Diseases of the Genito Urinary Organs. Syphilis.
Inflammation of the Bladder. Cystitis.
CYSTITIS may be either acute of chronic, and, when chronic, usually occurs quite independently of any acute attack, thus differing from other diseases. The cause is infection by a special germ, but certain agencies favor its development, such as exposure to cold or wet, retention of the urine, injuries to the bladder, certain irritating drugs, inflammation of nearby parts, foreign bodies in the bladder, etc., and in women in chronic cases, pressure from a displaced uterus.
"Pain, pus and frequency" are called the three leading symptoms of acute cystitis. This disease is described at length elsewhere in this book, so it may be said briefly that an acute attack may be preceded by chills and fever; that the pain is a constant dull ache or sharp, agonizing pain in the region of the bladder; that pus soon appears in the urine, and that there is frequent urging to pass water, which does not flow freely but only drop by drop.
In chronic cases the pain and urging are not so severe, but still there is frequent and difficult urination for weeks or months, with headache, backache, leg ache, debility, and loss of flesh.
Aconite. Chilliness and then much fever; dry, hot skin; full pulse; thirst and restlessness; constant desire to urinate; urine hot, dry, scanty.
Cantharis. Burning heat in bladder; burning and cutting pains, so severe that the patient screams aloud; constant desire to urinate, with almost ineffectual straining; urine passes in burning drops.
Terebinthina. Much irritability of the bladder not relieved by cantharis; bloody urine passed drop by drop; sensitiveness over the region of the bladder; slimy, bloody sediment to urine.
Belladonna. Region of bladder very sensitive; urine hot and red; involuntary dribbling of urine; great nervous irritability.
Apis. Especially useful in inflammation of the bladder following the use of cantharides, camphor, or other drugs; urine pale straw color, or scanty and red, with brick dust sediment; pain and burning before and after passing water; much straining.
Mecurius Cor. Especially in gonorrheal cases or where there is much straining in the rectum as well as in the bladder; sudden, irresistible desire to urinate, and perspiration while passing water; scanty, bloody urine containing white shreds, or dark, flesh like pieces of mucus.
Chimaphilla. Useful in both acute and chronic cases, with high colored, scanty, offensive, turbid urine, containing ropy or bloody mucus; much mucous sediment; great straining before and after urinating, difficulty in beginning to urinate; constipation.
Also Pulsatilla, especially in chronic cases in women having catarrhal troubles; frequent, ineffectual urging, with cutting pain and urging; slimy sediment; cystitis after exposure to cold. Cannabis sativa. Gonorrheal cystitis with urging every few minutes, and burning and straining worse after urinating; the whole length of the urinary passage burns and smarts. Boracic acid. Five grain doses four times a day in chronic cases, where there is great desire to urinate, and can not pass a drop, or frequent urination at night as well as in day time, with much smarting afterward. Nux vom. Especially in cases occurring in those of sedentary habits, who have indigestion and constipation; painful, ineffectual urging to urinate; urine passes in drops, with tearing pain in the passage; urine pale, and later thick, whitish, or may be reddish, with sediment like brick dust. A dose of the indicated remedy every hour in acute, and every three hours in chronic cases.
Absolute rest in bed is most desirable and essential, also the free use (three pints or more a day) of distilled or pure spring water, and a glassful of Vichy before each meal; hot sitz baths; hot fomentations over the bladder; washing out of the bladder in chronic cases; a largely milk diet; the avoidance of tea, coffee, alcohol, salty and spiced food, pork, lobster, cheese, beans, fried foods, pastry, and acid fruit.
Sufferers from chronic cystitis should take two to four warm tub baths weekly, besides the daily warm sponge bath, and should wear a flannel band about the abdomen. In women, diseases of the uterus and ovaries must receive proper treatment; vaginal injections of boracic acid and hot water, a dram to the quart, may be taken every other day. A good physician should be consulted so that local treatment of the bladder may be instituted. The bowels must be kept open. Cod liver oil should be taken when there is much debility and loss of flesh.
Retention of Urine and Strangury.
DR. E. L. KEYES, consulting surgeon to Bellevue Hospital, New York, states that, in his opinion, 95 per cent. of all cases of retention of urine are due to stricture of the urethra (the passage from the bladder through which urine is voided), to contraction of the bladder, or to enlargement of the male gland called the. prostate. The effect of retention of urine is congestion of the bladder in its straining efforts to empty itself, and as this condition increases and extend.,, congestion of the kidneys also, making them extremely susceptible to infection. The treatment must be directed chiefly to removing the cause.
Strangury is the passing of urine drop by drop, with much urging and straining, and may be due to inflammation of the urinary organs or passages, or to obstruction.
Arnica. Retention of urine from exertion; urine retained, with aching and pressing in bladder; constant ineffectual desire to pass water, or urging, with involuntary dropping of urine; urine dark, scanty, with brick dust sediment; after wounds.
Belladonna. Retention of urine, which passes only drop by drop; difficult, scanty urination, with urging pain, and heat along the urethra; paralysis of the bladder muscles.
Hyoscyamus. Paralysis of the bladder; frequent, scanty, difficult, or involuntary urination; retention of urine.
Veratrum Alb. Urine not secreted, or if secreted is only partially evacuated, with pain and burning along the urethra; greenish urine.
Consult the remedies given under 11 Cystitis," especially Cantharis, which is a very valuable agent in these cases, and Aconite in suppression or retention from exposure to cold. Also Camphor. Urine passed drop by drop, with great urging; retention of slow emission of red, thick urine having a musty odor; inflammation caused by the use of cantharides, turpentine, or other drugs; cold extremities. A dose of the indicated remedy every fifteen minutes to one hour.
Refer to the general directions in the section on 11 Cystitis." Hot baths and applications over the bladder, especially with flannels wrung out in very hot water and a few drops of turpentine sprinkled on them, are indicated. The urine must be withdrawn by catheter if it cannot be passed naturally. The unskillful or careless use of the catheter or any other instrument is a fruitful cause of wounds of the mucous membrane, and subsequent infection by pus germs.
Suppression of Urine.
IN suppression of urine, no urine is made by the kidneys. This is a serious symptom and may ,occur in old people, and in the course of other diseases at almost any age. The remedies mentioned under retention of urine may be consulted, but in all cases the cause of the condition, and all the associated symptoms must be taken into consideration. In suppression from long continued exposure to cold Aconite should be given, especially with pressure in the bladder or stitches in the region of the kidneys. Arsenicum for suppression in the course of diseases of the kidneys or heart, with poisoning of the whole system from the absorption of waste products, dropsy, and great prostration and exhaustion. Stramonium. Suppression during high fever and delirium, neither urine nor fecal matter from the bowels is passed. Pulsatilla. Suppression in little girls or in women with uterine disorders, with frequent~ ineffectual urging to urinate and cutting pains.
Hot baths, hot applications over the kidneys and bladder, and hot drinks are recommended; give the sufferer large quantities of distilled water or Vichy or Poland water, and injections of hot salt solution into the bowels.
Incontinence of Urine. Enuresis.
Adults as well as children may be subject to this annoyance. Of the causes in children mention has been made under “Wetting the Bed." In adults incontinence of urine may be due to piles, cracks in the rectum or worms; defective eyesight; paralysis of the bladder from repeated neglect to empty it when full; weakness of the bladder from wounds or uterine troubles, and frequently, great nervousness or a highly neurotic temperament; sexual excesses or unnatural practices may cause irritability of the bladder. For treatment consult the action just referred to.
Blood in the Urine Hematuria.
WOUNDS, congestion of the kidneys, Bright's disease, stone in the bladder, smallpox, scurvy, ulcers, and sometimes malaria account for blood in the urine. Blood in the urine may be detected by adding to the urine a drop or two of tincture of guaiacum and two drops of ozonic ether; at the junction of the two fluids a blue line forms, which becomes diffused through the ether. The cause must always be sought, and remedied when possible. Blood in the urine is only a symptom, and all the symptoms and the general condition must be taken into account in selecting a remedy.
Aconite. Blood in the urine especially in inflammation of the bladder and urethra; scanty, dark, scalding hot urine, passed drop by drop.
Cantharis. Violent, cutting, pressing, crampy pains in the, bladder, extending into the kidneys and urethra; urine passed drop by drop, with burning pain before, during and after urination; urine red or dark colored as if mixed with blood.
Nux Vom. Blood in the urine after alcoholic excesses, highly seasoned foods, or strong medicines; from indigestion with constipation; suppression of monthly flow; full feeling with pressure in the abdomen, loins, and region of the kidneys.
Terebinthina. One of the best remedies when this symptom is present; blood mixed with urine, forming a dirty, reddish brown or blackish fluid, or a coffee ground like sediment; burning, drawing pains in the kidneys; pressure in the bladder, extending up into the kidneys when sitting, disappearing when walking about; pressing and straining in the bladder when sitting before urination, passing off when walking; burning in the bladder, worse while passing water.
Also Arnica after injuries to the urinary organs. Arsenicum. Very painful urination, scanty secretion, burning pain in the urinary organs~, bladder seems paralyzed; great anguish and restlessness; bloody urine especially in infectious and septic diseases.
Gravel or Stone.
THE composition of the different varieties of urinary deposits is described at length elsewhere in this book. Gravel or stone may form in the kidneys or bladder, and in passing through the tubes from the kidneys to the bladder, or from the bladder to its outlet may cause severe pain and tenderness. Men the stone is from the kidneys, the paroxysm of pain is called renal colic; it radiates downward into the groin or bladder, and along the inner side of the thighs. The pain may be so severe as to cause nausea and vomiting; sweat; rapid, feeble pulse and even fainting. There is frequent and painful urination, from reflex irritation. Men there is stone in the bladder which passes into the urethra there is frequent urination, with pain and sudden stoppage of the stream of urine. The directly curative treatment of gravel or stone is surgical, and should not be postponed. Remedies will, of course, be resorted to for the alleviation of pain and other symptoms, and especially for the constitutional condition favoring the formation of stone.
Berberis. Renal colic with sharp, stitching pains, with red sediment in the urine which is dark red or yellow in color, becoming turbid; burning all along the urinary passages; severe pain in the hip.
Lycopodium. Dull pain, better on passing urine; renal colic, especially of the right side; scanty, high colored urine, smelling like ammonia, with red, sandy deposit, sometimes whitish; itching in the urethra before and after passing urine.
Arsenicum. Pain in the kidneys with the occasional passage of gravel; scanty urine passed with difficulty; suppression or retention of urine; sometimes blood in the urine.
Sarsaparilla. Urine passed with difficulty, and containing mucus, pus, gravel and small stones, urine slimy, flaky; clayey or sandy.
Pareira Brava. Four or five drops of the tincture at the first warning of the attack of renal colic, especially if the attack begins with pain in the genitals, followed by straining in the bladder and rectum; severe pains in the groins extending down the thighs; paroxysms occurring usually from 3 to 6 A..M.; urine smells of ammonia, and is passed with difficulty drop by drop.
Also Cannabis sat. Tearing, jerking, stitch like pains along the urethra, and feeling of soreness; burning while urinating, but especially afterward. Belladonna. Spasmodic, cramp like pains; high colored urine, with brick dust sediment; pains come on suddenly and radiate in different directions. Nux vom. Renal colic with intense backache, and pains extending into the genital organs, and down the leg. A dose of the indicated remedy every fifteen minutes during an attack; three times a day between paroxysms.
While one of these remedies may give relief in mild cases during an attack, it is chiefly toward correcting the constitutional condition favoring the formation of stone, that they are to be directed. A few whiffs of chloroform or ether will relieve the agonizing pain of a severe paroxysm; hot baths are helpful; a hypodermic of morphine, 1 grain, with atropine sulph., 120, or suppositories of opium and belladonna may be used.
Free drinking of rain water or distilled water is the best preventive of the formation of gravel or stone; meat should be eaten sparingly; green vegetables, salads and fruits freely; milk is an excellent food, also fish; avoid alcohol, spices, tea, rhubarb, onions, tomatoes, spinach and sorrel. Exercise out of doors is recommended, but must not be excessive; the bowels and pores of the skin must be kept open,
DIABETES may occur apparently alone or associated with affections of the liver, pancreas, nervous system or lungs. Men are attacked about three times as often as women, and the disease is rare under thirty years of age. It is characterized by a copious secretion of urine loaded with sugar, and by a progressive loss of flesh and strength.
The early symptoms are frequent, and excessive urination, great thirst and emaciation, later dry, harsh skin; itching; voracious appetite; constipation; normal or subnormal temperature; impairment of the sexual powers and the eyesight, and there may be drenching sweats; the amount of the urine increases to from four to forty pints. Acute cases last from eight to ten weeks; chronic cases from one to five years, but may continue ten or fifteen. Persons engaged in literary occupations inducing mental fatigue and sedentary habits and members of the "well-to-do" class, or those suffering from gout, syphilis, malaria, and "high living" are especially subject to diabetes.
Phosphoric Acid, 2 x. This remedy is of the first importance in the treatment, especially in the early stages, of cases of nervous origin resulting from overwork, worry or sexual excesses; rapid loss of flesh; emaciation; much sugar in the urine.
Uranium Nitrate. Best adapted to cases with marked failure of the digestive functions from the beginning.
Arsenicum. Great thirst; restlessness; anxiety; debility; oppressed breathing; rapid loss of flesh and strength, waxy look to the skin; and may be eruptions, swelling of the legs, and in the advanced stage, diarrhea, carbuncles and gangrene; all symptoms worse at night.
Plumbum Iod. Diabetes especially in gouty individuals, with crystals of uric acid in the urine, and small amounts of albumin; low spirits, anguish and melancholy; dimness of vision; mouth dry; tongue dry and cracked; some fever; skin dry; gangrene.
Also Nux vom. for indigestion, with much irritability. Lactic acid. Copious and free urination of light colored urine containing sugar; voracious appetite; thirst; nausea; constipation; food sours in the stomach, and much burning, hot gas is raised; skin harsh and dry. Podophyllum. Light colored stools with fullness and soreness in the region of the liver; tongue heavily coated white; head heavy and aches in the morning; blurring of vision. Lycopodium. Flatulency; full feeling after eating; pressure over the liver; constipation; uric acid crystals in the urine. Creosote. Diabetes complicated by consumption, with cough, expectoration, flatulency, and rapid emaciation.
A dose of the indicated remedy every two or three hours in acute cases; twice or three times a day in chronic. Alkaline waters, such as Vichy, Carlsbad and Marienbad may be used freely, also rain water and distilled water. Diabetics may eat eggs, cheese, shell fish, salt and fresh fish; fowl and game, ham, bacon, mutton, sweetbreads, kidneys; salads; olive oil, butter, cream, cod liver oil, bone marrow; sauerkraut, lettuce, sorrel, mushrooms, watercress, spinach, chicory, celery, cucumbers, tomatoes, lemons, sour cherries, gooseberries, strawberries, oranges, and nuts except chestnuts; gluten bread, bran bread, rusk, and almond bread; glycerin or saccharine should be used to sweeten tea or coffee; no alcoholic beverages; meat soups are allowable; a milk diet is beneficial in some cases.
Daily bathing, fresh air, sunshine, freedom from care and worry, and the wearing of flannel all the year round are recommended. Directions for the detection of sugar in the urine are given on page 373.
Acute Bright's Disease. Acute Nephritis.
THIS is an acute inflammation of the kidneys frequently brought on by exposure to cold and wet, especially if after the use of alcoholic beverages, or occurring in connection with scarlet fever or other infectious diseases, pregnancy, skin diseases, or may be caused b many vegetable and mineral poisons. Sometimes no cause is discoverable. Acute cases last from a few days to five or six weeks; the longer the duration of the case the worse the outlook; suppression of the urine is the most unfavorable symptom.
Generally the onset of this disease is sudden, with slight swelling or puffiness of the face, but this may be preceded by chilliness, fever with nausea, and persistent vomiting; dull pain over the kidneys extending downward; frequent desire to urinate, and diarrhea; much debility. As the disease progresses there is full, quick pulse; twitching of the muscles; drowsiness, and may be much dropsy.
Aconite. In the early stages in cases resulting from exposure to cold and damp, with high temperature, full, rapid pulse, dry skin, great restlessness, dark, scanty urine.
Belladonna. In the early stages, especially in children, with flushed face, throbbing arteries in the neck, bounding pulse; hot, but moist skin which steams when the bedclothes are raised.
Apis. Much dropsy, with no thirst; whitish, waxen, transparent look to the skin; scanty urination; albumen in the urine; more especially when this condition follows scar latina or accompanies pregnancy.
Cantharis. Burning pain in the loins; severe vomiting; mental stupor; constant desire to urinate but passes only a few drops of turbid, bloody urine; suppression of urine.
Terebinthina. Acute cases resulting from infectious diseases, or exposure to cold; burning, drawing pains in the region of the kidneys; scanty, bloody urine, passed drop by drop; general dropsy; suppression of urine.
Also Mercurius cor. when, with scanty urine containing albumen and much irritability of the bladder, there is diarrhea with much colic and straining; difficult breathing, and puffiness of the face and feet. Phosphorus when there is consumption of the lungs, or heart disease, or ulceration of the bones, with wasting and nervous exhaustion.
A dose of the indicated remedy every three hours. Rest in bed, quiet and warmth are essential in the general treatment; flannel blankets may be substituted for cotton sheets, and canton flannel or flannelette nightdresses used; milk, buttermilk and gruels are the best foods, with koumyss, rice, vegetable soups without onions, grape juice; distilled or carbonated waters in abundance, lemonade, especially hot. A hot pack for an hour, consisting of a blanket wrung out in hot water and wrapped round the patient, with a dry blanket and a rubber sheet on the outside, may be given every other day, or a hot tub bath to increase the activity of the skin.
Chronic Bright's Disease. Chronic Nephritis.
Gout, lead poisoning, chronic alcoholism, and an inherited tendency are the chief causes of one variety of the chronic form; prolonged exposure to wet and cold, pregnancy, scarlatina, acute nephritis, and some authors add malaria. The symptoms resemble those of the acute form, but develop more insidiously, with even greater general debility, headache, indigestion, lassitude, nausea and drowsiness. In the first named variety dropsy is infrequent except toward the last, with failing heart. The quantity of urine may be much increased for quite a long while. It contains a large amount of albumen. The duration of the disease is from one to twenty years. Consult the remedies given under "Acute Bright's Disease," especially Cantharis and Mercurius cor.
Plumbum. Loss of appetite; frontal headache, worse from mental application; oppressed breathing, worse at night; swelling of the ankles, dry skin, even after exercise; colicky pains; obstinate constipation; abdomen drawn in; skin pale, rapid emaciation and debility; absorption of the waste matter into the blood, causing a tendency to convulsions.
Phosphoric Acid. Frequent, profuse, watery or milky urine, depositing a sediment; great debility and loss of flesh; mental exhaustion.
Arsenicum. Much dropsy; restlessness, thirst, anxiety, restlessness, worse at night, and must lie with the head high; dropsy of the chest, puffiness about the eyes, and swelling of the feet and limbs.
Also Kali iod. in syphilitic cases, five to ten grain doses three times a day. Digitalis when with dropsy and difficult breathing there is a weak, irregular pulse. A dry, warm climate, and much rest in bed are desirable; a warm tub bath daily, continued for from ten minutes to half an hour; daily inhalations of oxygen gas; small quantities of food, as recommended for acute cases, and at frequent intervals; the securing of free movements of the bowels by the use of saline laxatives. To increase the flow of urine when dropsy is excessive, twenty or thirty drops of Apocynum cannabinum may be given every three hours until the desired effect is obtained.
Inflammation of the Urethra.
EXPOSURE to wet and cold and local injuries may cause inflammation of the urethra, but the most common cause is infection by the germ called the gonococcus of Neisser at the time of impure sexual intercourse, the disease resulting is called gonorrhea. This affection is fully described on page 404. The principal symptom following burning heat, tenderness and puffiness at the entrance to the urethra, is a catarrhal discharge soon changing to thick, purulent matter; there are painful and persistent erections, and owing to the swelling of the lining membrane of the urethra, the urine may be passed in spurts or drops, or as a twisted or forked stream. Symptoms appear between the first and fourteenth day after exposure; generally from the third to the seventh. The disease is highly contagious, and when transmitted from a man to a woman causes many and serious diseases of the pelvic organs.
Gelsemium. Drop doses of the tincture every three hours early in the acute stage; moderate discharge; smarting and burning at the entrance of the urethra, and not much pain.
Cannabis Sativa. Smarting, burning, stinging during urination; constant urging; copious, thin discharge; foreskin swollen and painful, urine passed drop by drop, pains extending into the scrotum, with dragging in the testicles. Drop doses of the tincture.
Cantharis, 2 x. Extension of the inflammation toward the bladder; passage of blood or bloody urine; inflammation of the bladder. See indications for Cantharis under that heading.
Mercurius. Free greenish and purulent discharges worse at night; dark purplish swelling of the parts; inflammation of the foreskin; thickening of the walls of the urethra so that the stream of urine is much diminished in size; painful erections. Give Mercurius cor instead when, with the above symptoms there is great urging to urinate, burning and scalding.
Also Aconite in the very beginning, if inflammation of the urethra is due to exposure to cold and wet. Arnica when caused by wounds.
Copaiva. Gonorrheal inflammation, with constant desire to urinate, painful, bloody urination; profuse, yellow, purulent discharge; painful erections. Capsules containing five minims or drops; one three times a day.
A dose of the indicated remedy every two or three hours, unless otherwise specified. Immersion of the male organ frequently and as long as possible in water as hot as can be borne is recommended in acute inflammation. A five to ten per cent. watery solution of ichthyol makes a satisfactory injection. Treatment by injections is best pursued, however, under the advice and direction of a competent physician, and only such should be consulted. For painful erections, keep the bowels, especially the rectum free; sleep on a hard mattress, with light bed coverings and in a cool room, and use suppositories of opium, one grain and camphor two grains. The diet, especially during an acute attack, should be light and unstimulating; no stimulants, tobacco, or effervescing drinks; avoid tea and coffee; refrain from sexual intercourse; take frequent sponge baths; drink water freely between meals; be very careful not to infect the eyes; a "gonorrhea bag" should be worn with a little cotton in it which should be frequently changed.
Inflammation of the Testicles. Orchitis.
INFLAMMATION of the testicles may occur in the course of gonorrhea, one or both being involved, and unless inflammation is checked, becoming exceedingly painful and badly swollen.
Aconite. In the very beginning when there is much congestion of the parts, with general feverishness.
Pulsatilla. Drawing, stretching pains, from the abdomen, through the spermatic cords, into the testicles; swelling of the testicles, with soreness and tearing pains; swelling of the right side of the scrotum. This remedy is doubly indicated when the above symptoms are associated with those enumerated under "Inflammation of the Urethra."
Clematis. Follows Pulsatilla well, when the testicles are inflamed, swollen and painful, sensitive to touch, and one or both drawn up), interrupted flow of urine, with burning, especially when beginning to urinate.
Hamamelis. Severe neuralgic pains in the testicles; intense soreness and swelling; pain running down the spermatic cords into the testicles.
A dose of the indicated remedy every two hours. Hot fomentations of hamamelis to the parts will relieve pain, or a tobacco and flaxseed poultice made light and as hot as can be borne. Support the scrotum by a square cloth folded diagonally, and the corners fastened to a waist band; when the swelling has partially subsided, apply ichthyol, ten per cent. in vaseline, or compress the testicle by strapping with straps of adhesive plaster. Avoid constipation, sexual excitement, alcoholic beverages, highly seasoned food, tea, coffee and tobacco. A light diet, and rest in bed are beneficial.
THIS loathsome disease is described at length on pages 394 to 432.
If curable, it is not to be eradicated in a few months. The sufferer owes it to himself and to the community to put himself under the care of a competent and conscientious physician, and scrupulously carry out his instruction. It will very likely be necessary to continue treatment for three years if the sufferer is a man, four years if a woman. No greater crime can be committed than to marry while uncured.
Phytolacca. In the first stage, with enlargement of the adjacent glands; headache; sore throat; syphilitic rheumatism and bone pains, worse at night and in damp weather; also, after eruptions and ulcerations occur.
Mecurius Sol. or Vivus, 2 x. For mild cases without much glandular enlargement; syphilitic fever; pains at night; red, flat and scaly eruption especially on the palms of the hands; lining membrane of the throat a darkish red.
Mecurius Prot, I x. When the glands are badly swollen, and the case proves a stubborn one; falling of the hair; throat very sore, or give Mercurius bin, 2 x when, with the above symptoms, the tonsils are badly swollen and very sore.
Mecurius Cor, 3 x. Rapidly spreading, creeping ulcerations with ragged edges, eating into the tissues; inflammation of the eyes; redness and burning of the mouth and palate, attempting to, swallow liquids or solids often causes spasms of the throat; syphilis of internal organs.
It is better not to begin taking any form of mercury until skin eruptions appear.
Kali Iod. Most useful in the third stage of syphilis, when the poison seems to have soaked into all the tissues, and where ulcerations of the skin and mucous membranes are extensive and extending; scrofulous, debilitated conditions; violent headache, with hard lumps on the head; eruptions on the face, scalp, chest and back that leave scars; foul breath; sore throat; fetid, greenish discharge from nose; ulceration and decay of the bones; gnawing, burning, boring pains worse at night.
Nitric Acid. A valuable remedy when a case has been so mismanaged as to have been saturated with mercury or potassium; offensive, corroding discharges from ulcers and sores; splinter like pains; scaly eruptions; deep, bleeding cracks at the corners of the mouth; foul breath; ulcers bleed easily; ulceration of the genitals, of the nostrils and throat.
A dose of the indicated remedy three times a day. Cleanse the sores with a mild antiseptic, as bichloride of mercury 1 to 2,000 or 1 to 3,000, and dust with calomel, aristol or iodoform, or protonuclein (special). As local treatment must be followed up for a long time, and changes made as indicated, the advice of a competent physician is highly desirable. Drink no alcoholic beverages; refrain from sexual intercourse or excitement; do not use tea, coffee, tobacco, spices or rich or indigestible food; take alkaline or sulphur baths; live out of doors as much as possible, and exercise or work in the open air; keep the mouth and teeth clean.
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