Chapter VIII (1)

DISEASES, AND THEIR TREATMENT WITHOUT ALCOHOL.

The question, "What shall I take instead of wine, beer or brandy?" is frequently asked by those who have been trained to think some form of alcohol really necessary to the cure of disease, but, who, from principle would prefer other agents, if they knew of any equal in effect. This chapter deals somewhat with the answer to that question.

ALCOHOLIC CRAVING:--The craving for alcohol may be present for a time after a person has commenced to abstain from all beverages containing it. Or, it may occur periodically, as a sort of irresistible impulse. For the periodical craving Dr. Higginbotham, of England, recommends that a half drachm of ipecacuanha be taken so as to produce full vomiting. He says the desire for intoxicating drinks will be immediately removed. The craving is caused by vitiated secretions of the stomach; the vomiting removes these. Dr. Higginbotham says:--

"If a patient can be persuaded to follow the emetic plan for a
few times when the periodical attacks come on, he will be
effectually cured."

Some men in trying to abstain have found the use of fresh fruit, especially apples, very helpful. Nourishing and digestible food should be taken somewhat frequently. A cup of hot milk or hot coffee taken at the right moment has saved some.

ANAEMIA:--In this complaint there is a deficiency of the red corpuscles of the blood. It may be the result of some fever or exhausting illness; it may accompany dyspepsia, and is then due to imperfect digestion and assimilation of the food. The poverty of the blood produces shortness of breath, and often palpitation of the heart also, especially on a little exertion. There is generally more or less weariness, languor and debility, sometimes also giddiness, sickness, fainting and neuralgia.

"In the treatment of anaemia, port wine and other alcoholic
liquors are worse than useless."--DR. J. J. RIDGE, London.

"The common prescription of wine or some form of spirits for
states of general exhaustion and anaemia, is a serious mistake.
It assumes that the temporary increase in the action of the
heart is renewed vigor, and that some power is added to the
failing energies. This theory rests solely on the statement of
the patient that he feels better. In reality the exhaustion is
intensified, though covered up."--_Medical Pioneer._

"Deficiency of nutrition, of light and of pure air may be
mentioned as common causes of anaemia. * * * * * It is evident
that the first step in the treatment of this disease is to
remove the cause. If the cause is dyspepsia, this must receive
attention; if intestinal parasites, they must be dislodged; if
prolonged nursing, nursing must be interdicted; if too little
food, a larger quantity of nourishing, wholesome food must be
employed. Such simple and easily digested foods as eggs, poached
or boiled, boiled milk, kumyzoon, good buttermilk, puree of
peas, beans or lentils, boiled rice, well-cooked gruels and
other preparations of grains are suitable. Beef tea and extracts
are worthless. * * * * *

"A careful course of physical training is essential to securing
perfect recovery in cases of chronic anaemia due to indigestion,
or any other serious disturbance of the nutritive
processes."--DR. J. H. KELLOGG.

APPETITE, LOSS OF:--"There is often disinclination for food
because _it is not required_. Many cannot eat much breakfast,
because they have had a hearty supper. Or having had both a
hearty breakfast and luncheon, they feel but little desire for a
dinner of four or five courses. Generally the stomach is right
and the habits wrong. What is to be done then, for such lack of
appetite? Simply go without food until appetite comes.

"When ale or beer is taken regularly with meals the stomach
learns to expect them, and the food is not relished without
them. The appetizing power of beer and bitter ales is chiefly
due to the hop or other bitter ingredients which they contain.
When it seems necessary to assist the appetite temporarily, a
small quantity of simple infusion of hops may be taken.

"Sometimes appetite fails because of exhaustion of body and
mind. This may be nature's warning against overwork, and cannot
be neglected with impunity. Life will inevitably be shortened if
it is found necessary to rely upon the aid of alcohol in any
form in order to do a day's work.

"Bouillon, or beef soup, at the beginning of a meal are
incentives to appetite. Change of scene, and life in the open
air are the very best aids to appetite, when aids are really
required."

APOPLEXY:--"There is a popular idea that whenever a person is
taken ill with giddiness, fainting or insensibility, brandy
should be at once procured and poured down his throat. Nothing
can be more dangerous in apoplexy. This disease is due to the
bursting of some blood-vessel in the head, and the poured-out
blood presses on the brain and leads to more or less
insensibility. If fainting occurs, it may possibly save the
patient's life, because then the blood-vessels contract, and the
flow of blood ceases immediately; time is thus given for the
ruptured blood-vessel to became sealed up by a clot, which will
prevent further loss of blood. If brandy is given, there is,
first, great risk of choking the patient; if that danger is
escaped and the brandy is swallowed and absorbed, the vessels
become relaxed and the heart recovers its force; hence the
ruptured vessel, if not sufficiently sealed by clot, may be
started again, and fatal hemorrhage result.

"The only _treatment_ which unskilled hands can adopt is to lay
the patient on his back on the floor or sofa with the head and
shoulders somewhat raised; to loosen all the dress round the
neck and body; to apply cold to the head and hot flannels or a
hot bottle to the feet and hands, or to soak them in hot mustard
and water, and to gently rub the arms and legs."--DR. J. J.
RIDGE.

Dr. Alfred Smee, surgeon to the Bank of England, says:--

"Give nothing by the mouth. Apply a stream of cold water to the
head. If the feet are cold apply warm cloths. If relief is not
soon obtained, apply hot fomentations to the abdomen, keeping
the head erect."

BED-SORES:--Some object to using alcohol even as an outward application. Dr. Ridge recommends that when a patient is confined to bed the parts pressed on be well washed every day with strong salt and water or alum water, and carefully dried. _Glycerine of Tannin_ may then be applied. If any redness appears, especially if any dusky patch is formed, _collodion_ may be applied with a brush, and all pressure should be taken off the part by a circular air-pillow or by a cushion; or small bran or sand-bags may be made and carefully arranged. If the skin is broken, _zinc_ or _resin ointment_ may be applied.

Some recommend finely powdered iodoform sprinkled over the surface of the sore.

BOILS AND CARBUNCLE:--"In many cases these troubles result from
an overloaded condition of the system, which is the result of
taking too much food, or some error in diet. The boils are an
effort of nature to be rid of offending matter. In some cases
they are due to the use of impure water, or the presence of
sewer gas in the house. In others, overwork, or other
debilitating causes, may have produced the state of the
digestive organs which usually causes the boils. Carbuncle is,
essentially, an extensive boil.

"Apply iodine early or a piece of belladonna plaster. The diet
should be plain and unstimulating, condiments being avoided and
plenty of fresh vegetables taken, if possible. Fresh-air,
exercise and proper rest should be obtained, and late hours
avoided.

"Medical advice is requisite in carbuncle. The popular notion
that port wine is absolutely necessary is both erroneous and
mischievous."--RIDGE.

CATARRH:--Among the causes are repeated colds; errors in diet, especially excess in the use of fats and sugar, and an inactive state of the liver.

Cut off from your bill of fare all salted foods, avoid fats and condiments; drink freely of pure water; live in the open-air and sunshine as much as possible, taking much out-door exercise. Take a cold sponge or towel bath every morning, beginning at the face and finishing by plunging the feet into a foot-tub. Follow with vigorous rubbing with a crash or Turkish towel. Those subject to sore throat should hold the head over a basin of cold water and lave the neck with the water for about two minutes. The writer was formerly subject to frequent sore throats, but has had none for over two years, as she believes, because of the adoption of this measure, together with the towel bath every morning, summer and winter.

Care should be taken to avoid exposure to draughts, or any other means which will produce liability to cold. Care in diet, good ventilation and the morning cold bath are essential if a radical cure is desired. Local measures, while giving relief, will not remove the predisposing causes. Dr. Kellogg recommends saline solutions in the form of the nasal douche, a teaspoonful of salt to a pint of soft water, adding twenty to thirty drops of carbolic acid, if there is offensive odor, as a relief measure.

Sleeping in a poorly ventilated room is said to be one cause of catarrh.

_Hay Fever_ is a form of catarrh. The vapor bath is recommended as very helpful in this trouble. _Nature Cure_ says that two vapor baths and a two or three days' fast will cure any case of hay fever. The use of pork and other clogging foods should be avoided by those afflicted with this trouble. The bowels should be kept in good condition. If constipated, the use of prunes, figs, grapes, apples and other such fruits will be very beneficial; walking, and massage of the bowels, being added if the fruits are not sufficient. No one able to walk should depend upon drugs to relieve a constipated condition.

COLDS:--"If the bowels are constipated, the skin over-burdened
and clogged with bilious matter, and the lungs weak, it is as
easy to take cold as to roll off a log. If, on the contrary, the
lungs are well developed, and the respiratory power large,
providing abundant oxygen to keep bright the internal fires, the
colon clean, the skin daily washed, and the system hardened by
the cold bath, taking cold is next to impossible.

"The first remedial agent for a cold should be a copious enema.
Then open the pores of the skin by a hot bath; take a glass of
hot lemonade and go to bed."--_The New Hygiene._

CHILLS:--For chill, take a hot foot and hand bath, with mustard in the water, 1/4 pound to a gallon; then go to bed in a well ventilated room. Drink freely of hot lemonade or hot water. Catarrh, colds and hay fever may all be effectually relieved by hot baths. Relief may be gained also from inhaling the vapor from pine needles or hemlock leaves. Put them in a bowl, pour boiling water over them, hold the face down over the bowl, the head being covered, and inhale the vapor well up into the nostrils and head. A few drops of hemlock oil in the hot water will do as well.

COUGHS AND HOARSENESS:--Boil flaxseed in 1 pint water, strain, add two teaspoons honey, 1 ounce rock candy, and juice 3 lemons. Drink hot. Also; roast a lemon till hot, cut, and squeeze on 3 ounces powdered sugar.

COLIC:--This may arise from cold, or from error in diet. If the latter it is desirable to induce vomiting. For the pain, apply hot flannels or fomentations; drink hot water. In severe cases, sprinkle a little turpentine on flannel, wrung from hot water, and apply to abdomen. Colic resulting from the accumulation of fecal matter should be treated with hot enemas until relieved. A hot hip-bath is sometimes necessary to relief.

The colic of children and infants should never be treated with alcoholics. In infants it generally arises from excessive or improper feeding; care should be taken that the milk provided them is not sour.

In severe cases the babe should be immersed in warm water, keeping the head above water, of course. This is also the best remedy in convulsions. The hot bath, with a copious enema of warm water, has saved the lives of many babes.

For adults, hot water, with a pinch of red pepper added, will do all that brandy can do, and more.

CHOLERA:--Brandy has been considered by many a really necessary medicine in cholera. The following is a discussion upon Alcohol in Cholera which was held at the annual meeting of the British Medical Temperance Association, in May, 1893, and is taken from the _Medical Pioneer_ of June, 1893:--

"Dr. Richardson opened a discussion on Cholera in relation to
Alcohol. He said he would bring forward five points on the
subject.

1. The negligence among the people at large produced by alcohol
in the presence of a cholera epidemic. There was no doubt on the
part of any who had seen an epidemic of cholera as to the
mischief done by alcohol, apart from its action as a remedy.
People rush to the public houses and take it to ward off the
danger, or to relieve them when they begin to feel ill, and the
result is very bad morally. He had seen this in different
epidemics. Or people got in spirits to face the danger, and many
became intoxicated and less able to resist.

2. Its misuse by those affected. It was often given to cheer
them up and remove their fear and nervousness. In his opinion it
invariably produced mischief.

3. He was unable to find any physiological reason for giving it.
There was a constant drain of fluid, causing spasms and cramp,
both of the muscles and blood-vessels, and difficult circulation
through the lungs. Spasm may be relaxed by alcohol, but, on the
other hand, alcohol is exceedingly greedy of water, and so
increases the flux. But it also reduces animal temperature,
which is a strong feature of cholera, so much so that he could
almost diagnose cholera blindfold in the stage of collapse, by
the icy coldness.

4. Its uselessness as a remedy during the acute stage. He had
seen a great deal of cholera and never saw alcohol do any good
whatever. There was a temporary glow which passed away in a few
minutes, and then the evil it does in other ways was brought
out. Water was far better, even if cold. The College of
Physicians had given some instructions and ordered great care in
the administration of alcohol; this was not far enough, but good
as far as it went. The recoveries were best where the treatment
was simplest, such as external warmth with plenty of diluents.
He had given creasote largely.

5. Its injuriousness during the stage of reaction. The reactive
fever following collapse caused a great number of deaths. In
this stage alcohol was absolutely poisonous. He could recall
many such cases in which he had given alcohol through ignorance,
and always with disaster.

"Brigade-Surgeon Pringle said that when he went out to India he
thought alcohol was something to stand by, but he had soon found
out his mistake; he had himself suffered from it. He could
confirm what Dr. Richardson had said as to the demoralization
produced by alcohol to which men resort to keep up their
spirits, and men seized under these circumstances were in the
greatest danger. Nature effects a cure in many cases without
assistance, and often with wonderful rapidity. People apparently
dead and about to be buried, he had known to get up and recover.
When alcohol is given during collapse there is often no
absorption until reaction occurs, and then the quantity
accumulated speedily produces intoxication. It was the same with
opium: he had found pills unchanged in the stomach for hours. He
recommended hot drinks; he had tried every kind of medicine and
had little faith in it. The nursing was very important, and it
was important that the nurses should abstain.

"Dr. Morton said it was easy to see that on physiological
grounds alone, alcohol, with its strong affinity for water and
its tendency to lower temperature, could not be a useful drug in
the treatment of cholera collapse, and with its powers of
paralyzing vascular inhibition and checking elimination of
effete matter, could not be otherwise than harmful in the stage
of reaction. As these conclusions were corroborated by practical
experience he did not think members would hesitate to banish it
from their equipment against cholera.

"Dr. Ridge said it should be remembered that Doyen had made
experiments on guinea-pigs and had found they were proof against
cholera, unless they had previously had a dose of alcohol. This
explained why drunkards and hard drinkers were so much more
liable to have cholera, and have it badly as all observers
declared to be the case. Another reason might be that small
quantities of alcohol, such as would be found circulating in the
blood, favored the growth and multiplication of bacteria,
certainly those of decomposition, and probably those of cholera.
Hence, other things being equal, the abstainer had a great
advantage.

"Dr. Norman Kerr said that he had observed both in America and
Glasgow that not only notorious drunkards but free drinkers
suffered; abstainers were less liable unless they took
contaminated water, and the less liquid taken the less chance of
taking cholera; beer-drinkers often took more than abstainers.
The alcohol-drinker uses up more water from his blood and so has
less to flush out the system. Alcohol, given to a patient,
disguised his condition so that he might seem better though
really worse. Hence it is better and safer not to give any. The
doctors and nurses ought to be abstainers. A doctor after dinner
was more likely to take a roseate view of a case, looking at it
through an alcoholic pair of spectacles. Alcohol was not really
a stimulant, but a depressant, and this is a very depressing
disease; it was important to have our vital resisting power as
vigorous as possible. Hot water both relaxes and stimulates, and
the whole cry of the sufferer is for water. Many persons who
died in cholera did not die of the disease, but of the drugs
such as alcohol and opium. Acid drinks should be given, as the
bacilli could not live in acid mixtures. Cholera might come, but
he believed we were better prepared to meet it and to treat it.

"Surgeon-General Francis sent a communication which was read by
the Honorable Secretary. He said: 'Having had many opportunities
of treating cholera in various parts of India and amongst all
classes, I have no hesitation in affirming that alcohol in any
shape is one of the very worst remedies. Life is, so to speak,
paralyzed, and we give a remedy which, apparently stimulating,
is in reality, a paralyzer and therefore mischievous; the
death-rate might be considerably reduced provided alcohol were
rigidly excluded.'"

Dr. Norman Kerr in a valuable paper upon Cholera says:--

"The first thing is to get rid of the poison. How? By assisting
it out; but alcohol keeps it in by blocking the doors, just as
the doors were blocked in the terrible calamity at Sunderland
not long ago. The alcohol makes the heart and circulation labor
more. Alcohol not only retains the cholera poison, but retards
the action of the heart. Brandy and opium used to be employed,
but the records show that if the object had been to make cholera
as fatal as possible, that object was achieved by the
indiscriminate administration of brandy and opium. Better leave
the victim alone, and his chances of recovery will be greater
than if he have a thousand doctors, and as many nurses,
administering to him brandy and opium. Alcohol is especially
dangerous in the third stage, that of reactive fever, because it
adds to the fever. Then, alcohol is not only unsafe in the three
stages of genuine cholera, but especially unsafe in the
premonitory diarrhoea stage, which gives nearly every one
warning before they are attacked by genuine cholera. Brandy is
taken simply because it puts away the pain. If there are only
the pain and slight diarrhoea, speaking medically, it is all
right, but if there is anything behind the pain, it is all
wrong. After the alcohol, the mischief is going on, only the
patient does not know it, and valuable time is lost. All the
alcohol does is to deaden sensation. * * * * * Here I can
thoroughly recommend ice and iced water. I have always treated
cholera patients with these. Let them drink iced water to their
hearts' content; they can never drink too much; and this opinion
is fortified by that of Professor Maclean, of Netley. There is
no need of a substitute for brandy in cholera, because in
ordinary circumstances in that disease the action of a stimulant
is bad. Flushing of the blood is required, and water will do
it. Milk will not do it, because it is too thick--nothing but
pure, cold water, all the better if iced."

In 1893 Dr. Ernest Hart, editor of the _British Medical Journal_, read an able paper upon Cholera before the American Medical Association. His argument was that the introduction of such a substance as alcohol, itself being a product of germ action, into a system already suffering from the toxic influence of a ptomaine, could not be otherwise than pernicious.

CHOLERA MORBUS:--Dr. Kellogg says: "The stomach should be washed
by means of the stomach-tube when possible. A large hot enema
should be given after each evacuation of the bowels. The
addition of tannin, one drachm to a quart of water, is
serviceable. When the vomited matter no longer shows signs of
food, efforts should be made to stop the vomiting. Give the
patient bits of ice the size of a bean to swallow every few
minutes. At the same time apply hot fomentations over the
stomach and bowels. If the patient suffer much from cramp, put
him into a warm bath. The first food taken should be
farinaceous. Oatmeal gruel, well boiled and strained, is
useful."

CHOLERA INFANTUM:--"Iced water may be given in very small
quantities every few minutes. Give the stomach entire rest for
at least twenty-four hours. There will be no suffering for want
of food as long as the stomach is in such a condition. Withhold
milk until nature has had time to rid the alimentary canal of
the poison-producing germs. White of egg dissolved in water is
an excellent preparation in these cases. Egg enemata may also be
advantageously used.

"Warm baths, the hot blanket pack when the surface is cold, and
the hot enema are all useful. Keep the child wrapped warmly.

"Great care should be taken in returning to the milk diet. The
milk should be thoroughly sterilized by boiling for half an
hour, and should be mixed with some barley water so as to avoid
the formation of large curds in the stomach. Cream, diluted with
water, may be used instead of milk."

CONSUMPTION.

Dr. Koch, the celebrated German microscopist, pronounces consumption contagious, because during its progress a very minute bacterium is developed which may be transmitted from one person to another.

It is said that a person with healthy lungs might daily breathe millions of tubercle bacilli without any danger, and that the best preventive of this disease is to live much in the open air, or if this is impossible to spend ten or fifteen minutes a day in deep breathing exercises in the open air. "Fresh-air and disease-germs are antagonistic."

Alcohol, chiefly in the form of whisky, was for many years considered of great value in the treatment of consumption of the lungs. Indeed, it was looked upon not only as a curative, but also as a prophylactic, or preventive, of great service to those predisposed to this disease by reason of narrow chest and weak lungs.

Sir Benjamin Ward Richardson was the first medical scientist who showed plainly that alcohol, instead of being a preventive of consumption, is really the sole cause of one type of this disease, the type now classed under the head of "alcoholic phthisis." For this kind of phthisis there is no hope of cure.

French physicians some years ago came to the conclusion that alcohol was a prolific cause of tuberculosis and that the administration of alcoholic liquors in tubercular troubles was a great error, and in the International Anti-Tuberculosis Congress held in Paris in 1905, about 2000 medical scientists being present, they presented the following resolution, which was adopted: "In view of the close connection between alcoholism and tuberculosis, this Congress strongly emphasizes the importance of combining the fight against tuberculosis with the struggle against alcoholism."

Since that time a great crusade against tuberculosis has been carried on by means of exhibits and lectures, and in connection with these, almost invariably the people are warned against intemperance. For example, a pamphlet sent out by the Boston Association for the Relief and Control of Tuberculosis says: "Do not spend money for beer or other liquors, or for quack medicines or 'cures.' Self-indulgence and intemperance are very bad. Vice which weakens the strong kills the weak." The New York State Charities Aid Association, working with the State Board of Health, says in a pamphlet: "Patent medicines do not cure consumption. They are usually alcoholic drinks in disguise, and the use of alcoholic drinks is dangerous to the consumptive." At the great exhibit in Washington in September, 1908, in connection with the International Anti-Tuberculosis Congress different warnings against alcohol were upon the walls. Among these was a large poster of white cloth on which was printed the opinions on alcohol, in brief, of some of the best-known authorities on consumption. The opinions as given on that poster are given here, with others, in order to show the great change of sentiment regarding alcohol and consumption which has come about within a few years:--

"Alcohol has never cured and never will cure tuberculosis. It
will either prevent or retard recovery. It is like a two-edged
weapon; on one side it poisons the system, and on the other it
ruins the stomach and thus prevents this organ from properly
digesting the necessary food."--S. A. KNOPF, M. D., New York,
Honorary Vice-President of the British Congress on Tuberculosis.

Dr. Knopf in his prize essay on "Tuberculosis and How to Combat
It," says in several places: "Avoid all alcoholic beverages." He
says also, "Alcohol should never be given to children even in
the smallest quantities."

"It is a recognized fact in the medical profession that the
habitual use of alcoholic drinks predisposes to tubercular
infection. It is also recognized, I think, by most physicians
that alcohol as a medicine is harmful to the tubercular
invalid."--FRANK BILLINGS, M. D., Chicago, Ill., Former
President American Medical Association.

"Alcoholic liquors are of damage to consumptives because they
tend to impair nutrition, disturb the action of the stomach, and
give a false strength to the invalid on which he is sure to
presume. Besides, we know that in countries where drinking
prevails most, the ravages of tuberculosis are most
marked."--EDWARD L. TRUDEAU, M. D., Adirondacks Sanitarium for
Consumptives, Saranac Lake, N. Y.

"In my judgment whisky should not be used by people who have
consumption, and in my practice I prohibit its use absolutely.
At the White Haven Sanitarium and Henry Phipps Institute we do
not use alcohol in any form in the treatment of our
patients."--LAWRENCE F. FLICK, M. D., Vice-President of the
National Association for the Study and Prevention of
Tuberculosis, Philadelphia, Pa.

"I do not feel that I can emphasize strongly enough the harm
that can be done by the use of alcohol in tuberculosis, and the
indiscriminate use of it certainly borders on the criminal. I do
not believe that any legitimate reason can be given for the
routine employment of alcohol in the treatment of tuberculosis.
I furthermore know of no emergency in which it is indispensable.
My experience with patients who have been accustomed to the use
of alcohol, especially moderately, is very unsatisfactory. They
seem to show an abnormally low resisting power to the tubercle
bacillus. The fact has been established that alcoholism is a
very potent factor in the causation of tuberculosis. I find it
not only unnecessary in treatment but believe it to be
contraindicated."--F. M. POTTENGER, M. D., Superintendent the
Pottenger Sanitarium for Diseases of the Lungs and Throat,
Monrovia, California.

"I have met with a small class of consumptive patients who could
take alcoholic liquors freely for a length of time, without
deranging either the stomach or the brain, and with a decided
amelioration of the pulmonary symptoms, and an arrest of the
emaciation. Some of these have actually increased in
_embonpoint_, and for three to six months were highly elated
with the hope that they were recovering. But truth compels me to
say that I have never seen a case in which this apparent
improvement under the influence of alcoholic drink was
permanent. On the contrary, even in those cases in which the
emaciation seems at first arrested, and the general symptoms
ameliorated, the physical signs do not undergo a corresponding
improvement; and after a few months the digestive function
becomes impaired; the emaciation begins to increase rapidly; and
in a short time the patient is fatally prostrated."--DR. NATHAN
S. DAVIS, SR., of Chicago.

"The use of whisky in this disease positively interferes with
digestion which must under all circumstances be kept as perfect
as possible in order that the patient may assimilate the food
which is so necessary to the upbuilding of the system and to
gain strength to fight the onslaught of the disease.

"Its constant use would not only interfere with digestion but
would have a tendency to create disease in other organs of the
body so that we therefore consider the use of whisky in
tuberculosis positively contraindicated.

"Wishing you success in your laudable campaign."--DR. M.
COLLINS, Superintendent National Jewish Hospital for
Consumptives, Denver, Colorado.

"It is difficult for many people to adapt themselves to a
methodical plan of life long enough to establish a permanent
cure in consumption. I have known many a young fellow with only
a slight trouble in his lungs to die in the Adirondacks more
from the effects of whisky than from the disease itself."--DR.
HENRY P. LOOMIS, of New York City, in a Lecture on Consumption.
(See page 232, of Handbook, on the Prevention of Tuberculosis.)

"The majority of our patients receive no medication whatsoever.
The stomach is rarely in condition to bear excessive medication,
and the promiscuous use of creosote and similar preparations is
to be condemned. Milk and raw eggs are the best articles of diet
in addition to a regular diet of simple food."--JAMES ALEXANDER
MILLER, M. D., of the Vanderbilt Clinic, New York. (From Medical
Record.)

"In my specialty, the treatment of pulmonary diseases, I rarely
prescribe alcohol in any form, and in the sanitaria with which I
have been connected it is the exception where alcohol in any
form is prescribed. I have advised against its use where such
has been the custom, believing that as a rule alcoholic liquors
do more harm than good in the treatment of this disease."--PROF.
VINCENT Y. BOWDITCH, M. D., Harvard Medical School, Boston.

"From personal experience in handling pulmonary tuberculosis,
not only at the Nordrach Ranch Sanitorium, for the past five
years, but in an active practice of thirteen years, I am more
than convinced that whisky and liquor, in any form, are
absolutely poisonous to the consumptive.

"Whenever we admit a patient to the Nordrach Ranch Sanitorium,
we ascertain whether the individual is an alcoholic or not; and
we invariably find that such an individual is lacking in
vitality enough to combat the disease. They may look fat and
strong, pulmonary tuberculosis usually makes quick work of them.

"It is also a noticeable fact, proven by various statistics,
that a very large percentage of alcoholics become tubercular;
and if we ever stamp out tuberculosis, we will also have to
stamp out intemperance.

"Trying to cure consumption with whisky is like trying to put
out a fire with kerosene. This is very easy to understand when
we stop to consider the nature of this disease. In the first
place, we have a very rapid heart's action, dating from the very
earliest manifestations of the disease. The pulse is often in
excess of 100, even in incipient cases, and if the stimulation
of alcohol is added, we have what might be called a 'runaway
heart'; and if there is one thing needed in the long combat
against tuberculosis, it is a good heart."--JOHN E. WHITE, M.
D., Medical Director Nordrach Ranch Sanitorium, Colorado
Springs, Colorado.

"You ask me my opinion as to the use of whisky in the treatment
of consumption. In reply permit me to say that I regard its use
in this disease as most universally pernicious."--PROF. CHARLES
G. STOCKTON, M. D., Buffalo Medical College, Buffalo, N. Y.

"It was formerly thought that alcohol was in some way
antagonistic to tuberculous disease, but the observations of
late years indicate clearly that the reverse is the case, and
that chronic drinkers are more liable to both acute and
pulmonary tuberculosis. It is probably altogether a question of
altered tissue soil, the alcohol lowering the vitality and
enabling the bacilli more readily to develop and grow."--DR.
OSLER, formerly Professor of Medicine in Johns Hopkins
University, Baltimore, Md., now of Oxford University, England.

"Upon investigation I found 38 per cent. of our male tubercular
patients were excessive users of alcohol, 56 per cent. moderate
users. From my study of the cases I am led to believe that in a
vast majority of these cases drink has been a large factor in
producing the disease, by exposure, lowering of vitality, etc. I
believe that alcohol has no place in the treatment of
tuberculosis. Many patients are deceived by the false strength
it gives them."--O. C. WILLHITE, M. D., Superintendent of Cook
County Hospital for Consumptives, Dunning, Ill.

"In tuberculosis there is a state of over-stimulation of the
circulatory system due to the toxins. The use of alcoholics
simply makes the condition worse. It reduces resistance and
makes the person more susceptible to the disease."--H. J.
BLANKMEYER, M. D., Sanatorium Gabriels, in the Adirondacks,
N. Y.

"The practice of taking alcoholics of any sort, and in any
quantity, over a considerable length of time, is certain to
produce more or less injury to a tubercular patient, and their
use by tubercular people cannot be too strongly condemned."--H.
S. GOODALL, M. D., Lake Kushaqua, N. Y.

Most of these opinions were written for the author of this book in response to letters of inquiry. Are they not indicative of a day when the medical profession will lay aside alcoholic liquors in the treatment of all diseases? It is acknowledged that the past usage of giving whisky and cod-liver oil to consumptives was an error; some day, it may be not far distant, a larger acknowledgment may be made, and the medical use of alcoholic liquors will be entirely a thing of the past.

Rev. J. M. Buckley, D.D., editor of _The Christian Advocate_, was in early manhood considered an incurable consumptive. Being a man of great will power and indomitable perseverance, he resolved to try the open-air cure, together with the use of an inspirator. The result was perfect restoration to health, so that, as is well known, he can be easily heard by audiences of thousands at Chautauqua and other places where he is greatly in request for lectures. He has written a pamphlet giving a full history of his case. It can be obtained from Eaton & Mains, 150 Fifth Avenue, New York, for fifty cents, and should be read by all consumptives who have any "grit" in their composition.

Dr. Forrest, a hygienic physician, says:--

"What is to be done if the germs have already obtained lodgement
in the lungs? Increase the general nutrition of the body in
every way, and then the lungs can resist the inroads of the
disease. The first thing necessary to improve the nutrition of
the body is to stimulate the digestive and absorbent functions
of the stomach and intestines. Naturally then, you must throw
the so-called cough medicines out of the window. The drugs used
to stop a cough are sedatives. Now, no sedative or nauseant is
known that does not lock up the natural secretions and thus
lessen the digestive powers. The cough is nature's method of
expelling offending matter from the lungs and bronchial tubes.
It is infinitely better to have this stuff thrown out of the
lungs than retained there."

Keep the bowels clean is this physician's next recommendation.

Sweet cream is preferable to cod-liver oil as it is not so likely to derange the stomach. Easily digested food is necessary, as the organs of digestion are in weakened condition.

Again Dr. Forrest says:--

"The consumptive should live as much as possible in the open
air.

"Dr. Trudeau inoculated twelve rabbits with tubercle or
consumptive germs. Six of these he turned loose on an island
where they ran wild. The other six were kept confined in hutches
such as rabbits are usually kept in. Results--All the six
rabbits in the open air recovered from the inoculation and
remained well. Five of the confined rabbits died of tubercles in
the lungs and different parts of the body. The sixth was still
lingering, badly diseased, when the experiment was brought to a
close. Fresh air and exercise enabled the first six to overcome
the disease germs. Confinement gave full play to the disease in
the others.

"Now, you house lovers, sleepers in close bedrooms, people
afraid of cold air, you are the rabbits in the hutches. Beware,
lest the verdict be in your case, 'Died of tubercles in the
lungs.' If you are not able to leave your home, live with open
windows, day and night, summer and winter.

"Exercise systematically, especially those exercises,
accompanied by deep breathing, that open and strengthen the
lungs--exercises without fatigue.

"If you are hoping that some wonderful, mysterious drug has been
or will be discovered, a drug that will cure consumption without
your help, you are hoping against hope. Improved nutrition is
your salvation, and that must come through exercise, diet and
fresh air."

Dr. J. H. Kellogg, in his _Home Hand-Book of Hygiene and Medicine_, recommends a salt sponge bath upon retiring, to arrest night sweats, or sponging with hot water. He adds:--

"It is important that patients should know that the sweats are
greatly aggravated by opium in any form, and hence are increased
by cough mixtures of any sort which contain this drug. Very
simple remedies are often effective to relieve the most
distressing cough, such as gargling of water in the throat,
holding bits of ice in the mouth, taking occasional sips of
strong lemonade, and similar remedies. As a general rule,
patients run down and the disease progresses much more rapidly,
after beginning the use of opium in any form. Sometimes it is
best that the cough should be encouraged instead of being
repressed. When the patient expectorates very freely, the cough
is a necessary means of relieving the chest of matters which
would seriously interfere with the functions of the lungs if
retained, by filling up the bronchial tubes and air-cells. The
kind of cough needing relief is an irritable, ineffective cough,
unaccompanied by any considerable degree of expectoration. Loaf
sugar, honey or a mixture of honey and lemon juice, and other
simple, familiar remedies are often effective in relieving such
a cough. * * * * *

"It is perhaps needless to add that the numerous quack remedies
for consumption advertised in the newspapers are wholly without
merit. There is no known drug which will cure this disease, or
in any certain degree influence its progress. Numerous remedies
have been recommended as curative, but not one has thus far
stood the test of experience."

DISPLACEMENTS OF THE UTERUS:--These conditions are not among those for which alcoholic liquors are likely to be advised by a physician, but women frequently resort to Lydia Pinkham's Compound and other alcoholic preparations in the vain hope of finding the relief so positively promised in the nostrum advertisements. Women are sometimes seriously injured by using the nostrums specially advised for uterine weaknesses, for this reason: a drug which may be of service in an anaemic condition of the womb may do much damage in an inflamed or engorged condition, yet the nostrum vendors advise their preparations for all alike, without a word of warning as to possible dangers.

Ordinary displacements may be recovered from by cleanliness of the parts and by exercises which strengthen the muscles in the pelvic region. The writer has known a considerable number of women who have been restored to health by exercises after months, in some cases, and several years in others, of weakness and misery. One of these women was a close relative of a celebrated specialist in women's diseases. He said he could not do any more for her, and gave permission for her to try the exercises, which were given her by a well-equipped teacher of physical training.

There are three kinds of displacements: anteversion, retroversion, and prolapsus. The causes of these troubles are various; lack of proper care in child-bearing, miscarriages, heavy lifting, a hard fall, jumping out of a carriage, straining, too violent exercise in gymnasium work, and tight-lacing, also gradual weakening of the ligaments which sustain the uterus in position.

An abdominal supporter should be worn constantly during the day for a year or so, then left off gradually an hour or two at a time. It should be worn during the second year whenever any extra work is to be done.

There is a supporter sold by the Battle Creek Sanitarium which is highly recommended, but any physician can get one for a patient.

Perfect cleanliness is necessary. For this purpose a hot vaginal douche should be taken two or three times a day. This douche should be made astringent by adding to a pint of water a quarter ounce of alum or tannin. The hot astringent injections tone up the lower supports of the uterus, and cleanse the passage. The patient should remain in a recumbent position for some hours after the douche if possible. Considerable rest hastens a cure. Take the rest in the fresh air when weather permits. Persistent use of sitz baths will be found helpful.

For prolapsus the simplest form of internal supporter is a small roll of cotton. After the organ is carefully put into position this supporter should be pressed up against the mouth of the womb, the patient meanwhile lying upon her back. The ball of absorbent cotton should be large enough to be retained in position, and should be saturated with a weak solution of glycerine and alum or glycerine and tannin before being applied. A piece of white cord should be tied firmly around the centre of this tampon by which it may be removed. Remove before taking the douche.

Persons who feel unable to purchase an elastic or other abdominal supporter can make a substitute (not so good, but of considerable service) from unbleached muslin made in the shape of the letter T, and having the cloth double. It should go up to the waist and be made to fit over the hips, then should be fastened firmly in front with safety-pins, and the cross-piece be drawn up from the back and fastened securely in front.

The daily exercises are the most important part of the treatment. They must be begun gradually, and taken at greater length as strength is gained. Those for prolapsus will be given first:--

The patient should lie upon a rug, or on a firm long sofa or couch. The feet should be drawn up as close to the body as possible. Now lift the lower part of the body so that the hips and lower portion of the trunk will have no support but what comes from the feet and shoulders. Hold this position for a minute or two (longer when able without much fatigue). After a few minutes' rest repeat. This exercise may be continued from twenty to thirty minutes, according to patient's strength. The elevation of the hips in this exercise aids in the restoration of the organ to its natural position. This exercise should be continued daily, the number of times being increased as strength increases.

A second exercise which is very helpful in prolapsus is to support the body on the toes and elbows with the face downward, and the hips raised as high as possible. Another exercise may be taken with an assistant; the patient should lie face downward, supporting the body by the chest, and keeping the limbs rigid while the assistant lifts the feet as high as possible without hurting. These movements strengthen the abdominal muscles and draw fresh blood to the weakened parts, and cause quickened circulation in addition to restoring the displaced organ to natural position. They should be taken at night just before retiring after a hot douche. The bowels should be kept open by the free use of fruit. The patient should sleep with the hips elevated as much as can be endured without real discomfort and sit with the feet on a stool. When strength sufficient is acquired the exercises for anteversion will be found useful, and any other exercises which strengthen the abdominal muscles, such as bending backward and forward, and sideways. Kneading and percussing the abdomen by an osteopath or masseur strengthens, and also relieves constipation. Rest during the day should be taken with the feet higher than the head.

Prolapsus due to laceration in child-birth may require a surgical operation.

In case of antiflexions the first exercise given for prolapsus should be taken daily. (The advice for the prolapsus treatment and the exercises are taken from the writings of Dr. J. H. Kellogg, superintendent of the Battle Creek Sanitarium.).

ANTEVERSION:--Persons suffering from anteversion or retroversion should sleep without pillows under the head, and lie flat upon the back; they should sit with the feet as high as convenient and avoid high seats which hinder the feet from touching the floor. They should discard corsets and tight stocking supporters which push or hold down the organs which need to be replaced. Stocking supporters should be fastened over the hips and comfort waists can be bought in place of corsets.

It is well to have an attendant to prepare weak patients for first exercises in all uterine troubles by the use of towels wrung from hot water applied to the back and abdomen for a few minutes to relax the muscles, or a hot water bottle, or hot salt bag may be used. Then, with the patient lying with head low, the attendant should give the abdomen and small of the back a thorough rubbing or kneading for ten minutes or less according to strength of patient. Olive oil can be used on the hand in the rubbing.

FIRST EXERCISE FOR ANTEVERSION:--Lie on bed or rug; fold arms on chest; hold trunk of body still; stretch legs, and hold the position about half a minute, then relax at the knee and ankle. Then point the toes down and stretch upper leg muscles; relax; then stretch under leg muscles by stretching heel out. The patient will feel the exercise as far as the shoulders, and should be careful not to lift the body from the floor at first. When patient can hold stretching exercise for a minute then lift first the right, then the left leg, and take same exercise until the person can give a quick little kick for, say, twelve times, as the leg is straightened.

SECOND EXERCISE:--Lying on the back, stretch to full length; move the left leg out at the side, then up and back to position, forming a semi-circle, keeping muscles tense throughout. Then move right leg out at the side--left--stretch toes long--relax--stretch heel--, lift a little higher and bring back to place in a circle and rest. Same with left leg and then both together. Few people can do this easily at first, the weight of the legs is too much for the weak muscles at the back; but some one can hold the foot at first. When the patient can do this easily without bringing on any pain or ache, she may sit in a low chair and take arm lifting exercises.

Raise both arms out at the sides, then slowly raise them up close to the head and consciously lift all the organs of the body up, relax, and lower arms down front and repeat slowly, six or ten times at first, until for five minutes the patient can do this sitting. Then take it standing for ten minutes or more. Stand with feet wide apart. Dr. Anderson says, "A woman who will do this twenty times each day can never have anteversion, if she dresses properly, for it lifts the organs in place each time." It lifts the chest and abdomen up, and brings a feeling of exhilaration if done in the open air.

After the patient has taken exercises for five or six weeks she may lie flat on the back, fold arms and raise body up to sitting position without unfolding arms. Then turn on right side and do the same, then on left side and do the same. This is fine for back and abdomen muscles.

Anteversion needs the Rest Cure, and resting with the body in a position in which nature can right things is an important thing to remember. Rest always after exercise, either with a pillow under the knees or with the legs hanging over a low foot-board, or lying on a couch with the feet higher than the head. Exercise will relax the muscles and call for blood which will revitalize and stimulate the weakened conditions. A woman with this trouble should be careful about bending quickly over, or climbing stairs, until she gains strength.

RETROVERSION:--Place the patient with face downward on bed or mat and with a small pillow under the lower part of the abdomen. Relax the muscles by applying a hot towel, hot salt bag or hot water-bottle just below the small of the back, and lower part of the abdomen for ten or fifteen minutes. (Hot salt bags are most effective and are easy to handle.) Then rub the back briskly with a circular movement; if tender in front, do not rub the abdomen. The circulation will gradually carry away any inflammation as soon as the muscles reach a normal condition, though kneading of back and abdomen, using sweet oil on the hand, is helpful if the patient can bear it.

The patient must remember that these conditions have been months in coming and only painstaking work and time can restore the weakened organs. The manner of dress is very important; loose, comfortable clothing must be worn. Sleep with the face down as much as possible; nature will correct itself, if allowed, many times.

FIRST EXERCISE:--Fold arms under forehead and draw right knee up close to body and hold two minutes (unless painful) and slowly straighten, and stretch very slowly. Do the same with the left leg until the patient can repeat the exercise twelve times with each leg and hold five minutes instead of two, with the knee close to the body. It will probably take two weeks to gain strength for this. After that time raise the body up on hands, and move legs just as a baby does when creeping, except that the patient only follows the movement and does not move along.

SECOND EXERCISE:--Patient take sitting position on floor and clasp hands under knees, and bring knees up, so that chin and knees meet and hold. Then straighten legs, slide hands toward the heels as far as hands can reach, (stretch hands toward heels); make a continuous movement of this.

THIRD EXERCISE:--Sit on floor. Place the hands on floor at sides, legs straight out in front, lift the body from the floor with the arms, up and down. This is a fine exercise for raising up the misplaced organs.

FOURTH EXERCISE:--Place the patient flat on back and push the body up to sitting position with hands quite far back and palms down, recline again, up and down until arms and back are very tired. Then sit up, legs straight in front, raise the body from the floor, (an inch) and move backward, resting weight on hands, then move over on knees as at first exercise and creep, then sit up and move backward again. These will take a month to perfect. Begin by exercising five minutes and gradually work up to half an hour, rest between, always. The patient must have the right mental attitude, must think that she is trying to replace the uterus by lifting it to its natural position. The exercises must not be lazily done.

Sitting in a tub of hot water is most helpful where there is much tenderness, or inflammation. Witch-hazel in hot water douches or a weak solution of hot salt water is a wonderful tonic in some cases.