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Many of the techniques and recipes in this chapter of the book are dangerous! They were written in a time before most of the advances of modern medicine. They advise the use of poisonous heavy metal salts, dangerously liberal bloodletting for inapropriate conditions, the use of drugs which it is now illegal to possess, unhealthy diet, etc. etc. There are much better treatments available today for all of the conditions described here, and none of these old techniques can be said to be any more "natural" or healthy than what we have now. Indeed, I regard this chapter as a potent reminder of just how grateful we should be for the medical treatment available today. |
Rule 1. - In every complaint, whatever it may be called, if you find the pulse quick, hard, full, and strong, the head aching, tongue foul, skin hot, or those marks which denote it to be of an inflammatory nature, remember the plan is to reduce excitement by purging, low diet, drinking plentifully of cold water and lemonade, rest, etc.
Rule 2. - If, on the contrary, the pulse be small, soft, feeble and intermitting, the tongue dark, and great debility or weakness is evident, reverse the whole plan; the diet must be generous and nourishing, the bowels opened with gentle laxatives, and the strength supported by bark, sulphate of quinine, wine, and tonics of various kinds.
It is necessary, however, to be careful in distinguishing the weakness which is here meant, from that state of debility which arises from excessive action, from the stuffing up of the vessels, and which requires the lancet. As a mistake might prove fatal, attention should be paid to the pulse by which they can be known. In that state which requires tonics, the pulse is small, soft - sometimes like a thread, and quick. In the other, it is slower and full, giving considerable resistance to the pressure of the finger.
Rule 3. - If, in addition to those symptoms mentioned in the second rule, the tongue be covered with a black coat - foul, dark-looking sores form about the gums and insides of the cheeks - the breath be offensive, etc., the same class of remedies is to be vigorously employed, with a free use of acids and other antiseptic articles.
Rule 4. - Severe local pains, as in the head, side, etc., may require the use of the lancet, purging, and blisters to the part.
Rule 5. - Incessant and earnest entreaties on the part of the sick for, or longing after, any particular article of diet, if steadily persevered in, may be safely indulged, whether the use of it agrees or not with our preconceived ideas on the subject.
Rule 6. - In all fevers, where the pulse is quick, full and strong, the skin burning to the touch, and there is no perspiration, apply gently cold water over the head and limbs of the patient, wipe him dry and cover him in bed. If, in consequence of this, a chill be experienced, and the pulse sink, give warm wine, etc., and omit the water for the future. Should a pleasant glow, over the whole frame, follow the effusion, and the patient feel relieved by it, repeat it as often as may be necessary.
Rule 7. - Observe carefully the effects of various articles of food, as well as physic, upon your own body, and choose those which experience proves to agree best with you. It is a vulgar, but true saying, that "What is one man's meat is another's poison." When, however, the stomach is out of order, do not conclude hastily that a particular article is injurious; as, at such a time, everything may seem to disagree, and the simplest things are then the best.
Rule 8. - Keep a sick room always well ventilated. Plenty of fresh air is an important remedial agent in all diseases.
It is not meant by this that the patient should be exposed to a direct current of air, which should be always avoided by well and sick.
The pulse is nothing more than the beating of an artery. Every time the heart contracts, a portion of blood is forced into the arteries, which dilate or swell to let it pass, and then immediately regain their former size, until by a second stroke of the same organ, a fresh column of blood is pushed through them, when a similar action is repeated. This swelling and contracting of the arteries then constitutes the pulse, and consequently it may be found in every part of the body where those vessels run near enough to the surface to be felt. Physicians look for it at the wrist from motives of convenience.
The strength and velocity of the pulse vary much in different persons, even in a state of perfect health. It averages about seventy boats a minute in adults. It is much more frequent in children than in adults; and in old men it grows more slow and feeble, owing to the decreased energy of the heart. The pulse is increased both in strength and velocity by running, walking, riding, and jumping; by eating, drinking, singing, speaking, and by joy, anger, etc. It is diminished, in like manner, by fear, want of nourishment, melancholy, excessive evacuations, or by whatever tends to debilitate the system.
In feeling the pulse, then, in sick persons, allowance should be made for these causes, or, what is better, we should wait until their temporary effects have ceased.
A full, tense, and strong pulse is when the artery swells boldly under the finger, and resists its pressure more or less; if, in addition to this, the pulsation be very rapid, it is called quick, full, and strong; if slow, the contrary.
A hard, corded pulse is that in which the artery feels like the string of a violin, or a piece of tightened cat-gut, giving considerable resistance to the pressure of the finger.
The soft and intermitting pulses are easily known by their names. In cases of extreme debility, on the approach of death, and in some particular diseases, the artery vibrates under the finger like a thread.
In feeling the pulse, three or four fingers should be laid on it at once. The most convenient spot to do this, as already mentioned, is the wrist, but it can be readily done in the temple, just before, and close to the ear, in the bend of the arms, at the under part of the lower end of the thing, among the hamstrings, and on the top of the foot.
There are two kinds of large blood-vessels in the human body: arteries and veins. The arteries carry the blood from the heart to the extremities of the body, where they are connected through the capillaries with the veins which bring it back again. An artery pulsates or beats; vein does not.
Fever is by far the most common complaint to which the human body is subject. It may be briefly described as a combination of heat, loss of appetite, weakness, and inability to sleep. It makes its appearance in two ways: either suddenly and violently, or gradually and gently. When it comes on in the first manner, a cold shaking, attended with sickness at the stomach, or vomiting, marks its access; the cold is more severe than in the latter, as is also the pain in the head, and other symptoms. When its attack is gradual, a feeling of soreness over the whole body such as is experienced after a hard day's work by one not accustomed to it, shows its approach. Nausea, pains in the head, chills, and more or less heat and thirst soon follow.
As these symptoms vary infinitely in their degrees of violence, the treatment to be pursued must differ accordingly. Thus the same directions that are given for simple inflammatory fever must be adhered to, in one whose symptoms are lighter, though similar, only there is no necessity for pushing them to so great an extent.
Symptoms. - Chills, flushed face, skin hot, eyes red, pulse quick, full, strong, and regular, great thirst, tongue white, urine high-colored and small in quantity, bowels costive, breathing quick, etc.
Causes. - Cold, violent exercise while exposed to the heat of the sun, intemperance, the indulgence of unruly passions.
Treatment. - Bleed the patient, if he be robust, at the very beginning of the attack. The quantity of blood to be taken should be regulated by the strength and age of the person, and the violence of the symptoms. In this country, where diseases are very acute, from twelve to fifteen ounces is an average quantity for a robust man. If there be great pain in the head, shave it and apply a blister, or cloths wrung out of iced vinegar and water, frequently renewed. The bowels are to be freely opened with Epsom salts or citrate of magnesia, and the diet should consist of plenty of cold water, rice water, or lemonade. If the heat of the body be excessive and burning to the touch, and there is no perspiration, let cold water be applied with a sponge to his head and limbs, and then wipe him dry and cover him in bed. If there be intense pain in the head or side, apply a blister. The saline mixture, below, will be found useful throughout. An emetic, at the very onset sometimes cuts short the disease. The room should be kept quiet, cool, and dark, every source of excitement being removed.
Saline Mixture. - Carbonate of potassa, 2 drachms; water, 6 ounces. When the salt is dissolved, add by degrees portions of fresh lemon juice till it ceases to effervesce. A tablespoonful may be taken every half hour.
Of this fever, there are several varieties, which differ from each other only in the length of time that elapses between their attacks. There is one called quotidian, in which it comes on every twenty-four hours; another named tertian, in which it arrives every forty-eight hours, and the third quartan, because the intermission lasts seventy two hours.
Symptoms. - The symptoms of fever and ague are, unfortunately, too well known among us, commencing with yawning, stretching and uneasiness; this is succeeded by slight chills or shiverings, that end in a violent or convulsive shaking of the whole body. This is the cold fit, and is immediately followed by the fever or hot fit. The pulse rises, the skin becomes hot, with pain in the head, tongue white, and all the marks of fever terminating in a profuse sweat, which gradually subsiding, leaves the patient in his natural state, though somewhat weakened.
Treatment. - On the first alarm that is given by a chill, or any of those feelings indicative of its approach, take 50 or 60 drops of laudanum in a glass of warm wine, with a little sugar and a few drops of the essence of peppermint, get into bed and cover yourself with several blankets; this seldom fails to out short the disease. If the cold fit, however, has passed by, the next accession should be carefully watched, and the same remedy resorted to. If the inflammatory symptoms seem to require it, open the bowels with senna and salts; when this is done, in the intervals use a quinine pill of one grain every hour; if it cannot be procured take as large doses Peruvian bark as the stomach will bear; in addition to this, endeavor during the cold fit to bring on the hot one, as speedily as possible, by warm drinks, bladders or bottles filled with warm water applied to the soles of the feet and the stomach. Weak whiskey punch answers this purpose very well; it also is of use by inducing sweat when the hot stage is formed. If the disease resists this treatment, try six drops of Fowler's Solution of Arsenic three times a day, with the bark, gradually increasing it to nine or ten drops at each dose. As this is a powerful remedy, care must be taken to watch its effects; if it produce sickness at the stomach, headache, or swelling of the face, it must be laid aside. To restore the tone of the system when getting better, remove to a healthy pure air, use gentle and daily exercise. with a generous diet, iron and bitters. If the liver or spleen become affected recourse may sometimes be had to mercury.
Much mischief is done by giving either the quinine or the hark too early in the disease, and before its inflammatory stage is passed. It should never be employed until the bowels have been well opened and the excitement reduced.
This is a kind of fever which occasionally abates, but does not entirely cease, before a fresh attack comes on, so that the patient is never completely free from it. The most usual form of it is called bilious fever, or bilious remittent.
Symptoms. - In this disease all the marks of great excitement and a superfluity of bile are visible; the skin is hot, the pulse tense and full, tongue white in the commencement, changing to brown, as the fever increases, breathing hurried and anxious, bowels very costive, and skin of a yellowish hue. In bad cases, there is great pain in the head, delirium, the patient picks at the bed clothes, a convulsive jerking of the tendons at the wrist, tongue black and furred, a deep yellow skin, vomiting, and hiccup.
Causes. - A peculiar poisonous vapor from ponds, marshes, and decaying vegetable matter.
Treatment. - This must be conducted on our general principles. As the inflammatory and bilious symptoms are the most prevalent at the commencement, bleed the patient if he be robust. The next step is to open his bowels. Ten grains of calomel, combined with a portion of jalap, may be given in molasses, and repeated or followed by a saline purgative, until copious evacuations are produced. If the pain in the head be very great, shave it and apply a blister. Should the skin be very hot, and great thirst and restlessness prevail, apply cold water over the body, as directed in simple inflammatory fever. The diet should consist of rice-water, lemonade etc., taking care to keep up a moderate discharge from the bowels by purgatives, during the whole of the disease.
If, however, in spite of all endeavors to the contrary, the complaint seems advancing, the patient should be brought carefully under the influence of quinine. As soon as symptoms of exhaustion or a typhoid state make their appearance, no mercury should be given internally; on the contrary, bark, wine, acids, etc., are necessary to support the patient, who should be kept clean, cool, and comfortable, excluding all noise. The extreme irritability of the stomach, which is frequently found in bilious fever, may be overcome by the saline draught, in a state of effervescence (to be found on page 123), and in the latter stage of it, when the pulse flags, and the system appears sinking, the quinine mixture, below, has been found extremely useful. Blisters and mustard poultices may also be applied in this case to the ankles, thighs, and wrists. The internal use of the quinine is an invaluable remedy in all such cases, and should never be omitted.
There are in fact two distinct stages in this disease that require two different plans of treatment. The first is bilious and inflammatory, and should be met by bleeding, vomiting, purging with calomel, blisters to the head, and the affusion of cold water.
The second is typhoid end bilious, and must be treated by wine, brandy, the quinine mixture, sound porter, and the peculiar plan recommended in typhoid fever.
Sulphate of quinine 32 grains; elixir of vitriol 1 drachm; peppermint water 4 ounces. The dose is a teaspoonful every hour or two.
Symptoms. - Languor, debility, dejection of mind, alternate flushes of heat and chills, bleeding at the nose, loathing of food, confusion of ideas. These are succeeded by vertigo, pain in the head, cough, frequent weak and sometimes intermitting pulse, the tongue dry and covered with a brown fur, the teeth and gums being encrusted with the same, the forehead is covered with sweat, while the hands are dry and glow with heat, the patient talks wildly. There is diarrheea and swelling of the abdomen.
Causes. - Grief, home-sickness, whatever tends to weaken the system, a poor diet, living in close filthy apartments. Distinguish it from typhus fever by the attack coming on more gradually, and by the greater mildness of the symptoms and the want of those marks mentioned in the former.
Treatment. - If the bowels be costive give some gentle laxative, as rhubarb or castor oil. As soon as this has operated, or even before (if the weakness of the patient seem to require it), exhibit wine whey and beef-tea, always remembering that if the strength of the patient be not supported by these means, he may die of debility. Applying cold water gently over the body is a remedy in this disease, of great value. If delirium or insensibility come on, shave the head and apply a blister to it, or cloths wrong out of iced vinegar and water. If a copious purging ensue it must be stopped or it will prove fatal; this may be done by the mixture No. 1, or by opium. Musk mixture No. 2. and the camphor mixture, No. 3, will also be found useful. Great reliance is sometimes placed upon the sulphate of quinine, which may be taken in doses of two or three grains four times a day, dissolved in a little gum arabic tea, or in pills.
The order of remedies, then, in typhoid fever, is to open the bowels with the mildest laxatives, to use wine or sometimes brandy, to apply cold water over the body, to give milk, chicken water, jellies, tapioca, sago, etc.; to check purging, keep the room cool and clean, use the quinine mixture, one or all of the different mixtures of camphor or musk, and if delirium come on to apply blisters to the head. Bleeding is, at best, a doubtful remedy in typhoid and should never be allowed without being ordered by a physician; nine times out of ten it is certain death to the patient.
No. 1. Astringent Mixture. - Chalk mixture 4 ounces; tincture of kino 1 drachm; lavender compound 1 drachm; laudanum 30 drops. Dose, a tablespoonful every two or three hours, as may be required.
No. 2. Musk Mixture. - Musk 1 drachm; gum arabic, powdered, 1 drachm; loaf sugar, the same; water 6 ounces. Rub up the musk and sugar, adding the water very gradually. The dose is a tablespoonful every two hours.
No. 3. Camphor Mixture. - Camphor 30 grains; powdered gum arabic 2 drachms; loaf sugar 1 1/2 drachms, peppermint water 6 ounces. Moisten the camphor with a few drops of spirits of wine, and rub it to a powder. The gum arabic and sugar beat to a paste, add the camphor, and pour in the water gradually. The dose is a tablespoonful every two or three hours.
Symptoms. - Severe chills, astonishing and sudden loss of strength, countenance livid and expressive of stupor, the skin sometimes burning to the touch, at others the heat is moderate, the pulse is quick, small and rarely hard, violent pain in the head, redness of the eyes, low, muttering delirium, the tongue is covered with a dark brown or blacklooking crust, blackish sores form about the gums, the breath is very offensive, and, in the latter stage, the urine also, which deposits a dark sediment; in extremely bad cases blood is poured out under the skin, forming purple spots, and breaks out from the nose and different parts of the body, the pulse flutters and sinks, hiccup comes on, and death closes the horrid scene.
Treatment. - As severe cases of this disease are apt to run their career with fatal rapidity, no time should be lost; bleeding is not admissible, the loss of a few ounces of blood being equivalent to a sentence of death. The first medicine given may be a mild purgative; castor oil will answer the purpose. If the heat of the patient's body be great, sponge him with vinegar and water. This practice produces the happiest results. As soon as he is wiped dry, and has taken the wine if chilled, give four drops of nitromuriatic acid in a wine glass of the cold infusion of bark every four hours. Wine and water should generally be liberally given in this disease as soon as the typhus symptoms show themselves. Liquid food, as milk or beef tea, should be given at short intervals. The sulphate of quinine in the same doses as mentioned in typhoid is a valuable remedy.
As a wash for the mouth, nothing is better than an ounce of alum dissolved in a pint of water. Rest at night must be procured by opium, if necessary. If towards the end of the complaint there arise a gentle looseness, accompanied with a moisture on the skin, that seems likely to prove critical, it should not be meddled with; but otherwise it must be stopped by astringents. As this is a contagious disease, all unnecessary communication with the sick should be forbidden. The chamber should be kept cool, clean, and frequently sprinkled with vinegar, and all nuisances be immediately removed. Much advantage will result from taking the patient, on the very commencement of the attack, into a new and healthy atmosphere.
This is never a primary disease, but is always found as a symptom of some other one, as consumption.
Symptoms. - Night sweats, bowels costive at first, then loose, alternate chills and flushes, a circumscribed spot on the cheeks, especially in the afternoon, a peculiar delicacy of complexion, and emaciation to so great a degree that the patient sometimes looks like a living skeleton
Treatment. - Remove the cause, if possible, by curing the disease of which it is a symptom; and support the strength of the patient.
Symptoms. - Intense pain in the head, the eyes incapable of bearing the light, delirium, face flushed, oppression at the breast, the pulse hard and very rapid, tongue at first of a fiery red, then yellow, brown or black.
Causes. - Exposure to excessive heat of the sun, blows on the head, intense application to study, intemperance. Distinguish it from inflammatory fever by the pulse, which in the one is full, strong and regular, in the other hard, quick and corded, and by the raving delirium. From typhus by the two latter marks.
Treatment. - Bleed the patient (as quickly as possible) until he nearly faints. Upon the resolute employment of the lancet in the onset we must place our chief dependence. The bowels should be freely opened with Epsom salts, the head shaved, and a blister or cloths dipped in iced vinegar and water, or pounded ice, be applied to it, and the room kept perfectly cool, dark and quiet. Rice-water, lemonade, or cold water is to be the only diet. Should the violence of the disease not give way to these remedies, repeat the purging, blistering, etc., as often as may be necessary. The most vigorous measures to reduce the inflammation are required, or death will be the consequence. Quietness of mind and body is also essential throughout the attack.
Causes. - Some particular disorder of which it is a symptom. Indigestion, a foul stomach, tight cravats or shirt collars, exposure to the heat of the sun, a rushing of blood into the head, neuralgia, etc.
Treatment. - This will vary according to the cause. If it arises from indigestion, that must be attended to. A foul stomach is one of the most usual causes of headache. In this case, from three to six grains of blue mass may be administered, which at a day's or night's interval, should be followed by a purgative. If from the beating of the artery in the temples, and a sense of fulness in the head, we suspect it to originate from an undue determination to that part, bleed freely or cup or leech, and apply cloths dipped in cold water to it. Long-continued and obstinate headache has been frequently benefited by a seton on the back of the neck.
Symptoms. - Pain, heat and swelling of the parts which appear bloodshot, the tears hot and scalding, fever, intolerance of light, sometimes when the lids are affected the edges become ulcerated.
Causes. - External injuries, as blows, particles of sand, etc., getting into them, exposure to cold, strong light, intemperance.
Treatment. - If the complaint is caused by foreign bodies, they must be removed with the point of a paint brush, or the end of a piece of wire covered with lint, or washed out by injecting warm milk and water into the eye with a small syringe. If particles of iron stick in it they may be drawn out by a magnet. From whatever circumstance it may originate, the inflammation is to be subdued by taking blood from the neighborhood of the eye by a dozen or more leeches. The bowels should be freely opened with Epsom salts, and a cold lead-water poultice, enclosed in a piece of thin gauze, be laid over the part. The room should be perfectly dark and the diet extremely low. Rose-water may be used as a lotion. If the pain is very severe, a small quantity of equal parts of laudanum and water may be dropped into the eye. If the eye-lids are ulcerated, touch them with the white vitriol ointment. Bathing the eye frequently with clear cold water is a refreshing and useful practice. If the eye-ball be ulcerated over the pupil, lead-water must be avoided; as, in that case, it might cause opacity.
There are many other diseases incident to the eyes, but none that can be managed by any but a physician or surgeon. When, therefore, any alteration in the structure of the eye is perceived, no time should be lost in having recourse to the one or the other.
Symptoms. - Pain in the ear, which at last either gradually ceases, or matter is discharged through the opening.
Causes. - The accumulation of hard wax, insects getting into it, injuries from blows, etc.
Treatment. - A little warm olive oil or glycerin with an equal part of laudanum, dropped into the ear, and retained there by a piece of wool or cotton, will frequently procure almost instant relief. If it be caused by hard wax, inject warm soapsuds or salt water to soften it, and then, with care, endeavor to extract it, when the oil and laudanum may again be employed. In cases of great severity a blister may be applied behind the ear. A temporary deafness frequently results from this complaint, and sometimes, when matter is formed, the bones of the organ are destroyed, and hearing is lost forever.
Causes. - Fullness of blood, violent exercise, particular positions of the body, blows, etc.
Treatment. - Keep the patient erect or sitting, with his head thrown a little backwards, take off his cravat, unbutton his shirt collar, and expose him freely to the cold air; apply ice or cold vinegar and water to the back of his neck. If the pulse be full, bleed him from the arm. If these are not sufficient, moisten a plug of linen or cotton with brandy, roll it in powdered alum. and screw it up the nostril. A piece of catgut may also be passed through the nostril into the throat, drawn out at the mouth, and a bit of sponge be fastened to it and drawn back again, so as to make the sponge block up the posterior nostril. In doing this it is necessary to leave a piece of the catgut so as to be got hold of, in order to withdraw the sponge. It is seldom, however, that the first remedies will not answer the purpose. The patient should avoid removing the clots which form until the bleeding has entirely ceased.
The nose is subject to two species of this tumor, the pear-shaped or pendulous polypus, and a flattened, irregular excrescence, which is extremely painful and is of a cancerous nature. As soon as any affection of this kind is suspected, apply to a surgeon.
This kind of cancer generally commences in a small crack, which, after a while, becomes exquisitely painful. If closely examined, this crack is found to be seated in a small, hard tumor, which soon ulcerates, and, if not checked, extends the disorder to the throat, thereby endangering life.
Treatment. - The knife is the only remedy for this, as well as every other species of cancer, and no time should be lost in resorting to a surgeon.
Large, dark-looking ulcers in the mouth are a common effect of the abuse of mercury. They may be known by the horrid smell of the breath, by the teeth being loosened from the gums, and by a coppery taste in the mouth.
Treatment. - Omit all mercurial preparations, wash the mouth frequently with sage tea or brandy and water, and keep the bowels open with sulphur.
Small pimples are occasionally found on the tongue, which at last form ulcers. Sometimes they are occasioned by the rough and projecting edge of a broken or decayed tooth: when this is the cause, the part must be rounded by a file or the tooth extracted, when the sore will heal without further trouble. Whitish-looking specks, which seem inclined to spread, are also met with on the inside of the cheeks and lips. They are easily removed by touching their surfaces with burnt alum.
Cancer of the tongue commences like that of the lip, being a crack or fissure in a small, hard, deep seated tumor on the side of the tongue.
Treatment. - No time should be lost in useless attempts to cure it by medicines. The only safety for the patient is in the knife, and that at an early period.
The uvula is that little tongue-like appendage that hangs down from the middle of the fleshy curtain which divides the mouth from the throat. It is very subject to inflammation, the consequence of which is that it becomes so long that its point touches, and sometimes even lies along the tongue, which creates considerable uneasiness, and is now and then the cause of a constant cough, which finally ends in consumption. It is commonly called the falling of the palate.
Treatment. - Strong gargles of vinegar and water, or a decoction of black-oak bark, or a watery solution of alum, will frequently cure the complaint. It happens very frequently, however, that in consequence of repeated attacks it becomes permanently lengthened, and then the only resource is to cut off the end of it. If you are near a physician apply to him; if not, the operation is so simple that any man of common dexterity can perform it, particularly as little or no blood follows the incision. All that is requisite is to seat the patient, seize the part with a hook, or a slender pair of pincers, draw it a little forward, and snap off its point with a pair of scissors.
The tonsils are two glands situated in the throat, one on each side, which are very apt to swell from inflammation by colds. They sometimes become so large as to threaten suffocation.
Treatment. - In the commencement this is the same as directed for inflammatory sore throat, which see. If it does not succeed, apply to a surgeon to take them away.
Symptoms. - Chills and flushes of heat succeeding each other; fever; the inside of the mouth, the throat and tonsils much inflammed;; swallowing is painful; hoarseness; heat and darting pains in the throat.
Causes. - Cold; sitting in damp clothes; wet feet; excessive exertions of voice.
Distinguish it from diphtheria by the fever being inflammatory, the absence of ash-colored patches near the tonsils, etc.
Treatment. - An emetic taken at a very early stage of this disorder will frequently prevent it from forming. The next step is to leech the patient freely and give him a large dose of Epsom salts. A mustard poultice or blister to the throat is an invaluable application, and should never be neglected. The room should be kept cool and quiet, and the diet consist of barley or rice-water. The throat may be gargled several times in the day with alum and water, inhaling the steam of hot water from the spout of a tea pot is of use.
Symptoms. - Difficulty of swallowing, respiration hurried; breath hot; skin dry and burning; a quick, weak and irregular pulse; scarlet patches break out about the lips, and the inside of the mouth and throat is of a fiery red color. About the second or third day, upon examining the throat, a number of specks or patches between an ash and a dark brown color are observed on the palate, uvula, tonsils, etc.; a brown fur covers the tongue: the lips are covered with little vesicles or bladders, which burst and give out a thin, acrid matter that produces ulceration wherever it touches. In bad cases the inside of the mouth and throat become black, and are covered with foul spreading ulcers, and all the symptoms that characterize low fever ensue.
Distinguish it from scarlet fever by the fever being a typhus and not inflammatory, and by the peculiar sore throat, and from measles by the absence of cough, sneezing, watering of the eyes, etc.
Treatment. - Bleeding in this disease is absolutely forbidden. The same may be said of active or strong purgatives. The bowels, however should be kept open by mild laxatives or clysters.
Emetics are used in the beginning with advantage, but the great and evident indication is to prevent and counteract the disposition to putrescency, and to support the strength. For this purpose the cold infusion of bark, or bark in substance, with ten or twelve drops of muriatic acid and eight or nine drops of laudanum, should be taken frequently, and in large doses Chlorate of potassa is a valuable article; it may be taken in solution, twenty grains for an adult every two hours, in a teaspoonful of water. To cleanse the throat, gargle frequently with vinegar or muriatic acid and water or glycerin. The diet should consist of milk, arrow-root, jelly, panada, tapioca and gruel, and the drink of wine whey, wine and water, etc., increasing the quantity of the wine according to the weakness and age of the patient. The greatest cleanliness is to be observed in the chamber. As this disease is thought by some to be contagious, all unnecessary communication with the sick room should be prevented.
Symptoms. - The first mark of an obstruction or stricture in the throat is a slight difficulty in swallowing solids, which continues increasing for months, or until the passage becomes so contracted that the smallest particle of food cannot pass, but having remained an instant in the strictured part is violently rejected. If the obstacle is not removed the patient starves.
Treatment. - Meddle not with the complaint yourself, for you can do nothing to relieve it, but apply with all speed to a surgeon, and remember that life is at stake.
Symptoms. - A dull pain in the head; swelling and redness of the eyes; the effusion of a thin, acrid mucus from the nose; hoarseness; cough; fever, etc.
Treatment. - If the symptoms be violent, bleed and give twenty drops of hartshorn in half a pint of warm vinegar whey. Hoarhound and boneset tea, taken in large quantities, are very useful. The patient should be confined to his bed, and be freely purged. If there is great pain in the breast, apply a blister to it. To ease the cough take one teaspoonful of No. 1 every thirty minutes, or till relief is obtained.
The Influenza is nothing more than an aggravated and epidemic state of catarrh, and is to be cured by the same remedies. No cough or cold is too light to merit attention. Neglected colds lay the foundations for diseases that every year send thousands to the grave
No. 1. Cough Mixture. - Paregoric 1/2 an ounce; syrup of squills 1 ounce; antimonial wine 2 drachms; water 6 ounces. Dose is one teaspoonfull every thirty minutes, or at longer intervals till the cough abates.
Symptoms. - A tightness across the breast, frequent short breathing, attended with a wheezing, increased by exertion and when in bed. It comes on in fits or paroxysms.
Treatment. - If the cough be violent and frequent, with great pain in the breast, and the patient be young and robust, it may be necessary to bleed or cup him. In old people it should be resorted to with caution. The tincture* of lobelia is highly recommended in asthma. It should be taken in doses of a very few drops at first, and cautiously increased. If the pulse sinks under it or nausea, giddiness, etc., is produced, it must be laid aside. In fact, it is hardly prudent to take this active and dangerous article, except under a physician's care. The dried roots of the thornapple and skunk-cabbage are sometimes smoked through a pipe for the same purpose, soaked in a solution of nitre and dried. Asthma is a disease that is seldom completely cured by art; nature, however, occasionally effects it.
(* Take a sufficient quantity of the leaves, stem and pods of the plant, put them into a bottle and fill it up a with brandy or spirits, and let it remain for a few days.)
Symptoms. - A sharp pain or stitch in the side, increased upon breathing, inability to lie on the affected side, pulse hard, quick and corded, tongue white.
Treatment. - Take away at once from twelve to fifteen ounces of blood, place a large blister over the side, and give a full dose of Epsom salts. Follow the bleeding by cups if relief is not obtained; and afterwards a blister. All the remedies for the reduction of inflammation must be actively employed. The patient should be confined to his bed, with the head and shoulders a little elevated, and if pain be severe, especially at night, 10 grains of Dover's powder may be given. The diet should always consist of rice or barleywater, gruel, etc.
Symptoms. - Blood of a bright red color, often frothy, brought up by coughing.
Causes. - Consumption, a fulness of blood, rupture of a blood vessel from any cause. Distinguish it from vomiting of blood by its bright color, and being brought up with coughing.
Treatment. - Give the patient at once a tablespoonful of common salt, and direct him to swallow it slowly. If the pulse be full, and he be robust, bleed him. The sugar of lead has much reputation in this complaint: two or three grains of it, with from a half to a whole grain of opium, may be taken every three or four hours, and in severe cases, where the blood flows rapidly, five or six grains, with two of opium, may be taken at once. The most perfect rest should be strictly enjoined, and the diet should be cooling and simple.
Symptoms. - A short, dry cough, languor and gradual loss of strength, pulse small, quick, and soft, pain in the breast, expectoration of a frothy matter, that at last becomes solid and yellow, the breathing grows more anxious and hurried, the emaciation and pain increase, hectic fever, night sweats, and a looseness of the bowels come on, and the patient, unsuspicious of danger, dies.
Causes. - Neglected colds, dissipation, hereditary tendency, etc. Distinguish it by the long-continued cough, pain in the breast, and great emaciation, by the substance thrown up containing pus, in common language, matter. It is known by its being opaque, mixing with water and heavier than it, so that if thrown into a vessel containing that fluid it sinks to the bottom. When thrown upon hot coals it yields an offensive odor.
Treatment. - In a confirmed state of consumption, nothing that art has hitherto been able to do can afford us any solid hopes of a cure. When once the disease is firmly seated in the lungs all that is possible is to smooth the passage to the grave, and perhaps for a while to retard it. If however, the disease is taken in its very bud, much may be done by a change of climate, a milk diet, cod-liver oil, moderate daily exercise on horseback, and by carefully avoiding cold and all exciting causes. A removal to a warm climate should be the first step taken, if practicable; if not, a voyage to sea or a long journey on horseback. A complete suit of flannel, worn next the skin, is an indispensable article for every one who is even inclined to this most fatal disorder.
The symptoms of this complaint must be obvious from its name. When it arises from organic disease of the heart or its vessels, nothing can be done to cure it. The patient should be careful to avoid a full habit of body, and abstain from violent exercise and sexual indulgences. He should live low, and keep as quiet and composed as possible. A fit of anger, or any imprudence, may cost him his life. There is a milder kind of this disease, resulting from debility, nervousness, indigestion, etc., which must be remedied by restoring the strength of the general system. It is also symptomatic of other diseases, and must be treated accordingly.
Symptoms. - Great difficulty of breathing, which is increased by lying down, oppression and weight at the breast, countenance pale or livid, and extremely anxious, great thirst, pulse irregular and intermitting, cough, violent palpitation of the heart, the patient can lie on one side only, or cannot lie down at all, so that he is obliged to sleep sitting, frightful dreams, a feeling of suffocation, etc.
Treatment. - All that can be done is to follow the same plan that is laid down for the treatment of dropsy in general, which consists of purging and diuretics. When the water appears to be confined to one cavity of the chest, and the oppression cannot be borne, some relief may be obtained by a surgical operation.
Symptoms. - A fixed, burning pain in the stomach, small, very quick hard pulse, sudden and great weakness, the pain in the stomach increased on the slightest pressure, vomiting, hiccup.
Causes. - Cold suddenly applied to the body or stomach, drinking largely of cold water while very warm. The striking in of eruptions, poisons, gout, rheumatism. Distinguish it from inflammation of the bowels by the seat of the pain, which is just below the breast bone, in what is called the pit of the stomach, the burning heat and pain there, by the hiccup and vomiting.
Treatment. - The softness of the pulse is here no rule to go by, for it is caused by the disease. The rule is to bleed or leech over the pit of the stomach. From ten to twenty ounces may be taken in a full stream from a robust man at the beginning. As soon as he is bled, or while the blood is flowing, put him into a warm bath, and have a large blister prepared, which, after he has remained some time in the bath, should be applied directly over the stomach. A warm laxative clyster is now to be thrown up, and when the stomach will retain it, give him small quantities of arrow root jelly or gum arabic tea from time to time, with a few drops of laudanum. The most rigid diet must be observed, and the patient kept very quiet.
When the inflammation is reduced, and the stomach will bear it, a grain of solid opium may be given occasionally with advantage. If the disease has been brought on by poison taken into the stomach, apply the remedies directed in such cases. If mortification ensues, death is the inevitable consequence. It is known to exist when from the state of torture we have just described there is a sudden change to one of perfect ease.
Symptoms. - Violent spasmodic pain in the stomach, which is so severe as nearly to occasion fainting.
Treatment. - Give thirty to sixty drops of laudanum, in a teaspoonful of ether, with a little hot wine. Apply a mustard plaster over the stomach, bladders or bottles filled with warm water to the soles of the feet, or put the patient into the warm bath. If the first dose of laudanum does not relieve the pain, repeat it.
Symptoms. - A spasmodic affection of the stomach and diaphragm, producing the peculiar noise which gives rise to the name.
Treatment. - When hiccups occur at the close of any disease, they may be considered the harbingers of death; they, however, frequently arise from acidity in the stomach and other causes. A long draught of cold water, a sudden surprise or fright puts an end to them. A blister over the stomach may be applied for the same purpose. I have succeeded in relieving a violent case of hiccups, that resisted every other remedy, by the oil of amber, in doses of five drops every ten minutes. It may be taken in a little mint-water. Camphor is also useful.
This common and distressing affection is generally connected with indigestion. To relieve it for the moment, magnesia, soda, or Seltzer water, or water acidulated with sulphuric acid, may be employed. To cure the complaint requires the digestive powers to be strengthened by tonics, bitters, and the different preparations of iron, etc., as directed for indigestion. The application of a blister over the stomach may be of use. The white oxide of bismuth in six grain doses, three times a day, taken in milk, has been found of service.
Symptoms. - Want of appetite; low spirits; pains and fullness in the stomach; belching; a sour water rising in the mouth; heartburn; the bowels irregular and generally costive; weakness and emaciation; pulse smell and slow; pain in the head; skin dry; great uneasiness after eating.
Causes. - All those which induce debility; eating too rapidly, without chewing the food; excessive indulgence in the pleasures of the table, or intemperance in any way; a sedentary life, or want of exercise; a diseased liver.
Treatment. - In every case of indigestion, the first thing the patient should do is to abstain from whatever may have tended to produce it. The diet should consist of animal food that is light, nourishing, and easily digested. Roasted beef or mutton is perhaps preferable to any other. Country air and constant exercise on horseback are invaluable remedies in this disease, which, as it is generally occasioned by a departure from natural habits and employments, must be relieved by a return to them. Flannel should be worn next the skin. and care taken to avoid cold or exposure to wet. A wine-glass of the infusion of bark and quassia (made by placing one ounce of powdered hark and one of ground quassia in a close vessel, to which is added a quart of boiling water; to be kept simmering near the fire until the whole is reduced to a pint), with ten or twelve drops of the elixir of vitriol, should be regularly taken three times a day, for months. The bowels are to be kept open by some warm laxative as rhubarb, and the whole frame braced by the daily use of the cold bath. Weak spirits and water, or a single glass of sound old Madeira may be taken at dinner. Much benefit has been found to result from a long-contained use of the wine of iron (made by taking iron-filings 4 ounces, and pouring on it 4 pints of Madeira wine; let it stand for a month, shaking it frequently), a glass of which may be taken twice a day. If the complaint arise from a diseased liver, recourse must be had to the plan laid down for its cure.
An attack of temporary indigestion may be treated by abstinence, rest, and a teaspoonful of magnesia, if the bowels be costive, otherwise a quarter of a teaspoonful of the bicarbonate of soda.
Symptoms. - A flow of dark blood from the stomach, preceded by a sense of weight and oppression in that organ. The blood is generally mixed with particles of food. etc.
Distinguish it from spitting of blood, by its dark color, and being mixed with food.
Treatment. - If the accompanying symptoms be inflammatory, bleed or cup, and use some cooling purge; if otherwise, try fifteen drops of the muriated tincture of iron, with six of laudanum, in a glass of water, every hour till the bleeding ceases. If the cause be a diseased liver, or tumor in the neighborhood, treat it accordingly.
Symptoms. - A dull pain in the right side below the rib, which is more sensible on pressure; an inability to lie on the left side; pain in the right shoulder; a sallow complexion. Such are the symptoms of an acute attack of this disease. There is another species of it called chronic, in which its approaches are so gradual that it is a difficult matter to determine its nature. It commences with all the symptoms of indigestion, and ends in jaundice or dropsy.
Causes. - Long-continued fever and ague: drunkenness, or a free use of spirituous liquors is a very common cause; injuries from blows, etc.
Distinguish it from pleurisy by the pain not being so severe, and by its extending to the top of the shoulder; by not being able to rest on the left side.
Treatment. - Bleed or cup the patient according to his age, strength, and the violence of the pain and, if necessary, apply a blister over the part which may be kept open by dressing it with the savin ointment. The bowels should be opened by Epsom salts or calomel and jalap. If this does not abate the symptoms in a few days, give a calomel pill of one-half grain every five hours, or rub a drachm of the strongest mercurial ointment into the side until the gums are found to be a little sore, when the frictions or pills must be discontinued until the mouth is well, and then again resorted to as before. If an abscess points outwardly, apply bread and milk poultices to the tumor, omit the mercury, use wine, bark, and a generous diet. As soon as matter is to be felt within it, open it at its lowest and most projecting part with the point of a sharp lancet, and let out its contents very slowly, taking care not to close the wound till this is completely effected. The nitromuriatic acid, in doses of four drops three times a day, steadily persevered in, will sometimes produce a cure. A tea made of the root or leaves of the dandelion is sometimes medicinal in liver complaint.
Symptoms. - Langour; loathing of food; a bitter taste in the mouth; vomiting; the skin and eyes of a yellow color; the stools clayey; and the urine giving a yellow tinge to rags dipped in it. There is a full pain in the right side, under the last rib, which is increased by pressure. When the pain is severe, there is fever, the pulse hard and full, etc.
Causes. - An interruption to the regular passage of the bile, which is retained in or carried into the blood. It may be occasioned by gall-stones, a diseased liver, etc. Intemperance is a very common cause, hence tipplers are more subject to it than others.
Treatment. - If the pulse be full and hard, the pain great, and other inflammatory symptoms be present, blood is to be taken away as freely as the age and strength of the patient, and the violence of the pain, seems to demand. He should then be placed in a warm bath, and allowed to remain there some time; when removed to bed, a grain or two of opium may be given every few hours until the pain is relieved. Bladders partly filled with warm water, or cloths wrung out of hot decoctions of herbs, may also be applied to the seat of the pain. If the stomach be so irritable as not to retain anything on it, try fomentations and the effervescing mixture, or a blister to the part. As soon as some degree of ease is obtained by these means, purgatives must be employed, and steadily persevered in; calomel and jalap or Epsom salts, in the ordinary doses, answer very well. If, however, this cannot be done, and, from the pain being acute at one particular spot, there is reason to suppose that a gall-stone is lodged there, the following remedy may be tried, of which one-fifth or a little less may be taken every morning, drinking freely of chicken broth, flaxseed tea, or barley water after it.
Ether 3 drachms; spirits of turpentine, 2 drachms; Mix them.
The diet ought to be vegetable, and should the disease have arisen from a neglected inflammation of the liver, it must be treated accordingly. (See Inflammation of the Liver.) Regular exercise (on horseback, if possible) should never be neglected by persons subject to this disease in its chronic form.
This is the vulgar appellation for an enlarged spleen, and expresses, with much brief meaning, the cause of the complaint, as it generally results from ill-treated or obstinate intermittents. It is, however, not productive of much uneasiness, and frequently disappears of itself. The plan of treatment, if there is acute pain in the part, is to purge and blister. If it remains enlarged after this, mercury may be carefully resorted to, as directed in chronic inflammation of the liver.
Symptoms. - Sharp pain in the bowels, which shoots round the navel, and which is increased by pressure, sudden loss of strength, vomiting of dark-colored, sometimes excrementitious matter, costiveness, small, quick, and hard pulse, high-colored urine.
Distinguish it from colic, by the pain being increased by pressure, whereas in colic it is relieved by it
Treatment. - This is another of those formidable diseases that require the most actively reducing measures in the onset. From ten to twenty ounces of blood ought to be taken away at once, and the patient placed in a warm bath, after which a large blister should be applied to the belly. Emollient and laxative clysters may be injected from time to time, and if the vomiting and irritability of the stomach permit it to be retained, give a dose of castor oil. If this be rejected too, the oil mixture No. 1. This, however, though one of great importance, is a secondary consideration, to subdue the inflammation, by bleeding or leeching, being the great object. The diet should consist of barley or rice-water only. If in the latter stages of the disease, when the inflammation has somewhat subsided, an obstinate costiveness be found to resist all the usual remedies, dashing cold water over the belly will sometimes succeed.
Remember that this complaint frequently runs its course in a day or two, and that, unless treatment be promptly employed in the very beginning, mortification and death will ensue. If a strangulated rupture occasion the disease, the same, and, if possible, still stronger reasons exist for bleeding, previously to any attempts at reduction.
When certain quantities are mentioned, it is always to be understood that they are applicable to robust men. Common sense will dictate the necessity of diminishing them, as the patient may fall more or less short of this description. If strangulated rupture be feared, surgical aid should be early obtained.
No. 1. Oil Mixture. - The yolk of one egg; castor oil, 2 ounces. Mix them well, and add lavender compound, 2 drachms; sugar, l ounce; water, 5 ounces. Mix them well. The dose is a tablespoonful every hour till it operates, or half the quantity at once; the remainder, in divided doses, if no passage is obtained after a space of four hours.
Symptoms. - A violent vomiting and purging of bile, preceded by a pain in the stomach and bowels; quick, weak, and fluttering pulse; heat, thirst, cold sweats, hiccups, and sometimes death in a few hours.
Treatment. - Bladders or bottles containing hot water should be applied to the feet, and flannel cloths wrung out of hot spirits, or a mustard plaster, be laid over the stomach. When it is supposed that the stomach is sufficiently cleared, give two grains of solid opium in a pill, and repeat half the quantity every few hours, as the case may require. If the weakness be very great, and the spasms so alarming as to cause a fear of the immediate result, the quantity of opium may be increased carefully. If the pill will not remain in the stomach, give eighty or ninety drops of laudanum, in a tablespoonful of thin starch, by clyster, and repeat it as often as may be necessary. Fifty or sixty drops of laudanum in a small quantity of strong mint tea, or the effervescing draught, will frequently succeed in allaying the irritation. If all these means fail, apply a blister to the stomach. For thirst, give ice; a little at once. To complete the recovery, and to guard against a second attack, a complete casing of flannel is requisite, together with the use of vegetable bitters and tonics. Persons subject to this disease should be cautious in their diet and avoid exposure to moist, cold air.
Symptoms. - Fever; frequent small stools, accompanied by griping, bearing down pains, the discharge consisting of pure blood or blood and matter, sometimes resembling the shreds or washings of raw flesh; a constant desire to go to stool.
Distinguish it from diarrhoea or lax by the fever, griping pains, and the constant desire to evacuate the bowels, by the discharge itself being blood, or matter streaked with blood, etc.
Treatment. - As dysentery or bloody flux is almost always in this country connected with considerable inflammation, it will be proper, in some cases, to bleed the patient at the beginning of the attack. Whether it be thought prudent to bleed or not, an early dose of castor oil, with clysters of the same, and the application of blisters to the belly should never be omitted. The stomach and bowels may be cleansed by barley or rice-water taken by the mouth and in clysters. As soon as this is effected give half a grain of opium with half a grain of ipecac every two, three or four hours. The diet should consist of gum arabic dissolved in milk, arrow-root jelly, barley-water, etc. Clysters of the same articles, with the addition of an ounce of olive oil and twenty drops of laudanum, may be likewise injected. Towards the latter end of the complaint, opium and astringents are proper, and indeed necessary. I say the latter end of it, for in the commencement they would be hurtful. In this stage of it also, if a severe tenesmus (or constant desire to go to stool) remains, anodyne clysters, as of forty to eighty drops of laudanum in an ounce of starch will be found useful, or what is more effectual, a couple of grains of opium placed just within the fundament. The various astringents which are proper for dysentery in its latter stages, are found below, and may be used, with port wine and water, as a drink:
Astringents. - Acetate of lead 1 scruple; opium 10 grains. Divide into twenty pills. Take one every two, three or four hours.
Tincture of catechu 2 ounces. Take two teaspoonsful in a little port wine every hour, or oftener if required; or,
Extract of logwood 20 grains; cinnamom water 2 ounces; tincture of kino 1 drachm; sugar 2 drachms. To be taken at once.
Symptoms. - Repeated and large discharges of a thin excrementitious matter by stool, sometimes attended with griping and a rumbling noise in the bowels.
Treatment. - If the disease arises from cold, a few doses of the chalk mixture, No. 1, will frequently put an end to it. It is, however, sometimes necessary to begin with an emetic of twenty grains of ipecacuanha, and then open the bowels by some mild purgative, as castor oil or rhubarb. Bathing the feet in warm water, and copious draughts of boneset tea, will be found of great benefit if it originate from suppressed perspiration. For the same purpose, also, from six to ten grains of Dover's powder may be taken at night, being careful not to drink much for some time after it. If worms are the cause, treat it as directed. When it is occasioned by mere weakness, and in the latter stages of it (proceed from what it may), when every irritating matter is expelled, opium, combined with astringents, is necessary as in the similar period of dysentery. The diet should consist, in the beginning, of rice, arrow-root, sago, etc., and subsequently of roasted chicken. Weak brandy and water, or port wine and water, may accompany the chicken for a common drink. Persons subject to complaints of this kind should defend their bowels from the action of cold by a flannel shirt; the feet and other parts of the body should also be kept warm.
No. 1. Chalk Mixture. - Prepared chalk 2 drachms; loaf sugar 1 drachm. Rub them well together in a mortar, and add gradually of mucilage of gum arabic 1 ounce; water 6 ounces; lavender compound 2 drachms; laudanum 30 drops. The dose is a tablespoonful every hour, or oftener. Shake the bottle well before pouring out the liquid, or the chalk will be at the bottom.
Symptoms. - Violent shooting pain that twists round the navel, the skin of the belly drawn into balls; obstinate costiveness; sometimes a vomiting of excrement.
Distinguish it from inflammation of the bowels by the pain being relieved by pressure, and from other diseases by the twisting round the navel, the skin being drawn into balls, etc.
Treatment. - The first thing to be done in this disease is to give a dose of oil or magnesia with laudanum in a little peppermint water, and apply a mustard poultice over or below the navel. Forty, sixty or seventy drops of laudanum may be given at once, as the pain is more or less violent, and the dose may be repeated in a half hour, or less time, if ease is not procured. During this time, if the first doses of laudanum are found ineffectual in reducing the pain, and it is very great, eighty or ninety drops may be given as a clyster in a gill of gruel or warm water. One great rule in the treatment of colic, where the pain is excessive, is to continue the use of opium in such increased doses as will relieve it. When this result is obtained, castor oil by the mouth and clyster must be employed to open the bowels.
In bilious colic, when there is vomiting of bile, the effervescing draught, with thirty drops of laudanum, may be taken to quiet the stomach, to which flannels wrung out of warm spirits may be applied. When the vomiting has abated, the oil mixture or the pills below should be taken until a free discharge is procured. If, notwithstanding our endeavors, the disease proceeds to such an extent as to induce a vomiting of excrement, the tobacco clyster must be tried, or an attempt be made to fill the intestines with warm water. This is done by forcibly injecting it in large quantities, at the same time the patient swallows as much as he is able. In this way, with a proper syringe, two gallons have been successfully introduced. In all cases of colic, when there is obstinate costivness, an examination of the fundament should be made with the finger. If there are any hard, dry pieces of excrement there, they may be removed either by the finger or the handle of a spoon. Examination of the groin and navel should also be made, to see if there be a rupture which may be strangulated.
Those who are subject to colic should avoid fermented liquors and much vegetable food, be always well clothed, and take care not to expose themselves to cold and wet. The bowels should never be allowed to remain costive.
Purgative Pill. - Of calomel and jalap each 10 grains; opium 1 1/2 grain; tartar emetic 1/2 a grain; oil of aniseed 1 drop. Make the whole into a mass. To be taken at once, or divided into pills, if the patient prefer it.
Symptoms. - Pain and weight in the belly; belching; constant desire to go to stool, which is ineffectual; quick, contracted pulse; the belly becomes painful to the touch, and is drawn into knots; constant colic pains; the patient sits in a bent position; after awhile palsy of part or of the whole body.
Treatment. - This disease is too apt to end in palsy, leaving the hands and limbs contracted and useless. In every case of colic, whose symptoms resemble the above, if the person has been exposed to lead in any of its shapes, all doubt on the subject vanishes.
Give laudanum in moderate doses, and rub the belly well with warm spirits, and place him in a bath as hot as he can bear. As soon as he is well dried, and has rested in bed a few minutes take him up and dash a bucket of cold water over his belly and thighs, or mix an ounce of sulphate of magnesia in a pint of water, and give a wineglassful every half hour until ease is obtained. If this with castor oil by the mouth and in clysters will not produce a stool, apply a large blister to the belly. As soon as the symptoms are somewhat abated, caster oil or laxative clysters may be resorted to for the purpose of keeping the bowels open, and to guard against a return small doses of opium should be taken from time to time. Bitters, the different preperations of iron, bark, etc., are necessary to restore the strength of the system.
Symptoms. - Intolerable itching at the nose, sometimes at the fundament; disagreeable breath; grinding of the teeth and starting during sleep; hardness of the belly; gradual emaciation; colic, and sometimes convulsions.
Treatment. - This will vary according to the kind of worm that is to be destroyed. They are of three kinds:
Resembles a small piece of white thread, and is usually found near the fundament, at the lower end of the guts, where it produces a contraction of the parts, and a most intolerable itching. Clysters of lime-water will frequently bring the whole nest of them away, and procure instant relief. The tincture of aloes below, however, is one of the best remedies known for not only this, but the round worm.
Tincture of Aloes. - Socotrine aloes 1 ounce; liquorice 2 ounces; coriander seed 1/2 an ounce; gin 1 pint. Digest in a bottle for a week, shaking the bottle frequently; then strain. The dose for a child is a teaspoonful every morning; for an adult two tablespoonsful, with half the quantity of a strong decoction of the Carolina pink root.
Santonin suppositories (three grains to a sufficient amount of cacao butter) are a certain cure for seat-worms.
Occupies the small intestines, and sometimes the stomach. It is of various lengths, from three to eight or more inches. If the tincture of aloes fail to remove it, the pink root may be taken in decoction, or in powder, in doses of sixty or eighty grains, to be followed after three or four days by ten or fifteen grains of calomel. Cowhage, in molasses or honey, with a dose of castor oil every third day, has been very highly extolled. In cases where all other means have failed, tobacco leaves, pounded with vinegar and applied to the belly, have produced the desired effect. They are dangerous, however, especially with young children.
Inhabits the whole of the internal canal, and sometimes defies all our efforts to get him out of it. Large doses of spirits of turpentine, from one to two ounces, in barley water, have been advantageously employed for this purpose. If the spirits of turpentine be tried, large quantities of gruel or barley water should be used with it in order to prevent its irritating the stomach and kidneys. Pumpkin seeds, taken largely on an empty stomach, will often expel the worm.
By whatever means these troublesome guests are got rid of, the patient should be careful to strengthen his system and bowels by a course of barks, bitters, wine, etc., and to use a great proportion of animal food in his diet. Repeated purging with calomel is, perhaps, as effectual a remedy for worms as we have, perticularly if succeeded by the pink root tea.
Symptoms. - Deep seated pain in the small of the back; urine high-colored and small in quantity, sometimes bloody; sickness at the stomach; vomiting.
Treatment. - This will depend upon the cause. If it proceed from gravel, the plan to be pursued will be detailed under that head. If it arise from any other, cup the back freely, repeat it in ten or twelve hours, if necessary, and put him into a warm bath. Twenty grains or more of the uva ursi, with half a grain of opium three times a day, accompanied by small quantities of warm barley or rice-water, is one of the most valuable remedies we are in possession of. The diet during the attack should consist of mucilaginous drinks only, which must be frequently taken, notwithstanding they may be rejected by vomiting.
Symptoms. - A fixed pain in the loins; numbness of the thigh; constant vomiting; retraction of the testicle; urine small in quantity, voided with pain and sometimes bloody. As the gravel passes from the kidney into the bladder the pain is so acute as to occasion fainting, etc.
Treatment. - Put him into a warm bath, where he should remain some time. Meanwhile an emolient and anodyne clyster should be got ready, which must be given to him as soon as he leaves it. Cloths wrung out of decoctions of herbs or spirits and water should be applied to the part, and small quantities of warm gum arabic tea or barley-water be taken frequently. A grain of opium every two hours will be found useful. Bicarbonate of soda in twenty-grain doses every three hours, often gives great relief. Strong coffee, without sugar or cream, sometimes acts like a charm in soothing the pain; twenty drops of the spirits of turpentine taken on a lump of sugar every half hour, is said by high authority to do the same. If the irritation of the stomach is very great, the effervescing draught, with thirty or forty drops of laudanum, may be tried. When the pain, etc., is somewhat abated, the bowels should be opened with castor oil. The uva ursi, as before mentioned, is one of the most valuable remedies in all diseases of the kidneys that we have. Blisters in all such cases are never to be applied. Persons subject to this distressing complaint should be careful to avoid acids and fermented liquors of all kinds, including the red wines, beer, pickles, etc. For a common drink soft water, or the seltzer and soda waters, are to be preferred. When any threatening symptoms are perceived, recourse should be had to the soda and uva ursi, with half a grain of opium three times a day, to be continued for weeks.
Symptoms. - Pain and swelling of the bladder, the pain increased by pressure; a frequent desire to make water, which either comes away in small quantities, or is totally suppressed.
Treatment. - Cup the patient freely, according to his age and strength, and put him into the warm bath. Inject mucilaginous and laxative clysters, and pursue the exact plan of treatment that is recommended for the cause from which it may proceed. See Suppression of Urine, etc.
Symptoms. - A frequent desire to make water, attended with pain, heat, and difficulty in doing so; a fullness in the bladder.
Treatment. - If it arise from simple irritation by blisters, etc., plentiful draughts of warm liquids, as gum arabic or barley-water, will be sufficient to remove it; if from any other cause, a bladder half filled with warm water, or cloths wrung out of a warm decoction of herbs, should be kept constantly applied over the parts, and occasionally clysters of thin starch with laudanum be injected.
Symptoms. - Pain and swelling of the bladder; violent and fruitless attempts to make water, attended with excruciating pain. etc.
Treatment. - As a total retention of urine is always attended with considerable danger, there should be no delay in endeavoring to remove it. The first step is to place the patient immediately in the warm bath. While he is there a laxative and anodyne clyster must be got ready, which is to be given as soon as he leaves it, and soon repeated. In the mean time the warm fomentations and bladder of hot water must be kept applied, and the mixture below be taken every three or four hours. If there be any difficulty in procuring it twenty drops of laudanum in a little warm barley or ricewater, or a decoction of the dandelion, will answer instead. Warm sweet oil or milk and water may be injected up the urethra, and three or four grains of camphor, in a little milk, be taken every hour.
If no relief is obtained by these means, leech the perineum, apply snow or ice to the bladder, or make the patient stand on a cold brick or stone pavement, and dash cold water over his thighs and, if this fail, try the tobacco clyster, which sometimes succeeds after everything else has been resorted to in vain. If a catheter can be procured, try gently to pass it into the bladder while in the bath. If the patient himself cannot do it, let a handy friend attempt it; if foiled in one position, try another. Success is of the utmost importance, for there is nothing but an operation, in the event of its not being obtained, that can save life.
In every case of retention of urine the order of remedies then is: the warm bath, laxatives and anodyne clysters, fomentations or bladders half filled with warm water over the lower belly, camphor and milk every hour or every three hours, passing the catheter, leeching, dashing cold water over the thighs and legs, or applying snow or ice to the bladder, and, lastly, the tobacco clyster.
Mixture. - Mucilage of gum arabic, 1 1/2 ounces; olive oil, 2 drachms. Rub them well together, and add ether, 1 drachm; laudanum, 30 drops.
Symptoms. - An involuntary dribbling or flow of urine.
Treatment. - If it arises from a relaxation or weakness of the parts, use the cold bath daily. Apply blisters between the fundament and the bag, and have recourse to bark and the different tonics, as iron, etc., recommended in indigestion. Twenty or thirty grains of the uva ursi, twice or three times a day, with half a pint of lime-water after each dose, may also be tried. If the disease is occasioned by a palsy of the parts, the tincture of Spanish flies may be of service. If a stone in the bladder is the cause, apply to a surgeon to cut it out. In the mean time some kind of vessel should be attached to the yard, to receive the urine, in order to prevent it from excoriating the parts.
Symptoms. - A frequent desire to make water which comes away in small quantities at a time, and is often suddenly interrupted, the last drops of it occasioning pain in the head of the yard; riding over a rough road, or any irregular motion or jolting, causes excruciating pain and bloody urine, accompanied with a constant desire to go to stool; itching of the fundament; a numbness in the thighs, etc.; retraction or drawing up of the testicle.
Treatment. - Cutting out or crushing the stone is the only remedy.
Symptoms. - Frequent discharges of large quantities of urine, which is sometimes of a sweet taste; skin dry, bowels costive, appetite ~ voracious, weakness, and gradual emaciation of the whole body.
Treatment. - The principal remedy for the cure of this disease consists in confining the patient to a diet composed almost exclusively of animal food. Blisters may, also, be applied over the kidneys, and kept open with the savin ointment. The prescription below has proved sometimes successful. The carbonate of ammonia, in doses of 11 or 12 grains three tissues a day, is strongly recommended, upon high authority. In addition to these, opium in liberal doses, exercise on horseback, the fleshbrush, and flannel next the skin, are not to be neglected. The bowels should be kept open by rhubarb.
Prescription. - Peruvian bark, uva ursi, of each 20 grains; opium, 1/2 grain. Make a powder, to be taken three times a day with lime-water.
Symptoms. - A swelling of the belly, from water contained in it, preceded by a diminution of urine, dry skin and oppression at the breast.
Treatment. - One of the most valuable remedies for dropsy is found in the elaterium, one-fourth of a grain of which is a dose. As it is a most active article, it is proper to begin with one-sixteenth of a grain daily, which may be cautiously increased to a fourth, or till it is found to exert its full powers by bringing away large watery stools. From an ounce to an ounce and a half of cream of tartar, dissolved in water, and taken daily, has frequently succeeded in removing the complaint. A tea made by stewing an ounce of bruised juniper berries in a pint of water may be freely drunk with advantage. Bathing the feet before going to bed, and taking immediately after 20 grains of Dover's powder, by producing copious sweating, has produced the same effect.
Dropsy is, notwithstanding, a difficult disease to cure. It must be attempted, however, by the use of such articles as we have mentioned, beginning with the first, and, if it fail, proceeding to the next and so on. If the swelling increases to such an extent as to be absolutely insupportable, send for a surgeon to draw off the water. At the decline of the disease the strength must be supported and restored by bark, wine, and the tonic plan recommended for indigestion. Elaterium or other purgatives must not be resorted to, if the patient be debilitated.
Symptoms. - The symptoms of tympany, or a collection of air either in the intestines themselves, or in the cavity of the belly, are more or less gradual in their approach. When the disease lies within the intestines, it commences with wind in the stomach and bowels, which keeps up a constant rumbling, belching, etc., colic, costivness, diminution of urine, want of appetite, etc. When it is in the cavity of the belly, and outside the intestines, the swelling is much greater, and very elastic, when it is struck, giving a hollow sound like a drum; there is no belching, etc.
Treatment. - If the complaint is within the intestines, keep the nozzle of a clyster-pipe up the fundament, to permit the wind to pass through it, in order to diminish the pressure on the bowels. Warm mint tea, ginger, horseradish, ether, Cayenne pepper, spices and essential oils, with laxative medicines and clysters, should be freely used, with a moderately tight broad bandage round the belly. If these means do not answer the end warm and active purges must be resorted to, such as the compound tincture of senna or jalap. Rubbing with turpentine may also prove useful. It is very apt to terminate in death.
Symptoms. - A tingling sensation at the end of the yard, which swells, looks red and inflamed, followed by a discharge of matter that stains the linen, first of a whitish, then of a yellow or green color, a scalding pain in making water, involuntary and painful erections.
Treatment. - There are two kinds of this affection, the mild and the virulent. The first is of so trivial a nature, that plentiful draughts of any soothing liquid, as barley-water or flaxseed tea with a low diet, are sufficient to remove it. The second produces effects more or less violent on different persons, and occasionally resists for months every remedy that can be thought of. If there be much pain and inflammation in the penis, apply a bread and milk poultice to it, take a dose of salts, and lose some blood. This is the more necessary if, in consequence of the swelling of the foreskin, it cannot be drawn back, or being back, cannot be drawn forward. In the meantime, take pretty large doses of the balsam copaiva daily. A very low diet should be adhered to, and the patient should remain perfectly quiet.
A painful incurvation of the yard, called a chordee, may be relieved by dipping it into cold water, or surrounding it with cloths soaked in laudanum. To prevent it, take fifty or sixty drops of the latter article, or two or three grains of camphor on going to bed.
If, in consequence of violent exercise, or strong injections, the testicles swell, confine the patient on his back, leech and purge him. Pounded ice or snow, or cloths dipped in cold vinegar or water, or lead-water should also be applied to the parts, and a very low diet strictly observed. If, from the same cause, the glands in the groin are enlarged, treat them in like manner.
Symptoms. - The weeping of a thin glairy fluid, like the white of an egg, from the penis, caused by a longcontinued clap.
Treatment. - A gleet is exceedingly difficult to get rid of, and frequently defies every effort that is made for that purpose. It must be attempted, however, by the daily use of the cold bath, and thirty drops of the muriated tincture of iron, taken three times a day, for months, in a glass of the cold infusion of bark. The best advice to be given in this case is to apply at once to an intelligent surgeon, who will prescribe injections of alum, sulphate of zinc, or nitrate of silver.
Symptoms. - An involuntary emission of semen during sleep, inducing great emaciation and debility.
Treatment. - Abstain from all sexual indulgence and lascivious ideas or books, sleep on a hard bed, use the cold bath daily, with a generous and nourishing diet. Chalybeate water and all the different preparations of iron, with the cold infusion of bark and elixir of vitriol, as directed for indigestion, should be freely employed.
Symptoms. - A difficulty in passing water, which, instead of flowing in a full stream, either dribbles away, twists like a corkscrew, or splits and forks in two or three directions. They are occasioned by strong injections, longcontinued or ill-treated clap. The cause, however, is not always to be satisfactorily ascertained.
Treatment. - Procure several bougies of different sizes. Take the largest one, dip it in sweet oil, and pass it into the urethra till it meets with the stricture, then make a mark on the bougie, so that when it is withdrawn you can tell how far down the passage the obstruction exists, and having ascertained this, take the smallest one, well oiled, and endeavor to pass it an inch or two beyond the stricture. If this can be accomplished let it remain so a few minutes. This must be repeated every day, letting the instrument remain somewhat longer each time it is passed, and after a few days using one a little larger, and so on progressively until the largest one can be introduced. If this fails, apply to a surgeon, who may destroy it with caustic or the knife.
Symptoms. - Chancres and buboes are among the first symptoms of this dreadful malady, which if not checked, goes on to cause an ulcerated throat, nodes, a destruction of the bones and cartilages of the nose, and the palate. The voice is lost, the hair falls off, foul spreading ulcers show themselves all over the body, the stench of which is insupportable, and before he dies the miserable victim to it becomes a loathsome mass of corruption.
A chancre at first resembles a pimple, with little pit or depression containing matter, which soon becomes an ulcer, with an irregular thickened edge, covered with a tough, ashcolored matter, the basis of which is hard and surrounded by inflammation. It is generally found on the foreskin or head of the yard.
A bubo is an enlargement of a gland in the groin. beginning in a smell hard lump, not bigger than a bean, and increasing to the size of a hen's egg.
A node is a hard tumor formed on a bone.
Treatment. - Apply at once to an intelligent physician. If this be impossible, confine the patient to a simple diet, and keep the part clean. Two or three grains of blue mass may be used daily, and all stimulating substances must be avoided. Every one has some infallible receipt to cure this disorder; but in nine cases out of ten the remedy proves worse than the disease. As for the chancres, touch them freely with lunar caustic, and apply a little piece of rag to them smeared with red precipitate ointment. If they are situated under the foreskin, which is held over the head of the yard by a permanent phymosis, it (the foreskin) may have to be slit up. If there is a bubo, apply thirty leeches. If this does not prevent its increasing, and the formation of matter is inevitable, apply poultices to it, and as soon as a fluctuation can be felt, let out its contents by several small punctures through the skin with a sharp lancet. To assist in the evacuation, press a soft sponge gently on the tumor.
Symptoms. - A small tumor, like a wart, upon the head of the yard or foreskin, followed by inflammation and ulceration, which discharges a thin, disagreeable fluid; after a time a cancerous fungus is produced, attended by a most intolerable burning and darting pain.
Treatment. - Apply at once to a surgeon, who will cut it out; death is the only alternative.
Crops of these animal mushrooms sometimes spring up round the head of the yard or on the foreskin. If flat, they may be destroyed by caustic or nitric acid; if mounted on a stem or foot-stalk, by tying a piece of thread tightly round it.
Symptoms. - A collection of water, which is first perceived at the bottom of the bag, increasing in size as it advances upwards, and forming a tumor of the shape of a pear. If examined as directed for dropsy of the belly, the wavy motion may be felt, and if a candle be placed behind it, it becomes partly transparent.
Treatment. - The only certain cure is an operation, for which, as there is no pressing danger, apply to a surgeon. There are three species of this dropsy, in one of which the water is contained within the lining of the bag; another, within the covering of the spermatic cord; and the third, in the cellular membrane of the bag, The first we have mentioned. The second occurs most frequently in children; it sometimes, however, is found in adults, and very much resembles a rupture. The treatment is the same as in the first. The third may be distinguished by a doughy feel and irregular shape. It is to be cured by punctures to let out the water, and by suspending the testicle.
Symptoms. - A hard knotty and irregular swelling of the vein, which sometimes increases to a large size. When lying down the swelling diminishes, which distinguishes it from a dropsy of the parts.
Treatment. - Suspend the testicles, or keep the patient on his back, apply lotions of lead-water to the parts; the cold bath.
Symptoms. - The testicle is enlarged, hardened, craggy and unequal in its surface, painful on being handled, with irregular pains shooting up the groin, into the back, without any previous inflammation disease, or external violence.
Treatment. - Apply immediately to a surgeon. Castration, and that at an early state of the disease, is the only remedy that can save life. Be careful, however, to distinguish it from simple swelling of the testicle by inflammation, blows, etc., which see.
This is of three kinds. The first arises from an original defect in the organs of generation. The second, from local debility of the parts, brought on by excessive venery, self-abuse, or some preceeding disease, while the third originates from fear, excess of passion, or want of confidence at the moment of coition.
The first is incurable. The second must ho treated by the general principles and remedies pointed out for restoring the strength of the system, consisting of the cold bath, preperations of iron, bark, elixir of vitriol, generous diet, exercise, and by steadily avoiding the onuses which may have produced it. The remedies for the third must be sought for in calming excessive agitation and acquiring, by habits of intimacy, that confidence they are sure to produce.
Symptoms. - Pain in the small joints, generally in the ball of the great toe, the parts swollen and red, the attack coming on in the night. Such are the striking symptoms of this disease, and generally the first that are noticed. It is occasionally however, preceded by all those attendant on indigestion. In the advanced stages chalky lumps are formed in the joints.
Treatment. - If the patient be young, vigorous, having the disease for the first time, bleed and purge him, confine him to a low diet, and treat it exactly as an inflammation arising from any other cause. To procure sweating, Dover's powder may be taken on going to bed. As soon as the inflammation, by these means, is reduced, use the cool or cold bath, and take strong exercise on foot daily; avoid highseasoned food, feather beds, wine, acids and fermented liquors, for the remainder of your life! Gout is the child of indolence and intemperance, and to avoid it the above means must be employed and steadily persevered in.
If, however, the patient is old or infirm, and subject to regular fits of it, he must not be handled so roughly. The most perfect rest should be observed, and the parts lightly covered with fleecy hosiery, and flannel cloths wetted with the lotion below, made milk warm, or with pure laudanum. The bowels should be opened with some warm laxative. Then give the alkaline mixture below. The degree of warmth that is applied to the part must be regulated by the feelings of the patient, who, if weak, may use a nourishing diet, if strong, a more abstemious one.
If from any cause the disease leaves the extremities and flies to the stomach, apply mustard poultices and blisters to the soles of the feet and ankles, give large doses of ether and laudanum, hot wine, brandy, etc., and endeavor by all such means (including the hot bath) to send it back again.
If the head be the part it is transferred to, and apoplexy is produced by it, take away fifteen or twenty ounces of blood immediately, and give active purgatives, as 10 or 15 grains of calomel, followed by senna tea or Epsom salts. If, in a few hours, the patient is not relieved, the head continuing confused and painful, and the pulse full and throbbing, cup him to the amount of eight or ten ounces, and apply cold vinegar and water constantly to the part.
Gout Lotion. - Alcohol 3 ounces; camphor mixture 9 ounces. Render the whole milk-warm by adding a sufficient quantity of boiling water.
Alkaline Mixture. - Carbonate of potassa 2 1/2 drachms; wine of colchicum root 1 1/2 fluidrachms; water 6 ounces. Take a tablespoonful three times daily.
Symptoms. - Pain; swelling and inflammation in some one (or several) of the larger joints, the pain shifting from one part to another, all the symptoms of fever, pulse full and hard, tongue white, bowels costive, and urine highcolored.
Treatment. - First purge with salts and magnesia; then give the alkaline mixture as above but without the colchicum, if the patient be not of a gouty habit. The Dover's powder should be taken to procure sweating, and a low diet should be strictly observed. In severe cases I have known it necessary to bleed. When the disease is overcome, if in consequence of the bleeding, etc., the patient is left very low and weak, wrap him up in blankets, give him warm, nourishing food, wine, etc., etc.
Symptoms. - A chronic rheumatism is nothing more than one of long standing. It is unaccompanied by fever, and makes its attacks on every change of weather, on getting wet, etc., etc. It is frequently caused by inflammatory rheumatism and sometimes seems to exist as a primary affection.
Treatment. - I have found no one plan of treatment in this species of the disease so effectual as the following: Purge moderately with senna and salts, rub the parts well with the volatile liniment, and use Cayenne pepper and mustard at dinner in large quantities, and on going to bed thirty drops of laudanum with a teaspoonful of the tincture of guaiacum. It is to be recollected that this is applicable only to chronic cases; if there is fever, etc., it will do much damage. Should there be any cause to suspect that a venereal taint is connected with it, have recourse to the iodide of potassium, five or ten grains thrice daily, in water. Warm liniments are useful. A large blister frequently relieves the whole of the symptoms in the course of a night. The best safeguard against the complaint is the use of flannel next to the skin winter and summer.
Symptoms. - Excruciating pain in the hip joint and knee, the leg becomes longer, then shorter than its fellow; when lying down the foot rolls outwards, the buttocks appearing flatter than usual; lameness; after a while abscesses in various parts of the thighs; hectic fever, etc.
Treatment. - Apply blisters to the part, and if there be much inflammation leech or cup; make a caustic tissue in the little hollow at the top and outside of the thigh, and use all the remedies directed for scrofula. The diet should be nourishing, and the limb kept at rest. Cod-liver oil, from a teaspoonful to a tablespoonful thrice daily, may be given. When matter is formed, bark, wine and a generous diet must be employed. It often proves incurable.
Symptoms. - The joint swells, the skin remaining of a natural color. By placing the hand on one side of it, and striking it gently on the other, the wavy or fluctuating motion is perceptible; steady pressure on one side will raise the other above its natural level.
Treatment. - Keep a perpetual blister on the joint, or make a caustic issue below it, on the inside of the leg; cold water from the spout of a tea-kettle is a useful application. Camphorated mercurial ointment to the knee, and iodine taken internally, have sometimes been of service.
Symptoms. - Deeply seated pains in the knee, unattended at first by swelling, which at last comes on with increase of pain. Atter a while the joint enlarges, matter is sometimes discharged, hectic fever follows, and cuts off the patient.
Treatment. - If from scrofula, use the general remedies directed for that disease, and apply a blister to the part, which may be kept open by the savin ointment for months; if from blows, apply the blister as before, leech and purge freely, and act as directed in cases of similar accidents. If in spite of these precautions the disease continues to advance, amputation may be the only resource.
Portions of cartilage are sometimes displaced in the joints, when they act like any other foreign body of a similar texture. While in the hollows of the part they give no uneasiness, but as they frequently slip in between the ends of the bones, causing excruciating pain, it is sometimes, though rarely, necessary to cut them out. For this purpose apply to a surgeon. As all openings into the cavities of the joints are attended with much danger, unless the pain be insupportable it is better to endure the inconvenience than to run the risk of the operation.
Symptoms. - Hard and indolent swellings of the glands of the neck, that when ripe, instead of matter discharge a whitish curd. It mostly occurs in persons of a fair complexion, blue eyes, and delicate make. In bad cases the joints swell with great pain, the limbs waste away, the ligaments and bones are destroyed, when hectic fever soon relieves the patient from his misery.
Treatment. - Sea-water is generally considered a great remedy in scrofula. It is to be used daily as a bath. Made milk warm it forms one of the most excellent local applications that we have. When the swellings break, a very strong decoction of hemlock may be advantageously used for the same purpose. The diet should be nourishing. After a fair trial of the waters of the ocean, recourse should be had to iodine and cod-liver oil. The former may be taken in Lugol's Solution, the dose of which is from three to six drops, according to age, twice or thrice daily.
Every gland in the body is subject to inflammation. Whenever one of them is perceived to be in this state, which may be known by the swelling and pain, measures should be taken to reduce it. Leeches, blisters and all the remedies directed for such purposes, should be actively employed, among which purging and a low diet must not be neglected.
Symptoms. - A hard tumor, unequal on its surface, and not very sensible, giving but little or no pain on being handled.
Treatment. - Do not meddle with the tumor, but apply to a surgeon as soon as possible.
Symptoms. - A tumor, differing from the preceding one, by being surrounded with enlarged veins. It is also, more painful, the skin being sometimes discolored and puckered. The whole tumor is particularly heavy, and at last breaks into a malignant ulcer, or sore, whose edges are raised, ragged, uneven, and curl over like the leaves of a flower; white streaks or bands cross it from the centre to the circumference. Acute and darting pains accompany both this and the preceding stage of the disease.
Treatment. - There is but one remedy that can be depended on for the cure of this painful and inveterate complaint, and even that should be resorted to early, in order to ensure success. All the diseased parts must be cut out. Arsenic, corrosive sublimate, phosphate of iron, and a thousand other articles have been recommended, both externally and internally, but without any effectual advantage. To relieve the pain, opium may be taken in large doses. The sore should be defended from the air, by some mild ointment. Powdered chalk, scraped carrots, fresh hemlock leaves and powdered charcoal may be used for the same purpose.
Symptoms. - A tumor in the fore part of the throat, seated in a gland close to the projection called "Adam's apple."
Treatment. - Goitre is sometimes incurable. When taken at the very beginning of the complaint, however, and in young persons, it is said to have been dispersed by a course of iodine joined to frictions of the part, with strong mercurial ointment. As it seldom causes any inconvenience, and is always unattended by pain, it is not a matter of much consequence. The inhabitants of the Alps consider it a mark of beauty, and there are some cantons where every man, woman and child is adorned with a tumor of this nature, of which they would feel very sorry to be deprived. It cannot be cut out, on account of the great number of blood-vessels of which it is composed.
Causes. - Sudden and violent emotions of the mind; bleeding; diseases of the heart and its great vessels.
Treatment. - Lay the person on his back, take off his cravat, then open the doors and windows, and sprinkle cold water in his face. Smelling salts may be held to his nose.
Symptoms. - Falling without sense or motion; profound sleep; face livid or flushed; eyes wide open or half closed, and immovable; breathing slow, laboring, and irregular; pulse full and slow.
Causes. - A rushing of blood to the head, excessive fat in persons with a short neck, gluttony, violent exercise, intense heat, anger, hearty meat suppers, blows on the head, intoxication, etc., etc.
Treatment. - If the pulse remains full, the face flushed, etc., take away twenty ounces or more of blood on the spot, remove the cravat, unbutton the shirt-collar, and place the patient in bed, with his head and shoulders a little elevated. The windows and doors must be thrown open, and no more persons than are necessary, be allowed to remain in the room. The head is to be shaved and cupped, a blister applied to the back of the neck and the head, and mustard poultices to the feet. An active purgative should always be administered as soon as the patient is bled, and its operation assisted by repeated clysters. If the patient cannot swallow pills, try liquids; if neither, have recourse to a strong purgative clyster. If, by these means, the breathing is not easier, and the pulse softer, bleed again, or cup the back of the neck.
If, however, the patient is old and infirm, and the attack has come on more gradually, if the pulse is weak, and the face pale, bleed moderately, or not at all, and give immediately a warm purgative, apply the blisters, etc. It it arises from swallowing vegetable poisons, give an active emetic, as thirty grains of white vitriol, and act as directed in cases of similar accidents. In this second kind of apoplexy, stimulants, as harts-horn to the nose, etc., may be used; in the first they are very injurious, and should never be employed.
This proceeds from exposure to the sun's rays, and exhibits the same symptoms as apoplexy, commencing with vertigo, loss of sight, ringing in the ears, etc., and must be treated by cupping or bleeding, and in every other respect as directed for apoplexy. Extreme heat sometimes, however, produces a state of prostration without head symptoms; for which cold effusion and rest are the best remedies.
Symptoms. - A fit, in which the patient falls to the ground in a convulsion; the eyes are distorted and turned up, hands clenched, foaming at the mouth, convulsions, the whole ending in a deep sleep.
Treatment. - Keep the patient from hurting himself, by holding gently his hands, legs, and particularly his head, which he is apt to dash violently against the ground, or surrounding objects. A piece of soft wood should be placed between his teeth, to prevent his tongue from being bitten. This is, in general, all that can be done during the fit. If, however, there are symptoms of great determination of blood to the head, bleeding should not be neglected. White vitriol, the mistletoe, carbonate of iron, etc., etc., have been recommended and tried for the cure of this complaint, but in vain.
The valerianate of zinc may, however, be tried. It is taken in pills of a grain each, one three times a day, gradually increasing this dose to five at a time. To reap any benefit from this medicine, it is necessary to persevere in it for months. If it fails, iron or some other tonic may be resorted to. Large doses of spirits of turpentine are said to have afforded relief. The diet, in all cases, should be vegetable, and if symptoms of fulness of blood be present, it will be proper to bleed. Persons subject to these fits, should never be left alone, or ride on horseback, for obvious reasons. It should be known that sexual excesses often produce or keep up this complaint.
Symptoms. - A partial or complete loss of the powers of motion, and the sensibility of particular parts of the body; the pulse soft and slow.
Treatment. - In a young and robust person, it may be proper to bleed, and give an active purgative. In old people, or where the powers of the body are much weakened, warm laxative medicines, with stimulating applications, as the flesh-brush, blisters, mustard poultices, and rubbing the spine with the volatile liniment, form the best plan of treatment. If it affect different parts of the body at once, horseradish, mustard, and Cayenne pepper should be used liberally, as they are prepared for table. If a swelling or tumor be found on the back-bone, or any injury has been done it, which may have caused the disease, caustic issues may be placed on each side of it, and as near the injured part as possible. The diet should be light and nourishing. The warm bath must not be neglected.
There are several very long and very learned names affixed to this disease, as it may happen to attack one part of the body or another. When it is confined to the muscles of the neck and jaws, lock-jaw is the common and expressive term for it. The affection, however, is always the same, requires similar treatment, and consists in an involuntary contraction and stiffening of a part of the muscles, the senses remaining perfect.
Symptoms. - A stiffness in the back of the neck, which renders it first painful, and at last impossible to turn the head round; difficulty in swallowing; pain in the breast, shooting to the back; the lower jaw becomes stiff and gradually closes.
Treatment. - If the disease is supposed to arise from a wounded nerve, or from an injury done to tendinous parts, by a pointed instrument, enlarge the wound with a sharp lancet or penknife, and pour laudanum or turpentine into it, as directed for similar accidents. Give 2 or 3 grains of opium at once, and repeat it every two hours, increasing the dose according to the violence of the symptoms and the effects produced by it, without too much regarding the quantity that has been taken. Cases are on record where 60 grains (a drachm) of solid opium have been taken at once, and with the happiest effect. This, however, is a large dose, and should never be ventured on but under the most desperate and alarming circumstances. Active purging with castor oil and senna tea must not be omitted, and if the power of swallowing be lost, laudanum, etc., must be given in clysters. Drawing a tooth is generally recommended by physicians in those cases where the jaws are firmly closed, for the purpose of transmitting medicines and food to the stomach. This has always appeared to me as every way calculated to increase the evil. If no opening exists between the teeth access can always be obtained by clysters, and in this way nourishment and remedies may be injected. It is always proper, however, when the disease is perceived to be coming on, to place two small pieces of soft wood between the grinders of the upper and lower jaw, one on each side, so that they may be kept asunder.
Madeira wine, in doses of a wineglassful every hour, continued for several days, and combined with the internal use of opium and the warm bath, has been found of great service. Cold water dashed freely over the patient every two or three hours may likewise be tried. After every affusion he should be well wiped and put into a warm bed, when a large dose of laudanum in warm Madeira wine should be given. The tobacco clyster has sometimes succeeded when everything else has failed. So has chloroform by inhalation. Blistering the whole length of the spine, and caustic issues on its sides, as nearly on a line with the parts affected as possible, are strongly recommended.
Although a valuable addition to our means of cure, the tobacco clyster is not to be employed lightly, or on common occasions. It should always be reserved to the last moment, never using it until everything else has failed. The prostration of the system, and other alarming symptoms it sometimes causes, renders this caution necessary.
This disease is also called tic-doloureux, neuralgia, etc.
Symptoms. - A very severe pain darting in particular directions, not lasting more than a second, but very rapidly repeated, and excited by the slightest touch; during the intervals there is no pain whatever. There is no inflammation or swelling of the cheek as in toothache, nor does the pain seem so deeply seated.
Treatment. - Blisters, tincture of aconite, mercurial ointment, opium, iron, and Fowler's Solution of Arsenic, with many other remedies of the same class, have been all recommended and used for the cure of this most painful of all the affections to which the human body is subject. Where the pains are so excessive as not to be borne, one or two grains of the extract of belladonna may be taken every three hours. When the pain is somewhat relieved, this quantity must be diminished. For a cure apply to a skilful surgeon, who may divide the nerves.
Symptoms. - An acute pain at the lower end of the breast-bone, shooting into the left arm; great difficulty of breathing; anxiety; palpitation of the heart; a feeling of suffocation. It usually comes on while ascending a hill or going up stairs.
Treatment. - During the fit place the patient's feet in a hot mustard foot-bath, and apply mustard plasters to the chest and back. Give one or two teaspoonfuls of Hoffmann's anodyne, in water, or forty drops of laudanum. If fainting, dash cold water in his face. Strips of linen, moistened with the solution below, applied several times a day to the breastbone for a month, are said to have effected complete cures. They act by producing a crop of pimples, on the appearance of which the disease sometimes declines.
Persons subject to this complaint should avoid all fermentable food, and excess in eating or drinking, taking care to live quietly and to keep the bowels open. Cupping and purging, followed by opium, to lessen the spasm, with the warm bath, and a perpetual blister or plaster of the tartar emetic ointment to the chest, are perhaps the best remedies that can be employed.
Tartar emetic, 1 drachm; spirits of camphor, 1/2 an ounce; boiling water, 1 pint. Mix.
Symptoms. - Irregular and convulsive motions of the limbs and head, usually occurring in children. It varies, however, in different persons, and is frequently counterfeited by beggars.
Treatment. - The daily use of the cold bath, with the Peruvian bark, has often succeeded in curing the complaint in young subjects. In addition to these, any of the preparations of iron combined with moderate doses of musk, opium, camphor, etc., may be tried. The disease is generally recovered from.
Symptoms. - Chills, heat, thirst, headache; the skin is marked with large red or scarlet patches, which at last unite, disappearing in a kind of branny scurf; sore throat.
Distinguish it from measles by the spots coming out on the second day of the fever. In measles they seldom appear until the fourth day. By their color, which is that of a boiled lobster, whereas in measles it is of a dark red.
Treatment. - An emetic (ipecacuanha) may be given on the first appearance of the disease, to be followed by a dose of salts, or eight grains of calomel, with as many of rhubarb. If the pulse is full and strong, the head aches, and the heat is great, draw blood, and apply cold water over the body freely and frequently. There is no disease in which the advantages of cold effusion are more striking. In order to reap the full benefit of it, however, it must be freely employed, that is, as often as heat, etc., seem to require it, or eight or ten times in the twenty-four hours. The saline mixture, (see), is of great use. If there is any soreness of the throat, the gargles recommended for that complaint should be used, and a mustard poultice be applied to the parts. If symptoms of putrescency appear, have recourse to the plan recommended for putrid sore throat. As scarlet fever is undoubtedly contagious, the usual precautions should of course be adopted.
Writers on this subject generally consider scarlet fever as consisting of three kinds, viz., the simple fever, the fever with sore throat, and the malignant fever. The treatment of the first should be like that of any other inflammatory fever; that of the second has been detailed in speaking of inflammatory sore throat; and the last is precisely that of putrid sore throat.
Symptoms. - Fever, delirium, vomiting; pulse strong or weak, as the fever inclines to the inflammatory or typhous kind. On the fourth day - sometimes on the second or third - the skin in some one part becomes red and inflamed, which is soon extended to others, the parts affected being swollen and of a bright scarlet. If the face is attacked, it spreads itself on the scalp, and the eyelids sometimes swell so as to prevent the patient from seeing. After a longer or shorter period, the eruption ends in small watery vesicles, or in branny scales. At this period the fever sometimes abates; at others, drowsiness or delirium comes on, which increases it, and destroys the patient by the eleventh day
Treatment. - This disease is of two kinds, one of which is principally confined to the skin, while the other affects the whole system. If the accompanying fever is inflammatory bleeding will be proper, otherwise not. This operation is to be cautiously employed in erysipelas, as it sometimes runs into a typhous state. If, however, the patient is robust, his head aches, and great marks of fullness and inflammation are evident, which is generally the case in this country, bleeding, purging with salts, and cooling drinks should be employed, to which, also, may be added Dover's powders, boneset tea, etc., to produce sweating. The room should be kept cool. If, on the contrary, the fever is typhous, or the patient is of a weak and irritable habit of body, bleeding should never be resorted to. Opium, wine, bark, elixir of vitriol, and tincture of chloride of iron (20 drops every three hours) are necessary in this case to guard against mortification, which sometimes ensues.
As local applications, bathing the parts with laudanum or lead-water, or dusting them with rye meal or wheat flour, are the best. Should the disease evidently be confined to the skin, the application of a blister will sometimes put an end to it. If it affect the face, it may be prevented from extending to the scalp by painting a line just beyond the eruption quite thickly with tincture of iodine. If abscesses form, large openings must be made, to let out the matter and the dead parts. When the first or inflammatory kind prevails, the diet should be barley, sago, or panada, etc., with lemonade, tamarind water, etc., for drink; and, on the contrary, when the second or typhous form of it (especially if accompanied by putrid symptoms) shows itself, a more generous diet, with a moderate quantity of wine, etc., must be employed.
It may not be useless again to observe, that in the United States erysipelas often calls for reducing and cooling measures. Among the various articles which are employed in this, as well as all inflammatory diseases, none ranks higher than lemonade, which should always, if possible, be made from the fresh fruit. When taken cold, and in liberal quantities, it is not only delicious to the palate of the patient, but tends powerfully to cure the complaint.
Symptoms. - Inflammatory fever, dry cough and hoarseness; sneezing, watering of the eyes, which itch; a running from the nose; great drowsiness. On the fourth day small red points break out, first on the face, and then gradually over the body. They are in clusters, and, on passing the hand over them, are found to be a little raised. On the fifth or sixth day the vivid red is changed to a brown, and the eruption goes off.
Distinguish it from small-pox and all other diseases by the dry cough and hoarseness, by the appearance of the eyes, which are red, swollen and loaded with tears.
Treatment. - The patient must be confined to a low diet, and kept in bed, with as much covering, but no more, as may be agreeable to his feelings. The room should be cool, and, if there is much fever and pain in the head, bleeding may necessary. Should there be pain and oppression at the breast, apply a blister. The bowels may be opened by salts. The mild form of measles ought to be treated like any other inflammatory complaint, taking care, however, not to repel the eruption by cold. If this happens, place the patient in a warm bath, give him warm wine, etc., internally, and apply mustard poultices and blisters to the feet and ankles.
There is another and more dangerous kind of this disease, which may be known by the fever being typhous, and by all the symptoms showing a depressing tendency. The moment this is perceived have recourse to bark wine, muriatic acid etc., etc., as directed in typhus fever.
Symptoms. - Fever; inability to sleep; pain in different parts of the body; a crop of small pimples or points on the back which, by the second day, are changed into little blisters, which are ripe on the third and disappear before the fifth day, without forming true pus or matter, and leaving no marks or pits behind them.
Distinguish it from small-pox by the eruption coming out on the back, by the mildness of the fever, by the fluid contained in the vesicles or blisters not being true pus, and by the whole falling off in scales on the fifth day.
Treatment. - Confine the patient to his bed, keep him cool and quiet, and give him a dose of salts. This is all that is necessary.
Symptoms. - A pimple at the spot where the matter was inserted, which gradually undergoes certain regular changes that characterize the complaint.
Changes of genuine Cow-Pox. - On the fourth day, or sooner, from the time of the operation, a small speck of inflammation is to be perceived, which, on the fifth day is a pimple, surrounded by a circle of inflammation. On the sixth this pimple changes to a vesicle containing a thin fluid. On the seventh this vesicle is more perfect, its margin forming a regular circle; it is also a little flattened on the top, the centre of which is of a dark color. On the eighth or ninth day slight chills, flushes of heat, etc., are sometimes felt, accompanied by swelling of the pustule and pains shooting up into the arm-pit, the glands or kernels of which occasionally swell.
On the tenth or eleventh day the pustule is surrounded by a circular, vivid, inflammatory blush that is very beautiful. This is regarded as a decisive proof of the presence of the genuine cowpox. On the eleventh day the centre of the pustule begins to grow of a dark color, which gradually increases to a brown or mahogany one by the end of the second week, when it begins to leave the skin, from which it is finally separated.
Treatment. - If the pain, inflammation and swelling are excessive, reduce them by cold applications, a dose of salts, low diet and rest.
Symptoms. - Inflammatory fever, drowsiness, pain in the pit of the stomach, increased by pressure; pain in the back; vomiting; on the third lay the eruption breaks out on the face, neck and breast in little red points that look like flea-bites and which gradually appear over the whole body. On the fifth day little round vesicles filled with a transparent fluid appear on the top of each pimple. The eruptive fever now declines. On the ninth day the pustules are perfectly formed, being round and filled with a thick, yellow matter, the head and face also swelling considerably. On the eleventh day the matter in the pustules is of a dark yellow color, the head grows less, while the feet and hands begin to swell. The secondary fever now makes its appearance. The pustules break and dry up in scabs and crusts, which at last fall off, leaving pits, which sufficiently mark the cause.
Such are the symptoms of the distinct or mild smallpox, but it frequently assumes a more terrible shape, in what is called the confluent. In the latter all the symptoms are more violent from the beginning. The fever is typhous; there is delirium, preceded by great anxiety, heat, thirst, vomiting, etc. The eruption is irregular, coming out on the second day in patches, the vesicles of which are flatted in; neither does the matter they contain turn to a yellow, but to a brown color. Instead of the fever going off on the appearance of the eruption, it is increased after the fifth day, and continues throughout the complaint. The face swells in a frightful manner, so as to close the eyes; sometimes putrid symptoms prevail from the commencement.
Treatment. - Place the patient in a cool, airy room, and let him be but lightly covered with bed clothes. Purge him moderately with salts, and give him thirty drops of laudanum every night. The diet should consist of panada, arrow-root, etc., and his drink consist of lemonade or water. If from any cause the eruption strikes in, put him into a warm bath, give a little warm wine whey, or the wine alone, and apply blisters to the feet. Obstinate vomiting is to be quieted by the effervescing draught, with the addition of a few drops of laudanum.
In the confluent small-pox the treatment must be varied as it inclines more or less to the inflammatory or putrid type. If it inclines to the first, act as directed for the distinct kind; if to the last, employ all those means directed in typhus fever. If the eyes are much affected, it will be necessary to bathe them frequently with warm milk, and to smear the lids with some simple ointment.
Symptoms. - An eruption of small pimples between the fingers, on the wrists, and over the whole body, which form matter, and are attended with an intolerable itching.
Treatment. - The remedy is sulphur. It should be used internally with cream of tartar, so as to purge moderately, and at the same time be applied externally in the form of an ointment. The following practice is said to be effectual: Take of flour of sulphur 2 ounces, and mix it well with 2 drachms of nitre; throw the mixture into a warming-pan containing live coals, and pass the pan between the sheets in the usual manner. The patient, stripped to his skin, now gets into bed (taking care not to let the fumes escape), when the clothes should be tucked in all round him. Repeat the process ten or twelve times. The sulphur ointment, applied after a prolonged tepid bath, will generally answer.
Symptoms. - Broad, itchy spots of a reddish or white color breaking out in different places, which at last run into each other, forming extensive ulcers: after a time they become covered with scales, which fall off, leaving the surface below red; while the disease heals in one part it breaks out in another.
Treatment. - The ointment of the oxide of zinc is a very common application. Washing the part with a solution of corrosive sublimate in water, one grain to the ounce, is, however, to be preferred. The citrine ointment may also be tried. If these fail, apply a strong solution of blue vitriol to the ulcers, and take a grain of calomel morning and evening. The decoction of sarsparilla and guaiacum maybe used with them. If the disease resists the mercury, try Fowler's Solution of Arsenic in doses of five drops three times a day, to be cautiously increased as directed for intermitting fevers. The warm bath should never be neglected in cutaneous complaints.
Symptoms. - Inflammation of the skin of the head, which ends in a scabby eruption that extends over the whole scalp.
Causes. - Want of cleanliness, putting on the hat, using the comb, or sleeping in the bed of a person who has it.
Treatment. - Shave the head close, wash it well with warm soap and water, and cover it thickly with fresh powdered charcoal. The bowels must be kept open by magnesia or Epsom salts. If this fails, try the citrine or tar ointment to the parts, with a liberal use of the compound decoction of sarsaparilla. The diet should be wholesome and nourishing. avoiding spirituous liquors and salted meats. The warm bath should not be neglected.
Symptoms. - An eruption running in curved lines, generally in a circle, that itches when rubbed, or when the body is heated.
Treatment. - Into one ounce of water throw more blue vitriol than it will dissolve, so as to form what is technically called a saturated solution. Touching the ulcerated parts with this liquid several times through the day, will alone frequently cure it. If this fails, apply the citrine or tar ointments. In very obstinate cases, recourse may be had to the usual doses of Fowler's Solution. If it affects the head, shave it. In this as well as all other diseases of the skin, the greatest cleanliness is necessary.
Symptoms. - An eruption similar to that caused by the stinging of nettles, whence its name. On rubbing the skin which itches, the eruption will suddenly appear, remain for a moment, and then vanish, breaking out in some other spot. The parts affected are swelled, at one time presenting the appearance of welts, as from the stroke of a whiplash, and at another, that of white solid lumps.
Treatment. - A few doses of magnesia or Epsom salts, and a little attention to the diet, which should be mild, are generally sufficient to remove it. If it proceed from eating poisonous fish, or any unwholesome food, take an emetic, etc., as directed in such eases.
Symptoms. - An eruption of hard, distinct tubercules or pimples, generally appearing on the face, but sometimes on the neck, breast, and shoulders.
Treatment. - There are a great many varieties of this affection, some of which have been separately treated of by Wilson and other writers on diseases of the skin, to whom I would refer any one who is particularly interested therein. Notwithstanding all that has been said on the subject, there is no disease more difficult to get rid of than this. Where it arises from suppressed perspiration, high-seasoned food, or intemperance, it may indeed be relieved by the warm bath, by sweating, purging, and a low diet; but when it exists in persons who have always led temperate lives, and in whom it seems constitutional, medecine has but little effect on it. In all cases, however, the following plan may be adopted: Take a dose of Epsom salts once or twice a week, use the warm bath daily, live on mush and milk exclusively and drink nothing but water. The parts may be touched frequently with the lotion below. If, after a trial of several months, this should not succeed, try Fowler's solution, or the pills for scald head, with the decoction of guaiacum and sarsaparilla. The various cosmetics and astringent applications recommended for these affections are always prejudicial, for although they sometimes repress the eruption, they occasion more severe and dangerous complaints.
Lotion. - Take of corrosive sublimate, 4 grains; of spirits of wine, 1/2 an ounce; when the salt is dissolved, add of common gin and of water, each, 3 ounces.
Symptoms. - Bleeding of the gums, teeth loose, spots of various colors on the skin, generally livid debility, countenance pale and bloated, pulse small, quick, and intermitting. In its advanced stage the joints swell, and blood bursts out from different parts of the body.
Treatment. - Remove the patient to a new and healthy situation, where the air is dry and pure, give him plenty of fresh vegetables, such as potatoes, spinach, lettuce, beets, carrots, and scurvy-grass. A small proportion of fresh animal food should be taken with them. This, with oranges, lemons and sugar, or lemonade, spruce-beer, with wine and water, are generally sufficient to cure the complaint. If there is much pain in the bowels, laudanum must be used to relieve it. If the breathing is difficult, or there is much pain in the breast, apply a blister to it, for on no account should blood be drawn in scurvy. A teaspoonful of charcoal, well mixed with half a pint of vinegar, forms an excellent gargle to clean the gums and ulcers in the mouth. Those on the body may be washed with the same, or lemon-juice, pure, or mixed with water. The yeast or charcoal poultice may also be applied to them with advantage. To restore the tone of the system, recourse must be had to the Peruvian bark, with the elixir of vitriol, the muriated tincture of iron, exercise, etc., etc.
By the word tumor is meant a swelling of any part of the body. They are of different kinds, arise from various causes, and are more or less dangerous according to the nature of their contents, and the spot they occupy. Unless cancerous, they are generally not dangerous to life.
Ruptures are tumors caused by the protrusion of a part of the bowels through certain natural openings. They are divided into reducible, irreducible, and strangulated. They mostly occur in men in the groin and bag.
Causes. - Straining in any way, as at stool, vomiting, lifting heavy weights, violent exercise, as jumping, running, etc., a natural weakness of the parts.
Symptoms. - A small swelling, free from pain, and generally soft, the color of the skin over it remaining unaltered. While standing up the swelling increases, on lying down it decreases, the patient being able to return the parts himself, while in that position. The swelling is also increased by coughing, sneezing, or straining as if at stool. If he is flatulent, a rumbling sensation may be felt in it.
Treatment. - The patient should place himself on his back, with his bead and shoulders a little elevated. Draw up his knees to his belly, and (if in this position the parts do not return of themselves) endeavor to push or kneed them gently up into the belly, through the opening at which they come out, and which, if the tumor be in the groin or hag, is an oval ring or slit in the groin, at the precise spot where the swelling first appeared. When this is effected, he should remain quiet until a truss can be procured, the spring of which must be passed round his body, the pad be applied directly over the spot just mentioned, and held there with one hand, while the other passes the strap into the buckle and draws it sufficiently tight. Having done this, he should get up and walk about. If the swelling no longer appears, the truss is properly applied; if otherwise, take it off, return the parts as before, and apply it again; when, if, on rising, walking about, slightly coughing, etc., the parts are found to be well kept up he may resume his ordinary business. The truss should be worn night and day, as long as he lives.
Symptoms. - A rupture in which there is no pain yet that cannot be returned into the belly, caused by an increased bulk of the parts, or their having formed adhesions, or grown fast to adjoining parts.
Treatment. - A rupture thus situated must be simply supported by a bag or bandage, and left to itself. The patient should be extremely cautious in his diet, and in avoiding costiveness, by the use of clusters, or, if necessary, laxative medicines. He should also be very careful to protect the tumor from blows, always recollecting that it is in danger of strangulation.
Symptoms. - The first mark of a rupture being strangulated, or of pressure being made on it, is costiveness. The tumor, which before was insensible, becomes painful, the pain being most severe at the spot where the strangulation or stricture exists, and extending from thence across the belly which becomes swollen and hard. The pain resembles that which the patient would suppose to arise if a cord was drawn tightly across it. The pain continues to increase, and is augmented by pressure: sneezing, coughing, nausea, and vomiting, first of the contents of the stomach, and afterwards of the intestines, ensue; great anxiety, restlessness, and a quick hard pulse. Hiccups, cold clammy sweats, weakened respiration, and a pulse so feeble as hardly to be perceived, announce the approach or presence of mortification.
Treatment. - Lose not a moment in sending for the best medical aid that may be within reach. In the mean time, having placed the patient as directed for reducible ruptures, apply both hands on the tumor with gentle pressure, or grasp the tumor gently but steadily with one hand, while with the fingers of the other you endeavor to knead or push up the parts nearest the ring in the groin, applying the pressure in the same course the parts have taken in their descent. If this fails, seize the tumor between the finger and thumb of the left hand, close to where it enters the belly, and carry them downwards, with a moderate pressure so as to dislodge any excrement which may be there, while with the right you endeavor to push in the gut.
If you cannot succeed in two or three attempts, place the patient in a warm bath and try it again. If still foiled (you have no time to waste in unavailing attempts) cover the tumor with pounded ice, snow, or any very cold application. Should this fail, bleed the patient until he nearly faints, regardless of the small thready pulse; if fainting actually occurs, seize that moment to return the parts, as before directed.
Should the rupture still remain irreducible there are but two resources left, the tobacco clyster and an operation. One-half of the clyster should be injected; if it occasions sickness and a relaxation of the parts, endeavor to return them. If the first half does not produce these effects throw up the remainder of it, and when relaxation comes on endeavor, as before, to push up the gut. As regards the operation, no one should ever attempt it but a surgeon. Large doses of laudanum allay vomiting, and are otherwise beneficial; in all cases of this kind they should never be omitted.
Remarks. - Ruptures are liable to be confounded with some other diseases, as dropsy of the bag, enlarged spermatic vein, etc. The modes of distinguishing them have already been pointed out, although it must be confessed that with respect to the latter considerable difficulty exists. If the disease is a rupture, by placing the patient on his back, returning the tumor, and holding the fingers firmly over the opening, and then desiring him to rise, the swelling will not appear. If, on the contrary, it is an enlarged spermatic vein, it will be found to be greater than ever. The latter has also a peculiar ropy feel, as if a bundle of cords were in the bag.
Symptoms. - At first a small tumor without pain or redness, attended by a peculiar throbbing; it disappears on pressure, and returns the moment it is removed. As the tumor increases in size, the throbbing or beating of the artery grows less perceptible. It is generally found in the ham, thich, neck, groin, and arm. Distinguish it by the beating or throbbing, which is diminished by pressing on the artery above the tumor, and by the latter disappearing on pressure, and returning when it is removed.
Treatment. - In the early stage apply a soft and elastic cushion to the tumor, and bind it tightly over it by a bandage. If the patient is of a full habit he should be bled and purged. This plan, steadily and vigorously pursued for a long time, has sometimes effected complete cures. There is nothing, however, but an operation that can be depended on; wherefore, as soon as any swelling of this nature is perceived, no time should be lost in procuring surgical assistance. If the tumor is left to itself it will finally burst, and death be the inevitable consequence.
Symptoms. - Small warty projections, which, as they increase in size, drag down the skin from the neighboring parts, which forms a kind of stem or foot-stalk, on which the tumor hangs. They are hard, full of vessels, and are neither painful nor inflamed.
Treatment. - When very small, they may be frequently touched with caustic, which will destroy them; if large, the ligature or knife must be employed, for which purpose have recourse to a surgeon.
Symptoms. - A small, fatty swelling, which gradually increases, and sometimes grows to an enormous size. It is soft and free from pain, the color of the skin remaining unaltered.
Treatment. - These tumors, technically called steatomatous, are merely inconvenient from their bulk. They can only be removed by the ligature or knife, for which purpose apply to a surgeon.
Symptoms. - A distinct, hard, circumscribed swelling, gradually growing larger until a slight inflammation comes on, when it becomes a little painful, soon after which a fluctuation is distinctly to be perceived. As it progresses the vessels become enlarged; it seldom exceeds the size of an egg.
Treatment. - Apply to a surgeon.
Symptoms. - A small, movable, elastic swelling, with little or no pain, or alteration in the skin, situated under or between tendons or sinews, and generally near to a joint; it sometimes hinders the motions of the part.
Treatment. - Apply pressure, blisters or frictions of strong camphorated mercurial ointment to the tumor. If those are of no avail, make a small puncture in it with the point of a sharp lancet, let out its contents and apply pressure to the part, so as to make the two sides of the sack or bag grow together.
Symptoms. - A hard, circumscribed, inflamed and very painful tumor, of a conical shape, seldom exceeding in size a pigeon's egg.
Treatment. - If the patient is of a full habit, bleed and purge him with Epsom salts. A soft poultice of warm bread and milk, or rye or flaxseed meal, should always be applied to the boil and frequently changed. If the pain is excessive, a teaspoonful of laudanum may be mixed with each one. In a few days matter will be formed, when it may be let out with a sharp lancet.
A deeply seated, hard, immovable and circumscribed tumor, which appears generally on the back, shoulders, etc. About the middle it is of a dark red or purple color, being much paler or mottled round its edges. It is attended with an intolerable itching and burning pain, and at last becomes a kind of sloughing ulcer.
Treatment. - This will depend upon the state of the constitution. Most generally there is great weakness, in which case the diet must be generous. Bark, with the elixir of vitriol and opium, to relieve the pain, are to be frequently employed. As a local remedy, a blister ranks very high. It should be placed directly on the part. After being cut, it may be succeeded by a basilicon plaster. A modern writer strongly recommends the solution of arsenic as a local remedy in this disease. Pledgets of linen dipped in the liquor, are to be laid on the swelling and frequently renewed. When matter begins to form, apply a bread and milk poultice, and treat it in every respect as a common ulcer. Surgeons mostly advise the early use of deep incisions of carbuncle entirely across it, in two directions, at right angles to each other.
Symptoms. - An inflamed tumor at the end of the finger. It is of three kinds. The first is situated immediately under the skin, around the nail; the second in the cellular membrane, the pain and swelling of which is much greater than in the first, and the matter much longer in forming; the third lies under the sheath or covering of the tendons of the fingers, and is infinitely more violent, painful and dangerous than either of the others.
Treatment. - If of the first description, open the little abscess with a needle and let out the matter, which should be prevented from forming, if possible, by bathing the part with camphorated spirits. The second should be dispersed by purging, and by leeches and blisters. If the inflammation is not reduced by these means, with a very sharp penknife make an early and free incision in the middle of the last joint of the finger down to the bone. Suffer the blood to run for a few minutes, and then treat it as a common cut. The same practice should be followed with regard to the third.
Symptoms. - A pain in the fundament when going to stool; on examination small tumors are perceived to project beyond its verge, They are of two kinds - the blind and bleeding. They may also be internal and external.
Treatment. - A diet of rye mush and milk, strictly adhered to for a length of time, will very frequently cure the disease. If they project, are swelled and painful, apply twenty or thirty leeches to them, and cold applications. The common gall ointment is a very soothing application. Balsam copaiva in doses sufficiently large to purge freely is also highly recommended. A radical cure, however, is only to be sought for in the knife or ligature, for which apply to a surgeon. If the pain is very great, laudanum may be taken to ease it.
Treatment. - If the bleeding is considerable, inject a solution of alum or a decoction of oak bark, or make pressure upon the vessels by introducing a sheep's gut, tied at one end, into the fundament, and then filling it with any astringent fluid by a clyster pipe. This evacuation is sometimes salutary, and it often requires much judgment to know if it should be stopped or not.
Symptoms. - The formation of matter under the skin, or in any part of the body, preceded by inflammation, and marked by a dull, heavy weight; by the pain becoming more acute and darting; by a peculiar throbbing; by the swelling becoming more elevated and soft to the touch. If the tumor is not opened it bursts.
Treatment. - Apply a soft and warm bread and milk or linseed poultice to the part, and endeavor to hasten the formation of matter. When this is evident, let it out with a sharp lancet. If the patient is weak, let him have a generous diet, with wine, porter, bark, etc.
Symptoms. - A weakness across the loins, accompanied by a dull pain. After a while the pain shifts from the back to the thigh and hip, becoming more darting and severe. The glands in the groin swell, and at last a soft tumor is perceived at the lower edge of the groin, or by the side of the fundament; the swelling increases to a large size, and sometimes extends itself down the thigh.
Treatment. - In the early stage purge the patient, keep him on a low diet and apply a large blister over the lower part of the back. Confinement in bed is absolutely necessary. When matter is formed make an opening into the tumor in the following manner: Push a sharp lancet first through the skin, then obliquely upwards under it, and then, by depressing the point, pierce the swelling itself. In this way the abscess is opened without the danger that attends wounds of large cavities. If it is small, the whole of the matter may be allowed to flow away at once; if large, after drawing a pint, close the wound for a few hours, and then finish the operation. The lips of the wound must be kept together by sticking plaster. As there are many vessels of importance in the groin, care must be taken to avoid wounding them, and, if a surgeon can be had, he should always be applied to for this purpose.
Symptoms. - An abscess or ulcer in the neighborhood of the fundament, preceded by an inflamed swelling, which gives much pain. If there is no communication between the gut and the sore, it is called an incomplete, if there is, a complete fistula.
Treatment. - As the tumor is often taken for piles, attention should be paid to distinguish them. In all cases apply forty or fifty leeches to the part, keep the bowels perfectly lose by a diet of rye mush, and confine the patient to his bed. If however, the formation of matter cannot be hindered, the swelling must be opened early and a poultice applied to it, when the disease occasionally heals like any other sore; but nine times out of ten it forms a callous winding abscess, through which (if it is complete) excrement, etc., often passes. When it arrives at this point, nothing but an operation can ever be of any service.
There is anther species of fistulous opening, which follows the obstruction caused by strictures, etc., in the urinary passage. The water not being able to flow through the natural canal, makes its way out between the bag and the fundament, constituting what is called fistula in perineo. It may almost be called an incurable disease; at all events, none but a surgeon can do anything to relieve it.
By ulcers are meant holes or sores in the skin and flesh, which discharge matter. They are divided into inflamed, fungous, sloughing, and indolent ulcers in the neighborhood of carious bone, and those attended by a peculiar diseased action.
Symptoms. - The margin of the sore is ragged, the skin ending in a sharp edge round it. The neighboring parts are red, swelled and painful; the bottom of the ulcer is uneven and covered with a white spongy substance. In place of healthy yellow matter, it discharges a thin fluid; the surface of it bleeds on the slightest touch.
Treatment. - Confine the patient to bed, purge him occasionally, let his diet be low, and apply a soft bread and milk or linseed poultice to the ulcer. When healthy yellow matter is formed, omit the poultice, keep the sore very clean, and apply a plaster of simple ointment.
Symptoms. - The presence of large round granulations, rising above the level of the adjoining parts, or what is commonly galled proud flesh, marks this species of ulcer.
Treatment. - Sprinkle red precipitate over the proud flesh, or touch it with lunar caustic, apply dressings of simple cerate to the sore, and pass a bandage tightly over the whole. Burnt alum and blue vitriol may also be used to destroy the proud flesh. Pressure by adhesive plaster or a bandage will often succeed when all other means fail.
Symptoms. - The death of parts of an ulcer which mortify and full off, generally attended by fever and pain.
Treatment. - The diet should be generous, laudanum must be taken to relieve pain, and bark wine, porter, etc., to strengthen the system. The carrot poultice is the best local application. The sore may also be washed with a solution of bromine, or of nitric acid, fifty drops to the pint of water. When the dead portions have all fallen off, treat it as a simple ulcer, paying attention, however, to the state of the system.
Symptoms. - The edges of the skin are thick, raised, smooth and shining. The points of new flesh are glossy, and the appearance of the whole ulcer is that of an old one in which the healing process is at a stand.
Treatment. - Touch the whole surface, sides and edges of the sore with caustic, blue vitriol, or powder it with Spanish flies or red precipitate, and endeavor in this way to rouse the parts to action. If one article fails, try another. Strips of sticking plaster may be passed over the ulcer, about an inch apart, so as to draw its edges nearer together, and a long bandage be applied over the whole.
Symptoms. - Ulcers situated over or near carious (or dead) bones, are thereby prevented from healing; they frequently penetrate deep into the parts, forming a canal with hard and indolent sides, that discharges an offensive, unhealthy matter.
Treatment. - Keep the sore clean, repress any proud flesh that may arise, and pay attention to the general health of the patient, taking care that his strength be kept up, if necessary, by wine, bark, porter, etc., etc. The ulcer will not heal until all the pieces of dead bone are thrown off. This process sometimes lasts for years, in which case patience is the only remedy and nature the best physician.
Cases of ulceration frequently occur, proceeding from various causes, whose ravages seem to bid defiance to medical power. In all cases of ulceration, too much stress cannot be laid upon the necessity of keeping the parts clean.
If, in consequence of a broken bone or other injury, the patient is unable to walk, take a door from its hinges, lay him carefully on it, and have him curried by assistants to the nearest house. If no door or sofa can be procured, two boards sufficiently long and broad, should be nailed to two cross pieces, the ends of which must project about a foot so as to form handles. If in the woods, or where no boards can be procured, a litter may be formed from the branches of trees. In this way a hand-barrow may be constructed in a few minutes, on which the sufferer may be properly carried.
If he has been wounded and bleeds, the bleeding must be stopped before he is removed.
Having reached a house, lay him on a bed, and undress him with care and gentleness. If any difficulty arises in getting off his coat or pantaloons, rip up the seams rather than use force. This being done, proceed to ascertain the nature of the injury.
This may be either simple or compound; that is, it may be a contusion or bruise, a wound, fracture, or dislocation, or it may be two or all of them united in one or several parts.
A contusion is the necessary consequence of every blow, and is known by the swelling and discoloration of the skin
Wounds are self-evident.
Fractures are known by the sudden and severe pain, by the misshapen appearance of the limb, sometimes by its being shortened, by the patient being unable to move it without excruciating pain, but most certainly, by grasping the limb above and below the spot where the fracture is supposed to exist, and twisting it different ways, when a grating will be felt, occasioned by the broken ends of the bone rubbing against each other. If the swelling, however, is very great, this experiment should not be made until it is reduced.
Dislocations, or bones being out of joint, are known by the deformity of the joint when compared with its fellow, by the pain and inability to move the limb, by its being longer or shorter than usual, and by the impossibility of moving it in particular directions.
Plunge the part sprained into very cold water, and hold it there as long at a time as you can bear it - for several hours - then rub it well with camphorated spirits. If the accident has happened to a joint, as in the ankle, and it remains weak, pour cold water on it from the spout of a teakettle, held at a distance, several times in the day.
If slight, bathe the part frequently with cold vinegar and water for a few hours, and then rub it well with brandy, or spirits of any kind. Should it be very great, or so as to affect the whole body, which may be known by a general soreness, bleed and purge the patient, and confine him to a diet of rice-water, lemonade, panada, etc. If fever comes on, repeat the purging, etc. In all cases of this nature, be sure the water is regularly evacuated, for it sometimes happens that in consequence of the nerves of the bladder being palsied by the blow, the patient feels no desire to pass it, though the bladder be full. If a suppression ensues, pass a catheter, if possible, or procure assistance for that purpose. The most serious effects, however, resulting from contusion, are when the blow is applied to the head, producing either concussion or compression of the brain.
Symptoms. - The patient is stunned, his breathing slow, drowsiness, stupidity, the pupil of the eye rather contracted, vomiting. After a time he recovers.
Treatment. - Apply cloths dipped in cold vinegar and water to his head, and when the stupor is gone and the pulse rises, bleed him, and open his bowels with Epsom salts. He should be confined to bed, kept on a low diet, in a quiet situation, and every measure taken to prevent an inflammation of the brain, which, if it comes on, must be treated by bleeding, blisters, etc.
Symptoms. - Loss of sense and motion, slow, noisy, and laborious breathing, pulse slow and irregular, the muscles relaxed, as in a person just dead, the pupil of the eye enlarged and will not contract even by a strong light, the patient lies like one in an apoplectic fit, and cannot be roused.
Treatment. - Open a vein and draw off sixteen or twenty ounces of blood, shave the head, and if possible, procure surgical assistance without delay, as there is nothing, unless an operation, that can be of any avail.
Wounds are of three kinds, viz., incised, punctural, and contused; among the latter are included gun-shot wounds. The first step in all wounds, is
If the flow of blood is but trifling, draw the edges of the wound together with your hand, and hold them in that position some time, when it will frequently stop. If, on the contrary, it is large, of a bright red color, flowing in spirts or with a jerk, clap your finger on the spot it springs from, and hold it there with a firm pressure, while you direct some one to pass a handkerchief round the limb (supposing the wound to be in one) above the cut, and to tie its two ends together in a hard knot. A cane, whip-handle, or stick of any kind, must now be passed under the knot (between the upper surface of the limb and the handkerchief), and turned round and round until the stick is brought down to the thigh, so as to make the handkerchief encircle it with considerable tightness. You may then take off your finger; if the blood still flows, tighten the handkerchief by a turn or two of the stick, until it ceases. The patient may now be removed (taking care to secure the stick in its position) without running any risk of bleeding to death by the way.
As this apparatus cannot be left on for any length of time, without destroying the life of the parts, endeavor as soon as possible to secure the bleeding vessels, and take it off. Having waxed together three or four threads of a sufficient length, cut the ligature they form into as many pieces as you think there are vessels to be taken up, each piece being about a foot long. Wash the parts with warm water, and then with a sharp hook, or a slender pair of pincers in your hand, fix your eye steadfastly upon the wound, and direct the handkerchief to be relaxed by a turn or two of the stick; you will now see the mouth of the artery from which the blood springs; seize it with your hook or pincers, draw it a little out, while some one passes a ligature round it, and ties it up tight with a double knot. In this way take up in succession every bleeding vessel you can see or get hold of.
If the wound is too high up in a limb to apply the handkerchief, don't lose your presence of mind, the bleeding can still be commanded. If it is the thigh, press firmly in the groin; if in the arm, with the hand end or ring of a common door key, make pressure above the collarbone, and about its middle against the first rib which lies under it. The pressure is to be continued until assistance is procured, and the vessel tied up.
If the wound is on the head, press your finger firmly on it, until a compress can be brought, which must be bound firmly over the artery by a bandage. If the wound is in the face, or so situated that pressure cannot be effectually made, or you cannot get hold of the vessel, and the blood flows fast, place a piece of ice directly over the wound, and let it remain there till the blood coagulates, when it may be removed, and a compress and bandage be applied.
By an incised wound is meant a clean cut. Having stopped the bleeding, wash away all dirt, etc, that may be in it with a sponge and warm water, then draw the sides of the wound together, and keep them in that position by narrow strips of sticking plaster, placed on at regular distances, or from one to two inches apart. A soft compress of old linen or lint may be laid over the whole.
Should much inflammation follow, remove the strips, and purge the patient (who should live very low, and be kept perfectly quiet) according to the exigency of the case. If it is plain that matter must form before the wound will heal, apply a hot poultice or wet lint (water dressing) until that event takes place, when dressing of some simple ointment may be substituted for it.
Although narrow strips of linen, spread with stickingplaster, form the best means of keeping the sides of a wound together, when they can be applied, yet in the ear, nose, tongue, lips, and eye-lids, it is necessary to use stitches, which are made in the following manner: Having armed a common needle with a double waxed thread, pass the point of it through the skin, at a little distance from the edge of the cut, and bring it out of the opposite one at the same distance. If more than one stitch is required, cut off the needle, thread it again, and proceed as before, until a sufficient number are taken, leaving the threads loose until all the stitches are passed, when the respective ends of each thread must be tied in a hard double knot, drawn in such a way that it hears a little on the side of the cut. When the edges of the wound are partly united, cut the knots carefully, and withdraw the threads.
From what has been said, it must be evident that in all wounds, after arresting the flow of blood and cleansing the parts, if necessary, the great indication is to bring their sides into contact throughout their whole depth, in order that they may grow together as quickly as possible, and without the intervention of matter. To obtain this very desirable result, in addition to the means already mentioned, there are two things to be attended to, the position of the patient and the application of the bandage. The position of the patient should be such as will relax the skin and muscles of the part wounded, thereby diminishing their tendency to separate.
A common bandage of a proper width, passed over the compresses moderately tight, not only serves to keep them in their place, but also tends by its pressure to forward the great object already mentioned. If, however, the wound is so extensive and painful that the limb or body of the patient cannot be raised for the purpose of applying or removing it, the best way is to spread the two ends of one or two strips of linen or leather with sticking-plaster, which may be applied in place of the bandage, as follows: Attach one end of a strip to the sound skin, at a short distance from the edge of the compress, over which it is to be drawn with moderate firmness, and secured in a similar manner on its opposite side. A second or third may, if necessary, be added in the same way.
In all wounds, if violent inflammation come on, reduce it by bleeding, purging, etc., but if there is reason to fear lock-jaw, give wine, porter, brandy, opium, and a generous diet.
These are caused by sharp pointed instruments, as needles, awls, nails, etc. Having stopped the bleeding, withdraw any foreign body, as part of a needle, splinters, bit of glass, etc., that may be in it, provided it can be done easily; and if enlarging the wound a little will enable you to succeed in this, do so. Though it is not always necessary to enlarge wounds of this nature, yet in hot weather it is a mark of precaution which should never be omitted. As soon as this is done, apply wet lint or soft linen, covered with oiled silk, or cover the wound with a poultice, moistened with laudanum. This practice may prevent lock-jaw, which is but too frequent a consequence of wounds of this description. When matter forms, cover the part with mild dressings, as a common sore. Laudanum may be given in large doses to relieve pain, and should the inflammation be excessive, bleed and purge. In hot weather, however, or in feeble persons, bleeding should be avoided.
Wounds of this nature are caused by round or blunt bodies, as musket-balls, clubs, stones etc. They are in general attended by but little bleeding; if, however, there should be any, it must be stopped. If it arises from a ball which can be easily found and withdrawn, it is proper to do so, as well as any piece of the clothing, etc., that may be in it; or if the ball can be distinctly felt directly under the skin, make an incision across it, and take it out; but never allow of any poking in the wound to search for such things; the best extractor of them, as well as the first and best application in contused wounds, proceed from what they may, being a soft bread and milk poultice.
Should the inflammation be great, bleed and purge. Pain may be relieved by laudanum, and if the parts assume a dark look, threatening a mortification, cover them with a carrot poultice.
If the wound is much torn, wash the parts very nicely with warm water, and then (having secured every bleeding vessel) lay them all down in as natural a position as you can, drawing their edges gently together, or as much so as possible, by strips of sticking-plaster, or stitches if necessary. A soft poultice or water dressing is to be applied over the whole.
The instant a person is bitten either by a mad dog, rattlesnake, or any rabid animal or reptile, he should apply a ligature by means of the stick, above the wound, as tightly as he can well bear it, and without hesitation or delay, cut out the parts bitten, taking along with them a portion of the surrounding sound flesh. The wound should then be freely touched with caustic, or have turpentine poured into it. A decoction of Spanish flies in turpentine may also be applied to the skin surrounding the wound. By these means inflammation will be excited, and suppuration follow, which may prevent the usual dreadful consequences of such accidents. As soon as the parts are cut out take off the ligature.
Should the patient be too timid to allow the use of the knife, apply a cupping-glass, and then burn the wound very freely with caustic, and place in it a tuft of tow or cotton, well moistened with the above decoction. The discharge of matter that follows should be kept up for some time. The only reasonable chance for safety is found in the above plan, all the vegetable and mineral productions that have been hitherto recommended as internal remedies, being of very doubtful, if of any, efficacy.
It is asserted, however, that not more than one in ten persons bitten by mad dogs have the hydrophobia. When it occurs it is incurable; but nervous symptoms produced by fear are sometimes mistaken for it. Rattlesnake bites are now commonly treated by giving the sufferer intoxicating doses of whiskey. Ammonia, locally applied immediately after the bite, may be of some use; and the same has been said of iodine and bromine. (Bibron's Antidote.)
Nothing relieves the pain arising from the sting of a hornet, bee, or wasp so soon as plunging the part in extremely cold water, and holding it there for some time. Water of ammonia may antagonize the poison. A cold lead-water poultice is also a very soothing application. If a number of these insects have attacked you at once, and the parts stung are much swollen, lose some blood, and take a dose of salts.
Musquito-bites may be treated in the same manner, although I have found a solution of common salt and water, made very strong, speedy and effectual in relieving the pain. Camphorated spirits, vinegar, etc., may also be used for the same purpose. A solution of Prussian blue in soft water, with which the parts are to be kept constantly moist, is a highly celebrated remedy for the stings of bees, wasps, etc., etc.
Wash the parts clean, and draw the edges of the wound together by as many stitches as are necessary. If the part is even completely separated, and has been trodden under feet, by washing it in warm water, and putting it accurately in the proper place, by the same means, it may still adhere, and so may teeth that have been knocked out, if replaced.
In all wounds of the scalp it is necessary to shave off the hair. When this is done, wash the parts well, and draw the edges of the wound together with sticking-plaster. If it has been violently torn up in several pieces, wash and lay them all down on the skull again, drawing their edges as nearly together as possible by sticking plaster, or, if necessary, by stitches. Cover the whole with a soft compress, smeared with simple cerate, or with water dressing.
Seize and tie up every bleeding vessel you can get hold of. If the windpipe is cut only partly through, secure it with sticking-plaster. If it is completely divided, bring its edges together by stitches, taking care to pass the needle through the loose membrane that covers the windpipe, and not through the windpipe itself. The head should be bent on the breast, and secured by bolsters and bandages in that position, to favor the approximation of the edges of the wound.
If it is a simple incised wound, draw the edges of it together by sticking-plaster, cover it with a compress of wet linen, and pass a bandage round the chest. The patient is to be confined to his bed, kept on a very low diet, and to be bled and purged, in order to prevent inflammation. If the latter comes on, reduce it by bleeding.
Should the wound be occasioned by a bullet, extract it and any pieces of cloth, etc., that may be lodged in it, if possible, and cover the part with a piece of linen smeared with some simple ointment, taking care that it is not drawn into the chest. If a portion of the lung protrudes, return it without any delay, but as gently as possible.
Close the wound by strips of sticking-plaster, and stitches passed through the skin, about half an inch from its edges, and cover the whole with a soft compress, secured by a bandage. Any inflammation that may arise is to be reduced by bleeding, purging, and a blister over the whole belly.
Should any part of the bowels come out at the wound, if clean and uninjured, return it as quickly as possible; if covered with dirt, clots of blood, etc., wash it carefully in warm water previous to so doing. If the gut is wounded, and only cut partly through, draw the two edges of it together by a stitch, and return it; if completely divided, connect the edges by four stitches at equal distances, and replace it in the belly, always leaving the end of the ligature to project from the external wound, which must be closed by stickingplaster. In five or six days, if the threads are loose, withdraw them gently and carefully.
Bring the edges of the wound together by stickingplaster, without any delay, keep the part perfectly at rest, bleed, purge, and live very low, to prevent inflammation. Should it come on, it must be met at its first approach by bleeding or leeching to as great an extent as the condition of the patient will warrant. If a permanent stiffening of the joint seems likely to ensue, keep the limb in that position which will prove most useful; that is, the leg should be extended, and the arm bent at the elbow. Wounds of joints are always highly dangerous, and frequently terminate in death.
Tendons or sinews are frequently wounded and ruptured. They are to be treated precisely like any other wound, by keeping their divided parts together. The tendon which connects the great muscle forming the calf of the leg, with the heel,
called the tendon of Achilles, is frequently cut with the adze, or ruptured in jumping from heights. This accident is to be remedied by drawing up the heel, extending the foot, and placing a splint on the fore part of the leg, extending from the knee to beyond the toes, which being secured in that position by a bandage, keep the foot in the position just mentioned. The hollows under the splint must be filled up with tow or cotton. If the skin falls into the space between the ends of the tendon, apply a piece of sticking-plaster, so as to draw it out of the way. It takes five or six weeks to unite, but no weight should be laid on the limb for several months.
The signs by which fractures may be known having been already pointed out with sufficient minuteness, it will be unnecessary to dwell thereon; it will be well, however, to recollect this general rule: In cases where, from the accompanying circumstances and symptoms, a strong suspicion exists that the bone is fractured, it is proper to act as though it were positively ascertained to be so.
The bones of the nose from their exposed situation are frequently forced in. Any smooth article that will pass into the nostril should be immediately introduced with one hand, to raise the depressed portions to the proper level, while the other is employed in moulding them into the required shape. If violent inflammation follow, bleed, purge, and live on a low diet.
This accident is easily discovered by looking into the mouth, and is to be remedied by keeping the lower jaw firmly pressed against the upper one by means of a bandage passed under the chin and over the head. If it is broken near the angle, or that part nearest the ear, place a cushion or roll of linen in the hollow behind it, over which the bandage must pass, so as to make it push that part of the bone forward. The parts are to be confined in this way for twenty days, during which time all the nourishment that is taken should be sucked between the teeth. If, in consequence of the blow, a tooth is loosened, do not meddle with it, for if let alone, it will grow fast again.
This accident is a very common occurrence, and is known at once by passing the finger along it, and by the swelling, etc. To reduce it, seat the patient in a chair, without any shirt, and place a pretty stout compress of linen, made in the shape of a wedge, under his arm, the thick end of which should press against the arm-pit. His arm, bent to a right angle at the elbow, is now to be brought down to his side, and secured in that position by a long bandage, which passes over the arm of the affected side and round the body. The forearm is to be supported across the breast by a sling. It takes from four to five weeks to re-unite.
Seat the patient on a chair, or the side of a bed. Let one assistant hold the sound arm, while another grasps the wrist of the broken one and steadily extends it in an opposite direction, bending the forearm a little, to serve as a lever. You can now place the bones in their proper situation. Two splints of shingle or stout pasteboard, long enough to reach from below the shoulder to near the elbow, must be then well covered with tow or cotton, and laid along each side of the arm, and kept in that position by a bandage. The forearm is to be supported in a sling. Two small splints may, for better security, be laid between the first ones, that is, one on top and the other underneath the arm, to be secured by the bandage in the same way as the others.
These are to be reduced precisely in the same way, excepting the mode of keeping the upper portion of it steady, which is done by grasping the arm above the elbow. Apply two splints, one extending to the palm and one to the back of the hand, and over them a bandage. When the splints and bandage are applied, support it in a sling.
This accident is of rare occurrence. When it does happen the injury is often so great as to require amputation. If you think the hand can be saved, lay it on a splint well covered with tow; this extends beyond the fingers. Place another splint opposite to it, lined with the same soft material, and secure them by a bandage. The hand is to be carried in a sling.
The bones of the hand are sometimes broken. When this is the case fill the palm with soft compresses or tow, and then lay a splint on it long enough to extend from the elbow to beyond the ends of the fingers, to be secured by a bandage, as usual.
When a finger is broken extend the end of it until it becomes straight, place the fractured portion in its place, and then apply two small pasteboard splints, one below and the other above, to be secured by a narrow bandage or adhesive straps. The top splint should extend from the end of the finger over the back of the hand. It may sometimes be proper to have two additional splints for the sides of the finger.
When, after a fall or blow, the patient complains of a pricking in his side, we may suspect a rib is broken. It is ascertained by placing the tips of two or three fingers on the spot where the pain is, and desiring the patient to cough, when the grating sensation will be felt. All that is necessary is to pass a broad bandage round the chest, so tight as to prevent the motion of the ribs in breathing, and to observe a low diet,
This bone is frequently broken, and hitherto has been considered the most difficult of all fractures to manage. To the ingenuity, however, of the late Dr. J. Hartshorne, of this city, the world is indebted for an apparatus which does away the greatest impediments that have been found to exist in treating it, so as to leave a straight limb, without lameness or deformity. Nor is it the least of its merits, that any man of common sense can apply it nearly as well as a surgeon.
It consists of two splints made of half or threequarter inch well-seasoned stuff, from eight to ten inches wide, one of which should reach from a little above the hip to fifteen or sixteen inches beyond the foot, while the other extends the same length from the groin. The upper end of the inner splint is hollowed out and well padded or stuffed. Their lower ends are held together by a crosspiece, having two tenons, which enter two vertical mortices, one in each splint, and secured there by pins. In the centre of this cross-piece (which should be very solid) is a female screw. immediately above the vertical mortices are two horizontal ones of considerable length, in which slide the tenons of a second cross-piece, to the upper side of which is fastened a foot-block, shaped like the sole of a shoe, while in the other is a round hole for the reception of the head of the male screw, which passes through the female one just noticed. On the top of this cross-piece, to which the foot-block is attached, are two pins, which fall into grooves at the head of the screw, thereby firmly connecting them. The foot-block, as before observed, is shaped like the sole of a shoe. Near the toe is a slit, through which passes a strap and buckle. Near the heel are a couple of straps, with two rings, arranged precisely like those of a skate, of which, in fact, the whole foot-block is an exact resemblance. A long male screw, of wood or other material, completes the apparatus.
To apply it, put a slipper on the foot of the broken limb, and lay the apparatus over the leg. By turning the screw the foot-block will be forced up to the foot in the slipper, which is to be firmly strapped to it, as boys fasten their skates. By turning the screw the contrary way, the padded extremity of the inner splint presses against the groin, and the foot is gradually drawn down, until the broken limb becomes of its natural length and appearance, when any projection or little inequality that may remain can be felt and reduced by a gentle pressure of the hand.
The great advantages of this apparatus, I again repeat, are the ease with which it is applied, and the certainty with which it acts. The foot once secured to the block, in a way that every schoolboy understands, nothing more is required than to turn the screw until the broken limb is found to be of the same length as the sound one. It is right to observe that this should not be effected at once, it being better to turn the screw a little every day, until the limb is sufficiently extended.
As this apparatus may not always be at hand, it is proper to mention the next best plan of treating the accident. It is found in the splints of Desault, improved by Dr. Physick, consisting of four pieces. The first has a crutch head, and extends from the arm-pit to six or eight inches beyond the foot. A little below the crutch are two holes, and near the lower end, on the inside, is a block, below which there is also a hole. The second reaches from the groin, the same length with the first, being about three inches wide above and two below. Two pieces of stout pasteboard, as many handkerchiefs or bands of muslin, with some tow or raw cotton, and a few pieces of tape, form the catalogue of the apparatus.
It is applied as follows. Four or five pieces of tape are to be laid across the bed, at equal distances from each other. Over the upper two is placed one of the short pasteboard splints, well covered with tow. The patient is now to be carefully and gently placed on his back, so that his thigh may rest on the splint. One of the handkerchiefs or a strong soft band, is to be passed between the testicle and thigh of the affected side, and its ends held by an assistant standing near the head of the bed. The second handkerchief is to be passed round the ankle, crossed on the instep, and tied under the sole of the foot. Instead of this, a number of long strips of adhesive plaster, two inches wide, may be applied to the ankle and up the leg, and tied together below the foot. By steadily pulling these two handkerchiefs, the limb is to be extended, while, with the hand, the broken bones are replaced in their natural position. The long splint is now to be placed by the side of the patient, the crutch in the armpit (which is defended with tow), while the short one is laid along the inside of the thigh and leg. The ends of the first handkerchief, being passed through the upper holes, are to be drawn tight and secured by a knot, while the ends of the second one pass over the block before mentioned, to be fastened in like manner at the lower one. All that remains is the short pasteboard splint, which, being well covered with tow, is to be laid on the top of the thigh. The tapes being tied so as to keep the four splints together, completes the operation.
Tow or raw cotton is to be everywhere interposed between the splints and the limb, and a large handful of it placed in the groin, to prevent irritation from the upper or counter extending band. It is necessary to be careful, while tying the two handkerchiefs, that they are not relaxed, so that if the operation is properly performed, the two limbs will be nearly of an equal length.
The superior advantages of Hartshorne's apparatus over this, as well as all others, must be evident to every one acquainted with the difficulty of keeping up that constant extension which is so absolutely necessary to avoid deformity and lameness, and which is so completely effected by the screw. Next to that, however, stands the one just described, which can be made by any carpenter in a few minutes, and which, if carefully applied, will be found to answer extremely well. While waiting for apparatus, the thigh may be kept extended by attaching a weight of a few pounds to the extending band below the foot, and suspending it beyond the foot of the bed.
Fractured thighs and legs generally reunite in six or eight weeks; in old men, however, they require three or four months.
In cases of fracture of the thigh or leg, the patient should always, if possible, be laid on a mattress, supported by boards instead of the sacking, which, from its elasticity and the yielding of the cords, is apt to derange the position of the limb.
This accident is easily ascertained on inspection. It may be broken in any direction, but is most generally so across or transversely. It is reduced by bringing the fragments together, and keeping them in that position by a long bandage passed carefully round the leg, from the ankle to the knee, then pressing the upper fragment down so as to meet its fellow (the leg being extended), and placing a thick compress of linen above it, over which the bandage is to be continued.
The extended limb is now to be laid on a broad splint, extending from the buttock to the heel, thickly covered with tow to fill up the inequalities of the leg. For additional security, two strips of muslin may be nailed to the middle of the splint and one on each side, and passed above the joint the one below, the other above, so as to form a figure of eight. In twenty or thirty days the limb should be moved a little to prevent stiffness. But it usually requires two or three months for perfect union of this bone.
If the fracture is through its length, bring the parts together, place a compress on each side, and keep them together with a bandage, leaving the limb extended and at rest. Any inflammation in this or other fracture is to be combated by bleeding, low diet, etc., etc.
From the thinness of the parts covering the principal bone of the leg, it is easy to ascertain if it be broken obliquely. If, however, the fracture be directly across, no displacement will occur, but the pain, swelling, and the grating sensation will sufficiently decide the nature of the accident.
If the fracture is oblique, let two assistants extend the limb, while the broken parts are placed by the hand in their natural position. Two splints, that reach from a little above the knee to nine or ten inches below the foot, having near the upper end of each four holes, and a vertical mortice near the lower end, into which is fitted a cross-piece, are now to be applied as follows: - Lay two pieces of tape about a foot long on each side of the leg just below the kneejoint, and secure them there by several turns of a bandage; pass a silk handkerchief round the ankle, cross it on the instep and tie it under the sole of the foot. The two splints are now placed one on each side of the leg, the four ends of the pieces of tape passed througb the four holes and firmly tied, and the cross-piece placed in the mortice. By tying the ends of the handkerchief to this cross-piece the business is finished.
If the fracture is across, and no displacement exists, apply two splints of stout pasteboard, reaching from the heel to the knee, and well covered with tow, one on each side of the leg, securing them by a bandage passing round the limb, and outside the splints. Instead of splints, however, a fracture-box is often used, made by fastening, with hinges, to a bottom-piece rather longer than the leg, two side-pieces about six inches high, and reaching above the knee. The leg may rest in this on a pillow. A footboard fastened to the bottom-piece may serve to fix the foot by the aid of a bandage.
In cases of oblique fracture of the leg close to the knee, Hartshorne's apparatus for fractured thighs may be applied, as already directed.
The bone of the heel is sometimes, though rarely, broken. It is known by a crack at the moment of the accident, a difficulty in standing, by the swelling, and by the grating noise on moving the heel. To reduce, take a long bandage, lay the end of it on the top of the foot, carry it over the toes, under the sole, and then by several turns secure it in that position.
The foot being extended as much as possible, carry the bandage along the back of the leg above the knee, where it is to be secured by several turns, and then brought down on the front of the leg, to which it is secured by circular turns. In this way the broken pieces will be kept in contact and in the course of a month or six weeks will be united.
Fractures of the foot, toes, etc., are to be treated like those of the hand and fingers.
The signs by which a dislocation may be known have been already mentioned. It is well to recollect that the sooner the attempt is made to reduce it the easier it will be done. The strength of one man, properly applied, at the moment of the accident, will often succeed in restoring the head of a bone to its place, which in a few days would have required the combined efforts of men and pulleys. If after several trials with the best apparatus that can be mustered, you find you cannot succeed, make the patient drink strong solution of tartar emetic until he is very sick. In this way, owing to the relaxed state of the muscles, a very slight force will often be sufficient, where a very great one has been previously used without effect.
If any objections are made to this proceeding, or if the patient will not consent to it, having your apparatus (which is presently to be mentioned) all ready, make him stand up, and bleed him in that position until he faints; the moment this happens, apply your extending and counterextending forces. Another important rule is to vary the direction of the extending force. A slight pull in one way will often effect what has been in vain attempted by great force in another.
This accident, which is occasioned by blows or yawning, is known by an inability to shut the mouth, and the projection of the chin. To reduce it, seat the patient in a chair, with his head supported by the breast of an assistant, who stands behind him. Your thumbs being covered with leather, are then to be pushed between the jaws, as far back as possible, while with the fingers outside you grasp the bone, which is to be pressed downwards at the same time that the chin is raised. If this is properly done, the bone will be found moving, when the chin is to be pushed backwards and the thumbs slipped between the jaws and the cheeks. If this is not done, they will be bitten by the sudden snap of the teeth as they come together. The jaws should be kept closed by a bandage for a few days, and the patient live on soup.
This bone is rarely dislocated. Should it occur, apply the bandages, etc., directed for a fracture of the same part.
Dislocations of the shoulder are the most common of all the accidents of the kind. It is very easily known by the deformity of the joint, and the head of the bone being found in some unnatural position. To reduce it, lay the patient on the ground, place your heel in his arm-pit, and steadily and forcibly extend the arm by grasping it at the wrist. The same thing may be tried in various positions, as placing yourself on the ground with him, laying him on a low bed, while you are standing near the foot of it, etc.
If this fails, pass a strong band over the shoulder, carry it across the breast, give the ends to assistants, or fasten them to a staple in the wall; the middle of a strong band or folded towel is now to be laid on the arm above the elbow, and secured there by numerous turns of a bandage. The two ends of the towel being then given to assistants or connected with a pulley, a steady, continued and forcible extension is to be made for a few moments, while with your hands you endeavor to push the head of the bone into its place.
If the patient has fallen on his hands, or holds his arm bent at the elbow, and every endeavor to straighten it gives him pain, it is dislocated backwards. Seat him in a chair, let one person grasp the arm near the shoulder and another the wrist, and forcibly extend it, while you interlock the fingers of both hands just above the elbow, and pull it backwards, remembering that under those circumstances, whatever degree of force is required, should be applied in this direction. The elbow is sometimes dislocated sideways or laterally. To reduce it, make extension by pulling at the wrist, while some one secures the arm above; then push the bone into its place, either inwards or outwards, as may be required. After the reduction of a dislocated elbow keep the joint at perfect rest for five or six days, and then move it gently. If inflammation comes on, bleed, purge, etc., etc. Dislocation of the elbow is often accompanied by fracture, in which case it will not bear violence.
Dislocations of the wrist, fingers and thumb are readily perceived on examination; they are all to be reduced by forcibly extending the lower extremity of the part, and pushing the bones into their place. If necessary, small bands may be secured to the fingers by a narrow bandage to facilitate the extension. These accidents should be attended to without delay, for if neglected for a little time they become irremediable.
Notwithstanding the hip-joint is the strongest one in the body, it is sometimes dislocated. As a careful examination of the part, comparing the length and appearance of the limb with its fellow, etc., sufficiently mark the nature of the accident, we will proceed to state the remedy.
Place the patient on his back upon a table covered with a blanket. Two sheets, folded like cravats, are then to be passed between the thigh and testicle of each side, and their ends (one half of each sheet passing obliquely over the belly to the opposite shoulder, while the other half passes under the back in the same direction) given to several assistants, or what is much better, tied very firmly to a hook, staple, post, or some immovable body. A large, very strong napkin, folded as before, like a cravat, is now to be laid along the top of the thigh, so that its middle will be just above the knee, where it is to be well secured by many turns of a bandage. The two ends are then to be knotted. If you have no pulleys, a twisted sheet or rope may be passed through the loop formed by the napkin. If you can procure the former, however, cast the loop over the hook of the lower block and secure the upper one to the wall, directly opposite to the hooks or men that hold the sheets that pass between the thighs. A steadily increasing and forcible extension of the thigh is then to be made by the men who are stationed at the pulleys or sheet while you are turning and twisting the limb to assist in dislodging it from its unnatural situation. By these means, properly applied, the head of the bone will frequently slip into the socket with a loud noise.
If, however, you are foiled, change the direction of the extending force, recollecting always that it is not by sudden or violent jerks that any benefit can be attained, but by a steady, increasing and long-continued pull. Should all your efforts prove unavailing (I would not advise you to lose much time before you resort to it), make the patient, as before directed, very sick or drunk, and when he cannot stand apply the pulleys. If this fails or is objected to, bleed him till he faints, and then try it again.
When this little bone is dislocated it is evident on the slighest glance. To reduce it, lay the patient on his back, straighten the leg, lift it up to a right angle with his body, and in that position push the bone back to its place. The knee should be kept at rest for a few days.
As these accidents cannot happen without tearing and lacerating the soft parts, but little force is required to place the bones in their natural situation. If the parts are so much torn that the bone slips again out of place, apply Hartshorne's or Desault's apparatus, as for a fractured thigh.
The foot is seldom dislocated. Should it happen, however, let one person secure the leg and another draw the foot, while you push the bone in the contrary way to that in which it was forced out. The part is then to be covered with compresses dipped in lead-water and a splint applied on each side of the leg that reaches below the foot. Accidents of this nature are always dangerous; all that can be done to remedy them consists in the speedy reduction of the bone, keeping the parts at rest and subduing the inflammation by bleeding, low diet, etc., etc.
Having spoken of the treatment to be pursued for a bruise, wound, fracture, and dislocation, as happening singly, it remains to state what is to be done when they are united.
We will suppose that a man has been violently thrown from a carriage. On examination, a wound is found in his thigh, bleeding profusely, his ankle is out of joint, with a wound communicating with its cavity, and the leg broken.
In the first place stop the bleeding from the wound in the thigh, reduce the dislocation next, draw the edges of the wounds together with sticking plaster, and lastly, apply Hartshorne's or Desault's apparatus to remedy the fracture.
If, instead of a wound, fracture, and dislocation, there is a concussion or compression of the brain, a dislocation and fracture, attend to the concussion first, the dislocation next, and the fracture the last.
As accidents sometimes happen at sea, or in situations where it is impossible to obtain a surgeon, and which require the immediate amputation of a limb, it is proper to say a few words on that subject. To perform the operation is one thing, to know when it ought to be performed is another. Any man of common dexterity and firmness can cut off a leg, but to decide upon the necessity of doing so, requires much judgment, instances having oocured where, under the most seemingly desperate circumstances, the patient through fear or obstinacy has refused to submit to the knife, and yet afterwards recovered.
Although in many cases much doubt may exist in determining whether it is proper to amputate or not, yet in others, all difficulty vanishes, as when a ball has carried away an arm. Supposing for a moment while rolling in heavy sea, during a gale, the lashings of a gun give way, by which a man have his knee, leg, or ankle completely mashed, or that either of those parts is crushed by a fall from the topgallant yard, a falling tree, etc. The great laceration of blood vessels, nerves, and tendons, the crushing and splintering of the bones, almost necessarily resulting from such accidents, render immediate amputation an unavoidable and imperious duty.
If there are none of the regular instruments at hand, you must provide the following, which are always to be had, and which answer extremely well - being careful to have the knives as sharp and smooth as possible.
Instruments. - The handkerchief and stick, a carving or other large knife, with a straight blade, a penknife, a carpenter's tenon or mitre saw, a slip of leather or linen, three inches wide and eighteen or twenty long, slit up the middle to the half of its length, a dozen or more ligatures, each about a foot long, made of waxed thread, bobbin, or fine twine, a hook with a sharp point, a pair of slender pincers, several narrow strips of sticking-plaster, dry lint, a piece of linen, large enough to cover the end of the stump, spread with simple ointment or lard, a bandage three or four yards long, the width of your hand, sponges and warm water.
Operation. - Give the patient ninety drops of laudanum or let him breathe ether from a large sponge till sound asleep, and seat him on a narrow and firm table or chest, of a convenient height, so that some one can support him, by clasping him round the body. If the handkerchief and stick have not been previously applied, place it as high up on the arm as possible (the stick being very short) and so that the knot may pass on the inner third of it. Your instruments having been placed regularly on a table or waiter, and within reach of your hand, while some one supports the lower end of the arm, and at the same time draws down the skin, take the large knife and make one straight cut all round the limb, through the skin and fat only; then with the penknife separate as much of the skin from the flesh above the cut, and all round it, as will form a flap to cover the face of the stump; when you think there is enough seperated, turn it back, where it must be held by an assistant, while with the large knife you make a second straight incision round the arm and down to the bone, as close as you can to the doubled edge of the flap, but taking great care not to cut it. The bone is now to be passed through the slit in the piece of linen before mentioned, and pressed by its ends against the upper surface of the wound by the person who holds the flap, while you saw through the bone as near to it as you can. With the hooks or pincers you then seize and tie up every vessel that bleeds, the largest first, and smaller ones next, until they are all secured. When this is done, relax the stick a little; if an artery springs, tie it as before. The wound is now to be gently cleansed with a sponge and warm water, and the stick to be relaxed. If it is evident that the arteries are all tied, bring the flap ever the end of the stump, draw its edges together with strips of sticking-plaster, leaving the ligature hanging out at the angles, lay the piece of linen spread with ointment over the straps, a pledget of lint over that, and secure the whole by the bandage, when the patient may be carried to bed, and the stump laid on a pillow.
The handkerchief and stick are to be left loosely round the limb, so that if any bleeding happens to come on, it may be tightened in an instant by the person who watches by the patient, when the dressings must be taken off, the flap raised, and the vessel be sought for and tied up, after which every thing must be placed as before.
It may be well to observe that in sawing through the bone, a long and free stroke should be used, to prevent any hitching, as an additional security against which, the teeth of the saw should be well sharpened and set wide.
There is also another circumstance, which it is essential to be aware of: the ends of divided arteries cannot at times be got hold of, or being diseased their coats give way under the hook, so that they cannot be drawn out; sometimes also, they are found ossified or turned into bone. In all these cases, having armed a needle with a ligature, pass it through the flesh round the artery, so that when tied, there will be a portion of it included in the ligature along with the artery. When the ligature has been made to encircle the artery, cut off the needle and tie it firmly in the ordinary way.
The bandages, etc., should not be disturbed for five or six days, if the weather is cool; if it is very warm, they may be removed in three. This is to be done with the greatest care, soaking them well with warm water until they are quite soft, and can be taken away without sticking to the stump. A clean plaster, lint, and bandage are then to be applied as before, to be removed every two days. At the expiration of ten or fifteen days the ligatures generally come away; and in three or four weeks, if every thing goes on well, the wound heals.
This is performed in precisely the same manner as that of the arm, care being used to prevent the edges of the flap from uniting until the surface of the stump has adhered to it.
As there are two bones in the leg which have a thin muscle between, it is necessary to have an additional knife to those already mentioned, to divide it. It should have a long narrow blade, with a double-cutting edge, and a sharp point; a carving or case knife may be ground down to answer the purpose, the blade being reduced to rather less than half an inch in width. The linen or leather strip should also have two slits in it instead of one, The patient is to be laid on his back, on a table covered with blankets or a matress, with a sufficient number of assistants to secure him. The handkerchief and stick being applied on the upper part of the thigh, one person holds the knee, and another the foot and leg as steadily as possible, while with the large knife the operator makes an oblique incision round the limb, through the skin, and beginning at five or six inches below the kneepan and carrying it regularly round in such a manner that the cut will be lower down on the calf than in front of the leg. As much of the skin is then to be separated by the penknife as will cover the stump. When this is turned back, a second cut is to be made all round the limb and down to the bones, when, with the narrow-bladed knife just mentioned, the flesh between them is to be divided. The middle piece of the leather strip is now to be pulled through between the bones, the whole being held back by the assistant, who supports the flap while the bones are sawed, which should be so managed that the smaller one is completely cut through by the time the other is only half so. The arteries are then to be taken up, the flap brought down and secured by adhesive plasters, etc. as already directed.
As the forearm has two bones in it, the narrow bladed knife, and the strip of linen with three tails, are to be provided. The incision should be straight round the part, as in the arm, with this exception, complete it as directed for the preceding case.
Draw the skin back, and make an incision round the finger, a little below the joint it is intended to remove, turn back a little flap to cover the stump, then cut down to the joint, bending it so that you can cut through the ligaments that connect the two bones, the under one first, then that on the side. The head of the bone is then to be turned out, while you cut through the remaining soft parts. If you see an artery spirt, tie it up; if not, bring down the flap and secure it by a strip of sticking-plaster, and a narrow bandage over the whole.
Remarks. - To prevent the troublesome consequences of secondary bleeding, before the strips of plaster are applied over the edges of the flap, give the patient, if he is faint, a little wine and water, and wait a few minutes to see whether the increased force it gives to the circulation, will occasion a flow of blood; if it does secure the vessel it comes from. If there is a considerable flow of blood from the hollow of the bone, place a small cedar plug in it. Should violent spasms of the stump ensue, have it carefully held by assistants and give the patient large doses of laudanum; it may in fact be laid down as a general rule, that after every operation of the kind, laudanum should be given in greater or less doses, as the patient may be in more or less pain.
From Drowning. - The common methods of rolling the body of a drowned person on a barrel, or holding it up by the heels, etc., are full of danger, and should never be permitted. If a spark of life should happen to remain, this violence would extinguish it forever. As soon, therefore, as the body is found, convey it as gently as possible to the nearest house, strip it of the wet clothes, dry it well, and place it on a bed between warm blankets. First draw the tongue out for a few noments while the body is prone to open the windpipe. Every part is now to be well rubbed with flannels dipped in warm brandy, or spirits of any kind, while a warming-pan, hot bricks, or bottles or bladders filled with warm water, are applied to the stomach, back, and soles of the feet. During these operations a certain number of the assistants (no more persons are to be allowed in the room than are absolutely necessary) should try to inflate the lungs by blowing through the nozzle of a common bellows or a pipe of any kind placed in one nostril, while the other with the mouth is kept closed. This should be done at intervals about sixteen times a minute. Raising both arms forward and upward, over the head, at the same time and at the same intervals, will aid in expanding the chest. If a warm bath can be procured, place the body in it. Clysters of warm brandy and water, salt and water, or peppermint water may be injected.
All these operations, particularly rubbing the body, and trying to inflate the lungs, should be continued for six or eight hours, and when the patient has come to himself, small quantities of warm wine, wine whey, brandy and water, etc., may be given to him from time to time. If, after he has recovered, a stupor or drowsiness remains (but not before) bleed him very moderately.
Should the accident occur in winter, and the body feel cold, as if frozen, previously to applying warmth, rub it well with snow, ice, or very cold water. Above all things remember that perseverance for many hours in the remedies pointed out, may give you the unspeakable pleasure of restoring a fellow creature to life.
From Cold. - Take the body into a room, the doors and windows of which are open, and where there is no fire, and rub it with snow or cold water; if this can be procured in plenty, the patient with the exception of his face, which should be left out, may be completely covered with it to the thickness of two feet. After a while, friction with flannels and hot spirits is to be used, as in the preceding case, and warmth very gradually applied. The lungs are to be inflated, as directed in cases of drowning, and when the patient is able to swallow, warm wine, etc., may be given in small quantities.
If a limb is frost-bitten, the cold applications should be continued longer, and warmth be more gradually applied than when the whole body is frozen. Care should be taken to handle the parts carefully, so as not to break off the ear, tip of the nose, etc.
From Hanging. - The remedies for this accident are the same as in drowning, with the addition of taking away a small quantity of blood, by cupping glasses, from the neck, or by opening the jugular vein.
From Foul Air. - Throw open the doors and windows, or take the patient into the open air, and seat him, undressed, well wrapped in a blanket, in a chair, leaning a little to the right side, place his feet or whole body in a bath, and sprinkle his stomach with cold vinegar or water, and rub it immediately with flannels dipped in oil. Clysters of vinegar and water are to be injected, and when animation returns, continue the frictions, and give warm mint tea, etc.
The first thing to be done when a person is discovered to have swallowed poison is to ascertain what it is he has taken, the next to be speedy in resorting to its appropriate remedies. If any one of these cannot be had, try some other without loss of time. An emetic is generally safe and proper.
Oil of vitriol, aqua fortis, muriatic acid, oxalic acid.
Symptoms. - A burning heat in the mouth, throat and stomach, stinking breath, an inclination to vomit, or vomiting various matters mixed with blood, hiccups, costiveness, or stools more or less bloody, pain in the belly, so great that the weight of a sheet cannot be borne, burning thirst, difficulty of breathing, suppression of urine, etc.
Remedies. - Mix an ounce of calcined magnesia with a pint of water and give a glassful every two minutes. If it is not at hand, use flaxseed tea, rice-water, or water alone, in large quantities, until the former can be procured. If it cannot be obtained, dissolve an ounce of soap in a pint of water and take a glassful every two minutes; chalk or whiting may also be taken by the mouth, and clysters of milk be frequently injected. If the patient will not vomit, put him in the warm bath, bleed him freely and apply leeches and blisters over the parts pained. If the cramps and convulsions continue, give him a cup of common tea, with an ounce of sugar, forty drops of Hoffman's Anodyne, and fifteen or twenty of laudanum, every quarter or half hour. No nourishment but sweetened ricewater is to be taken for several days. In these cases never give tartar emetic, ipecacuanha, or tickle the throat with a feather - they only increase the evil. For oxalic acid, some preparation of lime is the antidote.
Caustic potash, caustic soda, volatile alkali.
Symptoms. - These substances occasion the same effects as acids.
Remedies. - Take two tablespoonsful of vinegar or lemon-juice in a glass of water at once, follow it up by drinking large quantities of water. Pursue the same treatment otherwise as in poisoning from acids.
Corrosive sublimate, red precipitate, vermilion.
Symptoms. - Constriction and great pain in the throat, stomach and bowels, vomiting of various matters mixed with blood, unquenchable thirst, difficulty of urine, convulsions.
Remedies. - Mix the whites of a dozen or fifteen eggs with two pints of cold water, and give a glassful every two minutes, with as much milk as can be swallowed, and large doses of ipecacuanha. If after the egg mixture is all taken the vomiting does not stop, repeat the dose, with the addition of more water. Leeches, the warm bath, blisters, etc., are to be used to reduce the pain and inflammation, as before directed.
Symptom. - These are the same as produced by the mercurial poisons.
Remedies. - Give large quantities of warm water until a plentiful vomiting is induced, to assist which ipecacuanha may be taken in considerable doses at the same time. The antidote for arsenic is hydrated peroxide of iron. It may be prepared by adding spirits or water of ammonia to solution of persulphate of iron. The hydrated peroxide may be given freely after straining out the liquid in a bag. If it cannot be had, magnesia will be useful as a partial antidote. Barley, rice-water, flaxseed tea, milk, etc., should afterwards be employed. Oil is never to be used in this case until the symptoms have considerably abated, or the poison has been ejected.
The symptoms occasioned by swallowing verdigris are nearly the same as those of the mercurial poisons. The great remedy is large quantities of the white of eggs. In addition to this use all the means recommended for corrosive sublimate, etc.
Antimonial wine, tartar emetic, butter of antimony, etc.
Symptoms. - Excessive vomiting, pain and cramp in the stomach, convulsions, etc.
Remedies. - Encourage the vomiting by warm water, and if after awhile it does not stop, give a grain of opium in a glass of the sweetened water every fifteen minutes. To relieve the pain. apply leeches to the stomach, throat, or parts affected. Infusion of galls may be given also quite freely.
Give as much milk as can be got down, and if it is not at hand use large quantities of cold water to induce vomiting. If the symptoms do not abate, pursue the plan directed for acids.
Pursue the plan recommended for copper.
Dissolve two tablespoonsful of common table salt in two pints of water; a few glasses of this will induce vomiting. If not relieved, drink flaxseed tea, apply leeches, etc., as for acids.
Pursue the plan recommended for copper.
Symptoms. - Vomiting; pain in the belly; a stiffness of the whole body; convulsions.
Remedies. - Introduce your finger or a feather into the throat to induce vomiting, and give plenty of sweetened water. To relieve the convulsions, give the tea, laudanum, etc., as for acids, or the laudanum alone, and to ease the pain in the belly apply leeches, etc.
The symptoms and remedies are the same as by poisons from acids, with the addition of olive oil or lard oil by the tablespoonful
Symptoms. - Great pain in the stomach, with obstinate and painful erections, accompanied by a difficulty or suppression of urine, or if any is passed it is bloody; a horror of swallowing liquids; frightful convulsions.
Remedies. - Make the patient swallow as much sweet oil as he can possibly get down. Milk and sugared water are also to be freely used. In addition to the plan recommended for acids, solutions of gum arabic or flaxseed tea are to be injected into the bladder. If no vomiting is induced, put him in the warm bath, continue the sweetened water, and rub his thighs and legs with two ounces of warm oil, in which a quarter of an ounce of camphor has been dissolved. Eight or ten grains of camphor may be mixed with the yolk of an egg and taken internally. If there is acute pain in the bladder, apply leeches over it.
Stuff the patient with thick rice, bread, potatoes, or any other vegetable; then give him five grains of tartar emetic to vomit him, after which use milk freely, clysters and fomentations to the belly, with the warm bath; leeches, etc., are not to be neglected.
Sugar of lead, extract of Saturn, white lead, lõtharge, minium.
Symptoms. - A sweet, astringent taste in the mouth; constriction of the throat; pain in the stomach; bloody vomiting, etc.
Remedies. - Dissolve a handful of Epsom or Glauber salts in a pint of water, and give it at once; when it has vomited him use gum-water. If the symptoms continue, act as directed for acids.
Symptoms. - Stupor, an insurmountable inclination to sleep, delirium, convulsions, etc.
Remedies. - Endeavor to excite vomiting by two grains of tartar emetic, or four grains of blue or thirty of white vitriol. Thrust a feather down the throat for the same purpose, or use the stomach pump. Never give vinegar or other acids until the poison is altogether or nearly evacuated. After this has taken place, give repeatedly a cup of very strong coffee. The coffee, etc., are to be continued until the drowsiness is gone off, which, if it continues and resembles that of apoplexy, must be relieved by bleeding. The patient is to be forcibly kept in constant motion. The galvanic battery and artificial respiration are sometimes necessary.
Remedies. - Give the patient immediately two grains of tartar emetic, or thirty of ipecacuanha, and an ounce of salts, dissolved in a glass of water, one-third to be taken every fifteen minutes, until he vomits freely. Then purge with castor oil. If there is great pain in the belly, apply leeches, blisters, etc.
Remedies. - An emetic as directed for opium. If the poison has been swallowed some time, purge with castor oil. Brandy or ammonia may be required for stimulation in tobacco poisoning
Remedies. - An emetic. If it has been eaten some time, give castor oil by the mouth and clyster. After these have operated, twenty drops of ether may be taken on a lump of sugar.
Persons are frequently in danger of suffocation from fish-bones, pins, etc., which stick in the throat. The moment an accident of this kind occurs, desire the patient to be perfectly still, open his mouth, and look into it. If you can see the obstruction, endeavor to seize it with your finger and thumb, or a long slender pair of pincers. If it cannot be got up, or is not of a nature to do any injury in the stomach, push it down with the handle of a spoon, or a flexible round piece of whalebone, the end of which is neatly covered with a roll of linen, or anything that may be at hand. If you can get it neither up nor down, place two grains of tartar emetic in the patient's mouth. As it dissolves, it will make him excessively sick, and in consequence of the relaxation, the bone, or whatever it may be, may descend into the stomach or be ejected from the month.
If a pin, button, or other metallic or pointed body has been swallowed (or pushed into the stomach), make the patient eat plentifully of thick rice pudding, and afterwards give him a dose of castor oil, to carry it off by the bowels.
There are three kinds of remedies generally employed in accidents of this nature. Cooling applications, such as pounded ice, snow, cold water, lime-water and oil. Stimulants, as warm spirits of turpentine, and carded or raw cotton.
Any one of these articles that happens to be nearest at hand may be tried, although the preference is due to the lime-water and linseed or sweet oil, equal parts, applied on strips of soft linen or muslin, and laid over the parts burned, and covered with oiled silk. Raw cotton may be used if the burn is extensive but not deep. Sprinkling wheat, rye, or starch flour is preferred by some; fresh lard by others, or glycerin. Equal parts of lime-water and linseed oil, well mixed, form one of the most soothing of all applications. Should the system seem to sink, wine, bark, etc. must be employed.
From what has been already stated, it is evident that in treating wounds, etc., as well as diseases, one great and important indication is to repress excessive inflammation, which, if allowed to proceed to a certain point, sometimes produces mortification or death of the parts.
If the fever and pain suddenly cease; if the part which before was red, swollen and hard becomes purple and soft, abandon at once all reducing measures, lay a blister over the whole of the parts, and give wine, porter, bark, etc., freely and without delay. If the blisters do not put a stop to the disease, and the parts become dead and offensive, cover them with the charcoal or fermenting poultice until nature separates the dead parts from the living, during which process a generous diet, bark, etc., must be allowed. A wash of dilute solution of nitric acid, 50 drops to a pint, may be poured over the parts daily, or a dressing of solution of bromine.
There is a particular kind of mortification which comes of itself, or without any apparent cause. It attacks the small toes of old people, and commences in a small bluish or black spot, which spreads to different parts of the foot. To remedy it place a blister over the spot, and give two grains of opium night and morning, taking care to keep the bowels open by castor oil, and to diminish the quantity of opium, if it occasions any unpleasant effects.
In extensive mortifications of the forearm it is necessary to amputate. This, however, should never be done, until by the repeated application of stimulating poultices or washes to the sound parts adjoining the mortified ones, they are disposed to separate, which may be easily known by inspection.
Tie up the arm, placing the bandage at least two inches above the projection of the elbow joint, and then feel for the pulse at the wrist. If it is stopped, the bandage is too tight, and must be relaxed. Select the most prominent vein, and feel with the tip of your finger if an artery lies near it. If you feel one pulsating so close to the vein that you are fearful of wounding it, choose another. Having set your lancet (I allude, of course, to the spring lancet, the only one that can be used with safety), bend the arm in the precise position it is to be kept in while the blood flows. The cutting edge of the lancet is now to be placed on the vein, while you depress the handle or frame just as much as you wish the cut to be deep. By touching the spring on the side with your thumb, the business is done. To stop the bleeding, relax the bandage, press the two edges of the wound together, place a little compress of linen on it, and bind up the whole with a bandage passing round the joint in a figure of eight.
Take the penis of the patient near its head between the finger and thumb of your left hand (standing beside him), while with your right you introduce the point of the instrument into the urinary passage, its convex side towards his knees. While you push the catheter down the urethra, endeavor, at the same time to draw up the penis on it. When you first introduce it the handle will of course be near the belly of the patient, and as it descends will be thrown further from it, until it enters the bladder, which will be known by the flow of the urine. If you cannot succeed while the patient is on his back, make him stand up, or place him with his shoulders and back on the ground, while his thighs and legs are held up by assistants. If still foiled, place him again on his back, and, when you have got the catheter as far down as it will go, introduce the forefinger, well oiled, into the fundament, and endeavor to push its point upwards, while you still press it forward with the other hand. Force is never, on any account, to be used. Vary your position as often as you please; let the patient try it himself; but always remember it is by humoring the instrument and not by violence, that you can succeed.
Take the penis between your finger and thumb, and pass the point of the instrument (which should be well oiled) down the urethra, as directed for the catheter. When it has entered three or four inches, depress the penis a little, and, by humoring the bougie with one hand and the penis with the other, endeavor to pass it as far as may be wished. The patient himself will frequently succeed, when every one else fails.
Mix 1 drachm of Goulard's extract of lead, or solution of sugar of lead in water, with 4 ounces of rectified spirit, and 6 ounces of distilled water. Make a lotion, which is to be applied to those surfaces where inflammation is very rapid.
Another Method. - Dissolve 2 drachms of sulphate of zinc (white vitriol) in a pint of distilled water. To be applied as above.
Boil together for a quarter of an hour 1 ounce of dried marsh-mallow root, with 1/2 an ounce of chamomile flowers, in a pint of water; strain through a cloth. The fomenting flannels should be sprinkled with spirits just before they are applied to the inflamed part.
Bruise 4 ounces of dried poppy heads, and then boil them in 6 pints of water, until a quart only remains after straining. This fomentation is to be applied to inflamed parts, where there is much pain, but which are required to suppurate.
Mix together equal parts of acetated water of ammonia and tincture of camphor, which apply to the inflamed joint or other part.
Another. - Dissolve 1 ounce of muriate of ammonia in 4 ounces of common vinegar, and add 10 ounces of water. To be applied with or without a cloth to inflamed surfaces.
Another. - Mix together 2 ounces of rectified spirit, and 5 ounces of acetated water of ammonia.
Dissolve half a drachm of sugar of lead in 4 ounces of distilled vinegar, and then add 1 ounce of common spirits with a pint of water. Linen cloths dipped in this lotion are to be applied to inflamed joints, etc.
Take of goulard water, 1 1/2 drachms; rectified spirits, 2 ounces; water, 1 pint. These are to be mixed with a sufficient quantity of the crumb of a new loaf to form a eataplasm. To be applied at night to inflamed parts.
Another. - Mix with crumb of bread as above one drachm of goulard water (or solution of sugar of lead) and a pint of common water that has been boiled.
Make two quarts of finely-powdered bran, and one part of linseed meal, into a poultice, with boiling water. A little oil should be spread over the surface just before it is applied.
Another. - Take of crumb of bread and linseed meal equal parts; make them into a poultice with boiling milk.
Stir linseed flour into boiling water in sufficient quantity to form a cataplasm of proper consistency, and before application smear the surface with a little olive or linseed oil. If irritation, with great pain and tension, or hardness should prevail, it will be necessary to substitute a decoction of poppy heads for the common water. This poultice is in general use in all the hospitals.
Shake in a phial until they become white like milk, 10 drachms of olive oil, with 2 drachms of spirits of hartshorn (water of ammonia); then add 4 drachms of oil of turpentine. When properly mixed, they may be directly used as an embrocation for sprains and bruises.
Where weakness remains in consequence of a sprain, cold water ought to be pumped on the part every morning; and a long calico roller should be bound firmly (but not too tightly) round it immediately after. By these means strength will soon be restored.
Another. - Digest fifteen ounces of white hard soap scraped with a knife, in four pints of spirits of wine, and one pint of water of ammonia, or hartshorn (liquor ammoniae), previously mixed in a large bottle. When dissolved, add five ounces of camphor. When this last is entirely dissolved the embrocation is fit for use.
This excellent and powerful stimulant was selected from the Pharmacopoeia of the Middlesex Hospital: for private use the above quantities of the ingredients are to be reduced in proportion to each other, according to the quantity likely to be used in a family. If one-third only is required, use five ounces of soap, one of camphor, sixteen ounces of spirit of wine, and four ounces of water of ammonia.
In the applying of leeches to the human body, success is rendered more certain by previously drying them, or allowing them to creep over a dry cloth. To attract them the part should be moistened with cream, sugar, or blood, and if this should be insufficient, the leech may he cooled by touching it with a cloth dipped in cold water. The escape of leeches from the part is to be prevented by covering them with a wineglass or tumbler.
Boil any quantity of fresh carrots until they are sufficiently soft to be beaten up into a smooth pulp. This cataplasm is equally beneficial in the cure of sloughing, as well as scorbutic ulcers. The latter are known by a brown color, the discharge being thin and corroding, whilst the fungous excrescences which shoot out, bleed on the slightest touch. The ulcer is surrounded by a livid ring or areola, in which small spots are frequently observed. The former are known by their very dark and flabby surface, from several parts of which offensive matter exudes. They are attended by prostration, and have a fetid discharge.
Another. - Boil any quantity of the bottom leaves of the common meadow sorrel, until they are sufficiently soft, then heat them into a smooth pulp, which is to be applied as a cataplasm to ulcers of the above-mentioned nature.
Another. - Poultices of the pulp of apples have been successfully employed on the continent for these ulcers. They are made by mixing two ounces of the pulp of boiled apples with the same weight of the crumb of bread.
Mix from one to two drachms of muriatic acid (spirit of salt) with a pint of water. This lotion is very useful in cleansing and stimulating the above-mentioned ulcers.
Another. - Make a lotion by dissolving half an ounce of nitrate of potass (saltpetre) in half a pint of common vinegar; with which cleanse the ulcers in question.
Mix together an ounce and a half of the tincture of muriate of iron, with several ounces of distilled water. Apply as a lotion.
This ulcer generates a poison capable of converting other healthy ulcers into its own nature. It generally appears on the inner side of the leg near the ankle. It exhales a putrid smell, whilst a thin acrimonious humor is discharged, which excoriates the neighboring parts; and fungous excrescences frequently shoot out. The limb becomes much swelled and very painful, whilst the sore bleeds on the slightest touch. If not checked the most fatal consequences are to be apprehended.
Treatment. - The following remedies have been found most efficacious, viz., the carrot and yeast poultice as mentioned before; a lotion of tincture of myrrh, 1 ounce, with 7 ounces of decoction of bark, in equal parts; l scruple of sulphate of copper, or blue vitriol, in solution with distilled water or with 8 ounces of lime-water; camphorated spirit of wine; camphorated vinegar; the cold salt water bath; and the application of the juice of limes. If the sores remain irritable and painful, the hemlock and poppy fomentations are to be used; accompanied with the internal administration of Peruvian bark, and other tonic remedies.
Pure lime-water is one of the best dressings for ulcers.
The lotion made according to the following recipe, has been found very beneficial in cases of foul ulcers and sore legs of poor people. It has also succeeded (applied warm) in curing a fistulous ulcer: Take of green vitriol, 3/4 ounce; alum, 1/2 ounce; verdigris, 1/2 drachm; crude sal ammoniac, 2 scruples.
After reducing them to powder, put them into a new glazed pipkin, holding about a quart. Set it upon a slow fire, and increase by degrees till the ingredients boil up to the top two or three times. Then take it from the fire and set it to cool. Break the pipkin to get the stone out. Stir them round all the time they are on the fire with a lath. The dust and the smoke should not come near the eyes, nose, or mouth. Put a piece of the stone, the size of a walnut, to a quart bottle of soft water. To use, shake the bottle and wet a piece of fine linen four times doubled. Lay it upon a new burn or old ulcer. The linen should always be kept wet with it. [For this receipt the late Emperor of France gave 10,000 louis-d'ors, after it had been approved of in his hospitals.]
Mix as much ground malt with half a pint of yeast as will make a cataplasm of moderate consistence. This poultice is gently stimulating, and very serviceable in destroying the fetid and disagreeable smell which arises from foul ulcers and gangrenous wounds.
Another. - A similar poultice, and for the same purpose, is prepared by stirring into an infusion of malt as much oatmeal as may be required to make it of a proper thickness, and afterwards adding about a spoonful of yeast.
Stir into half a pint of ale, or strong beer-grounds, as much oatmeal or linseed-meal as will make a cataplasm of proper thickness. This will prove an excellent stimulant and antiseptic for foul ulcers. It should be applied as warm as the parts will bear, and should be renewed every six hours.
Mix well together 1 pound of linseed-meal, and a pint of ale yeast. Expose this cataplasm to a gentle heat until a certain degree of fermentation takes place. This poultice is excellent for stimulating and cleansing foul ulcers.
To half a pound of the common oatmeal cataplasm, add two ounces of fresh nurnt charcoal finely pounded and sifted. Mix the whole well together, and apply it to foul ulcers and venereal sores; the fetid smell and unhealthy appearance of which it speedily destroys.
This is a small tumor which appears under or around the finger nail; it is attended with redness and pain, and very quickly advances to suppuration. After the abscess is evacuated of the white matter contained in it, it very soon heals of itself. The loss of the nail, however, is sometimes, through improper management, the consequence of the disease.
In order to check the inflammation in the first instance, and thereby at once stop the disease, it will be proper frequently to apply the following lotion, that is, until the pain and heat are abated:
Dissolve one ounce of sal ammoniac in two ounces of common vinegar; adding one of rectified spirit, and twelve ounces of distilled water.
Another Application. - It sometimes happens that the ulcers which remains after the discharge of the matter, is very indolent and difficult to heal. In such a case the following application will be of great service: Rub 1/2 an ounce of camphor, in a mortar, with an ounce of olive oil. Now melt over a gentle fire 8 ounces of olive oil, with 4 ounces of yellow wax, and stir it in 1/2 an ounce of a solution of sugar of lead (liquor plumbi acetatis); when this mixture is cold, pour the camphor and oil in the mortar into it, taking care to stir the whole well until quite cold. If suppuration should ensue, marked by a white prominent spot, an opening should immediately be made, that the matter may escape.
This kind of whitlow being more deeply seated than that of the nail, is more severe, and is attended by throbbing and acute pain. The matter, likewise, often insinuates itself beneath the nail. To prevent suppurution it will be proper to keep the finger immersed for a long time in warm water and to apply the lotion, recommended for the same purpose in common whitlow. If these fail in effecting a resolution of the tumor, an early and free incision should be made through the integuments, and carried to the bottom of the diseased part; after which the blood may be allowed to flow for some time: the opening is to be treated afterwards as a common wound, viz., by the application of adhesive plaster.
Another Remedy. - Dr. Balfour, of Edinburgh, has found the application of pressure in incipient cases of whitlow to succeed in preventing the formation of matter, and speedily to cure the disease. He applies compression with the hand in a degree which the patient can easily bear, with the view of preventing extensive suppuration, and then a narrow fillet. This operation, in severe cases, is repeated three or four times in the course of the day, when the pain and swelling disappear, leaving a single speck of pus at the point of the thumb immediately under the skin. If vent be given to this by the slightest touch of the lancet, the wound will heal up immediately.
Dr. Kirkland recommends a volatile plaster for this disease, made after the following manner: Melt together in an iron ladle, or earthern pipkin, two ounces of soap and half an ounce of litharge plaster. When nearly cold, stir in one drachm of sal ammoniac in fine powder: spread upon leather, and apply to the joint as above.
If the above method fail, and ulceration take place, a surgeon should be applied to without delay.
Simmer ox marrow over the fire, and afterwards strain it through a piece of muslin into gallipots. When cold rub the part affected.
Mr. T. G. Graham, of Cheltenham, recommends the limewater which has been used for purifying gas, as a very efficacious remedy in the above troublesome disease. The head is to be well cleaned, morning and evening, with soap and water, and afterwards washed with the lime-water from the gas works. The above lime-water is a very heterogeneous compound, so that it is impossible to say which of its ingredients is effectual. It contains lime, ammonia, sulphuretted hydrogen, volatile oil, and probably several other compounds of a more complex nature.
Take of sulphur, 1 ounce; lard, 1 ounce; sal ammoniac, 2 drachms: Mix for an ointment, to be rubbed upon the part affected two or three times a day.
The following ointment for scald head, ringworm, and tetter, has uniformly succeeded in speedily effecting a cure.
Take of subacetate of copper (in very fine powder), 1/2 a drachm; prepared calomel, 1 drachm; fresh spermaceti ointment, 1 ounce. Mix well together. To be rubbed over the parts affected every night and morning. This ointment is also very efficacious in cases of foul and languid ulcers.
Dr. Hufeland praises the excellent effects of the oil of the walnut kernel in leprous and other cutaneous complaints. It is one of the safest, simplest, and most efficacious external remedies that can be employed, as it mitigates the pains, and that burning sensation, sometimes almost insupportable, which accompany these obstinate diseases; it never seems to have any ill effect, if attention be given to the eruption suddenly disappearing, or diving, as it is said, by repulsion - a circumstance which frequently happens by the application of metallic ointments, and which is often attended with much danger to the constitution; although it cures the cutaneous affection in a short time, it is not followed by any bad consequences, provided the eruption does not originate in any obstinate internal or general disease. In a child, which was almost covered with chronic and suppurating pimples, against which internal remedies, baths and mercurial ointments had been employed without producing a perfect cure, the oil of walnut kernel was used with complete success. It is likewise an excellent remedy in small cutaneous eruptions that are now and then observed in children. The oil ought to be fresh, expressed without heat, and applied to the affected places twice or thrice a day.
Take of flowers of sulphur 1 ounce; essence of lemon 1 ounce; hogs' lard 2 ounces. Make it into an ointment. Smear all the joints for three nights with this; wash it off in the morning with soap and water. Repeat the smearing three times at the interval of two days, and the most inveterate itch is certain to disappear. It will be well at the same time to take night and morning a teaspoonful of an electuary of flowers of sulphur, mixed with honey or treacle.
Take an ounce of white copperas dissolved in a quart of water, and occasionally apply it to the affected parts. This will ultimately remove the most obstinate blains. This application must be used before they break, otherwise it will do injury.
Take a piece of fresh wood of the fir, made flat and smooth, and hold it to the fire until it becomes moderately warm, and all the turpentine begins to exude; then place the part affected upon this board and keep it there as long as it can well be borne, after which let the part be washed with warm water, wrapped up in flannel and kept free from cold. This application is improper if the chilblains be broken, but if applied before it has arrived at that stage, it has never failed in removing the complaint after two or three applications.
Another. - Crude sal ammoniac 1 ounce; vinegar 1/2 a pint; dissolve, and bathe the part, if not yet broken, two or three times a day. If sal ammoniac is not at hand, alum or common soft will do, but not so effectually. If the chilblains are of very long continuance and obstinate, touch them with equal parts of liquid opodeldoc (linimentum saponis) and tincture of Spanish flies, or rather less of the latter. If the chilblains break, poultice or dress them with basilicon, and add turpentine if necessary.
Another. - The following ointment for this annoying disease has been attended with the most beneficial effect: Take of citron ointment 1 ounce; oil of turpentine 2 drachms; olive oil 4 drachms. Mix. To be well rubbed over the parts affected every night and morning.
Another. - The following has also been found very beneficial in the cure of chilblains both in the incipient or inflammatory stage or when advanced to ulceration. When in the former state, the part should be well rubbed over with it by means of a warm hand, and afterwards kept covered with soft, thin leather. When ulcerated it should be applied on lint sufficiently large to cover the surrounding inflammation: Take of spermaceti ointment 6 drachms; prepared calomel 2 scruples; rectified oil of turpentine 1 drachm. Mix. Pure glycerin is a very good mild application for chilblains.
When small in size they are to be removed either by stimulants or escharotics, as the application of nitrate of silver (lunar caustic), merely by wetting the corn and touching it with a pencil of the caustic every evening. Previous to this the skin may be softened by immersion of the feet in warm water.
Rub together in a mortar 2 ounces of powder of savin leaves, 1/2 an ounce of verdigris and 1/2 an ounce of red precipitate. Put some of this powder in a linen rag and apply it to the corn at bed-time.
If the corn has attained a large size, removal by cutting, or by ligature, will be proper; if it hangs by a small neck, the latter method is preferable. It is done by tying a silk thread round the corn, and on its removal next day tying another still tighter, and so on till completely removed. When the base is broad, a cautious dissection of the corn from the surrounding parts by means of a sharp knife or razor is necessary. This is done by paring gently until the whole is removed. In all cases of cutting corns the feet ought to be previously washed, as in case of making a wound in the toe great danger may result from want of cleanliness in this respect. Mortification has in some instances been the effect of such neglect.
Prevention, etc. - Corns should be secured from pressure by means of a thick adhesive plaster, in the centre of which a hole has been made for the reception of the projecting part. This, with frequent immersion in water and occasional paring, has often been found to remove them, and always prevents their enlargement. An effectual mode of extirpation is by the application of a small blister, the effect of which will be, generally, to raise them with the skin out of their bed. When rest from labor can be obtained, this is an excellent method. Dress the blister (which need not exceed the size of a silver dime) with hog's lard, or simple wax ointment.
Nitrate of silver (lunar caustic) cures those troublesome excrescences called warts in an extremely simple and harmless manner. Caustic potassa is still more certain.
The method of using it is to dip the end of the caustic in a little water and to rub it over the warts. After doing so a few times they will be gone. The muriate of ammonia (sal ammoniac) is likewise a very useful remedy. "Out of twenty years' practice," says a medical correspondent in the Monthly Magazine, "I never knew the above remedies to fail."
Pulverize finely in an iron mortar 1 ounce of black pepper, 1 ounce of elecampane root and three ounces of fennel seed, and mix them intimately together. Now melt together over a clear fire 2 ounces of sugar and 2 ounces of clarified honey, so as to form a clear syrup, which add to the mixed powder in the mortar, and heat the whole into a mass of uniform consistence. This medicine is to be taken when the irritation of piles runs so high as to threaten fistula. The dose is a piece of the size of a nutmeg, to be taken three times a day: this is to be washed down by a glass of cold water, or white wine.
These are to be extracted by means of a small forceps, or by syringing the ear with warm or tepid water. But should such means prove unsuccessful, they may be suffered to remain without danger if they do not produce pain, as in a very short time they will be forced out by the accumulating wax. Insects may be killed by filling the ear with oil and afterwards removed by syringing with warm water.
A good surgeon recommends the following method for the treatment of the above frequent and sometimes serious accident: "Take a small, fine phial cork, of a size adapted to the socket whence the tooth has been extracted and the haemorrhage proceeds; then with a small dossil of lint wet with tincture of chloride of iron, and put on the smallest end of the cork, push the cork into the bleeding orifice, pressing it firmly in till it be, as it were, wedged in the socket, and keep it there as long as may be necessary, desiring the patient to press against it with the teeth of the opposite jaw till the bleeding be stopped, which is almost instantly. This acts as a tourniquet, and gives time to use whatever other means may be deemed requisite, but it is seldom that anything else is required." Solution of persulphate of iron, alum, and powder of tannin are also good styptics.
If hollow or decayed, apply compound tincture of benzoin, or some essential oil, on cotton, to the part, or pills with camphor and opium: or chew the roots of pellitory of Spain. Some burn the nerve with sulphuric or nitric acid, or a hot iron.
Take of extract of lead, 10 drops; rose-water, 6 ounces. Mix, and wash the eyes night and morning.
Another. - Take of extract of lead, 10 drops; spirit of camphor, 20 drops; rose-water, 1/2 a pint. Mix. This eyewater is extremely useful in ophthalmia, attended with much inflammation.
Another. - Take of opium, 10 grains; camphor, 6 grains; boiling water, 12 ounces. Rub the opium and camphor with the boiling water and strain. This collyrium abates the pain and irritation attendant on severe cases of inflammation of the eyes.
Another. - Take of white vitriol, 3 drachm; spirits of camphor, 1 drachm; warm water, 2 ounces; rose-water, 4 ounces. Dissolve the vitriol in the warm water, and add the spirit of camphor and rose-water This is a useful collyrium in the chronic state of ophthalmia, or what is generally called weakness of the eyes after inflammation.
Another. - Dissolve 10 grains of soft extract of opium in 6 ounces of warm distilled water, strain through fine linen, and then add 2 ounces of liquor of acetate of ammonia. Where the pain is great, this collyrium will be productive of great relief.
Another. - Make a lotion for the inflamed eyes with 20 drops of tincture of camphor, 10 drops of solution of sugar of lead, 1 of Goulard's extract, and 7 ounces of distilled water. If the pain is very distressing, a drop of the vinous tincture of opium may be conveyed twice a day into the eye by means of a feather. This is an effectual means of obtaining relief.
Another. - Mix together 1 ounce of the liquor of acetate of ammonia, and 7 ounces of distilled rose-water.
Another. - When the eye is merely weak, frequent ablution with cold water, by means of an eye-cup of green glass, will be of great use. Still better is the application to the lids, very frequently, of lead-water, with a camel's hair pencil. At night a very cooling cataplasm, or poultice, may be made of crumb of bread soaked in a pint and a half of cold water, in which a drachm of alum has previously been dissolved. This is to be applied over the eyes in a handkerchief when going to bed.
The following ointment has been found exceedingly beneficial in inflammation of the eyeball and edges of the eyelids, which has become very prevalent. Take of prepared calomel, 1 scruple; spermaceti ointment, 1/2 an ounce. Mix them well together in a glass mortar; apply a small quantity to each corner of the eye, every night and morning, and also to the edges of the lids, if they are affected. Another good ointment is composed of carbonate of lead, 2 drachms; simple cerate, an ounce. If this should not eventually remove the inflammation, the following lotion may be applied three or four times a day, by means of an eye cup. The bowels should be kept in a laxative state, by taking occasionally 1/4 of an ounce of the Rochelle or Epsom salts.
Take of acetated zinc, 6 grains; rose-water (fresh), 6 ounces. Mix. Before the ointment is applied to the corners of the eyes, wash them with this lotion. These remedies have succeeded in almost every case of inflammation of the eyes to which they have been applied.
These are smell abscesses seated in the edge of the eyelid, and produced by the obstruction of very minute glands. They are often attended with much heat and pain, and always with great inconvenience. The application of ice to the part will sometimes check them in the beginning. If they do not suppurate quickly, a small poultice of bread and milk is to be applied warm. When the matter is formed, an opening should be made with the point of a lancet, or a needle, and a small portion of weak citrine ointment is afterwards to be applied.
Take of senna, 3 drachms; lesser cardamom seeds, husked and bruised, 1/2 drachm; boiling water, as much as will yield a filtered infusion of 6 ounces. Digest for an hour, and filter, when cold.
This is a well contrived purgative infusion, the aromatic correcting the drastic effects of the senna. It is of advantage that it should be used fresh prepared, as it is apt to spoil very quickly.
Take of senna, 8 ounces; coriander seeds, 4 ounces; liquorice, 4 ounces; figs, 1 pound; pulp of tamarinds, cassia fistula, and prunes, of each, 1/2 pound; double refined sugar, 2 1/2 pounds. Powder the senna with the coriander seeds, and sift out 10 ounces of the mixed powder; boil the remainder with the figs and liquorice, in 4 pounds of water, to one-half; express, and strain the liquor, which is then to be evaporated to the weight of about 1 1/2 pounds; dissolve the sugar in it, add this syrup, by degrees, to the pulps; and, lastly, mix in the powder.
This electuary is a very convenient laxative and has long been in common use among practitioners. Taken to the size of a nutmeg, or more, as occasion may require, it is an excellent laxative for loosening the belly in costive habits.
Take of pith of colocynth, cut small, 6 drachms; hepatic aloes, 1 1/2 ounces; scammony, 1/2 an ounce; lesser cardamom seeds, husked and bruised, 1 drachm; Castile soap, softened with warm water, so as to have a gelatinous consistence, 3 drachms; warm water, 1 pint. Digest the colocynth in the water, in a covered vessel, with a moderate heat, for 4 days. To the liquor, expressed and filtered, add the aloes and scammony, separately, reduced to powder; then evaporate the mixture to a proper thickness for making pills, having added towards the end of the evaporation, the soapjelly and powdered seeds, and mix all the ingredients thoroughly together.
These pills are much used as warm and stomachic laxatives; they are well suited for costiveness, so often attendant on people of sedentary lives, and, upon the whole, are among the most useful articles in the materia medica.
Take of socotrine aloes, powdered, 1 ounce; extract of gentian, 1/2 ounce; oil of caraway seeds, 2 scruples; syrup of ginger, as much as is sufficient. Beat them together. The dose is from five to ten grains.
Take of hepatic aloes, 1 ounce; ginger root, in powder, 1 drachm; soap, 1/2 an ounce; essence of peppermint, 1/2 a drachm. Powder the aloes with the ginger, then add the soap and the oil, so as to form an intimate mixture. This is an excellent purge for costive habits, in the dose of from 5 to 10 grains.
Take of rhubarb, in powder, 1 ounce; socotrine aloes, 6 drachms; myrrh, 1/2 ounce; volatile oil of peppermint, 1/2 drachm. Make them into a mass with a sufficient quantity of syrup of orange peel. These pills are intended for moderately warming and strengthening the stomach, and gently opening the bowels. A scruple of the mass may be taken night and morning.
Take of socotrine aloes, 1 pound; white canella, 3 ounces. Powder them separately, and then mix them. The spicy canella acts as a corrigent to the aloes; but the compound is more adapted to be formed into pills than to be used in the state of powder. It is a convenient medicine for costive habits, not subject to the piles. Dose from 10 grains to a scruple at bed-time.
Take of manna and oil of almonds, each 1 ounce; carbonate of potassa, 12 grains; cinnamon and rose-water, each 3 ounces. Mix carefully the oil, potassa and manna together, gradually pouring the liquids to form an emulsion, of which take two tablespoonsful night and morning.
Take of the electuary of senna, 1 1/2 ounces; washed flowers of sulphur, 4 drachms; syrup of roses, as much as is sufficient. Make into an electuary, of which take the size of a nutmeg, going to bed, as may be required. This is an excellent remedy for persons who have the piles, or are subject to their return.
Take of castor oil, 2 ounces; 1 egg; mix them well, and then add gruel 8 ounces; which will operate very mildly, and is efficacious in case of worms.
Take of manna, 1 ounce. Dissolve in 10 ounces by measure, of compound decoction of chamomile; then add of olive oil, 1 ounce; sulphate of magnesia, 1/2 ounce. Mix and let it be given directly.
Take of hard purified opium, in powder, benzoic acid, each 1 drachm; camphor, 2 scruples; essential oil of aniseed, 1 drachm; proof spirit of wine, 2 pints. Digest for ten days and strain. In this formula, the virtues of the opium and the camphor are combined. It derives an agreeable flavor from the acid of benzoin and essential oil. The latter will also render it more stimulating. It was originally prescribed under the title of elixir asthmaticum, which it does not ill deserve. It contributes to allay the tickling which provokes frequent coughing, and at the same time, it soothes the breast, and gives greater liberty of breathing. It is given to children against the chincough, etc. in doses of from 5 drops to 20; to adults, from 20, to 100. Half an ounce, by measure, contains about a grain of opium.
Take of dried root of squills, in fine powder, 1 scruple; gum ammoniac, lesser cardamom seeds in powder, extract of liquorice, each 1 drachm. Form them into a mass with simple syrup. This is an elegant and commodius form for the exhibition of squills, whether for promoting expectoration, or for the other purposes to which that medicine is applied. The dose is from 10 grains to 1 scruple, three times a day.
The following recipe was copied from one in the possession of the late Emperor of France, and was a very favorite remedy with Napoleon for difficulty of breathing, or oppression of the chest arising from a collection of mucus in the air cells and vessels of the lungs, and in the gullet. Considerable benefit has been derived from it in many similar cases. Take of ipecacuanha root, in powder, 30 grains; squill root, in powder, gum ammoniac, in powder, each 2 scruples; mucilage of gum arabic, sufficient to form a mass. To be divided into 24 pills; two to be taken every night and morning.
Mix together 4 drachms of syrup of squills; 4 drachms of elixir of paregoric; 4 drachms of syrup of poppies. Of this take a teaspoonful in a little tea or warm water, as occasion requires.
Take 4 drachms of paregoric elixir, 2 drachms of sulphuric ether; 2 drachms of tincture of tolu. Mix, and take a teaspoonful night and morning, or when the cough is troublesome, in a little milkwarm water.
Take of boiling water, half a pint; black currant jelly, a desertspoonful; sweet spirits of nitre, a teaspoonful. Mix the jelly in the water first till it is quite dissolved, and add the nitre last. Take a desertspoonful of the mixture at night, going to bed, or when the cough is troublesome. The mixture should be made and kept in a teapot, or other covered vessel.
The following is very serviceable in common obstinate coughs, unattended with fever. Take of tincture of tolu, 3 drachms; elixir of paregoric, 1/2 an ounce; tincture of squills, 1 drachm. Two teaspoonsful to be taken in a tumbler of barleywater going to bed, and when the cough is troublesome.
In the coughs of aged persons, or in cases where there are large accumulations of purulent or viscid matter, with feeble expectoration, the following mixture will be found highly beneficial: Pour gradually 2 drachms of nitric acid, diluted in half a pint of water, on 2 drachms of gum ammoniac, and triturate them in a glass mortar, until the gum is dissolved. A tablespoonful to be taken, in sweetened water, every two or three hours.
Take of oil of almonds, 6 drachms; milk of almonds, 5 ounces; rose water, gum arabic, and purified sugar, equal parts, 2 drachms. Let these be well rubbed together, and take two tablespoonsful four times a day, and a teaspoonful upon coughing. This is far preferable to the common white emulsions formed by an alkali, which, uniting with the oil, produces a kind of soap, and readily mingling with the water, forms the white appearance observed, and is commonly disgusting to patients, and unpleasant to the stomach; whereas this suits every palate, and removes that tickling in the throat so very distressing to patients.
Take of milk of almonds, 1 ounce; syrup of tolu, 2 drachms; rose-water, 2 drachms; tincture of squills, 16 drops. Make into a draught. Four to be taken during the day. This is an admirable remedy in colds, and also in chronic cough, as well as in asthma.
Thrush or aphthae in the mouth, will be greatly benefited by the frequent use of the following gargle: Mix together 20 drops of muriatic acid (spirits of salts); 1 ounce of honey of rose; and 4 ounces of decoction of barley.
Another. - Make a gargle of 2 drachms of borax; 1 ounce of honey of roses, and 7 ounces of rosewater. To be used three or four times a day.
Take of decoction of bark, 7 ounces; tincture of myrrh, 2 drachms; purified nitre, 3 drachms. Make into a gargle. This is a sovereign method to disperse a tumefied gland, or common sore throat. By taking upon such occasions a small lump of purified nitre, putting it into the mouth, and letting it dissolve there, then removing it, and applying it again in a few seconds, and swallowing the saliva, I have, says Dr. Thornton, for many years prevented a sore throat from forming.
Take of decoction of bark, 6 ounces; diluted muriatic acid, 1 drachm; honey of roses, 1 ounce. Make into a gargle. To be used, mixed with port wine, frequently during the day.
Take of nitre, 2 drachms; honey, 4 drachms; rosewater, 6 ounces. Mix. To be used frequently.
Another. - Dissolve 2 teaspoonsful of alum in 1 pint of sage tea.
Another. - Take of muriatic acid, 20 drops; glycerine, 1 ounce; water, 3 ounces. Mix.
The chlorate of potassa, in cases of putrid ulcerated sore throat, has been used with the most decisive success. Its internal exhibition more effectually allays thirst and abates fever than any other medicine; and, when applied as a gargle to inflamed or ulcerated sore throats, it has been found to disperse the inflammation and to deterge the ulcers more effectually than the infusion of rose-leaves with the sulphuric acid, the gargle generally resorted to in those cases. The chlorate of potassa may be given in the dose of from 20 to 30 grains in a half glass of water, three or four times a day. For the purpose of gargling the throat, 4 drachms of the chlorate may be added to half a pint of water.
The root of male fern has long been esteemed a powerful remedy for worms; and its powder has been sold under a fictitious name as an infallible specific for the broad or tape-worm. Sometimes it has been ordered to be taken without any mixture; at other times gamboge, scammony, mercury, and other purgative medicines have been ordered to be taken with it.
In the year 1755 the king of France purchased, for a large sum of money, the recipe of a medicine which was said to be an effectual cure for the tape-worm, from the widow of a surgeon in Switzerland, whose husband used to administer it. On discovery it proved to be fern-root reduced to powder, which is to be taken in the following manner: The day before the patient is to begin to take the fern he is to take a dose of some opening medicine, and after its operation to make a very light supper. Next morning he is to take 3 drachms of the powder of the fern-root, in a cup of lime-flower water, and after it a little orange-peel, or some other grateful aromatic, and, if he vomits it up, to take soon after another full dose of the powder of the fern-root. Two hours after this is swallowed the following purging powders are to be taken, viz., 12 grains of resin of scammony, mixed with as much of the panacea mercurialis (calomel digested in spirit of wine), and 5 grains of gamboge, in powder, the dose being made stronger or weaker, according to the strength of the patient. Soon after taking this dose, the patient is to drink tea, and as soon as the physic begins to operate, if he perceives that the taenia is coming away, he is to remain on the close-stool till it has entirely passed. If the purgative should prove too weak, the patient is to take a dose of Epsom salts, and to drink freely of broth. If the first dose of the fern powder and of the purging medicine has not the desired effect, the powder and purge are to be repeated next day; and if at anytime the taenia is observed to be coming away, the greatest care must be taken not to break it.
Worm-seed is one of the oldest and most common anthelmintics, especially in the lumbrici of children. On account of its essential oil, it is heating and stimulating. It is given to children to the extent of ten grains or half a drachm finely powdered, and strewed on bread and butter; or made into an electuary with honey or treacle; or candied with sugar; or diffused through milk and taken in the morning when the stomach is empty. After it has been used for some days, it is customary to give a cathartic; or it is combined from the beginning with rhubarb, jalap, or calomel.
Take of socotrine aloes, 2 drachms; new milk 8 ounces. Rub them together for a clyster. This is useful to destroy the ascarides, or little seatworm. Still more effectual are suppositories containing each 3 grains of santorin, in a sufficient amount of cacao butter.
In a teaspoonful of honey, or currant jelly, mix a drachm of powder of tin, and take it twice a day for six successive mornings and evenings, making altogether 12 drachms, or 1 1/2 ounces of the tin. A little rhubarb, or any mild aperient medicine, may be taken each alternate night of the six. This is the quantity for an adult person, but would not prove too much for a child, we apprehend, as the tin does not act upon the bowels, but upon the worm itself.
Dr. Gibney, of Cheltenham, observes that the oil of turpentine is almost a specific in every species of worms, and its failure, in the practice of many physicians, he attributes to the improper exhibition of it. When the dose is not sufficiently large, it affects the kidneys and skin, and produces no effect on the worm or intestinal canal. He prescribes 1 or 2 drachms, at intervals, for children of three years of age, and 6 drachms for older children, and more for adults. He directs it to be taken when the stomach is most empty, and enjoins strict abstinence during its use. Begin with a good dose early in the morning, and repeat it every hour for three or four hours, as circumstances may indicate. Combine with it mucilage of gum arabic, simple cinnamon water, and syrup. And, in case it should not operate on the bowels as an aperient, take a dose of castor oil. This treatment is renewed about every four or five days, for some time after the evacuation of worms, or until the faeces become healthy.
An Italian physician, of great eminence, has found the "essentia de cedra" (essence of bergamot), in the dose of one or two drachms, mixed with honey, more efficacious in destroying the tape, and also the long round worm, than the oil of turpentine or naphtha.
Beat up 5 1/2 drachms of rectified oil of turpentine with the yolk of an egg and some sugar and water, or common syrup. Give this to a child having tape-worms. Two doses are sure of expelling them. Pumpkin seeds, made into an electuary with honey or molasses, and taken rather copiously on an empty stomach, will generally kill and remove tape-worm.
Take of pink-root and senna each 1/2 an ounce, and infuse two hours in hot water. Take one or two glasses each morning on an empty stomach.
Take gentian root and dried lemon-peel, fresh, of each 1 ounce, 2 drachms of long pepper and 2 pints of light wine; infuse without heat for a week and strain out the wine for use. In complaints of the stomach arising from weakness or indigestion, a glass of this wine may be taken an hour before dinner and supper.
Take 2 ounces of filings of iron, cinnamon and mace, each 2 drachms, and 2 pints of Rhenish wine. Infuse for three or four weeks, frequently shaking the bottle; then pass the wine through a filter. This wine is a remedy for obstruction of the menses. The dose is half a wine glass taken twice or thrice a day. Lisbon wine, if sharpened with half an ounce of cream of tartar, is also beneficial.
Take of decoction of bark 6 ounces; compound tincture of bark 1 ounce; bark in powder 1 drachm; calcined magnesia 1 drachm. Form a mixture. Two tablespoonsful are to be given three times a day.
Take of chamomile flowers, lemon-peel, orange-peel, each 4 drachms; boiling water 1 pint. Let them remain for four hours, and strain. To the strained liquor add syrup of ginger 6 drachms. The dose is a wineglassful in the morning early and repeat an hour before dinner for habits debilitated by drinking or natural weakness of the stomach.
The pills made according to the following recipe have been long prescribed as a dinner pill with success: Take of rhubarb-root powdered 1 1/2 drachms; Turkey myrrh 1 drachm; socotrine aloes 1/2 a drachm; extract of chamomile flowers 2 1/2 drachms; essential oil of chamomile cowers 16 drops. Mix well together, and divide into 80 pills. Two or three to be taken about an hour before dinner.
Take of the decoction of bark 12 drachms; tincture of bark 1 drachm; syrup of Tolu 1/2 drachm; aromatic sulphuric acid 8 drops. Make into a draught, to be taken three times a dry.
Take of calomel (or proto-chloride of mercury), precipitated sulphuret of antimony, each 1 scruple, powder of gum guaiacum 2 scruples; Spanish soap as much as will be sufficient to form into twenty pills, which are to be taken night and morning.
The following remedies for indigestion, attended with heartburn and costiveness, were prescribed by Dr. Gregory, of Edinburgh: Take of carbonate of potassa 4 drachms; simple cinnamon-water, pure water, each 6 ounces; compound tincture of gentian 3/4 of an ounce. Mix. Three large spoonsful are to be taken twice a day.
Take of compound pill of aloes, with colocynth, 2 drachms. To be divided into 24 pills, two to be taken twice a week.
Take of bay-berries 6 drachms; grains of paradise 2 scruples; socotrine aloes and filings of iron each 2 scruples; oil of turpentine 2 drachms; simple syrup sufficient to form an electuary.
Take of carbonate of soda 1 drachm; compound tincture of rhatany 1 ounce; compound tincture of ginger and chamomile 3 drachms; camphorated julep 7 ounces. Mix. Three tablespoonsful are to be taken twice a day.
Great attention is to be paid to regularity and choice of diet. Intemperance of every kind is hurtful, but nothing is more productive of this disease than drinking bad wine. Of eatables those which are most prejudicial are all fat and greasy meats and pastry. These ought to be avoided, or eaten with caution. The same may be said of salt meats, for which dyspeptic patients have frequently a remarkable predilection, but which are not on that account the less unsuitable.
Moderate exercise contributes in a superior degree to promote the digestion of food and prevent flatulence; those, however, who are necessarily confined to a sedentary occupation, should particularly avoid applying themselves to study or bodily labor immediately after eating. If a strong propensity to sleep should occur after dinner, it will be certainly bettor to indulge it a little, as the process of digestion frequently goes on much better during sleep than when awake.
Going to bed before the usual hour is a frequent cause of night-mare, as it either occasions the patient to sleep too long or to lie long awake in the night. Passing a whole night or part of a night without rest likewise gives birth to the disease, as it occasions the patient, on the succeeding night, to sleep too soundly. Indulging in sleep too late in the morning, is an almost certain method to bring on the paroxysm, and the more frequently it returns, the greater strength it acquires; the propensity to sleep at this time is almost irresistible. Those who are habitually subject to attacks of the night-mare ought never to sleep alone, but should have some person near them, so as to be immediately awakened by their groans and struggles, and the person to whom this office may be entrusted should be instructed to rouse the patient as early as possible, that the paroxysm may not have time to gain strength.
Take of soft extract of quassia, 1 drachm; essential oil of peppermint, 1 drop. Make into 12 pills, of which take 3 an hour before dinner. These pills are excellent to create digestion in habits injured by hard drinking.
Eat a small crust of breed every morning, fasting, about an hour before breakfast.
Take of shavings of quassia, 2 drachms; boiling water, 1 pint. Let this remain in a close vessel until cold, then strain off, and add to the strained liquor, compound tincture of cardamoms, 2 ounces; spirit of lavender, 4 drachms; powder of rhubarb, 1 scruple. Take three tablespoonfuls an hour before dinner to create an appetite.
Take of socotrine aloes, in powder, assafoetida, soap, equal parts. Form them into a mass with mucilage of gum arabic. These pills, in doses of about 10 grains twice a day, produce the most salutary effects in cases of dyspepsia, attended with hysteria, flatulence, and costiveness.
This complaint is an uneasy sensation in the stomach, with anxiety, a heat more or less violent, and sometimes attended with oppression, faintness, an inclination to vomit, or a plentiful discharge of clear lymph, like saliva.
This pain may arise from various causes: such as wind, sharp humors, and worms gnawing the coats of the stomach; also from acrid and pungent food; likewise from rheumatic and gouty humors, or surfeits, and from too free a use of tea.
The diet should be of a light animal kind; the drink brandy and water, toast and water, Bristol water; no vegetables should be allowed; very little bread, and that well toasted.
If heartburn has arisen from acidity in the stomach, it will be necessary to take two tablespoonfuls of the following mixture three times a day:- 3 drachms of magnesia, 1 scruple of rhubarb, in powder, 1 ounce of cinnamon water, 1/2 a drachm of spirits of lavender, and 4 ounces of distilled water.
Mix together 12 grains of prepared chalk, 1/2 an ounce of peppermint water, 1 ounce of pure water, 2 drachms of spirits of pimento, and 12 drops of tincture of opium. This draught is to be taken three times a day.
Another. - Mix together 10 grains of bicarbonate of soda, 1 fluidrachm of compound tincture of cardamom, 20 drops of paregoric, and a tablespoonful of water. Take this occasionally.
In this case, gentle laxatives, combined with carminatives, are to be administered, until the cause is entirely removed. Take of confection of senna, 2 ounces; jalap, in powder, 2 drachms: compound powder of cinnamon, 20 grains; cream of tartar, 1 drachm, and syrup of ginger as much as will form an electuary; of which the bulk of a walnut is to be taken every night on going to bed.
Take of the soft extract of bark 15 grains; purified alum, in powder, 5 grains; tincture of opium, 6 drops. Make into a bolus, to be taken three times a day, in half a glass of red wine.
Take of tincture of opium, 15 drops; chalk mixture, 6 ounces; cinnamon water, 1 ounce. Make into a mixture, of which take a large tablespoonful every six hours.
Another. - Take of powder of rhubarb, 10 grains; powder of chalk, with opium, 1 scruple; powder of chalk without opium, 1 drachm. Make into four papers, of which take one night and morning.
Another. - Take of tincture of opium, 20 drops; chalk mixture, 4 1/2 ounces; tincture of cinnamon, 1/2 ounce; cinnamon water, 2 ounces. Make a mixture, of which take two tablespoonsful after every liquid motion. Given in diarrhoea, and the looseness often attendant upon consumption.
Take of tannin, 1 drachm; opium, 10 grains. Divide into 20 pills, one to be taken three or four times a day. This is excellent in obstinate diarrhoea, first evacuating with rhubarb and columbo, equal parts, 3 grains every four hours.
Take of tincture of opium, 1/2 drachm; decoction of barley, 8 ounces. Make a clyster, to be thrown up directly, to stop diarrhoea and remove spasm.
Take of milk of assafoetida, 8 ounces; tincture of opium, 1/2 drachm. To be injected as a clyster at bed-time. This is useful in disorders of the anus, which induce insufferable pain.
Take of galls, in powder, 2 drachms; hogs' lard, an ounce. Make into an ointment, to be applied by means of lint to the external piles, or even pressed somewhat up the fundament every night. This has done wonders in the piles, taking, at the same time, the following: Take of quassia, in raspings, 2 drachms; boiling water, 1 pint. Let it remain three hours, strain; to 7 ounces of the strained liquor, add aromatic confection, 1 drachm; ginger, in powder, 2 scruples. Take of this mixture, two tablespoonsful at twelve and seven every day.
Take of quaiacum (gum resin) in powder, soap, equal parts, 1 drachm; essential oil of juniper berry, 4 drops. Make into 28 pills; take two four times a day. This is an admirable remedy.
In America, an ointment of stramonium, made by gently boiling 6 ounces of the recent leaves (bruised) in a pound and a half of fresh hog's lard, till they become crisp, is in high repute as a remedy for this disease. The size of a nutmeg, Dr. Turner of Philadelphia, has found to remove rheumatic pains, after electricity and powerful liniments, with internal remedies, had totally failed, and Dr. Zollickoffer says, that he has known the stramonium ointment to succeed in cases of rheumatism after the internal exhibition of the tincture of stramonium had failed. For internal use he prefers a tincture of the leaves (made in the proportion of an ounce and a half of the dried leaves to a pint of proof spirit) to the extract.
At a meeting of the Medical Society of London, oil of turpentine was strongly recommended, as being almost a panacea for acute rheumatism, etc. The formula in which it was administered is as follows: - Oil of turpentine, 20 drops; decoction of bark, 1 1/2 ounces. To be taken every four hours. The use of the lancet and purgatives were generally premised. No sensible operation ensued from the medicine; but the patients were quickly relieved of the complaint.
M. Double has administered the sulphate of quinia in several cases of acute pains in the face, approaching to tic doloureux, with complete success. He advises it to be given in the dose of 6 grains, dissolved in camphorated jalap, three times a day. This dose, however, is large.
Not only rheumatism, but the cramp and gout, which bear affinity to each other, have long been greatly relieved by friction, wherever it was bearable, but some cures were performed upon patients slightly attacked, by pertinaciously rubbing the parts day after day; to this method of obtaining relief, Dr. Balfour has recently added those of compression and percussion, with complete success. Percussion at the sole of the foot relieves pain there and higher up the limb, and compression affords a certain degree of ease. Compression alone upon the tendon of the heel (grasping by the warm hand between the finger and thumb), is sure to afford relief, as long as the pressure is continued, at least so far as the knee. A bandage round the thigh gives instant relief to that part of the member; grasping, or repeated pinchings, leave the patient in comparative ease. Percussion, by the patient himself, with his crutch, upon the spot most affected, is very beneficial. Dr. Balfour "pummels" the same part daily, until the cure is effected.
Tremor, caused by lifting up the limb, is always to be checked by passing a bandage round the ankle; and the reason assigned for this whole series of remedies is the excitement of certain nerves to action, or arresting that of others. This practice is by no means a novelty; it has long been employed by the negroes upon their European masters, by whom it is termed "shampooing."
Wine of colchicum root, 15 drops; carbonate of potassa, 15 grains, in a tablespoonful of water, thrice daily.
Another. - Take of rhubarb, powdered, guaiac gum, nitrate of potass, flowers of sulphur, each, 1 ounce; treacle, 1 pound. Mix well together. From one to two teaspoonsful (according to its aperient effects) to be taken every night, with a little warm gin and water.
Gum guaiacum, 2 drachms; rhubarb, pulverized, 1/2 drachm; flowers of sulphur, 1/2 ounce; cream of tartar, 2 drachms; nutmeg, or ginger powder, 1/2 drachm. Made an electuary with treacle, and two teaspoonsful taken night and morning.
This disease, sometimes confounded with cholera morbus, is an epidemic; that is, it occurs at certain times, and moves from place to place; some parts of the world never having been visited by it. It prevails especially in cities; and follows the routes of travel, from India, where it is an annual scourge, westward across the globe, once in a number of years. It is not contagious from person to person, but is always propagated by human or other animal filth, in the air or water. An absolutely clean and pure locality will always be free from cholera.
After watery diarrhoea, generally, of a few hours' duration, vomiting begins, of a clear colorless fluid, which, as well as the copious passages from the bowels, resembles rice-water. There is, also, coldness of the skin, which gradually increases; with cramps, thirst, great feebleness of the pulse, and general prostration, deepening into collapse. In this last condition the patient is blue all over, with the skin shrunken, and the pulse at the wrist imperceptible; sometimes the breath is cold. Few recover from this state.
Medical men vary infinitely in their mode of management of this disease, as no specific remedy for it has been discovered. Considerable experience with it, in 1849, 1860, and 1854, enables the writer of this article to express a confident opinion in favor of the following mode of practice; by which, although it cannot be claimed to be infallible, he believes that he has saved a number of lives.
Apply a large mustard-plaster over the abdomen, and another on the back. Rub the limbs well with brandy mixed with Cayenne pepper. If the cramps continue, substitute for the mustard-plaster over the abdomen, a poultice of hops steeped in hot water. Let the patient have, very frequently, small pieces of ice to dissolve in the mouth, and, every five minutes, a dose of the following anodyne and cordial tincture:-
Take of aromatic spirits of ammonia, laudanum, chloroform, and spirits of camphor, each, 1 1/2 drs.; creasote, 8 drops: oil of cinnamon, 2 drops; alcohol, enough to make 1 oz. of the tincture.
Put 1 teaspoonful of this into a wineglassful of icewater, and give 1 teaspoonful of the solution every five minutes until the patient decidedly improves, then lengthen the intervals by degrees till the symptoms all abate.
It is important to know that epidemic cholera is not a disease of the bowels or stomach particularly, but of the whole system. In this it differs from common cholera morbus. When an epidemic of cholera is prevailing, it is not well to live on a thin or weak diet, of rice, etc., as this will not promote immunity from the disease. Neither is it prudent to indulge at such a time in spirituous or other stimulants, as intemperance increases the danger. The true plan is, to live regularly, according to one's usual habits and needs, so as to keep the system steadily up to par in every way, without excess or reduction.
Another important fact is, that the diarrhoea, which commonly, though not invariably, precedes an attack of cholera, may be checked often by very mild means. During a cholera epidemic no one should neglect even a slight looseness of the bowels. Paregoric, in doses varying from 20 drops to 1 dr., at intervals, according to the case, will usually be suitable; or the following mixture, used much in Turkey, will be found servicable: tincture of opii, camphor, and rhubarb, each 2 fluid drs. Dose, 18 to 20 drops every two hours in a little sugar-water. But medical advice should be early obtained.
Dr. Van Marum has discovered a very simple method, proved by repeated experiments, of preserving the air pure in large halls, theatres, hospitals, etc. The apparatus for this purpose is nothing but a common lamp, made according to Argand's construction, suspended from the roof of the hall and kept burning under a funnel, the tube of which rises above the roof without, and is furnished with a ventilator. For his first experiment he filled his large laboratory with the smoke of oak shavings. In a few minutes after he lighted his lamp, the whole smoke disappeared, and the air was perfectly purified.
Ships' holds are well ventilated when there is wind, by means of a sail, rigged out from the deck to below, like a funnel, whose largest orifice points to leeward. But in some situations, as prisons, where foul air stagnates, this method cannot be adopted. Therefore, the plan has been adopted of making two holes in the side of the building or ship, communicating with the open air by a tin tube. Two pair of bellows are fitted up, the nozzle of one being introduced airtight into one of the tin tubes, and a leathern pipe nailed on the wall, over the other tube, to which it may be fastened by wax thread. The other end of this pipe is to be made fast to the clicker-hole of the second pair of bellows; a luting of plaster of Paris rendering both ends air-tight. A common blacksmith's forge-bellows will thus empty a space containing thirty hogsheads of foul air, and supply its place with good fresh air in a very few minutes.
Air-pipes are used for drawing foul air out of ships, or other close places, by means of fire. One extremity is placed in a hole in the side of a furnace (closed in every part excepting the outlet for the smoke); the other in the place which it is designed to purify. The rarefaction produced by the fire, causes a current of air to be determined to it, and the only means by which the air can arrive at the fire being through the pipe, a quick circulation in the place where the extremity of the pipe may be situated, is consequently produced.
This apparatus was contrived by Dr. Hales, to prevent the stagnation of putrid effluvia in jails and other places, where a great number of people are crowded together. It consists merely of an oblong trunk open at both ends, one of which is inserted into the ceiling of the room, the air of which is to be kept pure: and the other extends a good way beyond the roof. Through this trunk a continued circulation is carried on; and the reason why vapors of this kind ascend more swiftly through a long trunk than a short one is, that the pressure of fluids is always according to their different depths, without regard to the diameter of their basis, or of the vessel that contains them. When the column of putrid effluvia is long and narrow, the difference between the column of atmosphere pressing on the upper end of the trunk, and that which presses on the lower end, is much greater than if the column of putrid effluvia was short and wide, and consequently the ascent is much swifter. One pan of a single pair of scales, which was two inches in diameter, being held within one of these trunks over the House of Commons, the force of the ascending air made it rise so as to require four grains to restore the equilibrium, and this when there was no person in the house; but when it was full, no less than twelve grains were requisite to restore the equilibrium; which clearly shows that these trunks must be of real and very great efficacy.
In the hot days of summer, especially in houses exposed to the meridian sun, a capacious vessel filled with cold water is placed in the middle of a room, and a few green branches (or as many as it will hold) of lime, birch, or willow tree, are plunged with the lower ends into the fluid. By this easy expedient the apartment is, in a short time, rendered much cooler; the evaporation of the water producing this desirable effect in sultry weather without any detriment to health. Besides, the exhalation of green plants, under the influence of the solar rays, greatly tends to purify the air; but care must be taken that they do not remain in the apartment after night-fall, or in the shade.
To one tablespoonful of common salt, and a little peroxide of manganese, in a glass cup, add four or five different times, a quarter of a wine-glass of strong sulphuric acid. Place the cup on the floor and go out, taking care to shut the door. The vapor will come in contact with the malignant miasma and destroy it. Prepared chloride of lime will do as well.
Never venture into a sick room in a violent perspiration (if circumstances require a continuance there for any time), for the moment the body becomes cold it is in a state likely to absorb the infection and receive the disease. Nor visit a sick person (especially if the complaint be of a contagious nature) with an empty stomach, as this disposes the system more readily to receive the infection. In attending a sick person, stand where the air passes from the door or window to the bed of the diseased, not betwixt the diseased person and any fire that is in the room, as the heat of the fire will draw the infectious vapor in that direction, and danger would occasionally arise from breathing in it.
Take of cascarilla reduced to a course powder, chamomile flowers, aniseed, each equal parts, two ounces. Put some hot cinders in a shovel, sprinkle this gradually on it, and fumigate the chambers of the sick. It takes away all smell, and keeps off infection.
Make a strong solution either of nitrate or acetate of lead; and sprinkle with it the floor and walls of a foul apartment. The first of the above is Ledoyen's liquid.
Put 4 ounces of acetate of lead, in powder, into a tubulated glass retort, and pour over it 4 ounces of sulphuric acid. Place the retort in a sand-bath, the heat of which should be kept as uniform as possible. Adapt a common receiver, over which there must be constantly kept a piece of wet flannel or cotton for the condensation of the gas as it comes over. Sometimes sulphuric acid gas will be found to adulterate the acetic acid; this is easily known by the suffocating odor which it emits. The best way to prevent this is by a slow distillation; or the whole may be distilled a second time. The acetic acid possesses a very pungent odor, owing to its volatility; consequently it should be kept in a well stopped phial. It is used as the basis of all the aromatic vinegars.
Acetic acid may be mixed with camphor and aromatics, as in Henry's Aromatic Vinegar, in a quantity sufficient for a small smelling bottle, at no great expense. But it is the acetic acid which is useful in preventing infection, and not the aromatics which are added for the pleasure of the perfume.
Take of common vinegar any quantity; mix powdered chalk or common whiting with it, as long as bubbles of carbonic acid gas arise. Let the white matter subside, and pour off the insipid supernatant liquor; afterwards let the white powder be dried either in the open air or by a fire. When dry pour upon it, in a glass or stone vessel, sulphuric acid as long as white acid fumes continue to ascend. This product is similar to the acetic acid known in the shops by the name of Aromatic Vinegar. The simplicity of this process points it out as a very useful and convenient one for purifying prisons, hospital ships, and houses where contagion is presumed or suspected, the white acid fumes diffusing themselves quickly around.
Wherever a number of people are assembled either in health or sickness, the walls become insensibly impregnated with infectious exhalations. Currents of air, when admitted, sweep and cleanse the atmosphere, but do not carry away the miasmata concealed in the porosity of the walls, which retain the infectious humidity of the perspiration of bodies, gradually condensing on their surface. Quick-lime may be substituted to destroy such mephitism of walls, and also to prevent the evil. The most infected tans and sieves lose their smell when mixed with the whiting or size of lime. Lime enters whitewashing, and may become the principal substance of it, by substituting it for Spanish white. When made the principal ingredient of whitewashing, it will prevent walls from being impregnated with infectious miasmata. The addition of milk and oil are requisite, for lime has no adhesion on walls, nor can a body or substance be given to the later. The slightest rubbing with a pencil brush will rub it off, and leave the wall naked. The cheesy part of the milk, with the addition of oil, which makes a soapy body with lime, form, after the evaporation of the humidity, a dense coherent layer, or sort of varnished plaster, which overcomes the porosity of stone, plaster, brick, and wood. This wash has another advantage, that of checking the nitrification of walls, which the painting of them in water colors has a tendency to accelerate.
Chloride of lime (bleaching powder) will effect this. So will chloride of zinc, or sulphate of iron. The first is the most convenient, although the last is also used, with fifteen times its weight of water.
In 100 parts, use of carbolic acid 5 to 8 per cent.; lime from magnesia limestone, 5 per cent.; fuller's earth, 70 to 80 per cent., with a little sulphate of potash and sulphate of soda.
A common method of disinfecting letters, and other articles coming from places that are supposed to be visited by the plague, is to expose them to the fumes of burning sulphur, mixed with saltpetre. A high temperature, short of combustion, will answer the same purpose.
The following medical cautions were recommended by the physicians and surgeons of the Bath Hospital, to those who have received benefit by the use of the Bath waters, in cases where the poison of lead is concerned, as plumbers, glaziers, painters, and other artificers, who work in trades which expose them to similar hazards from the same cause; to be observed by them at their return to the exercise of their former occupation.
1. To maintain the strictest temperance, particularly respecting distilled spirits, which had better be altogether forborne.
2. To pity the strictest attention to cleanliness; and never suffer paint to remain upon their hands, and particularly never to eat their meals, or go to rest, without washing their hands and face with soap, perfectly clean.
3. Not to eat or drink in the room or place wherein they work; and much less to suffer any food or drink to remain unused, even for the shortest space of time, in any part of a room while painting, or where color stands; and not to work on an empty stomach.
4. As the clothes of persons in this line (painters, particularly) are generally much soiled with color, it is reccomended for them to perform their work in frocks of ticking, which may be frequently washed, and conveniently laid aside when the workmen go to their meals, and again put on when they resume their work.
5. Every business which can, in these branches, should be performed with gloves on their hands. Painters, in performing clean light work, would find gloves an inconvenience; but to avoid the evil here mentioned, the handle of the brush should be often scraped. Woollen or worsted gloves are recommended, as they may and should be often washed, after being soiled with the paint, or even with much rubbing against the metal.
6. Caution is necessary, in mixing, or even in unpacking, the dry colors, that the fine powder do not get into their mouths, or be drawn in by the breath. A crape covering over the face might be of service, but care should be taken to turn always the same side of the crepe towards the face, and to clean or wash it frequently.
7. All artificers should avoid touching lead when hot, and this caution is especially necessary for printers or compositors, who have often lost the use of their limbs by handling the types when drying by the fire, after being washed.
8. Glaziers' putty should never be made or moulded by the hand. An iron pestle and mortar would work the ingredients together, at least equally as well, and without hazard. It is necessary in working putty to handle it, nor is it usually pernicious. Cleanliness is therefore the best recommendation,
9. If any persons, in any of the above employments, should feel pain in the bowels, with costiveness, they should immediately take 20 drops of laudanum, and when the pain is abated 2 tablespoonsful of castor oil, or 1/2 an ounce of Epsom salts, dissolved in warm chamomile tea. If this does not succeed, a pint or two pints of warm soapsuds should be thrown up as a clyster.
10. As a preventive, ten or fifteen drops of aromatic sulphuric acid (elixir of vitriol), is likely to be of service, if taken daily.
This complaint, called also the hysteric passion, appears under various shapes, and is often owing to a lax, tender habit, obstruction of the menses, fluor albus, etc.
In the fit the patient is seized with an oppression in the breast, and difficult respiration, accompanied with a sensation of something like a ball ascending into the throat, which puts her under great apprehensions of being suffocated. There is a loss of speech, and generally violent convulsive motions. These, with a train of hypochondriac symptoms, are sufficient to determine the disease. to which may be added frequent laughing and crying, and various wild, irregular actions: after which a general soreness all over the body is felt, the spirits are low, the feet are cold. The urine is clear and limpid, and discharged in great quantity. The hysteric fit may be easily distinguished from fainting; for in this the pulse and respiration are entirely stopped; in that they are both perceivable.
Nothing recovers a person sooner out of the hysteric fit than putting the feet and legs in warm water.
When low spirits proceed from a suppression of the piles or the menses, these evacuations must be encouraged, or repeated cuppings substituted. When they take their origin from long-continued grief, anxious thoughts, or other distresses of mind, nothing has done more service, in these cases, than agreeable company, daily exercise, and especially long journeys, and a variety of amusements.
Regimen. - A light animal food, red wine, cheerful company, and a good clear air, with moderate exercise, are of great importance in this disorder. Drinking tea, and such like tepid relaxing fluids, should be but moderately indulged in.
The cure consists in whatever tends to strengthen the solids, and the whole habit in general; and nothing will effect this more successfully than a long-continued use of the mineral chalybeate waters, and riding on horseback. Assafoetida pills, 3 grains each, are often temporarily useful.
Take of proof spirit, 1 pint; sal ammoniac, 2 ounces; assafoetida, 6 drachms; potash, 3 ounces. Mix them, and draw off, by distillation, 1 pint, with a slow fire.
The spirit is pale when newly distilled, but acquires a considerable tinge by keeping. The dose is a teaspoonful, in some water, during hysterics, and the same to be taken occasionally.
Take of compound pills of galbanum, 2 drachms; rust of iron, 4 scruples; syrup of ginger, as much as is sufficient. Form a mass, which is to be made into 40 pills, of which take 4 at noon and at seven in the evening every day, drinking after them half a glass of port wine. These pills are good in hysteric affections.
This is made by adding to the ingredients of the common clyster 2 drachms of the tincture of assafoetida.
In cases of hysterics and convulsions, the foetid enema is of singular use.
Mix together cinnamon water, 1 ounce; spirit of caraways, 1/2 an ounce; sulphuric ether, 1/2 a drachm; tincture of castor, 1/2 a drachm. Let this draught be taken every six hours, if the stomach should be affected by cramp. If the feet are cold, bottles filled with warm water should be applied to them.
Take of soft extract of bark, 2 drachms; columbo and rust of iron, each 1 drachm; simple syrup, as much as is sufficient. Make into fifty pills; take two, and gradually increase to five, three times a day.
Take of galbanum, myrrh, sagapenum, each 1 ounce; assafoetida, 1/2 an ounce; syrup of saffron, as much as is sufficient. Beat them together. These pills are excellent as anti-hysterics and emmenagogues: from five grains to half a scruple may be taken every night, or oftener.
Take of spirit of lavender, 3 pounds; spirit of rosemary, 1 pound; cinnamon, 1/2 an ounce; nutmeg, the same; red sanders, 3 drachms. Digest for ten days and then strain off. This is often taken upon sugar, and is a salutary cordial, far preferable to drams, which are too often had recourse to by persons feeling a great sinking or depression of the spirits.
Add to the infusion of senna, before it is strained, an ounce of tamarinds, then strain. This forms a mild and useful purge, excellently suited for delicate stomachs and inflammatory diseases. The taste of the senna is well covered by the aromatic sugar, and by the acidity of the tamarinds. An ounce is a convenient purge.
Take of manna, 2 ounces; tamarinds, 1 ounce; rosewater, 1 ounce. Boil the rose-water and tamarinds together for a quarter of an hour, then add the manna. Three tablespoonfuls to be taken every three hours, until a motion is obtained. Less is to be given to a child.
The fluor albus is a flux of thin matter, of a pellucid or white color; sometimes it is greenish or yellow, sharp and corroding, often foul and foetid, especially if it be of any long standing.
Tedious labors, frequent miscarriages, immoderate flowings of the menses, profuse evacuations, poor diet, an inactive and sedentary life, are the causes which generally produce this disease.
Regimen, etc. - The diet should be nourishing: milk, jellies, sago, broths and light meats, red port wine in moderation, chalybeate waters, moderate exercise, and frequent ablution of the parts should be recommended. A standing posture of body long continued, violent dancing, or much walking, must be forbidden
To restore tone to the parts, it will be necessary three or four times a day to inject a portion of the following mixture by means of a syringe:
Rub together in a mortar white vitriol, 1 drachm; sugar of lead, 10 grains; water, 2 drachms. Mix the whole with a pint of distilled water.
Another. - Mix together 1 drachm of powdered alum with 1 pint of decoction of oak-bark. Inject as above.
Take of gum kino, and extract of Peruvian bark, each, 1 drachm; grated nutmeg, 1 scruple; powdered alum, 1/2 drachm; syrup, in sufficiency to form a mass, which is to be divided into 36 pills. Three of these are to be taken at eleven, forenoon, and five in the afternoon, being taken two hours before dinner, three hours afterwards washed down by a glassful of good port wine. Recourse may, at the same time, be had to tincture of Peruvian bark, to preparations of steel, and mineral waters.
Prevention. - Females afflicted with this disorder should by no means indulge in the too free use of tea, or other warm slops of a relaxing nature. They should sleep on a mattress, rise early, and take such exercise as may be convenient, and, if possible, on horseback. Cold bathing should also be used as often as convenient. In winter a flannel shift ought to be worn.
When the menses continue too long, or come on too frequently for the strength of the patient, they are said to be immoderate, and are generally occasioned by weak vessels, thin blood, or a plethoric habit. This often happens in delicate women, who use enervating liquids too freely, especially tea. It also arises in consequence of abortion, and sometimes attends women who are obliged to work hard
Where the haemorrhage is excessive, opiates are of great use. Tincture of the chloride of iron may be given, 20 drops three times daily in water.
Astringent fomentations may often be very properly prescribed. Cloths dipped in decoction of oak or Peruvian bark, with the addition of a small quantity of brandy, or red wine and vinegar, will answer the purpose extremely well.
Where the haemorrhage is profuse, and resists the usual means now recommended, it will be necessary to throw up the following astringent injection into the uterus from time to time. Take of decoction of bark, 1 pint; alum, in powder, 3 drachms. Mix, and use as an injection, three times if necessary.
Regimen, etc. - To confirm the cure, and prevent a relapse, the body should be strengthened by proper exercise, mineral waters, a light but nourishing diet; such as light broths, red port wine in moderation, and an easy cheerful mind.
When an immoderate flux of the menses, or floodings after abortion, is either attended with or preceded by acute pain, not inflammatory, in the lower part of the back or belly, and returns with greater violence, as the discharge comes on, opium will, in such a case, answer better than astringents, and may be given in clysters, composed of water or 3 ounces of infusion of roses, with 1/2 a drachm of laudanum.
This disease is commonly attended with listlessness to motion, a heaviness, paleness of complexion, and pain in the back and loins, also haemorrhages at the nose, pains in the head, with a great sense of weight across the eyes, loathing of food, a quick and weak pulse, fluor albus, hectic heats, coughs, and hysteric fits.
There is often indigestion and costiveness, with a preternatural appetite for chalk, lime and other absorbents.
Regime, etc. - The diet ought to be nutritive and generous, with a moderate use of wine. Exercise ought also to be daily used, and particularly on horseback. The mind should likewise be kept amused by associating with agreeable company.
Mix together extract of bark and sulphate of iron (green vitriol),each 1 scruple; sub-carbonate of soda 15 grains; powdered myrrh 30 grains. Add syrup of ginger to form the whole into a mass, which divide into thirty-four pills. After the stomach has been cleansed by a gentle emetic, two of these are taken two or three times a day, taking care to wash them down with nearly a wineglassful of the following
Mix together compound tincture of Peruvian bark and compound tincture of cardamoms, each 1 ounce; compound infusion of gentian 1 pint.
Pour fifteen drops of tincture of muriate of iron into a glassful of cold water, or a decoction of Peruvian bark. Drink this twice or thrice a day, an hour before or two hours after eating,
In many cases of green sickness, attended with symptoms of approaching consumption, and also in incipient phthisis, the saturated tincture of iodine may be administered with great effect.
When taken internally it is very beneficial in dispersing wen. Ten drops of the saturated tincture taken three times a day, may effectually remove the complaint in the course of five or six weeks. The Lugol's Solution of Iodine will do as well as the above for the same uses. Dose five or six drops twice daily.
The constitution undergoes a very considerable change at the critical period when menstruation ceases, and it often happens that chronic, and sometimes fatal complaints arise, if care is not taken when this natural discharge terminates. It seldom stops all at once, but gradually ceases, being irregular both as to quantity and time.
Regimen, etc. - When the disappearance is sudden in females of a plethoric habit, malt liquors, wine and animal food ought for a time to be excluded from their diet. They should likewise avoid all liquors of a spirituous nature. Regular exercise should be taken and the body constantly kept open by the tincture of senna, Epsom salts or any other mild laxative medicine.
If giddiness and occasional pain in the head affect the patient, or if there be a visible fulness in the vessels, the application of leeches to the temple will be found very beneficial, and if ulcers should break out in the legs, etc., they ought by no means to be healed up, unless a salutary drain by means of an issue be established in some other part.
Dissolve an ounce of acetate of potassa in a pint of cold water; take a wineglassful every morning and evening.
The morning sickness is one of the most painful feelings attendant on the pregnant state, and it is one of those which medicine commonly fails to relieve. A cup of chamomile or peppermint tea taken when first waking, and suffering the patient to be still for an hour, will sometimes alleviate the distressing sickness, but should it recur during the day these means seldom succeed.
Two or three teaspoonfuls of the following mixture should then be taken, either occasionally or when the vomiting and heartburn are more continual immediately after every meal: Take of calcined magnesia 1 drachm; distilled water 6 ounces; aromatic tincture of rhatany 6 drachms; water, pure ammonia, 1 drachm. Mix.
Another. - Dr. Scellier extols the following mixture as a remedy for nausea and vomiting during the period of pregnancy: Take of lettuce-water 4 ounces; gum arabic 1 scruple; syrup of white poppies, syrup of marsh-meadow root, each 2 ounces; Prussic acid 4 drops. Let an apothecary prepare the mixture. A tablespoonful is to be taken every half hour when the vomiting is present.
If the lettuce-water cannot be obtained, 8 grains of the inspissated white juice (lactuarium) dissolved in 4 ounces of water, may be substituted for it.
Another. - The saline mixture in a state of effervescence, with a pill of one or two grains of lactuarium, is by some preferred to the above composition. When the matter brought up is acid, a weak solution of the carbonate of soda may be substituted for the saline mixture.
Take of infusion of quassia, 1 ounce; cinnamon-water, 4 drachms; aromatic spirit of ammonia, 20 drops; prepared oyster-shells, 2 grains. To be taken at a draught, at twelve and seven o'clock every day.
Take of solution of ammonia, calcined magnesia, each 1 drachm; cinnamon-water 2 ounces; common water 6 ounces. The dose is a tablespoonful as often as required.
When head-ache or drowsiness proves troublesome to a pregnant woman of robust habit, a few ounces of blood should be taken from the arm. If she be of a weak or irritable habit, leeches ought to be applied to the temples. In both cases the bowels should be opened by magnesia, rhubarb, or some other gentle laxative medicine.
When hysteria or fainting occurs, the pregnant patient should be placed in a horizontal position in the open air. When she is a little recovered a glass of wine in a little cold water should be administered, or what is perhaps better, a few drops of the spirits of hartshorn in a glass of water.
To prevent these, women in a pregnant state should make frequent use of the following electuary:
Mix together in a marble mortar 2 ounces of the electuary of senna, 1/2 a drachm of powder of jalap; 2 drachms of cream of tartar, and 1/2 an ounce of syrup of roses. Half a teaspoonful to be taken every night at bedtime, or oftener, as long as the above complaints continue.
Pregnant women should be particularly careful not to use aloes as a purgative, this medicine being very apt to increase the piles. The same caution is necessary with respect to Anderson's and Scott's pills, the basis of both of which is aloes. If the piles should prove so very troublesome us to prevent the patient from sitting comfortably, leeches ought to be applied to the part; in all other cases simple ablution with cold water with the use of purgatives as above directed, will be sufficient.
Cooling laxatives are likewise proper in this place, also frequent ablution with cold or lukewarm water. If the itching does not speedily abate, a lotion is to be applied to the parts twice a day, consisting of a drachm of sugar of lead in a pint of distilled water.
Pregnant women are usually free from this complaint in the morning, but suffer a good deal from it towards night.
Prevention. - In the commencement it will be merely requisite for the patient to use a footstool, when sitting, so that her feet may never be in a hanging position for any length of time.
Remedy. - If there should be great distension so as to give the sensation of almost bursting slight scarification may be made with the edge of a lancet, and flannels, wrung out of a hot fomentation of chamomile, are soon after to be applied. A teaspoonful of cream of tartar mixed in water may be taken once or twice daily, to act on the kidneys. It is almost unnecessary to state that this complaint invariably dissapears at the period of delivery.
This complaint may be speedily relieved by rubbing the part affected with the following liniment: Mix together (by shaking in a phial) laudanum, 1/2 an ounce; tincture of camphor, 1 ounce; and sulphuric ether, 1/2 an ounce.
This is to be avoided by proper attention to diet, which should not be of a flatulent nature, or too hard of digestion. Attention is likewise to be paid to the state of the bowels.
This is very apt to occur in the latter months of gestation, accompanied sometimes with considerable soreness. It is to be relieved by frequent friction with warm oil.
The veins of the legs, thighs, and belly are apt to become enlarged in the latter stages of pregnancy. Although no bad consequences ever attend this, it will be necessary sometimes to relieve it by moderate bleeding, and by repeated small doses of infusion of senna, mixed with Epsom salts; at the same time using a spare diet. The distended vein may frequently be relieved by the application of a pretty tight bandage.
This very uncomfortable complaint is to be relieved by a frequent horizontal position, but cannot be entirely remedied except by delivery. Strict attention, however, ought to be paid to cleanliness, and much comfort will be felt by the use of a large sponge properly fastened.
In this case, cooling laxative medecines, as the infusion of senna, with Epsom salts, ought frequently to be used. If relief be not soon obtained small quantities of blood are to be taken from the patient. Opiates ought seldom to be used, as they tend sometimes to increase the febrile state of the patient.
When a female is disposed to this complaint from a plethoric habit, there will be great fullness and giddiness in the head, in the latter months of gestation; also drowsiness, with a sensation of weight in the forehead when she stoops, or bends forward, accompanied sometimes by imperfect vision, and the appearance of atoms floating before the eyes. In such a case, ten or twelve ounces of blood ought to be taken from the arm, and the bowels are afterwards to be kept open by frequent and small doses of infusion of senna, mixed with cream of tartar, until the above symptoms entirely disappear. Wine, spirituous and malt liquors, and solid or animal food are likewise to be avoided.
When convulsions have occurred, and when there is reason to believe that they are owing to irritation, rather than plethora, it will likewise be necessary to bleed the patient in a small degree both from the arm, and by the application of leeches to the temples. The bowels are also to be kept perfectly open, and a common clyster, containing from half a drachm to a drachm of laudanum, is to be administered. The warm bath is likewise exceedingly useful; at the same time, taking care to strengthen the habit as much as possible.
This fever generally arises about the third or fourth day after delivery. The symptoms are pain and distention of the breasts, shooting frequently towards the arm-pit. Sometimes the breasts become hard, hot, and inflamed. It generally continues a day or two, and ends spontaneously by copious sweats, or a large quantity of pale urine.
Remedies. - If it should prove violent, especially in young women of a plethoric constitution, we should abate the inflammation by bleeding; this, however, is rarely necessary. But, in every constitution, the body must be kept open by gentle cooling laxatives, or clysters. The breasts should be often drawn either by the child, or, if the mother does not design to give suck, by some proper person. If the breasts are hard, very turgid, or inflamed, emollient fomentations ought to be applied to them. The common poultice of bread and milk, with the addition of a little oil, may be used on this occasion; and warm milk, or a decoction of elder flowers, for a fomentation.
Regimen. - The patient should use a simple diet, consisting only of panada, or some other farinaceous substances. Her drink may be barley-water, milk and water, gruel, or the like.
When the breasts tumefy, and begin to be uneasy, a few days after delivery, from the milk stagnating, gentle diaphoretics and purgatives are to be used, and camphorated spirits of wine is to be applied, or warm cloths dipped in brandy, are to be put to the arm-pits. Should pain with inflammation come on, apply a poultice of bread, milk and oil, and an emollient fomentation, and in case suppuration cannot be prevented, it must be opened with a lancet. The ulcer is afterwards to be treated according to the common rules for disorders of that kind.
If there be only a hardness in the breast, from coagulated milk, emollient cataplasms and fomentations are to be used; likewise fresh linseed oil, by way of liniment.
Chapped or sore nipples are very frequent with those who give suck. In this case the olive oil is a very proper application; or fresh cream spread upon fine linen, or a solution of gum arabic in water. Collodion, applied with a camel's hair pencil, is the most effectual remedy.
It is almost needless to observe that, whatever applications be made use of to the nipples, they ought to be washed off before the child is permitted to suck. This is not always necessary with collodion.
Puerperal fever commonly begins with a rigor, or chilliness, on the first, second, or third day after delivery, followed by a violent pain and soreness over the belly. There is much thirst; pain in the head, chiefly in the forehead and parts about the eyebrows; a flushing in the face; anxiety; a hot, dry skin; quick and weak pulse, though sometimes it will resist the finger pretty strongly; a shortness in breathing; high-colored urine, and a suppression of the natural discharge. Sometimes a vomiting and purging attend from the first, but in general, in the beginning, the belly is costive; however, when the disease proves fatal, a diarrhoea generally supervenes, and the stools at last become involuntary.
The cause of this fever has been commonly ascribed either to a suppression of the natural discharge, an inflammation in the womb, or a retention of the milk.
Remedies. - If the belly be costive, an emollient opening clyster is to be administered; and, if stools and an abatement of the pain be not procured thereby, immediate recourse is to be had to cathartics, and bleeding from the arm. Those to be recommended are, infusion of senna, or castor oil, either in sufficient quantity.
After the intestinal canal is sufficiently cleared, a gentle diaphoresis is to be encouraged by such medicines as at the same time promote the relief of pain. This intention is best answered by small doses of ipecacuanha, tartar emetic, or antimonial wine, combined with opium in pill or laudanum, and given about four times in the course of the twenty-four hours. In the intermediate spaces of time, interpose saline draughts. It is proper to state, that when child-bed fever is epidemic, especially in cities or hospitals, it is more malignant and prostrating, and will not bear reducing treatment.
Regimen. - The patient's drink should consist of pure water with toast in it, barley~water, either by itself or with the addition of a little nitre; whey made with rennet or vinegar; milk and water; lemonade; a slight infusion of malt; and mint or sage tea.
A child, when it comes into the world, should be laid (for the first month) upon a thin mattress rather longer than itself, which the nurse may sometimes keep upon her lap, that the child may always lie straight, and only sit up as the nurse slants the mattress. To set a child quite upright before the end of the first month is hurtful. Afterwards the nurse may begin to set it up and dance it by degrees; and it must be kept as dry as possible.
The clothing should be very light, and not much longer than the child, that the legs may be got at with ease, in order to have them often rubbed in the day with a warm hand or flannel, and in particular the inside of them. Rubbing a child all over, takes off scurf, and makes the blood circulate.
Rubbing the anklebones and inside of the knees will strengthen those parts, and make the child stretch its knees and keep them out.
A nurse ought to keep a child as little in her arms as possible, lest the legs should be cramped, and the toes turned inwards. Let her always keep the child's legs loose. The oftener the posture is changed the better.
By slow degrees the infant should be accustomed to exercise, both within doors and in the open air; but he never should be moved about immediately after sucking or feeding; it will be apt to sicken him. Exercise should be given by carrying him about and gently dandling him in his mother or nurse's arms, but dancing him up and down on the knee is very fatiguing for a young child.
Tossing a child about, and exercising it in the open air in fine weather, is of the greatest service. In cities children are not to be kept in hot rooms, but to have as much air as possible. Want of exercise is the cause of rickets, large heads, weak joints, a contracted breast, and diseased lungs, besides a numerous train of other evils.
Endeavor to harden the body, but without resorting to any violent means. All attempts to render children hardy, must be made by gradual steps. Nature admits of no sudden transitions. For instance, infants should, by imperceptible degrees, be inured to the cool, and then to the cold bath; at the same time attention must be paid to their previous management. If they have hitherto been accustomed to an effeminating treatment, and should be suddenly subjected to an opposite extreme, such a change would be attended with danger. When children have once been accustomed to a hardy system of education, such a plan must be strictly adhered to.
The child's skin is to be kept perfectly clean by washing its limbs morning and evening, and likewise its neck and ears; beginning with warm water, till by degrees he will not only bear, but like to be washed with cool or cold water.
After he is a month old, if he has no cough, fever, or eruption, the bath should be colder and colder (if the season be mild), and gradually it may be used as it comes from the fountain. After carefully drying the whole body, head and limbs, another dry soft cloth, a little warmed, should be used gently to take all the damp from the wrinkles or fat parts that fold together. Then rub the limbs; but when the body is rubbed, take special care not to press upon the stomach or belly. On these parts the hand should move in a circle, because the bowels lie in that direction. If the skin is chafed, starch-powder is to be used. The utmost tenderness is necessary in drying the head, and no binding should be made close about it. Squeezing the head, or combing it roughly may cause dreadful diseases, and even the loss of reason. A small soft brush, lightly applied, is safer than a comb. Clean clothes every morning and evening will tend greatly to a child's health and comfort.
With regard to the child's dress in the day, let it be a shirt, a petticoat of fine flannel, reaching two or three inches below the child's feet, with a dimity top (commonly called a bodice-coat), to tie behind. Over this put a robe or frock or whatever may be convenient, provided it is fastened behind, and not reaching much below the child's feet, that his motions may be strictly observed.
Caps are, as a general rule, undesirable. The head should be kept cool.
The dress for the night may be a shirt, a blanket to tie on, and a thin gown to tie over the blanket.
Some people in dressing an infant seem in such haste as to toss him in a way that must fatigue and harass him. The most tender deliberation should be observed. In addition to this hurried dressing, his clothes are often so tight that he frets and roars. Pins should never be used in an infant's clothes; and every string should be so loosely tied that one might get two fingers between it and the part where it is fixed. Bandages round the head should be strictly forbidden. Many instances of idiocy, fits, and deformity, are owing to tight bandages.
Infants cannot sleep too long; and it is a favorable symptom, when they enjoy a calm and long-continued rest, of which they should by no means be deprived, as this is the greatest support granted to them by nature. A child lives comparatively much fester then an adult; its blood flows more rapidly; and every stimulus operates more powerfully. Sleep promotes a more calm and uniform circulation of the blood, and it facilitates assimilation of the nutriment received. The horizontal posture, likewise, is the most favorable to the growth and bodily development of the infant.
Sleep ought to be in proportion to the age of the infant. After an uninterrupted rest of nine months in the womb, this salutary refreshment should continue to fill up the greater part of a child's existance. A continued wakefulness of twenty-four hours would prove destructive. After the age of six months, the periods of sleep, as well as all other animal functions, may in some degree be regulated; yet, even then, a child should be suffered to sleep the whole night, and several hours both in the morning and afternoon. Mothers and nurses should endeavor to accustom infants from the time of their birth, to sleep in the night preferably to the day, and for this purpose they ought to remove all external impressions which may disturb their rest, such as noise, light, etc., but especially they should not obey every call for taking them up and giving food at improper times. After the second year of their age, they will not instinctively require to sleep in the forenoon, though after dinner it may be continued till the third and fourth year, if the child shows a particular inclination to repose; because till that age, the full half of its time may safely be allotted to sleep. From that period, however, it ought to he shortened for the space of one hour with every succeeding year; so that a child seven years old may sleep about eight, and not exceeding nine hours; this proportion may be continued to the age of adolescence, and even manhood.
To awaken children from their sleep with a noise, or in an impetuous manner, is extremely injudicious and hurtful, nor is it proper to carry them from a dark room immediately into a glaring light, against a dazzling wall; for the sudden impression of light debilitates the organs of vision and lays the foundation of weak eyes, from early infancy. In fact it is a sound precept, never to waken a young child from sleep at all.
An infant is sometimes very restless at night, and it is generally owing either to cramming him with a heavy supper, tight night-clothes, or over-heating by too many blankets. It may also proceed from putting him to sleep too early. Undressing and bathing will weary and dispose him for sleep, and the universal stillness will promote it. This habit and all others depend on attention at first. Accustom him to regular hours, and if he has a good sleep in the forenoon and afternoon, it will be easy to keep him brisk all the evening. It is right to offer him drink when a young infant; and more solid, though simple food, when he is going to bed, after he is two or three months old, but do not force him to receive it; and never let anything but the prescription of a physician in sickness tempt the nurses to give him wine, spirits, or any drug to make him sleep. Milk and water, whey or thin gruel, is the only fit liquor for little ones even when they can run about. The more simple and light their diet and drink, the more they will thrive. In the night a drink of water will often do better than the breast. Such food will keep their bowels regular, and they cannot be long well if that essential point be neglected.
The bodily education of boys and girls ought in every respect to be uniform. A great difference usually prevails in the education of the sexes during infancy. Parents being too anxious for the accomplishment of girls, imagine that they must be kept under a certain restraint. Boys, in general, are not laced, but girls are compressed tight enough to suffocate them; because it is erroneously supposed, that this injudicious practice contributes to an elegant shape, though, ultimately, the contrary effect is obvious; as it is the surest way of making children round shouldered and deformed. Girls are, from their cradles, compelled to a more sedentary life, and with this intention, dolls, and other playthings, are early procured; yet boys are permitted to take more frequent exercise. Thus, girls are confined in their apartments, while boys amuse themselves in the open air. Such absurd constraints impede the free and progressive evolution of the different faculties and powers.
The yellow gum is known by a yellow tinge of the skin, with languor and a tendency to sleep. It is to be relieved by giving a teaspoonful or more of castor oil, to clear the intestines. When the disease does not give way to this treatment, give half a grain of calomel, or 4 grains of rhubarb.
When the food is vomited in an unaltered state, it is generally a sign of over-feeding; but when the vomiting is bilious, or when the food is partly digested, the diet ought to be changed, and the bowels opened by 1 grain of calomel, given in sugar. This is to be followed by a teaspoonful of castor oil on the following morning. If the vomiting should still continue, give lime-water or the calomel powder (containing 1 or 2 grains, according to the age) a second time. If there be much irritation, apply a spice-plaster to the stomach, and, if possible, give a teaspoonful of the saline medicine, in a state of effervescence, and containing 1 or 2 drops of laudanum.
These generally arise from acidity in the stomach, and may be remedied by the administration of 6 grains of prepared chalk with 2 grains of powdered rhubarb, given in a little syrup or gruel. If very severe, the stomach is to be rubbed with a little soap liniment, or opodeldoc, to which a little laudanum has been added.
These are known by continual crying, restlessness, and drawing up of the legs. When attended by diarrhoea and green stools, it is to be relieved in general, by the administration of a few grains of rhubarb and magnesia. If sour belchings, etc. still continue, it will be proper to give a teaspoonful every quarter of an hour, of equal parts of camphor-water and cinnamon-water. After this, particularly if there be any purging, it will be proper to give a little rhubarb and magnesia again, and now and then a little chalk mixture.
If the pains are very great so as to make the child scream violently, two teaspoonsful of the following mixture, with 1 or 2 drops of laudanum may be given directly: Mix together, prepared chalk, 1 scruple; tincture of caraway seeds, 3 drachms; compound spirits of lavender, 1 drachm; and of peppermint-water, 2 ounces.
As soon as there is diminution of pain, a purgative should be given, particularly if the bowels happen to be in a costive state. The best will be castor oil. The above mixture may afterwards be occasionally continued, but without the laudanum.
This may, in general, if the stools are green, be relieved by a brisk purgative, of from 1 to 2 grains of calomel, with 4 or 5 grains of rhubarb, according to the age of the child. The absorbent mixture is then to be given as before directed.
When the stools are very frequent, and are either slimy or tinged with blood, it will be proper to give 5 grains of rhubarb every six hours, the food being beef tea, sago, isinglass in milk or calfsfoot jelly, the body being wrapped in warm flannel. A spice plaster may likewise be applied to the belly, and a dessertspoonful of the following tonic and astringent mixture is to be given every six hours. Mix together chalk mixture, 2 ounces; laudanum, 12 drops; and cinnamon water, 1 ounce.
If the fluid stools are ejected with great force a clyster should be given composed of half a teacupful of boiled starch, and 2 to 5 drops of laudanum. This may be repeated at intervals of eight hours, if the symptoms do not abate.
Children are apt to be chafed between the thighs, behind the ears, and in the wrinkles of the neck, from want of proper attention to cleanliness. In such cases it will be necessary to bathe the parts twice a day (or every time that the child's things are changed) with a little warm milk and water, and to apply a puff with a little powder of pure starch, arrow-root, or rye-meal, immediately afterwards, so as to keep the parts dry. When discharges take place behind the ears they must not be dried up too suddenly, as such a circumstance might produce a diversion to the brain. In such cases it will be always best to give frequent doses of castor oil, or calomel, every other night, in the proportion of 1 grain to 3 grains of rhubarb.
No real danger attends these eruptions, which are generally known by the names of red-gum, nettle-rash, etc. All that is required to be done is to keep the bowels open by such means as are prescribed in the foregoing article, and to guard against cold, which might drive the eruption inwardly, and so produce internal inflammations of a critical nature. If the milk or food be considered the cause, the nurse or diet ought to be changed; and if sickness and vomiting should prevail, it will be proper to give the absorbent mixture mentioned under the head of Griping and Flatulency.
This disease makes its appearance with little ulcerations in the mouth, tongue, etc., of a white color, and sometimes of a yellow appearance. They are generally owing to acidities in the stomach, etc.
In this disorder nothing avails more than an emetic at first, and then a little magnesia and rhubarb (if there be diarrhoea), with thin chicken-water as drink. Chlorate of potassa, or the absorbent mixture (see Griping and Flatulency), will also be proper. If there is no looseness, it will be proper to give a grain or two of calomel, with 3 or 4 grains of rhubarb. The mouth and throat should at the same time be cleansed by gargles.
Take of the juice of black currants, strained, 1 pint; double refined sugar, 24 ounces. Dissolve the sugar, and boil to make a syrup.
A teaspoonful of this may be given to children in the thrush.
This happens frequently to children who cry much, or who have had a diarrhoea, or from straining on going to stool. If it proceed from costiveness, give lenitive clysters. In case the gut be swelled or inflamed, foment with warm milk, or decoction of oak bark, or wash frequently with cold water. The protruded parts are now to be replaced by the finger, and supported by a truss or bandage. The internal use of tonics will be proper. A child subject to this should not be allowed to sit on a low vessel or chair when the bowels are moved.
When children are about cutting their teeth they slaver much, are feverish, hot, and uneasy; their gums swell, and are very painful; they are sometimes loose in the bowels, and at other times costive, now and then convulsions come on.
Leeches are often of use applied behind the ears; also blisters.
Instead of giving narcotics to children cutting their teeth, it is strenuously recommended to have the tumid gums divided by a lancet down to the tooth, an operation at once sate and unattended with pain. If done in time, from removing the cause of the complaint, all the symptoms will disappear of themselves. Instead of giving preparations of opium, it will be found, in the majority of cases, far better to administer calomel, in minute doses, as this medicine is well known to possess peculiar efficacy in promoting absorption in these parts. The bowels, if costive, should be kept regularly open, and if there should be looseness of the bowels, it should by no means be discouraged. Instead of coral or any other hard body, let the child nibble at a ring of gumelastic.
Children are particularly liable to convulsions at the period of teething, small pox, measles, and other eruptive diseases; sometimes, also, from external causes, such as tight clothes, bandages, etc. When they proceed from any of these, bathing the feet, or the whole body, in warm water, of 92¡ or 94¡, and administering a mild clyster will almost immediately relieve them. To shorten the duration of the fit, cold water should be poured over the face and neck, while the rest of the body is in the bath. Afterwards a mustard plaster, weakened with flour, may be applied for a short time to the back.
The return of convulsions is to be prevented only by the removal of the cause of the existing irritation; but, in general, when the body is kept carefully open, there will be little cause to fear a return.
In these fits the infant appears as if asleep; the eyelids, however, are not quite closed, but frequently twinkle, and show the whites turned upwards. The muscles of the face are sometimes slightly distorted, the mouth having the appearance of a laugh or smile. The breath is sometimes very quick, and at others stops for a time; while the eyelids and lips are pale and dark alternately. The infant startles on the least noise, and sighs deeply or breaks wind. This relieves him for a little, but he soon relapses into a doze. Whenever the above-mentioned symptoms are observed, it will be right to awaken the infant, by stirring or otherwise, and to rub its back and belly well before the fire, until wind escapes. At the same time it will be proper to give half a teaspoonful of drink or pap, containing 2 drops of oil of anise or caraways. As soon after as possible, a purgative of castor oil, or a grain or two of calomel (according to the age), with 2 or 3 grains of rhubarb, is to be given, to empty the bowels of whatever crude matter may occasion the disorder.
This disorder affects the bones of children, and causes a considerable protuberance, incurvation, or distortion of them. It may arise from various causes, but more particularly when proper care has not been taken with children; when they have been too tightly swathed in some parts, and too loosely in others; keeping them too long in one and the same position, and not keeping them clean and dry. Sometimes it may proceed from a lax habit; at others from costiveness.
It usually appears about the eighth or ninth month and continues to the sixth or seventh year of the child's age. The head becomes large and the fontanel keeps long open; the countenance is full and florid; the joints knotty and distorted, especially about the wrists, less near the ankles. The ribs protuberate and grow crooked; the belly swells; cough and disorder of the lungs succeed, and there is, withal, a very early understanding, and the child moves but weakly, and waddles in walking.
Regimen, etc. - The regimen should be light and properly seasoned; the air dry and clear; exercise and motion should be encouraged, and bandages as well as instruments contrived to keep the limbs in a proper situation, but we should take care that they be so formed as not to put the child to pain or restrain it too much.
Cold sea-bathing is of infinite use, after which friction should be used, and the child placed between two blankets, so as to encourage perspiration. The back should be well rubbed with opodeldoc or good old rum every night. Chalybeates are also very serviceable.
A decoction of Peruvian bark is also good, with red wine; it is to be used with moderation in the forenoon and after dinner.
Dr. Weitch, an eminent physician of Berlin, has published in Hufeland's journal a simple remedy for weakness of the back-bone of infants, and which he considers capable of preventing distortion. This method consists, first, in frequent and close examination of the child's back-bone, and secondly, on the slightest trace of any distortion, to wash the same with brandy every morning and night, and to pay the strictest attention to the child's keeping a straight posture both sleeping and waking, and if it can be bathed from time to time it will be so much the better.
The raspings of ivory impart to boiling water a very pleasant jelly, which has been found more easy of digestion and more nutritious than that of the hartshorn shavings or isinglass. Mixed with the jelly of the arrow-root in the proportion of one part to seven, it has been recommended for weakly and rickety children and consumptive or emaciated invalids.
It is well known that these disorders, which are in many respects similar, are contagious; therefore no comb or hair-brush used by a child infected by them is to be used by another child either in a school or in the same family. Nor should the hat or cap of such a child be worn by any other.
Treatment. - The intractableness of most children, when attempted to be controlled or governed by the accustomed mode of treatment, proves in most instances a material obstacle in the way of curing this malignant disease, and the quickness with which the hair of the scalp grows in children, has hitherto in many instances rendered every effort ineffectual. It was a constant failure under these inauspicious circumstances that led Mr. Barlow, a medical professor in Lancashire, to adopt the subjoined lotion: Take of sulphate of potassa, recently prepared, 3 drachms; Spanish white soap 1 1/2 drachms; lime-water 7 1/2 ounces; and spirits of wine 2 drachms. Mix by shaking well in a phial.
By bathing the affected head with this lotion a few times, morning and evening, and suffering the parts to dry without interruption, the scabs will loosen and peel off from the scalp, and leave the parts underneath perfectly healed, without torturing the patient by shaving the head, though the hair should be kept short.
Take of spermaceti ointment 1 ounce; tar ointment 1 ounce; powdered angustura bark 3 drachms. Rub the whole well in a marble mortar and apply to the parts affected.
In six cases out of ten this disease is aggravated by a scrofulous taint of system, and when this is the case the following alterative medicines accelerates the cure:
Iodide of potassium 1 drachm; water 6 ounces. Give a teaspoonful night and morning.
Instead of the above 1 grain of calomel may be given going to rest, and repeated every night for a few nights; also, the use of arsenic and of salt water, externally and internally as an alterative, has been found very useful.
In all cases the bowels ought to be kept open, and the diet should consist of wholesome and nutritive food, avoiding fish and salt meats. Cleanliness and occasional use of the warm bath will likewise be of service.
This convulsive cough is occasioned by a viscid matter which cannot be easily expectorated. The poor infant, in endeavoring to bring it up, strains violently, till he becomes almost suffocated and convulsed.
Remedies. - In this complaint, next to occasional vomiting, the daily use of the warm bath is most useful. Bleeding may sometimes be used to prevent inflammation of the internal membranes, or cupping between the neck and shoulders. Gentle emetics may be given early.
Give a tablespoonful of milk of assafoetida every four hours, or half as much, with five or ten drops of wine of ipecac, or, in violent cases, 2 or 3 grains of musk as often.
To the above may be added, as auxiliaries, Burgundy pitch plaster on the pit of the stomach, a flannel waistcoat or shirt next the skin, and a change of air when practicable. The diet should be light and easy of digestion, avoiding everything of a fat and oily nature.
Take of tartar emetic 2 drachms; boiling water 2 ounces; tincture of cantharides 1 drachm; oil of thyme 3 drachms. Mix. A dessertspoonful to be rubbed upon the chest every night and morning till it becomes sore.
A frequent change of air is exceedingly useful in hooping cough, particularly short voyages at sea; at the same time flannel is to be worn next the skin. Young children should lie with their beads and shoulders raised, and when the cough occurs they ought to be placed on their feet and bent a little forward, to guard against suffocation. The diet should be light and the drink warm and mucilaginous
This disease is almost peculiar to children, and sometimes fatal, if care is not taken in the commencement. It commonly approaches with the usual signs of a catarrh, but sometimes the peculiar symptoms occur at the first onset; namely, a hoarseness, with a shrill ringing sound both in speaking and coughing, as if the noise came from a brazen tube. At the same time there is a sense of pain about the larynx, and some difficulty of respiration, with a whizzing sound in inspiration, as if the passage of air was diminished, which is actually the case. The cough is generally dry, but if anything is spit up, in the worst cases it is a matter, sometimes resembling small portions of a membrane. There is also a frequent pulse, restlessness, and an uneasy sense of heat. The inside of the mouth is sometimes without inflammation, but frequently a redness, and even a swelling, exists. Sometimes there is an appearance of matter on them, like that ejected by coughing.
Remedies. - As soon as possible a brisk emetic should be administered, for the purpose of freeing the patient from the coagulable lymph which is already secreted. The powder, wine or syrup of ipecac will generally answer. In obstinate cases a teaspoonful of alum powder with one of ipecac is recommended. Topical bleeding, by means of leeches, should immediately succeed, and the discharge be encouraged. As soon as it diminishes, a blister so large as to cover the whole throat should be applied, and suffered to lie on for thirty hours or longer. Then warm steam should be inhaled, and the bowels should be evacuated by calomel.
As soon as the emetic has operated sufficiently, 1 grain doses of calomel with 5 grains of nitre may be administered, by which means the breathing will in general be soon relieved, but should it become more difficult in the course of a few hours the emetic is to be again repeated, and after its operation the opium again employed. This practice is to be alternately used till such time as the patient is out of danger, which will in general be in the course of three or four days. The child should be kept nearly upright in bed.
The warm bath is very useful in this complaint. As an adjunct, apply an ointment to the breast composed of 5 grains of tartar emetic, and 5 grains of powdered opium, to a drachm of spermaceti cerate, until eruptions are excited on the skin.
Take of ipecacuanha in powder, opium (purified), each 1 part; sulphate of potass, 8 parts. Triturate them together into a fine powder.
The dose is from two to five or ten grains, repeated according as the patient's stomach and strength can bear it. It is proper to avoid much drinking immediately after taking it, otherwise it is very apt to be rejected by vomiting before any other effects are produced. Perspiration should be kept up by diluents.
Take of socotrine aloes, powdered, 13 ounces; myrrh, powdered, 2 ounces; extract of gentian and sulphate, each in powder, 1 Ounce. Mix them.
In this powder we have an aloetic and chalybeate conjoined. It is a useful medicine, and is particularly employed in cases of obstructed menstruation.
Take of assafoetida, galbanum and myrrh, each 1 ounce; rectified oil of amber, 1 drachm. Beat them into a mass with simple syrup.
These pills are anti-hysteric and emmenagogue, and are very well calculated for answering those intentions. Half a scruple, a scruple, or more, may be taken every night or oftener.
Take of hepatic aloes, 1 ounce; ginger powder, 1 drachm; soap, 1/2 ounce; essential oil of peppermint, 1/2 drachm.
Let the aloes and the ginger be rubbed well together, then add the soap and the oil, so as to form a mass.
These pills may be advantageously used for obviating the habitual restiveness of sedentary persons. The dose is from ten to fifteen grains.
Take of socotrine aloes, 4 drachms; myrrh, 2 drachms; saffron, 1 drachm. Beat them into a mass with simple syrup.
These pills have been long employed to stimulate and open the bowels in chlorotic, hypochondriacal, and longdiseased habits. The dose is from ten grains to a scruple, twice a day.
These pills are alterative, diaphoretic, purgative, and beneficial in cutaneous eruptions, etc.
Take of calomel, 1 drachm; sulphate of antimony, 1 drachm, gum guaiacum, 2 drachms.
Mix these assiduously with mucilage, and divide into sixty pills, two pills forming the dose. To be taken at night.
Take of camphor, 1 ounce; soap, 3 ounces; spirit of rosemary, 1 pint.
Digest the soap in the spirit of rosemary until it be dissolved, and add to it the camphor. This is useful to excite action on the surface, and is used to disperse scrofulous enlargements, and to moisten flannel which is applied to the throat in cases of quinsy.
Take of almond soap, 2 ounces; alcohol, 1 pint; camphor, 1 ounce; cajeput oil, 2 ounces.
First dissolve the soap and camphor in the alcohol in a retort, by means of a sand heat, and when the solution is about to congeal, or becomes nearly cold, add the oil of cajeput: shake them well together, and put it into bottles to congeal.
This composition is a great improvement on the opodeldocs in general use, and in cases of rheumatism, paralytic numbness, chilblains, enlargements of joints, and indolent tumors, where the object is to rouse the action of absorbent vessels, and to stimulate the nerves, it is a very valuable external remedy.
In several eases of lumbago and deep-seated rheumatic pains, it has been known to succeed in the almost immediate removal of the disease.
Take of water of ammonia, 1/2 an ounce; olive oil, 1 1/2 ounces. Shake them together in a phial till they are mixed.
In the inflammatory quinsy, a piece of flannel moistened with this mixture, applied to the throat, and renewed every four or five hours, is one of the most efficacious remedies. By means of this warm stimulating application, the neck, and sometimes the whole body is put into a sweat, which, after bleeding, either carries off or lessens the inflammation. Where the skin cannot bear the acrimony of this moisture, a larger proportion of oil may be used.
Ten or 12 grains of white soap are dissolved in 4 ounces of rectified spirit of wine; after which the solution is strained. A drachm of rectified oil of amber is then added, and the whole filtered. With this solution should be mixed such a proportion of the strongest volatile spirit of ammonia, in a clear glass bottle, as will, when sufficiently shaken, produce a beautiful milk-white liquor. If a kind of cream should settle on the surface, it will be requisite to add a small quantity of the spirituous solution of soap. Those who may wish to have this liquor water perfumed, may employ lavender or Hungary water instead of the spirit of wine.
This composition is, however, seldom obtained in a genuine state when purchased at the shops. Its use as an external remedy is very extensive; for it has not only been employed for curing the bites of vipers, wasps, bees, gnats, ants, and other insects, but also for burns, and even the bite of a mad dog, though not always with uniform success. Besides, it affords one of the safest stimulants in cases of suffocation from mephitic vapors, and in that state of apoplexy which is termed serous, as likewise after excessive intoxication, and in all those paralytic complaints where the vessels of the skin or the muscular fibre require to be excited into action.
Take of olive oil, 5 ounces; white wax 2 ounces. This is a useful emollient ointment for softening the skin.
Take of prepared hog's lard, 2 pounds; rosewater, 3 ounces. Beat the lard with the rose-water until they be mixed: then melt the mixture with a slow fire, and set it apart that the water may subside; after which, pour off the lard from the water, constantly stirring until it be cold.
This ointment may be used for softening the skin, and healing the chaps.
Melt together 2 1/2 ounces of white wax; 3 ounces of spermaceti; 7 ounces oil of almonds; 1 drachm of balsam of Peru; and 1 1/2 ounces of glycerin wrapped up in a linen bag.
Pour the salve into small gallipots or boxes, and cover with bladder and white leather.
Take of yellow resin, 1 pound; yellow wax, 1 pound; olive oil, 1 pint. Melt the resin and wax with a gentle heat; then add the oil, and strain the mixture while yet warm.
This plaster is employed for the dressing of broken chilblains, and other sores that require stimulating; it is also used to drive milk away, being placed over the tumid breasts when the child is weaned.
This ointment is known by the vulgar name of Turners' cerate, as curing the wounds of Turners. It is generally used for broken chilblains.
Take of prepared calamine, yellow wax, each 1/2 pound; olive oil, 1 pint.
Melt the wax with the oil, and as soon as they begin to thicken, sprinkle in the prepared calamine and keep it stirring till the cerate is cool.
Take of fresh savin leaves, separated from the stalks, and bruised, 1/2 pound; prepared hog's lard, 2 pounds; yellow wax, 1/2 pound. Boil the leaves in the lard until they become crisp; then filter with expression; lastly, add the wax, and melt them together.
This is an excellent issue ointment, being, in many respects, preferable to that of cantharides. It is mixed with equal parts of blistering ointment, in order to keep up a discharge.
Take of mercury, and mutton suet, each, 1 part; hogs' lard, 3 parts. Rub the mercury diligently in a mortar with a little of the hogs' lard, until the globules disappear; then add the remainder of the lard, and rub until the ointment is completely prepared.
One drachm of this ointment contains twelve grains of mercury.
The preparation of mercurial ointment requires much labor, care, and patience. During the trituration, the mercury is mechanically divided into minute globules which are prevented from running together again by the viscosity of the fat. These globules at length disappear, being oxidized, or rendered black by intimate mixture with the lard. Whatever tends to favor this (for instance, a slight degree of rancidity of the lard) shortens the time and lessens the labor required for the preparation of the ointment. It is not uncommon, however, to use other means, which are not admissible, to facilitate the process, such as the use of sulphur or turpentine. The first may be detected by the very black color of the ointment, and also by the sulphurous odor exhaled when a paper covered with a little of it is held over the flame of a candle. The turpentine is detected by its odor also, when the ointment containing it is treated in the same manner.
When newly prepared, mercurial ointment has a light gray or bluish color, owing to its containing some unoxidized metal, which separates in globules when it is liquefied by a gentle heat; when kept for some time the color is much deepened, and less metallic mercury is seen, owing to the more complete oxidizement of the metal.
Take of cerate of spermaceti, softened with heat, 6 drachms; Spanish flies, finely powdered, 1 drachm. Mix them by melting over a gentle fire.
Under this form cantharides may be made to act to any extent that its requisite. It may supply the place either of the blistering plaster or ointment, and there are cases in which it is preferable to either. It is particularly more convenient than the plaster of cantharides, where the skin to which the blister is to be applied is previously much affected, as in cases of small-pox, and in supporting a drain under the form of issue it is less apt to spread than the softer ointment.
Take of Burgundy pitch 2 pounds: labdanum 1 pound; yellow resin and yellow wax each 4 ounces; expressed oil of mace 1 ounce.
To the pitch, resin and wax melted together add first the labdanum and then the oil of mace.
After a long-continued cough in the winter, a Burgundy pitch plaster should be put over the breast-bone.
Take of labdanum 3 ounces; frankincense 1 ounce; cinnamon, powdered, expressed oil of mace, each 1/2 an ounce; essential oil of mint 1 drachm.
To the melted frankincense add first the labdanum, softened by heat, then the oil of mace. Mix these afterwards with the cinnamon and oil of mint and beat them together in a warm mortar into a plaster. Let it be kept in a close vessel.
This has been considered as a very elegant stomach plaster. It is contrived so as to be easily made occasionally (for such compositions, on account of their volatile ingredients, are not fit for keeping), and to be but moderately adhesive, so as not to offend the skin; also that it may without difficulty be frequently renewed, which these applications, in order to their producing any considerable effect, require to be. They keep up a perspiration over the part affected, and create a local action, which diverts inflammation; consumption from colds in delicate habits is by such means frequently obviated.
Take of common, or litharge plaster; 5 parts, white resin, 1 part.
Melt them together, and spread the liquid compound thin on strips of linen by means of a spatula or table knife.
This plaster is very adhesive, and is used for keeping on other dressings, etc.
Bruise a sufficient quantity of fish glue, and let it soak for twenty-four hours in a little warm water; expose it to heat over the fire, to dissipate the greater part of the water, and supply its place by colorless brandy, which will mix the gelatine of the glue. Strain the whole through a piece of open linen; on cooling it will form a trembling jelly.
Now extend a piece of black silk on a wooden frame, and fix it in that position by means of tacks or pack thread. Then with a brush made of badger's hair apply the glue, after it has been exposed to a gentle heat to render it liquid. When this stratum is dry, which will soon be the case, apply a second, and then a third if necessary, to give the plaster a certain thickness; as soon as the whole is dry cover it with two or three strata of a strong tincture of balsam of Peru.
This is the real English court-plaster, it is pliable and never breaks, characters which distinguish it from so many other preparations sold under the same name.
Take of rhubarb, sliced, 2 ounces; liquorice root, bruised, 1/2 ounce; ginger, powdered, saffron, each 2 drachms; distilled water, 1 pint; proof spirits of wine, 12 ounces by measure.
Digest for 14 days, and strain. Dose, 1/2 an ounce as an aperient, or 1 ounce in violent diarrhoea.
Take of ginger, in coarse powder 2 ounces; proof spirit, 2 pints
Digest in a gentle heat for 7 days, and strain.
This tincture is cordial and stimulant, and is generally employed as a corrective to purgative draughts.
Take of senna leaves, 2 ounces; jalap root, 1 ounce; coriander seeds, 1/2 ounce; proof spirits, 2 1/2 pints.
Digest for 7 days, and to the strained liquor add 4 ounces of sugar candy.
This tincture is a useful carminative and cathartic, especially to those who have accustomed themselves to the use of spirituous liquors; it often relieves flatulent complaints and colics where the common cordials have little effect; the dose is from one to two ounces. It is a very useful addition to castor oil, in order to take off its mawkish taste; and, as coinciding with the virtues of the oil, it is therefore much preferable to brandy, shrub, and such like liquors, which otherwise are often found necessary to make the oil sit on the stomach.
Take of magnesia, 120 grains; citric acid, 450 grains; bicarbonate of potassa, 40 grains; dissolve the citric acid in 4 fluidounces of water, and, having added the magnesia, stir until it is dissolved. Filter the solution into a strong twelve ounce bottle, into which has been poured 2 fluidounces of syrup of citric acid. Then add the bicarbonate of potassa, and enough water almost to fill the bottle, which must be closed with a cork, and this secured with twine. Shake moderately till all is dissolved. This is a very pleasant drink, and in the dose of a tumblerful a pretty active and cooling purgative.
Take of senna, 2 pounds; rhubarb shavings, 2 pounds; jalap root, 1 pound; caraway seeds, 1 pound; aniseeds, 2 pounds; sugar, 4 pounds; shavings of red sanders-wood, 1/2 pound.
Digest these in 10 gallons of spirits of wine for 14 days, and strain for use.
This elixir possesses almost the same qualities as the Compound Tincture of Senna. The above quantities may be reduced to as small a scale us may be required.
Take 1/2 a pound of opium, sliced; 3 pints of good verjuice; 1 1/2 ounces of nutmeg; and 1/2 an ounce of saffron; boil them to a proper thickness, then add a 1/4 of a pound of sugar and 2 spoonsful of yeast. Set the whole in a warm place near the fire for 6 or 8 weeks, then place it in the open air until it becomes of the consistence of a syrup; lastly, decant, filter, and bottle it up, adding a little sugar to each bottle. Dose, 5 to 15 drops.
The above ought to yield about two pints of the strained liquor.
Dissolve 1/2 an ounce of opium, 1 drachm of oil of sassafras, in 2 ounces of spirits of wine. Now mix 4 pounds of treacle with 1 gallon of boiling water, and when cold mix both solutions. This is often used to soothe the pains of children, etc. It must be employed with caution, however, as it contains opium. It is an injurious error to keep children quiet by stupifying them constantly or frequently with opiates, or other narcotics.
Take of balsam of Tolu, 2 ounces; gum storax, 2 drachms; opium, 2 drachms; honey, 8 ounces. Dissolve these in a quart of spirits of wine.
This balsam is exceedingly useful in allaying the irritation of cough. The dose is 1 or 2 teaspoonsful in a little tea or warm water.
Take of balsam of Tolu, 1 ounce; alcohol, 1 pint, Digest until the balsam be dissolved, and then strain the tincture through a paper
This solution of the balsam of Tolu possesses all the virtues of the balsam itself: It may be taken internally, with the several intentions for which that balsam is proper, to the quantity of a teaspoonful or two in any convenient vehicle.
Mixed with simple syrup it forms an agreeable balsamic syrup.
Take of Peruvian bark, 4 ounces; proof spirit, a pints. Digest for 10 days and strain.
It may be given from a teaspoonful to 1/2 an ounce, or an ounce, according to the different purposes it is intended to answer.
Take of Peruvian bark, powdered, 2 ounces; the peel of Seville oranges, dried, 1 1/2 ounces; Virginian snakeroot, bruised, 3 drachms; saffron, 1 drachm; cochineal, powdered, 2 scruples; proof spirit, 20 ounces. Digest for 14 days and strain.
As a corroborant and stomachic, it is given in doses of 1 to 3 drachms; but when employed for the cure of intermittent fevers, it must be taken to a greater extent.
Take of guaiacum, 4 ounces; rectified spirits of wine, 2 pints. Digest for 7 days and filter.
What is called gum guaiacum is, in fact, a resin, and perfectly soluble in alcohol. This solution is a powerful stimulating sudorific, and may be given in doses of about 1/2 an ounce in rheumatic and asthmatic cases.
Take of resin of guaiacum, in powder, 4 ounces; ammoniated alcohol, in powder, 1 1/2 pounds. Digest for 7 days and filter through a paper.
This is a very elegant and efficacious tincture; the ammoniated spirit readily dissolving the resin, and, at the same time, promoting its medical virtues. In rheumatic cases, a tea, or even tablespoonful, taken every morning and evening, in any convenient vehicle, particularly in milk, has proved of singular service.
Take of benzoin, 3 ounces; purified storax, 2 ounces; balsam of Tolu, 1 ounce; socotrine aloes, 1/2 an ounce; rectified spirits of wine, 2 pints. Digest for 7 days and filter.
This preparation may be considered as an elegant simplification of some very complicated compositions, which were celebrated under different names; such as Baume de Commandeur, Wade's Balsam, Friar's Balsam, Jesuit's Drops, etc. These, in general, consisted of a confused farrago of discordant substances. The dose is a teaspoonful in some warm water four times a day, in chronic bronchitis and spitting of blood. It is useful, also, when applied on lint, to recent wounds, and serves the purpose of a scab, but must not be soon removed. Poured on sugar it sometimes checks spitting of blood immediately.
Take of extract of catechu, 3 ounces; cinnamon, bruised, 2 ounces; diluted alcohol, 2 pints. Digest for seven days, and strain through paper.
The cinnamon is a very useful addition to the catechu, not only as it warms the stomach, but likewise as it covers its roughness and astringency.
This tincture is of service in all kinds of defluxions, catarrhs, loosenesses, and other disorders where astringent medicines are indicated. From one to three teaspoonsful may be taken every now and then, in red wine, or any other proper vehicle.
A pound of sugar candy, dissolved by heat, in a quantity of white wine vinegar, and evaporated to the measure of 1 pint, during which operation as much garlic as possible is dissolved with it, answers all the purposes of Godhold's Vegetable Balsam, and is probably the same medicine.
Take of bruised nutmegs, 2 ounces; proof spirit, 1 gallon, water sufficient to prevent burning. Distil off a gallon.
This is used to take off the bad flavor of medicine, and is a grateful cordial.
The common mode of preparing this, is to put 3 drachms of the essential oil of lavender, and a drachm of the essence of ambergris, into 1 pint of spirit of wine.
Take of sal ammoniac, 1 pound; quick-lime, 2 pounds; water, 1 gallon. Add to the lime two pints of the water. Let them stand together an hour; then add the sal ammoniac, and the other six pints of water, boiling, and immediately cover the vessel. Pour out the liquor when cold, and distil off, with a slow fire, one pint. This spirit is too acrimonious for internal use, and has therefore been chiefly employed for smelling in fainting, etc., though, when properly diluted, it may be given inwardly with safety.
Take of ammonia, by weight, 2 ounces; distilled vinegar, 4 pints, or as much as is sufficient to saturate the ammonia.
This is an excellent diaphoretic saline liquor. Taken warm in bed, it proves commonly a powerful sudorific; and as it operates without heat, it is used in febrile and inflammatory disorders where medicines of the warm kind, if they fail of procuring sweat, aggravate the distemper. Its action may likewise be determined to the kidneys, by walking about in cool air. The common dose is half an ounce, either by itself, or along with other medicines adapted to the intention. Its strength is not a little precarious, depending on that of the vinegar.
Take of extract of liquorice, gum arabic, each, 4 ounces; white sugar, 8 ounces.
Dissolve them in warm water, and strain, then evaporate the mixture over a gentle fire till it be of a proper consistence for being formed into lozenges, which are to be cut out of any shape.
Take of fine sugar, 1 pound; gum arabic, 4 ounces; starch, 1 ounce; flowers of benzoin, 3/4 of a drachm.
Having beaten them all in a powder, make them into a proper mass with rose-water, so as to form lozenges.
These compositions are very agreeable pectorals, and may be used at pleasure. They are calculated for promoting expectoration, and allaying the tickling in the throat, which provokes coughing.
Take of ginger, bruised, 4 ounces; boiling distilled water, 3 pints.
Macerate four hours, and strain the liquor; then add double refined sugar, and make into a syrup.
This syrup promotes the circulation through the extreme vessels; it is to be given in torpid and phlegmatic habits, where the stomach is subject to be loaded with slime, and the bowels distended with flatulency. Hence it enters into the compound tincture of cinnamon and the aromatic powder.
Dyspeptic patients, from hard drinking, and those subject to flatulency and gout, have been known to receive considerable benefit from the use of ginger tea, taking two or three cupfuls for breakfast, suiting it to their palate.
Take of the heads of white poppies, dried, 3 1/2 pounds; double refined sugar, 6 pounds; distilled water, 8 gallons.
Slice and bruise the heads, then boil them in the water to three gallons, and press out the decoction. Reduce this, by boiling, to about four pints, and strain it while hot through a sieve, then through a thin woollen cloth, and set it aside for twelve hours, that the grounds may subside. Boil the liquor poured off from the grounds to three pints, and dissolve the sugar in it, that it may be made a syrup.
This syrup, impregnated with the narcotic matter of the poppy-head, is given to children in doses of two or three drachms, and to adults of from half an ounce to one ounce and upwards for easing pain, procuring rest, and answering the other intentions of mild medication. Particular care is requisite in its preparation, that it may be always made, as nearly as possible, of the same strength.
Take of fresh flowers of the violet, 1 pound; boiling distilled water, 3 pints.
Macerate for twenty-five hours, and strain the liquor through a cloth, without pressing, and add double refined sugar, to make the syrup. This is an agreeable laxative medicine for young children.
Take of vinegar of squills, 2 pounds; double refined sugar, in powder, 3 1/2 pounds.
Dissolve the sugar with a gentle heat, so as to form a syrup.
This syrup is used chiefly in doses of a spoonful or two for promoting expectoration, which it does very powerfully. It is also given as an emetic to children.
Take of clarified honey, 3 pounds; vinegar of squills, 2 pints.
Boil them in a glass vessel, with a slow fire, to the thickness of a syrup.
Oxymel of squills is a useful aperient, detergent, and expectorant, and of great service in humoral asthmas, coughs, and other disorders where thick phlegm abounds. It is given in doses of two or three drachms, along with some aromatic water, as that of cinnamon, to prevent the great nausea which it would otherwise be apt to excite. In large doses it proves emetic.
Take of squills, recently dried, 1 pound; vinegar, 6 pints; proof spirit, 1/2 pint.
Macerate the squills with the vinegar, in a glass vessel, with a gentle heat, for twenty-four hours; then express the liquor, and set it aside until the faeces subside. To the decanted liquor add the spirit.
Vinegar of squills is a medicine of great antiquity. It is a very powerful promoter of secretion and hence it is frequently used with great success a diuretic and expectorant. The dose of it is from a drachm to half an ounce. Where crudities abound in the first passages, it may be given at first in a larger dose, to evacuate them by vomiting. It is most conveniently exhibited along with cinnamon, or other agreeable aromatic waters, which prevent the nausea it would otherwise, even in small doses, be apt to occasion.
Take of tar, 2 pints; water, 1 gallon. Mix, by stirring them with a wooden rod for a quarter of an hour, and, after the tar has subsided, strain the liquor, and keep it in well-corked phials.
Tar-water should have the color of white wine, and an empyreumatic taste. It is frequently used as a remedy in chronic bronchitis. It acts as a stimulant, raising the pulse and increasing the discharge by the skin and kidneys. It may be drunk to the extent of a pint or two in the course of a day.
Take of sarsaparilla root, cut, 6 ounces; distilled water, 8 pints.
After macerating for two hours with a heat about 195¡, then take out the root and bruise it; add it again to the liquor, and macerate it for two hours longer, then boil down the liquor to 4 pints, and strain it. The dose is from 4 ounces to half a pint, or more, daily.
Take of sarsaparilla root, cut and bruised, 6 ounces; the bark of sassafras root, the shavings of guaiacum wood, liquorice root, each 1 ounce; the bark of mezereon root, 3 drachms; distilled water, 10 pints.
Digest with a gentle heat for six hours; then boil down the liquor to one-half (or five pints), adding the bark of the mezereon root towards the end of boiling. Strain off the liquor. The dose is the same as the last, and for the same purposes.
These decoctions are of use in purifying the blood, and resolving obstructions in scorbutic and scrofulous cases; also in cutaneous eruptions, and many other diseases. Obstinate swellings, that had resisted the effects of other remedies for above twelve months, have been said to be cured by drinking a quart of decoction of this kind daily for some weeks. Decoctions of sarsaparilla ought to be made fresh every day, for they very soon become quite fetid, and unfit for use; sometimes in less than twenty-four hours, in warm weather.
Take of guaiacum raspings, 3 ounces; raisins, stoned, 2 ounces; sassafras root, sliced, liquorice root, bruised, each 1 ounce; water, 10 pounds.
Boil the guaiacum and raisins with the water over a gentle fire, to the consumption of one half, adding, towards the end, the sassafras and liquorice, and strain the decoction without expression.
This decoction is of use in some rheumatic and cutaneous affections. It may be taken by itself, to the quantity of a quarter of a pint, twice or thrice a day, or used as an assistant in a course of mercurial or antimonial alteratives; the patient in either case keeping warm, in order to promote the operation of the medicine.
Put a large spoonful of oatmeal into a pint of water, stir it well together, and let it boil 3 or 4 minutes, stirring it often. Then strain it through a sieve, put in some salt according to taste, and, if necessary, add a piece of fresh butter. Stir with a spoon until the butter is melted, when it will be fine and smooth. Raisins are often added to it.
Put a blade of mace, a large piece of the crumb of bread, and a quart of water, in a clean saucepan. Let it boil two minutes, then take out the bread and bruise it very fine in a basin. Mix with it as much of the warm water as it will require, pour away the rest, and sweeten it to the taste of the patient. If necessary, put in a piece of butter of the size of a walnut, but add no wine. Grate in a little nutmeg if requisite.
Put an ounce of isinglass and half an ounce of cloves into a quart of water. Boil it down to a pint, strain it upon a pound of loaf sugar, and when cold add a little wine, when it will be fit for use. A very nourishing beverage may be made by merely boiling the isinglass with milk, and sweetening with lump sugar.
Boil a pint of milk and put into it a glass of sherry or Madeira wine. Set it over the fire till it boils again; then put it aside till the curd has settled; then strain it, and sweeten to taste.
Cut a pound of lean beef into small pieces, pour over it a pint of cold water, and let it soak two hours; then boil it half an hour. Remove the scum that rises and all the fat or oil from the top. Pour off, and season with salt, but do not strain it.
Put a pound of lean beef, cut into pieces, into a porter bottle, without water; cork it loosely, and place it in a pot of water, which should be made to boil around it for an hour. The essence of the meat will thus be drawn out in the liquid state.
Cut the meat from a leg of veal into small pieces, and break the bone into several bits. Put the meat into a very large jug, and the bones at top, with a bunch of common sweet herbs, a quarter of an ounce of mace, and half a pound of Jordan almonds, finely blanched and beaten. Pour on it 4 quarts of boiling water, and let it stand all night covered, close by the fireside. The next day put it into a well-tinned saucepan, and let it boil down, till it is reduced to 2 quarts. Be careful, at the time it is boiling to skim it, and take off the fat as it rises. Strain into a punch-bowl, and when settled for two hours pour it into a clean saucepan, clear from the sediments, if any. Add 3 ounces of rice or 2 ounces of vermicelli, previously boiled in a little water. When once more boiled, it will be fit for use.
Take of Rochelle salts, 1 drachm; carbonate of soda, 25 grains; tartaric acid, 20 grains.
Dissolve the two first in a tumbler of water; then add the latter, and swallow without loss of time.
Nothing has been found so effectual for preserving water sweet at sea, during long voyages, as charring the insides of the casks well before they are filled. Care ought at the same time to be taken that the casks should never be filled with sea-water, as sometimes happens, in order to save the trouble of shifting the ballast, because this tends to hasten the corruption of the fresh water afterwards put into them. When the water becomes impure and offensive at sea, from ignorance of the preservative effect produced on it by charring the casks previous to their being filled, it may be rendered perfectly sweet by putting a little fresh charcoal in powder into each cask before it is tapped, or by filtering it through fresh-burnt and coarsely powdered charcoal.
To preserve seamen in health and prevent the prevalence of scurvy and other diseases, it will be further necessary to keep the ship perfectly clean and to have the different parts of it daily purified by a free admission of air when the weather will admit of it, and likewise by frequent fumigations. This precaution will more particularly be necessary for the purification of such places as are remarkably close and confined.
The coldness and dampness of the atmosphere are to be corrected by sufficient fires.
Cleanliness on board of a ship is highly necessary for the preservation of the health of seamen, but the custom of frequent swabbings or washings between the decks, as is too frequently practised, is certainly injurious, and greatly favors the production of scurvy and other diseases by a constant dampness being kept up.
The men should be made to air their hammocks and bedding every fine day; they should wash their bodies and apparel often, for which purpose an adequate supply of soap ought to be allowed, and they should change their linen and other clothes frequently. In rainy weather, on being relieved from their duty on deck by the succeeding watch, they should take off their wet clothes instead of keeping them on and lying down in them, as they are too apt to do. Two sets of hammocks ought to be provided for them. In fine pleasant weather, and after their usual duty is over, they should be indulged in any innocent amusement that will keep their minds as well as bodies in a state of pleasant activity, and perhaps none is then more proper than dancing. This makes a fiddle or a pipe and tabor desirable acquisitions on board of every ship bound on a long voyage.
In warm climates the crews of ships are healthier at sea when the air is dry and serene, and the heat moderated by gentle breezes, than when rainy or damp weather prevails; and they usually enjoy better health when the ship is moored at a considerable distance from the shore, and to windward of any marshy ground or stagnant waters, than when it is anchored to leeward of these and lies close in with the land. Masters of vessels stationed at or trading to any parts between the tropics, will therefore act prudently when they have arrived at their destined port, to anchor at a considerable distance from the shore, and as far to windward of all swamps, pools and lakes as can conveniently be done, as the noxious vapors which will be wafted to the crew when the ship is in a station of this nature will not fail to give rise to disease among them.
When unavoidably obliged to submit to such an inconvenience, some means ought to be adopted to prevent disagreeable consequences from ensuing. For this purpose a large sail should be hoisted at the foremast, or most windward part of the ship, so as to prevent the noxious vapors from coming abaft; the cabin, steerage and between the decks should be fumigated now and then, and the seamen allowed to smoke tobacco moderately.
Unless absolutely necessary it will be improper to permit any of the crew to sleep from on board when stationed off an unhealthy shore, but when necessity obliges them to do so for the purpose of wooding or watering, a tent or marquee should be erected, if a proper house cannot be procured, and this should be pitched on the dryest and highest spot that can be found, being so situated as that the door shall open towards the sea. Under cover of this a sufficient number of hammocks are to be suspended for the accommodation of the men by night, as they should by no means be suffered to sleep on the open ground.
If the tent happens unfortunately to be in the neighborhood of a morass, or has unavoidably been pitched on flat, moist ground, it will be advisable to keep up a constant fire in it by day as well as by night, and as a further preventive against those malignant disorders which are apt to arise in such situations, the men should be directed to smoke moderately of tobacco, and to take a half or a quarter of a wineglassful of the compound tincture of Peruvian bark every morning on an empty stomach, and the same quantity again at night.
In tropical climates the healthiness of seamen will much depend upon avoiding undue exposure to the sun, rain, night air, long fasting, intemperance, unwholesome shore duties, especially during the sickly season, and upon the attention paid to the various regulations and preventive measures. The bad effects of remaining too long in port at any one time (independent of irregularities of harbor duties, particularly after sunset, as well as during his meridian power) cannot be too strongly adverted to by the commander of every ship, and therefore a measure of the highest importance in the navy is the employment of negroes and natives of the country, or at least men accustomed to the torrid zone, in wooding, watering, transporting stores, rigging, clearing, careening ships, etc., and in fine in all such occupations as might subject the seamen to excessive heat or noxious exhalations, which cannot fail to be highly dangerous to the health of the unacclimated seaman.
The practice of heaving down vessels of war in the West Indies, in the ordinary routine of service at least, cannot be too highly deprecated, as well from the excessive fatigue and exertion it demands as because it is a process which requires for its execution local security, or in other words a land that is locked, and therefore generally an unhealthy harbor. The instances of sickness and mortality from the effects of clearing a foul hold in an unhealthy harbor are too numerous to be specified.
A very productive source of disease in warm climates among seamen is an immoderate use of spirituous and fermented liquors, as they are too apt, whilst in a state of intoxication, to throw themselves on the bare ground where, perhaps, they lie exposed for many hours to the influence of the meridian sun, the heavy dews of the evening or the damp, chilling air of the night. The commander of a ship who pays attention to the health of his crew, will therefore take every possible precaution to prevent his men from being guilty of an excess of this nature, and likewise from lying out in the open air when overcome by fatigue and hard labor.
The different voyages of that celebrated navigator, Captain Cook, as well as that of the unfortunate La Perouse, incontestibly prove that by due care and a proper regimen seamen may be preserved from the scurvy and other diseases which have formerly been inseparable from long sea voyages, and that they can thus support the fatigues of the longest navigations in all climates and under a burning sun. It has been thoroughly proved also, that grog is not at all necessary, or, in the long run, beneficial to seamen. In times of the greatest exposure and fatigue, as during severe storms, hot coffee has been found a more effective stimulant than spirits, without the dangers connected with the use of the latter.
Smoking or fumigating ships with charcoal or sulphur, is the most effectual means of killing all kinds of vermin, and is therefore always resorted to; but it is recommended that no sailor or boy be allowed to go under the decks until the hatches, and all the other openings, have been for three hours uncovered; in that time all noxious vapors will be effectually dissipated.
1. The crew to be at three watches. The men will by this means have time to shift and dry themselves, and get pretty well refreshed by sleep before called again to duty. When there is no pressing occasion, seamen ought to be refreshed with as much uninterrupted sleep as a common day laborer.
2. To have dry clothes to shift themselves after getting wet. One of the officers to see that every man, on going wet from his watch, be immediately shifted with dry clothes, and the same on going to bed.
3. To keep their persons, hammocks, bedding, and clothes clean and dry. This commander made his men pass in review before him one day in every week, and saw that they had changed their linen, and were as neat and clean as circumstances would admit. He had also every day the hammocks carried on the booms, or some other airy part of the ship, unlashed, and the bedding thoroughly shaken and aired. When the weather prevented the hammocks being carried on deck, they were constantly taken down, to make room for the fires, the sweeping, and other operations. When possible, fresh water was always allowed to the men to wash their clothes, as soap will not mix with sea-water, and linen washed in brine never thoroughly dries.
4. To keep the ship clean between decks.
5. To have frequent fires between decks, and at the bottom of the well. Captain Cook's method was to have iron pots with dry wood, which he burned between decks, in the well, and other parts of the ship: during which time some of the crew were employed in rubbing, with canvas or oakum, every part that had the least damp. Where the heat from the stoves did not readily absorb the moisture, loggerheads, heated red hot, and laid on sheets of iron, speedily effected the purpose.
6. Proper attention to be paid to the ship's coppers, to keep them clean and free from verdigris.
7. The fat that is boiled out of the salt beef or pork, never to be given to the men.
8. The men to be allowed plenty of fresh water, at the ship's return to port; the water remaining on board to be started, and fresh water from the shore to be taken in its room.
By means of the above regulations (in addition to rules relative to temperance, and supplying the crews as much as possible with fresh meat and vegetables), this celebrated navigator performed a voyage of upwards of three years, in every climate of the globe, with the loss of only one man.
The method of obtaining fresh water from the sea by distillation, was introduced into the English navy in the year 1770, by Dr. Irving, for which he obtained a parliamentary reward of £5000.
In order to give a clear notion of Dr. Irving's method, let us suppose a teakettle to be made without a spout, and with a hole in the lid in the place of the knob; the kettle being filled with sea-water, the fresh vapor, which arises from the water as it boils, will issue through the hole in the lid; into that hole fit the mouth of a tobacco pipe, letting the stem have a little inclination downwards, then will the vapor of fresh water take its course through the stem of the tube, and may be collected by fitting a proper vessel to its end.
This would be an apt representation of Dr. Irving's contrivance, in which he has luted or adapted a tin, iron, or tinned copper tube, of suitable dimensions, to the lid of the common kettle used for boiling the provisions on board a ship; the fresh vapor which arises from boiling seawater in the kettle passes, as by common distillation, through this tube into a hogshead, which serves as a receiver; and in order that the vapor may be readily condensed, the tube is kept cool by being constantly wetted with a mop dipped in cold sea-water. The waste water running from the mop may be carried off by means of two boards nailed together, like a spout. Dr. Irving particularly remarks, that only threefourths of the sea-water should be distilled; the brine is then to be let off and the copper replenished, as the water distilled from the remaining concentrated brine is found to have a disagreeable taste, and as the farther continuation of the distillation is apt to be injurious to the vessels. When the water begins to boil, likewise, the vapor should be allowed to pass freely for a minute; this will effectually cleanse the tube and upper part of the boiler.
It is well known that sea-water cannot be employed for washing clothes. It refuses to dissolve soap, and possesses all the properties of hard water.
This is a great inconvenience to seamen whose allowance of fresh water is necessarily limited, and it prevents them from enjoying many of those comforts of cleanliness which contribute not a little to health. The method of removing this defect is exceedingly simple, and by no means expensive. It was pointed out by Dr. Mitchell, of New York: - Drop into sea-water a solution of soda or potash. It will become milky, in consequence of the decomposition of the earthy salts and the precipitation of the earths. This addition renders it soft, and capable of washing. Its milkiness will have no injurious effect.
The instant an alarm is given that a man is overboard, the ship's helm should be put down, and she should be hove in stays; a hen-coop or other object that can float should also be thrown overboard as near the man as possible, with a rope tied to it, and carefully kept sight of, as it will prove a beacon towards which the boat may pull as soon as lowered down. A primary object is, having a boat ready to lower down at a moment's notice, which should be hoisted up at the stern if most convenient; the lashings, tackle etc., to be always kept clear, and a rudder, tiller and spare spar to be kept in her. When dark, she should not be without a lantern and a compass.
There should also be kept in her a rope with a running bowline, ready to fix in or to throw to the person in danger. Coils of small rope, with running bowlines, should also be kept in the chains, quarters and abaft, ready to throw over, as it most generally occurs that men pass close to the ship's side. and have often been miraculously saved by clinging to ropes.
If a person should fall out of a boat, or the boat upset by going foul of a cable, etc., or should he fall off the quays, or indeed fall into any water, from which he cannot extricate himself, but must wait some little time for assistance - had he presence of mind enough to whip off his hat, and hold it by the brim, placing his fingers within side of the crown (top upwards), he would be able, by this method, to keep his mouth above water till assistance should reach him. It often happens that danger is apprehended long before we are involved in the peril, although there may be time enough to prepare this, or adopt any other method. Travellers, in fording rivers at unknown fords, or where shallows are deceitful, might make use of this method with advantage.
Provide a cork waistcoat, composed of four pieces, two for the breast, and two for the back, each pretty near in length and breadth to the quarters of a waistcoat without flaps; the whole is to be covered with coarse canvas, with two holes to put the arms through. There must be a space left between the two back pieces, and the same betwixt each back and breast piece, that they may fit the easier to the body. By this means the waistcoat is open only before, and may be fastened on the wearer by strings; or if it should be thought more secure, with buckles and leather straps. This waistcoat may be made up at a small expense.
If those who use the sea occasionally, and especially those who are obliged to be almost constantly there, were to use these waistcoats, it would be next to impossible that they should be drowned.
It will likewise be proper to prepare an oil-skin bag, on going to sea, for a temporary supply of provisions, in case of shipwreck. If suddenly plunged into the water, and unable to swim, it will be necessary to keep the hands and arms under the water - few animals being capable of drowning, owing to their inability to lift their fore legs over their heads.
The legs, therefore, being necessarily immersed in the water, the difference between the specific gravity of the animal and the water is sufficient to enable it to keep its nostrils and mouth above the water, and therefore it is not suffocated by the fluid, but breathes freely. But man, on the contrary, being able to lift his hands over his head, and generally doing so in case of this accident, his hands and arms make up the difference in specific gravity, and his head, impelled by the weight of his hands and arms below the water, his body fills, and he is consequently choked and suffocated. The remedy therefore is, in all such cases, to keep down the hands and arms, and as a further security, to act with them under and against the water, it will then be impossible to sink, unless the weight of clothes or other circumstances operate to the contrary.
The marine spencer is made in the form of a girdle, of a proper diameter to fit the body, and six inches abroad, composed of about 500 old cavern corks, strung upon a strong twine, well lashed together with lay-cord, covered with canvas, and painted in oil so as to make it water-proof. Two tapes or cords, about two feet long, are fastened to the back of the girdle with loops at the ends. Another tape or cord of the same length, having a few corks strung to the middle of it, is covered with canvas painted. A pin of hard wood, three inches long, and half an inch in diameter, is fastened to the front of the girdle by a tape or cord, about three inches long. To use the spencer, it should be slipped from the feet close up to the arms, the tapes or cords are to be brought one over each shoulder, and fastened by the loops to the pin; those between the legs are to be fastened to the other pin. A person thus equipped, though unacquainted with swimming, may safely trust himself to the waves; for he will float, head and shoulders above water, in any storm, and by paddling with his hands, may easily gain the shore. Such a spencer may also be made of cork shavings put into a long canvas bag.
It has also been suggested, that every part of the usual dress of the sailor should be made with a view to preserving his life, in cases of accident; and for this purpose that a quantity of cork shavings or clippings should be quilted into his jacket about the collar and neck, between the outside and inside lining, or as a belt of considerable breadth across the back and shoulders, then principally omitted under the arms, and resumed over the chest and stomach, yet not so much as to create inconvenience. If in these, and other parts of his dress, so much cork could be conveniently worked, as would give the sailor an opportunity of recovering himself, and making use of his own powers in cases of contingency, many valuable lives might be saved.
The bamboo habit is an invention of the Chinese, by the use of which a person, unskilled in the art of swimming, may easily keep himself above water. The Chinese merchants, when going on a voyage, are said always to provide themselves with this simple apparatus, to save their lives in cases of danger from shipwreck. It is constructed by placing four bamboos horizontally, two before, and two behind the body of each person, so that they project about twenty-eight inches; these are crossed on each side by two others, and the whole properly secured, leaving an intermediate space for the body. When thus formed, the person in danger slips it over his head, and ties it securely to the waist, by which simple means he cannot possibly sink.
Let two or more persons hold a rope or ropes, at both ends, stretched over the broken ice; so that the drowning person may catch hold of it.
The life-boat is generally thirty feet long, and in form much resembles a common Greenland boat, except the bottom, which is much flatter. She is lined with cork, inside and outside of the gunwale, about two feet in breadth, and the seats underneath are filled with cork also.
She is rowed by ten men, double banked, and steered by two men with oars, one at each end, both ends being alike. Long poles are provided for the men, to keep the boat from being driven broadside to the shore, either in going off or landing. About six inches from the lower poles, it increases in diameter, so as to form a flat surface against the sand. The weight of the cork used in the boat seven hundredweight.
She draws very little water, and when full is able to carry twenty people. The boat is able to contend against the most tremendous sea and broken water, and never, in any one instance, has she failed in bringing the crew in distress into a place of safety. The men have no dread in going off with her in the highest sea and broken water; cork jackets were provided for them; but their confidence in the boat is so great, that they do not use them.
The success attending this expedient for diminishing the number of unhappy individuals almost daily lost in a watery grave appears to have been more than equal to the most sanguine expectations formed of its utility; and the great object in view, viz., the safety of those persons who hazard their own security to preserve others, has been fully accomplished.
In London Eng. a model of a life-boat was exhibited before the Royal Humane Society, which may be put together in the space of half an hour in any case of shipwreck, and which cannot sink or overset, let the sea run ever so high. All that is necessary to be provided is a keel or plank of any convenient length, and a few pigs of iron, such as vessels usually carry out for ballast. The officers of the ship are to take care to keep two or three empty water-casks, perfectly tight, the bungholes corked up, and a piece of tin or leather nailed over them. These casks are to be lashed with ropes to the keel, along with the pigs of iron for ballast, and any spare poles or spars may be also lashed to the sides, so as to give the raft the form of a vessel, and at each end make a lodgement for the men. Any of the square sails of the ship will form a lug-sail, and may speedily be adapted to the new life-boat, and a strong and broad spar may be lashed on as a rudder.
Another. - Let a quantity of ballast, even more than what is commonly used for sailing, be laid in the bottom of the boat; over this lay bags filled with cork, prepared for the purpose, and numbered according to their places, and if considerably higher than the gunwales, so much the better. A sail or part of one, folded, may be thrown over from stem to stern, to combine and unite the several parts; and, lastly, the whole is to be secured together by passing ropes by so many turns as may be deemed sufficient round and round over the gunwales and under the keel, and these, if necessary, may be hitched by a turn or two taken lengthwise.
Every person either on board or holding by the boat, so prepared, may be absolutely certain of being carried safe through any beach whatever.
When no such preparation of cork has been made, the following is proposed as a substitute:
Let a quantity of ballast, as coals in canvas, be secured in its place, as well as circumstances will admit; then take an empty water-cask (beer-cask, or any others that are tight) and fill the boat with them, and if the bilge of the cask rises considerably higher than the gunwales, it will be so much the better; let a sail then be thrown in to jam the cask and ballast in their places, as well as to combine and unite the several parts by covering all fore and aft; and, lastly, let the whole be lashed and secured together, in the manner above stated. It is believed the boat in this trim would always continue upright on her keel, be lively and buoyant on the water, and have sufficient efficacy to support the crew of any ordinary vessel, till drifted within their own depth.
It frequently happens that after men have gained the shore, they perish of cold for want of dry clothes. As a remedy for this, every man should try to secure one or two flannel or woollen shirts, by wrapping them up tightly in a piece of oiled cloth or silk; and, to guard against tearing, the last might be covered with canvas, or inclosed in a tin box.
It being the great object, in cases of shipwreck, to establish a communication betwixt the vessel and the shore with the least possible delay, various methods have been invented and pointed out for this purpose.
A common paper kite launched from the vessel, and driven by the wind to the shore, has been supposed capable of conveying a piece of packthread, to which a larger rope might be attached and drawn on board.
A small balloon, raised by rarefied air, might be made to answer the same purpose.
A sky-rocket, of a large diameter, has also been considered as capable of an equal service, and, indeed, this method seems the best; for, besides the velocity of the discharge, could it be brought to act during the night, it must both point out the situation of the ship, and the direction that the line took in flying ashore.
When a vessel springs a leak near her bottom, the water enters with all the force given by the weight of the column of water without, which force is in proportion to the difference of the level between the water without and that within. It enters at first therefore with more force, and in greater quantity than it can afterwards, when the water within is higher. The bottom of the vessel, too is narrower, so that the same quantity of water, coming into that narrow part, rises faster than when the space for it is larger. This helps to terrify: but, as the quantity entering is less and less as the surfaces without and within become more nearly equal in height, the pumps that could not keep the water from rising at first, might afterwards be able to prevent its rising higher, and the people might remain on hoard in safety, without hazarding themselves in an open boat on the wide ocean.
Besides the equality in the height of the two surfaces, there may sometimes be other causes that retard the farther sinking of a leaky vessel. The rising water within may arrive at quantities of light wooden works, empty chests, and particularly empty water-casks, which, fixed so as not to float themselves, may help to sustain her. Many bodies which compose a ship's cargo may be specifically lighter than water. All these, when out of water, are an additional weight to that of the ship, and she is in proportion pressed deeper in the water, but as soon as these bodies are immersed, they weigh no longer on the ship; but, on the contrary, if fixed, they help to support her, in proportion as they are specifically lighter than the water.
Captain Leslie, in a voyage from North America to Stockholm, adopted an excellent mode of emptying water from his ship's hold, when the crew were insufficient to perform that duty. About ten or twelve feet above the pump he rigged out a spar one end of which projected overboard, while the other was fastened, as a lever, to the machinery of the pump. To the end which projected overboard was suspended a waterbutt, half full, but corked down; so that when the coming wave raised the butt-end, the other end depressed the piston of the pump; but at the retiring of the wave this was reversed, for, by the weight of the butt, the piston came up again, and with it the water. Thus, without the aid of the crew, the ship's hold was cleared of the water in a few hours.
Another. - When a vessel springs a leak at sea, which cannot be discovered, instead of exhausting the crew by continual working at the pumps, they may form, with very little trouble, a machine to discharge the water, which will work itself, without any assistance from the hands on board.
Let a spar, or spare top-mast, be cut to the length of eight or ten feet, or more, according to the size of the vessel; mortise four holes through the thickest end, through which run four oars, fixing them tight, exactly in the middle. To the four handles nail on four blades (made of staves), the size of the other ends, which will form a very good water-wheel; if the oars be strong, then fix into the opposite end what is commonly called a crank: the iron handle of a grindstone would suit extremely well; if this is not to be had, any strong bar of iron may be bent into that form, wedging it tight to prevent its twisting round. Then nail up a new pair of chaps on the fore part of the pump, for a new handle to be fixed in, which will point with its outer end to the bow of the vessel. This handle will be short on the outside, but as long on the inside as the diameter of the bore of the pump will admit, in order that the spear may be plunged the deeper, and of course the longer stroke. The handle must be large enough to have a slit sawed up it, sufficient to admit a stave edgeways, which must be fastened with a strong iron pin, on which it may work. The lower end of the stave must be bored to admit the round end of the crank; then fix the shaft, with the oars (or arms) over the gunwale, on two crotchets, one spiked to the gunwale, and the other near the pump, cutting in the shaft a circular notch, as well to make it run easier, by lessening the friction, as to keep the whole steady. A bolt is now to be fixed in each crotchet close over the shaft, to keep it from rising. As soon as the wheel torches the water it will turn round, and the crank, by means of the stave fixed on its end, will work the handle of the pump.
According to the present plan of ship-building, in ease of a leak at sea, which cannot be kept under by pumping, the ship and crew must inevitably be lost, to the great affliction and loss of thousands of families. In order to prevent such accidents in future, which hitherto have been too common, a gentleman of the name of Williams suggests an easy arrangement which, if universally adopted, even under the worst circumstances, will enable the crew to save not only themselves, but the ship and cargo likewise:
It is that every ship should be divided into four equal compartments, with partitions of sufficient strength, the probability in case of a leak is that it would take place in one of them, and, allowing it to fill, the safety of the ship would not be endangered, for three-fourths of the cargo would remain undamaged. To prove this we will suppose a vessel of 100 tons so divided (though the plan is as applicable to a ship of 1000 tons as to a canal boat), and that one of the compartments filled with water; this would not increase her weight more than from six to eight tons from the cargo previously occupying the space and reducing her buoyancy about one-third. The same effect would take place was she sent out of port with only one fourth of her hull above water, though vessels are commonly sent out with onethird, and even more. Packets, as they carry little or no cargo, may with safety be divided into three compartments. In cases of fire the advantage is equally obvious, as any of the quarters might be inundated with safety.
It has been observed before that men are drowned by raising their arms above water, the unbuoyed weight of which depresses the head; all other animals have neither motion nor ability to act in a similar manner, and therefore swim naturally. When a man therefore falls into deep water, he will rise to the surface and continue there if he does not elevate his hands. If he move his hands under the water in any manner he pleases his head will rise so high as to allow him liberty to breathe, and if he move his legs as in the act of walking (or rather of walking upstairs), his shoulders will rise above the water, so that he may use less exertion with his hands, or apply them to other purposes. These plain directions are recommended to the attention of those who have not learned to swim in their youth, and they will, if attended to, be found highly advantageous in preserving life.
If a person falls into the water or gets out of his depth and cannot swim, and if he wishes to drown himself, let him kick and splash as violently as possible, and he will soon sink. On the contrary, if impressed with the idea that he is lighter than the water, he avoids all violent action and calmly but steadily strives to refrain from drawing his breath while under the water, and keeps his head raised as much as possible, and gently but constantly moves his hands and feet in a proper direction, there will be a great probability of his keeping afloat until some aid arrives.
For the cure of the cramp when swimming, Dr. Franklin recommends a vigorous and violent shock of the part affected by suddenly and forcibly stretching out the leg, which should be darted out of the water into the air if possible.
Never venture into cold water when the body is much exhausted or relaxed with heat.
Dr. Franklin relates an instance within his own knowledge of four young men who, having worked at harvest in the heat of the day, with a view of refreshing themselves plunged into a spring of cold water; two died upon the spot, a third the next morning, and the fourth recovered with great difficulty.
Be very careful where you bathe, even though ever so good a swimmer, lest there should be weeds to entangle the feet, or any thing else to endanger life. It is by the neglect of this precaution that many good swimmers expose themselves to greater danger than those who cannot swim at all, their very expertness thus becoming fatal to them by tempting them into places where their destruction is inevitable.
The use of the tepid salt water bath, or indeed of seabathing itself, when the water is warm, (that is) between 60¡ and 70¡ of heat, is in many cases beneficial, when a colder temperature would be decidedly injurious.
It may be satisfactory to know that in situations distant from the shore, where sea-water cannot be had, artificial sea-water, made by dissolving 4 pounds of bay-salt in 16 gallons of fresh water, possesses all the properties of the water of the sea, a small portion of sulphate of magnesia excepted.
The cold shower-bath is less alarming to nervous persons and less liable to produce cramps than cold immersion; it may be considered as the best and safest mode of cold bathing, and is recommended in many nervous complaints.
It has also afforded relief in some cases of insanity.
Where the saving of expense is an object, it may be effectually answered by filling a common watering pot with cold water. Let the patient sit undressed upon a stool, which may be placed in a large tub, and let the hair, if not cut short, be spread over the shoulders as loosely as possible. Now pour the water from the pot over the patient's head, face, neck, shoulders, and all parts of the body, progressively down to the feet, until the whole has been thoroughly wetted.
A large sponge may, in some measure, be substituted for the shower bath; particularly in affections of the head which arise from intemperance, night-watching, study, or other perplexity. Headache, from these causes, will be greatly alleviated by wiping the top and fore-part of the head with a sponge frequently dipped in water. The cold thus produced will check the determination of blood to the head, and has often been known to prevent delirium and insanity.
On immersing the body in a tepid-bath, which takes its range from 85¡ to 90¡, no striking sensation either of heat or cold is felt. But a person much chilled, will on entering the tepid-bath feel the water warm, while another who has been heated by exercise, will find it insensibly cold.
The tepid-bath is attended with several advantages: the surface of the skin is by it freed from that scaly matter, which always collects more or less on the healthiest person; the pores of the skin thus being free, the natural perspiration is promoted, the limbs are rendered supple, and any stiffness which may have been produced by exertion or fatigue, is removed. Such immersion has been found to allay thirst, a proof that a quantity of water is absorbed, and enters the body through the skin.
The tepid-bath seems the best adapted to the purposes of cleanliness and healthy exercise. To delicate females and young children, it is of primary importance. Nothing can be more absurd than the common practice of mothers and nurses in washing children, no matter how sickly or unwell, with cold water, under the idea of bracing the constitution: whereas the use of tepid water alone, is not only the most agreeable, but the most proper fluid to excite the energies of the system in young children
Affusion with tepid water has generally the same result, except, that if the body continue exposed to the air after the effusion, a sensation of cold is produced, which ought to be avoided by wiping dry the upper part of the body whilst the lower extremities are still covered with water.
There can be little doubt that human existence, by tepid bathing, temperance, and proper exercise, may be made more agreeable and also be prolonged.
1. Rise early, and never sit up late.
2. Wash the whole body every morning with cold water, by means of a large sponge, and rub it dry with a rough towel, or scrub the whole body for ten or fifteen minutes with flesh brushes.
3. Drink water generally, and avoid excess of spirits, wine, and fermented liquors.
4. Keep the body open by the free use of the syringe, and remove superior obstructions by aperient pills.
5. Sleep in a room which has free access to the open air.
6. Keep the head cool by washing it when necessary with cold water, and abate feverish and inflammatory symptoms when they arise by persevering stillness.
7. Correct symptoms of plethora and indigestion by eating and drinking less per diem for a few days.
8. Never eat a hearty supper, especially of animal food, and drink wine, spirits, and beer, if these are necessary, only after dinner.
This great man left, as a legacy to the world the following simple and unerring directions for preserving health; they contained the sum and substance of his vast professional knowledge during a long and useful life: - "Keep the feet warm, the head cool, and the body open." If these were generally attended to the physician's aid would seldom be required.
To adapt the dress with a scrupulous nicety to the fluctuations of temperature every day, would indeed require such minute attention as hardly any person can bestow; but every person may comply with the general rules of clothing, as far as not to lay aside too early the dress of the winter, nor to retain that of the summer too late: from a neglect of which precaution thousands of lives are every year sacrificed to mortality. The perfection of dress, considered merely as such, is to fit without fettering the body.
Nothing is more pernicious than the air of a place where a numerous body of people is collected together within doors, especially if to the breath of the crowd there be added the vapors of a multitude of candles, and the consumption of the vital air by fires in proportion. Hence it happens that persons of a delicate constitution are liable to become sick or faint in a place of this kind. These ought to avoid, as much as possible the air of great towns; which is also peculiarly hurtful to the asthmatic and consumptive, as it is likewise to hysteric women and men of weak nerves. Where such people cannot always live without the verge of great towns, they ought at least to go out as often as they can into the open air, and if possible pass the night in the wholesome situation of the suburbs.
Air that has long stagnated becomes extremely unwholesome to breathe, and often immediately fatal. Such is that of mines, wells, cellars, etc. People ought therefore to be very cautious in entering places of this description which have been long shut up. The air of some hospitals, jails, ships, etc., partakes of the same unwholesome and pernicious nature, and they ought never to be destitute of ventilators - those useful contrivances for expelling foul and introducing fresh air into its place. The same may be said of all places where numbers of people are crowded together; or where fires, especially charcoal fires, are burning.
It is found that most plants have the property of correcting bad air within a few hours, when they are exposed to the light of the sun; but that on the contrary, during the night or when flowering they corrupt the common air of the atmosphere. Hence it is an unwholesome practice to have shrubs in an apartment that is slept in, at least when in bloom.
Both in public and private buildings there are errors committed which affect in an extraordinary degree the salubrity of the air. Churches are seldom open during all the week; they are never ventilated by fires, and rarely by opening the windows, while, to render the air of them yet more unwholesome, frequently no attention is paid to keeping them clean. The consequence of which is that they are damp, musty, and apt to prove hurtful to people of weak constitutions; and it is a common remark that a person cannot pass through a large church or cathedral, even in summer, without a strong feeling of chilliness.
The great attention paid to making houses close and warm, though apparently well adapted to the comfort of the inhabitants, is by no means favorable to health, unless care be taken every day to admit fresh air by the windows. Sometimes it may be proper to make use of what is called pumping the room, or moving the door backward and forward for some minutes together. The practice of making the beds early in the day, however it may suit convenience or delicacy, is doubtless improper. It would be much better to turn them down and expose them to the influence of the air admitted by the windows.
For many persons to sleep in one room, as in the ward of a hospital, is hurtful to health, and it is scarcely a less injurious custom, though often practised by those who have splendid houses, for two or more to sleep in a small apartment, especially if it be very close.
Houses situated in low marshy countries, or near lakes of stagnant water, are likewise unwholesome, as they partake of the putrid vapors exhaled in such places. To remedy this evil, those who inhabit them, if they study their health, ought to use a more generous diet than is requisite in more dry and elevated situations. It is very important too, in such localities to dry the house with a fire whenever the air is damp, even in the summer.
It was formerly, and is now, too common to have churchyards in the middle of populous towns. This is not only reprehensible in point of taste, but, considering how near to the surface of the earth the dead bodies in many places are deposited, there must necessarily arise putrid vapors, which, however imperceptible, cannot fail to contaminate the air. The practice of burying in churches is still more liable to censure, and not many years ago, the pernicious' effects of this custom were so severely felt in France, as to occasion a positive edict against it.
Procure a pair of smith's bellows, affixed on A wooden frame, so as to work in the same manner as at the forge. This apparatus being placed at the edge of the well, one end of a leathern tube (the hose of a fire engine), should be closely adapted to the nose of the bellows, and the other end thrown into the well, reaching within one foot of the bottom.
If the well be even so infected, that a candle will not burn at a short distance from the top; after blowing with the bellows only half an hour, the candle will burn brightly at the bottom; then without further difficulty, proceed in the work.
It is obvious, that in cleaning vaults, or working in any subterraneous place subject to damps, the same method must be attended with the like beneficial effects.
Persons whose business requires them to attend upon large quantities of fermenting liquors, or to work in close places with lighted charcoal, frequently experience headache, giddiness, and other disagreeable effects from the noxious vapors which these exhale, and often have their health impaired, or their lives endangered by a continuance in the employment. In some cases, the danger, perhaps, cannot be avoided, except by going into the open air, as soon as headache or giddiness begins, and drinking a glass of cold water, or washing the face and neck with the same. In the case of persons whose work requires charcoal fires, their dangerous effects may be prevented, by taking care not to sit near the fire when burning, or to burn it in a chimney, and when there is none to keep the door open, and place a large tub of lime-water in the room.
It is advisable for all those who are exposed to the vapors of charcoal, particularly gilders, jewellers, refiners of metal, etc., to place a flat vessel filled with limewater, near the stove in which the charcoal is burnt.
The lime combines with the carbonic acid gas evolved by the ignited charcoal, and preserves the purity of the air. When the surface of the water becomes covered with a film, or pellicle, it must be changed for a fresh quantity.
The smoking of lamps is frequently disregarded in domestic life; but the fumes ascending from oil, especially if it be tainted or rancid, are highly pernicious, when inhaled into the lungs of asthmatic persons. To prevent this, let a sponge three or four inches in diameter, be moistened with pure water, and in that state be suspended by a string or wire, exactly over the flame of the lamp, at the distance of a few inches; this substance will absorb all the smoke emitted during the evening or night, after which it should be rinsed in warm water, by which means it will be again rendered fit for use.
Put a saucer full of chloride of lime on the floor of the room, and renew it every two or three days. Or, sprinkle Labarraque's solution of chloride of soda over the floor or walls. Ledoyen's solution of nitrate of lead will at once remove the odor of most foul air. But the only absolutely certain method of disinfection is by heat; for example, let every person be removed from the tainted building or vessel, and then by means of stoves, keep up a temperature of 140û fahr., for two or three days.
They should have two doors in their work room, opposite to each other, which they should keep open, that there may be a free circulation of air. They should likewise have a piece of gold applied to the roof of the mouth, during the whole time of the operation. This plate will attract and intercept the mercury as they breathe, and when it grows white they must cast it into the fire, that the mercury may evaporate, and replace it when it is cool again. They should, indeed, have two pieces of gold, that one may be put into the mouth whilst the other is purifying and cooling; by these means they will preserve themselves from the diseases and infirmities which mercury occasions.
For preserving health, there is no kind of exercise more proper than walking, as it gives the most general action to the muscles of the body; but, for valetudinarians, riding on horseback is preferable. It is almost incredible how much the constitution may be strengthened by this exercise, when continued for a considerable time; not so much in the fashionable way of a morning ride, but of making long journeys, in which there is the farther advantage of a perpetual change of air. Numbers of people, reduced to a state of great weakness, have, by this means, acquired a degree of vigor and health, which all the medical prescriptions in the world could not otherwise have procured. But it is of importance, in travelling for health, that one should not employ his mind in deep reflections, but enjoy the company of an agreeable companion, and gratify his sight with the prospect of the various objects around him. In this exercise, as well as in every other, we ought always to begin gently, and to finish gradually, never abruptly; and proportion the exertion to the strength.
Exercise is hurtful immediately after meals, particularly to those of nervous and irritable constitutions, who are thence liable to heartburn, eructations, and vomiting. Indeed, the instinct of the inferior animals confirms the propriety of this rule; for they are all inclined to indulge themselves in rest after food. At all events, fatiguing exercise should be delayed till digestion is performed, which generally requires three or four hours after eating a full meal.
This is a species of exercise much recommended by the ancient physicians; and to this may be joined that of speaking. They are both of great advantage to those who have not sufficient leisure or opportunities for other kinds of exercise. To speak very loud, however, is hurtful to weak lungs. Singing, as by the vibratory motion of the air it shakes the lungs and the bowels of the abdomen or belly, promotes, in a remarkable degree, the circulation of the blood. Hence, those sedentary artificers or mechanics, who from habit almost constantly sing at their work, unintentionally contribute much to the preservation of their health.
All these are more or less hurtful to the lungs, which they weaken, by introducing much air, and keeping that organ too long in a state of distention. On this account, persons of weak lungs, who play much on the flute, hautboy, or French horn, are frequently afflicted with spitting of blood, cough, shortness of breath, and pulmonary consumption. Blowing those instruments likewise checks the circulation of the blood through the lungs, accumulates it towards the head, and disposes such persons to apoplexy.
One of the most gentle and useful kinds of exercise is friction of the body, either by the naked hand, a piece of flannel, or, what is still better, a flesh-brush. This was in great esteem among the ancients, and is so at present in the East Indies The whole body may be subjected to this mild operation, but chiefly the belly, the spine, or backbone, and the arms and legs. Friction clears the skin, resolves stagnating humors, promotes perspiration, strengthens the fibres, and increases the warmth and energy of the whole body. In rheumatism, gout, palsy, and green sickness, it is an excellent remedy. To the sedentary, the hyperchondriac, and persons troubled with indigestion, who have not leisure to take sufficient exercise, the daily friction of the belly, in particular, cannot be too much recommended as a substitute for other means, in order to dissolve the thick humors which may be forming in the bowels, by stagnation, and to strengthen the vessels. But, in rubbing the belly, the operation ought to be performed in a circular direction, as being most favorable to the course of the intestines, and their natural action. It should be performed in the morning, on an empty stomach, or, rather, in bed before getting up, and continued at least for some minutes at a time.
This accident is at all times less frequent in towns than in the country, owing to the almost universal use of the umbrella in the former.
When a person is wet he ought never to stand, but to continue in motion till he arrives at a place where he may be suitably accommodated. Here he should strip off his wet clothes, to be changed for such as are dry, and have those parts of his body which have been wetted, well rubbed with a dry cloth. The legs, shoulders, and arms, are generally the parts most exposed to wet; they should, therefore, be particularly attended to. It is almost incredible how many diseases may be prevented by adopting this course. Catarrhs, inflammations, rheumatisms, diarrhoeas, fevers, and consumptions, are the foremost among the train which frequently follow an accident of this kind.
It should be a determined rule to avoid all rapid transitions from one extreme to another, and never to remove from a room highly heated to a fresh or cold air while the body remains warm, or till the necessary change to a warmer dress has been previously made. If, at any time, the body should be violently heated, during the warm weather, it is sure to suffer by going into vaults, cellars, ice-houses, by cold bathing, or by sitting on cold stones, or damp earth; many lingering and incurable maladies have been brought on by such imprudence; nay, present death has, in some instances, been the consequence of such transgression. Pulmonary consumption, which makes annually such dreadful ravages among the young and middle aged, has been frequently induced by such apparently trifling causes.
One method that has been found to succeed in keeping the feet dry is to wear, over the foot of the stocking, a sock made of oiled silk. To keep it in its proper place, it will be necessary to wear over it a cotton or worsted sock. India-rubber overshoes or boots are now generally worn. But they or oiled silk, as they prevent the evaporation of the insensible perspiration, and thus obstruct the pores of the skin, should never be worn long at a time.
1. Never sit for any length of time in absolute gloom, or exposed to a blaze of light. The reason on which this rule is founded proves the impropriety of going hastily from one extreme to the other, whether of darkness or of light, and shows us that a southern aspect is improper for those whose sight is weak and tender.
2. Avoid reading small print, and straining the eyes by looking at minute objects.
3. Do not read in the dusk, nor, if the eyes be disordered, by candle-light.
4. Do not permit the eyes to dwell on glaring objects, more particularly on first waking in the morning; the sun should not of course be suffered to shine in the room at that time, and a moderate quantity of light only should be admitted. For the same reasons, the furniture, walls, and other objects of a bed-room should not be altogether of a white or glaring color; indeed, those whose eyes are weak, would find considerable advantage in having green for the furniture, and as the prevailing color of their bed-chambers. Nature confirms the propriety of this direction, for the light of the day comes on by slow degrees, and green is the universal color she presents to our eyes.
5. Those individuals who are rather longsighted should accustom themselves to read with the book somewhat nearer to the eye than what they naturally like, while others, that are rather short-sighted, should use themselves to read with the book as far off as possible. By these means both will improve and strengthen their sight, while a contrary coarse increases its natural imperfections. It is well to read or sew with the light above or behind, rather than in front of the face, or with a shade to protect the eyes from glare.
From whatever cause the decay of sight arises an attentive consideration of the following rules will enable any one to judge for himself when his eye-sight may be assisted or preserved by the use of proper glasses:
1. When we are obliged to remove small objects to a considerable distance from the eye in order to see them distinctly.
2. If we find it necessary to get more light than formerly, as for instance to place the candle between the eye and the object.
3. If on looking at and attentively considering a near object it fatigues the eye and becomes confused, or if it appears to have a kind of dimness or mist before it.
4. When small, printed letters are seen to run into each other, and on looking steadfastly at them appear double or treble.
5. If the eyes are so fatigued by a little exercise that we are obliged to shut them from time to time, so as to relieve them by looking at different objects.
When all these circumstances concur, or any of them separately takes place, it will be necessary to seek assistance from glasses, which will ease the eyes, and in some degree check their tendency to become worse, whereas if they be not assisted in time the weakness will be undoubtedly increased and the eyes be impaired by the efforts they are compelled to make. When weakness of the sight is not remedied by glasses, it will be necessary to avoid all use of the eyes which gives pain or causes fatigue, especially at night.
To set off the complexion with all the advantage it can attain, nothing more is requisite than to wash the face with pure water, or if anything farther be occasionally necessary, it is only the addition of a little soap. [See pages 306, 466.]
An object very subservient to health, and which merits due attention, is the preservation of the teeth, the care of which, considering their importance in preparing the food for digestion, is, in general, far from being sufficiently attended to. Many persons neglect to wash their mouth, in the morning, which ought always to be done. Indeed this ought to be practiced at the conclusion of every meal, where either animal food or vegetables are eaten, for the former is apt to leave behind it a rancid acrimony, and the latter an acidity, both of them hurtful to the teeth. Washing the mouth frequently with cold water is not only servicable in keeping the teeth clean, but in strengthening the gums, the firm adhesion of which to the teeth is of great importance in preserving them sound and secure. The addition of a few drops of tincture of myrrh to the water will make it more cleansing and sweeter to the breath.
Many persons, while laudably attentive to the preservation of their teeth, do them hurt by too much officiousness. They daily apply to them some dentifrice powder, which they rub so hard as not only to injure the enamel by excessive friction, but to hurt the gums even more than by the abuse of the the toothpick. The quality of some of the dentifrice powders advertised in newspapers is extremely suspicious, and there is reason to think that they are not altogether free from a corrosive ingredient. One of the safest and best compositions for the purpose is a mixture of two parts of prepared chalk, one of Peruvian bark, and one of hard soap, all finely powdered, which is calculated not only to clean the teeth without hurting them, but to preserve the firmness of the gums.
Besides the advantage of sound teeth for their use in mastication, a proper attention to their treatment conduces not a little to the sweetness of the breath. This is, indeed, often affected by other causes existing in the lungs, the stomach, and sometimes even in the bowels, but a rotten state of the teeth, both from the putrid smell emitted by carious bones and the impurities lodged in their cavities, never fails of aggravating an unpleasant breath wherever there is a tendency of that kind. [See pages 307, 308.]
When the teeth are loosened by external violence, by falls and blows, or by the improper use of instruments in pulling diseased teeth in the neighbourhood of sound ones, they may again be made tolerably fast by pressing them as firmly as possible into their sockets, and preserving them so with ligatures of cat-gut, Indian weed or waxed silk, and keeping the patient upon spoon-meat till they are firm. When looseness of the teeth is owing to decay, nothing will fasten them till the cause be removed, and this ought to be done early, otherwise it will have no effect. Frequently the teeth become loose from a sponginess of the gums, often attributed to scurvy. The best remedy is scarifying the gums deeply, and allowing them to bleed freely; this should be repeated till they are fully fastened. Mild astringents, as tincture of bark, are here attended with good effects, though those of a strong nature will certainly do harm. The mouth should be frequently washed with cold water strongly impregnated with these, and the patient should not use the teeth which have been loose till they become firm again. The loosening of the teeth in old age cannot be remedied, as it is owing to the wasting of their sockets, from which the teeth lose their support.
The teeth sometimes become yellow or black without any adventitious matter being observed on them; at other times they become foul, and give a taint to the breath, in consequence of the natural mucus of the mouth, or part of the food remaining too long about them. The most frequent cause of foul teeth is the substance called tartar, which seems to be a deposition from the saliva, and with which the teeth are often almost entirely encrusted. When this substance is allowed to remain, it insinuates itself between the gums and the teeth, and then gets down upon the jaw in such a manner as to loosen the teeth. When they have been long covered with this or with any other matter, it is seldom they can be cleaned without the assistance of instruments. But when once they are cleaned they may generally be kept so by rubbing them with a thin piece of soft wood made into a kind of brush and dipped into distilled vinegar, after which the mouth is to be washed with common water.
When the teeth are to be cleaned with instruments, the operator ought, with a linen cloth or with a glove, to press against the points of the teeth, so as to keep them firm in their sockets with the fingers of the one hand while he cleans them with the necessary instruments held in the other, taking care not to scrape them so hard as to loosen them, or to rub off the enamel. This being done, the teeth should be rubbed over with a small brush or a piece of sponge dipped in a mixture of cream of tartar and Peruvian bark. The same application may be made to the teeth for a few days, when afterwards they may be kept clean as already directed.
The teeth are sometimes covered over with a thin dark colored scurf, which has by some been mistaken for a wasting of the enamel, but which is only an extraneous matter entering it. By perseverance this may be cleaned off as completely as where the teeth are covered with tartar; but it is apt, after some time, to appear again. When this is observed the same operation must be repeated.
For the purpose of applying powders or washes to the teeth, a hard or soft brush is commonly employed; the latter is supposed preferable, as being in less danger of wearing down the enamel or of separating the teeth.
Toothache may be of either of three kinds: from irritation of the nerve, exposed in the hollow of a decaying tooth; from inflammation of the jaw, with or without a gathering at the root of a tooth; and from neuralgia. For the first of these, there is a certain cure; but it requires care in the application. Wrap a small pledget of raw cotton around the point of a knitting or darning needle, and dip it in creasote; then insert the point with the cotton directly into the hollow of the aching tooth. If it reach the nerve, it will give relief instantly. The cotton may be left in for a while, covered by a dry piece. Care is needed not to let the creasote drop or run upon the lips or gums, on which it will act as a caustic. If a drop should escape, however, little or no harm will follow if the mouth be at once washed well with cold water.
By the following tables it will be seen that in the
| 1 gallon measure | = | 8 pints |
| 1 pint | = | 16 ounces |
| 1 ounce | = | 8 drachms |
| 1 drachm | = | 60 minims |
| 1 pound | = | 12 ounces |
| 1 Ounce | = | 8 drachms |
| 1 drachm | = | 60 grains |
| 1 scruple | = | 20 grs. or 1-3 of a drachm |
It is customary to distinguish quantities of fluid, from dry substances, by prefixing the letter f. (fluid) when an ounce or drachm is mentioned in medical works, but in the foregoing prescriptions or formula, this was considered to be unnecessary, as the slightest acquaintance with the substances to be used will point out what is implied.
In order to measure quantities of fluids, glasses, graduated on their sides (according to the above figures), will be found useful in all families and private laboratories:
No. 1, Represents a glass calculated to measure any quantity from two drachms to eight ounces.
No. 2, From one drachm to two ounces.
No. 3 From half a drachm to one ounce, and No. 4 Any quantity from five minims (or drops) to one drachm.
The following table of the gradations of doses of medicines for different ages, will in general be found pretty correct, and ought never to be deviated from, except by professional advice.
If at the age of manhood the dose be one drachm, the proportions will be at:
From 14 to 21 years, 2 scruples; 7 to 14 years, half a drachm; 4 to 7 years, 1 scruple; 4 years, 15 grains; 3 years, half a scruple; 2 years, 8 grains; 1 year, 5 grains; 6 months, 3 grains; 3 months, 2 grains; 1 month, 1 grain.
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