Diseases of the General System and Miscellaneous Diseases.
Asiatic Cholera.Epidemic Cholera.
This germ disease is well described on page 362. The symptoms to be especially emphasized as characteristic are vomiting alternating with painless diarrhea, the stools becoming like rice water, and very frequent and sudden; excruciating cramps in the calves of the legs and abdomen with knotting of the muscles; the face grows old as if by magic, pinched, blue, and sunken; the tongue cold and bluish; the eyes glassy; pulse thready and weak; voice hoarse; skin of a clammy coldness; then comes a partial or complete cessation of vomiting, an entire collapse of the vital forces, and death. Recovery, however, may and often does take place, and under no treatment more frequently than the intelligent and prompt use of homeopathic remedies.
Camphor. Early in the attack; immediate prostration; body cold; voice husky; face pinched and blue; skin shriveled; anguish and distress at the pit of the stomach, and burning in the bowels; watery diarrhea, sometimes slight; may be some vomiting. Two or three drops in sugar every five or ten minutes, at the same time rubbing camphor on the neck, chest and abdomen until reaction takes place.
Veratrum .Alb. Cases marked by excessive vomiting and purging, with violent abdominal pains; eyes sunken, with blue rings around them; cold sweat on the forehead, very profuse, flaky, frequent, rice water evacuations; violent colic, especially about the navel. Five drops of the tincture every fifteen minutes increasing the intervals as patient improves.
Arsenicum. Sudden and great prostration; anguish; violent thirst, with vomiting of least quantity of liquid; difficult breathing; burning in stomach; pulse small and vanishing; burning distress in the region of the stomach; collapse. Give as above.
Coldness and blueness of the skin; cramps of the muscles of the legs and thighs; unconsciousness; gurgling in throat, stomach and bowels; cessation of diarrhea. Give as above.
Also when the patient is extremely ill, and fails to respond to the above remedies give Carbo Veg. if the body is cold; skin bluish; breath cool; cold sweat on limbs; thready pulse frequently losing a beat, Hydrocyanic Acid 3x, with practically no pulse; respiration slow, deep and gasping, taking place at long intervals. A dose every five or ten minutes.
The patient must be placed in a warm bed, and surrounded by hot water bottles, or hot bricks, flat irons or even stove lids wrapped in flannel. Rub the body and especially the extremities with hot flannel, rubbing toward the heart; give hot milk by rectal injections, but nothing by mouth except ice, champagne or lemonade; have the room warm but well ventilated.
During convalescence the return to a solid diet must be very gradual; begin with milk, thin gruels, and strained broths; no solid food until the stools are no longer liquid, and begin to look natural.
Disinfect all the stools or vomited matter with carbolic acid solution one to twenty; boil all soiled clothing, if it is not first soaked in a disinfectant; keep the patient's dishes, etc., separate. The attendant should disinfect his hands frequently, and two or three times a day take drop doses of Camphor.
The prevention of cholera includes the use of boiled drinking water, avoidance of uncooked fruits or vegetables; absolute cleanliness of person, house, yards and streets; good drainage; clean and covered cesspools; regular habits; the avoidance of all stimulantŐs, overwork, worry, or exposure in chilly, damp weather, or to night air or crowds.
Although typhoid fever occurs in all countries and in all climates, it is more common in the temperate zones, and in the summer and autumn, being frequently called "Autumnal fever." It is contracted by taking into the system the typhoid bacillus or germ; this has a great vitality, and lives for months in the ground, in water or in a cake of ice, and multiples rapidly in milk. More men are affected than women, and in the young the disease usually runs a shorter course.
In the beginning there is slight headache, chilliness, languor, thirst, loss of appetite, constipation, and often nosebleed, sometimes diarrhea. A few days later fever develops, and pulse and temperature increase a little every day; the skin is hot and dry; thirst and feelings increase, and the abdomen becomes more or less disturbed and is sensitive to pressure. Successive crops of rose-colored spots, like fleabites, appear on the abdomen, beginning about the eighth day; inflammation of patches in the bowels leads to ulceration, and may cause death of the tissues, perforation of ' the intestines, peritonitis, hemorrhage and death, or death may result from pneumonia. In bad cases there is loud muttering delirium, with picking at the bed clothes; the teeth and gum are covered with a brown, sticky deposit called sordes.
Bryonia. Early in the disease debility, languor, loss of appetite; tongue coated white; wandering pains in the limbs; dry, burning heat; also later in the disease when there is great thirst; dryness of the mouth; distended abdomen sensitive to pressure; dark colored urine; shooting pains in the chest, with cough; hurried, labored respiration; apathy; drowsiness; picking of the bed clothes.
Baptisia. Dry mouth; coated tongue which shows impress of teeth; loss of appetite; nausea; flatulence in and tenderness of abdomen; dusky red face, and delirium following above symptoms; yellow, offensive stools; cordes on lips and tongue.
Rhus Tox. May follow Bryonia or Baptisia. Mind dull and clouded; muttering or active delirium; tongue brown and dry, with a red tip; lips, teeth and gums covered by a brownish deposit; much prostration; pulse weak and slow; muscular soreness and stiffness of the extremities; abdomen bloated; copious, yellow, involuntary evacuations. This remedy is most often indicated as the symptom given show in the second and third weeks.
Terebinth, I x. Bleeding of the intestines, with tenderness of the abdomen; great distention and accumulation of gas; red, glossy tongue; mouth dry; great prostration and emaciation; offensive stools; bloody urine; may be bed sores. Drop doses every fifteen minutes.
Hyoscyamus. Marked nervous symptoms; great nervousness; low, muttering delirium; sleeplessness; involuntary discharges from the bowels; picking at the bed clothes; gritting of the teeth; jerkings, trembling; rose spots on the chest and abdomen; cold extremities.
Also Belladonna, with great congestion of the head, red face, pupils of the eyes dilated, active delirium. Hyoscyamus may relieve this delirium if Belladonna does not. Muriatic Acid. Extreme prostration; patient stupid and unconscious, sliding down in bed; low, muttering delirium; involuntary discharges from the bowels, and bladder; picking at the bed clothes. Hamame&, I x.Dark, pitch like blood from the bowels; bruised, sore feeling in the lower part of the abdomen. Ten drops every half hour. Unless otherwise specified give the indicated remed every one to two hours; put y twenty drops in half a glass of water; teaspoonful doses.
Good nursing is of the utmost importance in typhoid; the patient must be put to bed, and not allowed to get up on any pretense; keep some disinfectant in the bed pan and disinfect the urine and stools with chloride of lime, six ounces to one gallon of water; protect the mattress with a rubber sheet; change the bed linen often, disinfect it and boil for half an hour; bathe the patient after each movement of the bowels with bichloride of mercury I to 2,000; cool sponge baths may be given every three hours, and should last twenty minutes, during which the skin should be exposed to the air; gas in the bowels may be relieved by passing a long rectal tube into the lower bowel.
While fresh, unskimmed milk is the best food (six ounces every two hours) with a teaspoonful of lime water if the stomach seems acid, peptonized milk, buttermilk, koumyss, matzoon, or white of an egg with water may be used as substitutes; strained mutton broth may be given, or meat juice if milk is not well borne; give plenty of pure water; rectal injections of nourishment if food is not retained by the stomach; during convalescence give broths; scraped beef; milk toast; blanc mange; wine jelly; soft egg; the soft part of oysters; steak to chew; baked potatoes, exercising with great discretion; no solid food of any kind if temperature goes over 1000. Brandy or sherry may be given for weak, irregular pulse, and delirium with much prostration; strychnine for heart failure, 1-50 to 1-100 of a grain. Persistent constipation may be relieved by soap and water injections.
Typhus Fever. Putrid Fever. Ship Fever.
Typhus fever is a highly contagious disease, due to a specific poison and developing especially where hygienic conditions are bad, as in overcrowded camps, prisons, hospitals, tenement houses or localities. It resembles typhoid fever but differs from it in many symptoms, typhus having a sudden onset; delirium from the first; high temperature on the second or third day (1040 to 1070), which continues high; small, slightly elevated eruption called 11 mulberry rash," which persists; slight emaciation, and a duration of about two weeks, typhoid lasting from three to six weeks. The symptoms generally appear in the order given; severe chill or chills; vertigo; bad headache ; muscular pains; loss of appetite; pain in the back.; profound prostration; fever, with rapidly rising temperature as given above, which continues without remission during the first week. The measly like eruption giving the skin a mottled look, appears by the fourth or fifth day; the pulse becomes rapid and feeble, and in the second week may reach 140 beats a minute; respiration is rapid delirium occurs, or stupor, the patient conscious but appearing unconscious; the teeth and tongue axe covered with the same deposit as in. typhoid fever, and there is muttering, and picking at the bed clothes. Death may occur from exhaustion, and from complications. Convalescence is generally slow.
Baptisia. Face flushed, dark red; mouth and tongue dry; putrid breath; sensitiveness on right side of abdomen; constipation; sweat on forehead and face; great prostration, livid eruption, stupor; this is the chief remedy, especially during the first week.
Belladonna. During the second week if headache is intense, and there is much nervous excitement with delirium, throbbing of the arteries in the neck, and jerking and sudden starting up, give Belladonna or Stramonium if the delirium is so violent as to threaten to exhaust the patient's strength.
Phosphoric Acid. During the second week when patient lies in a stupor or stupid sleep; when aroused is fully conscious, but shows stupor, indifference, a " don't care condition"; no excessive prostration; maybe copious, frequent diarrhea, preceded by rumbling in the bowels.
Arsenicum. Great prostration; thirst; burning sensations; sordes on teeth and tongue; watery, yellowish diarrhea, or stools containing blood, slime or pus; high fever; sometimes inability to pass urine.
Under "Typhoid Fever" read the indications for Rhus Tox, Muriatic Acid and Hyoscyamus. A dose of the indicated remedy every one or two hours. Opium may be thought of when the patient lies in a state of torpor from which he cannot be aroused, with heavy labored breathing; face flushed a dark red; full, slow pulse.
Follow the general treatment outlined under "Typhoid Fever." Fresh air is very essential; keep the windows wide open, and protect the patient with blankets. Every noise should be hushed. Use baths to reduce the temperature; give nourishment regularly and persistently in small quantities, and treat heart failure as under "Typhoid Fever." The patient must be strictly quarantined, and disinfectants used freely.
Yellow Fever. THIS disease is well described on page 524. Its chief characteristic symptoms are chill, fever of from 103' to 105'; headache; Severe backache; flushed face; eyes suffused; vomiting; albumen in the urine; then after two or three days a temporary subsidence of the symptoms for twenty-four hours, followed by signs of collapse; skin cold and yellow; weak pulse; "black vomit"; black stools: bleeding from nose, or stomach or bowels; dry, brown tongue.
Camphor. Drop doses of the tincture every ten minutes when the onset is marked by severe chills, and signs of collapse.
Aconite. After reaction from chill; fever; burning heat; dry skin; full, hard, and rapid pulse; violent thirst; red face; headache; restlessness; prostration, and vomiting.
Belladonna. Headache; face bright red, shining and swollen; throbbing of arteries in the neck; pain in the stomach, with nausea and vomiting; violent delirium.
Bryonia. When disturbances of the nervous system subside, and the stomach symptoms become prominent; splitting headache; eyes red and sparkling; tongue coated yellow; lips parched, dry, and cracked; great irritability and vomiting.
Also Arsenicum. Small, tremulous pulse; skin cold; cold, clammy perspiration; rapid prostration, and vomiting of brownish matter mixed with mucus. Veratrum Alb. Acute pains in the stomach and abdomen; violent vomiting; skin cold; cold perspiration; small, weak pulse; collapse. A dose every fifteen minutes to half an hour in serious conditions calling for either Arsenicum or Veratrum. A dose of Aconite, Belladonna, or Bryonia may be given every one or two hours.
The patient must remain in bed, and use a bed pan containing disinfectant, see "Typhoid Fever." Liquid diet; rectal injections )f nourishment if the stomach will not retain food; iced champagne )r stimulants if there is danger of heart failure. Evacuations, clothing, etc., must be disinfected. Early treatment and good nursing are of the greatest importance.
Yellow fever germs are conveyed by mosquitoes, and persons in hot latitudes should always be protected from their bites by netting; should lead temperate lives; eat moderate quantities of wholesome food; bathe regularly, and avoid the use of stimulants.
Acute Inflammation of the Peritoneum.
INFLAMMATION of the lining membrane of the abdomen may be limited or general, and may be due to exposure to cold, to the extension of inflammation of some organ in the abdominal cavity, to wounds, tuberculosis or consumption of the intestines, and often occurs after childbirth. Consult the section on page 345 for a detailed description of the disease. The chief characteristic symptoms are sudden onset with chill; sharp, cutting pains; fever, the temperature rising to 102' to 104'; great tenderness over the bowels, with distention from gas; hiccough; nausea and vomiting, constipation; face pinched and anxious; rapid, wiry pulse. The great tenderness and sensitiveness to the slightest touch, and increase of severe unbearable pain by coughing or taking a deep breath, the high f ever, and the position the patient assumes lying on his back with his knees drawn up show that the pain is not simple colic but either local or general inflammation of the peritoneum, and, it may be, of the bowels also. The course of acute peritonitis is very rapid, and the mortality is great. Death may ensue in from forty-eight hours to a week or two, or the disease assume a chronic form.
Aconite. Inflammation from cold or exposure, and should be given early; hot, dry skin; great restlessness; high fever; hard, full, frequent pulse; short, quick breathing; abdomen hot, hard, swollen, and sensitive; great thirst. When peritonitis follows childbirth, and Aconite is called for, there are the symptoms given, also suppression of the flow of milk, and of the discharges of the womb and vagina; sharp, cutting pains, worse from pressure or lying on right side.
Belladonna. Face flushed; throbbing of the arteries in the neck; great anxiety; the eyes shining and protruding; painful distention of the abdomen, with much heat and burning; sudden shooting, darting, colicky pains, worse from slightest contact or motion. After confinement when the discharges are hot and offensive, or suppressed, and there are violent after pains.
Bryonia. Follows either of the above remedies well, but Aconite best; splitting headache; shooting, cutting pains in the bowels, worse from slightest motion; great thirst for quantities of water; lips and mouth very dry; constipation; limpid exudation in the abdominal cavity.
Mercurius Cor. Follows Belladonna particularly well when the acute inflammation results in the formation of purulent fluid or exudation; creeping chills; skin cold and covered with perspiration; foul breath; flabby, coated tongue; disturbed and painfully sensitive abdomen; mucous stool with urging, and violent burning and cutting pains, weakness and emaciation; swelling of the feet.
Veratrum Album. Nausea and vomiting, with cold sweat; much diarrhea; slow breathing; small and weak pulse; great restlessness, anxiety and exhaustion, in fact collapse.
Arsenicum. Sudden sinking of the strength; restlessness; thirst for small quantities of water at a time; vomiting; violent burning and cutting pains in the abdomen; vomiting, and sometimes diarrhea; the whole system is involved from absorption of the poisonous products of the inflammation; all symptoms worse after midnight.
Also Rhus Tox when peritonitis occurs in the course of the fever. Cantharis in extreme cases with scanty urine passed with great difficulty and a few drops at a time; great prostration.
Sulphur.During convalescence to hasten the absorptions, and supplement the action of other remedies. A dose of the indicated remedy every half hour to one or two hours, according to the severity of the symptoms.
Good nursing is essential in these cases, and the removal of all sources of disturbances to the patient. Liquid nourishment in small quantities may be given every two hours, milk being best, hot or cold, plain, malted, peptonized or with Vichy water; soups or broths are sometimes more acceptable; beef juice and beef peptonoids are permissible; a return to solid food during convalescence should be cautious and gradual. Flannel compresses wrung out in nearly boiling water, and with a few drops of turpentine sprinkled on them before applying to the abdomen are recommended; cover them with oiled silk or dry flannel; renew frequently; cold compresses may be substituted for hot applications if preferred, but must not be allowed to become warm, or, saturate a linen cloth with one drachm of turpentine to one ounce of melted lard or olive oil. The bedding should be light, and pressure may be prevented by the introduction under them of a "cradle"; something similar may be improvised by using barrel hoops cut in halves. Bits of ice may be swallowed to relieve thirst, but should not be allowed to dissolve in the mouth when there is vomiting. Hot rectal injections are frequently beneficial.
THE chronic may follow the acute form, with thickening of the membranes, the formation of fibrous adhesions, and often the persistence of the effusions, so much exudation being present in some cases as to cause dropsy; obstinate constipation may alternate with diarrhea; pain and tenderness vary in degree; the general health may not be much impaired or there may be much disturbance of the stomach and bowels, with great emaciation. Consult the remedies mentioned under the acute form.
Apis. Soreness of the bowels and abdominal walls; pain in the abdomen on pressure, touch and on standing; pain extending upwards; swelling of the abdomen and legs.
Calcarea Carb. Abdomen hard and distended, with drawing pains or cramp like pains, and feeling of painful pressure in the lower bowels.
Sulphur. Distention of the abdomen and great sensitiveness to touch, with fullness as if from much wind; bruised pain in the muscles, and griping pains about the navel; much gas passes from the rectum, and smells like rotten eggs; worse at night.
Also Silicea in chronic, obstinate cases with alternate constipation and diarrhea; stools very offensive; abdomen distended and hard; cutting and pinching pains; much gas with rumbling in the abdomen. Arsenicum Iod. Much prostration and emaciation; sweats and tendency to diarrhea, and many of the symptoms given under Arsenicum, in the previous section. A dose of the indicated remedy three times a day.
The general treatment must be conducted along the same lines as in acute cases; absolute rest; light, nourishing diet; fresh air; gentle exercise if able, such as short drives or rides in a boat or wheel chair but not to the point of fatigue; frequent tapings of the abdomen if large quantities of fluid collect.
Inflammation of the Bowels.
Such cases may be recognized by heat, tenderness and distention of the abdomen; small, wiry and rapid pulse; obstinate constipation; excessive thirst, often severe pain and vomiting; drawing up of the knees as the patient lies on his back, and many other symptoms resembling those of peritonitis. In fact it is often very difficult for the nonprofessional to distinguish between the two conditions. It is of the less importance because the treatment general and special is practically the same, and the reader should consult the remedies given under acute and chronic inflammation of the peritoneum, as inflammation of the bowels also may be acute or chronic. Aconite, Belladonna, Bryonia and Mercurius Cor. are the remedies specially to be thought of, and Cantharis when the bladder is involved.
Prevention is an important part of the practice of medicine, so let the reader remember some of the common causes of inflammation of the bowels that they may be avoided so far as possible; exposure to cold and damp; eating unsuitable or tainted food; neglect of a hernia or rupture resulting in strangulation of the intestine; the excessive use of purgatives; neglect to have diseases of other organs properly treated. Other causes, such as wounds and typhoid fever, it may not be possible to avoid. In acute cases the diet should be light, and local application may be made as described under "Acute Inflammation of the Peritoneum."
Painter's Colic. IN lead or painter's colic, where lead has been absorbed into the system, there are violent, painful contractions of the abdominal muscles, a retraction or hollowing of the abdomen, and obstinate constipation; sometimes a blue line may be traced about the gums. A very good extended description of this condition is given on page 355.
Opium. Violent griping and cutting in the abdomen; pressive pain in the abdomen, as if the intestines would be cut to pieces; constipation; abdomen hollowed in; pulse full and slow; retention of urine.
Platina. Pressing, bearing down pain in the abdomen, extending into the groin; pain so severe it causes screaming and constant change of position while seeking relief.
Also Alumina, with spasmodic pains in the stomach and chest, with difficult breathing, or pain pressing down into the groins. A dose of the indicated remedy three times a day.
Workers in lead should wash their hands often, and always before eating, take frequent warm baths, and drink plenty of milk and large quantities of soft water; drink no liquors; lemonade is an excellent beverage. Change of occupation should be made whenever possible when affected by lead Copious injections of warm water are beneficial.
Fever and Ague. Intermittent Fever.
THERE, are severe forms of malarial fever described in detail on page 522, all characterized by three stages, the cold, the hot, and the sweating.
In the cold stage the patient has a severe chill, the face becomes pale, pinched and anxious; the teeth chatter, the body shakes, the rapidity of the perspiration and pulse is increased; while the urine diminishes and is passed frequently. When fever appears, the skin is burning hot; the face flushed; thirst is extreme; headache severe; pulse full, rapid and bounding; temperature high; urine scanty and high colored. In the last stage the patient generally perspires freely, the temperature falls and the attack is over for that time, after lasting several hours. If the disease persists, enlargement of the liver and spleen may result. Marshy districts are most prolific of chills and fever, but the wind may carry the disease inland. General debility, intemperance and exposure at night to the germ4aden air, favor its development. Defective drainage and sewerage may prove fruitful causes. The malarial parasite may be conveyed by the anopheles, a species of the mosquito, af ter the mosquito has become infected by feeding on the blood of a person having malaria.
Chininum Sulph.Recent cases in marshy districts. Paroxysm preceded by headache, hunger 'and palpitation. Each stage well marked; first, severe chill, with violent shivering and aching pains, then fever, no thirst; yellow, sallow face. Attack occurs every second day.
Arsenicum.After excessive use of Quinine, or in chronic cases with one stage absent, usually the chill, or with the chill and fever intermingled; urgent thirst throughout; pulse small and feeble; prostration, nausea, pains in the stomach and bowels; dropsical swellings.
Ipecac.Backache; short chill; long fever; nausea and vomiting predominate; tongue coated yellow; difficult breathing.
Natrum Mur. Chill, 10 to 11 A. m., beginning in the feet or small of the back; thirst; bursting headache; nausea and vomiting; nails blue. In the second stage heat, with violent headache and thirst followed by profuse perspiration which gives relief.
Eupatorium Perf. Thirst several hours before the chill, continuing during the chill and heat; short chill, the hot stage protracted, and sweat slight; back aches as if it would break during the chill and hot stage; lips and nails blue.
Also Veratrum Alb. when coldness of the skin cold, clammy perspiration are marked, also great thirst especially during chill and sweating;, profound prostration; vomiting and diarrhea, with griping, and pains in the back and loins.
Capsicum. When chill begins in the back, with thirst; worse after drinking; chill is followed by sweat, or by heat, with sweat and thirst. A dose of the indicated remedy every one to three hours.
The general health must be improved by nourishing food, cod liver oil, malt extracts, iron, etc.; cold sponge baths taken; light weight woolen underwear worn; night air and irregular living avoided; sleep in an upper room if in a malarial district.
Bilious Remittent Fever.
THIS is a somewhat severer form of malarial disease than the intermittent, but is milder in the northern than in the southern states, where it more frequently occurs. The fever does not intermit, but continues right along although there are marked remissions of its intensity. Remittent may follow intermittent fever. Mild cases may last a week or two, but severe and badly treated ones, several weeks. Its symptoms and course are given on page 520.
Gelsemium. Great languor and muscular weakness; head congested; face flushed; chilliness; full, quick, soft pulse; dull pain in the head, back and limbs.
Pulsatilla. Whitish coating on the tongue; bitter risings and vomiting; chilliness; no thirst; especially serviceable in cases that drag along, and seem to make no progress towards recovery.
Ipecac. Indigestion; headache; yellow or white coated tongue; bitter taste, vomiting and constant nausea.
Also Belladonna if the attack begins with a severe chill, with vomiting and retching; violent fever, worse at night. Consult the remedies under "Fever and Ague," also the general treatment.
Rheumatic Fever.Inflammatory Rheumatism.
Exposure to cold and dampness, or wet weather may cause rheumatic fever in those of lowered vitality. There is languor; chill or chilly sensations; fever; rapid pulse; soreness and stiffness of the joints, most frequently of the knee, ankle or wrist: profuse acid sweats; scanty urine. The temperature may rise as high as 103' or 104'. The attack may last from a few days to several weeks, and the acute form may become chronic. One attack predisposes to another. The heart may be more or less seriously affected.
Aconite. The leading remedy full, strong pulse; great thirst, anxiety and restlessness; the affected parts red, swollen and exceedingly sensitive; later, high fever; shooting, tearing pains.
Bryonia. When the disease is established; intense, local inflammation; joints pale or dark red, and exceedingly painful, worse by contact or the slightest motion; face flushed and hot; loss of appetite; tongue a dirty white; sticking pains in chronic cases.
Rhus Tox. A valuable remedy, especially when the patient is impelled to move the parts, regardless of pain; fever; great restlessness; parts red and swollen, but better on continued motion; pains, drawing, tearing, burning; little swelling in chronic cases.
Pulsatilla. Shifting, violent, drawing and jerking pains; chilliness; not much fever, redness or swelling; rheumatism in women with menstrual disorders.
Colchine 2 x. Acute attacks, with much swelling and severe pain; fever; irritability; sensitiveness to touch; shifting pains. Six tablets in half a glass of water, one teaspoonful every three hours, omitting or lessening the strength of the medicine if disturbances of the stomach or bowels arise.
Chronic Inflammatory Rheumatism.
PAIN is the most prominent symptom, generally worse on motion, which may relieve stiffness. There is tenderness of the joints, with crackling, some swelling and redness. This form of rheumatism is most common between the ages of forty and sixty.
Bryonia, Rhus Tox. and Pulsatilla are often called for. They are described under "Rheumatic Fever."
Calearea Carb. Swelling of the joints worse with every change of the weather; after working in water, or when rhus has only partially relieved.
Duicamara.Chronic cases from living in damp rooms; working in cold, damp places, ice houses, etc.
Ledum.Obstinate rheumatism, especially of the lower extreniities, and smaller joints; stitching, tearing, rapidly shifting pains, and bruised soreness in the muscles.
Also Mercurius sol. especially in syphilitics, with tearing pains; profuse perspiration, which gives no relief, worse at night and in cold, damp air. Kalmia. Wandering pains, especially in rheumatism of the chest and the upper part of the body, or affecting the heart; little or no fever or swelling. Sulphur. Pains worse at night; feet burn; drawing, tearing pains in the limbs or back; nape of the neck lame and stiff. A dose of the indicated remedy three times a day.
Water must be taken freely, litha and medicinal alkaline waters being indicated; milk is an excellent food; meat and stimulants are to be avoided. Massage of the affected joints is useful, also dry heat and galvanism. Turkish baths are frequently beneficial. Moderate movements of the affected joints should be persisted in. Sweets and starchy foods should be used sparingly.
Lumbago is rheumatism of the back for which Bryonia, Rhus Tox., Sulphur and Cimicifuga, already described, are most frequently indicated. Sciatica or neuralgia of the sciatic nerve is treated of in another section.
Gout is a near relation of rheumatism in many of its symptoms, and is a general disorder of nutrition characterized by an excess of uric acid in the blood. It is well described in the section on the allopathic treatment of this disease.
Colchicine, one grain doses every one-half to two hours is a most helpful remedy while the pain is severe, and may be given twice a day between the attacks. This remedy is very valuable when the joints are becoming deformed, especially these of the fingers, with slight, sticking pains, and sometimes redness. Lithium Benzoicum Ix. Gout with high colored, strong smelling urine. Nux Vom. between the attacks is valuable in correcting constitutional conditions due to the use of stimulating foods or beverages, "high living," also Pulsatilla after rich foods, sweets, pastry, etc.
DROPSY Of the abdomen is so common and dependent upon so many diseases that a separate section is given to it. There are many other local accumulations, as dropsy of the brain or hydrocephalus, in which Apis or Helleborus may prove serviceable; the latter remedy when there is effusion of fluid, with the patient in a state of stupefaction or insensibility, from which it is extremely difficult to arouse him; there is rolling of the head from side to side; boring of the head into the pillow; sudden screams; grinding of the teeth; sometimes suppressed urine.
In dropsy of the chest or of the heart, Jaborandi, Digitalis, Arseni curmm or Helleborus when there is the characteristic stupefaction and mental torpor, and when dropsy there or elsewhere in the body follows searlatina or other eruptive diseases. Apis when there is great suffocation, the patient not being able to lie down, and feeling as if he were going to die; exudations in pleurisy. There is also ovarian dropsy, dropsy of the scrotum called hydrocele, and general dropsy or Anadarko, well described on page 391, and in which any one of the remedies above mentioned may be indicated, especially, Arsenicum and Apis.
These conditions are dependent on diseases of the general system or of certain organs, and require the skilled care of a physician. Most of the remedies named in this section are described fully under "Dropsy of the Abdomen." The treatment for ovarian dropsy and hydrocele is surgical.
Dropsy of the Abdomen.Ascites.
ASCITES is an accumulation of serous fluid in the abdominal cavity. There is generally some history of disease of the liver, lungs, heart or kidneys. Enlargement of the abdomen begins from below and extends symmetrically upward, and pressure on the abdomen reveals a peculiar wavelike impulse of the fluid from one side to the other. Often swelling of the lower extremities follows, a diminution of the amount of urine and constipation. When there is heart or lung disease, the dropsical condition is general, and usually there is also water in the chest.
Apocynum .Especially when dropsy is dependent upon diseases of the liver or kidneys, and there is scanty urine; great thirst; irritability of the stomach. Five drops of the fluid extract three times a day; if it causes nausea it can be diluted and injected into the rectum.
Digital is. Great anxiety and oppression; suffocative spells; sudden sensation as if the heart stood still; pulse feeble, fluttering, irregular, intermittent, or extremely slow; any motion, especially rising from a bed or chair, causes the pulse to become rapid, weak, and jerky; sometimes the face grows livid and there is faintness. This remedy is specially useful in dropsy dependent on heart disease, and may be given the same as Apocynum.
Arsenicum. Ascites as part of a general dropsy, secondary to disease of the heart or liver, sometimes of the kidneys; pale, earthy, or ,allow countenance; great debility, with faintness on the slightest motion; great thirst but drinks but little; sensation of burning heat all through the body, while the skin is cool; urine scanty and high colored; emaciation; great prostration.
China, 2 x. Dropsy in great debility, with impoverished blood, or after exhausting discharges; dropsy due to enlargement of the liver or spleen, especially from malarial poisoning; great debility; poor blood; diarrhea and fermentation after eating; hunger; thirst; scanty urine containing a whitish or yellowish red deposit.
Apis. An important remedy, especially in general dropsy; skin whitish, waxy, transparent; eyelids puffy and swollen; scanty urination; no thirst; also in the dropsy accompanying heart disease, Bright's disease, pleurisy, etc.
Jaborandi. Especially useful when dropsy is due to disease of the heart or kidneys; it produces copious perspiration, rapidly withdraws the water from the blood, and causes active re absorption of the effusion. Five grain doses of the powdered leaves or tincture three times a day.
Medical treatment is always helpful, and may obviate the necessity for "tapping," as it is called, or the drawing off of the accumulated fluid. The latter must sometimes be done, however, to relieve pressure which interferes with breathing, and with the heart's action. Water should be drunk freely; a light, nourishing diet chosen, and vapor baths taken.
"Also Caulophyllum when the small joints of the hands or feet are attacked. Cimicifuga when the pains are wandering, in the muscles of the limbs and trunk; rheumatism in nervous women. Mercurius Sol. High fever; quick, hard pulse; obstinate inflammation of a single joint; ruffy swelling, pale or light red; burning, deep seated pains; foul breath; coated tongue; no appetite; great sensitiveness to cold. A dose of the indicated remedy every two hours, increasing the intervals as the symptoms are relieved.
During acute attacks of rheumatism the patient should remain in bed between blankets, wear a flannel nightdress, and be protected by a screen from all draughts. The room should be well ventilated. To acutely swollen and highly inflamed joints, antiphlogistine may be applied after cleansing the parts thoroughly with warm water and soap. In general, all joints may be protected by absorbent cotton or raw cotton and flannel bandages. An excellent lotion to apply by flannel compresses is carbonate of potash, one ounce, tincture of opium six ounces, warm water one pint. Change at once all coverings dampened by perspiration. Frequent warm sponge baths are a necessity. Liquid diet is indicated while there is fever, milk especially should be given; a light farinaceous diet during convalescence, no meats; an abundance of water should be taken but no stimulants.
NIGHT sweats are a marked symptom of pulmonary tuberculosis, and occur frequently during the course of acute diseases, in fact may be associated with a large number of diseases both acute and chronic. They are a symptom, and the cause must be found and removed. The reader is referred to the section on "Pulmonary Tuberculosis" for the indications for many remedies called for in night sweats in persons of a consumptive tendency.
For others a few remedies may be briefly mentioned, emphasis being laid on the fact that the general condition, habits and temperament of the individual must invariably be taken into consideration.
Hepar Sulph. Great sensitiveness to the slightest cold air, with a tendency to easy, profuse, sour smelling, offensive sweat on the slightest motion.
China. Sweat on back and neck from least motion in much debilitated conditions following diarrhea, leucorrhea, loss of blood, and in nursing mothers.
Arsenicum. Cold, clammy, or sour and offensive sweating in persons in malarial districts; copious perspiration when first going to sleep, with unquenchable thirst.
Ferrum. Great weakness and nervous prostration; chilly every evening; profuse, long lasting, clammy, debilitating sweating; sweat stains clothes yellow.
Phosphorus. Profuse perspiration at night, during sleep, in the morning in bed, and on slight exertion; especially in connection with masturbation and sexual excesses, or give Phosphoric Acid 'n the same conditions and in brain fag, and in young people growing too fast, very nervous and emotional.
A dose of the indicated remedy twice a day. Remove the cause of this complaint, and correct all errors in diet, manner of life, etc.
Specific Indications for Remedies in Fevers.
Aconite. Exposure to dry cold winds, draughts of air, effects of checked perspiration, getting wet when heated; fever after fright, chill from feet to chest; chilly when uncovered or even touched, coldness with redness of one, and coldness and paleness of the other cheek; dry heat in the face towards evening, with high fever, great fear, and nervous excitability, restlessness and tossing about; great thirst for large quantities of water; skin dry and hot; pulse full, hard, bounding; stinging, burning pains.
Antimonium Tartaricum. Fevers following rheumatic exposure, living or working in cellars or basements, underground habitation or employment; chill and heat without thirst, alternating during the day; cold skin; trembling and chilliness always from within outward; short chill and long heat, or the reverse, with drowsiness and profuse sweat on the forehead; cold, clammy, profuse sweat of affected parts; fevers in spring and autumn, with nausea, vomiting and drowsiness, especially in children. Antimonium Crudum. Fever with predominance of stomach symptoms; constant discharge of wind up and down; heat with sweat; sweat at same hour every other day; chill without thirst; milky white, thickly coated tongue; desire for pickles, disgust for drink or food.
Arnica. Malarial fever in cases when too much quinine has been taken; bruised, sore, weary feeling; great weakness making patient lie down, yet bed feels too hard, cannot find soft place; sour, offensive sweat; belching of gas tasting like rotten eggs; chill, with thirst, felt most in the pit of the stomach; heat of the upper part of the body, coldness of the lower; bitter taste in the mouth; tongue never clean; fever, especially in full blooded persons, who feel the effects of even slight blows or injuries a long time.
Arsenicum. A valuable remedy in typhoid, continued and intermittent fevers, malarial fever returning every year; chill, without thirst, better from external warmth; coldness of the whole body, pale, sunken face; chill mostly in the afternoon; hot stage intense and long lasting; great restlessness and debility; cold, clammy sweat; internal, burning heat; typhoid fever of a low type, with diarrhea, distended abdomen, great prostration, weak pulse, burning pains in the stomach, dry, red or brown tongue, disposition to vomit, brown sticky deposit on teeth.
Belladonna. Violent throbbing headache; rush of blood to the head; throbbing of arteries in neck and temples; skin bright, shining red; tongue red and dry; great thirst; burning heat within and without; boring of the head into the pillow; fever with delirium; sudden starting in sleep; pain in paroxysms, worse from any jar, from touch and towards midnight; excitability; convulsions.
Bryonia. Complaints occurring when warm weather sets in after cold days; from cold drinks or ices in hot weather; after taking cold or getting heated in summer; fever, with suppressed eruptions; diarrhea during hot days in summer; great thirst for large quantities of cold water; profuse, sour, oily sweat, easily excited by exercise, even slow walking; heat with increased thirst, dry, racking cough and pleuritic stitches in side; patient wants to be quiet and not move about; everything tastes bitter; pulse full and hard; violent headache as if the head would burst; constipation; dizziness.
Calcarea Carbonica.Fair complexioned persons or those of a scrofulous makeup, disposed to grow fat; children who take cold easily, have large heads and abdomens; head sweats profusely during sleeping; acid stomach; chill, with thirst; heat without thirst; coldness of face, hands or feet; cheeks red; especially in fever from working while standing in cold water, or from handling wet clay or cold vegetables, or women with menstruation too early and too profuse, with cold, damp feet.
Capsicum. Intermittent fever in midsummer, with chill beginning between the shoulder blades, better from hot applications externally, and by motion; thirst before and with the chill, but no pains in the bones; fever without thirst, and patient cannot bear any noise; sweat without thirst; burning blisters on tongue; sometimes diarrhea; burning and smarting sensations.
Carbo Vegetabilis, Fevers especially in persons who have suffered from exhausting diseases, and have never fully recovered; fever after eating spoiled meats or fish, from getting overheated; weak digestion, the simplest food disagrees; much gas in the stomach and bowels; feeling as if the stomach would burst after eating; thirst during chill only, followed by heat with headache, flushed face, vertigo and nausea; profuse, sour sweat, especially while eating; tearing pains in the limbs and teeth.
Chamomilla. Fevers of children with peevishness and irritability; feverish attacks in the spring in nervous persons, or from anger, vexation, etc.; young, fretful children during teething; chill without thirst; chilliness on undressing; heat and shivering intermingled; hot perspiration, especially of the face and head; one cheek red, the other pale; instead of fever a paroxysm of violent bilious colic with vomiting and diarrhea, from anger and vexation.
China. Ailments with fever from loss of blood, excessive lactation, diarrhea, of malarial origin with fever every other day; nausea; ravenous appetite, palpitation of the heart; much thirst before the chill, ceasing as soon as the chill begins; violent shaking chill; heat without thirst, followed by sweating, with great thirst; bitter taste in the mouth; great debility and exhausting night sweats; skin yellow; bitter eructations and bitter vomiting; marsh fever and malarial fever returning every seven or fourteen days.
Cina. Continued fevers in irritable children, who do not want to be touched or caressed, suffer from worms, rub or pick the nose all the time, hungry soon after a full meal and crave sweets; nervous, weakly, scrofulous children; pale face, with blue margins round the eyes; chill without thirst; shivering and creeping chills, with cold face and sweat on forehead and hands; heat with pale, puffy face; sweat without thirst, and vomiting after sweating.
Ferrum. Especially adapted to debilitated women who yet have a red face; to excitable, argumentative persons, with extreme paleness of the face becoming red on the least pain, motion or exertion; painful blushing; general constitutional weakness; pale, watery, debilitating monthly flow; raising of partly digested food; vomiting after midnight; constipation; chill with thirst, and headache, head gets glowing hot, feet cold; heat without thirst; profuse, long lasting sweat; prostration; lips, tongue, and inside of mouth bloodless.
Gelsemium . Recent cases of malarial fever, fever attacks returning regularly without chill, with burning heat, great restlessness, then profuse sweat with thirst, pain and jerking in the limbs; fever with drowsiness, trembling and languor, pains in the neck and back; headache beginning in upper part of spine; vertigo; fever in hysterical women and children.
Ignatia. Especially adapted to the nervous temperament, sensitive, excitable women; feverishness from grief, bad news, disappointments, in children after being punished; malarial fever with thirst only during the chill; shaking chill with redness of the face, great thirst, and desire for external warmth; heat of the whole body in the afternoon without thirst, and sweat without thirst; also fever with nettle rash of the whole body, and violent itching; lips dry and cracked; eruption on the lips and in the corners of the mouth.
Ipecacuanha. Persistent nausea is a prominent symptom; short chills worse in a warm room and from external heat, better from drinking and being in the open air; long attacks of fever, with nausea and vomiting, cold hands and feet, great oppression of the chest, can hardly breathe; light sweat or profuse sweat after excessive use of quinine; the feeling of greatest prostration occurs during the chill; fever from irritation of the stomach in deranged digestion, with persistent nausea.
Lachesis. Better adapted to dark, thin people with a tendency to low spirits, than to fair, fleshy persons; feverishness and hot flushes at the change of life with bursting headache, rush of blood to the head, great sensitiveness to touch and to tight clothing, feels worse after sleep, great physical and mental exhaustion; malarial fever returning every spring or after taking quinine or acids; chill beginning in the small of the back and without thirst, chill and heat in alternation, sometimes nausea or nausea and vomiting; heat with violent headache; profuse sweat smelling like garlic, and staining linen yellow; trembling of tongue when protruded; palpitation of heart.
Mercurius. Catarrhal and bilious fevers; yellow fever; malarial fevers; hectic and irritative fevers of children, with intestinal derangements; free perspiration in all fevers affording no relief, and sometimes aggravating symptoms; chilliness of whole body in afternoon or evening, and on going into the open air; heat with thirst; heat alternating with chilliness; profuse, sour, offensive sweat on every motion and at night, staining linen yellow and wrinkling fingers like a washerwoman's.
Natrum Muriaticum.Especially adapted to those debilitated from seminal losses or profuse menstruation, losing flesh even while living well; spring, summer and autumn fevers; malarial fevers, worse from heat of sun or stove, from sea air, talking, writing, reading or lying down; languor, headache and thirst before chill; chill with thirst about 8 A. M. followed about noon by heat with increased thirst and hammering headache; profuse sweat, with thirst, gradually relieving all pains except headache, fever blisters on lips; between attacks languor, debility, sallow complexion, loss of appetite and taste; muddy urine, with red, sandy sediment.
Nux Vomica. Fever and ague in children; shaking chill, with blue mottled skin, especially on covered parts; great thirst during chill and fever, tendency to spasms as the chill passes off and sweat comes on; constipation, with ineffectual urging to stool, especially in nursing children; malarial fevers in thin, irritable, nervous or sanguine persons, who are dyspeptic, and always on the rush, eating irregularly, and improper food, drinking much tea, coffee or other stimulants; morning chill, preceded by drawing pains in the lower limbs; sometimes heat and thirst, chill with bluish, cold face and hands; long lasting heat, with great thirst, but cannot move or uncover without feeling chilly; sweat, without thirst, relieving pains, tongue heavily coated white or yellow; bitter or sour taste; soreness of liver and spleen; loss of appetite; obstinate constipation. opium. Typhoid fever; childbed fever; intermittent fever, with chill predominating, shaking chill at 11 A. M. with great coldness of nearly the whole body, followed by burning heat all over, unrelieved by profuse sweat; heavy, snoring sleep, with open mouth and twitching hands. desire to be uncovered; typhoid fever with bloated, dark led and hot face; stupor or excessive drowsiness, with labored breathing. picking at the bedclothes; mild delirium or fury, singing, desire to escape
Pulsatilia. More especially indicated in fevers associated with pronounced disturbance of the stomach; gastric catarrh and indigestion in general, with putrid, slimy, greasy or bitter taste after eating, loss of appetite; tongue coated thickly white or yellow; bitter or rancid eructations; fat food and ice cream or ice water upset stomach; fever beginning with constant chilliness even in a warm room, worse evenings; shivering, creeping sensations; heat with thirst, intolerable, dry, burning heat evening or night, with distended veins and burning hands; one sided sweat worse at night, and ceasing in morning; fever in mild, tearful, fair women and children.
Rhus Toxicodendron. This remedy is indicated in scarlet fever of a typhoid tendency; irregular and dark red eruption, sometimes with watery pimples, swelling and dropsy of the tissues, enlargement and threatened suppuration of the glands of the neck and jaw; great restlessness; in small pox with dark, blackish eruption; dark, bloody stools, diarrhea and restlessness; typhoid fever with great restlessness, tongue and lips dry, brown and covered with sticky deposit, weak pulse, distended and tender abdomen; remittent fever, constant chilliness, especially evenings; pains in the limbs, much thirst, coldness of hands and feet; heat with thirst and throbbing dull head ache, profuse odorless, but not exhausting sweat; fevers in rheumatic persons.
Sulphur. Chronic cases in scrofulous or nervous persons, when the indicated remedy does not give favorable results, or there are constant relapses; malarial fevers with chilliness every evening in bed followed by heat and burning of the palms of the hands and soles of the feet, and profuse perspiration, frequent internal chilliness, without thirst, chills up the back, frequent flushes of heat, profuse sweat at night or after waking in the morning.
Veratrum. Congestive or pernicious malarial fever, with great prostration; fear of death; severe long lasting congestive chill, not relieved by external warmth; face and extremities cold and clammy; cold perspiration over whole body, especially forehead; small, weak pulse; skin bluish, danger of death from collapse during the attacks.
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