Chapter XV: Preface: iii (14)

Causes.--It usually occurs in blondes of from twelve to twenty years of age and most often from fourteen to seventeen years of age, when the menstrual function is being established and during which time they are rushed with their school work. There may be a family history of chlorosis or tuberculosis. Poor food, hard, unhealthy work, confinement in close unventilated rooms are other causes.

Symptoms.--Rounded fleshy appearance may continue. There is some difficulty of breathing, palpitation of the heart on slight exertion, from a fright or from excitement, tendency to faint feeling or even fainting, headache, a tired feeling, hard to stir or do anything, irritable temper, poor or changeable appetite, the digestion is disturbed, there is constipation, coldness of the hands and feet, difficult menstruation, irregular menstruation, leucorrhea, amenorrhea, and sometimes there is a slight fever. The color is often of a yellowish-green tinge, and this is more noticeable in the brunette type, though the cheeks may be flushed; the whites of the eyes bluish white in color. The heart sounds are not right. The blood is pale in color. The red cells are diminished, but usually are not below eighty per cent of the normal; the haemoglobin is greatly reduced, sometimes to thirty-five or forty per cent. The age, greenish tint of pallor, bluish whites of the eyes, poor nutrition, etc., aid in making the diagnosis.

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Treatment.--Fresh air, good food, care of the bowels and rest if the symptoms are severe. When it is not so severe, plenty of outdoor exercise is necessary and beneficial. That takes them away from their cramped sedentary life and gives the sunshine, good pure air, and change of the scene. Horseback riding is a very good form of exercise, but it should be slow riding. "Tending" the horse is also good, and sleeping in the open air is excellent. Automobile riding is too straining and should not be indulged in.

1. Blaud's pills are very much used. The formula follows:

Dried Sulphate of Iron 2 drams
Carbonate of Potash 2 drams
Syrup Sufficient

Mix thoroughly, and make forty-eight pills. Take one to three pills, three times a day after meals.

2. Fowler's solution of arsenic is also very good remedy; three to four drops three times a day. It must be watched for bad symptoms and should only be taken under a physician's supervision.

Diet.--This should be good and varied to suit the special taste, and as the stomach and bowels are usually disordered such food should be chosen as will best agree. Diet plays a very important part.

PERNICIOUS ANAEMIA.--This is characterized by great decrease of the red cells of the blood with a relatively high color index and the presence of large number of germs. The causes are unknown.

Condition.--The body is not emaciated. A lemon color of the skin is usually present. The muscles are a dark red, but all the other organs are pale and fatty. The heart is large and fatty. The liver and spleen are normal in size, or only slightly enlarged with an excess of iron in the pigment. The red cells may fall to one-fifth or less of the normal number. The rich properties of the blood are fearfully decreased.

Symptoms.--Stomach and bowels, dyspepsia, nausea and vomiting, or constipation, may precede other symptoms or they may last throughout the case. The onset is gradual and unknown, with gradually increasing weary feeling, paleness and some difficulty in breathing and palpitation of the heart on exertion. There is paleness of the skin and the mucous membranes, the lips look pale, no color. The paleness becomes extreme, the skin often having a lemon yellow tint. The muscles are flabby; the ankles are swollen, you can see the arteries beat. Hemorrhages may occur into the skin, mucous membrane and retina of the eye. Nervous symptoms are not common. The pallor and weakness become extreme, sometimes with intervals of improvement and death usually occurs. The following is Addison's description given by Dr. Osler:

[BLOOD AND DUCTLESS GLANDS 251]

It makes its approach in so slow and insidious a manner that the patient can hardly fix a date to the earliest feeling of that languor which is shortly to become extreme. The countenance gets pale, and white of the eyes become pearly, the general frame flabby rather than wasted. The pulse perhaps larger, but remarkably soft and compressible, and occasionally with a slight jerk, especially under the slightest excitement. There is an increasing indisposition to exertion, with an uncomfortable feeling of faintness or breathlessness in attempting it; the heart is readily made to palpitate; the whole surface of the body presents a blanched, smooth and waxy appearance; the lips, gums and tongue seem bloodless, the flabbiness of the solid increases, the appetite fails, extreme languor and faintness supervene, breathlessness and palpitation are produced by the most trifling exertion, or emotion; some slight oedema (swelling) is probably perceived about the ankles; the debility becomes extreme. The patient can no longer rise from the bed; the mind occasionally wanders; he falls into a prostrate and half torpid state and at length expires; nevertheless, to the very last, and after a sickness of several months' duration, the bulkiness of the general frame and the obesity (fat) often present a most striking contrast to the failure and exhaustion observable in every other respect. The disease is usually fatal.

Treatment.--The patient should remain in bed and should use a light nourishing diet, taking food in small amounts and at stated intervals. Rest in bed is essential. Dr. Osler treated a case in the following way: I usually begin with three minims (drops) of Fowler's solution of arsenic three times a day and increase the dose to five drops at the end of the first week; to ten at the end of the second week; to fifteen at the end of the third week, and if necessary go up to twenty or twenty-five. Symptoms of an overdose are rare; vomiting and diarrhea occur. Then the medicine must be discontinued for a few days.

SECONDARY ANEMIA. Causes.--Hemorrhage form (bleeding). (a) Rapid bleeding from the rupture of an aneurism, from a blow, or eating into the blood vessels by an ulcer. (b) Slow bleeding as from nose-bleed, flow from the womb, piles or in "bleeders" people who bleed readily.

2. Inanition form.--Not nourished because of interference in taking food or assimilating food, from cancer of the gullet, or disease of the stomach.

3. Toxic poison cases; from acute and chronic diseases, such as typhoid fever, tuberculosis, rheumatism, syphilis, malaria, nephritis; or chronic lead poisoning, mercury, arsenic, and copper poisoning.

Symptoms.--There is pallor, dizziness, headache, palpitation and dyspnoea, difficult breathing on exertion; there is weakness, tendency to fainting, poor appetite, dyspepsia and constipation. The red blood cells are diminished, also the haemoglobin. Death may occur from a single hemorrhage.

[252 MOTHERS' REMEDIES]

Treatment.--Remove the cause and rest. Good fresh air, good easily digested food. The bowels must be kept regular. Iron and arsenic are good remedies if necessary. It is not possible to give special directions. A person in this condition needs a good physician. There is no time to waste. Iron and arsenic are good remedies, but they must be used intelligently and in proper doses. Blaud's pill is good in some cases. It contains iron. Also Fowler's solution of arsenic.

LEUKAEMIA.--An affection characterized by persistent increase in the white blood corpuscles, associated with changes, either alone or together, in the spleen, lymphatic glands and bone-marrow.

1. Spleen and Bone-Marrow, (Spleen-Medullary) type.--The changes are especially localized in the spleen and in the bone-marrow while the blood shows a great increase in elements which are derived especially from the latter tissue.

2. Lymphatic Type.--The changes in this type are chiefly localized in the lymphatic apparatus, the blood showing an especial increase in those elements derived from the lymph glands.

Causes--Unknown. It is most common before middle age.

Symptoms.--Either type may be acute or chronic. The invasion may be gradual, sometimes with disturbance of the stomach and bowels, or nose-bleed. (a) The first type is the common one. The spleen generally becomes enlarged; it is sometimes tender and painful, it may occupy over half of the abdominal cavity and varies in size after a hemorrhage, diarrhea or after a meal. There may be paleness of the face, etc., early and late nausea, vomiting, diarrhea, and dysentery are common, as is also ascites (dropsy in the abdomen). The pulse is rapid, full and soft. Fever is usual. Hemorrhages occur in the skin, retina, pleura, peritoneum, etc. Headache, dizziness, short breathing, and fainting may occur from the anemia. The liver may be enlarged. The blood shows a great increase in the white cells. Sometimes they are more numerous than the red blood cells. (b) Lymphatic type is rare, various groups of the lymph glands are enlarged, usually separate, but sometimes matted together; others, such as the tonsils may become large. The blood shows an increase of the white cells, but less than in the other form. The spleen is usually somewhat enlarged. Recovery is rare; the lymphatic cases may last only six or eight weeks. The course is usually progressive for two or three years.

Treatment.--The same as for Pernicious Anaemia.

FALSE LEUKAEMIA. (Pseudo-Leukaemia).--Also called Hodgkin's disease, malignant lymphoma, and general lymphadenoma. This is a progressive anemia and enlargement of the lymph glands and the skin, with secondary lymphoid growth in the liver, spleen and other organs.

Causes.--Males are more affected than females, and usually young persons. Continual local irritation causes a local enlargement of the gland, but the actual cause is unknown.

[BLOOD AND DUCTLESS GLANDS 253]

Symptoms.--The lymph glands of the neck, arm-pit or groin are enlarged and without any pain, followed by anemia, loss of strength and slight fever. The glands enlarge slowly or rapidly, forming large masses, while the growth extends to other regions. The spleen may be felt; the skin may be bronzed. In cases with involvement of deep seated nodes the first symptoms may be those of pressure on blood vessels, nerves, trachea, bronchial tubes or other structures.

Treatment.--Cut them out if they are small and localized. Arsenic, quinine, cod-liver oil are good medicines.

PURPURA.--This is not strictly a disease, but a symptom. This includes a group of affections characterized by hemorrhages into the skin.

Symptoms.--There are hemorrhages into the skin, and this takes the form of small blood spots underneath the skin, (petechia) and spots like the bursting of a blood vessel shows vibices or ecchymoses. The first are in small minute points and appear, as a rule, in the hair follicles and unlike the erythemas (redness) do not disappear upon pressure. Another kind occurs as streaks, while the ecchymoses are larger, but similar in nature to the first kind. They may be larger than a split pea, and they range from a deep red to a livid bluish tint. They assume a yellowish brown, then a yellow color, as they fade away and finally disappear. This eruption appears in a series of crops and the legs are the usual seat.

1. Symptomatic Purpura. (a) Infectious. Occurs in typhus fever, endocarditis, cerebro-spinal meningitis, typhoid fever, etc. (b) Toxic; from snake bites, iodide of potash, quinine, copaiba, bella donna, ergot, etc., and with jaundice. (c) Cachectic; with cancer, tuberculosis, leukaemia, false leukaemia, scurvy, etc. (d) Neurotic; with hysteria, neuralgia, and some organic disease. (e) Mechanical; due to violent effort and poor venous circulation.

2. Type arthritic purpura. (a) Simple Purpura. A mild form usually occurring in children, sometimes with pains in the joints, rarely any fever. There is anemia, disturbance of the stomach and purpuric spots on the legs, often on the arms and trunks. (b) Rheumatic purpura; this usually occurs in men from twenty to forty years old. There is usually pain and swelling of several joints, temperature 101 to 103 degrees, purpuric eruption chiefly on the legs and about the affected joints, often with hives and digestive disturbances: (c) Henoch's purpura; usually in children and is sometimes fatal. There are recurrent joint pains and swelling, disturbances of the stomach and bowels, skin troubles resembling it, and hemorrhage from mucous membrane.

[254 MOTHERS' REMEDIES]

PURPURA HAEMORRHAGIC.--This is a severe form, usually seen in delicate girls. The cause is unknown.

Symptoms.--Weakness, extensive purpuric spots (small blood spots in the skin), eruption, hemorrhages from the mucous membranes which may cause secondary anemia, slight fever, slow clotting of the blood. The duration is from ten to fourteen days. Death may occur within a day in cases marked by profuse bleedings into the skin and prostration.

Treatment.--Remove the causes. Fresh air, food and tonics, etc. This disease is serious and needs careful treatment from a physician.

HAEMOPHILIA. "Bleeders."--This is a hereditary disorder characterized by a tendency to persistent bleeding, spontaneously or even after a slight injury.

Causes.--Usually hereditary through many generations. It is transmitted through daughters, themselves usually not "bleeders," to their male children. It is found most often in the Anglo-German races.

Condition.--The blood vessel walls are thin; the skin is delicate, clotting of the blood is usually retarded.

Symptoms.--It comes spontaneously or after only slight wounds; the person is extremely delicate. The bleedings occur from the skin, or mucous membrane, or from wounds, but rarely during menstruation or confinement. They vary from small spots to bleeding which may end fatally, or in recovery with marked anemia. There may be pain and swelling of the joints, etc., and this may leave deformities resembling deformed arthritis. The result is worse the earlier the disease shows itself. They may live to old age.

Treatment.--Avoid, as much as possible, wounds and operations in "bleeding" families. Marriage of the women should be discouraged. For bleeding: rest, ice, tannic or gallic acid or adrenalin locally if the bleeding points can be reached. Plug the nostrils for nose-bleed both behind and in front.

SCURVY. (Scorbutus).--A constitutional disease characterized by weakness, anemia, sponginess of the gums and tendencies to bleeding.

Causes.--This disease has been called "The calamity of sailors." It has been known from the earliest times, and has prevailed particularly in armies in the field and among sailors on long voyages. It has become a very rare disease in the United States.

Predisposing Causes.--Overcrowding; dark unhealthy rooms; prolonged fatigue; mental depression.

Exciting Cause.--The lack of fresh vegetables, poisoning from slightly tainted food, or an infection. The gums are swollen, sometimes ulcerated, skin is spotted, bluish, etc,

[BLOOD AND DUCTLESS GLANDS 255]

Symptoms.--It comes on gradually (insidiously). There is loss of weight, progressively developing weakness and pallor, very soon the gums are swollen and look spongy and bleed easily. The teeth may become loose and fall out. The breath is very foul. The tongue is swollen, but it may be red and not coated. The skin becomes dry and rough and (ecchymoses) dark spots soon appear, first on the legs, and then on the arm and trunk and particularly about the hair follicles. These are spontaneous or follow a slight injury. In severe cases hemorrhages under the periosteum (the covering of the bones) may cause irregular swelling, especially in the legs, and these may break down and form ulcers. The slightest bruise or injury causes hemorrhages into the injured part. Extravasion under the skin, especially in the lower extremities may be followed by permanent hardness (induration) and stiffness due to connective tissue infiltration (scurvy sclerosis). There may be pains in the joints and often watery swelling (oedema) of the ankles. Bleeding from internal mucous membranes is less common than from the skin. The appetite is poor, palpitation of the heart and feebleness and irregularity of the pulse are prominent symptoms. Owing to the sore gums the patient is unable to chew the food. The urine often contains albumin and is scanty and concentrated. There are weariness, depression, headache and finally delirium or coma, or symptoms due to hemorrhages within the brain; or day and night blindness may be present.

Recovery.--The patient will recover if the cause can be removed, unless it is far advanced. Death may result from complications.

Treatment. Preventive.--Fresh or canned vegetables or fruit must be eaten.

Treatment for the attack.--Dr. Osler, of England, says: "I think the juice of two or three lemons daily and a diet of plenty of meat and fresh vegetables will cure all cases unless they are far advanced. For the stomach small quantities of scraped meat and milk should be given at short intervals, and the lemon juice in gradually increasing quantities. As the patient gains in strength you can give a more liberal diet, and he may eat freely of potatoes, cabbage, water cresses, and lettuce. A bitter tonic may be given. Permanganate of potash or dilute carbolic acid forms the best mouth-wash. Penciling the swollen gums with a tolerably strong solution of nitrate of silver is very useful. Relieve the constipation by enemas."

ADDISON'S DISEASE. Diseases of the Suprarenal (above Kidneys) Bodies.--A constitutional disease characterized by great weakness, stomach and bowel symptoms, heart weakness, and dark coloring of the skin.

Causes.--It usually occurs in men from twenty to forty years old. The skin and mucous membrane and sometimes the serous, like the pleura, etc., membranes are pigmented (darkened).

Symptoms.--There is a gradual onset of weakness, changeable symptoms in the stomach and bowels and darkening of the skin. There is great feeling of fatigue and feeble irregular action of the heart; nausea and vomiting and often absence of appetite and some diarrhea. The abdomen may be painful and drawn back in the course of the disease. The pigmentation (coloring of the skin) varies from the light yellow to dark brown, olive or black. It usually begins on the skin or regions naturally pigmented; or where pressure is exerted by the clothing. The mucous membranes are also pigmented. Death may occur from fainting, extreme weakness, convulsions or delirium or through tuberculosis. Usually death occurs within one year, though this may occur in a few weeks to two years, sometimes after intervals of improvement.

[256 MOTHERS' REMEDIES]

Treatment.--This must be to meet the indications as they arise. It is a serious disease and should be under the supervision of a competent physician.

DISEASES OF THE SPLEEN. 1. Rupture of the spleen.--This may occur spontaneously from no apparent cause, or from hurts received in cases of typhoid or malaria.

Symptoms.--Severe pain, and signs of intestinal hemorrhages.

2. Acute inflammation of the spleen (splenitis).--This occurs in acute infections after injuries.

Symptoms.--They are pain, tenderness, and enlargement of the spleen.

Treatment.--Treat the cause and relieve the pain. As this is a serious and painful affection a physician should be called. The pain is often relieved by a mustard poultice or hot fomentations. The patient should remain in bed for acute inflammation of the spleen no matter what the cause.

3. Chronic Splenitis. Causes.--It comes from malaria, syphilis or leukaemia, etc.

Symptoms.--There is the feeling of weight and symptoms of pressure on the lungs or bowel.

Treatment.--Remove the cause. If it comes from malaria, attend to that, etc.

MOTHERS' REMEDIES. 1. Blood Purifier, Molasses and Sulphur as a.--"Take a pint of molasses to five cents' worth of sulphur, and mix well." A teaspoonful four times a day in the spring will do wonders towards purifying the blood.

2. Blood Purifier, Sassafras Tea, Known all over as.--"Sassafras tea made from the root and boiled to extract the strength." Drink freely of this for a few days in the spring. It thins the blood, and is a good tonic.

3. Blood Purifier, Herb Tea Used as.--

Burdock Root 2 ounces
Yellow Dock 2 ounces
Slippery Elm Bark 1 ounce
Mezeron Root 1 ounce
Licorice Juice 1 ounce

Simmer gently in three pints of water down to one quart; when cold, strain and add one-fourth ounce of iodine potassium." A wineglassful may be taken three times a day. This preparation is a fine blood purifier and can be relied upon.

[BLOOD AND DUCTLESS GLANDS 257]

4. Blood Purifier, Sweet Fern for.--"Make a tea of this and drink freely. This is very good to take in the spring of the year, as it thoroughly cleanses the system."

5. Blood Purifier, Doctor Recommends Senna and Salts for:--"Five cents' worth of senna leaves, one tablespoonful of epsom salts in one quart of cold water; cover and let stand over night, then strain and put in bottles. Take a wine-glass full every morning until you feel well." This is from Mrs. Jonathan Shaw, she has used it with good results in her family. A physician in England told her if people would use this the year round they would seldom need a doctor.

6. Blood Purifier, Remedy Easy to Make for.--"We always use one teaspoonful of cream of tartar, two spoonfuls of sulphur, and mix with syrup. Any size spoon will do. Take a teaspoonful at a dose." This is an excellent remedy, and should be taken before retiring; about three times a week would be sufficient.

7. Blood Purifier, Beech Bark and Blackberry Root a Good.--"One gallon white beech bark (after the rough bark is removed), good big handful of blackberry root (cut fine), and also of sassafras root. Cover with cold water and steep to get the strength, then strain. When cool (not cold) add one pint baker's yeast and one cup sugar. Let it stand twenty-four hours in a warm place. Then strain and set in a cool place. Take a wineglassful three times a day before meals. This has been highly recommended to me by a friend from Kalkaska, Michigan."

8. Blood Purifier, from a Madison, Connecticut, Mother.--"Take blackberry root, black cherry bark, spruce boughs, wintergreens: sarsaparilla roots; steep in a large vessel, till all the goodness is out; strain and when lukewarm put in a cup of yeast, let work and bottle up."

9. Blood Purifier, How to make, Celery Compound for a.--

"Celery Compound 2 ounces
Chamomile Flower 1 ounce
Sassafras Root 1 ounce
Senna Leaves 1 ounce
Mandrake 1 ounce
Wintergreen Essence 1 ounce
Whisky 1 gill
White Sugar 1 pound
Hops 2 handfuls

Steep three hours in four quarts of water, strain, add sugar, when cold add wintergreen and whisky. Dose:--One teaspoonful before meals and at bedtime."

10. Blood Purifier, Another Effective Herb Remedy.--"Pour boiling hot water on four ounces of gentian root with two ounces of dried orange peel, a sufficient amount of water should be used to exhaust the strength in the root and orange peel; then boil in a porcelain pot until there is left one-half pint of the concentrated infusion to every ounce of gentian root used. Then to every one-half pint add one half ounce alcohol. The effect of the alcohol is to coagulate it from a quantity of jelly looking substance which must be separated by straining. This is one of the best strengtheners of the human system. Dose:--One teaspoonful in an ounce of water."

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11. Blood Purifier, Burdock for.--"The root is the part employed eliminating very rapidly the specific poison from the blood. Best administered in decoction by boiling two ounces of the root in three pints of water, to two pints. Dose:--One tablespoonful four times a day." Burdock is a splendid blood purifier and is not expensive. It can be purchased at any drug store for a reasonable amount.

DISEASES OF THE THYROID GLAND.--Inflammation of the thyroid gland, (Thyroiditis),--Acute inflammation of the gland, simple or suppurative. It may develop in a patient with goitre, or acute infectious diseases, or from other parts, or from wounds. The gland is enlarged and soft and may contain abscesses.

Symptoms.--Pain, tenderness, and enlargement of the part or of all the gland. Fever may be present even in cases without signs of pus forming (suppuration). If there is great enlargement, there may be symptoms of compression of vessel, nerves or the windpipe.

Treatment.--If there is pus it must be carefully opened. The patient must remain quiet in bed. Sometimes cold applications relieve. Do not use warm applications. This disease is not frequent and the patient needs care and watching more than medicine.

GOITRE (BRONCHIAL). Causes.--No satisfactory explanation can be given for this disease. It seems to be more prevalent where lime-stone water is used. Heredity plays a part. This is an enlargement of the thyroid gland. Chronic enlargement of the thyroid is sporadic. Cases are scattered and endemic in certain mountainous regions. It affects young women most often. A great excess in lime drinking water may be the cause. It is very prevalent about the eastern shore of Lake Ontario and in parts of Michigan. It is a common complaint in this country.

Symptoms.--There is a gradual painless enlargement of the whole gland or one lobe, etc. It may press on the windpipe, and cause difficult breathing, also on the blood vessels and nerves.

Recovery.--This is usually favorable as to life, but not so favorable as a cure. It becomes chronic. A sudden fatal ending may come.

GOITRE, MOTHERS' REMEDIES,--1. Three Ingredient Remedy for.--"The following treatment is excellent, but must be continued for several months:

Extract of Belladonna 1/2 dram
Compound Ointment Iodine 1/2 dram
Vaselin 1/2 ounce

Apply this to the affected parts several times a day."

If this treatment is kept up faithfully it is sure to help.

[BLOOD AND DUCTLESS GLANDS 259]

2. Goitre, Simple Remedy for.--"Wring a cloth from cold water and bind it around the neck every night when retiring. This is a sure cure if continued for some time."

3. Goitre, Inexpensive Remedy for--"Apply the following several times a day: Extract of belladonna one-half dram, compound ointment of iodine two drams; this treatment must be kept up several months." The above treatment will be found very beneficial and is not an expensive one.

PHYSICIANS' TREATMENT for Goitre.--1. Locally tincture of iodine; paint some on the gland once or twice a day until it gets a little sore and keep it so for weeks, or use cosmoline and put in it about one-quarter as much iodine and rub on. Lard will do instead of cosmoline. The parts should be kept red and a little sore. Use also iodide of potash, five grains, three times a day internally, while you are using external applications.

2. Use the compound of tincture of iodine the same way, externally. This is not so strong and can be used longer with, I think, better results. At the same time you may use this same medicine internally. Take one to two drops internally three times a day; or you may take five grains of iodide of potash three times a day instead. Externally: These applications must produce a little redness and be continued for some time.

3. An Ointment. The red iodide of mercury is also good to rub on the part. This may be used if the others fail.

4. Other medical remedies are used, but they must be closely watched and must be used under the supervision of a doctor. The thymus or thyroid extracts are thus used and with good results in many cases.

5. Colorless Iodine: This does not stain, but I have no faith in it. It is used very much now and can be used freely. It is simply, druggists tell me, iodide of potash made in solution, dissolved, and put on the part. A great many cases of large goitres are now being operated upon with quite good success. It is not done until other measures have failed, unless the goitre is interfering with breathing and the blood supply.

6. This is very good, both for internal and external use.

Iodide of Potash 20 drams
Iodine 1 dram
Water enough for 3 ounces

Mix thoroughly and shake bottle before using.

Put some in two bottles; one for internal and other for external use. Take internally five to ten drops in a little water before meals. Externally, put on the enlarged neck, night and morning, unless it feels too sore, when you can use it once a day or less.

[260 MOTHERS' REMEDIES]

EXOPHTHALMIC GOITRE. (Parry's, Graves or Basedows Disease).--It is characterized by exophthalmos (bulging of the eyes), Goitre, fast beating of the heart, trembling and nervousness.

Causes.--It is most common in women from twenty to thirty. Several cases may occur in the same family. The exact cause is unknown.

Symptoms.--Acute cases. Sudden onset, vomiting, diarrhea, the heart beats fast with throbbing arteries, bulging of the eyes, enlarged thyroid gland. Death may occur in a few days.

Chronic Cases.--There is usually a gradual onset of tachy cardia,--fast beating of the heart,--pulse being 100 to 180 or more, if excited. Later there are throbbing of the arteries and of the thyroid glands.

Bulging of the eyeball is sometimes extreme. There may be fever and usually is anemia, emaciation, weakness, nervousness, perspiration, difficult breathing, dark color of the skin. It usually lasts several years. Spontaneous recovery may occur in six months to a year and is not common. Recovery is rare in advanced cases.

Treatment.--Prolonged rest in bed, with an ice bag constantly over the heart, or better over the lower part of the neck and upper breast bone. Avoid all worry and excitement. Drugs are uncertain. Surgery is sometimes resorted to. The thyroid extract has been used.

MYXOEDEMA.--This is a constitutional disease due to atrophy (wasting away) of the thyroid gland and characterized by swollen condition of the tissue under the skin, wasting of the thyroid and mental failures. Three forms exist, myxoedema proper, cretinism and operative myxoedcma.

Causes of Cretinism.--This may exist at birth (congenital) or it may develop at puberty, and is due to the absence or loss of function of the thyroid gland. Sporadic (here and there) cretinism may follow an acute infectious disease or it may be congenital. Myxoedema may be hereditary and is most common in women.

Symptoms, (a) Cretinism.--Mental and bodily development is slow. There is extraordinary disproportion between the different parts of the body. The condition is sometimes not recognized until the child is six or seven years old, then the slow development is noticed. The tongue looks large and hangs out of the mouth. The hair may be thin, the skin very dry. Usually by the end of the first year and during the second year the signs of the cretinism become very marked and should be recognized. The face looks large, looks bloated, the eyelids are puffy and swollen, the nose is flat and depressed and thick. Teething is late, and the teeth that do appear decay. The fontanelles are open. The abdomen is swollen, the legs are short and thick, the hands and feet are not developed and look pudgy. The face is pale and has a waxy, sallow tint. The muscles are weak and the child cannot support itself. Above the collar bone there are pads of fat. The child does not develop mentally and there may be one of the grades of idiocy and imbecility (feeble-minded).

[BLOOD AND DUCTLESS GLANDS 261]

(b) Myxoedema, proper--The skin is infiltrated, causing loss of the lines of the facial expression, skin is dry and harsh, much thickened, especially in the region above the collar bone. The face is broad, with coarse features, the nose is broad and thick, the mouth is large, lips thick, hair scanty and coarse, slowness of motion and thought, weak memory, irritability, headache, suspiciousness, followed sometimes by hallucinations, delusion and dementia (insane). The disease may progress for ten or fifteen years. Death may occur early.

Operative type.--This rarely develops except the thyroid glands have been entirely removed and then only if no extra glands are present.

Symptoms.--Are the same as that of cretinism.

Treatment.--An even, warm climate. Thyroid extract, to be given by a physician, is the remedy. After the recovery occasional small doses still may be necessary for some, or in cretinism for life.

DISEASES OF THE NERVOUS SYSTEM.

NEURALGIA.--Pain occurring in the course of the nerves and in their area of distribution. The pain has remission and intermissions, and is due to some morbid affection of the nerves of sensation or their spinal or (brain) centers.

Causes.--The affection may depend upon some functional disturbance alone; or it may be due to some organic disease of the nerve or to some disease or diseased state outside of the nervous system. It occurs more frequently in women past the middle-age, in those of a nervous tendency. As stated, it affects women more than men. Debility is a frequent cause. Neuralgia is frequently associated with the various forms of anemia. It may occur at the onset of acute diseases like typhoid fever. Exposure to cold causes it in susceptible persons. Decayed teeth may cause neuralgia of the fifth nerve. It also occurs in rheumatism, gout, lead poisoning, and diabetes. Persistent neuralgia may be a feature of hidden Bright's disease.

Symptoms.--Pain is the chief and characteristic symptom. It may develop suddenly and without warning, or soreness or stiffness in the tissues surrounding may precede it. There is a burning or violent sensation in the course of the affected nerve, increased on exertion in acute cases. In other cases the pain comes intermittently or in paroxysms, and is of a darting, stabbing character, or accompanied by tingling sensations. There may be a want of sensation of the skin in the affected region or over-sensitiveness over the entire nerve-trunk with certain painful points. The attacks of pain may come only at long intervals of time, but usually they occur every few minutes and last for some hours. Pain may be continued for hours or days in severe cases. In rare cases it may persist for months or years, being worse at a certain time each day, especially in cases where malaria exists. There is paleness or congestion of the part affected, various eruptions, and changes in the color of the hair occur and, in advanced chronic cases, symptoms of interference with the general nutrition also occur. Spasms of the adjacent muscles may accompany the severe paroxysms.

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Varieties.--Neuralgia may be classified according to its causes, as neurotic, toxic, rheumatic, etc.; or according to its location as trifacial, intercostal, sciatic, and so on, Exposure to cold, mechanical irritations, tumors, pressure on the nerves, and wounds may lead to neuralgia. It is more frequent in cold and damp climates than in dry and warm locations; everyone should remember the causes.

MOTHERS' REMEDIES. Neuralgia.--1. Lemon Juice as Liniment for.--"Cut a lemon in two and squeeze juice on parts afflicted and rub in, then place hot cloths over it. I know this will cure the pain." This is very good.

2. Neuralgia, Salt and Vinegar Will Relieve.--"A small sack of hot salt applied to the pain, or steam with vinegar." The heat from the salt is very effective and the moisture of the vinegar is also very good. This simply produces a counter irritation.

3. Neuralgia, Quinine Will Cure.--"Use quinine three times a day." It is well in taking quinine to take two grains three times a day for two days, then take some good cathartic, so as not allow the quinine to remain in the system. This is very beneficial, especially when neuralgia is due to malarial conditions.

4. Neuralgia, Four Ingredient Remedy for.--

"Oil of Peppermint 1 ounce
Oil of Mustard (strong) 1/4 ounce
Vinegar 1 pint
White of one egg.

Beat egg and stir all together."

5. Neuralgia, Good Liniment for.--

"Essential Oil of Mustard 1 dram
Tincture Aconite 1 dram
Glycerin 1 ounce
Alcohol 4 ounces

Mix and shake well before using."

This remedy is a valuable external preparation for all nervous and neuralgia pains, rub twice a day until relieved.

6. Neuralgia, Menthol Liniment for.--"One dram of menthol liniment, two ounces of alcohol. This makes a very excellent liniment for many purposes. For rheumatism, neuralgia, headache, etc." This liniment will be found very beneficial as the menthol is soothing and quieting, and we all know that alcohol is very good to be applied for any of the above mentioned diseases.

7. Neuralgia, Belladonna Plaster for.--"Melt three ounces of rosin plaster and add one-half ounce of extract of belladonna. An excellent application in neuralgia and rheumatism."

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PHYSICIANS' GENERAL TREATMENT for Neuralgia.--Remove the cause if possible. If from anemia, give tonics for that and try to cure that disease. Tonics with good nourishing food, and proper surroundings are needed for anemia. In malaria, syphilitic or gouty patients, constitutional treatment must be given for those diseases before the neuralgia will be better. The systematic use of galvanic electricity, properly used, is the most valuable means at the physician's disposal, especially in the descending current, beginning with the mild current and gradually increasing in strength. Internally: Arsenic, bromine, ergotinc, aconite, gelsemium, valerian, ether, cannabis indica and quinine are recommended. Opium may be used in the very severe forms, but it must be used with caution, or you will make your patient a drug fiend, and his latter state will be worse than the first condition. Wet compresses, vapor baths, cold affusions, wet cloths, are highly recommended.

1. For the Cure of an Attack--

Antipyrine 30 grains
Citrate of Caffeine 20 grains

Make into ten powders. Take one everyone-half hour until 3 doses are taken. Three (3) doses at least should relieve the neuralgia.

2. Antipyrine 30 to 60 grams
Bromide of Potash 3 drams

Mix: and make into ten powders; one every thirty minutes until relieved or until six doses have been taken; this is better than the first prescription when there is much nervousness with the neuralgia or neuralgic headaches.

3. If caffeine in first prescription causes nervousness, give this one:

Antipyrine 30 to 60 grains
Citrate of Caffeine 10 grains
Bromide of Potash 3 drams

Mix and make ten powders. Take one every half hour until relieved or until six doses have been used.

These are very effective prescriptions, but if a person has any heart trouble I would not advise their use except under a physician's care. (Sometimes a patient with neuralgia gets desperate, and he will even resort to morphine). Antipyrine is one of the simplest coal tar remedies, and most persons can safely take it. Persons who are subject to neuralgia or headaches need to take good care of themselves. Get plenty of rest and sleep. Neuralgia at first can be cured, but when it once becomes chronic, especially neuralgia of the face, it is hard to cure and frequently makes life a constant misery. Plenty of outdoor life is essential. In that way the system will be built up, and when the body is strong the disease can be thrown off much easier. A great many people depend too much upon strong medicines. Medicines are all right in their place, but all the medicine in the world cannot cure a person unless that person does his or her part.

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SPECIAL DISEASES. Facial Neuralgia. (Neuralgia of the fifth pair of Cranial Nerves. Also known as Trifacial Neuralgia. Neuralgia of the Trigeminus. Tic doloureux, etc.).--This form is more frequent than all other forms combined, this nerve being peculiarly susceptible to functional and organic disorders. All three branches are very rarely affected together, the ophthalmic (eye) branch being most often involved. The symptoms depend upon the branch involved.

1. Ophthalmic Neuralgia Pain, (eye neuralgia pain).--This pain is above the eye, or frontal kind, with a special painful point at the supraorbital (above the eye) notch. Sometimes the pain is very severe in the eye-ball.

2. Supramaxillary Neuralgia.--In this the pain is along the infraorbital (nerve beneath the eye) nerve, and there is a marked tender point at the opening in the bone (infraorbital foramen) beneath the eye. A toothache-like pain in the upper teeth is common in this variety.

3. Inframaxillary (lower maxillary) Neuralgia.--This is characterized by a scattered (diffused) pain along the inferior dental (teeth) branch, and extends from the temporal (side forehead) region over the side of the face to the chin, with pain in the lower teeth and side of the tongue. The pain in this nerve may come on without any special cause, or it may come after excitement of a physical or mental nature. Disorders of nutrition occur. The circulation is interfered with and the face, at first pale, becomes red. Eruptions may appear along the course of the nerve, while salivation and "running" (lachrymation) of the eyes are often prominent symptoms. Spasms of muscles of the face (tic doloureux) may accompany the paroxysms and this is the most terrible form of nerve pain. The attacks may be mild or very severe and sometimes sudden. This is a terrible disease, especially when it has existed for some time. A person with severe pain in the face should always attend to it immediately, before it becomes chronic.

Treatment.--It is directed towards removing the cause, if possible. Chronic cases are difficult to cure. The patient should be careful not to take cold, keep strong and healthy by regular hours for sleep, good sufficient clothing. The general health must be improved. These directions apply to all kinds of neuralgia.

INTERCOSTAL NEURALGIA.--A neuralgia of one or more of the intercostal nerves. These nerves run in a groove in the lower edge of the ribs. Causes.--It may develop without any special cause. It comes in anemia, after exposure to cold, from affection of the vertebrae, ribs, spinal cord, or from the pressure of tumors, or aneurism of the aorta. This is next in importance to neuralgia of the fifth nerve, and occurs more often in women and very common in those who have hysteria. It is more common on the left side and mostly in the nerves situated from the fifth to the ninth intercostal space. If it is located in the nerves distributed to the mammary glands it gives rise to neuralgia of the mammary gland. The flying darts of pain in the chest (pleurodynia) are to be regarded as neuralgic in character.

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Symptoms.--The pain is usually very severe, especially on movement of the intercostal (between the ribs) muscles. With this pain, as a rule, an eruption (herpes) appears along the course of the affected nerve and this is supposed to be due to the extension of the inflammation from the nerve-ends to the skin. Pain, when pressed upon, is most marked near the spinal vertebral, the breastbone (sternal) end and the middle part of the nerve. The trouble may continue a long time after the eruption (herpes) has disappeared, for it is very obstinate.

PHYSICIANS' TREATMENT for Intercostal Neuralgia.--This consists in using remedies that will cause counter-irritation. Electricity and pain destroying (anodynes) remedies are indicated in chronic cases. Apply heat for pain in the "breasts." For the eruption an ointment like oxide of zinc can be used.

Local Treatment.--A mustard plaster is frequently good to use. It produces the counter-irritation desired. Application of dry heat from hot cloths; a hot sand bag may help in some cases. A rubber bag containing hot water can also be used. Fomentations of hops, etc., applied hot and frequently changed to keep them hot are beneficial in some cases. I have found in some cases that an adhesive plaster put over the sore parts relieves the severe pain. Porous plasters are also good. Tincture of ranunculus bulbosus (buttercup) is a good remedy. Put ten drops in a glass half full of water, and take two teaspoonfuls every hour.

SCIATICA.--This is as a rule a neuritis of the sciatic nerve or of its cords of origin. It is characterized by pain chiefly along the course of the sciatic nerve.

Causes.--It occurs most commonly in adult males. The person may have a history of rheumatism or gout in many cases. Exposure to cold after heavy muscular work or exertion, or a severe wetting are common causes. The nerves in the pelvis may be compressed by large tumors of the ovaries or womb, by other tumors, or by the child's head during confinement. Occasionally hip joint disease causes it. The nerve, as a rule, is swollen, reddened, and in a condition of "interstitial neuritis." The pain may be most severe where the nerves emerge from the hip bone, behind, or in the inner back, and middle part of the thigh.

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Symptoms.--Pain is the most constant and troublesome. It is sometimes very severe. The onset is usually gradual, and for a time there is only a slight pain in the back of the thigh; soon the pain becomes more intense, extends down the thighs, and leg and reaches to different parts of the foot. The very sensitive spots can often be pointed out by the patient, and on pressure these spots are very painful. It is gnawing and burning in character, usually constant, but sometimes it comes in paroxysms, and is often worse at night. Walking usually causes great pain. The knee is bent and the patient treads on his toes. As a rule it is an obstinate trouble, and it may last for months, or even with slight remissions for years. In the severer forms the patient must remain in bed and such cases are very trying for both patient and doctor.

(See Mothers' Remedies under Neuralgia above).

PHYSICIANS' TREATMENT. Cautions for Sciatica.--Remove all causes if you can. Rheumatism and gout, if the patient have them, should be treated. The patient should not overwork or expose himself to wet, damp weather. Keep every part dry. Rest in bed with the whole leg fixed is a valuable mode of treatment in many cases. Hot water bags from the hip to the knee placed along the painful nerve, sometimes gives great relief. Mud baths are beneficial. Hot Springs baths relieve many cases. Fly blisters placed along the track of the nerve relieve the pain in many cases. Fomentations of smartweed and hops are good, but they must be changed often so as to be hot. Wet or dry cupping is a help in many cases. It draws the blood from the inflamed nerve. Morphine given hypodermically will relieve the pain, but it is a dangerous medicine to use in a chronic case. The patient will be very likely to form the habit, and that is worse than the sciatica. By care and treatment most cases can be greatly helped and cured. Rhus tox (poison ivy) is very good in minute doses in cases where it is impossible to remain in one position for any length of time. Ten drops of the tincture in a glass two-thirds full of water and two teaspoonfuls given every hour. I have helped many cases with this remedy. The hot iron along the track of the nerve is helpful. Electricity is better in a chronic case where there is wasting of the legs, and it should be combined with massage. The galvanic current should be used.

MOTHERS' REMEDIES. Nervousness. 1. Catnip Tea for.--"A tea made of catnip will quiet the nerves. This is good for women when they are apt to be nervous."

2. Nervousness, Hops Will Stop.--"Purchase a small package of hops at any drug store, and make a tea of it, drinking frequently in tablespoonful doses." It is a harmless remedy, and should be used more freely by nervous people. The hops are very soothing. Nervous mothers should never be without this. It is surprising to see how few people know the value of some of these simple home remedies.

3. Nervousness, Effective Remedy for.--

"Spirits of Camphor 1/2 ounce
Comp. Spirits of Lavender 1/2 ounce
Tincture of Valerian 1 ounce
Sulphuric Ether 1/2 ounce

Mix. Dose, one or two teaspoonfuls every three hours."

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The foregoing remedy is very effective, as spirits of camphor and the tincture valerian quiet the nerves. The sulphuric ether also has a soothing effect. This combination makes a fine tonic, but should not be taken too long, as it is quite strong.

4. Nervousness, Five Ingredient Remedy That Relieves.--"In extreme nervous debility with tendency to fainting fits, use the following:

Spirits of Camphor 1/2 ounce
Aromatic Spirits of Ammonia 1/2 ounce
Spirits of Lavender Compound 1 ounce
Tincture Valerian 1 ounce
Tincture Castor 1 ounce

Mix. Dose.--From one to three teaspoonfuls at intervals of from fifteen minutes to three hours, according to urgency of symptoms. This mixture should be kept on hand by all persons subject to fainting fits."

Spirits of camphor and aromatic spirits of ammonia stimulates the heart, while the tincture of valerian quiets the nervous system.

5. Nervousness, "Lady's Slippers" Breaks up.--"A decoction is made with two ounces of the root, sliced, to two pints of water, boiled to one and one-half pints. Dose: One tablespoonful four times a day. Has been used with marked success in epilepsy and in other various nervous diseases." This is used very extensively for nervous people, and has proven very successful.

HEADACHE.--This term means a pain in the head, all over the head, or at one particular spot. It may be only a symptom of a general constitutional derangement, some disease of some other organ, a temporary inability of some organ like the stomach, liver, bowels, etc., to do work, or it may be due to some local affection depending upon some trouble with the skull and its contents. It is frequently but a symptom of some other trouble. It occurs in fevers, infectious diseases, brain disease, etc. There are different varieties depending upon the causes.

Sick Headache.
Nervous Headache.
Catarrhal Headache.
Congestive Headache.
Neuralgic or Gastric (stomach) Headache.
Bilious Headache.
"Bowel" Headache.
"Womb" Headache.
Rheumatic Headache.

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CATARRHAL HEADACHE and RHEUMATIC HEADACHE may be treated together. This is due to exposure to a draught of air, walking against the sharp and keen wind, by getting the feet or other parts of the body wet, sudden suppression of perspiration about the head, or by some other exposure such as might result from cold, influenza or attack of rheumatism. There may be aching pains and a feeling of heavy weight in the forehead; tearing, stitching pains above the eyes, in the cheek bones; sometimes the skull feels as if it would fall to pieces. In the rheumatic variety the scalp is sore and tender, tearing throbbing pains or hard aching pains. There is some fever, dry skin, the pulse is faster.

Treatment.--Get into a sweat by hot drinks of lemonade and hot foot baths. Apply cold or warmth to the head, lie down and keep quiet.

Medicine.--Aconite in doses of one-tenth of a drop to an adult every hour will frequently abort it: open the bowels with salts. Remain in bed.

NERVOUS HEADACHE.--This may occur as a sick headache or be simply a nervous headache: This occurs oftenest in a nervous person, or in persons who are run down by different causes, such as diseases, overwork, worry, trouble, etc. It is not periodic, and has no fixed type, but breaks out at indefinite intervals, and is excited by almost any special cause such as motions, mental exertions, menses, excitement, overdoing, over-visiting, want of sleep. It is often due to eye strain in persons who have poorly fitted, or who do not wear glasses. It appears in any part of the head, usually one-sided, or it may be all over the head, which feels enlarged and sometimes as if a band was around it. The least mental effort makes it worse. Sometimes there is a feeling as if a nail was being driven into the head; head is too big; eyes feel heavy and the lids droop; sees double; hard to keep eyes open. This kind of headache, or sick-headache, can be brought on suddenly by womb trouble, especially if the womb has fallen from a jar, fall, etc. The patient often moans and cries, laments and simply cannot stand thc pain. In some cases the menses cause it, and it appears at every menstrual period.

Treatment.--The patient should be quiet and remain in bed in a darkish room. Womb troubles and other diseases that cause it such as protruding piles, etc., should be attended to. Tincture gelsemium is a good remedy. Put ten drops in a glass half full of water, and take two teaspoonfuls every half hour until better. A tea made from lady's slipper is also effective in some cases, used freely. Bromide of potash in ten-grain doses one-half hour apart, for three doses, if necessary, is quieting in many attacks. Mustard plaster to back of the neck.

CONGESTIVE HEADACHE.--In this kind there is or seems to be too much blood in the head. The patient may be stupid, with a flushed face. If conscious, the brain feels as if it was rising or falling, especially upon the motion of the head. The top of the head sometimes feels as if it would fly off. The head throbs and beats violently. The hands and feet may be cold, the face flushed or pale, the eyes bright, the pulse is generally heavy, full and fast, or it may be feeble, slow and intermittent.

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Treatment.--1. The patient should remain in bed in a dark room, with the head usually high. Cold should be applied to the head and heat to the hands and feet. Move the bowels with salts and, if necessary, give an enema also. It is well to give the foot-bath before going to bed. If these things do not relieve the headache a doctor should be called, for it may mean something serious. A hot mustard foot-bath and a mustard plaster applied to the nape of the neck are of great value. In severe cases an ice bag or very cold water, applied to the forehead and temples will very often give great relief.

2. Spirits of Camphor 1 ounce
Spirits of Lavender 2 ounces
Alcohol 2 ounces

Wet the top of the head with it.

3. Camphor 1 dram
Oil of Peppermint 1 dram
Chloroform 1-1/2 ounces
Alcohol enough for 3 ounces