a diluent. Pure water is the principal agent of this class. It
constitutes about four-fifths of the weight of the blood, and is the
most abundant constituent of the bodily tissues. Water is necessary, not
only for digestion, nutrition, and all functional processes of life, but
it is indispensable as a menstruum for medicinal substances. It is a
necessary agent in depuration, or the process of purifying the animal
economy, for it dissolves and holds in solution deleterious matter,
which in this state may be expelled from the body. In fevers, water is
necessary to quench the thirst, promote absorption, and incite the skin
and kidneys to action. Its temperature may be varied according to
requirements. Diluents are the vehicles for introducing medicine into
the system. We shall briefly mention some which prove to be very
grateful to the sick.
VARIOUS VEGETABLE ACIDS AND JELLIES may be dissolved in water, as apple,
currant, quince, grape, or cranberry.
THE JUICE OF LEMONS, ORANGES, PINE-APPLES, AND TAMARINDS, is also found
to be refreshing to fever patients.
SASSAFRAS-PITH, SLIPPERY-ELM BARK, FLAX-SEED, AND GUM ARABIC make good
mucilaginous drinks for soothing irritation of the bowels and other
parts.
BREWERS' YEAST mixed with water in the proportion of from one-eighth to
one-fourth is a stimulant and antiseptic.
THE WHITE ASHES OF HICKORY OR MAPLE WOOD dissolved in water make an
excellent alkaline drink in fevers, or whenever the system seems
surcharged with acidity.
DIURETICS.
_Diuretics_ are medicines which, by their action on the kidneys,
increase the flow of urine.
[Illustration: Fig. 130.
Marsh-mallow. ]
MARSH-MALLOW (_Althea Officinalis_) is used in irritable conditions of
the urinary organs. The infusion may be drunk freely.
GRAVEL-PLANT (_Epigea Repens_), is also known as Water-pink,
Trailing-arbutus, or Gravel-root. _Dose_--Of decoction of the plant, one
to three ounces; of fluid extract, one-fourth to one-half teaspoonful.
[Illustration: Fig. 131.
Stone-root. ]
STONE-ROOT (_Collinsonia Canadensis_), is also known as Knot-root,
Horse-balm, Rich-weed, or Ox-balm. This is a mild diuretic, slow in
action, yet effective in allaying irritation of the
FOXGLOVE (_Digitalis purpurea_) slows the action of the heart, lowers
the temperature, and acts indirectly as a diuretic. It is especially
valuable in the treatment of scarlet fever and in dropsy. _Dose_--Of
infusion, one-half drachm to one-half ounce; of the fluid extract or
strong tincture, from two to ten drops. It should be used with caution.
A poultice made of the leaves and placed over the kidneys is an
effectual method of employing the drug.
QUEEN OF THE MEADOW (_Eupatorium Purpureum_), is also known as
Gravel-weed, Gravel-root, or Trumpet-weed. This is a most valuable
diuretic. _Dose_--Of the infusion, one to three ounces; of fluid
extract, one-fourth to one-half teaspoonful; of the concentrated
principle, Eupatorin (_Purpu_), one-half to two grains.
BUCHU (_Barosma Crenata_). The leaves are used. This agent has been
extensively employed, generally in compounds. _Dose_--Of infusion,
(steeped for two hours or more) one to two ounces; of fluid extract, the
same; of the concentrated principle, Barosmin, one to three grains.
PIPSISSEWA (_Chimaphila Umbellata_), or Prince's Pine. This is a tonic
to the kidneys, as well as a diuretic and alterative, and is a mild, but
very efficient remedy. _Dose_--Of decoction, one ounce from four to six
times a day; of fluid extract, one-fourth to one-half teaspoonful; of
the concentrated principle, Chimaphilin, one to two grains.
WATER-MELON SEEDS (_Cucurbita Citrullus_). _Dose_--Of infusion, the
patient may drink freely until the desired effect is secured.
PUMPKIN SEEDS (_Cucurbita Pepo_). They are mild, unirritating, yet
effective diuretics. An infusion of these may be drunk freely.
SWEET SPIRIT OF NITRE (_Spiritus Ætheris Nitros_), is diuretic and
anodyne. _Dose_--One-fourth to one-half teaspoonful, diluted in water,
every two or three hours.
SALTPETRE (_Potassæ Nitras_). _Dose_--Powdered, five to ten grains.
ACETATE OF POTASH (_Potassæ Acetas_). _Dose_--Ten to fifteen grains,
largely diluted in water. It is more frequently used for this purpose
than the nitrate. It is a most valuable diuretic.
EMETICS.
These are medicines which cause vomiting and evacuation of the stomach.
Some of the agents of this class, termed irritant emetics, produce
vomiting by a local action on the stomach, and do not affect this organ
when introduced elsewhere. Others, which may be termed systemic emetics,
produce their effects through the nervous system, and, therefore, must
be absorbed into the circulation before they can produce vomiting. In
cases of poisoning, it is desirable to empty the stomach as quickly as
possible, hence irritant emetics should be employed, for they act more
speedily. Draughts of warm water favor the action of emetics.
MUSTARD (_Sinapis_) acts promptly and efficiently as an emetic, and may
be employed in poisoning. _Dose_--From one to two teaspoonfuls of
powdered mustard, stirred up in a glass of tepid water. It should be
quickly swallowed and diluents freely administered.
SULPHATE OF COPPER (_Cupri Sulphas_) is a prompt, irritant emetic. It
should be given in doses of ten grains dissolved in half a glass of
water, and its action assisted by the free use of diluents.
SULPHATE OF ZINC (_Zinci Sulphas_) is similar in its effects to sulphate
of copper, but less powerful, and may be taken in the same manner, and
the dose repeated if necessary in fifteen minutes.
YELLOW SUBSULPHATE OF MERCURY (_Hydrargyri Sulphas flava_), commonly
known as _Turpeth Mineral,_ is an efficient and most desirable emetic in
membranous croup. It is an active poison, but, as it is quickly thrown
up with the contents of the stomach, there is no danger from its
administration. _Dose_--It should be given to a child in doses of from
three to five grains, in the form of powder, rubbed up with sugar of
milk.
IPECAC (_Cephælis Ipecacuanha)._In large doses Ipecac is a systemic
emetic. In small doses, it exerts a specific influence upon the mucous
membranes, relieves nausea and irritation, and subdues inflammation. In
cholera infantum it is an invaluable remedy, if given in very small
doses. By allaying irritation of the stomach and restoring tone and
functional activity to it and the bowels, it gradually checks the
discharges and brings about a healthy condition. It is also valuable in
dysentery, and is borne in large doses. As an emetic the dose is, of
powder, five to ten grains in warm water; of fluid extract, ten to
twenty drops.
[Illustration: Fig. 132.
Lobelia. ]
LOBELIA (_Lobelia Inflata_), sometimes known as Indian Tobacco, or
Emetic-weed. The herb and seeds are used. This is a powerful, systemic
emetic, but very depressing. _Dose_--Of the powdered leaves, fifteen to
twenty grains; of the infusion, one to three ounces; of the fluid
extract, ten to fifteen drops.
BONESET (_Eupatorium Perfoliatum)._ _Dose_--Of the warm infusion or
decoction, two to three ounces; of the fluid extract, one teaspoonful in
hot water: of the concentrated principle, Eupatorin, two to five grains.
EMMENAGOGUES.
Emmenagogue is a term applied to a class of medicines which have the
power of favoring the discharge of the menses. We shall mention only a
few of those which are best adapted to domestic use.
[Illustration: Fig. 133.
Pennyroyal. ]
PENNYROYAL (_Hedeoma Pulegioides)._ Pennyroyal, used freely in the form
of a warm infusion, promotes perspiration and excites the menstrual
discharge when recently checked. A large draught of the infusion should
be taken at bed-time. The feet should be bathed in warm water previous
to taking the infusion.
BLACK COHOSH (_Cimicifuga Racemosa)._ Black Cohosh, known also as Black
Snake-root, is an effective remedy in uterine difficulties. _Dose_--Of
the tincture, twenty drops; of the fluid extract, ten drops.
TANSY (_Tanacetum Vulgare)._ Tansy is beneficial in suppressed
menstruation. _Dose_--Of the infusion, from one to four fluid ounces.
ERGOT (_Secede Cornutum_) in very small doses acts as an emmenagogue,
and in large doses it checks hemorrhage. The dose as an emmenagogue, of
the fluid extract, is from two to five drops, and to arrest hemorrhage,
from half a drachm to two drachms, repeated in from one to three hours.
LIFE-ROOT (_Senecio Gracilis._) Life-root exerts a peculiar influence
upon the female reproductive organs, and for this reason has received
the name of Female Regulator It is very efficacious in promoting the
menstrual flow, and is a valuable agent in the treatment of uterine
diseases. _Dose_--Of the decoction, four fluid ounces three or four
times a day; of the fluid extract, from one-fourth to one-half
teaspoonful.
MOTHERWORT (_Leonurus Cardiaca_). Motherwort is usually given in warm
infusion, in suppression of the menses from cold. _Dose_--Of the
decoction, from two to three fluid ounces every one or two hours.
DR. PIERCE'S FAVORITE PRESCRIPTION is an efficient remedy in cases
requiring a medicine to regulate the menstrual function. Full directions
accompany every bottle.
DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED is an excellent emmenagogue.
Dr. Eberle, a very celebrated medical writer, and author of a work on
medicine which is very popular with the profession, says that he has
used the "Extract of Smart-weed" in twenty cases of amenorrhea
(suppressed menstruation), and affirms "with no other remedy or mode of
treatment have I been so successful as with this." Full directions
accompany every bottle. It is sold by all druggists.
EXPECTORANTS.
Expectorants are medicines which modify the character of the secretions
of the bronchial tubes, and promote their discharge. Most of the agents
of this class are depressing in their influence and thus interfere with
digestion and healthy nutrition. Their application is very limited,
hence we shall dismiss them without further consideration.
LINIMENTS.
Liniments are medicines designed for external application. The benefits
arising from their use depend upon their derivative power, as well as
upon the anodyne properties which many of them possess, rendering them
efficacious for soothing pain. We cannot mention a more valuable agent
of this class than
DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. As an external application
this preparation subdues inflammation and relieves pain. For all wounds,
bruises, sprains, bee-stings, insect and snake-bites, frost-bites,
chilblains, caked breast, swollen glands, rheumatism, and, in short, for
any and all ailments, whether afflicting man or beast, requiring a
direct external application, either to allay inflammation or soothe
pain, the Extract of Smart-weed cannot be excelled.
NARCOTICS.
A narcotic is a remedy which, in _medicinal_ doses, allays morbid
sensibility, relieves pain, and produces sleep; but which, in overdoses,
produces coma, convulsions, and death. The quantity necessary to produce
these results varies in different individuals. We shall mention a few of
those most frequently employed.
[Illustration: Fig. 134.
Henbane.]
HENBANE (_Hyoscyamus Niger_). The leaves and seeds are used. Henbane, in
large doses, is a powerful narcotic and dangerously poisonous. In
medicinal doses, it is anodyne and antispasmodic; it allays pain,
induces sleep, and arrests spasms. _Dose_--Of the fluid extract, five to
ten drops; of the solid extract, from one-half to one grain; of the
concentrated principle, Hyoscyamin, from one-twelfth to one-fourth of a
grain.
INDIAN HEMP (_Cannabis Indica_). An East Indian plant. _Dose_--Of the
extract, from one-fourth to one-half grain, of the tincture, from three
to eight drops; of the fluid extract, from two to five drops. The plant
known as Indian Hemp, growing in this country, possesses very different
qualities.
[Illustration: Fig. 135.
Stramonium. ]
STRAMONIUM (_Datura Stramonium_). Stramonium, also known as Thorn-apple,
in large doses is a powerful narcotic poison. In medicinal doses it acts
as an anodyne and antispasmodic
_Dose_--Of extract of the leaves, from one-half to one grain; of the
fluid extract, from three to six drops.
NERVINES.
These are medicines which act on the nervous system, soothing excitement
and quieting the condition known as "nervousness."
HOPS (_Humulus Lupulus_). _Dose_--Of infusion, one to three ounces; of
the fluid extract, one-fourth to one-half teaspoonful of the
concentrated principle, Humulin, two to three grains.
[Illustration: Fig. 136.
Scull-cap. ]
SCULL-CAP. (_Scutellaria Lateriolia_). The herb is used. It is also
known as Mad-dog Weed. This is a valuable remedy. _Dose_--Of infusion,
one to two ounces, of the fluid extract, ten to twenty drops; of the
concentrated principle, _Scutellarin_, one to two grains.
LADY'S SLIPPER (_Cypripedium Pubescens_). The root is used. _Dose_--Of
the infusion, one-half to one-ounce; of THE fluid extract, one-fourth to
one-half teaspoonful; of the concentrated principle, Cypripedin, one to
two grains.
PULSATILLA (_Pulsatilla Nigricans)._ We employ the German tincture,
prepared from the green herb. In many of the distressing nervous
complications to which both males and females are subject in certain
diseases of the generative organs, we have found it very effectual. The
dose is from two to eight drops.
DR. PIERCE'S FAVORITE PRESCRIPTION. This is a tonic nervine of
unsurpassed efficacy, combined in such a manner, that, while it quiets
nervous irritation, it strengthens the enfeebled nervous system,
restoring it to healthful vigor. In all diseases involving the female
reproductive organs, with which there is usually associated an irritable
condition of the nervous system, it is unsurpassed as a remedy. It is
also a uterine and general tonic of great excellence. It is sold by all
druggists.
SEDATIVES.
Sedatives are a class of agents which control excitation of the
circulation, and diminish irritability of the nervous system.
ACONITE (_Aconitum Napellus_), The parts used are the root and leaves.
Aconite slows the pulse, diminishes arterial tension, and lowers the
temperature of the body in fevers. It is an effectual remedy in acute
inflammation of the tonsils and throat, in acute bronchitis, in
inflammation of the lungs, and pleurisy, in the hot stage of
intermittent and remittent fevers, in the eruptive fevers, in fever
arising from a cold, and in some forms of neuralgia. Acute suppression
of the menses from a cold, may be relieved by the tincture of aconite in
drop doses every hour. _Dose_--Of the tincture of the root, from
one-half of a drop to two drops, in a spoonful of water, in acute fevers
and inflammations, from one-half drop to one drop should be administered
every half hour or hour, according to the severity of the symptoms.
PEACH TREE (_Amygdalus Persica_). Peach tree leaves and bark are
slightly sedative, but the chief use which we have found for these
articles is to control nausea and vomiting arising from irritability of
the stomach. It also possesses mild, tonic properties. _Dose_--Of
infusion at the bark of the small twigs or of the leaves, from two to
six teaspoonfuls.
[Illustration: Fig. 137.
American Hellebore. ]
AMERICAN HELLEBORE (_Veratrum Viride_) is also known as White Hellebore,
Indian Poke, or Swamp Hellebore. The root is the part used. It is a most
valuable agent with which to control the frequent, strong, bounding
pulse common to many febrile and inflammatory diseases. When the pulse
is hard, incompressible, and bounding, this remedy is more effectual
than aconite. _Dose_--Of the tincture and fluid extract, from one to two
drops, repeated every half hour to two hours, according to the severity
of the symptoms. This remedy should be given in very small doses,
frequently repeated, if we would secure its best effects. Our favorite
mode of administering both veratrum and aconite is to add ten drops of
the tincture to ten or fifteen teaspoonfuls of water, of which one
teaspoonful may be administered every hour.
YELLOW JESSAMINE (_Gelseminum Sempervirens_). The root is the part used.
Through its controlling effect over the sympathetic nervous system, this
agent exerts a marked influence in controlling morbid excitability of
the circulatory organs. It allays irritation, and determination of blood
to the brain, indicated by flushed face, contracted pupils,
irritability, and restlessness, a frequent condition in diseases
incident to childhood. Its concentrated principle, Gelsemin, is an
efficient remedy in bloody-flux or dysentery. It should be administered
in very small doses to secure the best results. Only one-sixteenth to
one-eighth of a grain is required, repeated every two hours. It should
be triturated with sugar of milk or with common white sugar, in the
proportion of one grain to ten of sugar. _Dose_--Of tincture, from five
to fifteen drops; of fluid extract, three to six drops; of Gelsemin, as
a sedative, one-fourth to one-half grain.
STIMULANTS.
Stimulants are medicines which have the power of increasing the vital
activity of the body. Some have a very transient action, while others
are more permanent in effect.
CAYENNE PEPPER (_Capsicum Annuum_). Cayenne Pepper is a powerful
stimulant. _Dose_--Of the powder, from one to six grains, administered
in milk; of the tincture, from five to ten drops, largely diluted in
milk or water.
BLACK PEPPER (_Piper Nigrum_). Black Pepper is a warm, carminative
stimulant. _Dose_--From five to fifteen grains; of the fluid extract,
from ten to fifteen drops.
[Illustration: Fig. 138.
Prickly-ash. ]
PRICKLY-ASH (_Xanthoxylum Fraxineum)._ Prickly-ash bark is a stimulant
and tonic. The parts used are the bark and leaves. _Dose_--Of the fluid
extract, from five to fifteen drops; of the tincture, ten to twenty
drops; of the active principle, Xanthoxylin, one to two grains.
ALCOHOL is a powerful stimulant. It is never used in its pure state in
medicine, but when diluted forms a useful remedy in many diseases. It is
generally employed in the form of whiskey, gin, rum, brandy, and wine.
AMMONIA is an excellent stimulant. _Dose_--Of the carbonate, from three
to five grains; of the sesquicarbonate, from five to ten grains; this is
the same as the carbonate, which has been exposed to the air and slacked
(powdered hartshorn); of the aromatic spirit, from one-half to one
teaspoonful. The Aqua Ammonia and Liquor Ammonia are of such variable
strength that they are seldom employed internally, but may be applied
externally and taken by inhalation.
DR. PIERCE'S COMPOUND EXTRACT OF SMART-WEED. This quickly diffusible
stimulant and genial anodyne we have spoken of under the head of
Anodynes. But its medicinal properties equally entitle it to a place and
mention under the class of stimulants. As a stimulant it spurs the
nervous system and arouses the circulatory forces. Congestion of the
lungs, liver, bowels, or uterus, embarrasses the functions of these
organs. Frequently this congestive difficulty may be entirely obviated,
and the circulation of the blood restored to the surface of the body, by
the administration of a few doses of this pleasant remedy. Thus it often
acts like magic in giving relief, promoting the circulation, and
restoring the organs to their accustomed functional activity. Full
directions accompany every bottle.
TONICS.
Tonics are remedies which moderately exalt the energies of all parts of
the body, without causing any deviation of healthy function. While
stimulants are transient in their influence, tonics are comparatively
permanent.
[Illustration: Fig. 139.
White Poplar. ]
WHITE POPLAR (_Liriodendron Tulipfera_), called also American Poplar, or
White Wood. The part used is the inner bark. This is a mild but valuable
tonic for domestic use. _Dose_--Of the infusion, from one-half to one
ounce; of tincture, from one to two teaspoonfuls.
CHAMOMILE (_Anthemis Nobilis_). The part used is the flowers. This is a
mild, unirritating tonic. _Dose_--Of infusion (one-fourth ounce of
flowers to a pint of water) one-half to one ounce.
GENTIAN (_Gentiana Lutead_). The root is the part used. This is a
favorite domestic tonic in many localities. _Dose_--Of powdered root,
five to ten grains; of the tincture, ten to twenty drops; of the fluid
extract, five to ten drops, four or five times a day.
NUX VOMICA (_Strychnos Nux Vomica_), or Dog Button. This is a powerful
tonic. It increases innervation and is particularly valuable in cases
marked by feeble circulation and general impairment of muscular power.
In overdoses it is poisonous, and hence must be employed with much
caution. _Dose_--Of the tincture, three to five drops; of the fluid
extract, ONE TO THREE DROPS.
WILLOW (_Salix Alba_). Willow is a tonic and an astringent. _Dose_--Of
the decoction, from one to two fluid ounces; of the concentrated
principle, Salicin, from two to four grains.
[Illustration: Fig. 140.
Dogwood.]
DOGWOOD (_Cornus Florida_). Dogwood, also known Boxwood, is tonic,
astringent, and slightly stimulant. _Dose_--Of the solid extract, from
three to five grains; of the infusion, from one to two ounces; of the
fluid extract, from ten to twenty drops.
WAFER-ASH (_Ptelea Trifoliata_), also called Swamp Dogwood. The bark is
used. This is a pure, unirritating tonic. _Dose_--Of tincture, one-half
to one teaspoonful; of fluid extract ten to twenty drops; of the
infusion, one to two fluid ounces.
[Illustration: Fig. 141.
Golden Seal. ]
GOLDEN SEAL (_Hydrastis Canadensis_). Golden Seal is a powerful and most
valuable tonic. It is a valuable local remedy when used as a general
injection in leucorrhea. _Dose_--Of the powder, from ten to thirty
grains; of the tincture, from one-half to one fluid drachm; of the fluid
extract, from ten to twenty drops; of the concentrated principle,
Hydrastin, from two to three grains; of the muriate of hydrastia, from
one-half to one grain.
[Illustration: Fig. 142.
American Colombo. ]
AMERICAN COLOMBO (_Frasera Carolinensis_). American Colombo is a simple
tonic. _Dose_--Of the powdered root, from ten to fifteen grains; of the
infusion one-half to one fluid ounce, three or four times a day; of the
active principle, Fraserin, one to three grains.
[Illustration: Fig. 143.
Gold Thread. ]
GOLD THREAD (_Coptis Trifolia_). Gold Thread is a pure and powerful,
bitter tonic, and is also efficacious as a wash for sore mouth or as a
gargle. _Dose_--Of the decoction, from two to six fluid drachms; of the
tincture, from one-half to two teaspoonfuls; of fluid extract, from ten
to twenty drops.
IRON (_Ferrum_). Different preparations of iron are frequently
prescribed by physicians. They are particularly valuable in anæmic
conditions of the system. The following are a few of the preparations of
this metal most generally used:
IRON BY HYDROGEN (_Ferri Redactum_). _Dose_--One to two grains.
CARBONATE OF IRON (_Ferri Carbonas_). _Dose_--One to three grains.
CITRATE OF IRON (_Ferri Citras_). _Dose_--One to three grains.
PYROPHOSPHATE OF IRON (_Ferri Pyrophosphas_). _Dose_--One to three
grains.
TINCTURE OF MURIATE OF IRON (_Tinctura Ferri Chloridi)._ _Dose_--Three
to twenty drops.
DR. PIERCE'S FAVORITE PRESCRIPTION. The Favorite Prescription, in
addition to those properties already described, likewise combines tonic
properties. In consequence of the never ceasing activities of the bodily
organs, the system requires support, something to permanently exalt its
actions. In all cases of debility, the Favorite Prescription
tranquilizes the nerves, tones up the organs and increases their vigor,
and strengthens the system. Directions for use accompany every bottle.
DR. PIERCE'S GOLDEN MEDICAL DISCOVERY. In addition to the alterative
properties combined in this compound, it possesses important tonic
qualities. While the Favorite Prescription exerts a tonic influence upon
the digestive and nutritive functions, the Golden Medical Discovery acts
upon the excretory glands. Besides, it tends to retard unusual waste and
expenditure. This latter remedy tones, sustains, and, at the same time
regulates the functions. While increasing the discharge of noxious
elements accumulated in the system, it promptly arrests the wastes
arising from debility, and the unusual breaking down of the cells
incident to quick decline. It stimulates the liver to secrete, changes
the sallow complexion, and transforms the listless invalid into a
vigorous and healthy being. At the same time, it checks the rapid
disorganization of the tissues and their putrescent change, while it
sustains the vital processes. It is, therefore, and indispensable remedy
in the treatment of many diseases.
* * * * *
CHAPTER III.
BATHS AND MOTION AS REMEDIAL AGENTS.
The remedial effects of bathing are generally underrated. This want of
appreciation is more often due to the improper manner in which it is
performed than to an insufficiency of curative virtues. The term
_bathing_ not only implies a cleaning of the body or certain portions of
it, but also the application of water in such a manner as to influence
the nervous system, and regulate the functions of the secretory organs.
Cleanliness, while it preserves health and promotes recovery, has
reference only to the hygienic influences of water and not to its
curative effects. There are several kinds of baths, the names of which
indicate their character, manner of application, or the part of the body
to which they are applied. Among others, we have Cold, Cool, Temperate,
Tepid, Warm, Hot, Hot Air, Russian, Turkish, Vapor, Electric, Sea,
Shower, Sponge, Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid,
Iodine, and Sulphur Baths. Temperature influences the properties of any
bath; thus the sponge, sitz, and alkaline baths may be employed warm or
cold, according to the effect desired.
THE COLD BATH, used at a temperature of from 40° to 60° Fahr., is
powerfully sedative, and is employed for its tonic effects. If the vital
powers are low, or the individual remains in it too long (two or three
minutes should be the limit), the reaction is slow and its effects
injurious. While it is highly invigorating to robust persons, those who
have a low standard of vitality should be cautions in its employment. A
local bath may be followed by beneficial results, when a general bath
would be inadmissible. For these reasons we advise the general use of
the
COOL BATH, at a temperature of from 60° to 75° Fahr. If, in any
instance, the _reaction_ is _slow_, we recommend the
TEMPERATE BATH, at a temperature of from 75° to 80° Fahr. The time of
remaining in the bath should be regulated by the strength of the
invalid. As a rule, it should not exceed three _minutes_, and the colder
the water the less time should the patient be immersed. Immediately
after emerging from any bath, the body should be thoroughly dried and
rubbed with a moderately coarse towel until a glow is experienced and
reaction is fully established. The attempt to toughen children by
exposing them to low temperatures of either air or water, cannot be too
emphatically condemned. This caution, however, does not apply to the
employment of moderately cool water for ablutions. The cold or cool bath
should be taken in the early part of the day, but _never during
digestion_. Whenever reaction does not follow bathing, artificial means
must be resorted to, as stimulating drinks, dry warmth, or exercise.
THE TEPID BATH, the temperature of which is from 85° to 92° Fahr., is
generally used for cleansing the body. It is prescribed in fevers and
inflammatory affections for its cooling effects. It is usually medicated
with some acid or alkali. The latter unites with the oily secretion of
the skin and forms a soapy compound easily removed by the water. The
temperature should be regulated according to the vitality of the
patient; and the bath may be repeated two or three times a day. It
removes superfluous heat, and keeps the skin in a condition favorable
for excretion.
THE WARM BATH, at a temperature varying from 92° to 98° Fahr., is always
agreeable and refreshing. It equalizes the circulation and softens the
skin, by removing all impurities. It moderates pain and soothes the
whole system. It does not weaken or debilitate the person, but is in
every way beneficial. It is an efficient, remedial agent in many chronic
diseases, convulsions, spasmodic affections of the bowels, rupture,
rheumatism, and derangement of the urino-genital organs. It should be
employed immediately before going to bed unless urgent symptoms demand
it at other times. It may be medicated or not, as circumstances require,
but should always be taken in a warm room.
THE HOT BATH at a temperature of from 98° to 110° Fahr. is a powerful
stimulant. It excites the nerves, and through them the entire system. It
causes a sense of heat and a constriction of the secretory organs; but
perspiration, languor, and torpor soon follow. In the sudden
retrocession of cutaneous diseases, it restores the eruptions to the
surface and gives speedy relief. The hot bath may be applied locally
when circumstances require.
THE RUSSIAN BATH consists in the application of hot vapor, at a
temperature varying from 112° to 200° Fahr. The patient is first
subjected to a moderately warm temperature, which is gradually increased
as he becomes inured to it, the head being surrounded with cloths wet in
cold water. Upon emerging from it, the bather is plunged into cold water
or receives a cool, shower bath. In rheumatic and cutaneous diseases,
chronic inflammations, and nervous affections, the Russian bath is an
effective remedy.
THE TURKISH BATH is a, dry, hot-air bath. The bather passes from one
apartment to another, each one being of a higher temperature than the
preceding. He undergoes a thorough shampooing, and, although the person
may be scrupulously clean, he will be astonished at the amount of effete
matter removed by this process. The bather then returns through the
various apartments, and, upon emerging from that of the lowest
temperature, he experiences a delightful sensation of vigor and
elasticity.
As a hygienic agent, the hot-air bath has been' constantly growing in
favor. Its value is now recognized by all physicians throughout the
world. The judicious use of the Turkish bath serves to secure perfect
equalization of the circulation. Glandular activity is increased,
elasticity and power given to the muscles, and a permanent, stimulating
and tonic influence imparted to the system, a condition at once
conducive to the enjoyment and prolongation of life. Dr. Erasmus Wilson,
of England, says, in a paper read before the London Medical Association:
"The inhabitant of a large city would live as healthy, immured within
city walls, as amid the fields and meadows of the country. His bath
would be to him in the place of a country house or horse--it would give
him air, exercise, freshness, health, and life."
"The bath that cleanses the inward as well as the outward man; that is
applicable to every age; that is adapted to make health healthier, and
alleviate disease, whatever its stage or severity, deserves to be
adopted as a national institution, and merits the advocacy of all
medical men; of those whose especial duty it is to teach how health may
be preserved, and how disease may be averted."
The hot, _dry_ atmosphere of the Turkish bath promotes rapid evaporation
from the surface of the body, and it is well known that rapid
evaporation from the surface is a cooling process. A person's finger may
be frozen in one minute's time, by throwing upon it a constant, fine
spray of rhigolene or sulphuric ether. The rapid evaporation of the
light fluid congeals the liquids of the tissues and a film of ice is
rapidly formed upon the part. In a less intense degree the same cooling
process is carried on over the whole surface of a person, when in the
hot room, or _sudatorium_, of the Turkish bath. The evaporation from the
surface is so rapid that one can hardly appreciate the profuseness of
the perspiration going on. The evaporation from the surface so rapidly
carries off the heat from the body that one finds himself able, with
little or no inconvenience, to remain in a room heated to from 180° to
200° or even 220° Fahr.
As a hygienic measure to be regularly or occasionally employed by
persons in fair health, the Turkish or hot dry-air bath is far superior
to the Russian or vapor-bath. (1.) It produces more profuse
perspiration, and is therefore more depurating, or cleansing, in its
effects. (2.) It does not relax the system, but rather produces a tonic
effect, and fewer precautions are, therefore, necessary to guard against
taking cold after employing it. (3.) The Turkish bath can be better
ventilated than the Russian. While the air is heated to a high
temperature, it can be readily kept pure by constant changes. In the
Turkish hot-rooms, or _sudatorium_, of the Invalids' Hotel and Surgical
Institute, provision is made for bringing underneath the floors a
current of fresh air from without. This column of fresh air is carried
under the centre of each room where it escapes from the conductor, is
warmed, and rises into the room, from which extraction of air is
constantly going on through registers opening into tubes, communicating
with large ventilated shafts which are kept hot, summer and winter, to
insure a draught through them. In this manner, thorough ventilation of
our Turkish hot-rooms is insured.
The Turkish bath not only combines a most agreeable luxury with a
decidedly invigorating and tonic influence, but also, by its stimulating
power, induces proper glandular and cellular activity, producing a
healthy condition.
Sallowness, tan, and freckles, the result of local or general increase
of the pigment granules of the skin, soon disappear under the
stimulating influence and regular use of the Turkish bath, which causes
rapid development of new and transparent cells. The colored granules are
thus gradually replaced and the skin assumes a beautiful clearness and
purity of appearance, which transcends immeasurably the unhealthy hue
that follows the frequent employment of the various cosmetics.
The value of an agent which thus improves the general health, insures
immunity from coughs, colds, and other diseases, and at the same time
produces a healthy and permanent beauty of complexion, is at once
apparent. The purity of person, perfect circulation, increase of healthy
nutrition and glandular activity produced by the Turkish bath, serve to
make it of the most lasting utility.
The eminent Dr. Madden has said, and his experience is confirmed by
every regular patron of the bath, that, "Wherever the Turkish bath was a
national institution the hair of the women was peculiarly luxurious and
beautiful. I can vouch for it that the use of the bath rendered the
complexion more delicate and brilliant; that the eyes became clearer and
brighter; all the personal charms were enhanced. I can recommend no
hygienic measure more beneficial or effectual in preserving the health
and an attractive personal appearance."
Pimples, blotches, eruptions, and other disfigurations of the skin are
removed by the frequent use of the Turkish bath, leaving the integument
smooth and soft.
[Illustration: Fig. 144.
First Hot-room of the Turkish Bath. ]
HOW THE TURKISH BATH IS ADMINISTERED AT THE INVALID'S HOTEL AND SURGICAL
INSTITUTE. The hot-rooms, of which there are two, are exactly similar in
every respect except as regards temperature. The first room has a
temperature of from 110° to 120° Fahr. The bather is supplied by the
attendant every few minutes with copious draughts of cool water.
Gradually the relaxing influence of the elevated temperature manifests
itself. The capillaries slowly dilate, the veins enlarge under its
gentle stimulus, and small points of perspiration appear upon the
surface, which assumes a slight, rosy blush. A delightful calm, a
feeling of perfect rest and luxurious ease is imparted to the senses.
From this room, after an appropriate interval, the bather enters the
second room, in which the atmosphere is higher by from 20° to 30°, and
it may be made still higher, its regulation requiring but an instant.
[Illustration: Fig. 145.
One of the Shampooing rooms.]
A thorough sweating occurs while the subject remains in these rooms,
during a period of from ten to forty minutes. The secretions of the
skin, at first impure and loaded with the _débris_ of dead cells and
extraneous matter, gradually become purer, and clearer, until, finally,
all trace of color disappears and the pearly drops of sweat come full
and free. Soon the attendant appears and leads the way to the
shampooing-room, where, lying upon a warm marble slab, _massage_ is
applied most thoroughly to every portion of the body.
By the _massage_, shampooing, or rubbing, the superficial veins are
thoroughly emptied of their contents, the muscles are given elasticity
and tone, and glandular activity is promoted. Innumerable dead
epithelial cells, together with other impurities, are rolled off in
flakes under the skillful manipulation of the attendant.
After a thorough shampooing, the shower bath is applied, to secure a
contraction of the capillaries and a diminution of the perspiration.
THE SPIRIT VAPOR-BATH is very effective when employed in the earlier
stages of acute, febrile, inflammatory, and painful diseases. In many
forms of chronic diseases the administration of a spirit vapor-bath once
in from three to fifteen days, is a valuable adjunct to the treatment of
these affections. It exerts an exceedingly beneficial influence upon the
entire system, and, when habitually employed, may ward off disease.
The body should be moistened with an alkaline solution before the
administration of a spirit vapor-bath. After the perspiration which it
occasions has subsided, which will usually be in from three to four
hours, sponge the body with a mixture of the following ingredients:
water, three gills; alcohol, one gill; salt, one teaspoonful. By this
method the patient experiences none of the unpleasant effects which
generally follow the employment of diaphoretics. Various kinds of
apparatus have been devised to facilitate the application of the spirit
vapor-baths. Most of them are cumbersome and expensive, and,
consequently, are seldom used except in hospitals or sanitariums.
The following method described by Dr. J. King, may be advantageously
employed.
"The patient is undressed, ready for getting into bed, having removed
the clothing worn through the day and put on a night shirt or other
clothing to be worn while sweating, and during the night, if the bath is
taken at bed-time. He is then seated on a high Windsor or
wooden-bottomed chair, or instead thereof, a bench or board may be
placed on a common open-bottomed chair, care being taken that the bottom
is so covered that the flame will not burn him. After seating himself, a
large coverlet or blanket is thrown around him from behind, covering the
back of his head and body, as well as the chair, and another must be
passed around him in front, which last is to be pinned at the neck,
loosely, so that he can raise it and cover his face, or remove it down
from the face from time to time as occasion demands during the operation
of the bath. The blankets must reach down to the floor, and cover each
other at the side, so as to retain the vapor. This having been done, a
saucer or tin vessel, into which is put one or two tablespoonfuls of
whiskey, brandy, alcohol, or any liquor that will burn, is then placed
upon the floor, directly under the centre of the bottom of the chair,
raising a part of the blanket from behind to place it there; then light
a piece of paper, apply the flame to the liquor, and as soon as it
kindles let down the part of the blanket which has been raised, and
allow the liquor to burn until it is consumed, watching it from time to
time to see that the blankets are not burned. As soon as consumed, put
more liquor into the saucer, about as much as before, and again set it
on fire, being careful to put no liquor into the saucer while the flame
exists, as there would be danger of setting fire to the blanket, and
producing injury to the patient. Continue this until the patient
perspires freely, which, in a majority of cases, will be in five or ten
minutes."
"If, during the operation the patient feels faint or thirsty, cold water
must be sprinkled or dashed in his face, or he may drink one or two
swallows of it,--and in some cases the head may be bathed with cold
water. As soon as free perspiration is produced, wrap the blankets
around him, place him in bed, and cover him up warm, giving him about a
pint of either some good store tea, ginger, or some diaphoretic herb tea
to drink, as warm as he can take it. After two or three hours, remove
the covering, piece by piece, at intervals of twenty or twenty-five
minutes each, that he may gradually cease perspiring."
The above method may be improved by using an ordinary hoop skirt, ten to
twelve inches below the bottom of which is suspended a larger and
stronger hoop. The upper and smaller hoops should rest upon the
patient's shoulders. A woolen blanket, large enough to reach and rest
upon the floor, and envelop the whole person, is thrown over the hoops.
Unless the bath is employed to diminish the quantity of fluids in the
body (as in dropsy), the patient may drink some simple, diaphoretic
infusion, to hasten or facilitate perspiration. When he perspires
freely, small quantities of cold water may be frequently given. "There
is little or no danger of taking cold after this process, if ordinary
precaution is observed, and it is easy, agreeable, safe, and effectual."
"Occasionally we will meet with patients, upon whom it is almost
impossible to produce the slightest moisture, much less perspiration.
The skin of such persons is generally dry and harsh, communicating an
unpleasant sensation to the touch. In most instances the skin may be
restored to its normal condition, by adopting the following course: 1st.
Anoint the whole surface of the body and limbs with olive oil every
night upon retiring to bed. 2nd. Every morning wash the whole surface
with a warm, weak, alkaline solution, employing considerable friction
while drying. 3rd. Every two weeks administer a spirit vapor-bath. A
perseverance in this course for a few months will accomplish the desired
result."
Frequent reference to spirit vapor-baths will be made by the author of
this work, in speaking of those diseases in which its employment will
prove beneficial.
SEA BATHING is an excellent, remedial agent in chronic disorders,
particularly in those of an atonic character, such as nervous
prostration, dyspepsia, and general debility.
Much of the benefit attributed to this mode of bathing is undoubtedly
due to other influences, such as pure air, exercise, change of scenery,
diet, and associations which surround the patient during his sojourn at
the sea-shore.
At first, the duration of a sea-bath should not exceed three or five
minutes, but it may be gradually prolonged to fifteen or twenty minutes.
If the patient is very feeble, one or two baths a week are sufficient,
and the most robust person should never take more than one a day. They
should always be taken in the earlier portion of the day, before
breakfast if possible, and _never during digestion_.
Before entering this bath, a moderate degree of exercise should always
be taken, enough to arouse the vital energies, but not to produce
fatigue. Suitably dressed, the patient plunges into the water, in which
he remains during the prescribed time. Immediately after emerging from
the bath, the patient should be thoroughly dried and dressed and then
moderate exercise should be taken to induce reaction. If the reaction is
slow, a mild stimulant may be taken and the duration of the bath must be
diminished the next time. When sea-bathing is beneficial improvement is
soon manifested. The blood becomes richer, the whole system is
strengthened and the functions are performed with more regularity. To
the rich, sea-bathing is a luxury, but it is a remedy beyond the reach
of the poorer classes unless they live near the sea-shore.
THE SHOWER BATH produces a shock to the nervous system by suddenly
coming in contact with the skin. Numerous streams of cold water fall
upon the neck, shoulders, and body of the patient who stands beneath the
hose or reservoir. When the patient is plethoric, feeble, or nervous, or
when some internal organ is diseased, the cold, shower bath should _not_
be employed. In simple debility unaccompanied by inflammation or
symptoms of internal congestion, its use proves advantageous. By
moderating the force of the shower, and substituting tepid water, the
most delicate persons can endure it and profit thereby. The usual means
for inducing a good reaction, friction, and exercise, should be
employed.
THE DOUCHE BATH consists of a stream of water, dashed or thrown upon the
patient from a moderate height or distance, with considerable force. The
size, temperature, and force of the stream may be modified to suit the
exigencies of the case. It is locally employed as a remedy for sprains,
weak or stiff joints, old swellings, etc. The cold, douche bath is more
powerful than the shower bath and should be given with the same
precautions which govern the application of the latter.
THE SPONGE BATH admits of extensive employment in both acute and chronic
diseases, and its simplicity renders it of untold value. It consists in
a general or local application of water (medicated or not) at any
desired temperature. The quantity may be great or small to suit the
requirements of the case. If it is applied in acute diseases at a
temperature agreeable to the patient, it is exceedingly grateful and may
be repeated as often as necessary. It may be rendered alkaline by the
addition of some compound of soda, in the proportion of a teaspoonful to
a quart of water. A portion of the body may be bathed at a time, and
quickly dried, thus avoiding any exposure to cold. It removes excessive
animal heat, relaxes the capillaries, equalizes the circulation, and
produces comfort, tranquility, and sleep.
Nothing is more conducive to the health and comfort of laboring men in
summer than a daily bath, and it is a matter of regret that there are so
few conveniences for the purpose in most homes, especially those in the
country. Farmers in particular need bathing facilities, and yet in most
cases they are almost entirely without them. For their benefit we will
describe a device which we can recommend to all who want a cheap,
convenient, and easily managed apparatus for sponge bathing in the
bed-room.
The articles required are a piece of rubber-cloth a yard and a quarter
square, four slats, two inches wide and three feet long, notched at the
ends so as to lock together in the form of a square, and a large sponge.
The slats are placed upon the floor and the rubber cloth is spread over
them (there is no need of fastening it to the slats), forming a shallow
square vessel a yard wide. In this the bather stands and applies the
water with a sponge from a basin or bowl on a stand placed conveniently
near. There need be no danger of wetting the carpet, or spoiling the
furniture.
When the bath is finished, gather three corners of the rubber cloth in
the left hand, take the fourth corner in the right in such a way as to
form a spout when lifted or held over the slop-jar or bucket. The water
may be poured out in a moment, when the cloth should be spread over the
back of a chair to dry, and the slats unlocked and set away in a closet.
THE FOOT BATH is frequently employed, as a means of causing diaphoresis,
in colds, attacks of acute diseases, and also to draw the blood from the
head or some internal organ. It is a powerful auxiliary in the treatment
of those chronic diseases in which inflammation, congestion, and a
feeble circulation are prominent symptoms. The water should be as hot as
it can be borne and the temperature kept up by additions of hot water.
It may be made stimulating by the addition of salt, mustard, ginger, or
cayenne pepper.
THE SITZ BATH. A tub is so arranged that the patient can sit down in it
while bathing. In this manner the lower part of the abdomen, hips, and
upper part of the thighs, are immersed in whatever fluid the bath is
composed of. It is applicable in diseases of the pelvic organs, and may
be hot, warm, cool, cold, or medicated, according to the effect desired.
The bath tub should be large enough to permit a thorough rubbing and
kneading of the diseased parts, and the patient may remain in it from
ten to thirty minutes. The clothing may be wholly or partially removed,
as agreeable to the individual. A _warm_, sitz bath is an effective,
remedial adjunct in menstrual suppression and in painful menstruation,
gravel, spasmodic and acute inflammatory affections generally. The
_cold_, sitz bath is used as a tonic in cases of relaxed tissues of the
pelvis, in debility of the urino-genital organs, in piles, prolapsus of
the rectum, and in constipation.
THE HEAD BATH. A shallow basin contains the fluid for the bath; and the
patient, assuming a recumbent position, immerses a portion of the head,
generally the back part. The temperature may be warm, cool, or cold, as
desired.
MEDICATED BATHS are infusions of vegetable or other substances in water.
They are sometimes applied with the sponge, though generally the patient
is immersed. The temperature at which they are usually employed is that
of the tepid bath. The nature and strength of the medication depends
upon the character of the disease for which it is employed.
THE ALKALINE BATH is prepared by dissolving half a pound of carbonate of
soda in sixty gallons of water. It is useful in those diseases in which
the fluids of the body are abnormally acid, as in rheumatism.
THE ACID BATH is prepared by adding two pounds of muriatic or
hydrochloric acid to sixty gallons of water. A much smaller quantity of
the acid is sometimes used, and in some instances vinegar is
substituted.
_Scott's Acid Bath_ is composed of nitro-muriatic acid (aqua regia) and
water. It should be prepared in a wooden tub, and a sufficient quantity
of acid used to give the water a sour taste. It is extensively used in
India as a remedy for disorders of the liver.
THE IODINE BATH is composed of the following ingredients: tincture of
iodine, two drachms; iodide of potassium, four drachms; water, forty
gallons. It should be prepared in a wooden tub. It reddens the skin. For
children, a much weaker solution must be employed. Its use is generally
restricted to scrofulous and tubercular affections.
THE SULPHUR BATH is prepared by dissolving eight ounces of sulphuret of
potassium and two ounces of dilute sulphuric acid in sixty gallons of
water. The acid may be omitted.
A SULPHUR VAPOR-BATH is often employed in cities where the necessary
apparatus can be procured. It may be improvised by placing sulphur on a
shovel over hot coals. The patient should be prepared as in the spirit
vapor-bath, and burning sulphur substituted for the liquor. The patient
is then enveloped in the fumes of sulphurous oxide. Heating a mixture of
sulphur and sulphuric acid, produces the same result. If the gas is
inhaled in large quantities it causes irritation of the respiratory
passages, and suffocation. It is therefore necessary that the coverings
should be securely fastened at the neck, and that the room be one which
can be quickly filled with pure air This bath is used in cutaneous,
rheumatic, and syphilitic disorders.
FOMENTATIONS consist of the general or local application of woolen
cloths wrung out of hot water. They should not be so light as to be
ineffectual, nor so heavy as to be burdensome. They should not be wet
enough to drip, nor applied so as to expose the body to the surrounding
air. A fresh cloth should be ready for application before the first one
is removed, and the change quickly effected. Fomentations are effectual
in relieving congestion and inflammation.
THE WET SHEET PACK. As this remedial appliance will be frequently
recommended in the pages following, its mode of application is here
described. Take a pail half filled with cold water, gather together one
end of a common cotton sheet, and immerse it, allowing it to remain
while preparing the bed, which may be done as follows: remove all the
bed-clothes except a coverlet and the pillows, then spread upon it, in
the following order, two ordinary comforters, one woolen blanket, one
woolen sheet, (or two woolen sheets if a woolen blanket is not at hand);
then wring out one-half or two-thirds of the water from the wet sheet,
spread it smoothly upon the blanket, and the patient being undressed,
places himself on the sheet, with his arms extended, while an assistant
wraps him closely and tightly with it, as quickly as possible. Each arm
may be thus covered by the wet sheet, or may lie outside of it, and be
covered by wet towels, prepared in the same manner as the sheet. Then
quickly and tightly cover with the blankets and comforters, tucking
snugly from head to foot. The head should also be covered with a wet
towel, and a bottle of warm water placed to the feet, or near enough to
keep them warm.
After the first shock of the chill is over, the pack is very pleasant
and refreshing, and the patient should go to sleep, if possible. The
ordinary time for a patient to remain in a pack is about sixty minutes.
Thirty or forty minutes is sufficient, if he is in a feeble condition.
Never wring the sheet out of warm water, for one of its principal
benefits comes from the vigorous reaction induced by its cold
temperature. After remaining in the pack from thirty to sixty minutes,
allow the patient to stand on his feet, if he is able, and have the
whole surface of his body bathed. Rub briskly, and dry with towels, or
by throwing over the body a dry sheet and then rubbing him. The dry
sheet retains the bodily warmth and is more comfortable, but interferes
with the completeness and vigor of the rubbing of the body. Be sure and
establish full reaction, which may be known by the warmth of the
surface. Frequently, when the patient is released from the pack, and is
being bathed, rolls of scales, scurf, and _skin-debris_ come off, thus
giving palpable evidence of the utility of the pack in freeing the
myriads of pores of the skin of effete matter. It is efficient in
fevers, and for breaking up colds, and is a very valuable, remedial
agent in most chronic diseases, assisting in removing causes which
depress the bodily functions.
MOTION IS A REMEDIAL AGENT.
The stability of the planetary system depends upon the converted motion
of its parts. So in the human system, motion is a fundamental principle
which underlies every vital process. Health consists in normal,
functional activity. The human system is the arena of various kinds of
motions, both of fluids and of solids, and life and health depend upon
these physiological movements. There are the movements incident to
_respiration_, the expansion and contraction of the walls of the chest,
bringing the oxygen of the air into contact with the blood as it
circulates through the lungs. Corresponding with the movements of the
chest are the _motions of the abdominal walls_, which promote the
functions of the organs of the abdominal cavity.
There are _motions of the heart and arteries_, which urge the blood out
to the extremities and diffuse it through every part of the system, and
also _motion of the blood in the capillaries_, by which the blood is
circulated through the tissues, that the latter may be built up from its
nutritive constituents. Then there is the _motion of the vital current_
in the veins returning towards the heart, and urged forward by the
muscular and pump-like action of the chest and abdominal walls. The
peristaltic _motions of the stomach and bowels_ urge onward digesting
materials, exposing them successively to different solvents and aiding
the absorption of nutritive matter. No less essential to life and health
are numerous other minute operations or _motions_, on which vital power
in all its manifestations of muscular and nervous energy depends. Many
other _motions_ are consequent upon decay, growth, and repair. Oxygen,
carbonic acid, watery vapors, and other gaseous matter are constantly
being exchanged between the system and atmosphere. Then, the human
system being a complex, chemical laboratory, there are _motions
consequent upon chemical action_, constantly going on within it.
_Muscular motion_, under the direction of the will, is also absolutely
necessary for the maintenance of good health.
Animal heat and muscular and nervous power are dependent upon motions of
the minutest particles composing the body. The body is composed of fluid
and semi-fluid matter, permitting great freedom of motion. Health
requires that there shall be _a constant change of place_, an active
transmission of material to and from vital organs and parts, through the
medium of blood-vessels, as well as outside such vessels; that is,
motion of interstitial fluids.
NATURE'S MODE OF SUSTAINING HEALTH. The act of transforming latent,
non-vital force which exists pent-up in food, as heat is in coal, into
vital energy, requires the simultaneous elimination from the system of a
like amount of worn-out matter. Assimilation of nutritive materials is
impossible, unless a like amount of matter be eliminated from the
system. Muscular and nervous energy are dependent upon activities which
cause waste. Not only is this true in a general way, but it is also true
that the energy produced by the operations of the vital system has a
strict relation to the wasting products--that _full_ energy is only
attained by _perfected_ waste. Use, waste, and power, then, sustain
definite and dependent or corresponding relations, since waste is as
essential to health as is supply.
Without waste, disturbance is at once produced in the system similar to
that resulting from the introduction of foreign matter. These
disturbances constitute disease. The more obvious effects of lack of
waste and elimination are mechanical. The circulation is loaded with
effete and useless matter, the vessels being thereby weakened and
distended, and the circulation retarded. The capillaries become clogged
and vital action is diminished. Local congestions, inflammations,
effusions, morbid growths, and other pathological results follow.
Deranged or suppressed action characterizes, and, indeed, constitutes
all departures from health which we call disease. Suffering indicates
action, but action which is perverted into wrong channels, or action in
one part at the expense of motion in other parts, constituting a
disturbance in the equilibrium of forces, from which the system suffers.
VALUE OR MECHANICAL MOVEMENTS AND MANIPULATIONS FOR THE TREATMENT OF
CHRONIC DISEASES. To correct and restore deranged movements, thereby
producing normal, functional activity of every organ and part of the
system, must therefore be the chief object of the physician. All
remedies, of whatever school or nature, imply motion, and depend for
their efficacy upon their ability to excite motion in some one or more
elements, organs, or parts of the system.
While we do not wish to detract from the real merits of medicine as a
curative agent, yet we must admit that the remedial power of motion,
transmitted either manually or mechanically, is founded upon rational
and physiological principles. All systems of medicine, however much they
may differ superficially, propose, as the chief end to be attained by
the administration of medicine, or by other treatment, that _motions_
identical with physiological activity should be incited or promoted. How
best to accomplish this result, and with least cost to vitality, is an
important consideration. Bearing in mind the conservation of forces,
that energy or power is as indestructible as matter, that it may be
changed into other forms but never lost, it is plain that mechanical
force may be applied to the living system and transformed into vital
energy; that chemical action, animal heat, and magnetism may represent
in the system the mechanical force transmitted to the body. Keeping in
view the transformable nature of force, and the need that our systems
have of auxiliary power in different departments, when normal activity
is impaired by disease, we can readily understand how undoubted,
curative effects result from either the manual or the mechanical
administration of motion.
RUBBING is a process universally employed by physicians of every school
for the relief of a great diversity of distressing symptoms, is
instinctively resorted to by sympathizers and attendants upon the sick,
and constitutes one of the chief duties of the nurse. Uncivilized people
resort to this process as their principal remedy in all forms of
disease.
The difficulty in administering motion as a remedial agent by manual
effort, such as rubbing, kneading, oscillating, flexing, and extending
the limbs, lies in the impossibility of supplying the _amount,
intensity_, and _variety_ of movement required to make it most
effective. The power of the arm and the strength of the operator are
exhausted before the desired effect is produced. Inventive genius has at
last overcome the obstacles to the successful and perfect administration
of motion as a curative agent. We have now a series of machines
propelled by mechanical power, by the use of which we rub, knead,
manipulate, and apply in succession a great variety of movements to all
parts of the body. These machines transmit motion to the body from
inexhaustible sources, never tire, but are ever ready for new, remedial
conquests. The movements administered by their use, _while entirely
under the control of the patient_, are never disagreeable, and are far
more rapid and intense than can possibly be given by the hands. By the
application of short, quick movements of from _twelve to fifteen hundred
vibrations a minute_, deep-seated organs and parts are reached, to which
motion is transmitted and in which vital energy is thereby generated.
The hands have not the power, by kneading, manipulating, or rubbing to
impress the system except in a very mild degree, and deep-seated organs
and parts are scarcely influenced by the comparatively slow movements
thus administered. Among the most important, mechanical inventions
devised for administering motion as a remedial agent, is one which has
received the name of the _manipulator_.
THE MANIPULATOR. With this machine motion can be applied to any organ or
part of the system, and intensity of the application regulated to a
nicety. The rapidity of motion necessary to produce active exhilaration
of any part of the body is easily secured by the use of the manipulator,
but is far beyond the power of the hands. The degree of circulation
given to the fluids, both inside and outside of the vessels, and of
energy imparted to the organs and parts operated upon by the
manipulator, is also unapproachable by the application of manual power.
EFFECTS UPON THE CIRCULATION AND NUTRITION. The influence of motion on
these functions is as follows: The contents of the blood-vessels are
moved onward by the pressure and motion transmitted by the manipulator,
all backward movement of the blood being prevented by the valves of the
veins and by the propelling power of the heart and arteries. Fluids
outside these vessels pass through their walls, to take the place of the
stagnant blood that has been moved onward. Other blood flows into the
part, and thus active and healthy circulation is induced, and nutritive
material, capable of affording vital support is also brought to refresh
the local part.
We have found mechanical movements especially effectual in paralysis,
neuralgia, sleeplessness, and other nervous affections; in derangements
of the liver, constipation, and dyspepsia; in displacements of the
uterus, and congestion, and inflammation of the pelvic organs.
For a complete description of the mechanical movements and the machinery
employed in the treatment of diseases at the Invalids' Hotel and
Surgical Institute, the reader is referred to the appendix to this work.
* * * * *
CHAPTER IV.
HYGIENIC TREATMENT OF THE SICK.
There are two essentials requisite to the successful treatment of the
sick: (1.) Medical skill; (2.) Good nursing. The former is necessary in
order that the condition of the patient be fully understood, and the
proper means be employed to effect his recovery. The latter is
essential, in order that all influences favoring the production and
development of disease may be removed, the tendencies to restoration be
promoted by every possible means, and the directions of the physician be
properly observed.
Success in the treatment of the sick requires good nursing. Without it,
the most skillful physicians fail to effect a cure; with it, the most
unqualified may succeed. If certain hygienic agencies are essential to
the maintenance of health, how much more necessary it is that they be
employed in sickness! If certain conditions cause disease, how great the
necessity is that such conditions be obviated and hygienic ones
substituted!
Notwithstanding the importance of good nursing, in the rural districts
it is frequently difficult to find a professional nurse, or, if one can
be obtained, it is often impossible for the invalid to procure such
services, on account of the expense which must necessarily be incurred.
Hence, this office usually devolves upon some relative who is considered
to be the best qualified for the position; or, as is often the case,
necessity demands that the patient be left to a change of nurses. A
woman is generally selected for this important position. Her soft hand
and soothing voice, her kindly, sympathetic, and provident nature,
together with her scrupulous cleanliness, render her man's equal, if not
his superior, in the capacity of nurse. There are circumstances,
however, in which the services of a man are indispensable; hence the
necessity that all should be qualified to care for the sick.
A nurse should be attentive to the requirements of physician and
patient, for she sustains an intimate relation to both. She should
observe the directions of the physician, and faithfully perform them.
She should note all the symptoms of the patient, and do everything in
her power to promote comfort and recovery. She should anticipate the
wishes, and not cause the patient to ask for everything which is
desired. So far as practicable, let the wishes be gratified. The senses
of the sick often become morbidly acute, and those things which in
health would pass unnoticed, in sickness are so magnified as to occasion
annoyance and vexation. Sick persons are not all alike, and the
peculiarities of each must be studied separately. The nurse must be
_kind_, but _firm_, and not yield to such whims of the patient as may be
detrimental to recovery; neither must she arouse dislike or anger by
opposition, but endeavor to _win_ the patient from all delusions. The
feelings of the patient should never be trifled with, for idealities
become realities.
The nurse should possess an inexhaustible store of patience. Disease
affects the mind of the patient and fills it with strange delusions. The
sick are often querulous, fretful, and unreasonable, and should be
treated with kindness, forbearance, and sympathy. The nurse should
always be cheerful, look on the bright side of every circumstance,
animate them with encouragement, and inspire them with hope. Hope is one
of the best of tonics. It stimulates the flagging, vital energies, and
imparts new life to the weak and exhausted forces. Gloom, sadness, and
despondency depress the vital forces and lead to death. We have seen
patients rapidly sinking, who had given up all hope, and were quietly
awaiting the coming of death, snatched, as it were, from its grasp, and
restored to health, by words of cheer and encouragement.
The nurse should possess _moral principles_, which alone can win the
confidence of the patient. She should have judgment, circumspection,
intelligence, forethought, alacrity, carefulness, and neatness. In a
word she should exercise _common sense_.
We deem it but justice to say a word in behalf of the nurse. She, too,
is a human being, subject to disease, and, unless hygienic conditions be
observed, will soon be stricken low by its presence. She must be
relieved occasionally and get rest, or she cannot long withstand the
combined influence of fatigue and disease. Her office is an arduous one
at best, and the long, weary hours of night-watching should be
compensated by exercise in the open air, as well as by sleep during the
day. Unless this be done, the system will become exhausted, and sleep
will intrude itself upon her at the time when the greatest diligence is
required for the welfare of the patient, when the vital powers are at
their lowest ebb. She should be supplied with plenty of suitable food
during the night, to sustain her and to serve as a safeguard against the
invasion of disease. She should be treated with kindness and respect,
else her disposition may become morose and reflect itself upon the
patient, causing peevishness and despondency.
THE SICK-ROOM should be as comfortable, cheerful, and pleasant, as
circumstances will allow. Let the room be large and airy, and furnished
with a stove, or better still, a fireplace. All articles of clothing and
furniture, not necessary to the comfort of the patient, should be
removed from the room, and in _malignant_ or _contagious_ diseases the
carpets, even, should not be permitted to remain. The surroundings beget
happiness or gloom, in proportion as they are pleasant or disagreeable.
A tidy attendant, a few flowers and books, wonderfully enhance the
cheerfulness of the room. Permit no unnecessary accumulation of bottles,
or any thing that can in any way render the room unpleasant. Medicines,
drink, or nourishment should never be left uncovered in the sick-room,
since they quickly absorb the gaseous emanations from the patient, and
become unfit for the purpose which they were intended to serve. Their
presence gives the room an untidy appearance, suggestive of filth and
slovenliness, and imparts to the patient a feeling of loathing and
disgust for articles of diet.
THE BED should not be of feathers, on account of their undue warmth,
which causes a sensation of languor throughout the system. A husk or
sea-grass mattress, or even a straw bed, covered with a cotton quilt, is
far preferable. The bedding should be changed frequently. It is better
that the bed should be away from the wall, so as to admit of greater
freedom of movement about it.
PURE AIR. The air in the sick-room should be kept as pure as possible.
That which is so necessary in health, is indispensable in sickness. The
importance, therefore, of a perfect and free ventilation of the
sick-room cannot be too thoroughly impressed; and yet to properly secure
this end, may call forth a considerable amount of ingenuity on the part
of the nurse. A window should be open, but the current of air must not
be allowed to blow directly upon the patient. One window may be raised
from the bottom and another lowered from the top. This will permit the
entrance of pure air from without, and the exit of the vitiated air from
within. The patient, if sufficiently covered in bed, is not liable to
take cold from a proper ventilation of the room. Especially is this
true, when the bodily temperature is raised by febrile or inflammatory
affections. The _temperature_ of a room is no indication of the _purity_
of the air. It is a prevalent, but mistaken notion, that when a room is
cold, the air must be pure. Cold air is as readily contaminated with
impurities as warm air, therefore, it is not sufficient that the room be
kept cool, but the air should be frequently changed. During
convalescence, great care is necessary to protect the patient from
taking cold. Air which is admitted into the sick-room should not be
contaminated by passing over foul drains, privies, or other sources of
infection, since, instead of invigorating, it depresses the physical
forces and generates disease.
LIGHT is as necessary to health as is pure air. Banish either for any
continuous period of time, and serious results follow. The strong,
robust man, when deprived of light, soon degenerates into a feeble,
sickly being, and finally dies.
According to the investigations of the Massachusetts Medical Society, it
was found that absence of sunlight, together with moisture, not only
favor the development of tubercular consumption, but act as an exciting
cause. It is well known that persons living in shaded dwellings often
suffer from forms of disease which resist all treatment until proper
admission of light is secured.
The physician to the Emperor of Russia found upon examination that
patients confined in well lighted wards, were four times as liable to
recover as were those in poorly lighted rooms. Children reared away from
the sunlight are apt to be deformed and idiotic, while those partially
deformed have been restored by being admitted to the light.
Patients sometimes wish to have their rooms darkened, because the light
is painful to their weak and sensitive eyes. It is far better to shade
the eyes and admit the sunlight into the room, since its rays cause
chemical changes to take place, which favor the return of health. Many
invalids can ascribe their recovery to the influence of a sun bath.
There are, however, conditions in which the patients should be screened
from the light. In such cases a little arrangement of the curtains or
shutters will accomplish all that is to be desired.
Patients convalescing from acute, or suffering from chronic diseases,
should receive the influence of light in the open air, and be in it
several hours every day. Light and pure air stimulate a healthful
development, induce cheerfulness, hope, and recovery, while darkness
begets gloom, sadness, despondency, disease, and ultimately death.
WARMTH is essential to the well-being of the patient, and it is
necessary that a proper temperature be maintained in the room. Except in
very warm weather, a little fire should be kept in the room, and at the
same time fresh air should be admitted from without, and a uniform
temperature thus preserved. This arrangement is especially necessary in
localities where great variations in temperature are experienced during
the day and night.
The normal temperature of the body ranges from 98° to 99° Fahr. The
minimum occurs from 2 to 6 A.M.; the maximum, from 1 to 6 P.M. The
deviation of a few degrees from this standard indicates disease, and the
greater the deviation, the greater is its severity. During the early
stages of acute diseases, the animal heat is generally increased, and
should be allayed by bathing, and cooling or acidulated drinks. In the
latter stages, the temperature becomes diminished and the condition of
the system is favorable to congestions, which are most likely to occur
between the hours of 2 and 6 A.M., when the vital powers are lowest. The
patient then becomes feeble, his extremities grow cold, and he has what
is termed a "sinking spell," and perhaps dies. It is during these hours
that additional covering, the application of hot bricks to the feet, and
bottles of hot water to the limbs and body, friction upon the surface,
stimulating drinks, and increased vigilance on the part of the nurse
will often save the patient's life. But, unfortunately, at these hours
the nurse is apt to get sleepy and inattentive, the demands of the
patient go unheeded, and a sacrifice of life is the result.
Persons suffering from chronic diseases, or those in feeble health,
should preserve their vital energies by dressing warmly, by wearing
flannels next to the skin, and by carefully protecting the feet from
cold and moisture.
CLEANLINESS cannot be too thoroughly impressed upon the minds of those
who have the care of the sick. Filthiness is productive of disease and
favorable to its development. Bathing at least once a day, with pure,
soft water and toilet-soap, is strongly urged, and as this is designed
for cleanliness, the temperature of the bath should be made agreeable to
the patient.
THE CLOTHING AND BEDDING OF THE PATIENT in acute diseases, should be
changed frequently and thoroughly aired, if not washed. As soon as
removed, these articles should be taken from the room, replaced by
others _well aired and warmed._ The hands and face of the patient should
be bathed frequently, the hair combed, the teeth brushed, the nails
cleaned, the lips moistened, and everything about him kept clean and
tidy. These observances, although in themselves trifling, promote
comfort and cheerfulness, and contribute largely to the recovery of the
sick. All excretions from the patient should be buried, and not
committed to privies to communicate disease to those who frequent them.
THE DIET contains a very important relation to health. During the
process of acute disease, the appetite is generally much impaired, if
not entirely absent. It should then be the study of the nurse to devise
such articles of nourishment as will be acceptable to the patient and
suitable to the condition. The food should be light, nutritious, and
easy of digestion.
Each individual disease requires a diet adapted to its peculiarities.
Those of an inflammatory character require an unstimulating diet, as
gruel, barley-water, toast, etc. An exhausted or enfeebled condition of
the brain, unattended by irritability, demands a stimulating diet, as
beef, eggs, fish, Graham bread, oysters, etc. In wasting diseases, in
which the temperature of the system is low, beef, fatty substances, rich
milk, sweet cream, and other carbonaceous articles of diet are
recommended. In the various forms of chronic ailments, the diet must be
varied according to the nature of the disease and the peculiarities of
the patient. Deranged digestion is generally an accompaniment of chronic
disease. A return to normal digestion should be encouraged by selecting
appropriate articles of food, paying due regard to its quantity and
quality, as well as to the manner and time of eating. The appearance of
food, and the manner in which it is offered, have much to do with its
acceptance, or rejection by the patient. Let the nourishment be
presented in a nice, clean dish, of a size and shape appropriate to the
quantity. More food than can be eaten by the patient should not be
placed before him at one time, since a great quantity excites disgust
and loathing. In taking nourishment, drink, or medicine, the patient, if
feeble, should not be obliged to change his position.
MILK is one of the most important foods in fevers and acute diseases
attended with great prostration, and in which the digestive powers are
enfeebled. It contains within itself all the elements of nutrition.
BEEF TEA furnishes an excellent nourishment for the sick, but there are
few, even among professional nurses who know how to properly prepare it.
We give three good recipes. One method is to chip up lean beef, put it
in a porcelain or tin saucepan, cover it with _cold_ water, and bring it
up to just below the boiling point, at which temperature _retain it_ for
ten minutes, then season and serve. Another method is similar to the
foregoing, with this difference, that the juices of the meat are
squeezed through a piece of muslin or crash, making the tea richer.
Another way, which we consider preferable to either of the above, is to
take lean beef, cut it into fine bits, put them in a tightly covered
vessel, which is placed in a kettle of water kept boiling. Thus the
whole strength of the juice will be obtained from the meat without
losing any of its properties. It can be seasoned to the taste, and
reduced with water to suit the needs of the patient.
SLEEP is "Nature's grand restorer, a balm to all mankind; the best
comforter of that sad heart whom fortune's spite assails." It is
necessary in health, and doubly so in sickness. During sleep, the vital
energies recuperate, the forces are less rapidly expended, and the
strength increases. It is the great source of rest and refreshment.
Often a day's rest in bed, free from the cares and anxieties of an
active life, is sufficient to ward off the approach of disease. If quiet
and rest are essential to recuperation in health, their necessity in
disease must be apparent. Life frequently depends on tranquility and
repose, and the least noise or confusion disturbs the sufferer and
diminishes the chances of recovery. Nothing annoys sick or nervous
persons more than whispering and the rustling of newspapers. If
conversation be necessary, let the tones be modified, but never whisper.
In sickness, when the vital forces are low, the more natural rest and
sleep the patient obtains, the greater is the prospect for recovery. As
a rule, _a patient should never be awakened when sleeping quietly_, not
even to take _medicine_, unless in _extreme cases_. If the patient does
not sleep, the cause should be ascertained and the appropriate remedies
employed; if it arise from rush of blood to the head, cooling lotions
should be applied, and warmth to the feet; if, from restlessness or
general irritability, a sponge bath, followed by friction should be
administered; if the wakefulness is due to noise or confusion, quiet is
the remedy. When these means fail, anodynes, or nervines, should be
employed. Lying on the side instead of on the back should be practiced.
Patients afflicted with chronic diseases, on rising, should take a cold
bath, dry the surface quickly with a coarse towel, followed by friction
with the hand. Great benefit may be derived by following these
suggestions when the nature of the disease is not such as to forbid it.
EXERCISE and rest necessarily alternate with each other. Exercise, so
necessary to health, in many forms of disease greatly contributes to
recovery. It sends the sluggish blood coursing through the veins and
arteries with increased force and rapidity, so that it reaches every
part of the system, supplying it with nourishment. It increases the
waste of old material and creates a demand for new.
Convalescing patients, or those suffering from chronic diseases,
whenever the weather will permit, should take exercise every day in the
open air. This should be done with regularity. The amount of exercise
must be regulated by the strength of the patient; never take so much as
to produce fatigue, but, as the strength increases, the exercise may be
increased proportionately. Some interesting employment, commensurate
with the patient's strength, should be instituted, so that the mind may
be agreeably occupied with the body.
When unable to take active exercise, the invalid, properly protected by
sufficient clothing, should ride in a carriage or boat, and each day a
new route should be chosen, so that a change of scenery may be observed,
thus arousing new trains of thought, which will be exhilarating and
prove beneficial to him.
SEXUAL INFLUENCES. During the progress of disease or convalescence,
entire continence must be observed. It is then necessary that all of the
vital energies should be employed in effecting a recovery from disease,
without having the additional tax imposed of overcoming the debilitating
effects of sexual expenditure. This holds true with regard to all
diseases, and especially those of the nervous system and genitourinary
organs.
VISITING THE SICK may be productive of good or evil results. Mental
impressions made upon the sick exert a powerful influence upon the
termination of disease. The chances of recovery are in proportion to the
elevation or depression of spirits. Pleasant, cheerful associations
animate the patient, inspire hope, arouse the vital energies, and aid in
his recovery; while disagreeable and melancholy associations beget
sadness and despondency, discourage the patient, depress the vital
powers, enfeeble the body, and retard recovery.
Unless persons who visit the sick can carry with them joy, hope, mirth,
and animation, they had better stay away. This applies equally in acute
and chronic diseases. It does not matter what a visitor may _think_ with
regard to the patient's recovery, _an unfavorable opinion should never
find expression in the sick-room_. Life hangs upon a brittle thread, and
often that frail support is _hope_. Cheer the sick by words of
encouragement, and the hold on life will be strengthened; discourage, by
uttering such expressions as, "How bad you look!" "Why, how you have
failed since I saw you last!" "I would have another doctor; one who
knows something!" "You can't live long if you don't get help!" etc., and
the tie which binds them to earth is snapped asunder. The visitor
becomes a _murderer!_ Let all persons be guided by this rule: _Never go
into the sick-room without carrying with you a few rays of sunshine!_
If the patient is very weak the visitor may injure him by staying too
long. The length of the visit should be graduated according to the
strength of the invalid. Never let the sufferer be wearied by too
frequent or too lengthy visits, nor by having too many visitors at once.
Above all things, do not confine your visitations to Sunday. Many do
this and give themselves credit for an extra amount of piety on account
of it, when, if they would scrutinize their motives more carefully, they
would see that it was but a contemptible resort to save time. The sick
are often grossly neglected during the week only to be visited to death
upon Sunday.
THE USE OF TOBACCO AND OPIUM. The recovery of the sick is often delayed,
sometimes entirely prevented, by the habitual use of tobacco or opium.
In acute diseases, the appetite for tobacco is usually destroyed by the
force of the disease, and its use is, of necessity, discontinued; but in
chronic ailments, the appetite remains unchanged, and the patient
continues his indulgence greatly to the aggravation of the malady.
The use of tobacco is a pernicious habit in whatever form it is
introduced into the system. Its active principle, Nicotin, which is an
energetic poison, exerts its specific effect on the nervous system,
tending to stimulate it to an unnatural degree of activity, the final
result of which is weakness, or even paralysis. The horse, under the
action of whip and spur, may exhibit great spirit and rapid movements,
but urge him beyond his strength with these agents, and you inflict a
lasting injury. Withhold the stimulants, and the drooping head and
moping pace indicate the sad reaction which has taken place. This
illustrates the evils of habitually exciting the nerves by the use of
tobacco, opium, narcotic or other drugs. Under their action, the tone of
the system is greatly impaired, and it responds more feebly to the
influence of curative agents. Tobacco itself, when its use becomes
habitual and excessive, gives rise to the most unpleasant and dangerous
pathological conditions. Oppressive torpor, weakness or loss of
intellect, softening of the brain, paralysis, nervous debility,
dyspepsia, functional derangement of the heart, and diseases of the
liver and kidneys are not uncommon consequences of the excessive
employment of this plant. A sense of faintness, nausea, giddiness,
dryness of the throat, tremblings, feelings of fear, disquietude, and
general nervous prostration must frequently warn persons addicted to
this habit that they are sapping the very foundation of health. Under
the continued operation of a poison, inducing such symptoms as these,
what chance is there for remedies to accomplish their specific action?
With the system already thoroughly charged with an influence
antagonistic to their own, and which is sure to neutralize their effect,
what good can medicine do?
Dr. King says, "A patient under treatment should give up the use of
tobacco, or his physician should assume no responsibility in his case,
further than to do the best he can for him." In our own extensive
experience in the treatment of chronic diseases, we have often found it
necessary to resort to the same restriction.
The opium habit, to which allusion has also been made, is open to the
same objections, and must be abandoned by all who would seek recovery.
* * * * *
PART IV.
DISEASES AND THEIR REMEDIAL TREATMENT.
INTRODUCTION.
Knowledge which is conducive to self-preservation is of _primary_
importance. That great educator, profound thinker, and vigorous writer,
Herbert Spencer, has pertinently said that, "As vigorous health and its
accompanying high spirits, are larger elements of happiness than any
other things whatever, the teaching how to maintain them is a teaching
that yields to no other whatever. And therefore we assert that such a
course of physiology as is needful for the comprehension of its general
truths and their bearings on daily conduct is an all-essential part of a
rational education."
Believing that the diffusion of knowledge for the prevention of disease
is quite as noble a work as the alleviation of physical suffering by
medical skill, we have devoted a large portion of this volume to the
subjects of physiology and hygiene. These we have endeavored to present
in as familiar a style as possible, that they may be understood by every
reader. Freely as we have received light upon these subjects have we
endeavored to reflect it again, in hopes that a popular presentation of
these matters made plain and easy of comprehension to all people, may
lead the masses into greater enjoyment of life--the result of a better
preservation of health. This we do in part as a public acknowledgment of
our obligations to society, to whom every professional man is a debtor.
He belongs to it, is a part of its common stock, and should give as well
as receive advantages, return as well as accept benefits. We know of no
better way to signify our appreciation of the public confidence and
patronage, so generously accorded to us, than to offer this volume to
the people at a price less than the actual cost for an edition of
ordinary size. This we do as a token of the cordial reciprocation of
their good will. In giving to the people wholesome advice, by which they
may be enabled to ward off disease and thus preserve the health of
multitudes, we believe we shall receive their hearty approval, as well
as the approbation of our own conscience, both of which are certainly
munificent rewards. We believe that good deeds are always rewarded, and
that the physician who prevents sickness manifests a genuine and earnest
devotion to the common interests of humanity.
We have no respect for the motives of those medical men who would
withhold that information from the people which will direct the masses
how to take care of themselves, and thereby prevent much sickness and
suffering. Nor is the diffusion of such knowledge antagonistic to the
best interests of the true and competent physician. The necessity for
his invaluable services can no more be set aside by popularizing
physiological, hygienic, and medical truths, than we can dispense with
those of the minister and lawyer by the inculcation of the principles of
morality in our public schools. The common schools do not lessen the
necessity for colleges or universities, but rather contribute to their
prosperity. Nor are we so presumptuous as to anticipate that we could
possibly make this volume so instructive as to render "every man his own
physician." No man can with advantage be his own lawyer, carpenter,
tailor, and printer; much less can he hope to artfully repair his own
constitution when shattered by grave maladies, which not only impair the
physical functions, but weaken and derange the mental faculties. What
physician presumes to prescribe for himself, when suddenly prostrated by
serious illness? He very sensibly submits to the treatment of another,
because he realizes that sickness impairs his judgment, and morbid
sensations mislead and unfit him for the exercise of his skill. If this
is true of the physician, with how much greater force does it apply to
the unprofessional! If a sick sea-captain is unfit to stand at the helm
and direct his ship, how utterly incompetent must the raw sailor be when
similarly disqualified! Nor is the physician as competent to treat those
near and dear to him, when they are suffering from dangerous illness, as
another medical man not similarly situated, whose judgment is not liable
to be misled by intense anxiety and affectionate sympathy.
Notwithstanding all these facts, however, a knowledge on the part of the
unprofessional, of something more than physiology and hygiene, and
appertaining more closely to medicine proper, will many times prove
valuable.
In the first stage of many acute affections which, if unheeded,
gradually assume a threatening aspect, endangering life and demanding
the services of the most skilled physician to avert fatal results, the
early administration of some common domestic remedy, such as a
cathartic, or a diaphoretic herb, associated with a warm bath, a spirit
vapor-bath, or a hot foot-bath, will very often obviate the necessity
for calling a family physician, and frequently save days and weeks of
sickness and suffering.
So, likewise, are there numerous, acute diseases of a milder character
which are easily and unmistakably recognized without the possession of
great medical knowledge, and which readily yield to plain, simple,
medical treatment which is within the ready reach of all who strive to
acquaint themselves with the rudiments of medical science. But in sudden
and painful attacks of acute disease, life may be suddenly and
unexpectedly jeopardized, and immediate relief prove necessary. While
under these circumstances the prompt application of such domestic
treatment as good common-sense may dictate, guided by a knowledge of
those first principles of medical learning which we shall hereafter
endeavor to make plain, may result in speedy and happy relief, yet at
the same time there should be no delay in summoning a competent
physician to the bedside of the sufferer.
Then, and not the least important, there are the various chronic or
lingering diseases, from all of which few individuals indeed, who pass
the meridian of life, entirely escape. In this class of ailments there
is generally no immediate danger, and, therefore, time may be taken by
the invalid for studying his disease and employing those remedies which
are best suited for its removal. Or, if of a dangerous or complicated
character, and, therefore, not so readily understood, he may consult
either personally or by letter, some learned and well-known physician,
who makes a specialty of the treatment of such cases, and whose large
experience enables him to excel therein.
In consideration, therefore, of the foregoing facts, we deem it most
profitable for our readers that Part Fourth of this volume should be
arranged in the following manner:
The milder forms of uncomplicated, acute diseases, which may be readily
and unmistakably recognized, and successfully managed without
professional aid, will receive that attention which is necessary to give
the reader a correct idea of them, and their proper remedial treatment.
We shall devote only such attention to the severe and hazardous forms of
acute diseases as is necessary in order to consider their initial stage,
with their proper treatment, not attempting to trace their numerous
complications, or portray the many pathological conditions which are
liable to be developed. For, even by devoting much space to the latter,
we could not expect to qualify our unprofessional readers for
successfully treating such obscure and dangerous conditions.
We shall devote the largest amount of space to a careful and thorough
consideration of those chronic diseases, which, by a little study, may
be readily recognized and understood by the masses, and for the cure of
which we shall suggest such hygienic treatment and domestic remedies as
may be safely employed by all who are in quest of relief. In the more
dangerous, obscure, or complicated forms of chronic diseases, the
correct diagnosis and successful treatment of which tax all the skill
possessed by the experienced specialist, the invalid will not be misled
into the dangerous policy of relying upon his own judgment and
treatment, but will be counseled not to postpone until too late, the
employment of a skillful physician.
The apportionment of space which is made in considering the various
diseases and their different stages, as well as the course which the
people are advised to pursue under the different circumstances of
affliction, is not always in accordance with the plans and
recommendations which have been made by others who have written works on
domestic medicine. Most of these authors have attempted, by lengthy
disquisitions, to teach their readers how to treat themselves without
the services of a physician, even in the most hazardous forms of
disease. In such dangerous maladies as typhoid, typhus, yellow, and
scarlet fevers, typhoid pneumonia, and many others, in which life is
imminently imperiled, such instruction and advice is decidedly
reprehensible, as it may lead to the most serious consequences. We are
confident, therefore, that the manner of disposing of the different
subjects which are discussed in the succeeding chapters, and the course
of action which is advised, will commend themselves to our readers as
being such as are calculated to promote and subserve their best
interests.
MEDICAL DIAGNOSIS.
Skill in the art of healing is indicated in three ways: (1.) by
ascertaining the _symptoms, seat_, and _nature_ of the disease, which is
termed _diagnosis_; (2.) by foretelling the probable termination, which
is termed _prognosis_; (3.) by the employment of efficacious and
appropriate remedies, which is called _treatment_. Of these three
requisites to a prosperous issue, nothing so distinguishes the expert
and accomplished physician from the mere pretender as his ready ability
to interpret correctly, the location, extent, and character of an
affection from its symptoms. By medical diagnosis, then, is understood
the discrimination between diseases by certain symptoms which are
distinguishing signs. Every malady is accompanied by its characteristic
indications, some of which are _diagnostic, i.e._, they particularize
the affection and distinguish it from all others.
Medical diagnosis is both a _science_ and an _art_; a science when the
causes and symptoms of a disease are understood, and an art when this
knowledge can be applied to determine its location and exact nature.
Science presents the general principles of practice; art detects among
the characteristic symptoms the differential signs, and applies the
remedy. Da Costa aptly remarks: "No one aspiring to become a skillful
observer can trust exclusively to the light reflected from the writings
of others; he must carry the torch in his own hands, and himself look
into every recess."
The critical investigation of symptoms, with the view of ascertaining
their signs, is essential to successful practice. Without closely
observing them, we cannot accurately trace out the diagnosis, and a
failure to detect the right disease is apt to be followed by the use of
wrong medicines.
General diagnosis considers the surroundings of the patient as well as
the actual manifestations of the disease. It takes into account the
diathesis, _i.e._, the predisposition to certain diseases in consequence
of peculiarities of constitution. We recognize constitutional
tendencies, which may be indicated by the contour of the body, its
growth, stature, and temperament, since all these facts greatly modify
the treatment. Likewise the sex, age, climate, habits, occupation,
previous diseases, as well as the present condition, must be taken into
account.
Auscultation, as practiced in detecting disease, consists in listening
to the sounds which can be heard in the chest.
Percussion consists in striking upon a part with the view of
appreciating the sound which results. The part may be struck directly
with the tips of the fingers, but more generally one or more fingers of
the other hand are interposed between the points of the fingers and the
part to be percussed, that they, instead of the naked chest, may receive
the blow; or, instead of the fingers, a flat piece of bone or ivory,
called a _pleximeter_, is placed upon the chest to receive the blow.
Latterly, improved instruments greatly assist the practitioner of
medicine in perfecting this art. The _microscope_ assists the eye, and
helps to reveal the appearance and character of the excretions,
detecting morbid degenerations; _chemistry_ discloses the composition of
the urine, which also indicates the morbid alterations occurring in the
system; by percussion we can determine the condition of an internal
organ, from the sound given when the external surface is percussed; the
ear, with the aid of the _stethoscope_, detects the strange murmurs of
respiration, the fainter, more unnatural pulsations of life, and the
obscurer workings of disease; with the _spirometer_ we determine the
breathing capacity of the lungs, and thus ascertain the extent of the
inroads made by disease; the _dynamometer_ records the lifting ability
of the patient; the _thermometer_ indicates the morbid variation in the
bodily temperature; various instruments inform us of the structural
changes causing alterations in the specific gravity of fluids, _e.g_.,
the _urinometer_ indicates those occurring in the urine; and thus, as
the facilities for correct diagnosis increase, the art of distinguishing
and classifying diseases becomes more perfect, and their treatment more
certain. While physiology treats of all the natural functions, pathology
treats of lesions and altered conditions.
[Illustration: Fig. 146.
Dr. Brown's Spirometer.]
By the term _symptoms_ we mean the evidence of some morbid effect or
change occurring in the human body, and it requires close observation
and well-instructed experience to convert these symptoms into diagnostic
signs. Suppose "Old Probabilities" (as we commonly designate the
invaluable Signal Department) hangs out his warning tokens all along our
lake borders and ocean coasts; our sailors behold the fluttering symbols
indicating an approaching storm, but if no one understood their meaning,
a fearful disaster might follow. But if these signals are understood, a
safe harbor is sought and the mariner is protected. So disease may hang
out all her signals of distress, in order that they may be seen, but
unless correctly interpreted, and a remedial harbor is sought, these
symptoms are of little practical value.
Undoubtedly the reason why so many symptom-doctors blunder is because
they prescribe according to the apparent symptoms, without any real
reference to the nature of the affection. They fail to discover how far
a symptom points out the seat, and also the progress of a disease. They
do not distinguish the relative importance of the different symptoms.
The practical purpose of all science is to skillfully apply knowledge to
salutary and profitable uses. The patient himself may carefully note the
indications, but it is only the expert physician who can tell the import
of each symptom.
_Symptoms_ are within every one's observation, but only the physician
knows the nature and value of _signs_. We have read an anecdote of
Galen, who was a distinguished physician in his day, which illustrates
the distinction between sign and symptom. Once, when dangerously ill, he
overheard two of his friends in attendance upon him recount his
symptoms, such as "Redness of the face, a dejected, haggard, and
inflamed appearance," etc. He cried out to them to adopt every necessary
measure forthwith, as he was threatened with delirium. The two friends
saw the _symptoms_ well enough; but it was only Galen himself, though
the _patient_, who was able to deduce the _sign_ of delirium--that is,
he alone was able to translate those symptoms into signs. To determine
the value of symptoms, as signs of disease, requires close observation.
INTERPRETATION OF SYMPTOMS.
We shall refer to a few symptoms which any unprofessional reader may
readily observe and understand.
POSITION OF PATIENT. When a patient is disposed to lie upon his back
continually during the progress of an acute disease, it is a sign of
_muscular debility_. If he manifests no desire to change his position,
or cannot do so, and becomes tremulous at the least effort, it indicates
_general prostration_. When this position is assumed, during the
progress of continued fever, and is accompanied by involuntary twitching
of the muscles, picking of the bed-clothes, etc., then danger is
imminent and _the patient is sinking_. Fever, resulting from local
inflammation, does not produce muscular prostration, and the patient
seldom or never assumes the supine position. If this inflammation is in
the extremities, those parts are elevated, in order to lessen the
pressure of the blood, which a dependent, position increases.
For example, let us change the scene, and introduce a patient with head
and shoulders elevated, who prefers to sit up, and who places his hands
behind him and leans back, or leans forward resting his arms and head
upon a chair. The next week he is worse, and no longer tries to lie in
bed, but sits up all the time; note the anxious expression of
countenance, the difficult or hurried breathing, the dry and hacking
cough, and observe that the least exertion increases the difficulty of
respiration and causes palpitation of the heart. These plain symptoms
signify thoracic effusion, the collection of water about the lungs.
THE COUNTENANCE displays diagnostic symptoms of disease. In simple,
acute fevers, the eyes and face are red and the respiration is hurried;
but in acute, sympathetic fever, these signs are wanting. We cannot
forget the pale, sharp, contracted, and pinched features of those
patients whose nostrils contract and expand alternately with the acts of
respiration. How hard it was for them to breathe. The contraction and
expansion of the nostrils indicate active congestion of the lungs.
As a general rule, chronic inflammation of the stomach, duodenum, liver,
and adjacent organs, imparts a gloomy expression to the countenance, at
the same time the eye is dull, the skin dusky or yellow, and the motions
are slow. But in lung diseases, the spirits are buoyant, the skin is
fair, and the cheeks flushed with fever and distinctly circumscribed
with white, for delicacy and contrast, almost exceed the hues of health
in beauty. Note, too, the pearly lustre and sparkling light of the eye,
the quivering motion of the lips and chin, all signs of pulmonary
disease.
THE STORY OF SEXUAL ABUSE is plainly told by the downcast countenance,
the inability to look a person fairly in the face, the peculiar lifting
of the upper lip and the furtive glance of the eye. The state of the
mind and of the nervous system corroborates this evidence, for there
seems to be a desire to escape from conversation and to elude society.
The mind seems engrossed and abstracted, the individual appears absorbed
in a constant meditation, he is forgetful and loses nearly all interest
in the ordinary affairs of life. The whole appearance of a patient,
suffering from spermatorrhea, is perfectly understood by the experienced
physician, for the facial expressions, state of mind, and movements of
the body, all unconsciously betray, and unitedly proclaim his condition.
TONGUE. Much may be learned from the appearance, color, and form of the
tongue, and the manner of its protrusion. If pale, moist, and coated
white, it indicates a mild, febrile condition of the system. If coated
in the center, and the sides look raw, it indicates gastric irritation.
If red and raw, or dry and cracked, it is a sign of inflammation of the
mucous membrane of the stomach. If the inflammation is in the large
intestine, the tip of the tongue presents a deep red color, while the
middle is loaded with a dark brown coating. When the tongue is elongated
and pointed, quickly protruded and withdrawn, it indicates irritation of
the nerve-centers, as well as of the stomach and bowels. If tremulous,
it denotes congestion and lack of functional ability; this may be
observed in congestive fevers.
PULSE. Usually the pulse beats four times during one respiration, but
both in health and disease its frequency may be accelerated or retarded.
In adults, there are from sixty-five to seventy-five beats in a minute,
and yet in a few instances we have found, in health, only forty
pulsations per minute. But when the heart beats from one hundred and
twenty to one hundred and forty times a minute, there is reason to
apprehend danger, and the case should receive the careful attention of a
physician.
Irregularity of the pulse may be caused by disease of the brain, heart,
stomach, or liver; by the disordered condition of the nervous system; by
lack of muscular nutrition, as in gout, rheumatism, or convulsions; by
deficiency of the heart's effective power, when the pulse-wave does not
reach the wrist, or when it intermits and then becomes more rapid in
consequence of septic changes of the blood, as in diphtheria,
erysipelas, and eruptive fevers.
PAIN. The import of pain depends on its seat, intensity, nature, and
duration. An acute, intense pain usually indicates inflammation of a
nerve as well as the adjacent parts. Sharp, shooting, lancinating pains
occur in inflammation of the serous tissues, as in pleurisy. A smarting,
stinging pain attends inflammation of the mucous membrane. Acute pain is
generally remittent and not fixed to one spot. Dull, heavy pain is more
persistent, and is present in congestions, or when the substance of an
organ is inflamed, and it often precedes hemorrhage. Burning pain
characterizes violent inflammations involving the skin and subjacent
cellular tissue, as in case of boils and carbuncles. Deep, perforating
pain accompanies inflammation of the bones, or of their enveloping
membranes. Gnawing, biting, lancinating pain attends cancers.
The location of pain is not always at the seat of the disease. In
hip-disease, the pain is not first felt in the hip, but in the
knee-joint. In chronic inflammation of the liver, the pain is generally
most severe in the right shoulder and arm. Disease of the kidneys
occasionally produces numbness of the thigh and drawing up of the
testicle, and commonly causes colicky pains. Inflammation of the
meninges of the brain is often indicated by nausea and vomiting before
attention is directed to the head. These illustrations are sufficient to
show that pain often takes place in some part remote from the disease.
In chronic, abdominal affections, rheumatic fevers, gout, and syphilis,
the entire system is thrown into a morbid state, the nervous system is
disturbed, and wandering pains manifest themselves in different parts of
the body. Fixed pain, which is increased by pressure, indicates
inflammation. If it be due only to irritation, pressure will not
increase it. Some rheumatic affections and neuralgia not only bear
pressure, but the pain diminishes under it. Permanent pain shows that
the structures of an organ are inflamed, while intermittent pain is a
sign of neuralgia, gout, or rheumatism. Absence of pain in any disease,
where ordinarily it should be present, is an unfavorable sign. Internal
pain, after a favorable crisis, is a bad omen. Or, if pains cease
suddenly without the other symptoms abating, the import is bad. If,
however, pain and fever remit simultaneously and the secretions
continue, it is a favorable sign.
A dull pain in the head indicates fullness of the blood-vessels from
weakness, low blood, or general debility. It may be caused by taking
cold, thus producing passive congestion of the brain. It may proceed
from gastric disturbance, constipation of the bowels, or derangement of
the liver. Heaviness of the head sometimes precedes inflammation of the
brain, or chronic disease of its membranes. A dull, oppressive pain in
the head indicates softening of the brain, and is generally accompanied
by slowness of the pulse and of the speech. A pulsating pain of the head
occurs in heart disease, hysteria, and frequently accompanies some forms
of insanity.
THE EYE indicates morbid changes and furnishes unmistakable signs of
disease. Sinking of the eye indicates waste, as in consumption,
diarrhea, and cholera. In fevers it is regarded as a fatal symptom. A
dark or leaden circle around the eye, seen after hard work, indicates
fatigue and overdoing. If the mucous covering of the inner surface of
the lids and the ball of the eye is congested and inflamed, it exhibits
redness, and may indicate congestion or even inflammation of the brain.
A dilated pupil is often observed in catarrhal consumption, congestion
of the brain, low fevers, and chlorosis.
The pupil contracts in inflammation of the meninges, when there is
increased sensibility and intolerance of light, also in spinal
complaints. In some diseases the lustre of the eye increases, as in
consumption. But if it decreases with the attack of violent disease, it
indicates great debility and prostration.
EXAMINATION OF THE URINE. All medical authors and physicians of
education, freely admit and even insist upon the importance of
critically examining the patient's urine, in all cases in which there is
reason to suspect disease of the kidneys or bladder. In chronic
affections it is particularly serviceable, especially in derangements of
the liver, blood, kidneys, bladder, prostate gland, and nervous system.
Many scholarly physicians have sadly neglected the proper inspection of
the urine, because they were afraid of being classed with the illiterate
"uroscopian" doctors, or fanatical enthusiasts, who ignorantly pretend
to diagnose correctly _all_ diseases in this manner, thus subjecting
themselves and their claims to ridicule. Nothing should deter one from
giving to this excretion the attention it deserves.
The urine which is voided when the system is deranged or diseased is
altered in its color and composition, showing that its ingredients vary
greatly. So important an aid do examinations of the urine furnish in
diagnosing many chronic ailments, that at the Invalids' Hotel and
Surgical Institute, where many thousands of cases are annually treated,
a chemical laboratory has been fitted up, and a skillful chemist is
employed, who makes a specialty of examining the urine, both chemically
and microscopically, and reporting the result to the attending
physicians. His extended experience renders his services invaluable.
With his assistance, maladies which had hitherto baffled all efforts put
forth to determine their true character, have frequently been quickly
and unmistakably disclosed.
MICROSCOPICAL EXAMINATION. This method of examination affords a quicker
and more correct idea of a deposit or deposits than any other method.
The expert, by simply looking at a specimen, can determine the character
of the urine, whether blood, mucus, pus, uric acid, etc., are present or
not. But when no deposit is present, then it is necessary to apply
chemical tests, and in many cases the quantity of the suspected
ingredient must be determined by analysis. As a detailed account, of the
various modifications which the urine undergoes in different diseases,
would be of no practical use to the masses, since they could not avail
themselves of the advantages which it would afford for correct
diagnosis, except by the employment of a physician who does not ignore
this aid in examining his patients, we shall omit all further details
upon the subject. For the same reason we shall not often, in treating of
the different diseases in which examinations of the urine furnish such
valuable aid in forming a diagnosis, make mention of the changes which
are likely to have occurred.
INFLAMMATION.
The term _Inflammation_ signifies a state in which the infected part is
hotter, redder, more congested, and more painful than is natural.
Inflammation is limited to certain parts, while fever influences the
system generally. Inflammation gives rise to new formations, morbid
products, and lesions, or alterations of structure. The morbid products
of fever, and its modification of fluids are carried away by the
secretions and excretions.
The susceptibility of the body to inflammation maybe _natural_ or
_acquired_. It is natural when it is constitutional; that is, when there
is an original tendency of the animal economy to manifest itself in some
form of inflammation. We may notice that some children are far more
subject to boils, croups, and erysipelatous diseases than others. This
susceptibility, when innate, may be lessened by careful medication,
although it may never be wholly eradicated. When acquired, it is the
result of the influence of habits of life, climate, and the state of
mind over the constitution
Phlegmonous inflammation is the active inflammation of the cellular
membrane, one illustration of which is a common boil. The four principal
symptoms are redness, swelling, heat, and pain; and then appears a
conical, hard, circumscribed tumor, having its seat in the dermoid
texture. At the end of an indefinite period, it becomes pointed, white
or yellow, and discharges pus mixed with blood. When it breaks, a small,
grayish, fibrous mass sometimes appears, which consists of dead,
cellular tissue, and which is called the _core_.
There are certain morbid states of the constitution which lead to local
inflammation, subsequent upon slight injury; or, in some cases, without
any such provocation, as in gout, rheumatism, and scrofula. One of the
first results of the inflammation, in such cases, is a weakening of the
forces which distribute the blood to the surface and extremities of the
body. It is generally admitted that in scrofulous persons the vascular
system is weak, the vessels are small, and because nutrition is faulty,
the blood is _imperfectly organized_. The result is failure in the
system, for if nutrition fails, there may be lacking earthy matter for
the bones, or the unctious secretions of the skin; the sebaceous
secretion is albuminous and liable to become dry, producing inflammation
of the parts which it ought to protect.
Disorder of the alimentary canal and other mucous surfaces are sometimes
reflected upon the skin. We have occasionally observed cutaneous
eruptions and erysipelas, when evidently they were distinct signs of
internal disorder.
Inflammation may be internal as well as external, as inflammation of the
brain, lungs, or stomach, and it is frequently the result of what is
called a _cold_. No matter how the body is chilled, the blood retreats
from the surface, which becomes pale and shrunken, there is also nervous
uneasiness, and frequently a rigor, accompanied with chattering of the
teeth. After the cold stage, reaction takes place and fever follows. The
sudden change from a dry and heated room to a cool and moist atmosphere
is liable to induce a cold. Riding in a carriage until the body is
shivering, or sitting in a draft of air when one has been previously
heated, or breathing a very cold air during the night when the body is
warm, especially when not accustomed to doing so, or exposing the body
to a low temperature when insufficiently clothed, are all different ways
of producing inflammation.
Inflammation may result in consequence of local injury, caused by a
bruise, or by a sharp, cutting instrument, as a knife or an axe, or it
may be caused by the puncture of a pin, pen-knife blade or a fork-tine,
or from a lacerated wound, as from the bite of a dog, or from a very
minute wound poisoned by the bite of a venomous reptile. Local
inflammations may arise from scalds, burns, the application of caustics,
arsenic, corrosive sublimate, cantharides, powerful acids, abrasions of
the surface by injuries, and from the occurrence of accidents.
The _swelling_ of the part may be caused by an increase of the quantity
of blood in the vessels, the effusion of serum and coagulating lymph,
and the interruption of absorption by the injury, or by the altered
condition of the inflamed part.
The character of the _pain_ depends upon the tissue involved, and upon
the altered or unnatural state of the nerves. Ordinarily, tendon,
ligament, cartilage, and bone are not very sensitive, but when inflamed
they are exquisitely so.
The heat of the inflamed part is not so great, when measured by the
thermometer, as might be supposed from the patient's sensations.
TERMINATION OF INFLAMMATION. Inflammation ends in one of six different
ways. Inflammation may terminate in _resolution, i.e_., spontaneous
recovery; by _suppuration_, in the formation of matter; by _effusion_,
as the inflammation caused by a blister-plaster terminates by effusion
of water; by _adhesion_, the part inflamed forming an attachment to some
other part; by _induration_, hardening of the organ; or by _gangrene_,
that is, death of the part.
Thus, inflammation of the lungs may terminate by recovery, that is, by
resolution, by suppuration and raising of "matter," by hardening and
solidification of the lung, or by gangrene. Inflammation of the
endocardium, the lining membrane of the heart, may cause a thickening of
it, and ossification of the valves of the heart, thus impairing its
function. Inflammation of the pericardium may terminate in effusion, or
dropsy, and inflammation of the liver may result in hardening and
adhesion to adjacent parts.
SEVERAL PRINCIPLES FOR TREATMENT OF INFLAMMATION.
Remove the exciting causes as far as practicable. If caused by a
splinter or any foreign substance, it should be withdrawn, and if the
injury is merely local, apply cold water to the parts to subdue the
inflammation. If caused by a rabid animal, the wound should be enlarged
and cupped, and the parts cleansed or destroyed by caustic. The patient
should remain quiet and not be disturbed. The use of tincture of aconite
internally, will be found excellent to prevent the rise of inflammation.
A purgative is also advised, and four or five of Dr. Pierce's Pleasant
Purgative Pellets will be sufficient to act upon the bowels. If there is
pain, an anodyne and diaphoretic is proper. Dr. Pierce's Compound
Extract of Smart-weed will fulfill this indication. In local
inflammation cold water is a good remedy, yet sometimes hot water, or
cloths wrung out of it, will be found to be the appropriate application.
When the inflammation is located in an organ within a cavity, as the
lungs, hot fomentations will be of great service. Bathing the surface
with alkaline water must not be omitted. Whenever the inflammation is
serious the family physician should be early summoned.
FEVER.
In fever all the functions are more or less deranged. In every
considerable inflammation there is sympathetic fever, but in essential
fevers there are generally fewer lesions of structure than in
inflammation. Fever occasions great waste of the tissues of the body,
and the refuse matter is carried away by the organs of secretion and
excretion. The heat of the body in fever is generally diffused, the
pulse is quicker, there is dullness, lassitude, chilliness, and
disinclination to take food. We propose to give only a general outline
of fevers, enough to indicate the principles which should be observed in
domestic treatment.
Most fevers are distinctly marked by four stages: 1st, the forming
stage; 2d, the cold stage; 3d, the hot stage; 4th, the sweating or
declining stage. During the first stage the individual is hardly
conscious of being ill, for the attack is so slight that it is hardly
perceptible. True, as it progresses, there is a feeling of languor, an
indisposition to make any bodily or mental effort, and also a sense of
soreness of the muscles, aching of the bones, chilliness, and a
disposition to get near the fire. There is restlessness, disturbed
sleep, bad dreams, lowness of spirits, all of which are characteristic
of the formative stage of fever.
The next is the cold stage, when there is a decided manifestation of the
disease, and the patient acknowledges that he is really sick. In typhus
and typhoid fever the chills are slight; in other fevers they are more
marked; while in ague they are often accompanied by uncontrollable
shaking. When the chill is not so distinct the nails look blue and the
skin appears shriveled, the eye is sunken and a dark circle
circumscribes it, the lips are blue, and there is pain in the back. The
pulse is frequent, small, and depressed, the capillary circulation
feeble, the respiration increased, and there may be nausea and vomiting.
These symptoms vary in duration from a few minutes to more than an hour.
They gradually abate, reaction takes place, and the patient begins to
throw off the bed-clothes.
Then follows the hot stage, for with the return of the circulation of
the blood to the surface of the body, there is greater warmth, freer
breathing, and a more comfortable and quiet condition of the system. The
veins fill with blood, the countenance brightens, the cheeks are
flushed, the intellect is more sprightly, and if the pulse is frequent,
it is a good sign; if it sinks, it indicates feeble, vital force, and is
not a good symptom. If there is considerable determination of blood to
the head it becomes hot, the arteries of the neck pulsate strongly, and
delirium may be expected. During the hot stage, if the fever runs high,
the patient becomes restless, frequently changes his position, is
wakeful, uneasy, and complains of pain in his limbs. In low grades, the
sensibility is blunted, smell, taste, and hearing are impaired.
The patient in the hot stage is generally thirsty, and if he is allowed
to drink much, it may result in nausea and vomiting. Moderate indulgence
in water, however, is permissible. There is aversion to food, and if any
is eaten, it remains undigested. The teeth are sometimes covered with
dark _sordes_ (foul accumulations) early in the fever, and the
appearance of the tongue varies, sometimes being coated a yellowish
brown, sometimes red and dry, at other times thickly coated and white.
The condition of the bowels varies from constipation to diarrhea,
although sometimes they are quite regular. The urine is generally
diminished in quantity, but shows higher color.
The sweating stage in some fevers is very marked, while in others there
is very little moisture, but an evident decline of the hot stage, the
skin becoming more natural and soft. The pulse is more compressible and
less frequent, the kidneys act freely, respiration is natural, the pains
subside, although there remains languor, lassitude, and weariness, a
preternatural sensibility to cold, an easily excited pulse, and a pale
and sickly aspect of the countenance. The appetite has failed and the
powers of digestion are still impaired.
DOMESTIC MANAGEMENT OF FEVERS. It is proper to make a thorough study of
the early, insidious symptoms of fever, in order to understand what
ought to be done. If it arises in consequence of malaria, the treatment
must be suited to the case. If from irritation of the bowels and
improper articles of diet, then a mild cathartic is required. If there
is much inflammation, a severe chill, and strong reaction, then the
treatment should be active. If the fever is of the congestive variety
and the constitution is feeble, the reaction imperfect, a small, weak
pulse, a tendency to fainting, a pale countenance, and great pain in the
head, apply heat and administer diaphoretics, and procure the services
of a good physician.
As a general rule, it is proper to administer a cathartic, unless in
typhoid fever, and for this Dr. Pierce's Purgative Pellets answer the
purpose, given in doses of from four to six, according to the state of
the bowels. If these are not at hand, a tea of sage and senna may be
drunk until it produces a purgative effect, or a dose of Rochelle salts
taken. In nearly all fevers we have found that a weak, alkaline tea,
made from the white ashes of hickory or maple wood, is useful, taken
weak, three or four times daily, or if there be considerable thirst,
more frequently. Some patients desire lemon juice, which enters the
system as an alkali and answers all purposes.
Diaphoretic medicines are also indicated, and the use of Dr. Pierce's
Extract of Smart-weed will prove very serviceable. Drinking freely of
pleurisy-root tea, or of a strong decoction of boneset is frequently
useful. After free sweating has been established, then it is proper to
follow by the use of diuretic teas, such as that of spearmint and
pumpkin seed combined, or sweet spirits of nitre, in doses of twenty to
thirty drops, added to a teaspoonful of the Extract of Smart-weed,
diluted with sweetened water.
To lessen the frequency of the pulse, fluid extract or tincture of
aconite or veratrum may be given in water, every hour. During the
intermission of symptoms, tonic medicines and a sustaining course of
treatment should be employed. If the tongue is loaded and the
evacuations from the bowels are fetid, a solution of sulphite of soda is
proper; or, take equal parts of brewer's yeast and water, mix, and when
the yeast settles, give a tablespoonful of the water every hour, as an
antiseptic. Administering a warm, alkaline hand-bath to a fever patient
every day, is an excellent febrifuge remedy, being careful not to chill
or induce fatigue. If there is pain in the head, apply mustard to the
feet; if it is in the side, apply hot fomentations.
The symptoms which indicate danger are a tumid and hard abdomen,
difficult breathing, offensive and profuse diarrhea, bloody urine,
delirium, or insensibility. Favorable symptoms are a natural and soft
state of the skin, eruptions on the surface, a natural expression of the
countenance, moist tongue, free action of the kidneys, and regular
sleep. If the domestic treatment which we have advised does not break
the force of the disease and mitigate the urgency of the symptoms, it
will be safer to employ a good physician, who will prescribe such a
coarse of treatment as the case specially requires. It is our aim to
indicate what may be done before the physician is called, for frequently
his services cannot be obtained when they are most needed. Besides, if
these attacks are early and properly treated with domestic remedies, it
will often obviate the necessity of calling upon a physician. If, on the
other hand, fevers are neglected and no treatment instituted, they
become more serious in character and are more difficult to cure.
To recapitulate, our treatment recommends evacuation through nature's
outlets, the skin, kidneys, and bowels, maintaining warmth, neutralizing
acidity, using antiseptics, tonics, and the hand-bath, and the fluid
extract or tincture of aconite, or veratrum to moderate the pulse by
controlling the accelerated and unequal circulation of the blood. It is
a simple treatment, but if judiciously followed, it will often abort a
fever, or materially modify its intensity and shorten its course.
FEVER AND AGUE. (INTERMITTENT FEVER.)
The description of fever already given applies well to this form of it,
only the symptoms in the former stage are rather more distinct than in
the other varieties. Weariness, lassitude, yawning, and stretching, a
bitter taste in the mouth, nausea, less of appetite, the uneasy state of
the stomach and bowels are more marked in the premonitory stages of
intermittent fevers. The cold stage commences with a chilliness of the
extremities and back, the skin looks pale and shriveled, the blood
recedes from the surface, respiration is hurried, the urine is limpid
and pale, sometimes there is nausea and vomiting, and towards the
conclusion of the stage, the chilly sensations are varied with flushes
of heat. The hot stage is distinguished by the heat and dryness of the
surface of the body and the redness of the face; there is great thirst,
strong, full, and hard pulse, free and hurried respiration and increased
pain in the head and back. The sweating stage commences by perspiration
appearing upon the forehead, which slowly extends over the whole body,
and soon there is an evident intermission of all the symptoms. In the
inflammatory variety of intermittent fever, all these symptoms are
acute, short, and characterized by strong reaction. Gastric fever, the
most frequent variety of intermittent fever, is marked by irritation of
the stomach and bowels, and a yellow appearance of the white of the eye.
CAUSES. The cause of the malarial fevers, intermittent, remittent, and
congestive, is supposed to be _miasm_, a poisonous, gaseous exhalation
from decaying vegetation, which is generally most abundant in swamps and
marshes, and which is absorbed into the system through the lungs.
TREATMENT. During the entire paroxysm the patient should be kept in bed,
and in the cold stage, covered with blankets and surrounded with bottles
of hot water. The Compound Extract of Smart-weed should be administered
in some diaphoretic herb-tea. During the hot stage, the extra clothing
and the bottles of hot water should be gradually removed and cold drinks
taken instead of warm. During the sweating stage the patient should be
left alone, but as soon as the perspiration ceases, from two to four of
the Purgative Pellets should be administered, as a gentle cathartic. A
second paroxysm should, if possible, be prevented. To accomplish this,
during the intermission of symptoms, the Golden Medical Discovery should
be taken in doses of from two to three teaspoonfuls every four hours in
alternation with three-grain doses of the sulphate of quinine. If the
attack is very severe, and is not relieved by this treatment, a
physician should be summoned to attend the case.
REMITTENT FEVER. (BILIOUS FEVER.)
The distinction between _intermittent_ and _remittent_ fever does not
consist in a difference of origin. In the former disease there is a
complete intermission of the symptoms, while in the latter there is only
a remission.