A DICTIONARY

OF

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CLARKE

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A DICTIONARY

OF

DOMESTIC MEDICINE.

A DICTIONARY

OF

Domestic Medicine

GIVING

A DESCRIPTION OF DISEASES, DIRECTIONS FOR THEIR GENERAL MANAGEMENT

AND

HOMOEOPATHIC TREATMENT

WITH A SPECIAL SECTION' OX

DISEASES OF INFANTS.

HV

JOHN H. CLARKE, M.D. Edix.

FELLOW BRITISH HOMOEOPATHIC SOCIETY. EXT. MEM. ROY. MED. SOC. EDIX. PHYSICl\N TO THE LONDON" HOMCEOPATHIC HOSPITAL, AND LECTURER ON MATERIA MEDICA TO THE L.H.H. MEDICAL SCHOOL.

Editor oj " Hemaeopatkte World f Author of " The Preserver," " An Media,"

" frdide of Arsenic in Organic Disease ?fthe Heart;' Ore, I

LONDON : KLEXL & ASHWELL, 74 NEW BOND STREET, W

NEW YORK : BOERICKE ft TAFEL. 145 GRAND STREET. 1890. [All Rights Ret

Mht.

Coll,

PR KF ACE.

Many non-medical readers of the PrescHber having requested me to bring out a more popular and elementary work on the same lines of arrangement, I have used such leisure moments as I could find during a number of years in pre- paring such a work, and the present volume is the result. The Prescribe)- was originally intended for the use of

O J

medical men or medical students ; no description of diseases was given, but simply under the heading of the name of the disease the medicines most commonly indicated, with their differential indications. The Dictionary follows the plan of the Prescribe/- in giving in alphabetical order a list of diseases, with the appropriate homoeopathic treatment, but, in addition, each disease is described as plainly and con- cisely as possible, with diagnostic hints for distinguishing it from other similar diseases ; and directions are also added for dieting and general management.

In their proper alphabetical place will also be found special articles on Baths, Clothing, and Diet ; and under

vi PREFACE.

the heading " Infants " a sub-alphabetical arrangement of the disorders peculiar to the earliest years of life.

In the compilation of the Dictionary many sources have been drawn upon, but the author makes himself responsible for all the advice here given. Dr. Constantine Hering's Domestic Physician^ the most original of domestic treatises, and the author's Prescriber are the works which have been most largely used.

John H. Clarke.

34 Harrington Road, London, S.W.,

May 1890.

ERRATUM.

Page 51, line 6 from bottom, /i^ " then thicken :' read " this thickens.''

INTRODUCTION.

HOMOEOPATHY.

Homoeopathy is a system of cure based on the fact that any substance which is capable of producing symptoms of disease in the healthy will remove those symptoms and cure the disease when met with in the sick. That such a principle of cure existed was first enunciated by Hippo- crates, but it was not until centuries after, when Hahne- mann seized upon the idea, and by his herculean labours reconstructed the Materia Medica, that Homoeopathy be- came what we now know it — the most complete and scien- tific system of healing the sick the world has ever seen. Only those who have never experienced its effects in their own persons, and those who have not the skill or the patience to practise it, are now found capable of denying its existence.

There are two reasons why so many medical men are found who know nothing of Homoeopathy. The first is that it entails an enormous amount of trouble to learn to practise it as medical men must — nothing short of acquiring a new art after they have finished their work at the schools ; and the other is that, as one result of their pains, they lose caste with their professional brethren. For these two reasons homoeopathic doctors are likely to be for some

viii INTRODUCTION.

time to come a scarce commodity. Hence arises the necessity for books like the present, which shall enable those who cannot obtain homoeopathic medical advice to practise homoeopathy in their own homes and families. The Dictionary is not intended to make homoeopathic physi- cians, but to convey in easily accessible form such infor- mation as intelligent people ought to possess about diseases and their treatment, and to enable them to apply the treatment when the case is not too grave for a non-medical person to undertake.

MATERIA MEDICA.

The Homoeopathic Materia Medica consists of a record of the symptoms produced by the different drugs on healthy people. Those medicines which have produced the most marked and the greatest number of symptoms are the most important in homoeopathic practice, as they afford the greatest number of points for comparison with the symp- toms met with in disease. In this work only the most commonly required drugs are mentioned. To have introduced more would have been confusing rather than helpful. In stocking a full-sized Homoeopathic Medicine Chest the following medicines should be included; for a small-sized chest it will be sufficient to include only those printed in capitals. These are not the only medicines mentioned in the Dictionary, but the others are only required exceptionally, and can be obtained when wanted.

Names. A bbreviations. .

ACONITE Aeon.

Antimonium crudum ..... Ant. c.

ANTIMONIUM TARTARICUM . . Ant. t.

APIS , Apis.

ARNICA Am.

ARSENICUM ALBUM .... Ars.

INTRODUCTION.

IX

Aravics. BELLADONNA . BRYONIA .

CALCAREA CARBONICA

CAMPHOR .

Carbo vegetabilis .

Causticum

CHAMOMILLA .

CHINA .

Cina

Coffea

COLOCYNTH

Dulcamara Ferrum .

Gelsemium

Graphites

Hamamelis

HEPAR SULPHURIS

Hyoscynmus .

IGNATIA AMARA

IPECACUANHA

Kali bichromicum . Kali carbonicum

LACHESIS . LYCOPODICM .

MERCURIUS SOLUBILIS

NATRUM MUR.

Nitric Acid . NUX VOMICA .

Abbreviations. . Bell. . Bry.

. Calc. c. Camph.

. Carb v.

Caust.

Cham. . Chin. . Cina. . Coff. . Coloc.

. Dulc. . Ferr.

. Gels. . Graph.

Ham. . Hep. . Hyo.

• Ign. . Ipec.

. Kilibi.

. Kali c.

. Lach. . Lye.

. Merc. s.

. Nat. m. . Nit. ac.

Nux v.

INTRODUCTION.

Names. Abbreviations.

Opium Op.

PHOSPHORUS Phos.

Phytolacca ....... Phyt.

Podophyllin ....... Pod.

PULSATILLA Puis.

RHUS TOXICODENDRON . . Rhus.

Sabina Secaie SEPIA . SILICA . Spongia . Staphisagria Stramonum SULPHUR

Sabi.

Sec.

Sep.

Sil.

Spo.

Stap.

Stram.

Sulph.

Thuja occidentalis ...... Thuj.

Veratrum Album ...... Ver.

Strong tinctures required for external application- Arnica. Calendula.

More rarely required — Hamameiis. Hypericum. Ledum.

ATTENUATION OR POTENCY.

The mode of preparation of homoeopathic medicines is peculiar. Hahnemann discovered that many substances, such as chalk and flint, which in their crude state are inert, when finely triturated by being ground in a mortar with

INTRODUCTION. «

sugar of milk, develop surprising powers. He also found that vegetable and liquid poisons, by being gradually attenuated by dilution in a special way, lose all their material, physical, and chemical properties, whilst retaining their medical properties unimpaired. The scale in which he attenuated drugs was in the proportion of i part of the substance to 99 parts of the attenuating medium (whether alcohol or sugar of milk) for each degree. Hahnemann carried all his medicines up to the 30th degree, and expe- rience has shown that from the lowest attenuation to the highest all are effective. For ordinary domestic practice the 3rd attenuation of all soluble substances, and the 6th or 1 2th of all insolubles (Calcarea, Carbo veg., Ferrum, Graphites, Hepar, Lycopod., Sepia, Silica), are the best for general use. But where the lower attenuations prove ineffectual in old-standing cases, the higher should be tried before changing a remedy that seems appropriate. The 30th attenuations of Sulphur, Lycopodium, and Calcarea are useful to have in reserve. Camphor is most useful in the strong tincture or strong pilules.

FORM OF ADMINISTRATION.

The four principal forms in which homoeopathic medicines are administered are : Tinctures, Triturations, Pilules, and Globules; and any of these may be dissolved in water and the solution given in spoonfuls. Of the tinctures one drop is enough for a dose, and it may be given in a teaspoonful or dessert-spoonful of water, or on a piece of loaf sugar. If it is desired to repeat the dose frequently, eight or ten drops may be mixed in as many spoonfuls of water, a spoonful being given as often as is desired. One or two grains of a trituration (as much as would lie on a threepenny bit, or a sixpence) is the usual dose, one or two pilules, and two to five globules. For hot climates globules of the 12th or

xii INTRODUCTION.

30th attenuation are the best for keeping. All bottles con- taining homoeopathic medicines should have perfect necks and be fitted with sound corks. The corks should have the name of the medicine and the strength written upon it. Corks should never be changed from one bottle to another, and a bottle that has once contained one medicine should never be used for another. Special cups and earthenware spoons are sold by chemists for homoeopathic medicines, and are very useful. After each using they should be washed with hot water and thoroughly dried.

REPETITION OF DOSE.

Hints are given throughout the work as to how frequently a dose of a medicine should be repeated. As a general rule in acute cases the repetition should be frequent — as often as every five minutes where the symptoms are very urgent — until a decided remission of symptoms occurs, then gradu- ally increasing the intervals until the symptoms have gone. In acute cases, if there is no improvement after a few hours, a fresh medicine should be sought, but great care should be taken not to change a medicine too soon. If there is the smallest sign of improvement, continue the medicine, as a change may spoil all. In chronic cases a medicine should be given once, twice, or thrice a day until decided improve- ment sets in. It may then be discontinued, and not re- peated until the improvement comes to a stand-still. One grand rule to observe in all cases, acute or chronic, is this— NO SYMPTOMS, NO MEDICINE.

A DICTIONARY

OF

DOMESTIC MEDICINE.

ABSCESS. — The formation of matter as a consequence of inflammation of tissues under the skin, or mucous membrane, is called an abscess. An abscess may be acute or chronic. An acute abscess may follow an injury such as a blow, or the presence of a foreign body, as shot or a piece of wood, which has been driven into the flesh. A common seat of both acute and chronic abscesses is the lymphatic glands of the neck, groins, or armpits. Following a simple cold, or inflammation of the throat, especially in connection with fevers like scarlatina, the glands in the neck become irritated, and, if the irritation is intense, the tissues are then inflamed and form abscesses. The glands in the groin and armpit may become centres of inflammation or abscess in the same way from cold, over-strain, or injury to the skin of the foot or hand. Another common abscess met with in nursing women is abscess of the breast. Chronic abscesses appear in the same situations, and from the same causes, when there is some constitutional depravity, as scrofula. The commonest and most serious chronic

A

ABSCESS.

abscesses arise in connection with diseased bones. When the bone of any part becomes diseased, whether the bone of the spine or of any other part of the skeleton, the tissues around are irritated, as they are by the presence of a splinter or foreign body; they consequently become inflamed, and very large abscesses sometimes result.

Diagnosis. — The distinguishing features of an acute abscess are swelling, heat, redness, and pain. It is distinguished from other swellings and tumours by the rapidity of its formation, and by the throbbing pain and tenderness of the part, and by the constitutional symptoms, especially shivering fits, or " rigors," as they are called. The formation of an internal abscess may be discovered by the occurrence of these rigors when there is no other apparent cause. When the abscess is large, and has ripened, the sensation of " fluctuation " gives additional certainty. This is ob- tained by laying the finger on one side of the swelling, and gently tapping the other side ; a wave of impulse passes from side to side as when an india-rubber bag containing fluid is tapped in the same way. In chronic abscess there is less acute pain, and the formation is more slow, but there are rigors, and fluctuation can generally be obtained. With the constitutional history of the patient there will not be much difficulty in diagnosing the case, and, of course, when the abscess discharges, all doubt is set at rest.

General Treatment. — In the forming stage the part must be given absolute rest. As soon as matter has formed, if the pain is great, warm poultices of lin- seed or bread may be applied. After the abscess has opened, or has been opened, the poultices should be discontinued, and calendula lotion applied. Abscesses occurring in special places, as the ear and the breast, require special treatment, which will be described under those headings. The opening of chronic

ACCIDENTS— ACIDITY. 3

abscesses is attended with considerable danger, and should always be performed by a medical man. The dressing of chronic abscesses requires the services of a skilled nurse for the proper washing out and dressing of the cavity. Calendula lotion (one part of the tincture to ten) is of the greatest service in these cases.

Medicines. — (Every hour when the symptoms are acute until relief is obtained, then less often.)

Merc. sol. — So long as there is any chance of stopping the inflammatory process ; also for hardness remaining after the abscess has healed.

Bell. — When there is much redness, pain, and throbbing with it.

Hep. — When matter has formed; this will assist the maturing of the abscess, and in many cases render opening the abscess unnecessary.

Silic. — When discharge has taken place. Profuse dis- charge in chronic abscess.

ACCIDENTS. See BRUISES, BURNS, WOUNDS.

ACIDITY. — Definition.— A disordered condition of the stomach, in which an abnormal quantity of acid is secreted. The symptoms are, heat in the pit of the stomach, sour risings into the mouth, and sour taste in the mouth.

Diagnosis. — Acidity is a form of dyspepsia, and it may be uncomplicated. In that case it may be treated as an isolated disease. When it is only a symptom of disease of the stomach, the complicating symptoms, as wasting, loss of strength, and abdominal pains, will show what is the nature of the disease, and the patient will have to be treated according to the totality of the symptoms.

General Treatment.— Avoidance of fat, sugar, and starchy foods. Copious draughts of hot or cold water are sometimes of service.

4 ACNK— AGUE.

Medicines. — Two or three times a day until relief is obtained.

Calc. carb. — The most generally useful medicine j especi- ally indicated if the patient is pale, has cold, damp feet, and tendency to perspire about the head.

Argent, nit. 6. — Pain at the stomach, with eructation of wind, which gives relief.

Lye. — Constipation with much flatulence, dark-coloured urine ; symptoms worse from 4-8 p.m.

Snlph. — Sinking at the pit of the stomach about n or 12 in the morning ; hot flushings ; constipation, or diarrhoea driving the patient out of bed in the morning. See also HEARTBURN and WATERBRASH ; and under PREGNANCY: Heartburn. ACNE. — Definition. — Pimples, usually on the face, but also sometimes on the back and chest, and other parts, occurring mostly at the period of adolescence, and affecting the sebaceous glands of the skin.

General Treatment.— Avoidance of indigestible articles of food and all self-indulgent habits. Proper attention to bathing and exercise.

Medicines. — (Two or three times a day until there is marked improvement, then at increasing intervals.)

Carl?, v. — The most useful medicine in simple and recent cases occurring in young persons.

Puis. — In pale, impressionable subjects.

Bell. — Acne of face in young, full-blooded people.

Nat. Mur. — In persons of earthy complexion who suffer from constipation, or are bloodless.

Calc. and Sulph. should be given according as the con- stitution of the patient corresponds to either. See CONSTITUTIONS. AGUE. — Definition. — Fever occurring in marshy places, coming in paroxysms of one, two, or more days' inter- val ; commencing with chill, and followed by heat and sweat.

AGUE. 5

Diagnosis. — There is not much difficulty in distinguish- ing ague or intermittent fever from other fevers. The chill, followed by heat and sweat, the disappear- ance of the fever, and the return at more or less regular intervals, are characteristic. All these features are not always present in every case. There may be absence of chill or of sweat, but there will always be sufficient to decide its true nature. In the eruptive fever there is the rash, and the fever is continuous. In rheumatic fever the fever is also continuous, and there is affection of the joints. In ague there are often bone pains, but these are intermittent, like the fever.

General Treatment. — Where the air is malarious, the bedroom window should be open only a few hours in the middle of the day, and should never be on the ground floor. Nothing that lies heavy on the stomach should be eaten ; pastry and baked or roasted things should be avoided. Attention should be paid to the clothing, which should be warm and well aired. During the sweating stage of the fever, the patient should lie between blankets. If he is thirsty, he may drink water if it is good, toast-and-water if it is not.

Prophylactic Treatment. — Before entering a mala- rious district, it is advisable to take, for a week or two beforehand, one dose daily of China, or Arsen., and also from time to time whilst in the district. Those who live in marshy places, or near newly opened canals or dug land, should take, as soon as they feel any signs of illness, a dose of China. In twelve hours, if no better, they should take a dose of Ipecac, and after another twelve hours a dose of China, again. If this does not suffice to dissipate the illness, one of the following medicines must be given.

Medicines. — (A few doses to be given before an attack is expected, and after it is over, not during the attack.)

AGUE.

Ipecac. — Much internal chilliness, which is increased by external warmth ; little or no thirst in the cold stage, but much in the hot stage ; clean or slightly furred tongue ; nausea and vomiting, and oppression of the chest immediately before the attack, or during the cold and hot stages. Ipecac, will often develop the characteristics of an attack. If there is any doubt about the remedy, give Ipecac. every four hours after an attack is over for one day, and then another dose just before the attack is ex- pected. It may be there will be no other attack. If another attack occurs, another remedy must be given according to the indications. Arscn. — When the different stages are not distinctly marked, chills, heat, and sweat occurring together; or when frequent changes from chilliness to heat, and internal chilliness with external heat ; paroxysms im- perfectly developed • little or no sweat, or not till long after the heat has subsided ; prostration ; burning pains ; restlessness, anxiety ; drinking often, and but little at a time ; uneasiness about the heart or oppression and spasms of the chest ; nausea or sickness and vomiting ; bitter taste ; violent headache continuing after the hot stage ; buzzing in the ears during sweating. All the patient's sufferings, as headache and pains in the limbs, are worse during the attack. Chi?ia. — Paroxysm preceded by nausea \ voracious appe- tite ; headache ; agitation ; palpitation ; sneezing; thirst during sweat, sometimes continuing all the time be- tween the attacks ; chills alternating with heat, or when the heat does not come on for some time after the chills have ceased; sleeplessness, or disturbed sleep; prostra- tion and sallow complexion. When there is much thirst in the cold or hot stages it must not be given. Calc. — Alternate chills and heat ; external coldness and internal heat ; heat in the head and face, with coldness

AGUE. 7

of the limbs, and clammy hands and feet, sometimes cold up to the abdomen ; giddiness ; feeling of heavi- ness in the head and limbs j violent pains in the small of the back and anxiety. Sulph. — Attacks coming on in the after part of the day, with evening chills, fever during the night, with sweat- ing in the morning ; palpitation of the heart. After checked eruptions. Verat. — External coldness with internal heat; cold, clammy sweat, especially on the forehead, and general coldness of the whole body ; chilliness without heat, or chilliness and heat by turns ; giddiness ; constipa- tion or diarrhoea ; sometimes nausea or vomiting, or pain in the back and loins. Puis. — When the slightest disorder of the stomach brings on a relapse. Absence of thirst during the whole attack, or thirst only during the hot stage ; heat and chilliness at the same time ; bitter taste in the mouth ; bitter or sour vomiting of phlegm or bile \ the attacks come on in afternoon or evening, and the patient complains of chilliness continually. Ignat.—^ When there is thirst in the cold stage but not in hot ; chilliness relieved by external warmth ; heat of some parts of the body and chill of others ; heat ex- ternally only; pain in the bowels during the cold stage, followed by heat, with debility and sleepiness. Nux v.— W hen the attack begins with great debility and desire to lie down ; giddiness j cramps in muscles of abdomen or calves ; stitches in the sides ; alternate heat and chills, or heat preceding the chills ; heat ex- ternally and chilliness internally, or vice versa ; desire to be constantly covered, even during the hot and sweating stages ; external warmth gives no relief ; heat and pain in the head ; buzzing in the ears ; redness of the cheeks; thirst and anxiety during the hot stage; constipation.

8 ague-cake— Alcohol.

Natrum mur, — Useful in intermittents of old standing after the abuse of quinine. The special symptoms are, violent pains in the head during the chilliness, and in- creasing during the heat j prolonged chills, beginning about 10 a.m.; dimness of sight and partial loss of consciousness during the fever and during the time between the attacks ; lips chapped or blistered, slight fever continuing through the intermission.

Caps. — Chilliness preceded by thirst, followed by heat without thirst ; chills, violent and long-continued, beginning in the back between the shoulder-blades ; intense burning both internally and externally ; accu- mulation of phlegm in the mouth and throat ; slimy, burning diarrhoea \ great intolerance of noise.

Eupatorium perfoliatum. — When the attacks are preceded by violent pains in the bones and thirst, persisting through the attack.

AGUE-CAKE. — Enlarged spleen left behind after ague.

Diagnosis. — Under the free ribs of the left side and the upper part of the abdomen of that side, there is a hard swelling, often the seat of pain. Ic is firm and resistant to pressure, and gives a dull note when per- cussed with the finger. It is formed by the enlarged spleen. It may be distinguished from all other tumours in this situation by the history of the patient. It is always clearly traceable to former attacks of ague, and generally to residence in malarial districts.

Medicines. — (Two or three times a day until relieved.)

Natrum mur. — The most useful generally.

Ceanothus. — When there is pain in the spleen.

ALCOHOL HABIT.— The only cure for the habit of over- indulgence in alcohol is total abstinence. The craving for it may be relieved or removed by taking tincture of Ci?ichona rubra, <£, gtt. xxx. in a wine-glass of water three times a day. When the craving conies

ADMINISTRATION— ANEMIA. 9

on it may sometimes be relieved by eating a few

raisins. Medicines. (Every hour or two until relieved.) Nux v. For morning vomiting and tremulousness. Ant. tart.— Tor chronic vomiting with white tongue.

ADMINISTRATION OF MEDICINES.— Medicines are administered in various forms— in pilules, which may be taken dry, or, if the sweetness is objectionable, may be dissolved in a little water ; in powders, which are best taken dry on the tongue \ and in tinctures, which are taken mixed in water. When no special directions are given in this book, it is to be understood that the medicines named may be taken in the form of pilules or drops. One pilule or one drop is the usual dose. In cases of acute pain and imminent danger, the dose may be taken every hour or oftener. It is often con- venient to mix sufficient quantity of tinctures to last for one or two days In that case, eight drops may be mixed in eight dessert-spoonfuls of water, and a dessert-spoonful taken four times a day. The vessel containing the medicine must be scrupulously clean, must be kept covered with a saucer or piece of paper, and away from the light and from strong odours. The spoon should be of earthenware. The best time for administering medicines (if there are no special reasons for giving them otherwise) is from one hour to a quarter of an hour before meals and at bedtime.

ANEMIA. — A condition of bloodlessness, depending on many causes. Most frequent at puberty in young girls, and often accompanied by nausea and vomiting, with a greenish pallor, and known by the name of " green sickness." Diagnosis. — Anaemia is a disease which is obvious to the first glance. The pallor of the face and absence of colour from the lips explain themselves. But it is a mistake

io ANGER— ANKLES.

to regard the bloodlessness as the whole of the dis- ease. It is commonly dependent on some deep con- stitutional taint, as scrofula, or on chronic poisoning. Arsenical wall-papers are responsible for a good deal of anaemia, and also the excessive use of iron.

General Treatment. — Good food, warm clothing, open-air exercise.

Medicines. — (Two or three times a day until relief is obtained. To be resumed after an interval if the im- provement comes to an end.)

Uerrum. — When there is throbbing headache.

Nat. mur. — With constipation, chilliness, earthy com- plexion.

Puis. — Chilly subjects. When the monthly periods are scanty, or delayed.

Petrol. — When there is nausea or vomiting.

Argent, nit. — Sharp pain in the stomach and tenderness, palpitation, faintness.

Calc. — Weariness j patients who have cold, clammy hands and feet; pale, lymphatic subjects.

Sulph. — In sanguine subjects; cold hands and feet, hot head ; constipation.

ANGER, EFFECTS OF.— Anger may bring about serious bodily disorders. Women who are nursing children should never give the breast soon after a fit of passion. Quiet and seclusion are the best remedies for the fit.

Medicines. — (Every hour until relief is obtained ; then less often.)

Aeon. — When fever is the result.

Cham. — Where it takes the form of jaundice. Nursing women should take a dose of Cham, after an angry fit.

Igfiat. — When the result is an attack of hysteria.

ANKLES. — Weak; Painful; or Swollen.

General Treatment. — This will depend on the cause of the weakness. If it is rheumatism, the patient must

ANUS. ii

wear woollen clothing, and adopt all the precautions advised under that heading. If it is due to general debility, constitutional treatment will be required. In case of simple local weakness, hot salt-water or sea-water baths should be used, and proper exercises, which will be prescribed by a medical man, to develop and strengthen the parts that are weak.

Medicines. — (Two or three times a day.) Apis. — Simple swelling. Calc. pJws. — Weakness of the ankles. Calc. car/?. — For pale, fat children. Silic. — Thin, ricketty children.

ANUS, ITCHING OF.— This troublesome affection is gene- rally dependent on the presence of small worms in the lower bowel ; sometimes it is due to piles ; and it may also exist independently.

General Treatment. — When the itching is due to the presence of thread worms, inject warm water, in which eau de Cologne or turpentine (ten drops of either to the half-pint) has been mixed. When the itching is due to piles, apply Verbascum ointment (one tea- spoonful of the (/> tincture to the ounce of vaseline or pure lard). When the itching is simple, and does not depend on another disease, sweet oil may be rubbed on the part or injected ; injection of cold water or vinegar and water may succeed, if the other means do not suffice. Salt, sweetmeats, and pastry must be avoided.

Medicines. — (Morning and evening.)

Nux vom. — Itching, either internal or external j worse when sitting, or after stimulating food or drinks ; when due to coffee or strong liquors ; when accom- panied with pain ; when due to piles, dry, or moist and bleeding, and costiveness ; when due to worms.

Aco?i. — When due to small worms, and there is fever, this

12 ANXIETY— APOPLEXY.

may be given at night, and Ignatia in the morning, if

Nux is not sufficient Ferrum. — May be given after the above, if insufficient. China. — If there is diarrhoea. Sulph.— When, besides itching, there is burning pain,

and soreness in and around the anus, with sensation of

heaviness and fulness.

ANXIETY, VEXATION, WORRY.— The effects of these may be relieved by taking Ignatia every hour.

APOPLEXY. — Effusion of blood on the brain, causing loss of power, or disorder of sensation of some part of the body, usually one or other side. With this there may be loss of consciousness, and, when the effusion is very extensive, sudden death. Sometimes there are premonitory symptoms, such as numbness and prick- ing of the limbs, heaviness, drowsiness and vertigo, faintness, vomiting, alteration of temper. Diagnosis. — When an attack of apoplexy is slight, and the patient does not lose consciousness, there will be no difficulty. The patient suddenly feels he has no longer power in one or more of his limbs. With this loss of power there is generally altered sensation, numbness, tingling, and sometimes pain. When the attack is so severe as to completely prostrate the pa- tient it may be mistaken for a fit of drunkenness, and the alcoholic smell of the breath is not sufficient to distinguish between the two, since a patient may be seized with apoplexy soon after having taken alcohol to drink. The best rule to make in doubtful cases is to treat as if they were apoplexy until the effects of the alcohol have had time to pass off. Cases of opium poisoning are also difficult to distinguish from apo- plexy. There will generally be a history of poison having been taken ; there will be the smell of the drug, and the pupils will be found contracted to a pin-point

APPARENT DEATH. 13

aperture. In epilepsy there is struggling as a rule, and the history will help to decide in these cases. Persons subject to epilepsy are usually well known to be so.

General Treatment. — The patient should be placed in bed at once, with the head raised. The clothing should be loosened. Plenty of fresh air should be ad- mitted, and perfect quiet enjoined.

Medical Treatment. — This will not be undertaken except by a medical man, whenever there is one to be obtained. Medicines wiil be given according to the symptoms, and especially the premonitory symptoms, when they can be learned.

Nux v. 3. — Every hour. Giddiness, headache, fulness in t he head.

Bell. 3. — Every hour. Full throbbing head, with flushed face.

Opium, 3. — In an attack ; slow, full pulse; face red or pale.

Antim. Tart. 3. — If there has been vomiting before the attack, or on recovery.

Arnica, 3. — "When symptoms of active congestion are absent.

[N.B. The best mode of administering medicine in a tit of apoplexy is by placing a few globules of the remedy on the tongue. The effect of the remedy should be watched, and the dose repeated when its effect seems to be exhausted.]

APPARENT DEATH.— In all cases of sudden death, or apparent sudden death, the greatest care should be taken to ascertain which is the actual fact. The only absolutely certain sign of death is the appearance of putrefaction. So long as uncertainty exists efforts at restoration should not be omitted. The greatest care should be taken in handling the bodies, as any rough- ness may speedily convert a case of apparent death into one of actual death.

14 APPARENT DEATH.

Hunger. — Persons who faint from want of food may be mistaken for dead. Warmth and careful feeding is the remedy here, and the longer they have been without food the less of it must be given at first. In the worst cases injections of warm milk, frequently repeated, must be administered when signs of returning life are shown. A few drops of milk may be given to drink, increasing in quantity by slow degrees. Toast- water and broth may be given in addition, but no solid food until after the patient has had a sleep, during which care must be taken that he is covered up warm.

Accident. — When a patient is apparently dead after an accident, he should be placed on a bed with the greatest care, and a few globules of Arnica 3 put on his tongue. There is nothing else to be done but wait for the arrival of a doctor, to see if life is actually extinct, or what is the extent of the injury.

Drowning, Suffocation, Hanging, Choking. — There must be no delay in commencing the treatment in these cases. In cases of choking first ascertain if there is anything, such as a morsel of food, blocking the larynx. If so, and it cannot be dislodged through the mouth, tracheotomy must be resorted to at once, and then the measures below adopted. In cases of drowning :

" Instantly turn the patient downward, with a large, firm roll of clothing under stomach and chest. Place one of his arms under his head, so as to keep his mouth off the ground. Press with all your weight, for four or five seconds each time, upon the patient's back, so that the water is forced out of the lungs and stomach, and drains freely from the mouth.

"Then" — and this applies to all cases of suffocation as well as drowning: —

" 2. Quickly turn patient's face upward, with a roll of clothing under the back, just below the shoulder-blades,

APPARENT DEATH. 15

and make the head hang back as low as possible. Place patient's hands above his head. Kneel with patient's hips between your knees ; fix your elbows firmly against your hips ; now — grasping lower part of patient's naked chest — squeeze his two sides together, pressing gradually forward with all your weight for about three seconds until your mouth is nearly over mouth of patient ; then, with a push, suddenly jerk yourself back. Rest about three seconds ; then begin again, repeating these bel- lows-blowing movements with perfect regularity, so that foul air may be pressed out, and pure air drawn into lungs, about eight or ten times a minute, for at least an hour, or until the patient breathes naturally.

" Prevent crowding around patient ; plenty of fresh air is important. Be careful not to interrupt the first short natural breaths. If they be long apart, carefully continue between them the bellows-blowing movements as before. After breathing is regular, let the patient be rubbed dry, wrapped in warm blankets, take hot spirits and water in occasional doses, and then be left to rest and sleep." — Dr. Benjamin Howard, quoted by Dr. Hering.

Cold. — Persons may be restored after having been apparently dead from being frozen for some time. The greatest care is required. The application of heat is fatal. They must be placed in a cool room and covered with snow, or put into a bed cooled with ice and gradually thawed till all the limbs are pliable. Then they are to be placed on a dry bed and rubbed with cold flannel. If no signs of returning life give injection of camphor — one drop of spirit of camphor to half a tumbler of water, and, as soon as he can swallow, luke- warm coffee without milk, a teaspoonful at a time. If violent pains are experienced, Carbo veg. 6 should be given every five or six hours, and if this does not suf- fice, Arse?iicum 3. If there is heat, or stinging pains in the head are lelt, Aconite, wine, or brandy may be given

16 APPETITE— ASTHMA.

in small quantities if the patient craves for it. He must avoid going near a fire for a considerable time.

Lightning. — Put the patient in a current of cool fresh air, and dash plenty of cold water on face, neck, and chest. Give, as soon as he moves slightly, Nux vom. 3 every half-hour, either on the tongue or by injection. For blindness following lightning stroke, give Phosphorus.

Mental Emotions. — Violent mortification, Cham.; grief, Ignatia ; fright and violent anger, Aeon.

APPETITE, LOST.— Loss of appetite is usually only one symptom of a general disorder, and the whole bodily condition must be considered in treating it. The use of condiments to restore appetite is bad. When there is a strong craving for salt things or acids, these may be given until the craving is satisfied. Open-air exercise is the best restorative, and the free use of cold water. Water should be drunk very sparingly at meals, but freely before and an hour or two after meals. A glass of cold water first thing in the morning, and last thing at night, is often efficient. See also TONICS.

Iodine. — Loss of appetite with emaciation, two drops half an hour before meal times.

China. — Loss of appetite after debilitating diseases ; want of appetite, which returns while eating.

Depraved Appetite. — Calc. c. — For indigestible things, as chalk or coal.

Nat. Mur.—Yox salt things.

Puis. — For beer.

Hep. — For sour highly flavoured pungent things.

Increased Appetite. — Mine. — Canine hunger ; feels faint if food is not taken every three or four hours.

ASCARIDES. See WORMS.

ASTHMA. — Paroxysms of difficult breathing, sometimes associated with disease of the heart or chronic bron- chitis, and sometimes purely spasmodic, without any

ASTHMA. 17

affection of the lungs or bronchi. Asthma is often hereditary, and may attack persons of all ages, but is more commonly met with in age than in youth. The paroxysms come on suddenly, often in the night, with a feeling of suffocation and desire to take a long breath. All the muscles of breathing are brought into play, the patient sits up, the head is thrown back, the breathing is laboured, whistling and rattling sounds are heard all over the chest, the patient asks for the doors and windows to be thrown open. The face is pale or livid ; eyes anxious or protruding ; forehead covered with profuse cold sweat. An attack may be brought on by several causes — odours, smoke, dust, irregularity of diet, over-exertion, mental emotions, suppression of accustomed discharges.

Diagnosis. — The diseases likely to be mistaken for asthma are bronchitis > croup, and spasm of the larynx. From bronchitis it is distinguished by the rapid dis- appearance of the rattling and wheezing on the chest after an attack; by the sudden appearance and dis- appearance of the attack j and by the fact that the breathing is slow, wheezy, and prolonged, whilst in bronchitis it is hurried. In croup and laryngeal spasm the age of the patient helps to distinguish, children being more liable to these than to asthma j also the character of the breathing j in croup and spasm of the larynx the difficulty is in drawing in a breath, in asthma it is in expelling it.

General Treatment. — Relief may be obtained during an attack by plunging the hands into hot water ; by bandaging the arms above the elbows, commencing with the left. If the attack is induced by the smell of ipecacuanha, camphor or sweet nitre should be given to smell of; if by inhaling fumes of sulphur, Pulsatilla is better. When attacks come on immediately after a meal, chewing a little ginger will relieve. Patients

B

iS ATROPHY— BACK.

subject to asthma should wear woollen clothing, rub the skin well with a coarse wet towel, and take warm drinks. Those who have dusty occupations should wear respirators.

Medicines. — (To be given in the attack every fifteen minutes until symptoms improve, and then less fre- quently. In the intervals two or three times a day.)

Ipecac. — Feeling of constriction about the chest ; panting, rattling in windpipe, as if full of mucus, which seems to be moving up and down. Patient gasps anxiously for breath ; face pale, hands and feet cold.

Nux vom. — When the attack occurs early in the morn- ing ; when induced by disorders of the stomach or in- discretion in eating or drinking.

Lobelia. — With nausea and great depression of the heart.

Arsenicum. — Most violent attacks, especially those occur- ring in consequence of suppressed catarrh, moaning, groaning, uneasy tossing about ; in old people who are attacked whilst walking, who can breathe but the dis- tress continues.

Arnica. — When the attack is induced by exertion, speak- ing, or even blowing the nose ; respiration laboured or oppressed, with shooting pains in chest.

Sambucus. — Especially in children, attack beginning in the night, sweat of throat.

Pulsatilla. — In blondes, and persons of mild disposition ; breath seems to be impeded in lower part of chest, drowsiness, free expectoration.

Sulphur. — In chronic cases ; after suppressed eruptions ; patients who suffer from skin affections ; who have flushes of heat and fainty spells ; sinking feeling at the pit of the stomach, worse in the forenoon. The asthma may be dry or accompanied with profuse yellow expectoration. ATROPHY. See EMACIATION. BACK , PAINS — Pains in the back may be due to many

fiAD TASTE IN MOUTH— BATHS. 19

different causes. When they accompany constipation, piles, disorders of menstruation, or other affections, the primary ailment must be attended to. When the back pains are the chief or sole affection, they are generally due to rheumatism in some form affecting either the muscles of the back or their sheaths, and generally known by the name of Lumbago.

General Treatment. — Those who are subject to lumbago should wear woollen clothing next the skin, and be very careful about catching cold. A broad band of new flannel worn across the loins is a good preventive. For those who are exposed to the weather, a sheet of brown paper stitched into the waistcoat is as good a protection of the back as any. During the attack, ironing the part with a flat iron through flannel or brown paper is often an efficient remedy.

Medicines. — (To be given every half-hour until relief is obtained, and then less often.)

Aeon. — From dry cold or a draught ; pain sharp or as if sprained ; excited by touch ; the part sensitive.

Aet. r. — If with the pains there is restlessness and sleep- lessness.

Arniea. — If caused by sprain or external injury.

Bryonia. — Severe pains compelling the patient to walk stooping ; aggravated by the least motion.

JVux vom. — The part feels bruised, or as after fatigue, turning in bed aggravates ; when accompanied by constipation and irritable temper.

Rhus. — Pains like those oiNux v., but aggravated by rest.

Puis. — Similar pains to those of Nux r. in persons of mild disposition.

Merc. — When the pains are much worse at night.

BAD TASTE IN MOUTH. See TASTE.

BATHS. — Baths are useful for several purposes— for clean- liness, for warming or cooling the body, for stimu-

20 BATHS.

lating the skin, and for applying certain medicaments externally.

Except where there is deficient reaction, or where the skin is dry and poor in sebaceous secretion, all persons are the better for the morning cold bath or cold sponge- down. This should, of course,, be suspended during a cold. Women should suspend the cold bath during the period. They may, if they prefer, continue the sponge- down, but they should substitute tepid water for cold. Infants should be bathed in tepid water night and morning, and older children, if strong, in cold water every morning, great care being taken to rub them thoroughly dry afterwards. Hot baths may be given occasionally at night, but never cold baths.

Sea-salt may be added to the water of the morning bath in such quantity as to make it like sea- water. This increases the stimulating effects on the skin, and also tends to prevent chilling afterwards.

The Hip bath is given tepid or cold. The patient must sit in about twelve inches of water, and be warmly covered, the feet especially being kept warm. When given tepid the patient should sit in it from ten to twenty minutes, when cold from two to ten minutes. The tepid bath is useful for relieving congestion of the pelvic organs ; the cold bath is tonic to them.

The Foot bath is usually given hot, and is useful in colds. The cold foot bath is useful in determination of blood to the head, but must never be given for longer than one or two minutes.

Packs are a form of bath. A sheet, wrung out of hot or cold water (as the case may be), is laid on blankets, and the patient placed on the sheet. This is rapidly wrapped round him and the blankets over it, other blankets being placed over these to retain all the bodily heat. Partial packs of any locality of the body (as the throat) are given in the same way. A small piece of linen

BED-SORES— BILIOUSNESS. 21

dipped in water, wrung nearly dry, is placed on the part and several folds of flannel over this.

Hot air baths are useful for inducing perspiration where the skin does not act well in cases where it is more than usually important that it should, as in kidney dis- eases. A cradle is placed over the patient, and hot air introduced from an apparatus made for the purpose.

Turkish baths have a similar action, and are preferable when they can be obtained. They are useful in many rheumatic conditions.

BED-SORES.— When bed-sores threaten bathe the part with whisky.

In debilitated persons, who lie much in one position, the tissues which cover prominent bones, as, for in- stance, the hip-bones, are unable to bear the pressure, and become irritable and inflamed, and, if care is not taken, gangrenous. All patients suffering from long or severe illnesses should be carefully watched by the nurses who wash them, and the first signs of soreness should be reported to the doctor in attendance. But the nurse must herself begin the treatment. The tender part must be relieved of pressure by means of pillows or pads. Where this cannot be managed a water-bed must be procured. The sore part must be bathed with spirits of wine (or brandy or whisky) if the skin is not broken. If the skin is broken it must be dressed with Hypericum Oil.

BILIOUSNESS. — Some persons are subject to attacks of heaviness and low spirits, loss of appetite, and vomiting of bile every few weeks, or, it may be, at irregular times, from indiscretion in diet or other causes, and they are said to be " bilious," and these attacks are called "bilious attacks." They are at times accompanied with severe headache. Persons of this habit of body are usually compelled to take a certain amount of exercise each

22 BITES AND STINGS.

day to keep off these attacks. The attacks are due to1 imperfect action of the liver, which, unless kept in order by exercise and a proper mode of living, relieves itself periodically by excessive secretion of bile and a "bilious attack."

General Treatment. — Avoidance of rich food, or too much of any kind of food. Regular modes of living, open-air exercise, attention to the bowels, and the use of whole-meal bread if they have a tendency to be con- stipated.

Medicines.— In the old days a blue pill at night and a black draught in the morning was the medicinal treat- ment for these conditions, and it certainly had the effect of stimulating the liver and relieving the bowels, but it reduced the strength of the patient, and did nothing towards preventing a second attack.

The Attack. — (Medicines to be given every half-hour.)

Nux vom. — Vomiting of bile, violent headache, con- stipation.

Bry. — Sharp pain in liver, frontal headache, constipa- tion, white stools.

Podofih. — Vomiting of bile, morning diarrhoea, green or yellow stools.

The Constitution. — (Medicines to be given three or four times a day.)

Nux vom. — In spare persons of sedentary habits, sub- ject to constipation.

Bry. — In dark patients, subject to pains in the shoulder and liver ; feeling of weight at the stomach after food constipation with light stools.

Puis. — In blonde persons of mild disposition, with bowels regular or loose.

BITES AND STINGS.— Of Bees and Wasps.— Apply pow- der blue at once ; or, if that is not to be had, a freshly

BLACK EYE— BLEEDING OF THE NOSE. 23

sliced onion. Give internally Ledum one drop every five minutes.

Of Other Insects. — Apply a strong solution of Am- monia. (Sal volatile and ''smelling salts" are con- venient forms.)

Of Snakes. — Cut the wound open at once and suck it. If any strong disinfectant or caustic is at hand apply it to the wound. The best is chloride of zinc (Sir W. Burnett's Disinfecting Fluid.) Tie a handkerchief tightly round the limb above the wound. If possible, cause the patient to perspire, either by means of vapour baths, or by wrapping in blankets, supplying hot bottles or bricks. Administer stimulants freely, ammonia and whisky being the best, with hot water, as much as the patient can be made to swallow.

Of Rabid Animals. — The wound should be treated in the same way as the bites of snakes. For after-treat- ment, see HYDROPHOBIA.

BLACK EYE. — Effusion of blood into the tissues surround- ing the eyeball, usually the result of a blow. Treatment. — If the skin is unbroken apply Arnica lotion (five drops of the strong tincture in half a teacupful of water) j the eye to be bathed with this and a com- press kept applied, and covered with a single fold of flannel — not with oil-silk ; if the skin is broken, Arnica must not be applied locally, but Hamamelis instead, in the same way. Internally give Arnica 3 every half-hour.

BLEEDING OF THE NOSE.— This may occur in the course of many diseases, and may benefit the patient. If not excessive, it should not be interfered with. When it occurs from no particular cause and lasts long it should be treated. General Treatment. — Raise the arm of the side from which the bleeding occurs perpendicularly above the the head, or apply cold to the spine.

24 BLINDNESS.

Medicines. — (These should be given every few minutes till the bleeding begins to cease, and then less often. For the tendency the same medicine may be given three times a day for a few weeks.)

Arnica. — When due to injury.

Pulsatilla. — In women of mild disposition, or who have scanty menstrual flow; when bleeding takes place during a cold, or when it occurs in the afternoon, even- ing, or before midnight.

Aconit.— Yox plethoric individuals ; bleeding from being over-heated ; from drinking wine.

China. — In debilitated persons.

Mercurius. — Bleeding in the night, blood coagulating in the nostrils. Bleeding accompanied by fever in the night.

BLINDNESS. — Loss of sight depends on many causes. It may be sudden and temporary, or it may be perma- nent. Of course a medical man will be consulted to decide this. If it is accompanied by great pain and hardness of the eyeball (Glaucoma) immediate treatment by operation is demanded. Blindness may occur apart from any real change in the eyes, and in such cases, as well as in some where there is actual change, medicines may be very efficacious. They should be given fre- quently (every hour) until benefit is perceived, then less often.

Aco7iit. — Sudden temporary attacks. (Mercurius 6, if the attacks return frequently.)

Bellado7ina. — Night-blindness ; the patient can see nothing after twilight, particularly if something red or green appears before the eyes, or a coloured circle round the candle.

Lycopodium. — Night-blindness, when there are black spots floating before the eyes,

BLOOD TO THE HEAD. 25

Sulphur. — Day-blindness j when the patient can only see

well in the evening. Nux vom. — Blindness due to excessive smoking.

BLOOD TO THE HEAD.— Beating of the arteries of the neck and temples ; feeling of fulness in the head ; giddiness. This condition, if persistent, may be dan- gerous. It is due to a dilatation of the blood-vessels of the head brought about by some influence on the nerves which control the vessels, and gives the sensation as if all the blood in the body were streaming up into the head and face. It may be brought on by excitement, heat of the sun, shocks, emotions, or dissipated habits.

General Treatment. — Avoid excesses of all kinds, especially excitement or alcoholic drinks and coffee. Short cold foot-baths ; free use of cold water externally and internally.

Medicines. — (To be given three or four times a day, and more frequently in an attack.)

Aconite. — Strong pulsations of blood-vessels, head above the eye feels like bursting ; worse when stooping and coughing ; giddiness, especially when stooping or walking in the sun ; disturbance of vision ; fainting ; in children teething ; girls at puberty ; or from catching cold during the period.

Glonoin. — Coming on suddenly, brain feeling as if ex- panding ; beating in the head and down to the neck at every step.

Nux vom. — Patient irritable or passionate j or if he has drunk much ardent spirits ; after anger.

Belladonna. — Severe jerking, burning, shooting pains on one side of the head, or violent pressure on forehead at every step or motion, increased by noise and light. Coffea. — From excess of joy, or accompanied by great

excitement. Opium. — After fright,

26 BLOOD-POISONING.

Chamomilla. — From vexation.

Ignatia. — After suppressed vexation.

Arnica. — After a blow or fall on the head.

China. — When it arises from great debility.

Dulcamara. — If it returns after each time taking cold.

Rhus. — After strain.

Sulphur. — If it returns frequently.

BLOOD-POISONING.— This is a term which includes many different conditions. All the infectious fevers are, in one sense, diseases of blood-poisoning, the poison in each case being specific — that is, pecu- liar to the disease it produces. Again, the condition known as "pyaemia" is a blood-poisoning disease. This is brought about by the absorption of putrid matter into the blood from unhealthy abscesses and wounds, and results in the formation of abscesses in joints and other parts of the body, and is almost inva- riably fatal. Differing from this, though often con- founded with it under the same name, is " septicaemia," resulting from the absorption of the products of decomposition (" septic material ") into the blood and producing fever. Diphtheria is also a blood-poisoning disease, and may arise directly from the poisonous emanations of bad drainage. The two conditions usually referred to when blood- poisoning is mentioned are pyaemia and septicaemia. These are grave conditions, and must always be treated by a medical man.

General Treatment. — The patient must be placed in the best possible hygienic conditions, with abundance of pure air and pure water. The diet must be of the lightest and most nourishing possible, and be given frequently. Stimulants will be administered as the physician directs, but their place can often be taken with advantage by homoeopathic medicines.

BLOOD-SPITTING. 27

Medicines. — (To be given frequently, every hour or two.) Baptisia. — Fever of typhoid type j broad, coated tongue

loose bowels, formation of abscesses. Arsenicum. — Fever of typhoid type, red tongue, thirst,

anxiety.

BLOOD - SPITTING (HAEMORRHAGE FROM THE LUNGS— HEMOPTYSIS).— It is always an alarming thing to see blood in the phlegm one spits, but it is not always dangerous. The blood may come from the nose, or the throat, or the larger bronchial tubes, in all which cases it is unaccompanied with danger; and when it comes from the lungs it is not always dangerous, and should never be allowed to cause panic. When it comes from the chest it is usually accompanied with a sensation as if coming from a considerable depth, and there is a taste of blood in the mouth before it comes up. There is often a burn- ing pain in the chest at the part from which the blood comes. When the blood comes up in great quantities the danger is not so great as is usually supposed. Attacks are sometimes immediately fatal, but in these cases the disease is more often due to aneurism (disease of blood-vessels) than to disease of the lungs. General Treatment. — Avoid all possible exertion of the lungs, even talking. Let the patient be per- fectly quiet, propped up with pillows to support the head and chest. The room must be kept cool and well aired. No warm drinks or stimulants must be given for several days. Light, easily digestible food must be given, and mucilaginous drinks. All kinds of excitement must be avoided, and sleeping during the day, especially before meals, is an advantage. Whilst the bleeding lasts, cloths, dipped in cold water, may be applied to the lower part of the abdomen. Small pieces of ice may be given to suck.

28 BLOOD-VOMITING.

Medicines. — (To be given in an attack every quarter of an hour until improvement sets in.)

Aconit. — Slightest attempt to clear the throat brings up blood ; chest seems full with burning sensation \ pal- pitation j agitation ; uneasiness j worse lying down ; anxious, pale countenance.

Ipecac. — After Aconite ; constant taste of blood remaining ; short cough. Discharge of mucus mixed with blood, nausea and weakness.

Arsenicum. — Palpitation and agitation increasing after Aconite, disturbing sleep and driving patient out of bed ; dry burning heat.

Arnica. — Blood clotted ; black and raised easily, accom- panied by asthma, shooting pains, and burning con- traction of the chest. After injury.

BLOOD-VOMITING (HEMORRHAGE FROM THE STOMACH-KEMATEMESIS).— Bleeding from the stomach is generally due to ulceration. It is some- times mistaken for bleeding from the lungs, but the fact of it having been brought up by vomiting — blood from the lungs coming up with a cough — and that it is pure blood and unmixed with phlegm or froth shows pretty clearly its source ; and if there is absence of any history of recent lung disease, and, on the other hand, if there has been indigestion and pain at the stomach, the diagnosis is quite clear. Of course the doctor will be summoned at once ; but something may be done before he comes.

General Treatment. — Absolute rest. Avoidance of all solid food. Ice to suck. Iced drinks, as milk and soda water.

Medicines. — (To be given every ten minutes.)

Ipecac. — If the blood is very dark.

Hama?n. — If there is not speedy improvement under Ipec,

Arnica. — If Hamanielis fails.

BOIL— BONE. 29

BOIL. — Inflammation of the skin, and tissues under the skin, forming hard, painful swelling and suppuration, ending in the expulsion of a '; core," which is really a piece of dead tissue. Some people have a constitu- tional tendency to boils j they often follow acute illnesses.

General Treatment.— Attention to the general health ; avoidance of alcoholic drinks, abstemiousness in eating, open-air exercise. During the maturing period hot linseed poultices should be applied ; after- wards, Calendula lotion and compresses.

Medicines. — (Every two hours.)

Belladonna. — When just beginning to form.

Hepar.— When suppuration is too slow and scanty.

Mercurius. — If the suppuration is profuse and the swell- ing remains.

Arnica. — To prevent the recurrence. (Three times a day for several weeks.)

Sidph. — A few doses after the boil is healed. A course of Sulphur should be given when they recur fre- quently.

BONE. — Diseases of bone are too serious to be treated

domestically where good medical advice is to be had.

Many limbs condemned by allopathic surgeons have

been saved by homoeopathy. Inflammation of bone, or rather of the membranes

which cover the bone (periosteum), if not checked

result in death of the bone (necrosis). Ulceration of bone (caries) is a slower process. General Treatment. — The strength of the patient

must be maintained by strengthening diet. In caries

the wound should be bathed with a strong infusion of

hay, used as a lotion and as a compress.

Medicines.

Mezereum. — For inflammation (every hour).

3© BOWELS.

Silica. — For ulceration (every two hours). Phosphorus. — If Silica fails.

BOWELS, INFLAMMATION OF.— This is really inflam- mation of the membrane {peritoneum) which forms the outer coat of the bowels and lines the abdominal cavity, and it is called in medical language peritonitis. This is a painful and dangerous disease. The symptoms are burning and tearing pains in some part of the abdo- men, and great tenderness on pressure and on every motion. The body is sometimes tense and swollen. There is often vomiting and much constipation. There is fever, sometimes to a high degree, but sometimes the temperature is little above the normal. The face is sunken, anxious-looking, and grey.

Diagnosis. — Inflammation of the bowels may be acute or chronic. The chief diseases which may be mistaken for acute inflammation are an attack of colic, the passing of gall stones, pains connected with the womb, and typhoid fever. The history of the case will help to decide. As in most inflammations, there is generally a chill or a wetting to account for the symptoms ; colic can mostly be traced to indigestible food, and there is no fever ; also the symptoms in colic are generally relieved by pres- sure, whereas in inflammation there is great sensitive- ness to touch or pressure. The passing of gall-stones is attended with excessive pain, usually confined to a small area ; the symptoms come suddenly without warning, and are attended with no previous symptoms. Pains connected with the womb generally come on about the monthly periods. It is often difficult at first to distinguish inflammation from typhoid fever, but the progress of the case will soon show. In typhoid there is less pain than in inflammation, more fever, and more head symptoms.

Chronic inflammation of the bowels is usually a conse-

BOWELS. 31

quence of an acute attack, and with this history is not likely to be confounded with any other disease.

General Treatment. — The patient must be kept per- fectly quiet ; no emetics or purgatives must on any account be given. The constipation will right itself when the inflammation is gone. All solid food must be interdicted. Milk, beef-tea, gruel, and farinaceous foods only must be given. Locally, light linseed poul- tices should be applied, and if the body is distended with gas a few drops of turpentine should be sprinkled on them.

Medicines. — (Every half-hour or every hour until there is decided relief.)

Aconit. — Restlessness, anxiety, pain, fear of death.

Bryon. — If the pains persist or increase in spite of Aeon., and are worse by every movement ; much fever.

Merc. cor. — Griping, cutting pains, swelling, much tender- ness.

Arsen. — Thirst, restlessness, terrible anxiety, burning pains, diarrhcea, bloody stools without relief to pain j pain in region of right groin.

BOWELS, PAINS IN.— Sometimes the bowels are the seat of pain when there is no inflammation present. The pain may be due to various causes, as cold, indiscretions in diet, or accumulation of wind.

General Treatment. — The patient must be kept per- fectly quiet, and the lightest food given, as thin gruel or barley-water, until the pain is gone, and hot, dry flannels applied to the abdomen.

Medicines. — (Every hour.)

Aeon. — When the pain has been caused by a chill.

Cham. — Violent tearing, twisting pains, the patient can- not be quiet. It seems as if there was a large ball in the side.

Puis. — From disordered stomach after eating pork or rich

32 BRAIN.

pastry ; worse afternoon, evening, or night ; wind rolls about. Nux vom. — From undigested food, with constipation.

BRAIN, CONCUSSION OF.— The term' 'concussion of the brain" means simply "a shock to the brain," but when the shock is over there is also a certain amount of bruising or rupture of blood-vessels. Concussion may be caused by a blow or fall on the head, or on any other part of the body, when the shock is transmitted. Falls in the sitting position often cause concussion of the brain, the shock being transmitted through the spinal column.

The symptoms vary according to the intensity of the shock. When not very severe there is giddiness, stupe- faction, temporary loss of memory, singing in the ears. When severe, insensibility, stupor, feeble and irregular pulse, vomiting, cold extremities. In such cases it is sometimes impossible to distinguish between simple concussion and fracture of the skull.

Diagnosis. — The history of the fall or blow will serve to distinguish between concussion and some states of in- sensibility, such as apoplexy, for which it might be mistaken.

General Treatment. — Keep the patient very quiet, and let him lie on the side least injured. He will usually find the best position for his head himself. If the injury is internal, without any scalp wound, keep his head in an elevated position, and place a small round pillow at the nape of his neck. The diet must be unstimulating ; plenty of cold water being administered. Cloths dipped in cold water, to which a few drops of the strong tincture of Arnica have been added, should be applied to the head, Hypericum being substituted for Arnica if the skin is broken.

Medicines. — {Arnica is the medicine in concussion. It

BRAIN FAG. 33

should be given every fifteen minutes until signs of re- action set in, and then less often. Belladonna. — If the face flushes, and signs of inflammation set in.

BRAIN FAG. — Fatigue of the brain is a common com- plaint in these days of competition, worry, and excite- ment. But it is less often the actual fatigue of the brain that is at fault, than the measures that are taken to prevent it. The brain will stand a great deal of fatigue and worry without resenting it in any other way than by refusing to do more than a certain amount of work, and compelling the patient to take the natural remedy — sleep. But if the patient endeavours to calm his brain by smoking, or to drown his worries in alcohol, or to get more work out of his brain by taking tea or coffee to keep himself awake, then, of course, he must pay the price. He soon finds, if he will not sleep when he can, that he can no longer sleep when he would. He next appeals to opiates, and very soon he can get no sleep without them. A nervous irritable state is the result, and inability to get any work out of the brain at all. A forced rest of three months is the means now prescribed by the physician. General Treatment. — The patient must be warned against the danger of relying on artificial substitutes for rest and sleep, and, if he lack the necessary amount of self-control, the best thing he can do is to go to some hydropathic institution, where the regimen is strict and the society and surroundings cheerful, and stay there until he has got himself into better habits. He must remember that the treatment is not to be abandoned on his leaving the institution, but that he must carry out the same rules of living, as far as possible, on returning to active life. In very bad cases it may be necessary to send the patient to travel

c

34 BRAIN FEVER.

abroad, or on a voyage to Australia. When there are in addition to nervous symptoms great wasting and inability to take food, the "Weir Mitchell" treatment of combined massage and feeding is the best.

Medicines. — (To be given every two or three hours.)

Phos. — Nervous prostration.

Nux vom. — Where reliance has been placed on tobacco or alcohol.

Ignat. — Nervousness or sleeplessness.

Aconit. — Feverish restlessness, sleepless tossing about at night.

BRAIN FEVER. — This is a popular name for many different affections. Properly speaking it should be confined to acute mental derangement. There is deli- rium, tremor, wasting, refusal of food, attempt to injure himself or others, sometimes stripping naked. With all this excitement there is absence of any increase ot temperature. This distinguishes it from ordinary fever with delirium. Of course this cannot be dealt with in a work on domestic medicine. Scarlet fever with violent brain symptoms is sometimes called " brain fever," but more correctly it is given to typhus fever, in which the brain symptoms are always severe. The term is also applied to inflammation of the brain or its covering membranes {meninges as they are called, and meningitis as the disease is called).

Meningitis is more common in children than in adults. The children of consumptive parents are especially liable to it. It is a very fatal disease, and when recovery does take place, it is long before the patient can exert his brain again. General Treatment. — Most vigilant nursing, and feeding with small quantities of the most nourishing food. It will sometimes be necessary to shave the head Medicines. — (Every hour.)

BREASTS. 35

Bell. — Flushed face, wild delirium, bright eyes. Bryon. — Fever more of typhoid type, low delirium, head drawn back.

BREASTS. — Ignorant nurses often cause irreparable damage to the breasts of female children by what they call " breaking the nipple strings," which is, really, destroy- ing the natural ducts which are destined to carry the milk from the breast gland to the nipple. This is a fruitful source of breast abscesses in later life. The pressure of stays also produces ill effects.

If proper attention is paid to the breast for some time before confinement much subsequent trouble may be prevented. The development of the breast during pregnancy is frequently accompanied by much pain and soreness. The nipples are apt to become excori- ated, cracked, and scaly.

Care of the Breasts. — For several weeks before delivery the entire breast and chest should be bathed with cold water, and afterwards well dried and rubbed with warm towels. If there is tenderness or excoriation bathe twice a day with spirit (brandy or whisky) and water.

Medicines. — (Every two hours.)

Admit. — Inflammation of nipples, aching or sharp pains shooting into the breast.

Mercurius. — Swelling and burning of nipples.

Hepar. — Cracks.

Sulph. — Itching and eruptions.

BREASTS AFTER DELIVERY.— The child should be put to the breast .soon after delivery, even if there is no milk. The secretion will be hastened by it, and the liability to breast troubles will be diminished.

BREAST-ABSCESS.— The breasts are liable to become inflamed and " gather " during the whole period of nursing. Injury, cold, sudden weaning may set up inflammation. The best preventive is to keep the

36 BREASTS.

breast well drawn, either by natural means or artificially, by means of nipple-glasses.

General Treatment. — When suppuration does occur the breast must be supported with light bandages and protected from all irritation. Light linseed poultices should be applied at intervals to relieve pain. When they fail to do this they should not be continued. The breast should be drawn with nipple-glasses if any milk can be induced to flow.

Medicines. — (Every hour until relief is obtained.)

Bryonia. — At the commencement, breasts swollen, hard, and feel heavy, shooting pains, dry skin, thirst, fever.

Bel/ad. — Where the skin is red like erysipelas, swelling, hardness, shooting and tearing pains.

Mercur. — Hardness remains after inflammatory symptoms have subsided (Every three hours.)

Hepar. — When suppuration has already commenced indicated by throbbing and chills.

Silic. — Fetid watery discharge.

BREASTS, PAIN IN.— The breasts are often the seat of pain, unconnected with inflammation or pregnancy. This is of a neuralgic character.

Medicines. — (Every three hours).

Act. r. — In young girls.

Puis. — Associated with scanty menses.

Sore Nipples. — During the nursing period, especially if no care has been taken with the breasts before confine- ment, the nipples are apt to become sore, and then they are difficult to treat on account of the repeated irritation by the child's sucking.

General Treatment. — When there is a tendency to soreness, bathe with a solution of Arnica (ten drops to half-tumbler of water), washing with cold water after each time the child has taken the breast.

Medicines. — (Every three hours.)

BREATH— BRONCHITIS. 37

Arnica. — When they threaten to become sore.

Sulph. — Nipples sore and chapped ; deep fissures toward

the base, which bleed and burn like fire. iVux vom. — Nipples sore, with painful excoriation of

parts around nipple.

BREATH, OFFENSIVE.— Offensiveness of breath may arise from many causes, as disordered stomach and de- cayed or improperly cleaned teeth, ulcer of the mouth, unhealthy gums, sore throat, secretion of the tonsils, discharge from the nose. It may also be a symptom in itself apart from any of the above affections.

General Treatment. — This will depend on the cause. When due to decayed teeth, unhealthy gums, and the like, these must be seen to. (See under TEETH, INDIGESTION, MOUTH, THROAT, OZJENA.) Wash the mouth out carefully after every meal, and cleanse the teeth. The use of a little Condy's Fluid in the water will be beneficial temporarily (one or two drops in a tumbler of water). The smell of garlic or onions is best counteracted by eating parsley.

Medicines. — (Four times a day.)

Am. — In general.

Nux v. — If only perceived in the morning.

Puis. — Morning and night.

Cham. — After dinner only.

Cepa. — Like onions.

Card. veg. — Putrid.

BREATH, SHORT. See under ASTHMA and CROUP.

BRONCHITIS.— The mucous membrane which lines the air passages, from the Adam's apple {larynx) and wind- pipe {trachea) to the finest bronchial tubes, is liable to be inflamed in any part. When a cold descends from the head down the windpipe to the bronchial tubes, then it becomes bronchitis, and this is the usual way in which bronchitis is set up. It may be set up, how-

38 BRONCHITIS.

ever, directly, without there being at first a cold in the head. One attack predisposes to others, and a chronic condition of congestion of the mucous membrane may be set up. This is chronic bronchitis.

The symptoms of acute bronchitis are tightness across the chest, frequent short cough, at first dry, then result- ing in expectoration of scanty, frothy, or viscid mucus, at first clear, then yellow and frothy, becoming thick and white. The phlegm may be streaked with blood. Sometimes bronchitis is accompanied with much fever \ sometimes there is little. According to the ex- tent of it, and the bronchial tubes affected, the difficulty of breathing will vary. If the smaller tubes are attacked, the shortness of breath will be intense. This is the form most to be dreaded in children. It is a frequent complication of measles and whooping- cough. As the disease improves, the breathing be- comes easier and the phlegm thicker. Diagnosis. — Bronchitis must be distinguished from in- flammation of the lungs (pneumonia), from pleurisy, and from asthma. Bronchitis, pneumonia, and pleurisy are all characterized by cough following a chill. In bronchitis there is usually more distress of the breathing, and less pain and fever than in the other two. In the early stages of bronchitis on putting the ear to the chest there is wheezing heard almost all over, and afterwards a loose rattling sound ; in pneumonia there is over the inflamed part a dry tubular sawing sound — as if some one were blowing across the end of a pipe, with very fine crackling (crepitation) like the sound made by rubbing a few hairs between thumb and finger close to the ear ; in pleurisy there is a creaking, rubbing sound. On tapping the chest there is no loss of resonance in bronchitis ; in the other two there is dulness. In bronchitis there is at first no expectoration, then yellowish mucus is brought up, and finally thick whitish

BRONCHITIS. 39

mucus. In pleurisy there is no expectoration ; in pneumonia there is at first rusty and afterwards clear transparent expectoration. Asthma is distinguished from bronchitis by the suddenness and transient nature of the attacks.

Many coughs are due to irritation affecting the wind- pipe, and not extending so far as the bronchial tubes. These are often called bronchitic, but on listening to the chest there are no abnormal sounds, and the irritation is usually referred to the throat-pit.

Chronic bronchitis is not to be easily mistaken for any- thing else, and the persistent loose cough with copious yellowish expectoration, and the history of repeated acute attacks, make it clear enough.

General Treatment. — Care must be taken to protect the patient from chills and draughts ; at the same time, the apartment must be well supplied with fresh air. Light, easily digestible nourishment must be given frequently. \i the breathing is laboured, the air of the room may be softened by keeping a kettle on the tire. Kettles are made on purpose, with long spouts, which may be made to come close up to the patient's bed if necessary. Poultices are not of much value in bronchitis, but an occasional linseed poultice is often useful. In chronic bronchitis, which usually recurs in those subject to it every winter, wearing woollen cloth- ing and avoiding exposure to chills are necessary pre- cautions. It is often desirable to spend the winter abroad.

Medicines. — (Every hour, or less often, according to urgency of symptoms.)

Aconite.— Skin hot and dry, pulse hard, frequent, quick breathing, short, dry, frequent cough, as if excited by tickling in throat or chest, thirst, restless tossing about.

Antim. tart. — Much rattling of phlegm ; patient inclined to slumber with eyes half open ; cries from being touched, but will be carried about. Face bluish, pale, and puffy.

40 BRUISES— BUNION.

Bell. — Severe headache aggravated by coughing, op- pression of chest and constriction as if bound, with rattling in the chest ; dry, fatiguing cough, worse at night ; child cries when coughing.

Bry. — Cough dry or with viscid mucus, sometimes tinged with blood, mouth dry ; stitches in chest hinder breathing.

Phos. — Respiration continuing oppressive ; dry cough, excited by tickling in throat or chest, aggravated by talking or laughing, or going into open air.

Merc. — When accompanied by excessive perspiration, which does not relieve. Tongue coated thick yellow. Patient cannot endure either hot or cold air.

Jpec. — Mucus rattling in chest, almost suffocating patient on coughing ; coughing in fits ; shortness of breath, perspiration on forehead. See also under COUGH.

BRUISES. — Injuries from external violence, causing rup- ture of small blood-vessels and escape of blood into the tissues, and giving rise to discoloration. General Treatment. — There is nothing better for bruises than the internal and external use of Arnica. A lotion should be made of the strong tincture of Arnica, in the proportion of ten drops to the half- tumbler of water. Linen cloth should be dipped in this, and one or two folds of it laid on the bruise, and over this a piece of flannel should be laid. Oil-silk should not be used, as this tends sometimes to set up arnica erysipelas. Should the bone have been bruised, Ruta must be substituted for Arnica.

Medicines. — (Every two hours.) Arnica. — In almost all cases. Ruta. — Where the bones are injured. Hepar. Where abscess follows.

BUNION. — Enlargement and inflammation of the synovial

BURNS AND SCALDS. 41

sac over the root of the great toe, and, more rarely, the outer side of the little toe. This is generally due to pressure; or it may be due to rheumatism, and then it is not a true bunion. The joint is red, and generally tender, the tissues over the joint being greatly thickened and hard.

General Treatment. — When painful and inflamed, a compress, moistened with a liniment composed of equal parts of Verat. v. <p, spirits of wine, and distilled water, to be kept applied. Boots must be made to keep off all pressure from the part.

Medicines. — (Four times a day.)

Si lie. — For true bunion.

Rhus. — For rheumatic bunion.

BURNS AND SCALDS.— Scalds are generally less severe and less dangerous than burns, since scalding water cannot be above a certain temperature, which is below that of burning solids. But the danger of a burn or scald depends more on the locality and extent than on the intensity of the burn. A burn or scald may be immediately fatal, causing death by shock, or it may cause intense inflammation, especially inflammation of the kidneys, and bronchitis. General Treatment. — The thing to avoid in all cases of burn is the application of cold water. The less the patient is interfered with the better. Unbroken blisters should be left unbroken. Carron oil (equal parts of lime-water and linseed oil) is the best applica- tion ; lint saturated with it should be laid gently on, and kept applied by light bandages. If this is not procurable at once, spread on the wound ordinary cooking soda and cover with a wet cloth ; or make a thick salve with white castile soap, scraped fine, and dissolved in lukewarm water, and spread on lint. For scalds of the mouth from taking hot liquids, or the

42 CATARRH— CANCER.

bursting of a roasted chestnut, dissolve ten drops of Cantharis 3X in half a tumbler of water, and hold a little in the mouth every few minutes. If diarrhoea results it should not be interfered with.

Medicines. — (Every hour.)

Cantharis. — In almost all cases, especially where there is inflammation of the kidneys.

Antim. tart. — When bronchitis sets in.

Aconite. — Where there is much fever.

CATARRH. See COLD.

CANCER. — Cancer is a new growth, or tumour, the essential property of which is, to increase indefinitely, to recur after removal, and to infect other parts of the body remote from the locality in which it is found. This is what is called " malignant," — a " benign" tumour being one which is purely local, does not return after excision, and does not infect other parts. Cancers, or malignant tumours, are of many different kinds, and have different appearances and characteristics accord- ing to the different tissues from which they take their rise ; and there is no tissue of the body from which they may not arise.

The Treatment of cancer is only to be undertaken by a medical man. The amount of suffering caused by cancers is very variable ; some cause hardly any, and others give rise to intense sufferings. Operation never cures cancer, and almost invariably makes it worse. The growth is sure to return in an aggravated form, and is then much more difficult to deal with by medi- cines. It may be laid down as a fundamental rule that the less the new growth is interfered with the better for the patient.

Cures of cancer have been effected by medicines, and this possibility must never be lost sight of. Arse?iic, Hy- drastis, Coniuw, Lachesis, Cundurango, Silica, Sulphur,

CARBUNCLE. 43

and (in cancer of the tongue) the Cyanide of Potassium (Kali cyanicum) have all been accredited with cures. But the choice of the remedy will be decided by the symptoms of each patient.

Medicines. — (Two or three doses daily, or oftener,

according to the urgency of symptoms.) Arsen. — Epithelial cancer. Burning pains ; pains worse

at night, and especially at 3 a.m. j aggravated by cold,

relief from warmth; anxiety, restlessness, thirst. Cundurango. — Cancer of breast. Cracks in the corners of

the mouth. Conium. — Cancer of breast. Scrofulous subjects; women

who have scanty menses. Kali cyanicum. — Cancer of the tongue. Lachesis. — Dirty ulceration, black clots at the bottom of

the ulcer like charred straw, blue look of the parts;

patient is intolerant of anything tight about her. Silica. —In subjects who are sensitive to least draught of

air. Sulphur. —Where the well-known indications for Sulph.

are present — sinking sensation in the forenoon, cold

feet, hot head, hot fainty spells, symptoms worse in bed

at night. Sulph. is valuable as an intercurrent remedy.

CARBUNCLE. — A circumscribed inflammation of the tissue under the skin, leading to death of part of the tissue and of the skin over it. The disease is a constitu- tional one, and generally comes from a depressed state of health. It is usually situated on the back of the neck or trunk, but sometimes on other parts, and even on the face. There is a large hard swelling, ex- tremely painful, and this is often accompanied by a low fever of the typhoid type. Diagnosis. — A carbuncle is an exaggerated boil, from which it is distinguished chiefly by its large size and the gravity of the accompanying symptoms.

44 CATARACT— CHANGE OF LIFE.

General Treatment. — The strength of the patient must be kept up, and if the constitutional symptoms are not severe, he need not be confined to the room or even to the house. Linseed poultices should be applied until suppuration has taken place, and the Calendula lotion (thirty drops to the ounce") kept applied and frequently changed. When healing is commencing, Boracic acid ointment (powdered Boracic acid, one drachm to the ounce of vaseline) should be used instead.

Medicines.— (Every hour at first.)

Arnica. — At the beginning.

Nux v. — When occurring in drunkards.

Arsen. — Burning pain, worse at night, restlessness, irri- tability, weakness, thirst ; typhoid state.

Carl?, veg. — Dark appearance of carbuncle ; general low state.

Silica. — After it has begun to discharge.

CATARACT.— A disease of the anterior lens of the eye or its capsule, resulting in opacity and blindness. It is easily recognized by the greyish white appearance of the pupil. When the disease has advanced to a cer- tain stage, the only remedy is removal of the lens. In the earlier stages it is amenable to the action of medicines, among which Silica, Sulphur, Calcarea are the most useful.

CHANGE OF LIFE. When the period of child-bearing comes to an end, the organism of women undergoes certain changes, principally manifested in the circula- tory and nervous systems. The blood supply has to be adjusted to altered conditions, the heart and blood- vessels are affected, and the result is felt by the patient in flushes of heat, followed at times by perspiration and chills. Along with these symptoms are heightened sus- ceptibility of the nervous system to ordinary influences,

CHAPPED HANDS. 45

and also the emotional balance is very unstable for tl it- time. This condition lasts indefinitely. Some women are scarcely conscious of any difference, and others suffer for years. Men are not always exempt from climacteric sufferings, though in them they are the exception rather than the rule. Palpitation, giddiness, and rush of blood to the head are the chief symptoms they experience.

General Treatment. — Avoidance of excitement of all kinds ; light, unstimulating diet ; no alcoholic drinks except a little light wine. The way in which this period is got through depends very much on the patient. She must make up her mind to endure a certain amount of inconvenience and unwonted ner- vous sensations, and must beware of flying to stimu- lants or narcotics for relief. These only make the con- dition worse, and often destroy the patient. The treatment is thus largely moral.

Medicines. — (Every -two or three hours.)

Ignat. — Nervousness, numbness in various parts, sink- ing sensation, flushings, constipation, sensation as of a ball in the throat.

Act. rac. — Restlessness, sleeplessness, "sinking" sensa- tion, unhappy state of mind.

Lack. —Flushings excessive ; symptoms worse on waking from sleep ; external pressure intolerable ; melancho- lic ; irritable.

Sulph. — Sinking sensation at n a.m. : flushings, hotfainty spells, hot head and cold feet.

CHAPPED HANDS.— The best treatment for chapped hands is to rub them well every night with glycerine or glycerine jelly. More pleasant, but not always so effective, is " Vaseline Cold Cream." Large painful cracks should be painted with Friar's balsam (com- pound tincture of benzoin).

4^> CHEST— CHILBLAINS.

Medicines.

Petrol. — Night and morning, if the chaps are very in- tractable.

CHEST, AFFECTIONS OF. See BRONCHITIS, LUNGS, INFLAMMATION OF.

CHICKEN-POX. — Chicken-pox is an infectious disease resembling small-pox, but in no way allied to it. The symptoms appear about thirteen days after exposure to infection, and begin with mild fever, followed in a day by the appearance of vesicles or blisters. They are distinguished from small-pox vesicles by not having a hard circle of inflammation round them, or a depres- sion in the centre of them. In the course of a day or two the vesicles become pustules, on the fourth day dry up, and by the sixth day complete scabs are formed. When these fall off they may leave a few pits. Some- times several crops of vesicles appear in succession, and then the disease lasts longer.

General Treatment. — This disease is usually of such a mild character that very little in the way of treat- ment is needed. If there is considerable fever, the patient should be kept in bed and on fever diet until it subsides.

Medicines. — (Every two hours.)

Antifti. tart. — In the early stage.

Mercurius.— When matter appears in the vesicles.

CHILBLAINS AND FROSTBITE —When frostbite is in- tense it causes death of the part, leaving an ulcerating surface, which must be treated as other ulcers. When it is less intense it causes a low kind of inflammation, of which chilblain is a familiar form.

General Treatment. — When a part becomes frozen as the tip of the nose or ears, great care must be taken not to let the person go near a fire. The frozen part

CHILD-BIRTH. 47

should be rubbed with snow until it thaws and becomes quite soft.

Chilblains may be treated by rubbing with snow or bathing in cold water. Among other applications that are useful is painting with the strong tinctures of Veratrum Viride or Tamus communis or Rhus /ox., or with coal oil in which camphor has been dissolved. For broken chilblains a lotion of Verat. v. # (one part to two of water) should be applied as a compress. When ulcerated, Calendula ointment.

Medicines. — (Every hour or two.)

Agar. — Simple chilblains.

Puis. — In blonde girls, with scanty or delayed menstrua- tion.

Rhus t. — Dusky red chilblains, with much burning.

Arsen.— Acute burning pains j irritable, ill-conditioned ulcers.

CHILD-BIRTH. — Normally, the duration of pregnancy is nine months. The best mode of reckoning is to count two hundred and eighty days, or forty weeks, from the last day of the last menstrual period. The duration of labour is very varied. Frequently the pains begin some days before labour is accomplished. From four to six hours is the average duration of the severe pains, but some women have hardly any pain at all.

Towards the latter end of the time the child sinks lower in the abdomen than it was before, and the woman becomes smaller round the waist than she has been for some weeks before. Labour is often preceded by nervous symptoms, trembling, disposition to tears, low spirits. Looseness of the bowels should not be inter- fered with. The actual onset of labour is announced by a slight reddish discharge, called a " show." General Treatment. — The care of a woman in child- birth must only be undertaken by a doctor or a mid-

48 CHILD-BIRTH.

wife, but there are points in the general management of the patient, both before and after confinement, that ought to be attended to. Under BREASTS I have described the attention that ought to be paid to them during the later months of pregnancy. The best ordinary preparation is attention to the general health, taking plenty of plain, unstimulating food and open-air exercise. Sometimes at the beginning of labour, and occasionally two or three days, or even weeks, before the actual onset of it, women suffer from " false pains." These may be checked by medicines.

Medicines. — (Every hour or two.)

Nux vom. — Pains in abdomen and back ; constipation ; in passionate persons.

Puis. — Pains in abdomen and loins, as if from continued stooping ; stiffness ; aching and dragging in thighs, diarrhoea or constipation. From eating fat or indiges- tible food. In mild-tempered persons.

Bell. — Spasmodic pains.

During Labour. — Drugs and stimulants of all kinds should be avoided.

Flooding. — This is one of the most dangerous incidents of child-birth, and it is well that every nurse should know how to deal with it, as a doctor cannot be always ob- tained immediately. A certain amount of bleeding is natural, and need give no alarm. Also the waters mixed with blood give an appearance of excessive bleeding when there is actually not much. It is when the blood comes away in gushes, after the child is born, that the condition is dangerous.

Treatment. — Keep the patient perfectly quiet. Give no warm drinks. Let the patient smell a little vinegar. Place the hand on the body low down, and press so as to get the womb to contiact and expel the after-birth. If this fails, introduce the hand into the womb and take firm hold of the after-birth (not the cord, but the whole

CHILD-BIRTH. 49

after-birth), and draw it out, keeping pressure with the left hand on the body all the time. If the bleeding does not then cease, inject water as hot as the hand can be borne in.

Medicines. — (Every five minutes until bleeding is arrested.)

China. — When there is giddiness, faintness, or loss of consciousness.

Ipec. — When there is nausea or vomiting.

After Delivery. The patient must be kept perfectly quiet for an hour. If, after the lapse of this time there is no bad symptom, especially no bleeding, she may have her things changed and her bed made. A ban- dage (or " binder ") may be applied immediately after delivery without disturbing the patient.

After Pains are troublesome contractions that come after delivery in women who have borne children before. They seldom occur in first labours. They may be checked by medicines.

Medicines. — (Eveiy hour until relief.)

Arnica. — Not very violent ; accompanied by feeling of soreness.

Cham. — In nervous, excitable patients, with restlessness.

Puis. — In persons of mild and gentle disposition.

Bell. — Much bearing down • fulness of the head ; tender- ness and fulness of abdomen.

Duration of Confinement. — This will depend on the individual patient. The usual period is nine days, and that should be the least allowed. The patient may get up for a time on the tenth day if all has gone well. But if there have been any drawbacks she must be kept in bed longer.

The Diet should be at first very light, consisting chiefly of gruel, milk, and farinaceous food, beef-tea, and eggs. After a few days a mutton chop may be given, and gradually ordinary diet may be returned to.

D

So CHILDREN.

Diarrhcea sometimes occurs during the period of con- finement. This is a bad symptom, and must be attended to at once.

Fids. — (Every hour until relief.) When there is much in- effectual straining ; chilliness ; mucous discharge ; in night and early morning. See also DIARRHCEA.

Constipation is a normal state for the first few days, and need not be interfered with. After five or six days medicines may be given (every three or four hours until relief).

Bry. — When there is fulness in the head and pains in the bowels.

Nux vom.— After Bry. See CONSTIPATION.

For care of breasts and nipples, see BREAST.

For the management of the child, see INFANTS.

For weaning and milk affection, see MILK and MILK- FEVER. See also WHITE LEG.

CHILDREN, DISEASES OF.— Children differ from adults in this respect, that their tissues are in a more active state of change ; consequently, the diseases which are more peculiarly incident to childhood are diseases con- cerned with nutrition and growth. Also, they are more liable to those epidemic diseases which generally attack a person only once in a lifetime adults being as a rule protected by having passed through an attack already. Then, the smallness of their organs, especially the bronchial tubes and air passages, makes inflamma- tion of these a much more serious thing than it is in adults. In other respects the diseases are much the same whether met with in children or adults, and the descrip- tion of the diseases and their treatment applies to all alike. Articles dealing with the diseases of children will be found, in their proper order, under headings BRONCHITIS, CROUP, COUGH, WHOOPING COUGH, MEASLES,

CHILDREN. St

SCARLATINA, CHICKEN-POX, DIARRHEA, CHO- LERA INFANTUM, RICKETS, TEETHING. For

the management of the new-born, see INFANTS. Feeding and Management of Children. — If the mother is strong and healthy the best food for the child is her milk, and for the first eight months it need take nothing else. But unfortunately it is somewhat rare to meet with mothers who are both strong and healthy, and consequemly provi- sion must be made for feeding them in other ways. The best food after human milk is cow's milk. There is no necessity to have it always from the same cow, though some people make a great point of this. During the first month the milk should be diluted with one-third of warm water, and, of course, heated to blood-heat, but not boiled. The greatest care must be taken with the feeding-bottle when bottles are used. It is best to have a large number, and let each bottle after using be put into water in which a little bicarbonate of soda has been dissolved. The tubes and nipples must be especially frequently cleaned with the soda solution. Milk should be the staple article of diet for the first eight months. When teeth begin to appear, the child may have crusts to chew, and may also have bread-and-milk. The pro- gress of the teeth will be the index of the time when solid food may be given. But before this time the milk may be thickened for children in various ways. A very good one is to put a tablespoonful of Embden groats into a pint of milk, and let it simmer for two hours, and then carefully strain ; then thicken the milk a little. It is excellent for all infants who can and will take it, but especially for ill-nourished and rickety children. Next to fresh cow's milk is Swiss condensed milk. This agrees with some children better than fresh milk, and sometimes it is well for a

52 CHOLERA.

change. There are many preparations of artificial food for infants, and among the best are Reed & Carnrick's (which I prefer to all others), the Aylesbury Dairy's Artificial Human Milk, Neave's, Ridge's, Mellin's, and Savory & Moore's.

Washing. — The greatest care must be taken with the washing and bathing of children. When healthy, every infant should have a tepid bath twice a day, morning and evening. After a child is two months old, if the weather is warm, a cold bath in the morning may be generally substituted for the tepid, but a cold bath should never be given at night. The greatest care should be taken with the drying of the skin.

Clothing. — The clothing of infants should be loose, light, and warm, and adapted to the weather. No pins should be used except safety-pins. Dr. Roth has devised a dress for children which can be fastened on at once, the child being simply laid upon it, and the dress fastening behind. This obviates the necessity of rolling the child round and round, as is now done in yards of swaddling-clothes.

Open-air Exercise. — When the weather is fine a child should be taken out twice a day after it is a month old ; in summer it may be out all day long if circum- stances allow.

Sleep. — The best mode of securing sleep in infants is to feed and clothe them properly, and see that they have plenty of out-door exercise. If they do not sleep perfectly it may be taken for granted that there is some cause, which ought to be found out and removed. On no account should children have sleeping-doses given to them.

CHOLERA ASIATICA (EPIDEMIC CHOLERA).— Asiatic

cholera is an infectious disease due to some specific poison the nature of which is not known, and the con-

CHOLERA. 53

dition of whose development and mode of propagation is also imperfectly understood. The disease commences with violent chills, and the poisoning may be so intense as to destroy life within one or two hours. The patient shakes with the chills and becomes visibly shrunken, the blood collects in the internal parts, and generally there is diarrhoea and vomiting, the patient becomes cold, and a complete and fatal collapse very frequently occurs in this stage. In favourable cases there is cessation of the violent purging and vomiting, some warmth returns to the skin, the patient gradually recovers, and asks for drink and food. General Treatment. — (i) Prevention. — Wear next the skin a plate of copper (6 in. by 4, for a man of large size; 5 in. by 3 for a small man, and for a woman ; 4 in. by 2 for children). Let it be fastened round the waist by straps attached to longitudinal slits cut in the ends of the plate, which should be oval. Let the plate rest on the front of the abdominal wall, and let it be made slightly concave, so as to adapt itself to the shape of the body. The plate should be worn day and night. It may be cleansed from time to time by rubbing with vinegar.

In addition to this, if the person to be protected is much exposed to the disease, one drop of Cuprum aceticum 3X should be given in a little water night and morning.

(2) Preliminary Symptoms. — In cholera times, whenever diarrhoea occurs, give Rubini's Tincture of Camphor^ five drops on a lump of sugar, every fifteen minutes to every hour, according to the urgency of the symptoms, until the diarrhoea is completely removed.

Should an attack come on without premonitory diar- rhoea, sudden coldness and lividity seizing the patient, give Rubini's Camphor, five drops every ten minutes.

54 CHOLERA.

This may be given if there is diarrhoea at the same time, provided it is not excessive.

(3) Care of the Patient. — The patient should now be kept at rest, and as warm as possible, hot flannels being applied to the abdomen, and hot bottles to the feet. No solid food whatever should be given ; water may be taken ad libitum ; and small pieces of ice may be given to suck. Milk is the best food, if it is tolerated. Movement is to be avoided. It is better to treat patients at their own homes if at all possible, as the very fact of moving a patient into hospital may make the difference between death and recovery.*

Medicines. — (Every fifteen minutes until reaction sets in, then less often, waiting until the effect of each dose is exhausted.)

Camphor (Rubini's). — The use of this has been explained above.

Veratrumalb. 3. — Should reaction not come on with cam- phor; vomiting, purging, cold sweat on forehead.

Cuprum 6. — Cramps, with vomiting and purging.

Arsen. alb. 3. — Collapse deepening, great general depres- sion, endangering life.

Hydrocyanic arid 3X. — Collapse most profound, respiration slow, gasping, patient appearing dead in the intervals between the breaths.

CHOLERA INFANTUM.— In summer time children are liable to sudden attacks of vomiting and diarrhoea, which cause rapid prostration, and, if not speedily checked, death. The vomited matters consist at first of food, then of mucus, and there may be empty retching. The motions are mostly thin and watery, and green or yellow ; at times they are slimy and • mixed with blood ; at times they consist of undigested food. The child wastes rapidly; there is usually great thirst ; the body is hot, and hands and feet cold.

* From the Author's " Prescriber,"

CHOLERA. 55

The chief causes are improper feeding and changes of temperature

General Treatment. — To guard against it, pay great attention to the clothing and diet of the child, and of the nursing mother of the child if at the breast. All stimulating food and drinks should be avoided. The child should be fed at regula intervals. It should be clothed well, but not too warmly. Very light woollen clothing is the best for summer. The room it is kept in should be well aired. Daily bathing in cold water is beneficial.

During an attack the child should be allowed to drink cold water, or thin barley-water or toast- water. The white of eggs, beat up into a froth, and given in a tea- spoon, is an excellent diet in diarrhoea. If the child is at the breast, it must not be allowed to take more than a very little at a time. The craving for drink is natural, and should not be resisted, and when it is re- tained there is nothing better than water ; it must be given in teaspoonfuls.

Medicines. — (Every fifteen minutes until reaction sets in, then gradually increasing the intervals.)

Aeon. — Watery diarrhoea, crying, complaining, biting fists restless.

Arsen. — Weakness, pallor, emaciation, great thirst ; white or brownish offensive diarrhoea, worse after midnight or towards morning, and after eating or drinking.

Carb. veg. — Stools thin and offensive, child cold, blue collapsed.

Ipec. — At the beginning of an attack, nausea, vomiting of food and drink or mucus and bile, thirst.

Chi?ia. — Diarrhoea after every meal, stools foetid, thin, undigested.

Verat. — Great weakness, fainting, coldness, vomiting after swallowing the least liquid ; or after the slight est movement j colic, loose brownish stools.

56 CHOLERA— CIRCULATION.

Sulph. — Stools frequent, greenish, thin, watery, slimy.

CHOLERA MORBUS, CHOLERINE, COMMON CHO- LERA.— The symptoms of common cholera are much like those of Asiatic cholera, but are less severe as a rule, and the disease is seldom fatal. There are also violent purging and vomiting, griping, and thirst, preceded by shivering, and terminating, if not checked, in collapse. But the disease is not dependent on a specific poison, like the epidemic cholera. The common cause is in- discretion in eating and changes of temperature.

General Treatment — This is the same as in the case of Asiatic cholera. Keep the patient warm and quiet in bed ; give small pieces of ice to suck ; no solid food, only milk and barley-water. Beef-tea must be avoided.

Medicines. — (Every fifteen minutes until there is im- provement, then less often.)

Veratrum alb. — Is the most useful medicine in general. Violent vomiting : severe diarrhoea, watery, painful or painless ; coldness.

Arsen. — Great prostration \ fear of death ; insatiable thirst.

Cuprum. — Violent cramps in calves of legs.

China. — Eor weakness remaining after.

CIRCULATION, FEEBLE.— A large percentage of the population of the British islands suffer more or less from defective circulation. The symptoms of it are congestion of the small blood-vessels, as indicated by blueness of the exposed parts, such as the face and hands ; tendency to chilblains, and a constant feeling of chilliness, and especially coldness of the hands and feet.

General Treatment. — The best way to counteract this condition is to take regular open-air exercise, and, when a good reaction can be obtained, to sponge all

CLERGYMAN'S SORE THROAT. 57

over with cold water in the morning, rubbing briskly

with a rough towel afterwards until the whole surface

of the skin is aglow. Medicines.— (Three or four times a day.) Cak. carb. — In those subject to cold, clammy feet. Nux v. — Chilly subjects; like to be warmly wrapped

up ; sensitive to changes of temperature j irritable dis- position. Pulsatilla. — In fair subjects of mild disposition ; though

chilly, they cannot bear the heat of a fire, and throw

off the bed-clothes at night. Carb. veg. — Especially in old people, with great vital

depression. Rhus t. — Great blueness of the surface ; chilblains.

When the state is due to poverty of the blood itself

the treatment recommended for ANEMIA will be

beneficial. See also CHILBLAINS.

CLERGYMAN'S SORE THROAT.— Public speakers are liable to a chronic relaxed sore throat, which has been called in consequence " clergyman's sore throat," but which is by no means confined to persons of this class. It consists of chronic congestion of the follicles of the mucous membrane of the throat, often extending to the back of the nose and to the vocal cords. The symptoms are a feeling of dryness in the throat, con- stant desire to hawk up mucus, dropping of mucus from the back of the nostrils down the back of the throat ; hoarseness. It is usually a very inveterate complaint. General Treatment. — Care must be taken in using the voice, when this disease occurs in speaking, not to strain it in any way, and much may be done by vocal drill and exercise in breathing. Much relief may be ob- tained by gargling the throat with warm milk and water. Medicines. — (Three or four times a day.)

58 CLOTHING— COLD.

Mercurius. — Throat swollen red; tongue furred and

flabby ; hoarseness j disposition to sweat easily. Phosph. — Hoarseness with cough and soreness in larynx,

worse in the evening ; cannot talk on account of pain

in the larynx. Hepar. — Feeling as if a splinter or fish-bone were in the

throat, scarcely allowing him to swallow ; symptoms

worse during the night. See also under THROAT.

CLOTHING. — Dress is not by any means a matter of fashion merely. A man's spirit is "confined to what it works in," in more senses than one. Ill-fitting clothes are not only objectionable from an aesthetic point of view, but very decidedly also from a point of view of health and morals. It is impossible for a man to be at his best if he wears badly made clothes, or clothes of wrong materials. The essentials of good clothing are the following : —

i. The material should be good, and adapted to the purposes for which it is required.

2. It should be of such a nature as to retain the bodily heat, whilst permitting the escape of perspiration.

3. It should be so made as to permit the freest move- ments of the chest, body, and limbs, whilst at the same time fitting gracefully so long as the wearer retains good positions ; for it is just as easy for the wearer to spoil his clothes, as it is for bad clothes to injure the wearer.

COLD IN THE HEAD.— The symptoms of cold in the head need no describing, as they are well known to all. But it is not recognized by everybody that a cold is a constitutional disorder. A chilling of the skin, when it results in a cold in the head, also affects the whole system, producing an abnormal chilliness and sensitiveness to cold. But colds are not always caught in

COLD IN THE HEAD. 59

this way ; they are often due to atmospheric influences, and, again, often caught from those who have colds.

General Treatment. — Whenever it is possible it is well to stay in one temperature until a cold has passed oft". A liberal dietary, hot drinks, putting extra blan- kets on the bed, wrapping up the head at night, and putting the feet into hot water, are all well-known remedies for colds, and are all useful in many cases. They should not be neglected by homoeopathists.

Medicines. — (Unless otherwise directed, every hour until relief is obtained, then less often.)

Camphor. — (Camphor pilules are the best). Immedi- ately the chill has been taken, and while it is still on. One pilule every fifteen minutes, until the chill is succeeded by a glow. If this does not follow in the course of two or three hours, this medicine should be discontinued, and aco?iite given instead.

Aeon. — In the early stage of colds, if the initial chill has passed, or when a feverish state has supervened. This may be continued forty-eight hours, by which time, in most cases, the cold will have disappeared.

Mercurius. — Fully established cold j thick or thin un- irritating discharge ; sensitive both to heat and cold.

Arsen. — Influenza cold j thin, irritating, hot discharge ; prostration, anxiety, thirst.

Hepar. — Nose inflamed and swollen ; bones of the nose sore to touch.

Nux v. — Running cold by day, stopped at night.

Puis. — Running colds, greenish discharge, sore eyes, in blonde mild-tempered subjects, chilly but cannot bear a fire or warm room.

Nat. mur. — Chronic or recurring colds. Colds in chilly persons, constipated, subject to palpitation.

Cale. — In chilly subjects, who have cold clammy feet, tendency to perspire in the night or early morning. Chronic colds.

60 COLIC.

SuJph. — When there is constipation, a u sinking " sensa- tion in the forenoon, and chronic colds in persons sub- ject to skin eruptions.

COLIC. — Painful contraction of the bowels, compelling the patient to bend double, due to indigestible articles of food ; drinking cold water ; chills ; or lead poisoning. The last is especially found in painters.

Diagnosis. — The absence of all signs of fever separates colic from inflammation of the bowels ; also in in- flammation the patient cannot bear the least pressure, whilst in colic pressure relieves. The passage of gall- stones may be taken for colic, but in that case the pain is more definitely localized, and there are accom- panying liver symptoms, as yellow skin, and even jaundice, with light-coloured stools. The passage of renal calculi (kidney-stones) cause pains like colic, but these pains are lower down in the body, are confined to one side, and are accompanied by frequent urging to pass water, which is scanty.

General Treatment. — The patient must keep at rest, and take only liquid food until the attack is over. To prevent future attacks he must avoid the causes which bring them on. Painters must be scrupulously careful in washing their hands before they eat. When caused by overloaded stomach, give coffee without milk.

Medicines. — (Every half-hour, or less frequently accord- ing to the urgency of the case.)

Nux vom. — Pinching, drawing, compressing pains in body, making patient bend double, worse at every step, when due to indigestible food and constipation.

Cham. — Flatulent colic, intolerance of pain, aggra- vated at night and by warmth. After violent in- dignation.

Coloc. — Pains very violent, constant or only ceasing for a short time, most violent at spot near navel.

CONFINEMENT— CONSTIPATION. 6 1

Puis. — From overloaded stomach. Wind that cannot be got rid of; abdomen painful to touch ; pains worse when lying down ; tearing shooting about the navel ; diarrhoea yellow grey evacuations, pressing tensive headache.

Opium. — For lead colic.

Dioscorea. — Colic relieved by moving about.

CONFINEMENT. See CHILD-BIRTH.

CONSTIPATION.— When a person does not have a mo- tion of the bowels as frequently as is natural to him, the condition is called constipation. This may occur temporarily from various causes, the bowels returning to their proper condition after a few days, or it may become a habit. In the latter case the condition is termed costiveness. Constipation generally occurs after acute illnesses; also as a reaction after the use of purgatives ; from irregularities in diet, or from want of proper attention to the calls of nature. Certain articles of food produce constipation in some individuals, whilst others are not affected by them. Occasionally it is due to disease or malformation of the bowels. When it occurs after acute illness it is generally due to loss of power of the bowel itself, and disappears when the strength is restored.

Many persons imagine themselves constipated when they are not. It is not necessary for every one to have a motion of the bowels daily. Some people can go two, or even three or more days, without any desire for a motion. If the action takes place without dis- comfort, and the delay causes no other symptoms, such as headache, there is no occasion for the least anxiety. Indeed, patients who are habitually costive may console themselves with the reflection that the condition is much better than its opposite— chronic looseness of the bowels — and that costive persons are usually long livers. But when constipation or costiveness is attended with

62 CONSTIPATION.

pain, or difficulty in evacuating the bowels, it may be" enough to make life a burden, and something must be done. The usual thing is for the patient to resort to purgatives, and this is the worst thing to do. The usual result of this is to give present relief at the expense of aggravating the condition.

Obstruction of the Bowels is the extreme stage ot constipation. In this there is a blocking of the bowel by hardened faeces, which cannot be passed by the bowel, which is in a state of paralysis. If purgatives are given in this state the general result is to irritate the bowel, and cause irregular contractions, which may cause one part of the bowel to slip into another part {intussusception), and this, if not speedily re- lieved, ends in gangrene. Obstruction is not nearly jo common as is imagined; many people who suffer from very sluggish bowels consider they have obstruc- tion, when there is really no blocking of the bowels, but only inactivity.

General Treatment. — Much may be done in the way of restoring to the bowels their natural function by exercise and diet. The use of whole-meal bread in place of white bread (which often contains alum, a possible cause of constipation), dried fruits, such as figs, prunes, and ripe fruits, fresh and cooked, should be tried. Stewed rhubarb is often efficient. Meat must be taken mode- rately not oftener than once a day, and a liberal supply of vegetables. Alcohol in all forms should be avoided. Strong tea should not be taken. The substitution of coffee for tea at breakfast will often assist the bowels to act.

Among other remedial measures may be mentioned the use of a cold water compress placed on the body at night ; drinking a glass of cold (or hot) water on rising and going to bed, and the use of the enema or injection. For this only water should be used, warm or cold ;

CONSTIPATION. 63

warm water, when the enema is given to produce an immediate relief ; cold, when it is given to strengthen the lower bowel. In the latter case it should be given at bed-time, and the water should be quite cold and retained if possible. Another useful domestic remedy may be mentioned, and it is especially useful where constipation is complicated with piles. Put a table- spoonful of coarse black treacle (golden syrup will not do) into a tumbler of cold water over-night. In the morning stir it and drink by sips whilst dressing. This will often assist the action of medicines.

Medicines. — (Two or three times a day.)

Opium. — An inclination to evacuate but feeling as if the orifice were closed ; no regular pressure ; sensation as if a load on abdomen ; heavy drowsy feeling ; dry mouth, thirst, want of appetite. Stool hard round black balls like marbles.

Nux vom. — In sedentary persons and those accustomed to drink spirits. Bad taste in the mouth, want of appetite, especially in the morning, slimy tongue, irrita- bility, headache ; frequent urging, little or nothing passes.

Puis. — After taking rich or fat food j with moroseness and taciturnity.

Pry. — With indigestion, weight at stomach after food and pain between shoulders \ patient irritable, feels chilly, subject to rheumatism. Stool hard, large, light-coloured, and dry.

Lycop. — Constipation with sadness, complete loss of appetite. When there is much flatulence and gravelly urine.

Plumb. — Constipation of hard round balls; colic; abdomen drawn in ; also constipation of children with large bellies in mesenteric disease.

sEsculus Hip.— Constipation of hard round balls, backache aggravated by walking.

Nat. m. Constipation in chilly subjects; earthy com-

64 CONSTITUTIONS.

plexion j feeling of contraction at the anus ; and as if something were lodged in the rectum (lower bowel). Salph. — Frequent disposition to go to stool with in- effectual efforts. Sinking sensation at stomach, hot flushes, and fainty spells. See also FILES.

CONSTITUTIONS.— It is of great service in homoeopathic practice to be well acquainted with the different kinds of constitutions that prevail, and their corresponding medicines. When a patient has very marked constitu- tional characteristics, it often happens that one or two medicines will give relief, no matter what the dis- ease may be that he is suffering from. For instance, those patients who are subject to clammy cold hands and feet, perspiring heads (either hot or cold), chilli- ness with relief by warmth, and irritability of temper, will almost always receive benefit from Calcarea. No matter what disease they may have, if these symptoms are prominent, Calcarea will relieve and often cure. Such are said to have the Calcarea constitution.

Contrasted with this is the Sulphur constitution. The Sulphur patient, instead of being chilly like the Calcarea patient, is hot, apt to perspire, has an irri- table skin, and cannot endure warmth. He is always worse near a fire, in a hot room, and when warm in bed at night. The feet may be cold, but they are generally dry \ often they are hot and burning, espe- cially the soles ; they may be hot and perspiring ; cold hands and feet and hot head are a characteristic feature. The most characteristic feature of Sulphur is a sinking, " all gone," empty sensation at the pit of the stomach, generally worst in the forenoon. With this there are often hot fainty spells, with perspiration. The Sulphur patient dislikes washing. Such is the Sul- phur constitution. When these symptoms are present, Sulphur must be given, no matter what the complaint.

CONSUMPTION. 65

Like Calcarea, in the matter of chilliness and aggravation by cold or draughts, are Hepar Sulph., Silica, and Arsenicum, among the remedies for chronic diseases, and Nux and Belladonna, among the reme- dies for acute diseases. Nux corresponds very closely to Calcarea in its action, and will often help a Cal- carea patient temporarily.

Allied to Sulphur in aggravation by heat are Apis, Iodum, and Pulsatilla.

A third type may be described which is represented by Lycopodium. The chief symptoms of this remedy are great tendency to accumulation of flatulence, constipa- tion, red sandy deposit in urine, affections or pains occurring on the right side of the body and travelling to the left (Sulphur has a preference for the left side), aggravation of all symptoms in the afternoon, especially from 4-8 p.m. It has a sinking sensation like Sulphur, but it is generally worst in the afternoon, or it may prevent the patient sleeping at night. In this it is like Ignatia. Nux and Pulsatilla have both affinities with Lycopodium.

These are the three chief types commonly met with. They are not always distinct, and we often find all three combined in the same patient. But generally the char- acteristics of one predominate, and the medicine which corresponds to that is the one to be given first. When it has done all it is capable of doing, the remaining symp- toms will show which medicine should be chosen next.

CONSUMPTION OF THE LUNGS (PHTHISIS).— There

are many different conditions included under the term " Consumption of the Lungs." When any affection of the lungs, involving consolidation or destruction of its tissue, is accompanied by wasting, fever, night-sweats, and loss of strength, it is fitly termed " consumption." This may follow an ordinary inflammation of the lungs

E

66 CONSUMPTION.

which does not clear up, it may follow (but this is rare) bronchitis, or it may arise from infection. But before a person can be infected with consumption there must be some predisposition already existing. Persons who have this predisposition should not nurse consumptive patients or they may become infected. Consumption may depend on the deposition of what are called "tubercles" in the lung. These are minute greyish bodies composed of degenerate tissue, and containing minute organisms, called bacilli, which appear to be the carriers of the infection when the disease is conveyed in that way. But for practical purposes it is unneces- sary to make any distinction between tubercular and non-tubercular consumption. Both are curable at times, and when they are fatal both are fatal in the same way.

Diagnosis. — The cough, wasting, hectic fever, night-sweats, and blood-spitting, and unnatural hopefulness of the pa- tient (spes phthisica) are sufficient to distinguish con- sumption from other lung diseases which might be mis- taken for it. Chronic bronchitis is a disease that gets better and worse, and has not the steady downward pro- gress of consumption. When one side of the chest only is affected there is a sinking in of the chest-wall, and tapping gives a dull sound instead of the natural resonant sound. On applying the ear, there is gene- rally much rattling and a resonating sound heard which denotes that a cavity has formed in the lung. Chronic suppurative pleurisy may cause symptoms closely re- sembling phthisis, but in these cases there is the history of pleurisy to guide.

The treatment of consumption is of course a matter for the medical man. There is much to be done in the way of prevention by proper attention to food and clothing. The best way to guard against consumption (as well as every other disease) is to keep the body

CONSUMPTION. 67

well nourished and well clothed. Generally consump- tives have a great dislike to fat, and fat is one of the necessary elements of their dietary, and should there- fore be supplied in the most agreeable form. Cod- liver oil is one of the best fats, and it is also a good deal more — it is a powerful medicine. It should form a regular article of the dietary of children who are at all weak-chested or whose families are consumptive. In one sense consumption is not an hereditary disease ; no child is ever born with consumption. But the tendency lo consumption is very decidedly hereditary, and it is in those cases where one or both parents are consumptive that the greatest care is needed in the case of their children. When the disease has actually declared itself, one of the chief points to attend to is the diet. If the strength of the patient can be kept up, the disease may be kept at bay, and eventually conquered. Medicines. — (Every two or three hours.)

Arsen. — Fever, restlessness, red tongue, burning thirst, cough worse at night ; great emaciation, anxiety.

China. — Hectic fever, copious night-sweats ; diarrhoea.

Phos. — Constant irritable cough, bloody expectoration. In commencing phthisis, with blood-stained expectoration.

Hepar. — Great sensitiveness to cold and all impressions ; hectic, night-sweats, spasmodic cough, purulent ex- pectoration.

Other medicines may be given as indicated by the symptoms. See COUGH.

CONSUMPTION OF THE BOWELS,— This is a name given to two different conditions — disease of the lymph- atic glands of the abdomen, and tubercle of the covering membrane of the intestine. The former is the disease more commonly met with in infants and children ; the latter is more common in adult life. The symptoms of the former are great wasting of the limbs and trunk muscles,

68 CONVULSIONS.

with increase in size of the abdomen. With this there may be chronic diarrhoea, or obstinate constipa- tion. The symptoms of the latter are the usual symp- toms of inflammation of the bowels {see BOWELS, INFLAMMATION OF), but with great wasting.

The Treatment of these conditions can only be directed by a medical man. The prevention is chiefly a question of proper nourishment and care of the general health. See previous article ; also BATH, CLOTHING, DIET.

Medicines. — (Two or three times a day.)

Arsen. — Anxiety, restlessness, diarrhoea, fever, wasting.

Plumb .^—Shrunk limbs and swollen body; obstinate constipation.

Merc. — Mucous or bloody stools.

CONVULSIONS. — There are several diseases attended with spasms of the muscles of the body resulting in various contortions of the features and limbs. When such spasms are attended with loss of consciousness, they are epileptic. Many children have fits of this kind, due to various causes, such as the irritation of teething or unsuitable diet. These may never recur, and then the disease is not called epilepsy proper, but only if there is a periodical return of the attacks. Hys- terical attacks are sometimes mistaken for epilepsy, but in these the loss of consciousness is never complete, and as they occur in young women who are generally known to be hysterical, there is not much difficulty in distinguishing between them. Sometimes fright will send a person into convulsions, either hysterical or truly epileptic. There may never be a second attack, but not unfrequently the patient has become epileptic from that moment, and subject to fits all the rest of his life. Diagnosis. — Epilepsy is easily distinguished from apoplexy in general. In the latter there is no struggling, and in many cases there is no loss of consciousness ; but in

CONVULSIONS. 69

the worst forms of the two there may be difficulty. When patients fall down unconscious and lie still with con- gested face it may be impossible to decide between the two. If there is a history of previous epileptic attacks this will make the case clear. Where there is no such history the event will have to decide.

Ix Children. — General Treatment. — Put the legs of the child up to the knees in water as hot as can be borne. Let them remain in five or ten minutes, or until the fit appears to be gone off. Wipe perfectly dry and wrap the child warmly after. This may be repeated shortly if no relief follows the first time, or if the fit returns. Whilst the feet are in the bath cold water may be applied to the head. If the attack is traceable to the presence of an irritating substance in the bowels an injection of warm water should be given to bring it away if possible.

Medicines. — (To be given just as the fit is gone off; or, if long continued and frequently recurring, imme- diately, and repeated every ten or fifteen minutes according to urgency. If there is no recurrence the medicine should be repeated two or three times a day for a few days.)

Cham. — If the child is cross, and especially teething, and if there is convulsive jerking of limbs, twitching of face and eyelids, constant moaning, craving for drink, one cheek red the other pale.

Bel/ad.— Starting suddenly when asleep or staring about wildly ; dryness and burning heat of forehead and palms ; involuntary discharge of urine after the return of consciousness.

Ignat. — Sudden and violent starting from a light sleep with loud screaming and trembling 01 the whole body ; spasms of a single limb or single muscles.

Cina. — When there are worm symptoms, itching at the nose and anus, and wetting of the bed.

70 CORNS.

Opium. — When due to fright ; loud screaming, tossing of the limbs ; or an unconscious state as if stunned.

Sulph. — When following repelled eruptions.

Epileptic. — During the attack no treatment should be attempted. Tight garments may be loosed, and a tooth-brush handle may be inserted between the teeth to prevent biting of the tongue. When the conditions which induce an attack are known, such as indiscre- tions in diet, these should be avoided. The ?nedical treatment should, when possible, be undertaken by a medical man.

Medicines. — (Two or three times a day.)

Bell. — Convulsions violent ; followed by mental disturb- ance.

Opium. — When the fit occurs in sleep ; heavy drowsy con- dition ; constipation ; when the fits are a consequence of fright, reproach, violent scolding, or taking offence.

Plumb. — In unhealthy -looking subjects who suffer from constipation.

Sulph. — Fits occurring about the full moon. In constitu- tions of the sulphur type, subject to eruptions, to flushes of heat and fainty spells, when there is a "sinking" sensation at the pit of the stomach, worse in the forenoon.

Hysterical. See HYSTERIA.

CORNS. — Overgrowth of the scarf-skin, due to pressure on certain parts of the foot and toes from ill-fitting boots, the growth pressing on the sensitive true skin and causing much pain. The Treatment consists in wearing boots specially made for avoiding pressure on the affected parts. Relief may be obtained by bathing in hot water and paring, and applying arnica plaster afterwards.

Medicines. — (Two or three times a day.)

CORPULENCY— COUGH. 71

Rhus. — When corns pain at changes of the weather ; and afterwards Bry.

Sulph., Ca/c, and Ly cop. — When these are given according to the temperament of the patient they will lessen the tendency to corns. See CONSTITUTIONS.

CORPULENCY.— With some persons the increase of fatty- tissue becomes so great as to amount to positive disease. This may be combated in various ways.

General Treatment. — Open-air exercise should be taken regularly. The freest ventilation should be secured in the house. Meals should be taken regularly, three times a day, and foods rich in fat, starch, or sugar should be avoided or taken sparingly.

Medicines. — The medicine most commonly useful in this condition is Phosphorus. After a course of this, Calc. carb. should be tried. After this Arsen.

COUGH. — A cough is usually a symptom of some affection of the lungs, bronchial tubes, or throat. In that case the chapters on BRONCHITIS, CONSUMPTION, and INFLAMMATION OF THE LUNGS must be con- sulted. But often a cough is the whole of the disease, and is due to irritation or irritability of the air passages, which does not amount to inflammation. General Treatment. — Persons who are constantly catching colds and getting coughs should adopt the measures recommended for the prevention of colds. Cold sponging, followed by brisk rubbing; warm, but not too warm, clothing, and open-air exercise are all helpful. It is not necessary to stay indoors always for a cough. Rubbing the chest with olive oil or (especially in children) cod-liver oil is good. Cold drinks if desired ; gum water, and hot milk with water, and linseed tea may be taken in any quantity. Pastry and rich or spiced food must be avoided. Medicines. — The types of cough are endless, but for

72 COUGH.

the most characteristic of them the corresponding medicine will be found in the following list : — Aconite. — A dry irritating cough, tickling in the larynx

(Adam's apple), the beginning of a cold. Nux v. — Dry cough with rough scraping raw sensa- tion in the throat ; oppressed breathing at night ; in those who indulge much in coffee or spirituous drinks ; asthma. Hyoscy. — Dry cough, worse at night, coming on as soon

as patient lies down. Caustic. — Protracted dry short cough ; or hollow cough ; burning or excoriating pain in chest and windpipe; urine escapes whilst coughing. Bryonia. — Dry cough commencing with tickling in throat ; comes on after eating and causes vomiting ; cough begins as soon as patient enters warm room j stitch in side j comes on in morning on first moving about, with expectoration then. Cough with shooting pains in the head, throat, and chest. Hard shaking cough which causes pain in the head and abdomen. Ipecac. — Cough of children when mucus almost suffocates them. Spasmodic cough, face becomes purple, and limbs stiff. Dry cough with tickling sensation in larynx. Cough causing nausea and vomiting of mucus. Walk- ing in cold air makes the cough worse. Bellad. — Spasmodic cough excited by constant insup- portable tickling in larynx, without phlegm on the chest ; cough barking. Merc. — Dry cough exhausting and shaking the patient,

more especially at night; hoarseness, fluent coryza. Cina. — Dry cough, at times accompanied by expectora- tion of mucus; in children, who start suddenly, especially if they have worms. Fluent catarrh, burning- sensation in nose ; children object to being touched. Puis. — Cough ceasing in open air, violent in warm room; cough dry in the beginning, then attended

COUGH. 73

with expectoration of mucus, which is easily raised ; in the morning much yellow, salt, bitter, disgusting expectoration, sometimes accompanied by retching ; cough loose by day, dry and tickling at night, com- pelling the patient to sit up and coming on as soon as he lies down j rough feeling in windpipe, soreness of abdomen and sides, as from a bruise, or shooting pains in arm, shoulder, and back ; urine escapes whilst coughing.

Arsen. — Loose cough with but little expectoration ; cough difficult and causing constriction of the chest ; cough- ing each time after drinking ; cough during the night, with spitting of blood and burning heat all over the body, want of breath, extreme fatigue and weakness. Every evening dry cough which is very weakening, oppression of chest on going upstairs and into cold air j palpitation and agitation during the night.

Sulph. — Chronic dry cough from tickling in the throat, coming on in the afternoon and continuing till towards midnight ; cough only during the night, preventing the patient from sleeping; dry cough during the night, with yellow, greenish, offensive expectoration of thick mucus, pus, and blood during the day ; cough which seems to tear the chest under the sternum ; when coughing, single stitches in the chest or under the ribs on the right side ; feeling as if the chest would burst when coughing or sneezing ; the chest feels narrow and full, difficulty of breathing, whistling and rattling in the chest, palpitation of the heart, the patient is obliged to sit up during the night Cough attended by a crushing pain in the head, blackness before the eyes, heat in head, neck, and face, but cold hands.

Calc. carb. — Tedious cough caused by tickling or pain down in the throat, so violent in evening and during the night that every blood-vessel throbs. Dry cough in the night during sleep; dry cough with pain or

74 COURSES— CRAMP.

rattling in the chest, particularly in very fat childien, when Ipec. suits but does not suffice. Cough with copious expectoration, particularly during the day, lumpy, purulent, yellow, greenish, brown, so offensive as to cause vomiting ; when coughing a stitch in side and chest and burning in the latter ■ tearing and shoot- ing pains in the head ; stitching pain in side when breathing deeply, when moving and bending. In the evening, heat, then chills and thirst, night-sweats, par- ticularly on the chest; great weakness and much anxiety concerning the malady. Lack. — Cough excited by pressing the hand on the chest, the patient unable to bear anything about the neck, coughing during the night in his sleep ; coughing as if something fluid had got into the windpipe ; difficulty in expectoration. Cough much worse after meals, after sleeping, and after rising ; is accompanied by pain in throat, ears, head, and eyes.

COURSES. See MENSTRUATION.

CRACKS IN THE SKIN. — Nostrils cracked, Petrol. \ apply vaseline locally, and give Petrol. Lips cracked and sore, Graphit. j vaseline locally. See also HANDS, CHAPPED.

CRAMP. — Sometimes certain muscles, especially of the calves and feet, are subject to painful contractions, which are called cramps, coming on generally during sleep.

Treatment. — Press or squeeze the parts ; if in the feet press them against the foot of the bed.

Medicines.— (One dose to be given at bedtime for a few nights.)

Am. — When they occur after fatigue.

Verat. — To overcome the predisposition ; feet cold.

Nux v.— From no special cause, coming on in the night.

Sulph. — If these are insufficient.

Rhus.— Cramps in the daytime, only whilst sitting.

CROUP. 75

Lycop. — Cramps whilst walking.

Coloc. — Soreness and stiffness after an attack.

CROUP. — A spasmodic affection of the larynx (spasm of vocal cords) and windpipe of children,, in the milder form unaccompanied by inflammation, and consisting of sudden attacks of suffocating cough, usually waking the child from sleep. This is called " Miller's asthma," or Laryngismus stridulus. Another form, usually arising from cold, and especially from exposure to cold east wind, begins with a slight cough and hoarseness, the suffocative attacks occurring suddenly in the night. This kind arises from catarrhal inflammation of the larynx and windpipe, occasioning spasm of the vocal cords. In the worst form of all there is, in addition to inflammation, the formation of a thick membrane. This is almost always associated with diphtheria in the throat. All forms of the disease are dangerous, and require prompt treatment. A medical man will, of course, always be consulted when possible, but there is much to be done before he can be obtained, as the attacks come on suddenly and find everybody unprepared.

Symptoms. — Whether preceded or not by slight cough, the attack, which comes on suddenly and almost always in the night, partakes of the same general characters. A choking cough wakes the child from sleep. The cough has a shrieking, sharp sound like the first attempt at crowing of a young cock. There is great difficulty in inhaling, and the breath is expelled in jerks. After the attack has passed off the child remains hoarse and cross. There may be a return the same night. Often the child is apparently quite well the next day, but has a return of all the alarming symptoms in the night.

General Treatment. — During the attack apply a sponge wrung out of hot water, as hot as can be borne, to the larynx (" Adam's apple ") and let both the arms be im-

76 CRYING.

mersed in the water itself. If the patient grows cold and struggles with suffocation, pour very cold water on the head, nape of the neck, and throat. The room must be kept warm, and during the day the child must be carefully guarded from colds. Flannel must be put round the neck, and he must not be allowed to eat fruit of any kind.

Medicines. — (To be given every ten or twenty minutes during an attack, according to the urgency of the symp- toms. Every three or four hours during the interval.)

Aeon. — The slight premonitory cough, as soon as cold is observed ; at the beginning of the attack, choking, dulness, anxiety, fright.

Hepar. — For the premonitory cough when hollow and wheezing. For the hoarseness remaining in the morning after an attack in the night. If the attacks come on after midnight or grow worse then, Hepar is better than Spongia. Rattling with the cough.

Spongia. — Voice rough, cough hollow, breathing sawing, piping ; can be heard at a long distance, the attack comes on before midnight ; absence of rattling.

Carbo veg. — Face blue, extremities cold, breath cold, voice almost extinct.

CRYING. — When crying is excessive in children it is usually caused by pain. Care should be taken to see that there is no mechanical cause for this, no pin sticking into the child, and no derangement of the dress.

Medicines. — Never on any account give laudanum, or opiates, or u soothing syrups" of any kind to children. They are always dangerous to the life of the child and injurious to its health if it lives. — One of the following may be given every few minutes till quiet :

Bell. — Starting suddenly out of sleep and beginning to cry violently.

Aeon. — If crying is accompanied by uneasiness and heat.

CUTS— DEAFNESS. 77

Cham. — Fretfulness, wanting to be constantly carried about j if the crying appears to be caused by earache or headache.

CUTS. See WOUNDS.

DANDRIFF. — A scurfy state of the scalp. A certain amount of scaling is natural ; it is only when it becomes excessive that it constitutes disease.

General Treatment. — When the crust is thick it may be removed by anointing with lard at night and wash- ing with a weak solution of soda in the morning. It must not be removed forcibly.

Medicines. — (To be given night and morning.)

Arsen. — When dry.

Sep. — When moist.

Sidph. — When dark or dirty-looking, with offensive odour, red under the crust ; itching.

DEAFNESS. — This may be due to accumulation of wax in the ears, to cold, to changes in the internal cavity of the ear, or to affection of the nerve of hearing.

General Treatment. — When there is wax in the ear it must be removed. This should never be attempted with hair-pins or anything of that kind. Warm sweet- oil should be dropped into the ear every night for two or three nights, and then the ear should be syringed out with warm water, very gently, as permanent harm may be easily done if violence is used. For deafness, when due to other causes, medicines will be required. When accompanied by inflammation or earache, see under EARS.

Medicines. — (To be given three or four times a day.)

Merc. — When due to cold and accompanied with cold in the head or soreness of the throat ; swelled tonsils.

Puis. — If there is yellow discharge ; after measles.

Bell. — After scarlatina.

Verat. v. — With singing, twittering, tingling.

78 DEBILITY.

China. — With noises in the head and giddiness. Magnes. card. — When due to shock or nervous causes. Calc. carb. — In persons who have cold, clammy feet, or are sensitive to changes of the weather.

DEBILITY. — When the bodily powers are in any way reduced, and the general state is one of languor and disinclination to attend to the usual duties, without there being any definite disease to account for it, this condition is called " Debility." The term is a useful one, though it has no very definite scientific meaning. It is persons in this condition who usually fly to " tonics " in allopathy, and, if they happen to get the right tonic, and do not take too much of it, well and good ; but there are so many tonics, and the chances of selecting the wrong one are so great, that harm much more often than good results from their indiscriminate use. The best, safest, and most efficacious of all " tonics " are rest and change. But these are not ' always attainable, and then other measures must be adopted. Cold or tepid sponging in the morning, early retiring, and drives in the open air are generally available. Liberal dietary is necessary in all cases. The meal- times should be regular, and there should be a period of rest after each. Wine is not to be relied on; but it is sometimes of temporary use. It should never be taken except with meals, and never to relieve the feeling of " sinking " at the stomach which is a frequent accom- paniment of debility. Burgundy is the best wine when any is required. Nervous Debility is usually the consequence of excesses of some kind, and among these abuse of the sexual function is the most fruitful. It is attended with suffer- ings of all kinds — depression of spirts, indigestion, sleeplessness, nervousness. The same General Treat- ment as sketched above is applicable here, but more reliance must be placed on medicines.

DELIRIUM TREMENS. 79

Medicines. — To be taken three or four times daily.

China. — Debility after illnesses, loss of blood and other fluids, discharges from abscesses; nervous debility.

Arsen. — Debility, characterized by a low feverish condi- tion, with anxiety, restlessness, thirst.

Nux v. — Debility in nervous patients ; spare habits ; tendency to constipation ; nervous debility.

Ignat. — With excessive nervousness and sleeplessness.

Act. r. — With great melancholy, restlessness, and sleep- lessness.

Ferrum. — With bloodlessness, palpitation, headache.

Calc, Sulph., atid Lye. — "When constitutionally indicated. See CONSTITUTIONS.

DELIRIUM TREMENS.— One of the effects of alcohol poisoning is the inducing of a state of violent delirium, accompanied by visions of diverse animals, and some- times by fever. This usually comes on after a long period of indulgence, insufficient food being taken during the time. It also comes on with the sudden leaving off of stimulants after excess.

Diagnosis. — Poisoning with belladonna, an attack of acute mania (brain fever), and the delirium of typhus fever often resemble delirium tremens ; but the history of the case will generally make it clear. There is almost always the history of drinking habits in delirium tremens, and very often a strong smell of spirits about the patient.

General Treatment. — This disease is always attended with great danger, and the treatment should never be undertaken except by a medical man when possible. The principal thing is to keep up the patient's strength. Strong soup or beef-tea should be administered at frequent intervals. When the patient is violent, means must be taken to prevent him hurting himself or others.

Medicines. — (To be given frequently,every half-hour until their action is apparent, and then at longer intervals as required.)

8o DELIVERY— DEPRESSION.

Bell. — Flushed face, violent delirium, tries to escape.

Verat. a. — Cold sweat on face, anxious desire to run away, sees devils.

Ant. tart. — Foul tongue, tremulousness, vomiting, prostra- tion.

Arsen. — At the beginning. In tobacco-chewers. Sees the room full of thieves and spectres ; great anguish ; fear to die ; pangs of conscience.

DELIVERY. See CHILD-BIRTH.

DENTITION. See TEETH.

DEPRESSION OF SPIRITS.— In general, low spirits pass off when the cause is removed. But sometimes it becomes itself a disease, and persists when there is no longer any cause acting, and sometimes the cause is of such a kind that it cannot be removed. In all cases the cause should be sought and removed if ppssible.

General Treatment. — This is largely moral. The patient must be encouraged to do his business and transact his ordinary occupation in spite of his low spirits. Often the malady will be forgotten if the mind or hands are actively employed. In any case occupation is the best palliative when it is not a cure. One par- ticular precaution should be observed — the patient should never be allowed to resort to stimulants. This is fatal to any treatment, moral or medicinal, and the habit once formed soon becomes confirmed.

Medicines. — (Two or three times daily.)

Act. rac. — As if a cloud settled over patient ; sleepless and restless.

/gnat. — When due to worry; at change in life; with hysterical symptoms.

Merc. — Wretchedness and dejection ; apprehension.

Nat. in. — Melancholy, depressed, sad and weeping ; con- solation aggravates.

DERBYSHIRE NECK— DIARRH<K A. 81

Sulph* — With heaviness and drowsiness, or absence of sleep ; " sinking " sensation, especially in the morning ; broken-down dejected look.

DERBYSHIRE NECK. See GOITRE. DIABETES. — A wasting disease, of which the prominent symptoms are thirst and dryness of mouth, with passage of large quantities of urine containing sugar. It is a chronic disease, and may go on for years without affect- ing the general health to any great extent ; but diabetics should be careful, as the disease is liable to take a dan- gerous turn. The older a patient is before the disease sets in the less dangerous it is.

General Treatment. — Avoidance of chills by the use of warm woollen underclothing j restriction of diet to articles of food containing little starch or sugar. Gly- cerine is a good substitute for sugar.

Medicines.

Ac. phos. — When connected with nervous weakness and an apathetic condition.

Nat. m. — Great thirst, w-asting, constipation.

Sulph— When the constitutional symptoms of sulphur are present.

DIARRHOEA. — The passage of loose or watery stools more frequently than is natural constitutes diarrhcea. This is a consequence of increased secretion of the intes- tinal mucous membrane and intestinal glands, and may result from many causes, such as a chill, from excessive heat, sudden fright, vexation, burns or scalds. Diarrhcea is looked upon by some people as a cleansing process, and they are in the habit of taking purging medicines perennially with this object. This is a mistaken notion. Diarrhcea is no more "cleansing" than a cold in the head is. But it is not advisable to check a diarrhcea with astringents, for then the morbid process may be transferred to some other part.

F

82 DIARRHCEA.

General Treatment. — The quieter the patient can be kept when suffering from diarrhoea the better, and in severe cases absolute rest must be enjoined. The diet should consist of mucilaginous food, such as arrowroot, rice, sago, mutton-broth thickened with wheaten flour or sago. Boiled milk may be taken, warm. The white of eggs beat up, just sweetened with a little sugar, is also useful in diarrhoea. Acids, coffee, tea, and such things must be avoided. Fruit, fresh or dried, eggs, poultry, and veal are bad. Beef- tea also is apt to increase the disorder.

Medicines. — (To be taken every hour or two until relief is obtained, and then less often.)

Veratrum alb. — Painful watery diarrhoea; summer diar- rhoea; great coldness; cold sweat on forehead ; nausea and vomiting.

Chi?ia. — Frequent watery stools, withgripingpains; chronic painless watery diarrhoea ; food passes undigested.

Aeon. — Following a chill.

Coloc. — With much colic ; stools brown or yellow, pappy or waterv.

Puis. — Slimy diarrhoea, each stool of a different colour, much pain.

C/iam. — In teething children, uneasy, want to be carried about constantly ; cry, twist, and writhe ; stools slimy or watery, green or brown, smelling of rotten eggs. In adults when evacuations are green, watery, hot, and offensive ; bitter taste in mouth, bilious vomiting, griping, headache.

Merc. — Mucous bilious diarrhoea, sometimes mixed with blood ; attended by screaming fits, ineffectual urging and trembling, great exhaustion, fetid breath.

Arsen. — Watery, yellow, acrid stools ; great emaciation, anguish ; chronic diarrhoea.

Sulph. — Diarrhoea coming on early in the morning; green, slimy, acrid, excoriating the parts ; emaciation ;

DIET. S3

hard, distended abdomen j chronic diarrhoea. See also CHOLERA.

DIET. — The three essential points to observe in regard to food are — the quality of it, the quantity, and the times at which it is taken.

In general a substantial breakfast at eight, a light lunch at one, and a substantial dinner at seven, and nothing between these, is the best possible arrangement for the daily meals. The quality should be light and digestible, the quantity enough to satisfy hunger, and the drink non-medicinal, and in quantity enough to allay thirst.

In sick?iess the diet will be regulated according to the disorder. In acute ilhiesses it must be of the lightest and simplest kind. Pure water may be given as much as is desired in these cases ; it may be sweetened with pure fruit syrup, if desired. Toast-water, barley-water, rice-water, gum-arabic-water, thin oatmeal gruel, milk whey; also arrowroot, sago, tapioca, semolina, all made with milk only. Ripe juicy fruit, as grapes, peaches, oranges, raspberries, but nothing at all acid, and no fruit at all when there is diarrhoea, as in cases of typhoid fever.

In coJivalescence or chronic illnesses a more liberal dietary may be allowed. Bread not too fresh, and not containing alum or other impurities, biscuits, plum- cakes, milk puddings, soup with barley or rice boiled in it, beef-tea, chicken broth, mutton broth.

Meats. — Beef, mutton, tongue, game, pigeons, chickens, sweetbread, tripe, the lean of ham, and for breakfast bacon. These should not be partaken of cold, nor done up a second time. The only exception is in the cases of ham and bacon ; these may be taken cold. The fat of bacon is the most digestible of all fats. The finest bacon boiled, and eaten cold with toast or stale bread, the lean very carefully cut away, is an excellent breakfast diet.

84 DIPHTHERIA.

Fish. — Cod, haddock, whiting, sole, turbot, herring, and

salt fish after it has been well soaked in water : also

oysters, either raw, roasted in the shell, or boiled in soup.

Vegetables. — Potatoes, spinach, cabbage, cauliflower,

green peas or beans, asparagus, haricots. Milk. — Raw or boiled, butter-milk, whey. When milk dis- agrees the additionof a little salt often makes it digestible. Drinks. — Pure chocolate or cocoa, weak black tea, scalded milk (fresh milk with boiling water poured into it in about equal proportions). Other articles. — Butter, milk, cheese, cream, custard.

Salt and sugar must be taken only in moderation. Of course, in prescribing a diet individual peculiarities

must be studied. Forbidden Articles in Homoeopathic Dietary. — When under homoeopathic treatment, there are certain articles which patients must avoid, unless expressly allowed by the physician : The flesh of young animals ; liver, and internal organs generally ; geese, ducks ; fat pork, roast pig ; eels, crabs ; smoked or salt meat, sausages, mince-pies. All highly seasoned soups and sauces. Rich cake, pastry, honey; confectionery except barley- sugar ; nuts of all kinds ; all fruit, except grapes, oranges, peaches, sweet apples, pears, raspberries when properly ripe, and of dried fruits, raisins, prunes, dates, figs. Vinegar, and all things made with it ; pickles, aromatic herbs, parsley, garlic, onions ; pepper, ginger, nutmeg and flavouring. Distilled or fermented liquors ; coffee, green tea ; lemon- ade and acid drinks ; mineral waters. Scents, perfumery, medicated tooth-powders. Tobacco, except very moderately.

DIPHTHERIA. — This is a specific infectious disease, which manifests itself in a peculiar ulceration of the the throat and great general prostration and fever. The

DIPHTHERIA. 85

throat is covered with a dark-grey membrane, which emits an exceedingly offensive odour. The contagious principle is contained in the breath.

Diagnosis. — Diphtheria is distinguished from all other throat affections by the presence of a dirty grey, tough coating on the mucous membrane of the throat. There is no other kind of sore throat which is accompanied and followed by such grave constitutional symptoms. The heart is very frequently affected, and almost always weakened temporarily ; and for a long time after the throat is well there is a danger of paralysis coming on. This may affect any of the muscles of the body, and sometimes attacks the heart.

General Treatment. — The great object is to keep the patient nourished, and support the strength. Strong beef-tea and milk, when it is tolerated, should be given at frequent intervals. Patients suffering from it should never be raised up from the recumbent position, except with greatest care, as the prostration is so great it may bring on fainting.

Medicines. — (Every few minutes to every hour or longer, according to the urgency of the symptoms.)

Bry. — Great prostration; patient cannot bear to be moved; complains of pains everywhere when moved; white tongue ; dry mouth ; thirsts for large quantities of water.

Bell, — Restless; complains of sore throat, which looks highly inflamed ; pupils large ; drowsy, but unable to sleep ; starts suddenly out of sleep.

Lack. — After Bell. ; worse after sleep ; patches on tonsils, worse the left side ; croupy symptoms ; patient cannot bear to have anything touch the neck and throat.

Lye. — Throat brownish red ; worse right side ; worse from swallowing warm drinks ; nose stopped up ; patient cannot breathe with mouth shut ; keeps mouth con- stantly open, slightly protruding the tongue, which gives a silly expression ; unsteady step ; on awaking from

S6 DISTENSION.

short nap he is cross ; kicks ; is naughty (if a child) ; or jumps up in bed, stares about, and knows nobody, seemingly dreaming with open eyes ; frequent jerkings of lower limbs, mostly with a groan, awake or slumber- ing ; great fear of being left alone.

Rhus. — Restless ; wants to be carried about ; wakes com- plaining of pain in throat ; bloody saliva runs out of mouth during sleep ; parotid glands good deal swollen ; transparent jelly-like discharges from bowels at stool or afterwards.

Apis. — Great debility from the beginning ; membranes at once assume dirtygreyish colour, or there is great oedema of soft palate and much pufhness round the eyes ; pain in ears on swallowing ; an itching, stinging eruption on skin ; sensation of weakness in larynx ; numbness of ieet and hands and even paralysis. {Apis is incompa- tible with Rhus, and should not be given after it, nor Rhus afte: Apis.)

Ignat. — Pain in throat worse when not swallowing ; re- lieved by swallowing ; membrane more abundant on right side ; much prostration ; sensation of lump or marble in the throat.

Merc. — Tongue coated thickly, white or yellowish ; much salivation ; glands swollen ; much membrane on tonsils.

DISTENSION.— This is a frequent symptom of weak digestion, and where there are other symptoms the case must be considered as a whole. When it is the chief or only symptom, after the diet has been attended to, and the dress — for modern dresses are made to compress the lower ribs and deprive the stomach and liver of the space they require — a remedy may be selected. Medicines. — (To be taken an hour before food.) Card. v. — When the distension and distress are high up in the body, affecting the chest, the flatulence passes away by the mouth.

DIZZINESS— DREAMS. 87

Lycop. — Distension more in lower part of the body and passes downwards. See also FLATULENCE.

DIZZINESS, OR VERTIGO.— Sometimes dizziness is a

symptom of some other disease, and in this case the

whole condition of the patient must be considered.

At times it is a disease in itself, and may be relieved

or removed by treatment. General Treatment. — Those who suffer from vertigo

should lead regular lives, eat moderately and at regular

times, drink no alcoholic beverages, and not smoke.

Open-air exercise is very necessary. Medicines. — (To be taken two or three times a day, or

often er when an attack comes on.) Gels.— Simple giddiness. Nux vom. — From disordered stomach. Bell. — When turning over in bed, or on rising up from lying

down. Nat. m. — When lying down ; in unhealthy subjects who

are always cold ; constipation. China. — With noises in the ears and deafness. Sulph. — When associated with hot head and cold feet j with

" sinking " at the stomach in the forenoon \ following

suppressed eruptions or discharges.

DREAMS. — Dreaming is natural to some persons in sleep. Some never dream unless they are ill. Dreams may be so unpleasant and persistent as to seriously injure the health, and then the patient should be treated. Atten- tion should be paid to diet, the meals taken regularly, and nothing but digestible food.

Medicines. — (To be taken two or three times a day, the last dose being at bedtime.)

Bell. — Anxious and frightful dreams.

Bry. — Dreams of business transacted during the day.

Arsen. — Anxious dreams, with feverishness.

See also NIGHTMARE.

88 DROPSY— DRUNKENNESS.

DROPSY. — When the blood-vessels give way and allow fluid to be exuded from them into the tissues or cavities of the body the condition is called " dropsy." Dropsy may be an independent condition, or it may arise from a number of causes, most frequently general weakness, depraved state of the blood, heart disease, liver disease, or kidney disease. Dropsy may be local, affecting any limb or part of the body, or it may be general. ' A moderate amount of dropsy is not a matter of great importance. Many weakly people without being actually diseased suffer from constant swelling of the ankles. But if the same symptom occurs when known disease is present, it is a sign that the disease is advancing or that the system is giving way under it.

The Treatment of dropsy will depend on the nature and cause of it. See under ANEMIA, DEBILITY, HEART, KIDNEYS, LIVER.

Dropsical limbs should be supported with light bandages, and when oozing takes place linen rags smeared with vaseline should be wrapped round and changed fre- quently. When it is an independent disease, it must be treated according to the symptoms of the patient.

Medicines. — (Two or three times a day.) Apis. — Will be found the most generally useful medicine. Arsen. — If there is thirst, anxiety, great weakness. Nat. m. — In chilly subject, with thirst, low pulse, con- stipation, depression.

DROWNING. See APPARENT DEATH FROM.

DRUNKENNESS.— For a fit of drunkenness there is no- thing better than to let the person sleep it off. Cold water applied to the head or body will restore him more quickly if it is necessary. Nothing but moral effort will cure the habit. Drunkards should abstain from salt.

DYSENTERY. 89

Medicines.

Nux vom. — For the after-effects of fit of drunkenness.

It may be given every hour until the headache or other

reminders of the previous night are gone. China. — (Being given in the strong tincture, five drops in

a wineglassful of water) is the best medicine when the

craving for drink comes on.

See also ALCOHOL HABIT and DELIRIUM TREMENS.

DYSENTERY, OR BLOODY FLUX.— Inflammation or ulceration of the large intestines, with straining, and sometimes discharge of mucus and blood, and scarcely any real faecal matter. The disease often appears in epidemics, affecting armies on the march, or travellers in malarious districts ; it is endemic (a commonly occur- ring disease) in certain parts, chiefly seaport towns in hot latitudes, and mostly traceable to sanitary defects.

Diagnosis. — Dysentery cannot well be mistaken for any other disease. In typhoid fever there is often pas- sage of large quantities of blood, but in this case there is much fever and absence of pain. In piles there is loss of blood with stool, but the presence of piles is gene- rally recognized, and the motions are of the ordinary kind, the blood being separate.

General Treatment.— Whenever dysentery makes its appearance see that the water is good, and if not cer- tain about it have it first boiled and afterwards filtered, the filter being a new one, or not long in use. All out- houses must be carefully disinfected. It is also necessary to guard against chills, for there may be the conditions of dysentery present, and yet it may require something such as a chill to determine an attack. Unripe fruit must also be avoided. The diet must be confined to gruel and farinaceous food, with as much cold water as the patient likes. When he is recovering, mutton broth may be given, and the re-

90 DYSPEPSIA.

turn to ordinary diet gradually permitted. In the

great straining that occurs sometimes during conval- escence, injections, of linseed-tea are very soothing. Medicines. — (Every hour until relief is obtained, then less

often.) Merc. — Greenish-looking matter mixed with blood ; more

straining after each motion than before. Nux vom. — Much straining before and during stool ; great

relief after. Merc. cor. — Severe colicky pains ; first much bile, and then

blood and slime, or light-coloured blood alone, or

nothing but slime. Aeon. — After a chill ; heat ; thirst ; red face. Coloc. — Extreme pains in the bowels ; patients double

themselves up ; stool slimy, sometimes mixed with

blood. Sulph. — In all chronic cases which resist other medicines ;

much urging and ineffectual straining ; worse at night ;

aversion to beer, meat, milk, sweet and warm things,

malt liquors, and wine.

DYSPEPSIA, OR INDIGESTION.- The inability to digest food is an accompaniment of many diseases. Acute inflammations and fevers give rise to it, and organic disease of the heart, liver, and stomach itself. In these cases it is the original disease that needs attention, or rather the whole condition of the patient. But indiges- tion may be a disease in itself. The causes of it are manifold, as badly cooked food or drink, over-indulgence in wine or tea, or bodily excess of any kind. Abuse of the sexual functions, especially self-abuse, so un- happily common among boys, is a prolific source of indigestion. Tobacco, unsanitary houses, poisonous wall- papers, anxiety and worry, are accountable for many cases of the disease. Diagnosis. — Ulcer of the stomach and cancer of the stomach both give rise to symptoms of indigestion ;

DYSPEPSIA. 91

but are attended with more violent pain and more persistent vomiting ; and there is generally vomiting of quantities of blood. In cases of cancer, if advanced, a hardened mass may be felt about the region of the pit of the stomach. Ulcer of the stomach is most fre- quently met with in young women who are anaemic, and also in persons who have sustained severe burns.

General Treatment. — This may be summed up very shortly — wholesome feeding and wholesome manner of life. For the first, the article on DIET may be referred to ; for the second, every one must do the best he can. There are many avoidable causes of dyspepsia, such as bad habit*, which all may conquer if they will. Some are dependent for their livelihood on injurious trades ; these will have to make the best they can of their situation, taking -such care as they can, and living healthily when not actually at work. Dyspeptics should avoid all food that has been preserved, cold meat, meat cooked a second time, salted, pickled food, cakes, fruit pies, acids. For drink, cold water or toast-water, or weak black tea freshly made, with plenty of milk. If this disagrees, scalded milk (milk with boiling water poured into it in equal proportions).

Medicines. — (Three or four times a day.)

Nux vom. — Dyspepsia from dissipation and late hours ; tongue coated brown at the back, mouth dry, heartburn, flat taste in the mouth, constipation.

Puis. — When different kinds of food that do nut agree with each other have been taken at the same time ; after fat food, pork sausage, or fat mutton, or anything fried in rancid butter, or pastry. Taste bitter, salt, or putrid ; food tastes bitter ; distaste for tobacco. Accumulation of mucus in the mouth ; scalding in the throat ; eructation tasting of bile ; a feeling of acidity or acridness in the stomach ; aversion to warm food ; no thirst ; diarrhoea.

92 EARS.

Bry. — Stomach disordered; patient feels chilly j bowels constipated ; tongue white or yellow \ weight at the stomach as a load after meals.

Carb. v. — Everything turns to wind ; much pain in the chest ; eructations j coldness ; blueness ; slow circulation.

Lycop. — Distension after food \ white moist tongue \ flatu- lence in the bowels ; constipation.

Hydrast. — Yellow, slimy tongue ; " gone " sensation at the stomach j constipation, or constipation alternating with diarrhoea.

Sulph. — Tedious cases of dyspepsia. This medicine should be given in infrequent doses. After the first, wait until improvement ceases before repeating.

EARS. — The organ of hearing consists of three well-defined portions— the Outer, visible ear with the tube leading from it into the head. At the end of this passage is the drum-head, or, as it is shortly but less correctly called, the " drum " of the ear. This name should pro- perly be given to the entire chamber behind the drum- head, the " tympanic cavity," as it is called, or the Middle Ear. Another tube (Eustachian) leads into this from the throat, and when the throat is inflamed this is liable to be blocked and to give rise to " throat deafness." Be- hind the middle ear are two chambers — the Inner Ear — containing the expansions of the auditory nerve, the organ of hearing proper. These innermost chambers are shut off from the middle earby small membranes closing the open- ings into them, and are connected with the outer ear by a chain of small bones connected with the drum on the one side and these membranes on the other. Any one of these portions of the ear may become affected, and result in deafness ; and, on the other hand, a great change may take place in the outer or middle ear and yet hearing need not be lost. In a treatise of this kind only the commoner of the ear-affections need be touched

EARS. 93

upon j for the graver kinds medical help will be sought.

External Ear. — Sometimes the external ear and the passage leading from it to the middle ear or drum become inflamed and swollen. The commonest form of this is the formation of pimples in the passage, which give rise to intensepain.

General Treatment. — For general inflammation of this visible part of the ear (pinna) there is little to be done in the way of local treatment. When it affects the passage, an elm-bark poultice, or else a slender piece of fat ham inserted into the ear, will be found to give relief. Warm applications generally are good.

Medicines. — (Every hour until relief is obtained, then less

often.) Bell. — Erysipelatous inflammation of the ear. Rhus. — When the inflammation goes on to form vesicles,

or is eczematous. Graph. — Inflammation behind the ear, especially if it

exudes a sticky secretion. Hep. — Painful boils or pimples in the canal.

Foreign Bodies, or Insects in the Ear. — If an insect has crawled into the ear, place the patient on his side, and pour into the ear warm olive oil until the canal is filled. The insect will float on the top of it, and may be lifted off. When a bead, pea, cherrystone, or some such object has been forced into the ear, it is of the greatest importance to have it seen to at once before inflammation has set in. A surgeon must be con suited without delay, and if there is not one to be had the greatest care and gentleness must be used in the endeavour to extract the body. This may be done by syringing with warm water if the stream can be made to pass beyond the object. Or it may be done by means of a pair of fine forceps. Or a hair-pin may be used. The free

94 EARS.

ends being stuck into a cork, while the bent end may be passed into the ear so as to get behind the object, which may then be drawn out. But no one who has not a steady or a skilful hand should attempt to do this operation, as much harm may result.

Medicines. — (Every hour or two according to urgency.)

Am. — If pain and inflammation remain after extraction.

Puis. — After Arnica. If the inflammation is great and there is so much swelling that nothing can be got out.

Bell. — If there is pain, fever, and delirium.

Discharge. — An ear discharge may originate in the canal of the ear, or in the middle ear or drum. It is usually the latter. A discharge is an affection which may be of very little consequence, but also it may be of very great consequence, and should therefore never be neglected. It is of most frequent occurrence in children. The graver forms of ear discharge originate in inflam- mation of the Middle Ear, with consequent rupture of the drum : see Middle Ear. When the dis- charge is established and there is no sign of active inflammation left, the chief indications are to keep the ear clean, to moderate the quantity of the discharge, and when it cannot be arrested to im- prove its quality. It is not always desirable to arrest a discharge from the ears altogether ; and it may con- sole some sufferers to know that deafness with an ear discharge is much more likely to be cured than deafness with a dry ear.

General Treatment. — The ear must be kept clean by washing out very gently with a syringe. Warm water containing a little borax (half a teaspoonful to a tea- cupful) is the best wash to use. Care must be taken to use no violence at all, but just enough force to send the water into the canal in a continuous stream. After the washing a little cotton-wool should be placed lightly in the orifice to protect from cold.

EARS. 95

Medicines. — (Two or three times a day.)

Puis. — After measles and after small-pox. For swelling of the neck-glands after suppression of discharge.

Bell. — After scarlatina, when accompanied by severe headache.

Merc. — After scarlatina, following Bell., discharge offen- sive, purulent, long lasting ; worse when warm in bed.

Ifepar. — In cases similar to those of Merc, when mercury has been given already.

Sul ph. — After measles, following Puis.

Ear-wax. — Drop warm oil into the ear for several suc- cessive nights and then syringe gently with warm water. This will remove the wax without difficulty.

Middle Ear. — Inflammation of the tympanic cavity is a common sequel to measles, scarlatina, and occasion- ally to severe cold, and it commonly ends in suppu- ration and discharge by rupture of the drum-head. This is a membrane which readily heals, but when healing is prevented by any cause there results a chronic dis- charge. Sometimes the air-cells in the bony prominence immediately below the ear become inflamed, and then there is risk of the disease spreading to the brain and causing abscess there.

General Treatment. — The patient must be kept as quiet as possible on light diet, and the ear kept warm. A poultice of slippery-elm bark is the best application, but any warm application is good. The pain is usually great.

Medicines. — (Every hour until relief, then at longer intervals.)

Acoii. — Fever, restlessness, anxiety j as soon as the chill is taken.

Puis. — After Aconite ; great pain.

Bell. — Pain in the ear ; throbbing headache ; flushed face ; delirium ; hot skin.

Merc. — After the acute stage.

96 EARACHE.

Noises in the Ears. — These may be due to affection of the internal ear, auditory nerve expansion, or to affec- tions of the middle ear and its chain of bones. It is generally amenable to treatment.

Nux vom. — From cold ; worse in the morning.

Puis. — Worse in the evening.

Merc. — In persons who perspire much; worse in the night.

China. — Buzzing, hissing, singing.

Sulph. — When the least noise (external) is intolerable.

See also DEAFNESS.

EARACHE. — Sometimes the ears are the seat of pain of a neuralgic character and independent of inflammation. Often, however, it is dependent on a slight cause, as con- gestion from cold, and care should always be taken to ascertain that no inflammation is present. The history will be of assistance here ; those who have had earache previously will recognize it by their own sensations. Whenever the pain persists or is accompanied by fever symptoms, inflammation is almost certainly present, and medical aid should be sought.

General Treatment. — The chief thing to be done is to keep the patient warm. The same local measures as directed above, under Middle Ear, may be adopted.

Medicines. — (Every half-hour until relief is obtained.)

Aeon- — When it follows a chill.

Puis. — Jerking tearing pains, as if something would be pressed out. External ear hot and swollen, the pain going through the whole side of the face. Especially suited for blonde persons, inclined to tears.

Merc. — Especially in children ; sweating without relief ; tearing extending to the cheeks, pricking deeply, tear- ing, pressing, burning pain.

Sulph. — If the pain returns frequently ; is on the left side ; aggravated in the evening or before midnight. After Merc.

ECZEMA. 97

Cham. — Simple acute stabbing pains ; patient very cross ; pains intolerable ; aggravation by warmth.

Rhus. — Earache from getting wet or from suppressed perspiration.

ECZEMA. — Eczema is a disease of the skin characterized by the formation of minute watery vesicles which soon break and leave a raw moist surface. Eczema is one of the commonest of skin diseases, and many persons are subject to it periodically, especially in the spring and autumn. It is often an indication of the state of the general health, and sometimes it acts as a relief to the internal organs. Many patients watch for the appearance of their eczema, as they know they will feel better when it comes. All attempts, therefore, to heal the eruptions without attention to the general health should be carefully avoided. The disease should be healed from within, or something worse will take its place. Eczema is one of the commonest expressions of the chronic disease called by Hahnemann Psora.

General Treatment. — In acute eczema it is advisable to put the patient on an absolute milk diet, no other food of any kind being given. In all cases the diet should be regulated, and milk should form a principal part of it. Sugar is bad for the disease and all rich food. Meat should be taken sparingly ; green vegetables are good.

Medicines. — (Two or three times a day.)

Rhus. — Acute eczema. (Rhus is apt to aggravate the disease before curing it : if this should occur, wait until the action of the first dose has ceased before repeating it. After the aggravation has passed improvement will set in : do not repeat the dose until the improvement ceases.)

Sulph. — Irritation coming on when warm in bed at night.

Arsen. — Much redness of the skin, the patient is irritable and anxious.

G

98 ECZEMA— ERUCTATIONS.

Graph. — When there is glutinous exudation. Merc, — Weeping eczema ; in the bend of elbows and knees. Hepar. — After Merc; in pustular cases \ sensitive subjects that must be covered up and kept warm.

ECZEMA CAPITIS. See under INFANTS and MILK- CRUST.

EMACIATION, ATROPHY, OR WASTING.— Many diseases, acute and chronic, cause wasting of the bodily tissues, but sometimes this cannot be traced to any definite cause, and then it becomes itself a disease.

Diagnosis. — Great and increasing thinness, in the absence of any discoverable cause : the diagnosis is arrived at by ascertaining that all the organs of nutrition are in good order and that the emaciation does not depend on any organic defect.

General Teeatment. — As a matter of course the most nourishing and digestible diet will be selected. When the disease affects children they should be rubbed all over at night with cod-liver oil, sleeping in a flannel night-dress, the skin being washed with tepid water, without soap, in the morning.

Medicines. — (Three times a day.)

Iodine. — In general.

Arsen. — When there is fever, anxiety, restlessness.

Silk. — With great prostration and irritability. In rickety children.

Lycop. — In constipated subjects, who suffer from flatu- lence and acidity.

EPILEPSY. See CONVULSIONS.

ERUCTATIONS.— Belching up of food, fluid, or of gas formed in consequence of imperfect digestion of food in the stomach. General Treatment. — See under DYSPEPSIA, and DIET. Those who pass offensive flatus should not eat eggs.

ERUPTIONS. 99

Medicines. — (Three times a day.)

Ipec. — Rising of food from disordered stomach ; tongue coated.

Ant. tart. — Rising of food, with clean tongue.

Puis. — Eructation of food from overloading the stomach, attended with bitter taste ; burning sensation remain- ing in throat after vomiting.

Carl?, veg. — Great accumulation of gas ; often offensive.

Lycop. — Collection of wind under the left ribs ; difficult to dislodge; constipation.

Cham. — Belching and flatulence ; " windy spasms " ; irri- tability. (In these cases Cham, is best administered in hot water.)

Sulph.— Acidity, belching, sinking sensation at stomach.

See also DYSPEPSIA.

ERUPTIONS. — Many diseases manifest themselves in inflammatory affections of the skin. Certain fevers, such as typhus, measles, scarlatina, small-pox, have some of their most characteristic features in the peculiar inflammations they cause in the skin. These are examples of acute diseases. But chronic diseases or disease-possibilities or tendencies ("diatheses" as they are technically called) also manifest themselves in appearances on the skin. The gouty, the scro- fulous, the rheumatic constitutions often declare them- selves in eruptions on the skin, and the patients are frequently better in general health when these eruptions are out. The skin may be affected locally as well as constitutionally, but care should be taken to treat patients constitutionally, and not locally, when the disease is constitutional. Of eruptions the com- monest are ACNE or PIMFLES, ECZEMA, ERYSI- PELAS, ERYTHEMA, NETTLE-RASH, SHINGLES, or " moist tetter," PSORIASIS or " dry tetter." and the treatment of each of these will be found under its proper heading.

ioo ERYSIPELAS.

ERYSIPELAS. — Acute, spreading inflammation ot the skin, due to blood-poisoning ; often originating in a small wound or sore. It sometimes goes on to the formation of matter or blebs. It is attended with much burning heat, and the digestion is disordered, the tongue being loaded.

Erysipelas generally comes on with a shivering fit and symptoms of indigestion. In this stage it cannot be distinguished from many fevers and acute inflam- mations, but very soon the rash appears, generally at some part where there is a slight abrasion, often on the face and near the nose. The eruption has sharply defined borders, is red, raised, and at times has blis- ters, and tends to spread. It is often accompanied with great pain, a splitting, throbbing headache, nausea, and vomiting. Often the face is swollen out of all re- cognizable proportions. It may attack the throat. It often follows surgical operations. Persons of all ages are liable to it. Erysipelas may become chronic, and it almost always leaves behind it a tendency to recur.

Diagnosis. — When the rash is out, erysipelas cannot easily be mistaken for anything else. Abscess near a tooth with swelled face is something like, but the swollen gum will reveal its true nature. Erythema is less intense, the eruption is in spots and not con- tinuous, and there is much less constitutional dis- turbance.

General Treatment. — The patient must be kept on fever diet, all solid food being forbidden ; and the part mast be kept from the air by dusting with flour.

Medicines. — (Every hour, or less often according to urgency.)

Bell. — Smooth erysipelas ; heat, redness, burning, swell- ing; headache; hot dry skin ; restlessness; delirium.

ERYTHEMA— EXCESSES. 101

Rhus. — If blisters form ; generally commences on right side and goes to left ; patient is restless.

Apis. — Burning and stinging pain; much swelling; pa- tients do not like to be touched ; are ill-humoured ; cannot bear warm room. (Not to be given before or after Rhus. )

Arsen. — When there is great prostration; tendency to gangrene.

Hepar. — When there is suppuration.

Sulph. — Chronic and recurring erysipelas.

ERYTHEMA. — A diffuse redness and inflammation of the skin, not due to blood-poisoning, like erysipelas, and not tending to formation of pus.

It is sometimes accompanied by fever, and some- times it is in raised spots {Erythe??ia nodosum}.

Erythema may appear on any part of the body, the favourite site for the nodose variety being the legs, and especially the front aspect of them. For the Diagnosis between erythema and erysipelas, see ERYSIPELAS

General Treatment. — Rest and light diet.

Medicines. — (Every hour or two.)

Bell. — In almost all simple cases.

Rhus. — Great restlessness, patient cannot bear to be still.

Apis. — When there is much swelling (not after or before Rhus).

Arnica. — If the eruption is dusky, or if there is a burning sensation in the parts, and the patient fears to be touched.

EXCESSES. — No person can indulge his appetites without suffering the consequences in mind and body. The appetites are not given to be indulged as if their indulgence were an object in itself, but for ulterior ends, as the nourishment of the body. Nothing can be more pernicious than the belief too com-

io2 EXCESSES.

monly held that occasional excesses are good for the body; a belief, unhappily, sometimes supported by physicians who ought to know better. The strength and sanity both of mind and body depend on the virtues of temperance and chastity. Young men cannot have this truth too strongly impressed upon them, for it is in the period of youth that the seeds of much after- trouble are sown. The treatment of one of the chief kinds of excess— DRUNKENNESS — is considered under that head. Of equal, if not of greater moment, is the abuse of the organs of genera- tion. This is often begun in childhood, from no fault of the child's, but in consequence of an irritation in the lower parts. Sometimes it is due to worms. Sometimes to difficulty in making water in boys, owing to a narrow orifice. The treatment for this is circumcision. Much more often it is due to a habit learned at school. One evil-minded boy or girl is capable of corrupting numbers of others. Once acquired the habit is very difficult to overcome. The symptoms are manifold. Aches and pains in various parts; very obstinate indi- gestion, with constipation generally; loss of courage, manliness, and straightforwardness. Those addicted to this habit can seldom look straight into another's face. Excesses of adults, married or unmarried, are no less injurious. General Treatment. — The first thing of course is to do away with the habit, and this is a question of morals and religion. This done the effects remain. For these the best general treatment is a regular, wholesome life : early rising, morning cold bath, plain food, -and open-air exercise. When indigestion results, for treatment see under DYSPEPSIA.

Medicines. — (Three or four times a day.) China. — The chief remedy.

EXCITEMENT— EXHAUSTION. 103

Nux vom. — Spare subjects; great depression; consti- pation.

Sulph. — Heats and chills; hot head, and cold feet and hands ; generally sinking sensation at the pit of the stomach in the forenoon.

Nat. m. — Constipation; chilly subjects ; depression.

EXCITEMENT, EFFECTS OF.— Great excitement is apt to cause disturbance of the circulation and feverish- ness. Rest and quiet should be enjoined when possible.

Medicines. — (Ever}- few minutes until relieved.)

Aeon. — Feverishness ; restlessness; sleeplessness.

Bell. — Headache ; flushed face.

Coffea. — Sleeplessness.

Cham. — Bilious derangement.

EXCORIATION (CHAFING).— In children some parts of the skin, especially between the legs, is apt to become raw. This is a skin affection, and is not a conse- quence of washing. General Treatment. — Use no soap. Wash the child in plain warm water. Rain water is the best, and if this is not obtainable, boiled water should be used. Do not rub the parts, but mop them dry with very soft cambric.

Medicines. — (Three times a day.)

Cham. — This will suffice to cure in most cases.

Lyeop. — After Cham., sandy red urine ; constipation ;

flatulence. Sulph.— Irritation, worse at night ; cold feet, hot head,

acidity.

EXHAUSTION.— This is apt to follow great exertion, fatigue, or over-heating. For the effects of mental exertion, see BRAIN FAG. General Treatment. — For exhaustion from over-

104 EYELIDS.

heating, see SUNSTROKE. When it is due to fatigue a cup of tea or a Turkish bath (failing that a hot bath) are the best restoratives.

Medicines. — (Every half-hour until relieved.) Am. — If there is a general bruised feeling. Arsen. — Prostration.

Aeon. — Feverish symptoms ; hot skin ; rapid pulse ; rest- lessness.

EYELIDS. — The three principal affections of the lids are styes, concretions, inflammation of the margins, and inflammation of the inner surfaces.

Styes are best treated by medicines alone, given every

few hours. Puis. — At the beginning. Hepar. — When suppuration occurs. Calc. c. — When hard concretions are left behind.

Inflammation of the Margins. — This condition pro- duces an unsightly redness of the margins of the eye- lids, and is sometimes attended with 'great irritation and turning-in of the eyelashes.

General Treatment. — Local applications are for the most part injurious. A little vaseline may be applied to the lids at night to prevent inflammation, and the eyes may be bathed with warm milk.

Medicines. — (Three times a day.) Sulph. — When the lids are very red. Calc. c. — After Sulph.

Inflammation of the Inner Surfaces. — This may be acute, when it is associated with general inflam- mation of the eye surface {conjunctivitis — the mem- brane covering the eye and lining the lids being called the conjunctiva), or it may be chronic (the condition

EYES. 105

known as granular lids) which is a consequence of repeated acute attacks.

General Treatment. — Bathing with hot water and anointing the margins of the lids with vaseline at night are the simplest and safest local measures to adopt.

Medicines.

Aeon. — Red hard swelling, with burning heat and dry- ness.

Apis. — Eyelids much swollen.

Sulph. — Violent burning ; mucus and matter exude.

Arsen. — Eyelids very painful ; eyes can scarcely be opened.

Rhus. — Lids closed as if by spasm.

EYES. — The only diseases of the eye which can be dealt with domestically are inflammation of the surface mem- brane (conjunctiva) which covers the eyeball and also the internal surface of the lids. The latter has been dealt with under EYELIDS. " Inflammation of the eye," popularly understood, includes two main kinds, acute and chronic, the chronic being often due to scrofula.

General Treatment. — The chief thing to be observed is cleanliness. Many cases of chronic inflammation of the eyes are due to the want of this. Frequent bathing with hot water is useful in almost all cases. Inflammation of the eyes in new-born children is a very serious thing and demands immediate atten- tion from the doctor and nurse. For this see under INFANTS. When foreign bodies have got into the eye care must be taken not to rub it. For ordinary dust the best thing to do is to wash the eye with water. Immersing the eye in a vessel con- taining cold water and opening and shutting the lids will get rid of it. If it is lime it should be washed with vinegar and water, and afterwards bathed with olive

106 FACE.

oil. If it is a particle of iron it will have to be re- moved by a surgeon.

Medicines. — (In acute inflammations every hour until relieved ; in chronic cases two or three times a day.)

Aeon. — Acute inflammation of the eye from cold, or from injury.

Bell. — When the eyes are quite dry and much affected by light ; face red.

Puis. — Abundance of tears during the day ; whitish pro- fuse bland discharge. In scrofulous children at the beginning.

Merc. — Profuse excoriating flow of tears, and thin acrid matter; pains in eyes worse at night; scrofulous inflam- mation when the pains are worse from heat or cold.

Sulph. — In acute inflammation after Aeon. In chronic scrofulous inflammation, eyelids almost closed ; light very painful ; is blind during the day, and can only see a little during twilight.

Calc. — Film on the clear part of the eye remaining after inflammation.

Hepar. — Eyelids and eyes red and sore, lids close spas- modically ; light intolerable in the evening ; pimples about the eye ; eyes worse in cold and dry weather ; better when wrapped up warmly.

See also BLINDNESS.

FACE. — The face may become spotty and the complexion unhealthy from a variety of causes. Gout is answer- able for some cases, and scrofula for others. Un- wholesome occupations, and want of attention to ordinary rules of healthy living. The period of adol- escence is often marked by an eruption of pimples. General Treatment. — When the spots depend on some chronic disorder like gout, constitutional treat- ment will be required. Plain regular living and plenty of open-air exercise are the best remedies in

FACEACHE— FAINTING. 107

general. The worst thing that can be done (after cosmetics) is to take "tonics" and "blood-purifying" mixtures indiscriminately. The use of face powder of all kinds is injurious. When the skin of the face is tender, no soap of any kind should be used to it. Plain water is generally enough, and if anything more is desired, Fuller's- earth is the best.

Medicines. — (Three or four times a day.)

Arseji. — Scurfy eruptions round the mouth.

Kali c. — Blotches and roughness of the skin produced by cold winds.

Nat. m. — Earthy complexion, unhealthy-looking; patients who are generally chilly and of a constipated habit.

Sep. — " Liver-spots."

See also ACNE.

FACEACHE. — By this term is meant neuralgia of the face, which is frequently dependent on bad teeth. When that is the case, the treatment for TOOTHACHE must be adopted. When faceache is independent of any affec- tion of the teeth, the following remedies will be found successful.

Medicines. — (Every hour until relieved.)

Aeon. — Heat and redness of the face ; agitation ; restless- ness.

Bell. — Pains suddenly appearing and suddenly disap- pearing. More violent under the eye, and affecting cheekbones, nose, jaws ; convulsive twitches and jerks. Right side generally affected.

Arsen. — Attacks periodic ; burning pains ; anguish and restlessness \ prostration j pains relieved by heat.

Spig. — Various shooting burning pains in all directions, worse from mution or noise. Left side most affected.

FAINTING. — The significance of fainting depends alto- gether on the patient in whom it occurs, and the cause which induces it. If it occurs suddenly in a patient

108 FALLS— FEAR.

who is not specially nervous, and from no apparent cause, it may indicate grave disease, which will need the attention of a medical man. If a patient is known to faint easily on slight provocation, an attack is much less serious.

General Treatment. — The best thing for bystanders to do when a patient faints, is to retain their self-pos- session. There is very little necessary to be done. Place the patient flat on the floor and loosen any articles that may be tight about the neck and chest ; a little cold water may be sprinkled on the forehead. When the cause is known, the proper remedy may be selected and a few drops placed between the teeth.

Medicines. — (Every few minutes until reaction occurs ; or two or three times a day to correct the tendency.)

Aeon. — Fever or pain.

Coffea. — From excessive joy.

Opium. — From fright, reproach, violent scolding, taking offence.

China. — From loss of blood.

Ignat. — After sudden emotions.

Verat. — After violent pain, driving the patient to distrac- tion.

FALLS.— The chief effects of falls are shock, bruises, sprains, and fractures. When bones are broken skilled aid must be called in. For BRUISES and SPRAINS con- sult the articles under those headings.

FATIGUE. ^EXHAUSTION.

FEAR AND FRIGHT.— The consequences of fear and sudden fright are often most serious, and the senseless practice of practical joking cannot be too sternly con- demned. Diarrhoea, fever, convulsions, and even mental derangement are frequently met with as consequences of fright. Medicines. — (Every half-hour, or according to urgency.)

FEET. 109

Aeon. — Fright with vexation ; difficult breathing, and violent pains in the pit of the stomach.

Opium. — Immediately after fright ; if still fearful ; faint- ness j twitching of limbs ; involuntary passage of water with stool ; fits ; perspiration and red face.

Bell. — Great agitation remaining after fits (after Opium) ; derangement of mind ; blood rushes to the head ; face red, burning hot ; patient cannot bear anything about the neck ; sleepless ; raving mad ; would run away ; fears imaginary things.

Ignat. — Fits, if the patient becomes very pale ; twitching of the limbs; stiffness of the back j if the fright is followed by sadness or grief.

Puis. — Diarrhoea.

Verat. — Involuntary evacuations, patient cold and trem- bling ; fear of special things.

Stram. — Children, fear to go to bed in the evening.

Arsen. — Fear of being alone.

Puis. — Afraid of people.

FEET : Sore. — When the feet become sore from walking, if they are much blistered, bathe them with hot water in which a few drops of the strong tincture of arnica have been mixed. Arnica should be taken internally. When there are blisters they should be kept unbroken as long as possible. If it is impossible to rest apply some simple grease, such as suet or lard, to cover the part, and when the patient can rest he should apply a wet cloth, and take Cepa.

Cold. — The best remedy for cold feet is exercise. But when the condition is constitutional no amount of exercise will keep them warm when not in action.

Medicines.

Card. v. — Blueness and tendency to chilblains.

Secale. — Numbness and cramps along with the coldness.

Nat. m. — In chilly subjects ; constipation.

no FELON— FEVER.

Calc. c. — Cold, clammy feet ; always feel as if stockings

were damp. Sulph. — Cold feet and hot head.

Perspiration. — This is a very troublesome affection, but it should never be suppressed by external means, as this will be certainly followed by something much worse. It is a constitutional affection and demands consti- tutional remedies.

General Treatment. — The best thing the patient can do is to lay in a large supply of hose, which should be changed once or twice a day, the feet being washed in plain warm water, to which a little Condy's fluid may be added, if there is any offensive odour, every evening.

Medicines. — (Two or three times a day.)

Sulph. — At the commencement. It may be sufficient to cure the case, or it may be required after others have been given for a time.

Silk. — After Sulphur. The perspiration is fetid.

Petrol. — Perspiration with tenderness of the feet.

Calc. — Cold clammy perspiration.

FELON. See WHITLOW.

FESTER, Tendency of Slight Wounds to. — When wounds refuse to heal, and when slight injuries always suppurate, give Hepar two ©r three times a day.

FETID BREATH. See BREATH.

FEVER. — The normal temperature of the body is 98.40 01 the Fahrenheit scale. When it rises above this there is fever. Slight fluctuations are not of any great conse- quence, but if it rises above ioo° there is cause for a certain amount of anxiety to ascertain the cause, and when above 1040 there is ground for alarm. It is not often that patients recover after the temperature has registered 1060.

FITS— FL ATULEN C Y. 1 1 1

Fever may be due to many causes. It may be simple fever and due to cold, disordered stomach, or mental emotions. The infectious fevers are due to blood-poisoning, the poison being the contagious prin. ciple of the fever. Ague and malarial fevers arise from poisoning with marsh miasm. Inflammations of all kinds are attended with more or less fever, but in this case the fever is only symptomatic. The specific fevers will be dealt with under their own headings. I only speak here of Simple Fever.

Simple Fever. — This may be the result of a chill, of overloading the stomach, or of fright. The temperature seldom rises very high. There may be headache, rest- lessness, nausea, vomiting, and diarrhoea.

General Treatment. — The patient must be kept quiet and have plenty of water to drink. The diet must be of the lightest. No solid food must be given, and when it is the result of overloading the stomach no food at all for a day or two until the stomach is right.

Medicines. — (Every hour or two.)

Aeon. — Most cases of simple fever, especially following a chill or fright. Heat, restlessness, thirst, anxiety are the leading indications.

Bell. — Flushed face; dry mouth and throat ; headache.

Bry. — Fever with disordered stomach, white tongue, bitter taste in mouth, vomiting.

Bapt. — Bilious fever ; loaded tongue ; heavy dull appear- ance; diarrhoea.

FITS. See CONVULSIONS.

FLATULENCY.— (For stomach flatulence, which finds relief in eructations, see ERUCTATIONS).— Gas may accu- mulate in the intestines from decomposition of the food which is improperly acted on by the digestive juices. This is especially the case when improper articles of food are taken, or foods that do not agree well with each

1 1 2 FLOODING— FRACTURES.

other. With some patients it does not matter what kind of food they take, the same thing results. Some- times it almost seems as if the mucous membrane of the intestines secreted air, the accumulation is so great. General Treatment. — When it can be clearly traced to errors of diet, these should be rectified or avoided. Eggs, green vegetables, potatoes, peas, and all kinds of pulse are decidedly flatulent in their tendency, and should be avoided or only taken in great moderation. Cold meat will often produce flatulence when hot meat will not.

Medicines. — (Every hour when the condition is trouble- some. Two or three times a day when taken as a course.)

Cham. — Swelling of the body, pinching about the navel, passage of offensive flatus without relief.

Puis. — After eating fat or rich food. Wind rolls about the body.

Nux vom. — From indigestible food ; in choleric persons.

Lycop. — Much rumbling in the body; tightness after meals ; thick, sandy urine.

Sulph. — In chronic cases ; acidity ; fainty spells ; sinking at the pit of the stomach in the forenoon.

FLOODING AFTER LABOUR. See CHILDBIRTH.

FRACTURES.— When an accident has resulted in the breaking of a bone, it will be necessary to consult a medical man if possible. But when no medical aid is at hand, it is well to know the best thing to be done. The bones most liable to fracture are the long bones of the limbs, the ribs, and the skull. Fracture of the skull can only be dealt with by skilled persons. Until skilled help can be obtained, the patient must be kept perfectly quiet, and the wound, if there is one, kept clean. When a long bone of a limb is broken, there are two things to be done: first, to bring the

FRACTURES. 113

broken ends of the bone properly together (or, in other words, to get the limb into its natural position and shape); and, secondly, to keep it there until the bones are strongly united. If, as sometimes happens, there is no displacement of the broken ends of the bones, the second indication is all that remains to fulfil. When there is displacement of the broken ends, strong traction must be made at the two extremities of the limb to overcome the action of the muscles, until the broken ends, which generally slip beside one another, are brought to a level j then, by a little manipulation, they can be brought together, the traction being kept up until this is effected. This done there remains to