and frictions, with the flesh-brush, over the region

of the stomach and bowels, are of no small service. The bowels must of

course be kept open by purgatives, when necessary, even when making use of

state of irritation of the stomach;

other curative means.

2. Plump wheat carefully burned to a charcoal, and powdered, a teaspoonful into the nursing bottle before filling it, once a day. The same, taken

before each meal, is good for dyspepsia.

RINGWORM. — A

disease of the skin appearing in small circular

1,

patches, or rings of vesicles round the circumference of a circle of apparently healthy skin: these vesicles are small, and contain a transparent fluid,

which is discharged in three or four days, when little dark scabs form over

them. Sometimes there is a succession of the circles on the upper parts of

the body, as the face and neck, and the arms and shoulders.

The more formidable and infectious species of ringworm appears in distinct patches of an irregularly circular figure, on the scalp, head, and neck.

It commences with clusters of small light yellow pustules, which soon break

and form thin scabs over each patch; and these, if neglected, become thick

and hard by gathering on one another. If the scabs are removed, however,

the surface of the patches is left red and shining, but studded with white elevated points, in some of which, minute globules of pus again appear in a few

days.

As the patches extend, the hair covering them becomes lighter in its

color, and sometimes breaks off short; and as this process is repeated, the

roots of the hair are destroyed, and at length, there remains uninjured only a

narrow border of hair round the head. It generally occurs in children of three

or four years old and upwards, and often continues for several years.

It can

be considered as about to terminate, only when the redness and exfoliations

disappear together, and the hair begins to grow of its natural color and tex-

DR. CHASE'S RECIPES.

230

ture.

The disease seems to originate spontaneously in children of feeble and

flabby habit, or in a state approaching to marasmus;

who are ill fed, uncleanly,

and not sufBciently exercised; but it is principally propagated by the actual

conveyance of the matter from the diseased to the healthy, by the frequent

contact of the heads of children, but more generally by the use of the same

towels, combs, caps, and hats.

Treatment. While the patches are in an inflamed and irritable condition, we must be content with regular washing or sponging with warm water,

or some emollient fomentation. Even the operation of shaving, which is

—

necessary to be repeated at intervals of 8 or 10 days, produces a temporary

increase of irritation.

At this time, all stimulant lotions and ointments should

be avoided. The disease assumes various forms, and these require a corresponding variety in the treatment; so that no single application can be said to

possess any unfailing power against the ringworm.

When the inflammatory

state subsides, a dry scabbing and exfoliation ensues, but again the pustular

eruption breaks out, and the patches again become red and tender. In other

instances, the surface becomes inert and torpid, while a dry scaly scab constantly appears, and active stimulants are requisite to effect any change in the

disorder.

In more irritative stales, the milder ointments, with calomel, oxide

of zinc, acetate of lead, should be employed, or sedative lotions, or decoctions

or infusions of poppy heads or tobacco. When there is an acrimonious discharge, the ointments of zinc and lead, or the milder mercurial ones, or a

lotion of lime-water with calomel, are advantageous.

In a very dry and inert

state of the patches, caustic substances are often

very successful.

The late

Dr. A. T. Thomson strongly recommends the application of a solution of 1

dr. of nitrate of silver in 3^ an oz. of diluted nitric acid.

But in the varying

forms and degrees of ringworm, the remedies must be varied, and combined,

according to the degree of irritation which prevails. The constitutional treatment is of consequence. A nutritious diet must be prescribed, containing a

due admixture of animal food; the clothing must be warm; regular exercise

must be enjoined; and a course of tonic medicines, such as iron or quinine,

must be ordered.

2.

3.

Touch it with caustic ammonia,

Apply sulphate of copper, 20 grs., to 1 oz. of water.

The same is

good for Itch.

COLIC—

PAINTERS'

This form of colic is caused by the slow introduction of lead into the system,

generally the carbonate of lead.

It passes

under the different English names of painters' colic, Devonshire colic, and dry

—

The first of these is the name by which it is most commonly

known, from its frequent occurrence among painters, who use white lead (carbelly-ache.

bonate of lead) a great deal in the preparation of their colors.

—

Treatment. For relieving the pain and opening the bowels, the treatment should be very much the same as that for bilious colic. There is one

article, however, which is thought to have some special influence in curing this

disease, after it has become chronic; it is alum.

Fifteen grs. of alum, 2 of

'jloes, 2 of jalap, and 4 of Dover's powder, may be mixed, and taken for

a

TREATMENT OF DISEASES.

231

dose 2 or 3 times a day. If the muscles of the arm be palsied, 1-16 of a

The aromatic sulphuric acid,

gr. of strychnine may be added to the above.

taken as a drink, fifteen drops to the tumblerful of water, is always worthy of

trial.

The use of the electro-magnetic machine may be tried for the palsy;

or a

splint applied to the arm and hand, with vigorous friction applied once or twice

a day, will sometimes do much for recovering the use of the muscles.

But the best remedy for the palsied muscles that I know of is the following: Fl. ex. of sarsaparilla, 4ozs.

iodide of potassium, 2 ozs.

;

Mix.

fl.

ex. of pipsissewa, 1 oz.

;

water, 1 quart;

Dose — A table-spoonful 3 times a day.

The sulphuret of potassa, 1 oz., dissolved in a quart of water, and taken in

The affected arm

tea-spoonful doses, 3 times a day, is also worth a trial.

should be soaked an hour, once or twice a day, in the same amount of this

The following is Dr. Gunn's treatlatter salt, dissolved in a gallon of water.

ment:

Treatment.

— The treatment in this form of colic should be very similar

to the bilious form.

The first thing to be done, is to overcome the constipation

medicines to allay it. Then make

If there is vomiting, give

of the bowels.

use of strong purgatives, with hot fomentations to the bowels. Narcotics and

As

relaxants are also indicated to relieve the pain, and overcome the spasms.

a narcotic and anodyne use the ex. of hyosciamus; take 20 grs., and form into

6 pills; give 1 every 2 hours. At the same time give the Anti-bilious Physic,

and aid the operation with purgative, stimulating and relaxing injections. A

portion of the physic, with a little salt, a tea-spoonful of tincture or powder of

lobelia and hot water may be used as an injection, to be repeated according to

Sometimes it will be well to add a little cayenne to

Apply hot fomentations to the bowels, and if the physic does not operate

the urgency of the case.

it.

in 2 or 3 hours, give the croton oil, 2 or 3 drops at a time, in a spoonful of castor

Also rub a little of the croton

In other respects, treat the same as a

severe case of bilious colic. It is sometimes well to put the patient into a warm

bath, for half an hour, or even longer, in order to relax the muscular system,

and overcome the spasm of the intestines. After you have got an operation on

oil,

or a little milk, and repeat every 2 hours.

oil on the abdomen,

the bowels

over the bowels.

you may give the following pills: Ex. of hyosciamus, 40 grs.;

make into 20

pulverized opium, 10 grs. podophyllin, 10 grs.

and give 1 every 3 or 4 hours. Also Cholagogue as a tonic and alterative.

The numerous persons who work in lead, should comb their

Remarks.

hair with a fine comb, wash their hands and face, and rinse their mouth several

times a day, and also wash the whole person with soap once or twice a week,

and with clear water, or saleratus and water, once a day. Their working

clothes should be of a kind to admit of being washed once or twice a week,

and they should be put off for others when out of the workshop. A paper cap

should be worn while at work. Tiie food of the workmen should not be

exposed to the vapors or floating particles of lead, and consequently should not

be carried into the shop; and when much of the poison is floating in the air of

ipecac, 20 grs.

;

pills,

—

;

;

DB. CHASE'S RECIPES.

232

the work room, it is a good plan to wear a mask to prevent its being drawn

with the breath into the throat and lungs.

It has been said that those who eat freely of fat meats, butter, and other

oily substances are not attacked by the disease, though exposed to the poison.

I know not what protection this can give, unless the skin is in this way kept

more oily, which prevents the absorption of the poison. This would seem to

afford a hint in favor of anointing the whole person once or twice a week

with sweet oil.

STITCH IN THE SIDE. — This is a spasmodic affection of the

muscles of the chest, and is rheumatic in its origin. With this there are not

the symptoms of inflammation nor the difficulty of breathing, except that

caused by the pain or stich in the side.

Exposure to cold or violent exercise

Apply warm applications, mustard poultices, or stimuThe best medicines in this case will be pills of colocynth

will also cause this.

lating liniments.

3 grs., with ex. of colchicum J^ of a gr. in each, taken every night; and 3

times a day a seidlitz draught, with 15 grs. of wine of colchicum and 6 of

laudanum in each.

PROUD FLESH. — The granulations which arise when a sore

is

in

progress of healing, sometimes project beyond the level of the surrounding

parts, and

form a red excrescence very irritable, easily made to bleed, and

sometimes growing fast in spite of all that can be done to prevent it.

Caustics

of various kinds, as lunar caustic, or the blue vitriol, are to be applied, or red

precipitate of mercury, and occasionally pressure, by straps of adhesive plaster

or other bandages, is found useful.

—

The constant pressure of certain portions of the body

1. BED SORES.

upon the bed or mattress frequently produces in invalids excoriations, which

are known bv the above name.

Treatment. When the skin becomes red and inflamed, and painful to

—

the touch, immediate steps should be taken to prevent if possible an abrasion

of

the skin.

Mix two tea-spoonfuls of brandy with a wine-glassful of hot

Dab the part with tliis, and dry

water, with 30 drops of tincture of arnica.

with violet powder. Or, either before or after the skin breaks, dip a camel

hair brush into collodion, and brush the inflamed surface over, repeating the

operation from time to time until the part is healed.

2. Saturate cloths with alcohol and apply; not painful and effects speedy

cure.

3.

Bismuth powder is also good, and is just the thing for chafing.

mineral earth " is recommended also.

ing the sore with clay dust or

FITS

Cover-

'

'

OR CONVULSIONS IN CHILDREN.—Most persons

have seen a baby in fits; and it is a sad sight,

—

its little face all distorted and

and squinting frightfully; its hands clenched, and arms

bent, and legs drawn up, and body arched backward, and limbs twitching

itself insensible, and unable to see, or swallow, or move.

violently,

After a

time the fit ceases, sometimes by degrees, at other times suddenly, the child

fetching a deep sigh, and then lying quiet and pale, as if it had fainted

livid; its eyes rolling

—

—

TREATMENT OF DISEASES.

233

From this state it passes into a sleep, and, on waking some hours later, seems

quite well.

Fits may attack a child which

is apparently well,

and cause death immedi-

ately, or it may have fits daily, or even several times a day, and linger on for

A child may have fits from a great variety of causes. Fits, therefore,

have a diHereut meaning in different cases. But they always show that the

brain has in some way been disturbed.

Treatment. As fits are not a disease in themselves, but only a symptom

of some disease, the treatment must have reference to the cause. Sometimes,

while the fit lasts, it is wise to do nothing. But, if a fit come on suddenly, in the

weeks.

—

case of a child previously healthy, it is generally safe to place it in a hot bath,

and at the same time to dash cold water on its face, or to pour cold water on

its head, or hold on it a large sponge dipped in cold water.

The hot bath will

draw the blood to the skin, and away from the over-loaded brain. It will

quiet the disturbance of the system, and if scarlet fever or measles are about

to appear, it will bring them out.

HYSTERIA—HYSTERICS.—Treatment.—To treat this complaint

successfully, it is necessary to search out its cause, and remove that.

Like the

whites, it is not so much a disease in itself, as a symptom.

The first inquiry to be made should have reference to the real origin of the

Is it dependent upon inflammation of the ovaries or the womb, or

complaint

to displacement of this latter organ

;

or does it arise from the low state of the

blood, and the weakened condition of tJie nerves, acted

upon by some irrita-

tion or heightened sensibility of the sexual organs.

If dependent upon inflammatory disease, that is to be treated according to

upon falling of the womb, no remedies will avail until

If diluted blood and weakened nerves be the

cause, iron and quinine are the remedies.

When the complaint arises from

deficient menstruation, iron and aloes will be serviceable.

The nervous spasm

can sometimes be broken up by pouring cold water upon the head, or face, or

directions elsewhere

'that is put

;

if

in its proper place.

limbs of the patient.

The Hygienic and Moral Treatment are of great consequence.

The complaint is very much under the control of the will.

"Whatever tones

the moral nature and strengthens the will, tends to subject this disorder to the

control of the patient.

Plain wholesome diet, exercise, bathing, and the

enforcing, as far as possible, of a rugged, self-reliant habit, generally go far

towards breaking its force.

TONGUE-TIED.—The tongue is fixed down to' the lower part of the

mouth by a membranous cord, which prevents too great a degree of motion.

Sometimes the cord ties down the tongue of infants so much that they cannot

This is supposed by the common people to be the case much often er

than it really happens; and they very often request the surgeon to remove Ike

iucoDVPnience; but so long as the patient sucks there is no occasion for any

operBtion. But it happens sometimes that the tongue is not perceived to be

ti^a till the child begins to articulate, and is prevented from forming certain

suck.

DR CHASE'S RECIPES.

334

letters for which

a free motion of the tongue is requisite.

At whatever time

the operation may be necessary it is easily done by a pair of scissors; but the

surgeon must be careful not to wound any of the neighboring large vessels.

1.

GANGRENE.— Treatment.— When the result of cold, the part

becomes first white, and a restoration of the suspended circulation should be

attempted by rubbing with snow, if it can be procured if not, with a coarse

cloth or flesh-brush.

No heat must be applied even that of the bed-covering

will sometimes set up inflammation.

Camphorated spirit of wine is, perhaps,

;

;

the best liniment that can be used.

After the rubbing, if it appears to be at

apply cold poultices. If, in spite of these efforts, a discoloration

of the skin shows that gangrene has really commenced, apply to the part a

poultice of flaxseed with a little powdered charcoal in it, and also spirit

lotions, to keep the disease from spreading.

^Jhe constitution of the patient

must be soothed and supported by some anodyne and stimulant.

Cooper

recommends from 7 to 10 grs. of carbonate of ammonia, with 20 or 30 drops

of tincture of opium, 2 or 3 times a day or more frequently if required. A

bolus composed of 5 grs. of carbonate of ammonia, with 10 grs. of musk, may

be given every 4 hours, with excellent effect. When the gangrene has proceeded to a sloughing sore, a port wine poultice is a good application, as is

all effectual,

spirits of turpentine, to stimulate the parts.

2.

Apply yeast

poultice

mixed with charcoal powder, and renew the

poultice often; or keep the part well covered with charcoal powder.

If, however, the gangrene is not stopped in its first stages, it can seldom

be after; and the only chance of saving the patient's life is to amputate the

limb; and this must be done before the morbific influence has spread far

towards a vital part.

BLOODY FLUX. — Treatment. — In mild cases, give a table-spoonful

of castor oil and 2 tea-spoonfuls of paregoric, mixed, once a day.

Sometimes,

in place of the above, a dose of Rochelle powder, dissolved in water, with

30 or 40 drops of laudanum, may be taken.

A moderate quantity of flaxseed

or slippery elm tea, may be taken as a drink, and the bowels be well emptied

by an injection of starch.

When there is much pain in the bowels, a mustard poultice laid upon them,

will have a good effect.

The starch injections should, in such case, have a J^

it.

The compound syrup of rhubarb

tea-spoonful of laudanum mixed with

and potassa will often act favorably, given in table-spoonful doses.

If there is reason to suppose the liver is affected, give podophyllin, or some

other liver remedy recommended under the head of "Liver."

The patient should not be allowed to sil up, and must be kept very still,

and be allowed only a very scanty diet, as flour porridge, well boiled, rice

water etc.

RUPTURE

—

(Hernia). Children and old people are most liable to this,

though sometimes they occur to persons of middle age. If difficult, or impossible to be returned, it is called strangulated rupture, and requires the best

assistance^

TREATMENT OF DISEASES.

Treatment.

235

—The patient must be laid on the back, the head low, and the

buttocks raised; while in this position the gut must be returned by a gentle

After it is returned, a piece of

pressure, if it does not fall back of itself.

sticking-plaster may be applied over the part, and a truss, or bandage, worn for

If it has been forced down with great violence, or happen

from any cause to become inflamed, it is often very difficult to return it, ami

sometimes impracticable, without an operation, a description of which ii

foreign to our purpose, but in those cases, until some assistance can be obtained, act as follows: foment with warm fomentations; give clysters; ther,

when the bowels have emptied, the operator must press and guide the gut back

through the aperture, if possible to do so. An adult, after being ruptured,

should never neglect wearing the proper truss.

a length of time.

—

HAY

FEVER. This disease is so called on account of its occurring

during hay time, or summer, and is thought to be caused by the odor of newmown hay; but it may be caused by other strong odors. It does not differ

very much from the ordinary asthma, except perhaps there is not so much

difficulty of breathing, and the attacks last longer in the hay-asthma; the

lining membrane of the nose is also much more inflamed and the throat

irritated in the latter disease.

The best thing to do is to remain within doors and keep quiet for a few

days; take a few doses of Rochelle salts or rhubarb, also a tea-spoonful of

paregoric at bed-time for two or three nights, and live on light diet.

A dose

or two of quinine (1 gr.) may be beneficial, night and morning.

Remarks.

—Thousands of people go to Northern Michigan annually for

have never heard of one that did not get relief— Northern

this disease, and I

Michigan is the surest cure in the world for Hay Fever.

VARICOSE VEINS OR ENLARGED VEINS.— The veins

which lie near the surface, especially those of the legs, are apt, by exhausting

labor upon the feet, and by strains, to get weakened, so that their valves lose

their tone, and their sides stretch and give way in certain places, letting the

blood bulge out, and form purple bunches. These bags of blood, lying along

upon the surface of the limb, form knotty tumors, looking like blood boils.

They occasion a kind of distress, but no sharp pain.

Persons of weak, soft, and relaxed muscles and blood vessels are particularly liable to this complaint.

It often attacks women in the family way.

Treatment. Where only a few veins are affected, it may be sufficient,

in some cases, to apply firmly over them a few strips of leather, spread with

soap plaster. But generally it is better to support the whole limb with a good

cotton bandage, or with a laced stocking, which should be applied in the

morning before the patient is up. It is generally also well to use friction with

some liniment or iodine ointment. Lead water or alum water, or an infusion

of white oak bark, may be used with advantage. Burdock and plantain

leaves, bound upon the skin, and removed before they are dry, are useful

Showering with cold water strengthens the veins.

—

DR. CHASE'S RECIPES.

236

INGROWING TOE NAILS.—Those who have been afflicted with

this affection have often

found it to be very troublesome and painful, at least

The edges or sides of the nail are disposed

I have found it to be so myself.

to turn down and grow into the flesh, giving rise to inflammation, ulceration,

and often great pain and suffering.

For this difficulty the best remedy I have ever known is to scrape with

some sharp-pointed instrument, as the point of a pen-knife, a sort of groove

or gutter in the center of the nail, lengthwise from the root to the end. It

should be scraped down to near the quick, or as thin as it can be borne.

This

makes the nail weak, so that it will gradually and ultimately turn up at the

sides until the edges come above and over the flesh.

Keep up this practice as

fast as the nail grows out and grows thicker, and you will eventually succeed

in getting the nail in its proper shape and position.

It is a good idea to

poultice if there is much inflammation, and also apply healing salve.

If ulcera-

bathe the parts occasionally with tinctures aloes, myrrh, and opium,

mixed in equal parts.

tion,

1.

FEVER-SORES.— One lb. fresh lard, % lb. red lead, 1 table-spoonfid

soft water; put in

stir most of

an iron dish and cook until it turns to quite a dark brown;

the time while cooking, and watch to keep it from running over;

apply it, spread on a cloth, change twice a day,

2. The following has cured some very severe cases of fever sores, and is

good for cuts and bruises in man or beast. Take a quantity of the bark of

sumac root and boil for two hours;

strain

and add fresh lard to the liquid,

then boil down until the water is all out; anoint the sore three times a day.

—

Remarks. This salve cured a sore on a son of G. W. Childs, of Petoskey,

Mich., from which pieces of bone had been taken. They had tried several

Uncle Chancy Howard, Chardon, Ohio, cured

long standing, and up to the time of his death, some ten years ago,

it had never bothered him.

The above is also good for chilblains and ulcers.

things but all but this failed.

a' fever-sore of

—

CHOLERA. — Treatment. There is one important precaution which

ought to be observed at all times, but more particularly during the epidemic of

cholera: the ^QriecX, purity of tJie drinking water should be ascertained, and its

freedom from all deco7?iposing organic matters made certain.

Care is also to be observed not to take active picrgatives, especially salines,

such as Epsom or Rochelle salts, seidlitz powders, etc., which produce watery

evacuations; if ai^erient medicine is required, it ought to be of a waiTo character, such as magnesia and rhubarb, with some aromatic, (cinnamon or

allspice), for whatever produces free action of the bowels apparently increases

the susceptibility to attack.

For this reason, too, the slightest tendency to dia/rrhcea sJiould at once be arrested by a dose of paregoric or laudanum, or what is

preferable, a mixture of prepared chalk, 1 table-spoonful;

cinnamon or allspice

powdered, 1 table-spoonful; white sugar and flour, 1 table-spoonful each, water,

1 wine-glassful paregoric, 2 table-spoonfuls; Cayenne pepper, i^ tea-spoonful.

Mix, and take a tea-spoonful every half hour, or as may be needed, and the use

of milk and farinaceous preparations (corn starch, farina, flour, etc.,) contain;

TREATMENT OF DISEASES.

237

The speedy adoption of these measures, in places

ing gelatine, for food.

Should

distant from medical assistance, might do much to check the disease.

the astringents above recommended fail, use the remedies recommended below.

As to the actual treatment of the disease itself, when fully established,

many different methods have been proposed and practiced, and few of them,

perhaps without apparent advantage in some cases, but as yet no treatment

which can be called d«*cidedly successful (a cure), has been discovered.

The treatment which would be safe in the hands of others than medical

men would be about the following: When vomiting and purging have set in,

with cramps, give the following mixture: Tincture of Cayenne pepper, laudanum, spirits of camphor, of each 1 oz. spirits of hartshorn, J^^ oz. mix

together, and take 1 table-spoonful every hour or half hour according to the

symptoms.

Or give 1 gr. of opium, 1 of camphor, 1 of Cayenne pepper,

(made into a pill with a little flour and water) every hour, or as may be needed.

The patient should be wrapped at once in a blanket, or flannels next the

skin.

For the cramps use the following as a liniment: Tincture of Cayenne

;

;

pepper, spirits of hartshorn, chloroform, turpentine, or kerosene oil, 2 ozs. of

each.

Mix, and rub over the affected parts with a woolen cloth.

Be careful to

remove the contents of the chamber from the room immediately and bury it in, the

ground. Also mix with the discharges from the stomach and bowels, as soon

as voided, some sulphate of iron (common green vitriol), also dissolve some of

the green vitriol in hot water, and set the same in vessels around the room and

and then throw some down the sinks, privy,

and such places, once every day. Keep the sick chamber well aired,

and by all means try to cheer and comfort the patient, so as to keep up his

spirits.

A mixture of mustard and Cayenne pepper moistened with strong

vinegar, applied to the stomach and bowels is good to check the vomiting and

in the different parts of the house;

cellar,

purging, or applied to the limbs for cramps.

During the prevalence of

this disease the greatest care is necessary in

regard to cleanliness, ventilation, etc.

It

may be mentioned also that warm

bricks or warm stones, irons, or hot salt should be applied to the limbs or body

where there is coldness or cramps.

An injection up the bowels of J^ a tea-

spoonful of laudanum, 4 or 5 table-spoonfuls of brandy or whisky, with a little

thin starch, is often very beneficial in the active stage of this disease, to be

repeated if necessary.

—

1.

ULCEUS. A chasm or vacancy formed on the surface of a part,

whether external or internal, by the absorbent vessels removing parts back into

the system.

Ulceration takes place more readily in the cellular and fatty substance, than in muscles, tendons, blood-vessels, and nerves. (Forjreatment by

bandaging, see page 82.)

—

2. Simple Purulent Ulcer. Some ulcers are covered with matter of

a white color, of a thick consistence, and which readily separates from the

surface of the sore. There are a number of little eminences called granulations,

which are small, florid, and pointed at the top. As soon as they have risen to

the level of the surrounding skin, those next the old skin become smooth, and

DB. CEASE'S RECIPES.

238

are covered with a thin film,

which afterwards becomes opaque, and forms

The principal thing to be done in the treatment of this kind of ulcer,

skin.

the surface clean by putting on a little dry lint, and a pledget over

covered with very simple ointment. In some patients ointment irritates and

is to keep

it,

inflames the neighboring skin.

Bandages sometimes irritate the sore, and dis-

turb the healing process; but when they do not, they are useful in giving a

moderate support to the parts, and in defending those that are newly formed.

3.

Ulcers in Weakened Parts. — Other ulcers are in parts which

are too weak to carry on the actions necessary to their recovery.

In them the

granulations are larger, more round, and less compact than those formed on

ulcers in healthy parts.

When they have come up to the level of the healthy

parts, they do not readily form skin, but rising still higher, lose altogether the

power of forming it. When the parts are still weaker, the granulations sometimes fill up the hollow of the ulcer, and then are suddenly absorbed, leaving

the sore as deep as ever.

Ulcers are very much under the influence of what-

ever affects the constitution; so that change of weather, emotions of the mind,

diet,

and other agents, quickly occasion a change in their condition.

Such

ulcers as we have been describing, require general as well as local treatment;

bark, wine, porter, and other cordials and tonics are to be given;

and the granfrom rising too much, by the prudent application of

blue vitriol, lunar caustic, and the like, weakened sufficiently by proper admixThis will give a

ture of ointment to act as stimulants, and not as caustics.

proper and healthy action to the granulating surface; whereas the destroying

of the rising parts by escharotics seems rather to encourage the growth.

Bandages and proper support to the parts are highly useful. These ulcers, in

weak parts, do not seem to be the better of poultices, or other relaxing applications; powders rarely do good, and perhaps the best dressing is the citrine ointment, more or less diluted.

ulations are to be kept

—

Irritable Ulcers. There are certain ulcers, which may be called

The margin of the surrounding skin is jagged, and terminating in an edge which is sharp and undermined. There is no distinct appearance of granulations, but a whitish spongy substance, covered with a thin

ichorous discharge.

Every thing that touches the surface gives pain, and

commonly makes the ulcer bleed. The pain sometimes comes on in paroxysms,

and causes convulsive motions of the limb. Such ulcers seldom do well

without a frequent change of treatment. Fomentations with poppy heads,

chamomile flowers, or hemlock leaves, are sometimes of use in irritable ulcers.

4.

Irritable Ulcers.

When poultices are prescribed, they should never be allowed to rest or bear

weight on the sore limb.

Powdered applications are generally too stimulating

for irritable ulcers, and bandages also prove hurtful.

5.

Indolent Ulcers.

—These ulcers are those which have the edges of

the surrounding skin tliick, prominent, smooth, and rounded.

the granulations

is smooth and

The surface, of

glossy; the matter is thin and watery, and the

bottom of the ulcer is nearly level.

pitals are of the most indolent kind.

A great proportion of the ulcers in hosIndolent ulcers form granulations, but

TREATMEYT OF BTSEA8ES.

239

frequently they are all of a sudden absorbed, and in four and twenty hours the

sore becomes as much increased in size as it had been diminished for many

The principal applications required for indolent ulcers are those of a

stimulating nature, as the basilicon ointment, and occasional sprinkling with

red precipitate. Pressure is to be made by a roller, and by slips of adhesive

weeks.

plaster.

Scrofulous, syphilitic, and cancerous ulcers are to be treated according

to the methods laid down under these various diseases,

PALSY. — A disease in which

some part of the body

is

affected

It may be of all degrees, from a

with the loss of the power of motion.

universal attack of the whole body, or a complete palsy of one of the sides, to

It proceeds from the

the palsy of a single finger, or a few fibres of a muscle.

same causes as apoplexy, and is in reality often a modification or partial attack

of that disease. The disease is also brought on by mere loss of nervous power,

When a patient,

as when the brain "gives way," in hard-worked literary men.

by proper remedies, or the powers of nature, recovers a little from an attack

of apoplexy, it is very common for him to be seized with palsy.

Palsy sometimes comes on suddenly, at other times there is numbness,

Sometimes the judgcoldness, and paleness of the part about to be affected.

ment and memory are impaired; the speech is imperfect from the disease of

both body and mind; the mouth and cheeks are distorted, and the countenance

When the lower extremities are partially

expressive of much anxiety.

is

affected, the patient drags them after him.

Causes.

—The same causes that excite apoplexy, occasion palsy when

applied in a less degree; therefore tumors, wrong determination of blood,

bruises, pressure on nerves, the drying up of usual evacuations, are often found

When one side of the body is palsied, the disease is termed

to induce palsy.

hemiplegia, and when the lower part of the body is affected the disease is called

paraplegia.

Certain sedative substances, long applied, produce palsy of some

parts of the body, as we see in those who work

among lead, and are affected

with the Devonshire Colic; one remarkable symptom of which is the palsy of

Palsy is not unfrequently produced graduthe thumbs and calves of the legs.

ally by some tumor or other disease pressing on the vertebrae of the back; and

this is commonly the cause of the palsy of young people.

Prognosis.

—

It is

generally unfavorable.

Palsy does not suddenly prove

more difficult the more the senses are injured; and

such cases commonly continue till the end of life, often very remote. When

palsy follows apoplexy, or happens in old people, it is seldom cured. The

If convulsions occur

palsies of young people are sometimes recovered from.

mortal.

in

Its cure is the

the parts opposite to those that are palsied, the danger

jialsy occurs from

nerves, it

is

is

great.

When

pressure or blows on the spinal marrow, or on any large

generally hopeless, and the dragging of the limb

is

seldom got

completely the better of.

—

When palsy comes on suddenly, it is proper to treat it as

apoplexy sometimes, by bleeding, by purging, by blisters to the head;

and when the acute symptoms are in some measure relieved, we apply stimulants to the limbs, or weakened parts, if they are within our reach.

"When

Treatment.

v/e do

DR. CHASE'S RECIPES.

240

the case

is

of longer standing, and the constitution is in a state of debility,

those evacuating measures would be improper; and instead of them we must

be contented with stimulating applications, aided by such exercise as the

patient is able to take.

It is surprising

how much may be done in cases appar-

The patient must not be discouraged at the apparent bad

ently very hopeless.

success of his first efforts at motion, but must persevere, and his perseverance

The applications proper for palsied limbs

Ammoniated oil, camphorated oil, cajeput oil, when

will probably at last be rewarded.

are such as the following:

it

can be got; turpentine and

nettles, mustard, etc.

oil,

warm sea- water, warm salt, stinging with

Great benefit is often derived from strychnia, but this

drug is so powerful that it ought to be given only by a medical man. Electricity and galvanism are also frequently had recourse to; also the use of

Our choice

the Bath or other mineral waters pumped upon the palsied limbs.

of internal medicines must be determined by the state of the constitution. If

there be any excitement, or inflammatory tendency, or any probability that

the palsy may be followed by apoplexy, all internal stimulants must be avoided;

and it is only in old cases, unattended by fever, that we are to give such medicines as guaiac, iron, aromatics, or the like. Paralytic limbs should be kept warm,

and well covered with flannel

The diet should be light and nutritive. The

patient should take what exercise he can; and if he is unable to do it by his own

In the

exertions, he must have it by a carriage, or by sailing, or by a swing.

palsy of the lower limbs from diseases of the spine, issues to the back, or to

.

the neighborhood of the diseased vertebrae, are of great service.

Remarks.

(See Apoplexy.)

— Many astonishing cures have been effected by taking the min-

Clemens and Ypsilanti, Midi. There may be other places,

and I have no doubt there are, where the mineral waters will have the same

effect.

I only speak of these from my own knowledge.

Palsy in children occurs pretty frequently, and attacks infants and young

persons in different degrees. It often attacks one side at first, and gradually

comes on the other side. It is generally attended with cosliveness and deranged

eral baths at Mt.

state of the bowels

;

and, accordingly, a course of purgative medicines of con-

siderable activity, as jalap

time effects a cure.

and calomel, or rhubarb and calomel, in no long

Blistering on the head, or on the palsied limb, may be

and leeches to the temples, when the head is much affected. If the

owing to water in the head, it is to be feared the case is hopeless.

Tonic medicines and external stimulants are proper, when there is no fever

tried;

palsy is

present.

Electricity is often a valuable assistant to other remedies.

SUPPOCATION.— Is the extinction of life by the function of breathThis may happen from hanging and drowning;

from blood or matter bursting from the lungs into the branches of the wind

pipe; from inflammation or croup, producing a false membrane or thickened

mucus in the air passages from foreign bodies sticking in the same; from large

pieces of meat in the gullet pressing on the back of the wind pipe; and many

ing being violently stopped.

Where the suffocation is complete nothing can be done;

only threatened the proper means of relief are to be had

recourse to, varying, of course, according to circumstances. Foreign bodies

similar incidents.

but -^here

it

is

TMEATMENT OF DISEASES.

241

are to be extracted, if possible, from the windpipe,

and vomited from the

pushed down into the stomach; and the means for restoring suspended animation to be employed in the case of hanging and drowning.

gullet, or

SUFFOCATION FROM HANGING.— Immediately remove all

clothing from the upper part of the body, and follow the directions \mder

Artificial Respiration to restore breathing.

SUFFOCATION FROM GAS AND OTHER NOXIOUS

VAPORS. — Immediately remove the person into the open air, and throw

cold water upon the face, throat and chest, expel the foul gas from the lungs,

and restore respiration by means prescribed for Artificial Respiration. As.

soon as you discover the least breathing, hold strong vinegar to the nostrils.

Should the suffocation be from breathing carbolic acid gas, chloride of soda

or a solution of chloride of lime, is preferable, sometimes moistening a cloth,

with either of the solutions, and holding it to the nose, will produce the

desired effect.

Oxygen should be forced into the lungs if it can be produced.

Excite warmth in the manner prescribed for " Drowned Persons " on pages

80 and 81. Where suffocation is caused by fire-damp in mines, wells, etc,

remove the person at once and treat as above.

SUSPENDED ANIMATION FROM COLD.—

When a person is

apparently frozen to death, the body should be handled very carefully, and be

very careful not to bend the joints; have the body in a cold place, and rub the

same from head to foot with cold water or snow, for fifteen or twenty minutes,

body perfectly dry and rub with bare

warm hands; it is better if several persons will join in this rubbing, and then

wrap the body in a woolen sheet, and follow the directions as in "Artificial

Respiration " to restore breathing. This treatment must be continued with

energy for several hours if necessary, and until animation and respiration are thoroughly restored. Allow the patient to swallow a little lukewarm water and

wine or red pepper, or ginger tea.

until the surface is red, then wipe the

THE RECTUM.—

STRICTURE OF

In many cases this is the result of

an inflammatory process, simple or syphilitic, from the cicatrization of deepseated and extensive ulceration; in others, it is due to the contraction of inflammatory material poured out external to the bowel in the sub-mucous tissue; in

exceptional instances it may be caused by contraction of the parts external to

the bowel, after pelvic cellulitis, and Curling quotes a case where it was the

direct result of injury.

The disease, taken as a whole, is twice as common in women as in men,

my note book revealing the fact that thirty-two out of forty-eight consecutive

cases were in this sex.

But syphilitic stricture is more common in the female,

and cancerous stricture in the male.

Constipation is the one early symptom, and it is not till some ulceration

has commenced, either at the stricture or above it, that others appear, such as

diarrhoea, with lumpy stools, containing blood, pus or mucus, straining at stool,

and a sensation of burning afterward, with at last a complete stoppage,

abdominal distension and dyspeptic symptoms,

16

DR. CHASE'S RECIPES.

242

An examination with the finger carefully introduced into the rectum will,

as a rule, at once reveal the true nature of the case, for about

the rectum the narrowing will be

the part or ulceration.

felt,

two inches up

with or without new tissue infiltrating

In exceptional cases the stricture is beyond the reach

of the finger; under these circumstances, however, it may, at times, be brought

within reach by pressing with the free hand upon the abdomen above the pelvis.

The examination of a rectum, the subject of disease with a tube, flexible

or otherwise, requires the greatest care and gentleness.

Fallacies

may mis-

lead the surgeon in every way, the end of the instrument striking against the

sacrum, or being caught in a fold of mucous membrane, may lead him to suspect obstruction where none exists.

But if some warm fluid, as linseed tea,

be injected somewhat forcibly through the tube, a place is formed admitting

the easy transit of the instrument. In stricture pain is felt when an instrument reaches the point of contraction, and a flexible one is arrested or passed

on with more or less difficulty.

Treatment. It is so rare for a surgeon to be consulted about a stricture

of the rectum till the ulcerative stage has set in, or nearly complete obstruction has taken place, that he has few opportunities of testing the value of

dilatation of the stricture, for, although this practice is clearly useless if not

injurious when ulceration exists, it is probably of great value before any

breach of the surface has taken place. In cicatricial or inflammatory strictures, indeed, it is the only form of practice upon which reliance is to be

placed, but in the cancerous, whether in the ulcerating style or not, it is not

wise to make the attempt.

The dilatation is to be effected by mechanical means, and many instruments have been invented for the purpose. The elastic gum bougie, in the

hands of the surgeon is, however, the best; forcible dilatation is inadmissible.

They are made in many sizes, and the one just large enough to pass through

It should be warmed and well greased, and

the stricture should be chosen.

guided by the finger passed gently through the stricture, and retained for ten or

fifteen minutes at a time.

When it does not produce any irritation, a second

But when irritation has set in, the repelarger, may be passed in two days.

By these

tition of the operation should be suspended until it has subsided.

means a simple stricture may be checked in its progress, and even dilated, but

Mr. Curling has, howrarely cured; this practice may prolong life for years.

ever, given a case in his book in which he believes he cured an annular stricture in a lady, age 24, by incisions and dilatation.

This dilatation is, however, only a means to an end, and that end is to

—

secure a passage for the

intestinal

contents.

Enemata

are

valuable

aids

to effect this purpose, the daily washing out of the bowels with gruel and oil

giving great relief, or the daily dose of mist, olei with manna, confection of

senna with sulphur, or any other gentle laxative that the patient has found to

suit.

Cod liver oil in full doses often acts as a laxative as well as a tonic.

Care must, however, be observed in the introduction of the tube, for in a cancerous bowel perforation is very apt to occur, and even in a healthy one the

same accident has taken place.

TREATMENT OF DISEASES.

243

How far it is safe to allow a patient to pass a bougie for himself or herself,

is another question.

I

am disposed to think it is an unwise act to allow when

the bougie is solid, for I am sure I have seen great irritation and

harm follow

upon the practice, and in several cases deep seated suppuration. Curling has

given a case where the patient caused his own death by perforating the bowel,

half au inch in extent, above the stricture.

I have, consequently,

been in the

habit of instructing my patients to use candles as bougies, and have been well

pleased with the practice.

There comes a time, however, when this treatment by dilatation ceases to

be beneficial; when the stricture has so closed as to render it useless; or ulcerated so as to render it unwise to adopt the practice; or associated with so much

distress as to forbid its use;

and under these circumstances the practice of

colotomy is of great value;

gives comfort to a degree that sometimes aston-

ishes,

and always gratifies.

it

On convalescence or recovery, it is not found to

be practically associated with such inconveniences as surgeons of old have

practically surrounded