Diseases of the Respiratory Organs.
Bleeding from the Nose. Epistaxis.
Hamamelis I x. Ten drops in one third of a glass of water, and a teaspoonful taken every ten minutes will usually quickly relieve any ordinary attack of nosebleed, even when bleeding has continued for some time, when due to a fall, blow or no apparent cause.
Ferrum Phos. Frequently recurring hemorrhages from the nose, especially in excitable young or full blooded persons, or in delicate children, A dose every ten or fifteen minutes.
Aconite. Profuse and continued bleeding in 'full blooded persons, or after getting overheated, with full, rapid bounding pulse and feverishness; athletes after violent exercise. Give as above.
China I x. Great exhaustion, paleness and faintness from loss of blood; nosebleed in weak and debilitated subjects. A dose every half hour or more.
Arnica. Nosebleed resulting from direct injuries. A dose every ten or fifteen minutes.
Ferrum Mur 1 x. Nosebleed during fevers or malaria. A dose every half hour or more.
Erigeron. Three drop doses of the oil in severe nosebleeds, especially if the blood is bright red, and the flow increased by every movement of the patient.
In a simple attack of bleeding from the nose, press upon the affected side, just below the bone, with the finger nail. A clot will frequently form and check bleeding, if this treatment is continued three or four minutes. Ice or ice water to the nose, forehead and back of the neck is serviceable. An injection of vinegar or pure lemon juice into the nose, or of peroxide of hydrogen will often relieve bad cases. Powdered tannin may be snuffed up, or a pledget of styptic cotton, iodoform or sterilized gauze inserted in the nostril affected.
A noted physician having a large and successful practice, recommends passing a long strip of bacon rind through the nostril, and allowing it to remain there some time.
Polyps in the Nose.
SMALL fleshy or mucous growths in the nose occasion difficulty in breathing, sometimes violent sneezing, and a watery discharge which may become purulent. Proper treatment should be at once instituted, as any interference with nasal respiration affects the health of the whole body, by lessening the amount of oxygen received by the blood through the lungs. Also mouth breathing is a prolific cause of disease of the respiratory passages.
Calcarea Carb. Rapidly developing fleshy growths in the nose in persons of scrofulous constitution. A dose every four hours.
Teucrium .Small, mucous growths in the nose in those having chronic catarrh; feeling as if the nose were stopped up; blowing and sneezing give no relief. Give as above.
Phosphorus. Growths in the nose that bleed easily; frequent blowing of the nose, with resulting slight show of blood. Give as above.
Also Sanguinaria can. internally for mucous polypi that bleed profusely, and powdered sanguinaria nitr. applied directly to the growth daily by means of a powder blower. While constitutional treatment is always indicated, it is best to have the growth removed by a competent physician. This can be done by the use of cocaine and a wire snare or loop, making it a simple and practically painless operation.
Cold in the Head. Acute Rhinitis.
SUDDEN changes of temperature, and the chilling of the overheated or sensitive body by draughts of air are the most frequent causes of this affection.
Other exciting causes are damp or wet f feet or clothing, irritation and poisoning of the lining membrane of the nasal passages by dust, noxious fumes, chemicals, etc., great depression of the system, sleeping in draughts, and sometimes indigestion. Whether a simple cold is infectious, has not been absolutely determined. With the symptoms everyone is familiar; they are well emphasized under the indications of remedies.
Camphor. After getting damp or wet, or being exposed for some time in damp,, wet or foggy weather; in the very beginning with chilly, shivery sensations; back feels cold; sudden sneezing. A drop or two on sugar every ten or fifteen minutes for several doses.
Aconite. After exposure to cold, dry winds; standing on cold pavements, or being out long in cold weather especially with snow on the ground; give at once if there is chilliness; feverishness but cannot get warm; thirst; sneezing; watering of the eyes and nose; throat rough; whole system feels depressed. A dose every half hour, increasing the interval.
Belladonna. Follows Aconite well when symptoms become more marked, and with watery discharge from nose and sneezing; the throat is affected, feels raw and intensely sore, is a vivid red, and swallowing is painful; face flushed and headache in forehead and temples. A dose every hour.
Arsenicum Iod. When the cold is well started and chiefly in the nose, though with some headache in forehead; constant desire to sneeze, frequent sneezing without relief, constant running of thin watery, acrid discharge making nose and upper lip sore; burning in the nasal passages and throat and some soreness. Give as above.
Mercurius Viv. Copious discharge of thick, acrid mucus; bones of the nose feel sore; frequent sneezing and swallowing of the saliva; perspiration; catarrhal headache. A dose every hour or two.
Nux Vom. Nose stopped up at night; feels stopped up in daytime; or sometimes free then suddenly obstructed; running of mucus in the daytime; severe headache; creeping chills are felt even if near the fire. Give as above.
Sanguinaria. Much soreness of the palate, and the back of the mouth, worse on the right side; throat feels as if scalded; loss of taste and smell; constant acrid, watery discharge from the nose; nostrils sore; catarrhal headache; may be deafness and dizziness. Give as above.
Pulsatilla. Thick, copious, disagreeable, greenish yellow discharge, may be lumpy; loss of smell and taste; constant chilliness; all symptoms better out of doors; worse evenings. A dose every two hours.
Consult the medicinal treatment under "La Grippe," especially noting the indications for Gelsemium.
Take the indicated remedy regularly and faithfully. A cold needs to be followed up, and as it shifts its location, or as new symptoms arise, the remedy must be changed, but this does not mean a new remedy every five or six hours.
During an acute attack stay in the house, it possible, and preferably in bed. In the beginning, at bedtime, take a hot foot bath to which a little mustard may be added, and drink a glass of hot lemonade or gruel. If very feverish, the diet should be light, milk, gruels and broths. Ordinarily a generous, but unstimulating, nourishing diet is called for. If unable to remain in the house, unnecessary exposure, draughts, and overwork should be avoided, especially protect the feet from dampness, and breathe through the nose if possible.
The inhalation of the steam of two drachms of tincture of benzoin to a pint of water, heated to the boiling point, will soothe the membrane of the nose and throat. Men the throat is involved consult the section on "Inflammation of the Throat," for the local treatment. Very hot fomentations applied over the forehead and eyes often give great relief to the pains in the head, especially when there is much swelling in the upper air passages. Seiler's tablets to be used as a nasal douche, and as recommended on page 239, are excellent.
Above all, preventive measures should be faithfully carried out, that the system may not be debilitated by frequent colds, and a fertile soil created for the development of other diseases such as diphtheria, la grippe, bronchitis and pneumonia. These measures include the cold or tepid sponge bath every morning, with friction; frequent bathing of the neck and chest with cold water, and subsequent brisk rubbing; avoidance of unnecessary wraps about the throat; outdoor exercise, breathing deeply through the nose, with forcible expiration; protection of the feet from dampness, and the abdomen from cold; immediate changing of wet clothes, and the avoidance of draughts and overheated rooms. Nourishing food, good ventilation, sufficient sleep, and a cheerful spirit are recommended.
Chronic Nasal Catarrh Chronic Rhinitis.
CHRONIC nasal catarrh most frequently follows the acute form, although injuries and irritants, syphilis, tuberculosis and extreme debility may be sufficient causes. One form of this chronic affection is characterized by swelling and increase of the tissues in the nose, the other by their shrinking and drying up. The latter often follows the former, with symptom reversed, that is, breathing through the nose is unobstructed, there is little sneezing, the discharge at first is slight, then scabs form, but finally there is a very putrid discharge due to the decomposition of the secretions, or to ozena, which is an ulceration of the nasal cavities, with loss of smell.
When the tissues swell and become thickened, nasal breathing is difficult, and there is a most annoying discharge which may be thin or thick, scanty or copious, bland or excoriating; white, discolored, or bloody. When it dries in the nose it causes tickling, fullness or pain, with dull pains in the forehead and eyes. In its simplest form no appreciable shrinking or increase of the tissues may be noticeable.
Pulsatilla. See the indications given under "Cold in the Head."
Ammonium Mur. Clear, watery, corrosive mucus running from the nose; itching in the nose; stoppage of the nostrils, in children preventing them from sleeping, and causing nervous starting when falling asleep.
Argentum Nit. Bloody and purulent nasal discharge; ulcers and erosions in the nose, covered with yellow crusts; itching; headache, with chilliness and sneezing.
Calcarea Carb. Offensive smell in the nose like rotten eggs; nose dry and stuffy at night, free during the day; sore, ulcerated nostrils; chronic hoarseness; glands in the neck enlarge; (carcarea iod. is an excellent remedy when the last named symptom is present, and in those of a scrofulous constitution) tendency to grow fat; head sweats during sleep.
Aurum. Especially valuable when there is decay of the nasal bones', very foul discharge; nose obstructed by crusts; nostrils ulcerated; burning, itching, and smarting in the nose; after the abuse of mercury in syphilitic subjects.
Hydrastis. Thick, yellow, sticky discharge, dropping back into the throat, and causing hawking; catarrhal headache in forehead; constipation; constant tendency to "catch cold."
Hepar Sulph. Swelling and boil like painfulness of the nose; sensitiveness to every draught; pus like discharge sometimes bloody; catarrh of one nostril; tonsils and glands in the neck swollen and hard.
Mercurius Sol Syphilitic ulceration of the bones of the nose, with profuse watery, or greenish pus like discharge. Mercurius iod.
Tough, white or yellowish mucus especially in the back of the nose; cases of long standing; also profuse, acrid, long-lasting discharges which excoriate the nostrils and upper lip; shooting pains at the root of the nose.
Also kali bich. for tenacious, stringy, yellow mucous discharge, with pressive pain and obstruction of and ulceration in the nose. Silicea. Nasal passages dry, painful, excoriated, covered with crusts; nasal bones affected; discharge acrid and corroding. Graphite’s. Dry scabs in the nose; sore, cracked, and ulcerated nostrils; tough, lumpy, bloody, or yellow; foul discharge; fleshy persons and those with eczema. Sulphur. Chronic, obstinate cases, especially in thin people with coarse skin and hair. Alumina. Chronic catarrh in old people, with hard scabs, and greenish yellow discharge. A dose of the indicated remedy three times a day.
An excellent cleansing solution for douching, or syringing out the nasal passages is made by adding ten grains each of salt and bicarbonate of soda to four ounces of warm water. Glycothymoline one part, to three or four parts of warm water is a mild and soothing antiseptic. Two Seiler's tablets dissolved in from four to six ounces of warm water can be fully recommended. Any one of these cleansing solutions may be used two or three times a day. Pledgets of absorbent cotton wet with peroxide of hydrogen and placed in the nose will soften even very hard crusts; any bland oil like liquid vaseline, cosmoline or albolene may be applied with an oil spray; pine needle oil and eucalyptus are also used. When there is much chronic swelling of the nasal tissues, surgical interference may be necessary.
Hay Fever. Hay Asthma. Rose Cold.
The, pollen of plants excites attacks of this disease, which occurs more often in the male, and in persons of an excessively nervous organization. The symptoms are well described on earlier pages of this book, and are chiefly those of acute influenza, with those of bronchitis or asthma in addition. May, June, the latter part of August and September are the critical periods for sufferers from this complaint, which occurs annually, and lasts from four to six weeks.
Arsenicum Iod. 2 x. Constant inclination to sneeze, and sneezing which gives no relief; acrid discharge from the nose making it very sore, as also the upper lip; glands of the back of the mouth enlarged and sore; great prostration; burning and itching of the nose; symptoms worse after midnight; hay fever, especially in delicate or debilitated individuals.
Inpecac. 2 x. May be given in alternation with arsenicum, when in addition to the above symptoms there is wheezing, difficult breathing with great feeling of anxiety, and pressure in the chest; constriction and cough.
Euphrasia. Irritation and sneezing all day, with copious, unirritating discharge from the nose, but profuse, excoriating watering of the eyes, with swelling, burning, itching and redness of the lids, causing constant desire to rub them.
Sabadilla. Spasmodic and severe paroxysmal sneezing in the morning with excessive or slight catarrhal discharge; one or the other nostril stuffed up; watering of the eyes following sneezing; oppressed breathing, and cough at night.
Terpine Hydrate. The author cannot vouch for the efficiency of this remedy, but it is highly recommended by good authorities in fifteen grain doses, in capsules, three or four times a day in the twenty four hours.
Also Naphthalin, especially where, with the influenza there is fun feeling in the forehead, puffiness of the face, and much asthma. This remedy may also be given as a preventative, or Cepa which has immoderate sneezing; profuse bland or excoriating discharge from the nose, with itching and obstruction of the nose; headache; loss of appetite; broken sleep; slight hoarseness; tickling in the throat and cough; especially if the attack is made worse by dust or the smell of onions. Gelsemium. For great prostration, and intense headache in the forehead or back of the neck, with dryness of the nasal passages. A dose of the indicated remedy every three hours.
About two weeks before the attack is expected wash the passages of the nose and where they lead into the throat with glyco thymoline or hydrozone, one to ten, using cold boiled water to dilute the remedy, and after ten days increasing the strength to one to four. Use a syringe or nasal douche. Seiler's Tablets, two to four ounces of water may be used. During an attack a ten per cent. solution of naphthalin or a two per cent. solution of menthol may be dropped or sprayed into the nasal cavities.
Change of climate is the first thing to be thought of, from the country to the shore or to the Adirondacks or White Mountains, or take a sea voyage. Live hygienically, abstemiously, and with regularity; avoid excitement, and use no stimulants.
La Grippe. Grip. Epidemic Influenza.
THE grip is not a disease needing much introduction to the readers of this book, as probably nearly every one has suffered from it. The first American epidemic occurred in 1655, but within the past ten years outbreaks, especially in large cities, have been numerous and serious. This is a contagious specific disease, the organism causing it having been identified by Pfeiffer of Berlin in 1892. Its name is very appropriate, being taken from the French verb gripper, to seize, which it certainly does both suddenly and violently. The contagion is probably transmitted by means of the moist accretions of the mucous(lining) membrane of the respiratory tract, and the period of incubation is only two or three days. Although epidemic influenza manifests itself in several forms, there are two principal ones, the catarrhal and the nervous, according as the symptoms of the one or the other are most prominent; but, as a basis for selecting the remedy indicated, names are of far less importance than the careful observation of all the symptoms.
Lowered vitality; damp, cold, murky weather; filth in the streets, and dirt and dust in the air; overwork, bad ventilation in houses, shops, theatres, street cars, etc., all predispose one to the disease, also breathing through the mouth which causes congestion of the sensitive mucous membrane, and allows irritating substances to pass to the lower respiratory tract that the hairs in the nose would otherwise strain from the air, at the same time the air is being warmed.
The onset of grip is usually abrupt. A majority of the following symptoms are generally present. There is general chilliness or a severe chill, followed by the speedy development of coryza; feverishness, followed by quickly rising temperature; aching all over as if beaten; severe bursting, tearing headache; profound prostration which continues throughout the attack; much depression of spirits, restlessness, and sleeplessness. There may be disturbance of the stomach and intestines, with nausea, abdominal tenderness, and diarrhea. The most agonizing pain may be in the eyeballs and at the root of the nose, but may be most severe in the back of the head and nape of the neck. Delirium may occur in the pronounced nervous form of the disease. Convalescence is slow. Men death results, it is generally from some complication such as bronchitis, bronchopneumonia, cerebrospinal meningitis. Grip often leaves the, sufferer with such aftereffects as insomnia, neuralgia, pleurisy, abscess of the lung, kidney or heart disease.
Gelsemium, 1 x. Early, often and almost invariably in the beginning. Chilliness, yet feverishness; heat of the head and face; dull headache, especially of the back of the head, great prostration; full feeling at the root of the nose; eyes heavy and reddened; drowsiness, languor; full, frequent pulse; little thirst; bruised pains in the back, and all over; dizziness. Ten drops of the tincture, i. e., 1 x new style, ~D old style, to one half a glass of water, a teaspoonful every hour
Aconite. May be called for in the earliest stage when there is great restlessness; high fever; hot, dry skin, dry, violent racking cough. A dose every hour.
Arsenicum Iod. Marked catarrhal symptoms, affecting the eyes, nose, and throat; acrid, copious, irritating discharges; great prostration; restlessness and thirst; desire for artificial warmth. Later great difficulty in breathing, with coldness, and cold sweating; fatiguing, shaking cough, with expectoration of tough, sticky sputum; especially in feeble, old people without pronounced involvement of the lungs or bronchial tubes, but with great general prostration. Give as above.
Eupatorium Perf Soreness and pains as if in the bones; aching pain in the back as from a bruise; sneezing; soreness of the eyeballs; eyes water. Give as above.
Bryonia. Bronchial catarrh; pleurisy, or pneumonia; fever, languor and pains all over. Give as above.
Rhus Tox. Rheumatic pains without much fever, but with great restlessness. Give as above.
Cuprum Ars. When there is pain and soreness in the region of the stomach; catarrhal diarrhea; nausea and sometimes vomiting. Give as above.
Also during convalescence, three times a day, Ferrum phos. or Arsenicum iod. when there is great debility, and the strength returns slowly. Cod liver oil and malt is recommended in these cases. Zincum phos. when the nervous symptoms have been very marked, and there is neuralgia; sensitiveness of the spine; a headache that persists, and disinclination to use the head. Strychnia phos. Great debility; no appetite; unrefreshing sleep, with headache early in the day.
In mild cases of grip as well as in severe, the patient should go to bed. Grip is not a disease to be trifled with, and it is true economy to give up to it. Liquid diet should be given while there is fever, diarrhea or any difficulty in digesting the food. Dry heat in the form of hot water bags, will often relieve pain in the back and elsewhere. Cold compresses to the head and eyes may be acceptable in the nervous form of the diseases.
Preventative measures include cold sponge baths with friction; good ventilation; the avoidance of draughts, overwork, or the free use of stimulants, A liberal nourishing diet is advisable.
Sore Throat. Acute Laryngitis.
THE Common sore throat is called laryngitis, and the acute form may become chronic. Draughts, getting wet or damp, overexerting the voice, badly ventilated rooms, dust and noxious vapors, keeping on wet clothes are common causes of this affection which also may accompany influenza, measles, scarlet fever and other fever, and be excited by disturbances of the stomach and intestines. There may be a superficial inflammation causing chiefly hoarseness or even loss of voice, burning and tickling in the throat; slight cough; rawness, redness and more or less swelling; but the catarrhal form, which in children we call croup, may be very severe.
Aconite. In the beginning, fever; full, rapid pulse; hot, dry skin; throat feels rough and dry; sometimes dry cough; much restlessness and anxiety. When the two last mentioned symptoms are wanting, Ferrum phos. may be even better. A dose every hour.
Belladonna. Violent attack; high fever; dryness, redness and rawness of the throat especially in the right side; red face; throbbing of the arteries in the neck; inflammation and swelling of the tonsils; loss of. voice; sleeplessness. Give as above.
Mercurius Bin. Constant secretion of mucus in the throat; frequent difficult, painful and empty swallowings; some swellings of the glands under and back of the jaws; perspiration, especially at night. A dose every two or three hours.
Phosphorus. Continued and great rawness, with dry cough and loss of voice. Give as above.
Apis. Dryness of the mouth, and throat; puffy swelling of the mucous membrane; stinging, sticking pains; swallowing painful and almost impossible. This condition is really edema, or swelling of the larynx, and apis is the first remedy to be thought of. A dose every hour.
Phytolacca. Dark red, dry, swollen mucous membrane; sometimes pastoral spots; pain on swallowing; swelling and tenderness of the glands externally at the angle of the jaws; aching in the back and limbs. A dose every one to three hours.
Hydrastis. Rawness and soreness of the throat; constant hawking of mucus, which drops into the throat from the back of the nose. Give as above.
A cold pack to the larynx, or the application of antiphlogistine often relieves the inflammation quickly. For direct treatment of the inflamed surface, use an oil spray of liquid vaseline one ounce, oil of sandal wood six drops, and oil of tar three drops, or a gargle of twenty drops of phytolacca tincture, or a teaspoonful of common salt, or half an ounce of listerine to a cupful of water as near the boiling point as can be borne. Bathe the throat often with cold water, and rub briskly with a coarse towel. Rest during the attack. Inhalations of steam medicated with iodine, bromine or eucalyptol are useful.
Chronic Sore Throat. Chronic Laryngitis.
THE usual form of this affection is the catarrhal, following acute attacks or from long continued use of the voice, inhaling dust, excessive smoking, mouth breathing, or in connection with some other disease of the air passages such as nasal catarrh. There is hoarseness, especially on beginning to use the voice; a feeling of stiffness of the throat; tickling, itching and an uneasy consciousness of the need of constant hemming and hawking; hoarseness may extend even to loss of voice. The removal of the cause is of the greatest importance. Singers, preachers and teachers are particularly liable to chronic laryngitis.
Causticum. Hoarseness and loss of voice, always worse mornings; rawness and burning under the breast bone; paralysis of the vocal cords. This acts as a tonic to the muscles when used a few hours before singing or speaking.
Carbo Veg. Long lasting hoarseness, worse every evening and from talking, with raw feeling in the throat; dry, tickling cough. A dose three times a day.
Phosphorus. Hoarseness and loss of voice, worse in the evening; throat sensitive to touch, and so sore it causes pain to talk or cough; voice tires easily; rawness in larynx; tickling; hawking; dry, hacking cough. Give as above.
Argentums Met. A valuable remedy in chronic laryngitis and hoarseness, especially in public singers or speakers; cough from laughing or talking, with easy expectoration of white, thick mucus. like boiled starch. Give as above.
Hepar Sulph. Persons of consumptive tendencies, very sensitive to cold air, who perspire easily and profusely; scanty, tenacious, muco purulent expectoration. Give as above.
Kali Bich. Hoarseness and accumulation of much tenacious mucus in the larynx in the morning; tickling in the larynx caused by coughing and clearing the throat; tickling extending into the mouth and ears. Give as above.
Manganum. Obstinate chronic hoarseness, and roughness of the throat, especially in the morning, in the open air, and in debilitated or consumptive persons; better from smoking and after raising lumps of mucus, though after long hawking. Give as above.
Heated, badly ventilated rooms, crowds, smoking, the use of alcohol, spices, rich food must all be avoided. The voice must be rested. Change of air, especially to that of pine forests, and to a warm, dry equable climate is most desirable. Do not muffle up the throat; bathe it often with cold water, using friction. Cleansing the nasal passages and throat with borolyptol, listerine, glycothymoline, diluted with three or four parts of warm water is advised, or use ten grains of bicarbonate or biborate of soda to one ounce water.
Tonsillitis and Quinsy.
SIMPLE acute tonsillitis is a mild superficial inflammation due to cold or wet, or occurring during scarlatina, measles or some similar disease, and characterized by swelling and redness of the tonsils to which tenacious mucus adheres, some pain and stiffness of the jaws on swallowing. In a few days, as a rule, recovery takes place. In quinsy, or tonsilar abscess, however, the deeper tissues are involved, and there is suppuration. There are chills; high fever; headache; backache; rapid, painful inflammation of the tonsils; swelling of the glands of the neck; pain and difficulty in swallowing, and finally the formation of an abscess which bursts, or may be lanced to evacuate the pus. Those most subject to quinsy have a rheumatic history. This disease may last from a few days to two weeks.
Belladonna. The leading remedy, throat bright red, raw, and dry; swelling of the throat generally worse on the right side, painful to touch; flushed face; fever; headache in the forehead; throbbing of the arteries in the neck.
Mercurius Bin. After belladonna when the tonsils are a dark red, hard and swollen; worse on the left side; the back of the mouth raw and burning; grayish white patches on the tonsils, painful swelling of the glands under the lower jaw. A dose every two hours.
Hepar Sulph. Tonsils and glands of the neck much swollen; parts very sensitive to touch; sticking, splinter like pains or throbbing. Give as above.
Baryta Carb. Comparatively mild cases, and in those very sensitive to cold air; frequently recurring tonsillitis, with tendency to suppurate. A dose three times a day.
Kali Bich. Copious secretion and discharge of ropy, tenacious, stringy mucus, with swelling of the tonsils, which are dark red; sharp, shooting pains. A dose every two hours.
Also Phytolacca when tonsils are swollen and bluish; throat dry, swallowing difficult, and with every attempt there are excruciating pains through both ears. Silicea when, after abscesses form and open, they refuse to heal, and there continues to be some discharge.
The sufferer should stay in a warm room, if not in bed; gargle the throat with a mild antiseptic, see section on "Sore Throat." As soon as an abscess forms, and by its soft, fluctuating feel it seems ready to be opened, it should be, lanced, as this will save the patient much pain. The general health must be improved. Cod liver oil is recommended, and the malt extracts.
DIPHTHERIA is an acute, infectious, contagious, inoculable disease affecting chiefly the mucous membranes of the pharynx at the back of the mouth, and the upper air passages, and characterized by the formation of a fibrinous, grayish white membrane, in the meshes of which are found the " Klebs Loffler bacilli," or diphtheria germs. In pseudo diphtheria," or false diphtheria there is a membrane resembling that of true diphtheria, but it does not contain these germs, nor is the whole system so profoundly affected. False diphtheria is common in scarlet fever, and like the true, may also occur in erysipelas and measles. Membranous croup has been mistaken for diphtheria. No age is exempt, although children from one to seven years old are the most frequent sufferers.
Diphtheria may occur at any time of year, but cold damp weather favors epidemics, and its development is encouraged by bad drainage, open cesspools, defective plumbing, sewer gas, damp cellars, previous catarrhal affections of the nose and throat, and all unhygienic surroundings and manner of living. The diphtheria germ possesses great vitality, and will remain active on furniture, walls, clothing, books, toys and animals for many months, and even years. Direct contagion usually takes place from the patient's coughing, or from an attendant's breathing the air from the patient's mouth.
The period of incubation or hatching of the disease after exposure to it is from two to ten days, and may be longer, but not as a rule. As diphtheria poisons the blood, there are many constitutional as well as local symptoms; all will be mentioned in the order in which they generally appear: Languor; chilliness; moderate fever, and there may be some pain in the head, back and limbs, with loss of appetite; soreness, followed by inflammation and swelling of the throat; the formation of an exudate upon the tonsils as yellowish or grayish spots which run together, form patches, and may extend to the roof of the mouth, soft palate, upper part of the throat, and even involve the nose, and the lower air passages to the bronchial tubes and lungs. Unlike the secretion sometimes seen in tonsillitis, the exudation in diphtheria is firmly adherent to the lining beneath, and when the membrane is torn or thrown off it leaves a raw, bleeding surface, and tends to reform. With the appearance of the membrane the breath becomes very foul, and has a peculiar, sickish odor. Swallowing becomes painful and difficult, and fluids may return through the nose; the glands under the jaws swell; breathing is interfered with, there is great prostration; rapid, feeble pulse; high fever; vomiting; frequently a rash about the face, neck and chest, soon disappearing.
Men the nose is affected, there is a yellowish, offensive, acrid discharge, obstruction of breathing, glandular swelling, and frequently nosebleed.
When the above symptoms are severe, the patient's strength may fail, and blueness of the skin show how much breathing is interfered with; the pulse grows weak; delirium or stupor may develop, and death follow in a short time.
Many cases, however, recover, and in these improvement generally sets in by the end of a week, characterized by the gradual softening and peeling of the membrane. Diphtheria may be complicated by bronchitis, bronchopneumonia, kidney disease or bleeding from the nose or throat. Paralysis, especially of the throat, is common during convalescence, and may occur during the disease; heart paralysis is the most dangerous form.
A dose of one of the following remedies may be given every hour:
Belladonna. Mild cases only, before exudation takes place, and when there is high fever; dryness of the mouth; the tonsils or throat bright red; much pain on swallowing, especially liquids; congestion of the face, and headache.
Phytolacca. Mild or moderately severe cases when the throat and back of mouth are covered with a dirty, dark, false membrane like wash leather; mucus is hawked up with difficulty and is stringy; great prostration, and severe pains in head, neck, back and limbs.
Nitric Acid. Yellowish or grayish white patches on the tonsils and nearby parts, extending to the mouth, lips, and nose; swallowing very difficult as if throat were constricted; splinter like pains; glands under lower jaw swollen and painful; especially useful when the nose is involved, and there is a very bad smelling, excoriating discharge.
Mercurius Bin. In cases not so bad but what they may be mistaken for a form of tonsillitis; tongue thickly coated a dirty yellow; glands in the neck swollen; tonsils and opening into the back of the nose covered with a somewhat soft and pasty membranous deposit; much mucus in throat, causing hawking.
Kali Bich. When the deposit located as above and extending down the throat and up into the nose is thick, tenacious, and yellow, with tough, stringy mucous discharges; shooting pains from throat to ear on swallowing; red, raw, shining tongue, change from Mercurius bin. to Kali bich.
Mercurius Cyan. Early and great prostration; involvement of the larynx and swelling of the glands; extensive white, yellow or gray exudate in mouth, throat and nose, very foul; very rapid, weak, intermittent pulse.
Baptisia. Stupefaction and drowsiness; mind wandering, or low, muttering delirium; restlessness; face dusky red; throat dark red; tonsils and glands swollen; absence of pain.
Apis. Great prostration from the beginning; throat looks puffy, glossy, red or purple; no thirst; burning, stinging pains; exudation dirty gray; urine scanty.
Arsenicum. The infection of the whole system is very pronounced; the breath is putrid; prostration and restlessness great; feeble, quick pulse, dark membrane; throat badly swollen; thin, excoriating discharge from the nose; may be offensive diarrhea.
Bromine. Diphtheria of the larynx, with much constriction, and paroxysms of suffocation; hoarse, croupy cough, rattling in the larynx.
Cantharis. Mucous membrane of the throat dark red and as if blistered; severe burning pains, with rawness; blood in the expectoration; cannot swallow, throat is so raw; urine scanty, may be bloody or contain albumen; passing it causes burning and smarting.
Gelsemium. Paralysis of the throat, tongue or larynx; sometimes of the heart or muscles of the eyes, following diphtheria. A dose every three hours. Also Lachesis in malignant diphtheria in bad cases where the whole system is poisoned; the throat a purplish livid color; pulse feeble and heart failure threatened; extreme prostration, patient drowsy; extremities cool. A dose every half hour. If no other remedies are available, five to fifteen drops of a chlorinated solution of lime may be added to one half a glass of water, and a teaspoonful given every half hour to three or four hours, according to the urgency of the symptoms.
Every remedial measure should be immediately supplemented, if not preceded, by the administration of diphtheria antitoxin. If in doubt whether the disease is diphtheria or tonsillitis, give an injection of 500 units for a child, 1,000 units for an adult. The average dose (Behring's Standard) in mild cases is 1,500 units, but in severe cases may be from 2,000 to 3,000 or more units. The dose varies with the duration and severity of the disease. Full instructions, which should be carefully followed out, come with all preparations, also as to the use of the syringe. After exposure to diphtheria a dose of 1000 units should be given an adult, 300 units a child, and the protection thus acquired will last three or four weeks.
The throat may be swabbed with a fifteen volume solution of peroxide of hydrogen to dissolve the membrane and may be disinfected by use of potassium bichlorate, one grain to one ounce of water, used in a hand or steam atomizer every two hours. When the nose is chiefly affected, use permanganate of potassium in the same proportion.
Alcohol as a gargle, I to 4 or even I to 2 is excellent. Steam may be obtained from a teakettle, if one has no steam atomizer, by using a rubber tube to convey it to the patient.
The patient should be isolated in an upper room, well ventilated, and from which all draperies, rugs, etc. have been removed. Sterilize all bedding and clothes by boiling; burn all rags and cloths used by the patient for the secretions; and have the patient expectorate into such cloths or into a cup containing carbolic acid solution, 1 to 20. No food should be allowed to remain in the room. The attendants should use an alcohol gargle, wash their hands in a carbolic solution 1 to 40, and wear no clothes which cannot be sterilized by boiling or baking.
The nourishment of the patient is of great importance. Milk and egg; peptonized milk; koumiss; eggs raw; egg nogg; ego, and coffee; mutton or chicken broth, oyster broth; beef peptonoids; wine whey and trophonine are recommended. Nutritive enemata may become necessary, especially if there is paralysis of the throat. Give no solid food at any stage even of convalescence in the latter case. If the heart's action is very weak give stimulant, about half an ounce of wine for a dose. Men the heart seems to be giving out entirely, give Strychnine, one fiftieth of a grain every two or three hours, reducing the dose to one hundredth of a grain as soon as the pulse grows stronger.
Whooping Cough. Pertussis.
WHOOPING COUGH is a specific, contagious disease characterized by paroxysms of coughing, attended at their close by a long drawn inspiration, the "whoop," which gives it its name. It is most common in children, but may attack adults and prove quite serious. The period of incubation is from seven to fourteen days, and the disease frequently appears as an epidemic in the winter and early spring.
Commencing as an ordinary cold or coryza with cough, running from the nose, redness and puffiness of the lower eyelids, and watering of the eyes, it progresses for ten days or more until the cough suddenly assumes a violent, spasmodic, paroxysmal form, with the characteristic whoop. The paroxysms of coughing may number anywhere from three or four to fifty or sixty in the twenty four hours. During one of them the sufferer cannot get his breath, and suffocation seems imminent; the face is suffused, the eyes infected and bulging, and the tongue protrudes; sometimes there is nosebleed or vomiting. The paroxysmal stage may last from two to six weeks, and the duration of the disease, as a whole, varies from six to twelve weeks. Between the attacks of coughing the patient seems well.
The contagious principle of this disease is probably in the expectoration, and possibly in the air from the lungs.
The most frequent complications are vomiting; bronchitis; bronchopneumonia, and collapse of the lungs; pleurisy. There may be bleeding from the nose and convulsions.
Aconite. First stage, with fever, hard, dry, wheezing cough; burning pains and tickling in the throat. A dose every two hours.
Belladonna. In the beginning, sudden, violent paroxysms of, coughing, without expectoration, worse at night; with sore throat, flushed face, eyes bloodshot, and sometimes nosebleed. Give as above.
Ipecac. Violent, suffocating cough, the child becoming stiff, and blue in the face; gagging and vomiting of mucus. Give as above.
Drosera. Spasmodic paroxysms of hoarse, loud cough, threatening suffocation; constriction of the chest; often vomiting of food or mucus. Give as above.
Cuprum. Violent paroxysms of coughing, causing convulsions, stiffening of the body, and loss of breath, followed by vomiting and prostration. Give as above.
Corallium rubrum. Short, quick, ringing cough; the paroxysms occurring in rapid succession, with extreme violence, making the face purple, and followed by vomiting of mucus and great prostration. Give as above.
Naphthalin, I x. Long and continued paroxysms of coughing, with inability to inspire air, so the child is almost suffocated. Give as above.
Hyoscyamus. Dry, spasmodic cough at night, aggravated by lying down, better from sitting up; face dark red, swollen and distorted; constriction of the throat; much mucus in the throat, and further down.
Tartar Emet. Severe cases where the lungs are involved and there is much rattling of mucus in the chest; rapid pulse, nausea, vomiting, and drowsiness, mucus raised with difficulty, but expectoration gives relief, as does also vomiting.
Isolate the sufferer from others as much as possible; let him expectorate on pieces of old cotton cloth which should be burned; the same may be used in place of handkerchiefs, and then burned. Ventilation should be perfect; light weight woolen clothing worn next the skin; the diet should be ample but digestible and nourishing; exposure to cold and damp air must be avoided; nutritive rectal injections may be given if vomiting is excessive. Remedies which can be inhaled are mentioned on page 502. Mild cases should spend as much time as possible in the open air in fine weather. Change of climate is frequently beneficial,
AN acute attack of inflammation of the bronchial tubes is generally the extension downward of an ordinary cold, which is followed by tightness and oppression in the chest; more or less fever; a raw, scraped feeling under the breast bone; a dry, hoarse, hard cough, followed later by expectoration of frothy, then thick, stringy mucus, which may be blood streaked, but does not look like rusty nails as in pneumonia. After secretion has formed, the cough is not so hard, but there are crackling or rattling sounds in the tubes from the mucus there. A simple attack lasts a week or ten days, but bronchitis may become chronic, or be severe in old people or delicate young children.
Aconite. Early in the attack; chilliness; high fever; hot, dry skin; short, hard tickling cough; great restlessness.
Ferrum Phos. The same symptoms, but without restlessness or much fever.
Bryonia. Heat, soreness, and pain behind the breast bone; dry, rough cough; labored breathing, and stitches in the chest; cough hurts the head and is worse in a warm room, and from moving about.
Phosphorus. Should not be given before bryonia as it is seldom indicated until later, when there is tickling under the notch in the breast bone, and a very tight, constricted feeling in chest; cough better indoors, and worse on going from warm into the cold air.
Kali Bich. Especially serviceable after Aconite in bronchitis following influenza, when there is free expectoration of thick, yellow, it may be ropy secretion, with hard, deep cough, and heavily coated tongue; loathing of food.
Ipecac. Asthmatic breathing, much nausea and vomiting of mucus; rattling of mucus in the bronchial tubes; face livid while' coughing; wheezing respiration.
Tartar Emet. Profuse secretion of mucus in the bronchial tubes, great rattling of mucus with the cough, but nothing is raised; great oppression and suffocative breathing; nausea, vomiting, drowsiness; face bloated or livid. Both the. remedy and Ipecac are valuable in treating bronchitis in children, and in the aged.
Belladonna. Particularly useful for young children, spasmodic violent dry cough, with tickling in the throat; high fever.
A dose of the indicated remedy should be given every one or two hours. Keep the patient in a well ventilated room, temperature 70' to 75' F. The air should be kept moist by a steam atomizer, boiling water in a teakettle or other contrivance. Apply antiphlogistine to the throat and upper part of the chest, and cover with gauze and absorbent cotton, holding all in place by a bandage. Keep the bowels open by injections of warm water or glycerin. Give milk, gruels, barley water, wine whey, broths, egg nogg, and after fever subsides and convalescence has begun, a light diet including custards, wine jelly, ice cream, blanc mange, soft-boiled eggs, minced chicken, sweetbreads, steak, etc.
Persons showing a susceptibility to bronchitis should not keep their living rooms too warm; should have plenty of fresh air; bathe the throat and chest with cold salt water, with friction; and not muffle up the throat; breathe through the nose, and wear light weight woolen or linen mesh underclothes.
CHRONIC bronchitis may follow an acute attack and occurs more often in gouty, rheumatic, or elderly or middle-aged persons. It may follow other diseases. Cough and expectoration are the principal symptoms, although the latter is sometimes scanty. There may be a fetid expectoration, partly mucous, partly purulent, and this form of bronchitis is called bronchorrhea. Attacks of chronic bronchitis may occur every winter. There may or may not be any pain, but there is a sense of oppression, and shortness of breath. Asthma and heart disease may complicate chronic bronchitis.
Tartar Emet. Especially for old people, with suffocative cough. and profuse secretion of mucus difficult to raise.
Stannum Iod. Copious, easy expectoration of thick greenish or grayish semi purulent mucus, which may be lumpy, tasting salty or sweetish; may be oppression in the chest and short breath.
Kali Bich. Stringy expectoration; asthmatic breathing, worse about three or four o'clock in the morning; wheezy cough forcing the sufferer to sit up; hoarseness and burning pain low down in the throat; general weakness; eyelids puffy
Sulphur. Refractory chronic bronchitis in rheumatic, gouty, or scrofulous individuals, with oppressed breathing and putrid expectoration.
Phosphorus. Dry, hacking cough with pain or tightness in the chest; tickling in the larynx; thin, delicate persons of a consumptive tendency.
Also Hepar sulph. Loose cough; expectoration partly mucous, partly purulent; worse at night and in the early morning hours. Silicea. Purulent expectoration with fever and profuse night sweats in consumptive persons. Arsenicum. Bronchitis with disease of the lungs or heart, or Bright's disease; debility; emaciation; restlessness and anxiety; asthmatic breathing, dropsy.
A dose of the indicated remedy three times a day. A nutritious, easily digested diet is essential, attention to personal hygiene, and remaining indoors in cold, damp and changeable weather. A warm, dry climate is desirable, especially where there are pine groves. Read the recommendations under acute bronchitis. Syrup of tar or wild cherry may prove a palliative when the cough is very annoying, or drop doses of chloroform on sugar. The inhalation of preparations of beech wood tar, creosote, or eucalyptol by means of a hot air inhaler purchasable at any drug store with directions for use, frequently gives considerable relief.
Asthma. Bronchial Asthma.
TRUE asthma is probably of nervous origin and due to spasmodic contractions of the bronchial muscles, although some writers think it caused by inflammation or swelling of the bronchial mucous membrane. Whatever the cause, it is a most distressing affection; chiefly characterized by sudden paroxysms of suffocative breathing generally at night, awakening the patient from sleep. The symptoms are well described in earlier pages of this book under "Asthma." Men are more frequently affected than women. Irritating vapors, fog, smoke, dust, mental shocks and deep emotions may excite an attack, and affections of the nasal passages. In families of a highly nervous make-up the disease is often hereditary.
Arsenicum. Paroxysms after midnight, obliging the sufferer to sit up at once and bend forward; painful and distressing restlessness; loud wheezing; dry, hard, spasmodic coughing followed by expectoration of frothy mucus streaked with blood; great prostration after the attack.
Ipecac. Violent constriction of the throat and chest, with shortness of breath and wheezing respiration; the sufferer gasps for air at the open window; threatened suffocation; vomiting gives relief; face pale; asthma with bronchitis, and loose mucus in the tubes which cannot be raised.
Grindelia. Five drop doses of the tincture three times a day, when the patient is subject to asthmatic attacks, and has a nervous fear of going to sleep on account of breath awakening him; the heart's action during an attack becomes weak and feeble, and breathing very difficult.
Nux Vom. Asthma without bronchitis, but with irritable stomach; coated tongue; constipation; flatulence; for persons using much tea, coffee or alcohol.
Also Aconite during an attack excited by exposure to cold air, and in robust persons; full, bounding pulse; heat, restlessness, and perspiration. Lobelia. Nervous asthma; nausea; vomiting; vertigo indigestion; great prostration. Sambucus. Asthma in children; quick, wheezing, suffocative attacks after midnight, with crying and profuse perspiration. The indicated remedy may be given every ten minutes during an attack, and three times a day during the intervals. Persist in its use.
Hygienic living is essential; no hearty meals at night; digestible food at all times and avoidance of overeating; change of air is frequently beneficial; the air of the sufferer's room should be fresh and moist.
For relief during the attack get amyl nitrite perles containing two to five drops, and break one in a handkerchief, inhaling the vapor. A cup of very strong black coffee, or the dried leaves of stramonium smoked in a pipe, or burning blotting paper soaked in potassic nitrate and then dried, are about the most effective immediate measures that can be taken. A whiff of chloroform or ether will often give relief. These are not curatives but palliatives, and the indicated remedy should be taken faithfully, and the general health improved.
Lung Fever. Pneumonia.
PNEUMONIA is now known to be one of the infectious germ diseases, to which exposure to cold, unhygienic surroundings, worry and overwork, and alcoholism predispose one. Those suffering from chronic Bright's disease, diabetes, rheumatism, typhoid fever, gout, influenza, bronchitis or diphtheria, are particularly liable to pneumonia. Pneumonia may follow injuries, especially those of the chest. The three stages of this disease are congestion or inflammation, consolidation or hardening of the lung tissue, resolution or softening, and absorption or expectoration of the products of the disease. On earlier pages of this book there will be found an excellent description of pneumonia and its symptoms.
Veratrum Vir. Severe and long lasting chill, rapid, full, strong pulse which is not lessened by pressing on the artery with the finger; great difficulty in breathing; rapidly rising and very high temperature, throbbing headache. Must be given in the beginning when all the symptoms point to intense congestion.
Aconite. Symptoms similar to above but less severe, and accompanied with great anxiety and restlessness, also hot, dry skin; intense thirst; hard, dry, teasing cough. This remedy also should be given early.
Bryonia. This remedy is especially adapted to the second stage when there is exudation in the lung tissue and hardening; severe, stitching or shooting, cutting pain between the ribs; painful cough, with scanty expectoration; patient holds his breath to avoid coughing, and feels more comfortable lying on the affected side.
Phosphorus. Follows bryonia well when hardening of the lung tissue has taken place, dry cough, with bloody mucus or rust colored expectoration; great oppression or tightness of the chest; difficult breathing as if there were a weight on the chest; moderate, vaguely localized pain.
Sulphur. Slow softening and absorption, little or no expectoration; fever; oppressed breathing; feeling of heat in the chest; flushes of heat; the lungs are filled with the secretions and remain hard.
Rhus Tox. So called "typhoid pneumonia"; lips and tongue dry, brown and cracked; low muttering delirium, with restlessness; expectoration like prune juice; emaciation; weak pulse; may be pains like rheumatism, and putrid diarrhea..
Tartar Emet. Catarrhal pneumonia with great accumulation of mucus in the chest, loud rattling of mucus with great oppression, and very difficult breathing; loose, rattling cough, but patient cannot raise anything, face pale or livid.
A dose of the indicated remedy every one or two hours. The patient should be in a large, well ventilated room, temperature about 72' F. The air may be kept moist as in bronchitis. Keep the patient lying down; every two hours give four to eight ounces of milk, egg and milk, egg in coffee, broths or gruels, or give ice cream, grape juice, meat juices, and plenty of water, lemonade if desired. Partial or complete sponge baths while the fever is high and there is much restlessness, are soothing.
Apply antiphlogistine to the chest, or if that is not available, put on a soft cotton jacket or absorbent cotton kept in place by a swathe and straps over the shoulders. Do not put on poultices. For pleuritic pains apply several thicknesses of flannel, sprinkle the outside one with water, and quickly run a hot flatiron over it until it steams; repeat often. Use a hot water bag. When the heart's action is weak give from one teaspoonful to half an ounce of brandy or whiskey, with water; repeating the dose as necessary. The free use of strong oxygen gas is strongly advocated in threatened heart failure, suffocative respiration, and face pale or livid. Also subcutaneous injections of strychnia, 1100 grain every three or four hours, or 1-50 to 1-100 grain by mouth. The bowels should be kept open by daily injections; this is important,
WHEN the pleura, that is, the membrane covering the lungs and lining the chest, is wholly or partly inflamed there is a sharp, cutting pain, worse from coughing, taking a deep breath or moving. Pain is generally preceded by chilliness, fever and a hacking cough. If the inflammation goes on, fluid is secreted in the pleural cavity, and presses upon the lung; this watery fluid may become purulent. The disease may last a few days or many weeks, is excited by cold or wet, and caused by germs.
There is a form of pleurisy called "false pleurisy" or pleurodymia, which occurs between the ribs, and is merely neuralgic from inflammation of the nerves, or due to muscular rheumatism, or uterine disease.
Aconite. To be of service must be given early; acute pleurisy, coming on with chill, followed by fever; thirst; quick, rapid pulse; skin hot and dry; rapid respiration; great nervous restlessness; stitching pains in the chest; hard, dry cough.
Bryonia. Acute, stitching pains; worse from motion or breathing; short rapid respiration.
Cantharis. Follows bryonia well when fluid has formed; heat, burning and stitches in the chest; difficult breathing; scanty urine.
Arsenicum. Much fluid in the chest; breathing difficult, but little pain; much prostration and weakness; restlessness and anxiety.
Also Sulphur in chronic pleurisy when the fluid is slow to absorb. Phosphorus when pleurisy accompanies pneumonia or bronchitis. Rhus tox. Pleurisy after exposure to wet, or from straining or lifting, with muscular pains and great restlessness. A dose of the indicated remedy every one or two hours.
In false pleurisy Bryonia or Rhus tox. may be given when the pains are of a rheumatic character. Cimicifuga. Neuralgic pains in the left side, just below the breast, and especially when there is some uterine trouble. Arnica. Shooting pains, or pains as from a bruise when moving or coughing. May be given in true pleurisy, after an injury to the chest wall.
Give a dose of the indicated remedy every hour or two. The sufferer from pleurisy should have absolute rest in bed, and a liquid diet. Apply antiphlogistine or flannels wrung out in hot water and frequently changed. Do not use cold applications or poultices. Straps, three inches wide, of adhesive plaster, long enough to encircle the diseased side and to extend a short distance over the sound half of the body, may be applied just as the patient has fully let out a breath. Strapping limits motion, and so lessens pain.
In false pleurisy make hot applications or take a sitzbath. Galvanism is helpful. Uterine derangements should receive appropriate treatment.
Pulmonary Tuberculosis. Consumption of the Lungs.
THIS is the most frequent variety of consumption, and is caused by the organism known as the bacillus tuberculosis, first described in 1881 by the great scientist Koch. The disease may be acute or chronic, and is characterized by the formation of nodular bodies called tubercles, or by the production of areas of diseased tissue in the lungs. Wherever the disease develops, the tissues become cheesy or hard, and extension of the inflammation and ulceration may follow. Indians and negroes succumb more readily to consumption than white people, but the "great white scourge" is dreaded by the inhabitants of every part of the world. The death rate, however, is being lowered every year, chiefly, and this is a very important point, through people learning how to prevent the disease.
Consumption is an infectious disease transmitted most often by inhalation, that is, the germs entering the lungs in the air breathed in. These germs are in the expectoration of the person suffering from consumption, and every time he spits, unless into a receptacle that is afterwards burned or that contains a strong disinfectant, he may be giving consumption to someone, for the sputum dries, and the germs enter the air as a fine dust to be breathed in at once by other people, or to be deposited on carpets, clothing, utensils, etc., and the contagion carried about, or conveyed back into the atmosphere. The germs are very tenacious of life, and will infect a person long after they are thrown off by a consumptive. This is why persons contract consumption living in a house where someone has had the disease. The germs may be taken into the system by eating meat from an infected animal, or using a consumptive's dishes, or clothes, or through the bacilli touching an abrasion on the skin or lips.
People very seldom inherit consumption, but often inherit the tendency, that is, constitutions which offer a fertile field for the development of the germs. Pulmonary consumption is more common between twenty and thirty, and in women than men, but no age is exempt. Many conditions favor its development, such as confining work in ill ventilated rooms; lack of proper nourishment; living in damp houses or crowded tenements, under unhygienic conditions; bronchial affections; syphilis; alcoholism; wounds of the chest, or injuries to the lungs; many organic diseases, and occupations such as stone cutting, coal mining, etc.
In acute consumption, " galloping consumption," the onset of the disease may be sudden, with chill; pain in the side; fever; cough; bloody expectoration or bleeding; distressed breathing; much fever; night sweats; rapid emaciation; great prostration; and a semi purulent expectoration in the later stages. The disease may terminate fatally in two to six weeks.
" Galloping consumption " may affect the bronchial tubes as well as the lungs, and follow whooping cough, measles or other infectious diseases in children. These cases may recover, chronic consumption result, or death ensue.
The early symptoms of chronic tuberculosis of the lungs are in general, slight fever; irritable pulse; emaciation; languor; capricious appetite or loathing of food; indigestion; sweats, and impoverished blood. There also develop cough; expectoration; pain in the chest; bronchial catarrh; bleeding from the lungs. What is discovered in all these cases by examination of the chest, is described elsewhere in this book. Diagnosis is best confirmed by the finding of the bacillus in the expectoration. Early diagnosis is of the greatest importance, that the disease may be treated during the curable stages.
Arsenicum. In incipient consumption, especially when there is rapid loss of weight, and in "galloping consumption," with great prostration; rapid emaciation; hectic flush of the cheeks; fever; cough; interference with breathing. In the later stages Arsenicum iod., when the expectoration is semi purulent; the prostration great, and diarrhea present.
Phosphorus. Especially in consumption following pneumonia, and in tall, thin, "hollow chested" persons; young people growing rapidly; great debility; frequent attacks of bronchitis; dry cough; soreness in the larynx and trachea; long continued hoarseness, and sometimes loss of voice; blood streaked expectoration; tightness across the chest; hectic fever; night sweats; diarrhea after meals.
Calcarea Carb. In incipient consumption in fat, fair persons, or in rather phlegmatic, scrofulous children who cannot eat fat; young girls in whom the monthly flow is too frequent and profuse, or disappears; free perspiration; "acid dyspepsia"; nosebleed; sensitiveness to cold or damp, slight effort causes fatigue. This remedy in these cases has loose, rattling cough, with yellow expectoration; persistent hoarseness; soreness in the chest; diarrhea.
Iodide of Antimony, 2 x. Three grain doses, three times a day in consumption in scrofulous persons, with good appetite, but fast losing flesh; enlarged glands; persistent, short, hacking cough; profuse, partly purulent expectoration; morning sweats.
Nux Vom. For digestive disturbances when prominent; morning headache; sour, or bitter taste; vomiting, or violent retching; neuralgic pains in stomach; constipation, with ineffectual urging.
Sanguinaria." Galloping consumption," especially when following pneumonia; hectic fever; circumscribed redness of cheeks; loose cough, but expectoration difficult; cough worse lying down, oppressed breathing; bleeding from the lungs.
Stannum iod. Especially when there is also consumption of the throat; profuse, sweetish tasting greenish or partly purulent expectoration; flushed face; emaciation; rattling of mucus, and soreness and weakness in the chest; debilitating sweats night and morning; reading or talking cause great fatigue.
Ferrum Phos. Bleeding from the lungs with consumption, especially in young people; fugitive pains in the chest; difficult breathing and palpitation; thick, frothy expectoration streaked with blood; may be vomiting; sensation of fullness in the stomach. Consult the remedies given under "Bleeding from the Lungs."
Also Agaricine, 1 x. one tablet at night, or repeat the dose in two hours, for profuse sweating, or in "galloping consumption" with drenching sweats where Agaricine is not effective, give Pilocarpine, 2 x. China, 1 x, great debility following profuse sweats, diarrhea, seminal emissions, leucorrhea; weak voice; impoverished blood supply Having selected the indicated remedy give it three times a day unless otherwise directed.
The main reliance in the treatment of consumption must be placed in a proper mode of life under favorable climatic conditions, meaning an equable climate, with pure dry air, and a large proportion of sunny days. The patient should be out of doors practically all the time, sleeping on a piazza rather than in the house, even if there are many windows in the room and kept wide open. With rugs and hot water bags a patient can be kept comfortable in the coldest weather. Woolen underwear should be worn all the year round, but clothing so heavy as to cause perspiration should be avoided. Systematic deep breathing exercises must be performed several times a day. The amount of exercise must depend on the strength of the patient, and rest out of doors must be substituted for exercise when there is f ever.
The diet must be simple, generous, and nutritious, cream, milk and eggs especially; meat juices white of egg; peptonized or malted milk; koumiss buttermilk. Cod liver oil is valuable if it can be taken. Malt liquors and the red wines may be beneficial. Nourishment should be given every two or three hours. * Cold sponge baths may be taken daily; alcohol baths for the night sweats. Every consumptive should use a spit cup which can be burned, or which contains a strong disinfectant, as carbolic acid 1 to 20, and can be thoroughly cleansed. No handkerchief should be used, but pieces of cheesecloth or soft cotton to be afterwards burned. Children of consumptive tendencies should have nourishing simple food; be out of doors a great deal; go to bed early; take daily cold baths with friction; keep out of school if necessary and away from excitement. Delicate persons especially should avoid the use of alcohol, sexual excesses, overwork and worry. Catarrhal affections of the nose or throat should receive prompt attention.
Bleeding from the Lungs.
BLEEDING from the lungs may be caused by wounds rupturing the lung, congestion caused by heart disease, by ulcer, cancer, yellow fever, scurvy, violent paroxysms of coughing as in whooping cough, etc., but most commonly bleeding from the lungs is associated with consumption. The blood is nearly always bright red and frothy, may simply well up in the mouth or be preceded by a slight cough. The attacks are generally sudden, and may be preceded by a sense of warmth under the breast bone, sweetish taste in the mouth, headache, vertigo and palpitation of the heart. There is fever, and the sufferer is anxious and irritable.
Aconite. Bright red blood; incessant, hacking cough; warmth in the chest; red face; great anxiety; full, bounding pulse.
Ipecac. Sensation of bubbling in the chest, followed by copious bleeding, worse on the least movement, of bright red, frothy blood; oppressed breathing; faintness; nausea
Hamamelis. Blood dark, thin, coming into the mouth without effort, like a warm current.
Millefolium, I x. Bleeding not relieved by aconite; profuse flow of thin, bright red blood, with oppression and palpitation, but not much cough.
Ferrum Phos. Free, slight bleeding of bright red blood in delicate persons of a consumptive tendency or having consumption; dry, hacking cough with pressure on the chest.
A dose of the indicated remedy every fifteen minutes. Let the sufferer assume a semi recumbent position, with head and shoulders elevated, and in a cool room which must be kept absolutely quiet. Do not give stimulants. In the absence of medicines put a small pinch of salt on the tongue. Small pieces of ice may be swallowed. If fainting occurs, do not attempt to revive the patient at once as temporary loss of consciousness is beneficial. Injections of normal salt solution are recommended after profuse hemorrhage, but require the skill of a physician. A hot water bag partly filled with hot water, temperature 120' F., (use a bath thermometer) should be applied to the back between the shoulders.
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