_Physic Nut, Poisoning by._ See _Croton Seeds_.
_Piles._ Sulphur (344) internally, and Gall Ointment (148), or
astringent enemas, as Decoction of Babúl Bark (9), or Galls (148),
suffice in ordinary cases. In old debilitated subjects Confection of
Pepper (300) proves very useful. _When inflamed and painful_, the Hip
Bath, or sitting over the steam of hot water (392), and the application
of a solution of Borax (56) and soft Rice Poultices (322), with or
without the addition of Opium (293), give great relief. The Acetate of
Lead Solution advised for _Inflammations_ (see _Index_) is peculiarly
serviceable in these cases. It may be used cold or warm, as is most
agreeable to the patient's feelings. _To control bleeding from_, use
Alum (25), or enemas of Sulphate of Iron (179). When bleeding from piles
in residents in hot climates has been long continued, it is unadvisable,
so long as it remains within moderate bounds, to take any means of
arresting it suddenly; the suppression of the discharge having in some
instances been known to be followed by congestion and even abscess in
the liver, and in others by congestive headaches and determination of
blood to the head. It seems to be an effort of nature to relieve the
abdominal circulation, which it is unwise to interfere with, unless the
discharge be so profuse as to debilitate the patient, and then the
object should be rather to moderate than to arrest it altogether.
Persons subject to Piles will do well to avoid the use of coffee, as
this often appears to aggravate the severity of the symptoms.
Cleanliness in these cases is of the greatest importance: the parts
should be well washed with soap and water after each motion, and if the
piles are internal and protrude during evacuations, they should be
washed before they are returned.
_Pregnancy._ _For Pains in the Loins_ use Camphor (68) or Camphorated
Opium Liniment (291). _To allay the Vomiting_ try Infusion of Cloves
(105), Mustard Poultice (251). A cup of hot coffee and a piece of dried
toast should be taken in bed very early in the morning, after which the
woman should remain quiet until the usual hour for rising; by this means
the vomiting may often be prevented. When procurable, a glass or two of
Sparkling Moselle is often productive of the best effects, allaying the
vomiting, and enabling the patient to retain and digest food.
_Prickly Heat_ may in a great measure be relieved by Solution of Borax
(57) or Sulphate of Copper (115), and subsequently dusting the surface
with Rice Flour (322) or finely powdered Sandal Wood (333).
_Pyrosis._ See _Water Brash_.
_Rectum, Stricture and Painful Affections of._ Castor Oil (83), Fish
Liver Oil (139).
_Rheumatism, Acute._ _Rheumatic Fever_ may be treated much in the same
way as _Ardent or Continued Fever_ (see _Fever_, Index); by confinement
to bed in a cool, well-ventilated apartment, farinaceous diet, and
abstinence from alcoholic and other stimulants. Nitre (270) should be
given freely, with Lemonade (232) as an ordinary drink. The bowels
should be carefully regulated, one or two motions procured daily by a
dose of Calomel (three or four grains) and Opium (one grain, or even two
grains if there should be great pain or restlessness) at bedtime,
followed by Infusion of Senna (336), or Castor Oil (83), in the morning.
To the swollen and painful joints a strong solution of Nitre (270)
should be kept constantly applied; it generally affords great relief; if
not, a Datura Poultice or moistened Datura leaf (or Tobacco leaf),
applied as directed in Paragraph 130, may be tried.
_Rheumatism, Chronic._ Here Sal Ammoniac (327) and Country Sarsaparilla
(163) promise to be of much use. Chaulmúgra (94), Mudar (242), and
Gulancha (352), have been advised, but in long-standing cases more
benefit may be expected from Fish Liver Oil (142). The action of the
skin may be kept up by Camphor, both internally and in the form of
Vapour Bath (69), and by hot Infusion of Ginger (156) at bedtime, and by
constantly wearing flannel next to the skin. _Amongst external
applications_, Camphorated Opium Liniment (291) and Lemon Grass Oil
(217) are the best; the others comprise liniments containing Camphor
(68), Croton Oil (122), Oil of Country Nutmeg (274), Petroleum (410),
Physic Nut Oil (302), Sulphur (343), and Turpentine (366); Piney Tallow
(373) has been well spoken of. Should one or more joints be specially
attacked, make trial of the applitions advised in Acute Rheumatism, or
of Flour of Sulphur, as directed in Paragraph 343.
_Rickets._ Fish Liver Oil (138) may be used with great advantage: it may
be combined with Sulphate of Iron (177) if the child is weak and anæmic.
Lime Water and Milk (222) forms an eligible ordinary drink.
_Ringworm._ Apply Borax and Vinegar (60), Cassia alata Ointment (81),
Unripe Papaw fruit (295), Sulphate of Copper (115), Oil of Turpentine
(367), or Kerosene Oil (416).
_St. Vitus's Dance._ See _Chorea_.
_Salivation._ Use gargles of Alum (29) or Borax (55), or try Catechu in
substance (89).
_Scalled Head._ See _Ringworm_.
_Scarlatina or Scarlet Fever._ Commence with an emetic of Country
Ipecacuanha (368) or Mudar (241); place the patient in a cool,
well-ventilated apartment; give plentifully of Lemonade (232) or rice
_Conjee_ (322) to allay thirst and feverishness, and give Capsicum
Mixture (78) internally. _For the sore throat_, inhale the fumes of hot
Vinegar (377), and use Capsicum gargle (78). Sponging the surface with
diluted Vinegar (376) or Water (385) is attended with great comfort to
the patient, and is otherwise beneficial. The advanced stages,
complications, and subsequent debility, are treated in the same manner
as in Fevers (see _Index_).
_Sciatica._ See _Neuralgia_. Enveloping the whole of the painful limb in
the "Wet sheet" (397_b_) proves sometimes successful when other remedies
fail. Quinine in full doses, five to eight grains thrice daily, may be
given at the same time.
_Scorpions, Stings of._ Alum (32). See also _Bites, Venomous_.
_Scrofula._ Fish Liver Oil (138) proves most useful in cases in which
_Abscesses, Ulcers, or Skin Diseases_ are present. _Scrofulous
Ophthalmia_ is also greatly benefited by it. When the patient is
debilitated and anæmic, the Oil may advantageously be combined with
Sulphate of Iron. Chaulmúgra (94), Hydrocotyle (169), and Lime Water
(225), are amongst the remedies occasionally useful. A dose of Opium
(283) or Tincture of Datura (128) may be given at night, if the pain or
irritation from ulcers or skin disease occasion sleeplessness. A liberal
animal diet, gentle outdoor exercise, and sea-bathing are valuable
adjuncts to the above remedies.
_Scurvy._ Lime-juice (231) holds the highest rank both as a curative and
preventive agent. All acidulous fruits, Lemons, Oranges, Tamarinds
(346), &c., may be used with the greatest advantage. As a preventive of
Scurvy in jails, &c., Lime Juice and other analogous agents will prove
of comparatively little use unless attention is paid to hygienic
measures, _e.g._, the cleanliness, ventilation, dryness of the building,
reduction of numbers in cases of overcrowding, and the use of a liberal
and wholesome diet, containing a large proportion of fresh vegetables.
_Diarrhœa of_, give Bael (44).
A new antiscorbutic called ÁM-CHUR has lately been brought into use
amongst our native troops in India, and promises to be a powerful rival
to Lime Juice. It consists of green Mangoes, skinned, stoned, cut into
pieces, and dried in the sun. According to Dr. Clarke, Deputy
Surgeon-General Eastern Frontier District, Ám-chur not only maintains
the digestive energy of the men, but its use amongst troops, where
neither a variety of food nor vegetables is obtainable, commends itself
strongly as a result of practical experiment to the military
authorities. One ration should be half an ounce, which would be
equivalent to an ounce of Good Lime Juice. (_British Med. Jour._, Sept.
30, 1882.) Another anti-scorbutic well worthy of attention, especially
as an article of diet on long voyages, consists of DRIED OR PRESERVED
BANANAS. When carefully prepared, they are agreeable to the taste, much
resembling dried figs, of small cost, and will keep good for a
lengthened period.
Sweet Mango pickle, _freely_ eaten with the diet, is an excellent method
of administering Ám-chur.
_Seminal Discharges, Involuntary._ Give Camphor (72) at bedtime. When
attended with much sexual excitement, a full dose of Bromide of
Potassium, 20 to 30 grains in a wineglassful of water at bedtime, is
often most serviceable. These discharges being sometimes due to
irritation caused by Thread Worm in the lower bowel, attention should be
directed to this point. See _Worms_.
_Skin Diseases._ Country Sarsaparilla (163*), Chaulmúgra (94), or Mudar
(242); or where the affection occurs in debilitated, scrofulous, or
leprous individuals. Fish Liver Oil (138) may be given internally. One
of the following may at the same time be applied externally: Cassia
alata (81), Chaulmúgra (94), Lime Liniment (225-229), Myrobalan Ointment
(257), Sulphur (342), Turpentine (367), Kerosene Oil (414*), or
Petroleum (411). The Vapour Bath (396) is often very useful where the
skin is hard, dry, and rough. Borax lotion (57) in many instances will
allay the irritation.
_Sleeplessness in Head Affections._ Mustard Bath (249). A full dose of
the Bromide of Potassium, 20 to 30 grains in a wineglassful of water,
taken at bedtime and persevered in for days and weeks, will often be
found more effectual and less hurtful than the most powerful narcotics.
_From pain attendant on Ulcers, Rheumatism, &c._, Opium (283) or
Tincture of Datura (128) at bedtime. [N.B.—_Sleeplessness, arising from
no evident cause, as bodily pain, mental anxiety, &c., is often
dependent on an empty state of the stomach_, and many a sleepless night
may be prevented, and many a wakeful hour obviated, by the simple
process of eating a few biscuits or a crust of bread before going to
bed, or during the night as occasion may require.]
_Small-pox._ Commence with a mild aperient of Castor Oil (83) or Senna
(336); place the patient in a cool, well-ventilated room, and give
freely Lemonade (232), Rice _Conjee_ (322), &c., with solution of Nitre
(264); sponge the surface daily with diluted Vinegar (376) or Water
(385); and, still further, to _allay irritation_, dust the eruption
freely with Rice Flour (322). The Carbolic Acid treatment promises the
best results. Carbolic Acid, as an external application in Small Pox, is
strongly recommended by Dr. Aitchison. He directs that from the very
earliest stage of the disease the whole body be rubbed with a mixture of
the Acid (one part) and Sweet Oil (ten parts) twice daily. "This
application," he remarks, "relieves the patient marvellously—the oil
soothing and cooling the skin, the acid deodorising the stench, and
destroying the contagious influence of the particles thrown off from the
skin. The oil is as much a part of the treatment as the disinfectant,
and is an old Egyptian remedy for this disease. In many cases the
application seems to destroy the Smallpox poison to the extent that the
disease does not reach the pustular stage; the vesicles form themselves
into hard lumps, dry up, and disappear, without the usual Small-pox
pustular cicatrix." (See Appendix C for details of treatment.) With the
view of _preventing pitting_, apply Lime Liniment (229). _In the
advanced stages, attended with great exhaustion, delirium_, &c., give
Camphor (74), Brandy Mixture (426), and other stimulants, with
nutriment. _Subsequent debility and Convalescence_, treat as in Fever.
(See _Index_).
_Snake Bites._ See Appendix B.
_Sneezing, when violent or prolonged._ Insert lightly into the nostrils
a small piece of cotton wool. A case in which this gave instantaneous
relief, when all other remedies had failed, is recorded by Dr. Bradley.
(_British Med. Jour._, Dec. 1879.)
_Spermatorrhœa._ See _Seminal Discharges_.
_Spleen, Enlargement of, "Ague Cake."_ Give Sulphate of Iron and
purgatives, as advised in Paragraph 176, or Papaw juice (296), or,
better still, Cinchona Febrifuge (402). Extract of Gulancha (353) is
worth a trial. Quinine, in doses of five to eight grains thrice daily,
produces the best effect in these cases; it may be advantageously
combined with Sulphate of Iron (176). The most effectual local
application is Biniodide of Mercury Ointment (16 grains of the Biniodide
to simple Ointment, one ounce). In obstinate cases change of air is the
best and only remedy.
_Sprains, Blows, and Bruises._ Solution of Sal Ammoniac (332), Hot Water
Fomentations (393), or Evaporating Lotion (380) are most suitable
applications for the early stages. Should there be much swelling and
heat of skin, Leeches (212) may be necessary. When the active symptoms
have subsided, Liniments of Camphor (68), Opium (291), Lemon-grass Oil
(217), or Turpentine (366), are indicated. _In Sprains_, warm
applications, with perfect rest of the part, are best suited for the
first few days. The sprained part should be kept in a raised position,
well supported, and should on no account be allowed to hang down. The
following treatment is highly spoken of in cases of _Sprained Ankle_. As
soon after the accident as possible immerse the foot in a tub of _hot_
water for ten minutes, and then into a tub of cold water for a similar
period. Afterwards put on a wet bandage pretty tight, and cover with
oil-silk, plantain leaf, or other impermeable covering. _To remove
subsequent swelling_, apply Alum Lotion (32). _To remove discoloration_,
Solution of Sal Ammoniac (332).
_Stiff Neck._ Apply Opium Liniment (291).
_Stomach, Acidity of._ Give Lime Water (221). _Bleeding from._ See
_Hæmorrhage from internal organs_. _Pains in._ See _Flatulence,
Flatulent Colic, and Bowels, Spasmodic Affections of_.
_Stomatitis._ See _Mouth, Ulceration of_.
_Sunstroke._ Employ Cold Water Affusion and other measures advised in
Paragraph 386. Artificial Respiration, as described in Appendix A, is
worth a trial where the insensibility is deep and prolonged.
_Syphilis._ On the first appearance of a chancre or ulcer on the penis,
sprinkle its surface with a little very finely powdered Sulphate of
Iron, and this having been removed, dress subsequently with Black Wash
(225) till the sore shows signs of healing. As a local application, Dr.
Aitchison advocates Carbolic Acid. "No time should be lost," he remarks,
"in obtaining medical aid when an ulcer on the penis has formed. But
when it is impossible to get such aid, touch the sore with pure Carbolic
Acid, taking care that the healthy parts are not touched with it. Apply
Sweet Oil to the parts after burning the ulcer, and then dress it as you
would any healthy ulcer until the slough caused by the acid falls off."
Mercury (if at hand) should be given so as to induce slight soreness of
the gums.
To effect this, give one grain of Calomel, with a quarter or half a
grain of Opium, night and morning, and should the gums at the end of a
week not be affected, the dose of Calomel may be doubled. Soreness of
the gums, with a peculiar (mercurial) fetor of the breath and metallic
taste in the mouth, may be taken as an indication that the remedy has
been carried to the required extent, and this condition it is desirable
to maintain until the sore heals or the symptoms subside; this may
occupy four or five weeks. No good, but rather great harm, will result
from carrying the use of mercury beyond this point. Should it cause much
increased flow of saliva (which is very undesirable), use the remedies
advised for _Salivation_, or if during a course of mercury, the sore,
instead of improving, becomes worse, it should at once be discontinued.
Stimulants and all kinds of excitement, as well as exposure to
atmospherical changes, especially wet, should be avoided during its use;
in fact, this treatment requires the greatest care throughout, and
should, if possible, _be never undertaken except under proper medical
supervision_.
Country Sarsaparilla (163), Hydrocotyle (169), and Mudar (242), are
better suited for the more advanced stages of the disease, or when it
becomes constitutional. The use of the Country Sarsaparilla, however,
may well be conjoined with the mercurial treatment from the very
commencement. N.B.—Avoid all the crude preparations of Mercury in use by
the native doctors, or sold in the bazaars; they are likely to do
_incalculable mischief_.
_Tetanus_ (_Lock-jaw_). Try Datura (131). The treatment of Tetanus by
smoking GUNJAH (INDIAN HEMP), introduced by Assistant-Surgeon A. C.
Khastagir (_Indian Medical Gazette_, August 1878), promises to supersede
all others in India if it were only from the fact that the remedy is
procurable at a trifling cost in every bazaar throughout the country,
and that its application is simple in the extreme. A pipe, _hookah_, or
Indian hubble-bubble, charged with about 15 grains of dried Gunjah
leaves, alone or mixed with twice as much tobacco leaves, is to be kept
in readiness, and immediately on the indication of a spasm coming on it
is to be lighted and handed to the patient with directions to smoke. By
the time this is finished, or even before, the spasm relaxes, the eyes
close, and the patient falls into a kind of slumber. The pipe is again
charged, and kept in readiness for the approach of the next spasm, when
the process is repeated with similar results. In this way the drug is
administered day and night uninterruptedly, during which the irritation
of the nervous system slowly but steadily yields to its influence. Mr.
K. details five cases successfully treated in this manner. No auxiliary
medicine, beyond an occasional purgative if required; no solid food
allowed; milk and soup the only nutriments. This treatment is further
advocated by Dr. J. C. Lucas, of the Bombay Medical Service (_Med. Times
and Gaz._, February 21, 1880). The advantages which he claims for it
are—(1) the spasms are cut short; (2) they reappear gradually at longer
and longer intervals; (3) they gradually become not only less frequent,
but less severe; this (4) saves the patient's vital powers, and thus, by
prolonging life and preventing death, life, which would otherwise have
succumbed, may eventually be saved. He places the dose at from eight to
thirty grains, commencing with the smaller dose, and gradually
increasing it as tolerance is established. He insists, properly, on the
vast importance of quiet, _perfect quiet_, in a pure air (without too
much breeze or draught), and he directs that the patient should on _no
account be disturbed to take his food or for any other reason_, for
which opportunity is to be taken when the patient awakes of his own
accord, or from the recurrence of spasm. In the case of very young
children, this mode of treatment cannot, of course, be carried out, but
in all others it seems well worthy of a fair trial.
_Throat, Dry and Irritable States of, giving rise to Cough_, inhale the
vapour of Hot Decoction of Abelmoschus (3) or of Hot Water (390). _In
Inflammatory States of, without Ulceration_, use the same inhalations,
and allow a piece of Nitre to dissolve in the mouth (266). _Relaxed or
Ulcerated Sore Throat._ Use gargles of Alum (29), Capsicum (78), Moringa
(238), Black Pepper (300), or Pomegranate Rind (313), Catechu (89),
Ginger (158), and Omum Seeds (316), used in substance, prove useful in
some cases, as do inhalations of the vapour of Hot Vinegar (377), or
simple Hot Water (390).
_Tic Douloureux._ See _Face Ache and Neuralgia_.
_Tongue, Fissures or Cracks of, in the advanced stages of Fever, &c._
Use Borax (55) or Alum (29).
_Toothache_ sometimes yields to Opium (292*) or Catechu (89) locally
applied, with or without Ginger (157), or Mustard Poultices (253)
externally. Extraction is the only certain cure in the majority of cases.
_Tumours, Painful._ Apply Datura in one of the forms advised in
Paragraph 130, and give Opium (283) or Tincture of Datura (128) at night
to procure sleep. A Tobacco leaf may often be advantageously substituted
for Datura.
_Ulcers_ may be successfully treated by the local application of
solution of Sulphate of Copper (114*). Ceromel (167*) "Oil Dressing"
(338) "Water Dressing" (394), (Dr. Aitchison states that for years he
has discarded Water Dressing in any form to ulcers, but has substituted
for cleansing and dressing them a mixture of one part of Carbolic Acid
and ten of Sweet Oil. He pronounces this a far more effectual mode of
treatment), and Rice Poultices (322), varied according to circumstances;
_if attended with fetid discharge_, Charcoal Poultices (91); _if with
much discharge_, Catechu Ointment or Lotion (90) and Myrobalans Ointment
(257). _To destroy Maggots on surface of_, Butea Seeds (65). _Sloughing,
Gangrenous, or Ill-conditioned Ulcers_ require Alum Ointment (31), Borax
(59), Camphor (75), Ním Poultices (261), Oil of Country Nutmeg (274),
Petroleum (412), _Toddy_ Poultices (355*) Turpentine Ointment (367),
Resin Ointment (372), or Sugar (408). "Irrigation" (395) is most useful
in removing the slough and stimulating to healthy action. _If the pain
and irritation are so great as to prevent sleep_, Opium (283) or
Tincture of Datura (128). _To excessive Granulations_ ("_Proud flesh_"),
apply Sulphate of Copper (114). In all cases Country Sarsaparilla (163),
Hydrocotyle (170), or Mudar (242) may advantageously be given
internally; and _for Ulcers occurring in Scrofulous subjects_, Fish
Liver Oil (137, 138) proves most useful. "Whenever in India an ulcer
looks angry and is in an _unhealthy_ and _non-healing_ condition, as is
the case with Scind boils, Multan sores, Delhi sores, &c. &c., all
applications to the ulcer itself are useless until the general health of
the patient undergoes a thorough alteration. The want of power to heal
in the ulcer shows that the system is in an unhealthy condition and that
it is incapable of putting on the healing process in the ulcer. This
state of things is no doubt due to the climate, malaria, poor food, and
bad water; these combined develop in the system, scurvy, or a condition
of the body allied to scurvy.
"An addition to, and a change in the diet is of the first consequence.
This is to be done by administering _as drugs_ a daily liberal
proportion of _good butter_, _sugar_, and _lime-juice_.
"In many parts of India, especially during the hot weather, _good_
butter is not to be got as a fresh article of food; an excellent
substitute for it is the tinned article, now so readily obtainable,
which, if salt, can be carefully prepared for use by having the salt
washed out of it. The lime-juice should be, if possible, in the form of
_fresh_ limes, lemons, or oranges; rather than the lime-juice of
commerce. Where fresh limes, &c., or lime-juice cannot be procured,
sweet mango pickles, lime pickles, or the bazaar commodity Ám-chur (see
_Index, Scurvy_) should be employed; from the last excellent preserves
and tarts can be made, which are relished as a diet.
"The water supply should be changed, and even, if necessary, condensed
water be drunk, in place of the saline stuff so common along our
north-west frontier, where the river water is to be preferred to that of
brackish wells full of nitrates.
"Other vegetables, such as potatoes, cauliflower, and artichokes should
be added to the dietary if obtainable, and when possible an immediate
change of climate, even for a few days, and to another _water supply_ is
of immense importance.
"The good results in following up the above proposals can be at once
seen in the rapid alteration of the conditions of the ulcer, or ulcers,
which at once begin to take on a healing action. They require after this
but simple dressing, and indeed disappear as if by a miracle, leaving,
however, behind them a _scar_, a well known momento of having once lived
in an unhealthy climate."—_Aitchison._