary tract. Remember, that the dis- 
 charge of Hydrastis is yellow, thick and tena- 
 cious. 
 
 HAMAMELIS. 
 
 Dose. — Ten to 30 drops of the fluid extract 
 three or four times a day. 
 
 Hamamelis is a good remedy for blood 
 spitting in 5 to 10 drops every two or three 
 hours until better. 
 
 Itching or painful piles are much relieved 
 by bathing them in a warm solution of Hama- 
 melis and hot water of equal parts. 
 
 For diseases of the vagina, with a white, 
 milky discharge and a heavy, sore feeling of 
 the womb and pain in the back, Hamamelis 1 
 ounce to the pint of hot water makes a very 
 soothing and healing injection. 
 
 Hamamelis is a very soothing application 
 when rubbed on bruised or injured surfaces 
 or used as wet dressing to injured parts. 
 Hamamelis acts much the same as Arnica, 
 and is safer where the skin has been broken, 
 for Arnica has been known to set up erysipelas 
 when applied to areas where the skin has been 
 broken. 
 
214 MEDICAL HANDBOOK. 
 
 HYOSCYAMUS NIGER (HOMCEOPATHIC) . 
 
 Dose. — 6 to 6x, i to 3 tablets every three or 
 four hours. 
 
 Indications for Hyoscyamus. — Muttering 
 delirium, with pricking at the bed clothing; 
 does not recognize friends, fear of being 
 poisoned, may become furious and use inde- 
 cent language and be immodest; there is spark- 
 ling eyes, red face and congestion of the brain ; 
 objects appear red or double, blinking of the 
 eyelids, tongue dry and clean, yet the patient 
 may foam at the mouth and swallow with 
 difficulty; there is thirst, but the patient 
 dreads to drink and drinks very little at a 
 time with apparent difficulty ; there may be in- 
 voluntary movements of the bowels of a yel- 
 low, watery nature ; the urine may pass with- 
 out the knowledge of the patient or be very 
 scarce and at times suppressed ; there may be 
 spasms during sleep, dry, spasmodic cough, 
 relieved by sitting up ; slow breathing, with 
 rattling in the chest; in fevers the pulse is 
 hard and full ; congestion of the brain, with 
 hot head and face, though the hands and feet 
 may be cold; hot all over the body in the 
 evening, perspires during the sleep and feels 
 weaker after perspiring, desires to be uncov- 
 ered or to be naked. 
 
 Hyoscyamus is often indicated during the 
 delirious stage of typhoid fever and for de- 
 
LOCAL USE OF COLD AND HEAT. 215 
 
 rangement of the mind, with hallucinations 
 and imaginings and glassy eye, jealousy and 
 talkative and silly, goes rapidly from one sub- 
 ject to another, is obscene of speech and im- 
 modest in actions ; insanity, delirium and 
 jealousy often call for Hyoscyamus. , 
 
 LOCAL USE OF COLD AND HEAT. 
 
 Poultices applied to inflamed and painfui 
 parts afford much comfort and often hasten 
 restoration. Flax seed, oat meal or bran 
 may be used. Stir whichever ingredient is to 
 be used into boiling water until a thick pap 
 is formed, spread on muslin and smear the 
 surface with lard or sweet oil, cover the out- 
 side with oiled paper and several folds of 
 flannel to retain the heat and moisture. Oiled 
 silk or oil-cloth may be used instead of paper 
 if handy. Poultices should be applied hot and 
 changed frequently. Several folds of cloth 
 wrung out of hot water and applied hot can be 
 used much the same as poultices. Often drugs 
 are added to the water, making the applica- 
 tion of hot fomentations of double value. Cold 
 applications are used in the early stage of 
 bruises and strains. Several folds of cloth 
 are rung out of ice water and applied in the 
 same manner as hot fomentations, only there 
 should be no covering to retain heat. Hot 
 pads of salt or sand are often used where dry 
 heat is wished to a painful part. The hot 
 
2l6 MEDICAI, HANDBOOK. 
 
 water bottle or bag is the most frequent ap- 
 plication to supply heat to the surface. As 
 a rule these bottles are of rubber, but com- 
 mon bottles may be used in their absence. 
 Care should be observed not to burn the pa- 
 tient. Those coming out of ether have fre- 
 quently been burned by careless nurses. Cover 
 the hot water bottle with some woolen cloth 
 and keep to the desired heat by changing the 
 water. A quite cold, or quite hot, fomentation 
 applied to the chest on retiring will often stop 
 an irritating cough that prevents sleep. 
 
 IODOFORM UM IODOFORM. 
 
 Iodoform is in small, lemon yellow crystals 
 and has a very tenacious and insuppressible 
 odor. Iodoform has been used as a drug, but its 
 chief field of action is as a local dressing for 
 wounds. Applied to wounds or sores the ef- 
 fect is to ease the pain, cleanse the wound by 
 the liberation of its Iodine under the influ- 
 ence of heat and moisture of the body and 
 to stimulate the injured tissues, thus hasten- 
 ing healing. Continued for a long time or 
 used in large quantities over extended areas 
 there is danger of poisoning from the drug. 
 
 The symptoms of Iodoform poisoning which 
 require its immediate cessation are headache, 
 loss of appetite, rapid pulse, depression, 
 drowsiness and faintness or marked restless- 
 ness. There is delirium in the later stages 
 
REMEDIES. 217 
 
 of poisoning from this drug. The tempera- 
 ture is not much raised by this drug. On 
 small wounds the pure drug may be used, 
 but on large injuries it is best used one part 
 of Iodoform with two parts of Boracic Acid. 
 
 IODUM. IODINE. 
 
 This drug should be preserved in glass- 
 stoppered bottles in a cool place. On remov- 
 ing the cork Iodine gives off a purple vapor. 
 
 Tincture Iodine painted on sprains and sub- 
 cutaneous swellings is of much service as a 
 counter-irritant. Enlarged, inflamed and 
 hardened glands are often reduced and soft- 
 ened by the local use of this drug. In a region 
 affected by erysipelas iodine is often of much 
 value when painted around the inflamed area 
 that the infection does not spread to healthy 
 parts of the body. 
 
 The benign action of Iodide of Potassium 
 on enlarged glands, when taken internally, is 
 due to the Iodine. 
 
 Iodoform owes its kind action over wound- 
 ed areas to the fact that the Iodine is liberated 
 from the Iodoform by the action of heat and 
 moisture in the wounded area. 
 
 Constitutional symptoms are sometimes pro- 
 duced by the use of Iodoform on wounds and 
 by the use of the Iodides internally. A mild 
 iodism is often produced, having some or all 
 of the following symptoms : Pain over the 
 
2l8 MEDICAL HANDBOOK. 
 
 eyes, soreness and heaviness of the mouth and 
 throat an excess of spittle and perhaps an 
 eruption over the body. If these symptoms 
 become worse and others develop, the drug 
 should be discontinued or much reduced in 
 dose. 
 
 IPECACUANHA. 
 
 Dose. — Fluid Extract of Ipecacuanha, 2 to 5 
 drops. 
 
 Syrup of Ipecac, 5 drops to 1 teaspoonful. 
 
 Wine of Ipecac, 5 drops to 1 teaspoonful. 
 
 To cause vomiting, ^ to 4 teaspoonfuls of 
 the Wine or Syrup ; repeat in fifteen minutes 
 if necessary. , 
 
 In the larger doses Ipecac is given as an 
 emetic to produce vomiting, and is a safe and 
 reliable remedy. 
 
 From 3 to 5 drop doses of the Wine or 
 Syrup of Ipecac will at times relieve an irri- 
 tated stomach when there is a tendency to 
 vomit. Also 3 to 5 drop doses will often be of 
 much service for summer diarrhoea. Give for 
 nausea or diarrhoea a small dose, and repeat 
 every fifteen minutes to a half hour. 
 
 Where there is a dry hacking cough that 
 ought, to be loosened up give from 5 to 15 
 drops of the Syrup of Ipecac every 3 hours. 
 Ipecac in mild doses increases the action of 
 the skin, and is, therefore, all the more of 
 value in the treatment of colds. 
 
REMEDIES. 219 
 
 For croup in children, 10 to 15 drops of the 
 Wine or Syrup of Ipecac, repeated every 15 
 minutes until nausea or vomiting is produced, 
 is a very efficacious remedy. 
 
 IPECACUANHA (HOMCEOPATHIC) . 
 
 Dose. — to 3X, 1 to 5 tablets every 15 min- 
 utes to every 3 hours. 
 
 Indications for Ipecac. — Headache, bruis- 
 ed feeling of the head, worse on one side. 
 Pale face with blue rings around the eyes and 
 mouth. Flat taste in the mouth with nausea 
 and fulness of the throat. There is a con- 
 tinual aversion to food with a feeling as if the 
 patient would vomit. Pain in the stomach 
 with nausea, worse on motion. Diarrhoea of 
 green, fermented, slimy stool, with cutting and 
 burning in the lower bowel and rectum at the 
 time of stool. 
 
 Dark urine which leaves a brick-dust sedi- 
 ment. Rattling of the chest on breathing, 
 and the chest seems full of phlegm. Difficult 
 cough with little expectoration, and cough 
 causes nausea. The throat seems too small 
 for the air and phlegm to get through, and 
 there is a blueness of the face during cough- 
 ing. 
 
 The menses are too frequent, too early, too 
 profuse, and are of a bright red blood. 
 
 Remember Ipecac for croup of children, 
 cough with difficult breathing and little ex- 
 
220 MEDICAI, HANDBOOK. 
 
 pectoration. Ipecac is of service in all de- 
 rangements of the mucous surfaces of the 
 body associated with nausea. 
 
 For cough, give 6 or ix, i tablet every 2 
 hours. For croup, give of 6 2 tablets every 
 15 minutes, until better. 
 
 For diarrhcea or nausea give or ix, 1 
 tablet every two hours. 
 
 IGNATIA AMARA (HOMCEOPATHIC). 
 
 Dose. — to 6x, 1 tablet three times a day. 
 
 Indications for Ignatia. — Depression of 
 mind, easily angered. Sensation as if a nail 
 were driven in the side of the head. Aver- 
 sion to light. Toothache as if the tooth were 
 crushed. Stitches in the throat and a feeling 
 as if there were a lump in the throat. No 
 taste to the food. Empty feeling in the 
 stomach. Pricking, stinging pain in the 
 stomach as if from pins. Difficult stool as if 
 the anus were too small, with sticking pain in 
 the anus after a movement. Protrusion of 
 piles with sticking pain. Cough with stitch- 
 like pain in the chest. Palpitation of the heart 
 with sticking pain in the heart. 
 
 The menses in women are delayed, scant, 
 dark in color and of an offensive odor. Cramp- 
 like pains in the uterus at the time of the 
 menses, and at the same time there is in- 
 digestion with cramp-like pain in the stomach. 
 Weakness and languor as if the woman could 
 
REMEDIES. 221 
 
 not go around, and yet she refuses to give up 
 and rest. 
 
 Ignatia is a good remedy for women who 
 are dark of complexion, and who do not give 
 up and cry as do the Pulsatilla patients ; but 
 who are, as it were, angered by their symp- 
 toms and who refuse to yield to them. Re- 
 member the sticking or stitch-like pains of 
 Isrnatia, 
 
 ■& j 
 
 KALI BICHROMICUM (HOMCEOPATHIC) . 
 
 Dose.— -2x to 6x, i tablet three times a day. 
 
 Indications for Kali Bichromicum. — Ver- 
 tigo, dull, throbbing frontal headache. Heavi- 
 ness of the eyes on waking in the morning. 
 Swelling of the eyelids. Dryness and ulcera- 
 tion of the nose with the formation of crusts. 
 Greenish-yellow, offensive discharge from the 
 nose. Tough, yellow, stringy discharge into 
 the throat from the posterior nares. Thick, 
 yellow coating of the tongue. Inflamed ton- 
 sils that are covered with a stringy mucus 
 that is hard to dislodge. Hoarseness of the 
 voice in the evening. Tickling of the throat. 
 Cough with difficult expectoration. Pain back 
 of the breast bone extending between the 
 shoulders. Desire for acids and sour foods. 
 Indigestion. After eating, fullness and dis- 
 tension of the abdomen. Cutting pain in the 
 abdomen and stitch-like pain in the region of 
 the liver. Constipation. Movements are dry 
 
222 MEDICAL HANDBOOK 
 
 and lumpy, and are followed by burning in 
 
 the anus. 
 
 In women there is a yellow, stringy leucor- 
 rhcea that scalds and burns the parts. Sore- 
 ness of the genital tract. 
 
 Remember Kali bich. when there is a tena- 
 acious, stringy discharge from any of the 
 mucous surfaces. 
 
 Fat, fair children often have symptoms call- 
 ing for this drug. 
 
 KALI CARBONICUM (HOMOEOPATHIC) . 
 
 Dose. — 2x to 6x, i tablet three times a day. 
 
 Indications for Kali carb. — Headache 
 when on the cars. Headache on one side of 
 head. Tendency to take cold in the head. 
 Redness of the eyes. Sticking of the eyelids 
 together in the morning. Spots before the 
 eyes. Swelling of the upper eyelids. Crack- 
 ing sound in the ears. Ulcer of nose. Desire 
 for sour foods. Constipation with colicky 
 pain before stools. Large movements passed 
 with white mucus. Burning in the anus after 
 stool. Hoarseness of the voice. Dry, hard 
 cough. Stitches in the right side of the chest, 
 in the heart, in the liver and in the kidneys 
 and back. Swelling of the glands of the 
 neck. Pain in the limbs. Rheumatic pains 
 extending down the arms and legs. The sex- 
 ual desire is weak. The menses too late, too 
 scant and too light in color. Leucorrhcea with 
 pain in the back. 
 
REMEDIES. 223 
 
 LYCOPODIUM (HOMCEOPATHIC). 
 
 Dose. — 2x to 6x, 1 tablet three times a day. 
 
 Headache worse from stooping or lying 
 down. Pain in the temples as if the sides of 
 the head were pressed in a vise. Indifference 
 of the mind with a tendency to cry. Wants 
 company, cannot bear to be alone. Sleepy in 
 the day, and cannot sleep at night. Roaring 
 in the ears. Sallow color with dark rings 
 around the eyes. Sense of smell very acute. 
 Difficult breathing with motion of the angles 
 of the nose during the act of breathing. 
 Toothache, dry tongue. Sore throat with 
 spots or ulcers on the tonsils. Intense hunger, 
 but there is a bloated sensation as soon as a 
 little food is eaten. Windy rumbling of the 
 bowels. Constipation, and when the bowels 
 do move there is still a feeling as if the bowel 
 was not empty. The urine is scant and soon 
 deposits a yellow, sandy sediment. Before 
 voiding urine there is intense pain in the 
 bladder. Cough worse in the evening, asso- 
 ciated with stitch-like pain in the left side of 
 the chest. Salty tasting, thick, yellow ex- 
 pectoration from the chest and nose. 
 
 Stiffness of the neck with swelling of the 
 glands. Pain in the small of the back. Itch- 
 ing of the skin. Dry, harsh, cracked skin. 
 Redness and swelling of the joints. Pain in 
 the hip-joint. Ulcers on the limbs that itch 
 and burn at night. 
 
224 MEDICAL HANDBOOK. 
 
 LACHESIS (HOMOEOPATHIC). 
 
 Dose. — 6x. i tablet three times a day. 
 
 Indications for Lachesis— Giddiness and 
 heaviness of the head. Headache with nausea 
 and chilliness. Tendency to be sad with in- 
 disposition to think. Burning in the mouth 
 with dry, trembling tongue. Pain in the left 
 side of the throat. Sensitiveness of the 
 throat, cannot bear to have the collar touch 
 the throat. Bitter taste to everything that is 
 eaten. Food comes back into the throat after 
 being swallowed. Burning and griping in the 
 abdomen. Alternating constipation and diar- 
 rhoea. The urine is dark or yellow, and there 
 is a sensation as if a lump were in the bladder. 
 The left ovary is swollen, with sharp, stitch- 
 ing pains. Cough with pain in the left side 
 of the chest. Cough worse in the morning. 
 Neck very sensitive, and slight pressure on 
 the throat causes severe coughing. Ulcers of 
 the skin that are tender and burn after being 
 dressed. Offensive discharge from very sen- 
 sitive ulcers. 
 
 The Lachesis patient is of depressed spirits. 
 Always worse after sleep. The surface of the 
 body is tender to touch. The left side of the 
 body is more affected than the right. 
 
 MERCURIUS CORROSIVUS (HOMOEOPATHIC) . 
 
 Dose. — 3x to 6x, i tablet three times a day. 
 
REMEDIES. 225 
 
 Indications for Mercury. — Anxiety, sleep- 
 less. Vacant, stares at persons and does not 
 understand. Dizziness. Sore eyes with edges 
 crusted. Sore nose with dry scabbing. Burn- 
 ing in the mouth and stomach. Sore throat. 
 Ulcerated tonsils. Diarrhoea with cutting, 
 colicky pains. Dark urine that leaves a 
 brick-red sediment. 
 
 CORROSIVE SUBLIMATE ( ALLOPATHIC ) . 
 
 The Bichloride of Mercury is used as an 
 antisyphilitic in doses of 1 / 100 part of a grain, 
 three times a day. 
 
 The Blue Ointment of Mercury is also used 
 as an antisyphilitic, and to reduce swollen 
 glands. Used by rubbing in well once or 
 twice a day. 
 
 Corrosive Sublimate is also used as an anti- 
 septic, but in the quantity needed as an anti- 
 septic it is a violent poison. 
 
 NUX VOMICA. 
 
 Dose. — Tr. Nux vomica, 1 to 10 drops, 
 three times a day. 
 
 Strychnine Sulphate, 1 / 100 part of a grain, 
 three times a day. 
 
 Nux vomica stimulates the heart and nerve 
 centres. The spinal cord in particular. In- 
 creases and strengthens the pulse. Quickens 
 and deepens the breathing. Increases the ac- 
 tion of the stomach and bowels. Nux vomica 
 
 15 
 
226 MEDICAL HANDBOOK. 
 
 exerts a tonic effect on the heart, lungs, di- 
 gestion and nervous system. 
 
 For heart failure from accident or injury 10 
 drops of the Tincture of Nux vomica, or * / 
 part of a grain of Strychnine sulph., will 
 strengthen the heart's action. 
 
 For numbness and paralytic affections fol- 
 lowing diphtheria, scarlet fever and allied 
 affections, Nux vomica has a strong restora- 
 tive action on the nerves. Give 3 drops of the 
 Tr. Nux vom. three times a day, and if neces- 
 sary, inject a small amount into the paralyzed 
 area, using the Strychnine sulph., and giving 
 the same with a hypodermic syringe. For 
 chronic constipation or those suffering from 
 a relaxed condition of the abdomen. The 
 aged or fat, flabby people, give Tr. Nux vom., 
 3 drops, three times a day. 
 
 For chronic dyspepsia, 2 to 4 drops of the 
 Tr. Nux vom. before meals will aid digestion 
 very much. After dinner if there is indiges- 
 tion, the same dose will help to stimulate the 
 stomach to get rid of its burden. 
 
 If, after giving Nux vom. for some time, 
 there is twitching of the limbs, acute vision, 
 restlessness and a stiff neck, you may know 
 there has been enough of the drug given, and 
 it should at once be discontinued. 
 
 NUX VOMICA (HOMOEOPATHIC). 
 
 Dose. — to 6x, 1 to 4 tablets three times a 
 day. 
 
REMEDIES. 227 
 
 Indications for Nux vomica. — Irritable, 
 easily angered. Noise, light and strong odors 
 are unbearable. Wishes to be alone. Mental 
 derangement with a desire to kill. Delirium 
 from alcoholic drinks. Pain on top of the 
 head as if a nail were driven in. Head feels 
 too large. Dizziness and ringing in the ears. 
 Bloodshot eyes or bloody spots in the mem- 
 branes of the eye. Running of the nose in the 
 day and dryness of the nose at night. Sal- 
 low, pale complexion. Can't sleep after 3 a. 
 m. Sore spots in the mouth. Sore throat. 
 Rawness of the throat on swallowing. 
 Tongue coated black. Bitter taste in the 
 mouth and offensive breath. Sour belching. 
 Stomach painful to pressure. Clothing feels 
 too tight. Fullness after eating, with feeling 
 of pressure on the stomach. Cramp-like pain 
 in the stomach and abdomen. Constipation 
 with difficult passage of stool. Pain in the 
 rectum with a tendency to haemorrhoids. 
 Difficult urination of a small amount of 
 bloody urine. Dry cough, worse in the early 
 morning, worse from eating and worse from 
 lying on the back. Chest feels as if being 
 pressed upon by a heavy load. Pain in the 
 neck, between shoulders and back of the 
 shoulder-blades. Pain in the back. Numb- 
 ness of the limbs. 
 
 In men pinching, constrictive pain in the 
 testicle. Pain in the back from weakness and 
 
228 MKDICAI, HANDBOOK. 
 
 nervousness from over sexual indulgence or 
 from nocturnal emissions. In women the 
 menses are too early, too excessive, and of 
 dark or black blood. Irregular menstruation. 
 Vomiting of pregnancy. Threatened miscar- 
 riage with a desire to urinate and move the 
 bowels at frequent intervals. 
 
 Remember Nux vomica for dark complected 
 persons who cannot sleep. For irritableness 
 and indigestion, and for the bad effects of 
 over-indulgence in any way. 
 
 OPIUM. 
 
 Opium is the gum from the Papaver som- 
 niferum, a plant of Asia. The extended use 
 of the drug in medicine in many forms, and 
 in its various alkaloids, also its combination 
 with other drugs, makes it a very valuable 
 drug and one worthy of careful consideration. 
 
 The great tendency to form the drug habit 
 makes it a drug to be feared, and used with 
 great caution by physician and patient. 
 
 The many fatal results from its use should 
 make all think twice before prescribing it. 
 
 Opium, Morphine and Tr. Opii or Laud- 
 anum are all one in their results so far as 
 the danger from the use of the drug goes. 
 There are many alkaloids of Opium, but for 
 this present subject in hand they will not be 
 mentioned. Children and the aged are very 
 susceptible to Opium in any and all of its 
 
REMEDIES. 229 
 
 forms and preparations, and its use for such 
 persons should be very urgent before the 
 drug is employed, as small doses have proven 
 fatal when none suspected that there was any 
 danger. 
 
 Dover's Powders, Brown mixture, and the 
 various cough compounds have Opium as one 
 of the most active ingredients. 
 
 Morphine is the active principle or alkaloid 
 of Opium, and has much the same action as 
 the crude drug. 
 
 Laudanum or Tr. Opii retains all of the 
 active principles of Opium, and should be 
 used as nothing more or less than Opium. 
 
 In medical doses the effect of Opium is first 
 to produce a short period of exhilaration or 
 excitement followed by drowsiness, and an 
 almost irresistible desire to sleep. The sleep, 
 however, is not natural, as the drug con- 
 tinues its exciting influence on the brain ; 
 dreams chase each other through the mind, or 
 a gentle revery seizes the sleeper and the 
 mind follows up the phantom dream, forget- 
 ting all else. An itching or tingling of the 
 skin is one of the first* symptoms that the drug 
 is beginning to act. 
 
 In overdoses the sleep is profound, follow- 
 ing very soon upon the first stage of excite- 
 ment. Snoring or stertorous breathing is 
 marked, and the pulse, though weakened, is 
 full and slow. There is almost total insen- 
 
230 MEDICAL HANDBOOK. 
 
 sibility to external impressions. In the latter 
 stages of poisoning the pallid countenance is 
 very marked and the face is bathed in a 
 clammy sweat. 
 
 Where an overdose of the drug has been in- 
 jected from whatever cause the first thing to 
 be done is to empty the stomach by an emetic 
 of mustard and Ipecac, or by the use of Ipecac 
 alone, or by any other good and prompt 
 emetic. Strong black coffee should be given 
 internally, and the patient kept from going to 
 sleep by being walked about, and also by 
 striking him with a wet towel, or, in fact, 
 any device to prevent sleep. To stimulate the 
 lungs and the breathing, Atropine Sulphate 
 should be given hypodermically, 1 / 50 th part 
 of a grain. Where there has been much of the 
 Opium taken there will be need of more than 
 3 7 / 5o § ram °^ tne Atropine. Hypodermic in- 
 jections of the 1 per cent, solution of the Per- 
 manganate of Potash is also of service. 
 
 Opium is contra-indicated in all diseases of 
 the brain, and in any affection where there is 
 much mental excitement. See Bromide of 
 Potash for such cases. 
 
 The full medical dose of Opium is 1 grain, 
 of Morphine Sulphate ^4 grain, and of Laud- 
 anum 11 minims, or 22 drops. Try a smaller 
 dose before using the full medical dose. 
 Opium dries up the mucous secretions of the 
 body and constipates the bowels. Babes have 
 
REMEDIES. 231 
 
 been fatally affected by giving a nursing 
 mother the full medical dose of the drug. 
 Beware of the drug where there are children. 
 
 POTASS II BROMIDE, BROMIDE OF POTASH. 
 
 Bromide of Potash is in colorless crystals, 
 odorless and is salty of taste and is perma- 
 nent in dry air. 
 
 The medical uses of the drug are to pro- 
 duce a quieting influence on the nervous sys- 
 tem. It is of much value in the convulsions of 
 children. Puerperal convulsions and general 
 nervous excitement and unrest. The dose is 
 from 20 to 60 grains for adults and 3 to 8 
 grains for children. In cases of convulsions 
 the dose may be given every twenty minutes 
 for 2 or 3 doses, and also it may be neces- 
 sary to increase the dose a half or even give 
 double the amount indicated. 
 
 Do not use the drug continually for weeks 
 or months, as the drug habit may be formed. 
 
 POTASSII IODIUM, IODIDE OF POTASSIUM. 
 
 Iodide of Potassium is in colorless trans- 
 lucent crystals, having a faint odor, pungent, 
 salty taste that afterwards is bitter. 
 
 The drug is of especial value in syphilis 
 and tubercular affections, glandular en- 
 largements and as a tonic. Dose, from 3 to 10 
 grains three times a day well diluted in water. 
 
232 MEDICAL HANDBOOK. 
 
 POTASSII CHLORAS, POTASSIUM CHLORATE. 
 
 Chlorate of Potassium is a colorless, pearly 
 powder, odorless and salty of taste. The drug 
 is chiefly used for sore mouth and sore throat. 
 Tablets of from 3 to 5 grains may be held in 
 the mouth and allowed to dissolve, thus bath- 
 ing the sore or sores in the solution, after 
 which it may be expectorated or swallowed at 
 will. The continued use of the drug has a 
 bad result on the kidneys and it should not 
 be used over an extended period. 
 
 POTASSI PERMANGANAS, PERMANGANATE OF 
 POTASH. 
 
 Potassium Permanganate comes in deep 
 purple crystals, having no odor. Is very solu- 
 ble in water. The value of this drug is prin- 
 cipally due to the amount of oxygen it carries. 
 The drug is used as a disinfectant and deodor- 
 izer. Applied in a strength of 10 to 20 per 
 cent, solution it disinfects, deodorizes and 
 stimulates old or slow healing ulcers. In 
 strong solution it acts as a caustic. Internally 
 it has been used for the poisoning of Opium 
 or Laudanum. It is best used for this pur- 
 pose in the 1 per cent, solution hypodermical- 
 ly. The medical dose of the drug is from 1 
 to 2 grains. Alcohol decomposes the drug and 
 should not be used in conjunction with Potas- 
 sium Permanganate. 
 
REMEDIES. 233 
 
 PHOSPHORIC ACID (HOMCEOPATHIC) . 
 
 Dose. — 3X to 6x, 1 tablet three or four times 
 a day. 
 
 Indicated for Phosphoric Acid. — Head- 
 ache, worse from motion or noise ; pain in the 
 top of the head, low spirits, with no desire to 
 talk; ringing in the ears, annoyed by a noise 
 or conversation, stye on the eyelids, cold feel- 
 ing of the eyes, dark-coated, dry tongue, with 
 sticky mucus in the mouth ; pain in the front 
 teeth, bitter taste in the mouth, the stomach 
 feels as if suspended, desire for juicy fruits 
 or foods, cramp of the abdomen, watery diar- 
 rhoea, milky urine, pain in the back, soreness 
 and weakness of the throat, hoarseness and 
 tickling in the throat, causing cough ; rash 
 of the whole skin of the body, resembling 
 scarlet fever. 
 
 Weakness and relaxation of the sexual 
 organs, dragging, gnawing pain in the tes- 
 ticles, nocturnal emissions, weakness in the 
 back and legs, itching and burning in the end 
 of the penis. 
 
 Phosphoric acid is to be thought of in the 
 nervous exhausted condition of homesick- 
 ness, of over-nervous strain, for grief and 
 anxiety and all debility with low spirits. 
 
 PHOSPHORUS (HOMOEOPATHIC). 
 
 Dose. — 4X to 6x, tablet every three to six 
 hours. 
 
234 MEDICAI, HANDBOOK. 
 
 Indications for Phosphorus.* — Dizziness 
 on rising, dull headache, worse in the morn- 
 ing on rising from bed; wakefulness or very 
 light sleep, but sleepy after meals ; fearful of 
 something in the distant parts of the room, 
 noise in the ears, burning in the eyes, black 
 spots before the eyes, halo around the lamp at 
 night, nosebleed on slight provocation, dryness 
 of the mouth and throat, tongue coated white, 
 thirst for cold drinks, vomits when the con- 
 tents of the stomach becomes warm, pain in 
 the stomach, emptiness of the stomach, sour 
 belching, waxy stools that are long and very 
 difficult to pass, dark urine that leaves a brick 
 dust sediment, pain in the back, dry, tight 
 cough, hoarseness of the voice, stitches in the 
 chest, rusty or frothy blood-colored sputa, 
 cough excited by cold air or the use of the 
 voice. Phosphorus is good in lower fevers, 
 with involvement of the chest, night sweats, 
 blue lips and open mouth and burning and 
 itching of the skin of the whole body. 
 
 In the male there is irresistible desire for 
 sexual satisfaction, but sexual power is want- 
 ing and the act may be a failure. Dreams, 
 with emissions. In the female there is nose- 
 bleed instead of the menses at the time of the 
 flow. 
 
 Remember Phosphorus for tall, dark com- 
 plected persons and for men in particular. 
 
REMEDIES. 235 
 
 PLUMBI ACITAS,, SUGAR OF LEAD. 
 
 Sugar of lead is in colorless, transparent 
 crystals, has a faint acid odor and a sweetish 
 astringent taste. Should be kept in well-stop- 
 pered bottles, as it is acted upon by the air. 
 Sugar of lead is soluble in water. In large 
 doses internally the drug is an irritant poison. 
 
 Lead Water and Laudanum is one of the 
 most useful preparations made from this drug. 
 
 Dressings saturated with Lead Water and 
 Laudanum and applied to bruises where the 
 skin is not broken, sprains and subcutaneous 
 injuries are soothing to the pain and material- 
 ly lessen the swelling. 
 
 The Lotion of Lead Water and Laudanum 
 is made as follows : 
 
 ]J. Sugar of Lead, 120 grains. Laudanum 
 or Tr. Opii, V 2 fluid ounce. Water, 16 fluid- 
 ounces. 
 
 Dissolve the Sugar of Lead in 10 ounces of 
 hot water, and then add the Laudanum and 
 enough water to make 16 fluidounces. 
 
 Shake well before using. 
 
 PULSATILLA NIGRICANS ( HOMOEOPATHIC) . 
 
 Dose.--0 to 3x, from 3 to 5 tablets every 
 three to six hours. 
 
 Indications for Pulsatilla. — A weeping 
 disposition, dizziness on rising, head feels 
 empty, one-sided headache that is worse in the 
 
236 M3DICAI, HANDBOOK. 
 
 evening and worse from lying down, better 
 from sitting up and better from being in the 
 open air, hardness of hearing, purulent dis- 
 charge from the ears, the margins of the eye- 
 lids are sore, with a tendency to styes ; green, 
 offensive discharge from the nose, yellow or 
 sallow complexion, with dark rings around the 
 eyes ; tongue coated yellow, sore throat, tooth- 
 ache, offensive taste in the mouth, with 
 nausea; colic and rumbling in the abdomen, 
 followed by diarrhoea ; worse at night, fre- 
 quent urination of clear urine, inability to hold 
 the urine, dry cough when lying down, better 
 from sitting up, hoarseness, stitches in the 
 chest and in the region of the heart, tight- 
 ness of the chest, sleepy in the day, but can- 
 not sleep at night from the rapid change of 
 ideas, restless, wakeful, frightful dreams. 
 
 In women the menses are too scant, ap- 
 pear too late and are associated with abdom- 
 inal pain, bland, watery discharge instead of 
 the flow, stoppage of the flow from exposure, 
 nervous symptoms, but no flow in girls who 
 should begin to menstruate, colic when the 
 flow does come, so that the patient tosses 
 about and may cry from the pain. 
 
 In men there is pain in the rectum and 
 bladder, with a clear discharge ; soreness and 
 a sickening pain in the testicle. Pulsatilla is 
 the remedy for light complected women who 
 are sad, who flow late or the flow is scant, 
 
REMKDIKS. 237 
 
 who have dark rings under the eyes and who 
 are tender in the abdomen at time of the 
 flow. Pulsatilla is indicated for bland dis- 
 charges from the eyes, ears, nose and geni- 
 tal tract and stoppage of the flow from ex- 
 posure. 
 
 PHYTOLACCA DECANDRA (HOMOZOPATHIC) . 
 
 Dose. — to 3x, 2 to 4 tablets three times a 
 day. 
 
 Indications for Phytolacca. — Indifference 
 of mind, with sick headache; backache and 
 general exhausted feeling, watery discharge 
 from the nose, one side of the nose clogged 
 and the other open, sore throat that is dark 
 red, excessive saliva in the mouth, swelling of 
 the glands of the neck, goitre, bruised sore- 
 ness of the stomach, with belching and vomit- 
 ing of food, of bile or of slimy mucus, thin, 
 dark stools ; there is a bruised feeling of the 
 muscles, worse in the house, worse at night 
 and worse in damp weather, better from mo- 
 tion and from being in the open air. 
 
 In the female breast lumps or hard nodules, 
 pain extending over the breast on nursing. 
 
 Phytolacca is to be thought of for females 
 who have a tendency to get fat and who are 
 subject to glandular enlargements, especially 
 of the neck and of the breast. 
 
238 MEDICAL HANDBOOK. 
 
 QUININE SULPHATE. 
 
 Dose. — From 1 to 20 grains ; usual dose, ;< 
 to 10 grains. 
 
 Quinine in large doses or in small oft repeat- 
 ed doses causes a fullness of the head, with 
 ringing in the ears and deafness or poor hear- 
 ing. Quinine congests the head and middle 
 ear and would be contraindicated in any af- 
 fection where there is an excess of blood to 
 the head or ear. Small doses of Quinine stim- 
 ulate the digestion, and what is not absorbed 
 in the stomach passes on into the intestines 
 and acts as an antiseptic there. For the anti- 
 septic action in the intestines Quinine is much 
 prescribed in typ'hoid fever. For diarrhoea of 
 the amoebic variety, or army diarrhoea or 
 bloody flux, much benefit may be derived from 
 washing out the lower bowel with a solution 
 of from 7 to 15 grains to the pint of boiled 
 water. Quinine is often given in 2 or 3 grain 
 doses after meals as a general tonic for a run 
 down condition of the system. Quinine has an 
 action in the blood to destroy the germs of 
 malaria. Ten grain doses for two or three 
 doses an hour apart before the time of the 
 expected chill in malaria will often avert the 
 chill. In the course of one morning in malaria 
 it is best not to exceed 20 or 25 grains of 
 Quinine as the aggregate amount of the drug 
 given. 
 
REMEDIES. 239 
 
 In the early stage of labor, when the pains 
 are irregular and weak, 10 grains of Quinine 
 and ' three or four teaspoonfuls of whisky 
 will often hasten regular and firm labor pains. 
 
 Some people cannot take Quinine, and even 
 small doses will produce a red rash of the 
 skin, much resembling scarlet fever or of 
 hives or of ivy poison. To such persons 
 Quinine should not be given. 
 
 TINCTURE OF STROPHANTHUS. 
 
 Dose. — Tr. Strophanthus, 1 to 3 drops 
 morning and evening. 
 
 Strophanthus has not the culminative action 
 of Digitalis, does not act on the nerves of the 
 heart and arteries as does Digitalis. Strophan- 
 thus acts directly on the heart muscle itself 
 and the muscular walls of the blood vessels. 
 For this reason Strophanthus is a prime rem- 
 edy where there is failing of the heart or 
 arteries. Digitalis again is best where there 
 is a disturbance of function and little real 
 impairment of the heart or blood vessels them- 
 selves. Strophanthus slows the heart and in- 
 creases the force of the heart's action, in- 
 creases the flow of urine by direct stimulation 
 of the circulation in the kidney. 
 
 The indications calling for the drug are a 
 weak heart, scant urination, blue lips, dizzi- 
 ness or faintness associated with palpitation 
 and shortness of breath on exertion. 
 
240 MEDICAL HANDBOOK. 
 
 EPSOM SALTS. 
 
 Dose. — i to 8 teaspoonfuls, given well di- 
 luted in water. 
 
 Epsom Salts causes the intestinal mucous 
 membrane to give off a great amount of fluid, 
 prevents the absorption of the fluid from the 
 food and causes a movement in much the same 
 manner as an enema. The distension of the 
 intestine with fluid encourages the action of 
 the muscles of the intestines and a movement 
 is produced. Where there is constipation and 
 an accumulation of hardened faeces in the in- 
 testines Epsom Salts should be given first 
 choice, as it increases the fluid of the bowel 
 and assists thus in getting rid of any hardened 
 masses. 
 
 In chronic lead poisoning Epsom Salts re- 
 lieves the constipation and combines with the 
 lead to form a non-poisonous compound. In 
 Carbolic Acid poisoning Epsom Salts acts 
 much the same as in lead poison, by moving 
 the bowels and combining with the acid to 
 form a non-poisonous substance. In poison 
 cases, after the bowels have been moved, give 
 salts in small doses three or four times a day. 
 
 To produce catharsis dissolve the salts in 
 a half glass of water and drink at one draught, 
 best before breakfast. If nausea is produced, 
 add 3 grains of the Carbonate of Magnesia 
 to each drachm of salts used. Epsom Salts is 
 
RKMKDIKS. 241 
 
 not a good remedy for the atony of the bowel 
 and constipation of elderly people. 
 
 SUPPOSITORIES. 
 
 Suppositories produce much the same result 
 and are given for the same purposes as 
 enemata. Suppositories may be medicated or 
 non-medicated. They are usually oblong and 
 made of some substance that, though firm 
 enough to handle, readily melts from the heat 
 of the body. By their action they stimulate 
 the bowels to move. If medicated they are 
 used as a vehicle to carry the medicine to the 
 part. Cacao butter is the chief ingredient of 
 laxative suppositories ; pure and of itself it 
 acts much the same as an enemata of watei, 
 moving the bowels in about 15 minutes to a 
 half hour. Glycerine suppositories are much 
 used to cause evacuation of the bowels. Small 
 suppositories are very useful to cause move- 
 ment in infants and small children. Medicated 
 suppositories are given according to the direc- 
 tions of a physician. To give a suppository 
 have the patient, as in enemata, lie down 
 on the left side, and as the nozzel of the syringe 
 should be introduced, so also should the sup- 
 pository, upward, backward and slightly to the 
 left. Never use any force. 
 
 SODII SALICYLIC, SALICYLATE OF SODIUM. 
 
 The pure drug is found in small, white crys- 
 16 
 
242 mkdicai, handbook:. 
 
 talline powder, odorless and having a sweetish, 
 salty taste. The chief use of the drug is to 
 alleviate the pain and inflammation of rheu- 
 matism. 
 
 One dose is 15 grains, three times a day. 
 
 STRAMONIUM (HOMOEOPATHIC). 
 
 Dose. — to 6x, from 2 to 3 tablets every 
 three to six hours. 
 
 Indications for Stramonium. — Delirium, 
 very talkative, sees objects coming from the 
 corners of the room, animals spring up be- 
 fore the eyes, laughs, sings and dances, fears 
 the dark, wants light and company, imagines 
 all sorts of things, sparkling, staring eyes, with 
 dilated pupils; imagines evil is coming to him 
 or is being planned about him, grinds the 
 teeth, does not want water, food tastes un- 
 natural, sleepy, but cannot sleep. 
 
 Stramonium is the prime remedy for over- 
 wrought nerves, for excessive nervousness, 
 with great imaginings and sleeplessness ; is 
 one of the best remedies for acute mania or 
 insanity. For some of the acute deliriums 
 of the fevers. In mental derangement look up 
 Belladonna, Hyoscyamus and Stramonium. 
 
 SILICEA (HOMOEOPATHIC). 
 
 Dose. — 6x to iox, 1 tablet three times a day. 
 Indications for Silicea. — Great sensitive- 
 ness to noise, poorly nourished, child cries if 
 
RKMKDIKS. 243 
 
 spoken to, pain in the neck, extending up over 
 the head to the forehead; worse on the right 
 side, better from warmth, pustular eruption of 
 the eyelids, with burning and smarting; mid- 
 dle ear disease, ulcers in the nose, abscess at 
 root of the teeth, ulcers on the tonsils, bitter 
 taste in the mouth, constipation, scant urina- 
 tion, with yellow sediment; pain in the joints 
 of the feet, intense pain in the joints of the 
 next to the little toe when wearing shoe, of- 
 fensive perspiration of the feet. 
 
 Silicea is a prime remedy for suppurating 
 conditions where wounds heal poorly, derang- 
 ed condition of the skin where every scratch 
 develops into a sore. For nervous scrofulous 
 subjects, with swelling of the glands of the 
 neck, axilla, breast and groin ; for styes and 
 purulent eye troubles, purulent discharges from 
 the ears, ulcers of the throat that do not heal, 
 felons and suppurative bone diseases. 
 
 SULPHUR. 
 
 Dose. — Sublimed Sulphur, 5 to 120 grains. 
 
 Sulphur is said to purify the blood and has 
 been used for this purpose for many years. 
 Given in molasses, one to two teaspoonfuls 
 may be given daily until the bowels move 
 freely. 
 
 For rheumatism of the joints 10 to 15 grains 
 three times a day has often proven beneficial. 
 
 Locally Sulphur is a valuable remedy for 
 
244 MEDICAL HANDBOOK. 
 
 skin diseases where redness and swelling are 
 absent. 
 
 For the itch and for ringworm two tea- 
 spoonfuls of Sulphur to eight teaspoonfuls of 
 lard makes a very reliable remedy. Rub in 
 well once a day for a week and then take 
 a bath for the first time during the week of 
 treatment. 
 
 SULPHUR (HOMOEOPATHIC). 
 
 Dose. — ix to 6x, 3 tablets three or four 
 times a day. 
 
 Indications for Sulphur. — Dizziness when 
 sitting, heat on top of the head, fullness of the 
 forehead, throbbing headache in the morning, 
 large opening on the top of the head in babes 
 that closes late, light sleep, dullness of thought, 
 forgets words, inclined to be sorrowful and 
 ill-natured, intolerance of light, black spots be- 
 fore the eyes, eyes burn, roaring whizzing in 
 the ears, nose bleed, blisters on the nose, dis- 
 charge from the nose that burns and makes 
 the nose raw, eruptions on the face, and in the 
 hair, a dirty greasy appearance of the skin, 
 putrid taste in the mouth, feeling as if there 
 were a lump in the throat, sore swollen glands, 
 intense hunger in the morning and at times 
 must get out of bed because of the hunger, to 
 satisfy the gone, empty feeling in the stomach. 
 
 Desire for sweets, but sweets cause intense 
 heartburn, soreness in the region of the liver 
 and stomach. 
 
RKMKDIES. 245 
 
 Diarrhoea early in the morning that compels 
 the patient to get out of bed, constipation and 
 diarrhoea alternate, uncertainty of the abdo- 
 men and an unsatisfied feeling after a move- 
 ment. Burning of the anus after a move- 
 ment. Frequent urination of- offensive urine, 
 burning of the urinary passage during urina- 
 tion, pain and rattling in the chest, dry cough 
 excited by talking, stitches in the chest. Mu- 
 copurulent expectoration, dry, unhealthy skin, 
 every injury becomes a sore, pimples of the 
 skin, long lasting ulcers. 
 
 Sulphur is to be thought of in dry harsh 
 skin diseases, in a greasy condition of the 
 face with black heads or comedones, for pim- 
 ples and blotches of the face, in goneness of 
 the stomach with hunger that must be satis- 
 fied, in diarrhoea that gets the patient out of 
 bed every morning, in glandular diseases with 
 a tendency to the formation of abscesses, 
 where all the discharges of the body burn and 
 excoriate the surfaces over which they flow. 
 
 SEPIA SUCCUS (HOMOEOPATHIC.) 
 
 Dose. — 2x to 6x, from 2 to 3 tablets 3 times 
 a day. 
 
 Indications for Sepia. — Violent headache 
 in the evening, dizziness when walking in the 
 open air, one-sided headache with nausea and 
 sadness, weakness of memory and an inability 
 to think, does not care for friends or relatives, 
 
246 MEDICAL HANDBOOK. 
 
 sleepy in the day and wakeful at night, black 
 spots before the eyes, watery discharge from 
 the ear, sore nose, dryness of the nose with ob- 
 struction to breathing, yellowness of the face 
 and marked yellowness of the bridge of the 
 nose, toothache worse from hot or cold 
 drinks or food, aversion to food and every- 
 thing tastes salty, emptiness of the stomach 
 and a feeling as if food must be taken to satis- 
 fy the empty feeling, constipated, hard, diffi- 
 cult stool, the urine is offensive and there is 
 a tendency to wet the bed before the patient 
 is aroused from sleep, clay-like or red sand- 
 like deposit in the urinal after the urine has 
 been left standing" for a while, cough in the 
 morning, tickling in the throat exciting cough. 
 In women, there may be the greatest variety 
 of change from the time and nature of the 
 flow. The flow is not normal in nature or 
 time, and with this change there are many 
 other nervous sensations or disturbances 
 throughout the system, watery leucorrhcea, a 
 sensation as if the womb would protrude and 
 the patient sits with the legs crossed to over- 
 come this feeling, toothache during pregnancy, 
 itching of the genitals, with a milky discharge 
 during pregnancy, and there is apt to be pain 
 in the shoulder and joints of the arms, and 
 heaviness of the limbs during pregnancy. 
 
 Sepia is a good remedy where the flow is 
 deranged in time or nature and for the many 
 
REMEDIES. 247 
 
 nervous phenomena of the change of life and 
 for the nervous disorders of pregnancy. 
 
 TEREBINTHINA, OIL OF TURPENTINE. 
 
 Dose. — Five to 20 drops on sugar. 
 
 Internally, Turpentine causes a warmth of 
 the stomach. Acts as an antiseptic in the 
 stomach and bowels, and is used with Castor 
 Oil for the destruction of tape-worm. Four 
 teaspoonfuls to V/2 ounces of Castor Oil is 
 thus employed. Turpentine increases the flow 
 of urine. On the lungs Turpentine acts as a 
 mild expectorant. 
 
 Colic with distension of the stomach and 
 bowels may be relieved by an injection of 6 
 teaspoonfuls to a pint of soapy water. For 
 painful joints, pain in the back or pain of the 
 chest and colic, wring out a cloth from hot 
 water and sprinkle on it a few drops of Tur- 
 pentine and apply to the painful part. 
 
 Turpentine, Water of Ammonia and Olive 
 Oil in equal parts make a very good liniment. 
 
 THUJA OCCIDENTALIS (HOMOEOPATHIC) . 
 
 Dose. — 2x to 6x, 1 tablet three times a day. 
 
 Indications for Thuja. — Always in a hurry, 
 in moving and in every act. Feels as if his 
 body was scattered about the bed, or was 
 double, or made of glass. Sharp stabbing pain 
 in the head. Diarrhoea. Burning and scalding 
 of urinary tract as from hot water. Warts on 
 
248 MKDICAI, HANDBOOK. 
 
 the genitals. Thuja is a good remedy for dry, 
 fissured warts of the skin. Warts of the 
 mucous membrane. Rheumatic affections of 
 the joints associated with warty growths of 
 the skin and mucous membranes. 
 
 TARTARUS EMETICUS, TARTAR EMETIC (H0MCE0- 
 PATHIC) . 
 
 Dose. — 3X to 6x, from 1 to 2 tablets three 
 times a day. 
 
 Indications for Tartar emetic. — Confu- 
 sion of the mind. Throbbing headache, bad 
 humor. Dimness of vision. Flickering and 
 streaks of light before the eyes. Running of 
 the nose. Pale face. Red, streaked tongue. 
 Flat taste in the mouth. Sore throat. Nausea 
 or vomiting. Pain in the stomach. Diar- 
 rhoea. Dark, cloudy urine. Difficult breath- 
 ing. Fine rattling in the chest. Coughing 
 with vomiting, but little expectoration. Erup- 
 tions on the skin and mucous membranes. 
 
 Tartar emetic is a good remedy for croup. 
 For rattling in the chest with vomiting, but 
 little expectoration. For pustular skin erup- 
 tions with complications of the chest. 
 
 veratrum viride. 
 
 Dose. — Two to 6 drops of Tr. Veratrum 
 viride. Do not exceed 20 drops in a half day. 
 
 Veratrum viride depresses the nerve cen- 
 tres. Slows the pulse and lowers the blood 
 
VAGINAE INJECTION. 249 
 
 pressure throughout the arteries. In child- 
 bed convulsions Veratrum viride slows and 
 softens the pulse, relieves the brain of conges- 
 tion and quiets the irritability of the nerves. 
 Give 5 drops and repeat in 15 minutes until 
 the pulse becomes slower and softer. Reduce 
 the pulse to about 60 per minute, but do not 
 give more than is required to reduce the pulse 
 thus far. 
 
 VAGINAL INJECTION. 
 
 Vaginal injections are, as a rule, not needed 
 in health, but their utility in disease makes 
 the subject of import. Douches are of use to 
 restore the flow when from some cause it has 
 stopped too soon, and also to carry antiseptics 
 and medical agents to the female genital tract. 
 A vaginal douche to be of any service must be 
 given in the recumbent posture, and be given 
 slowly. Injections to restore the flow should 
 be hot, not less than no degrees Fahrenheit. 
 Medicated and antiseptic injections are given 
 in diseases of the female genital tract, and as 
 a cleansing douche after confinement. The 
 size and nature of such a douche will be indi- 
 cated under the head of those respective con- 
 ditions. To give a douche the patient should 
 lie on the back, the knees flexed, and the hips 
 slightly elevated; give as directed for the effect 
 desired. 
 
INDEX. 
 
 Abortion, 84. 
 
 Abscess, 9. 
 
 Acid, carbolic, 177. 
 
 iVcid, phosphoric, 233. 
 
 Aconitum napellus, 168. 
 
 Actea racemosa, 191. 
 
 Administration of drugs, 194. 
 
 Alum, 174. 
 
 Amenorrhcea, 101. 
 
 Amputations, 11. 
 
 Anaesthesia, 154. 
 
 Anaesthesia, examination before, 157. 
 
 Anaesthesia, local, 166. 
 
 Anaesthesia, preparation of patient for, 156. 
 
 Anaesthetics, 154. 
 
 Antimonium crudum, 174. 
 
 Antiseptics, 176. 
 
 Apis mellifica, 170. 
 
 Applications, 135. 
 
 Arnica Montana, 175. 
 
 Arsenicum album, 171, 172. 
 
 Asafoetida, 170, 171. 
 
 Asphyxia, 15. 
 
 Baptisia tinctoria, 182. 
 Barley soup, 203. 
 Barley water, 204. 
 
252 MEDICAL HANDBOOK. 
 
 Bed-wetting, 22. 
 
 Beef tea, 206. 
 
 Belladonna, 179, 181. 
 
 Berberis vulgaris, 185. 
 
 Beta naphtol bismuth, 185. 
 
 Bismuth subnitrate, 182. 
 
 Blood poison, 25. 
 
 Blood spitting, 20. 
 
 Blue vitriol, 192. 
 
 Boils, 19. 
 
 Breathing, normal, 22. 
 
 Bronchitis, 28. 
 
 Bronchitis, chronic, 30. 
 
 Broths, 207. 
 
 Bruises, 18. 
 
 Bryonia alba, 184. 
 
 Burns, 16. 
 
 Caffeine citras, 193. 
 
 Calcarea carbonica, 189. 
 
 Carbolic acid, 177. 
 
 Carbuncle, 30. 
 
 Cascara sagrada, 188. 
 
 Castor oil, 187. 
 
 Catarrh of nose and throat, 135. 
 
 Cathartics, 186. 
 
 Cathartic vegetable pills, 187. 
 
 Chamomilla, 190. 
 
 Change of life, 104. 
 
 Chicken broth, 207. 
 
 Chilblain, 59, 63. 
 
 Child, the, 98. 
 
INDEX. 253 
 
 China, 193. 
 
 Chloroform, 155. 
 
 Chloroform, contra-indications for the use of, 
 
 163. 
 Chloroform, indications for the use of, 163. 
 Chloroform, the administration of, 163. 
 Chronic sore, throat, 137. 
 Cimicifuga, 191, 192. 
 Citrate of caffeine, 153. 
 Coffee, 205. 
 Cold, 59- 
 
 Cold, local use of, 215. 
 Cold on chest, 28. 
 Cold in head, 26. 
 Colic, 49. 
 Colocynth, 186. 
 Conjunctivitis, 156. 
 Consciousness, loss of, 167. 
 Constipation, 35. 
 Constipation of infants, 37. 
 Consumption, 146. 
 Convulsions, 32. 
 Copper, sulphate of, 192. 
 Corrosive sublimate, 176, 225. 
 Coryza, 26. 
 Cough, chronic, 30. 
 Cough, whooping, 148. 
 Croton oil, 188. 
 Croup, 37. 
 Custard, egg, 206. 
 
254 MEJDICAI, HANDBOOK. 
 
 Dentition, 46. 
 
 Diarrhoea, 43. 
 
 Digestion, disturbances of, 47. 
 
 Digestive system, 50. 
 
 Digitalis, 198. 
 
 Diphtheria, 39. 
 
 Discharges from the bowels, 45. 
 
 Disturbances of digestion, 47. 
 
 Dose, 7, 194. 
 
 Dropsy, 42. 
 
 Dulcamara, 198. 
 
 Dysmenorrhea, 103. 
 
 Dyspepsia, 50. 
 
 Earache, 55. 
 
 Eczema, 53. 
 
 Egg-nog, 205. 
 
 Emergencies, how to meet, 161. 
 
 Emetics, 199. 
 
 Enemata, 200. 
 
 Enuresis, 22. 
 
 Epsom salts, 240. 
 
 Erysipelas, 52. 
 
 Ether, 154. 
 
 Ether, contra-indication to giving of, 157. 
 
 Ether, how to administer, 158. 
 
 Ether, indications for, 157. 
 
 Eyes, 58. 
 
 Eyes, sore, 56. 
 
 Face, 58. 
 Fainting, 67. 
 
INDEX. 255 
 
 Falling, S3. 
 Farina gruel, 208. 
 Ferrum, 202. 
 Flooding, 89. 
 Flow, want of, 101. 
 Food for the sick, 203. 
 Fractures, 64. 
 Frost-bites, 59, 60. 
 
 Gargles, 135. 
 Gelatine,. 206. 
 Gelsemium semp., 209. 
 Graphites, 210. 
 Grippe, 79. 
 Guaiacum, 210. 
 
 Haemorrhoids, 75. 
 Hamamelis, 213. 
 Headache, 72. 
 Heart action, normal, 68. 
 Heart disease, 69. 
 Heart, palpitation of, 109. 
 Heat, local use of, 215. 
 Hepar sulphur, 211. 
 Hiccough, 48. 
 Hives, 74. 
 
 Hydrastis Can., 212. 
 Hyoscyamus niger, 214. 
 
 Ignatia amara, 220. 
 Indications for drugs, 7. 
 
256 MEDICAI, HANDBOOK. 
 
 Infantile scurvy, 129. 
 Influenza, 79. 
 Injection, vaginal, 249. 
 Iodine, 217. 
 Iodoform, 216. 
 Ipecacuanha, 218, 219. 
 Iron, 202. 
 Itch, 78. 
 
 Jaundice, 81. 
 
 Kali bichromicum, 221. 
 Kali carbonicum, 222. 
 
 Labor, 85. 
 
 Lachesis, 224. 
 
 Lead, sugar of, 235. 
 
 Local use of cold and heat, 215. 
 
 Lycopodium, 223. 
 
 Measles, 95. 
 Menopause, 104. 
 Menstruation, 100. 
 Menstruation, painful, 103. 
 Mercurius corrosivus, 224. 
 Mercury, bichloride, 176. 
 Milk, 207. 
 
 Milk, peptonized, 204. 
 Milk punch, 204. 
 Miscarriage, 84. 
 Morning sickness, 83. 
 Mouth, sore, 98. 
 Mumps, 94. 
 
INDEX. 257 
 
 Neuralgia, 106. 
 Normal temperature, 144. 
 Nose-bleed, 108. 
 Nose, catarrh of, 135. 
 Nux vomica, 225, 226. 
 
 Oatmeal gruel, 208. 
 Opium, 228. 
 
 Organic heart trouble, 69. 
 Orphol, 185. 
 
 Palpitation of heart, 109. 
 
 Peptonized milk, 204. 
 
 Permanganate of potash, 2^2. 
 
 Pharyngitis, 136. 
 
 Phosphoric acid, 233. 
 
 Phosphorus, 233. 
 
 Phytolacca decandra, 237. 
 
 Piles, 75. 
 
 Piles, internal, JJ. 
 
 Pin worms, 151. 
 
 Pleurisy, 114. 
 
 Plumbi acetas, 235. 
 
 Pneumonia, no. 
 
 Potassi permanganate, 2^2. 
 
 Potassium chlorate, 232. 
 
 Potatoes, 206. 
 
 Preface, 6. 
 
 Pregnancy, 82. 
 
 Pudding, 207. 
 
 Pulsatilla nigricans, 235. 
 
 17 
 
258 MKDICAI, HANDBOOK. 
 
 Quinine sulphate, 238. 
 Quinsy, 131, 132. 
 
 Respiration, artificial, 15. 
 Rheumatism, 118. 
 Rice pudding, 207. 
 Rice soup, 204. 
 Rickets, 117. 
 Ringworm, 116. 
 
 Salicylate of sodium, 241. 
 Salts, epsom, 240. 
 Scabies, 78. 
 Scarlet fever, 120. 
 Scurvy, 127. 
 Seat worms, 151. 
 Sepia succus, 245. 
 Silicea, 242. 
 Skin, the, 130. 
 Small-pox, 123. 
 Sodium salicylate of, 241. 
 Sore mouth, 98. 
 Sore throat, 133, 136. 
 Soup, 203, 204. 
 Spitting blood, 20. 
 Stramonium, 242. 
 Strophanthus, 239. 
 Sulphur, 244. 
 Suppositories, 24 t. 
 
 Tape-worms, 145. 
 Tartar emetic, 248. 
 
INDEX. 259 
 
 Tartarus emet., 248. 
 Tea, 205. 
 Teething, 46. 
 
 Temperature, normal, 144. 
 Terebinthina, 247. 
 Tetter, 53. 
 
 Throat, catarrh of, 135. 
 Throat, sore, 133, 136. 
 Thuja occid., 247. 
 Toast, 208, 209. 
 Tongue, the, 143. 
 Tonsillitis, 131. 
 Toothache, 143. 
 Tuberculosis, 146. 
 Turpentine, 247. 
 IVphoid fever, 138. 
 
 Urine, 148. 
 Urticaria, 74. 
 
 Vaginal injection, 249. 
 Varioloid, 126. 
 Veratrum viride, 248. 
 
 Wetting, bed, 22. 
 Whooping-cough, 148. 
 Worms, pin, 151. 
 Worms, seat, 151. 
 Wounds, 153. 
 
IAPR 28 1904