9. Cholera Infantum, Injection for.—"For infant one year old inject into the bowels one pint of thin starch, in which is mixed from three to five drops of laudanum; cool, repeat night and morning. Plenty of water or cold barley water may be given and the food for a time may consist of egg albumen with a few drops of brandy. When the symptoms first appear apply a spice plaster or hot application over the abdomen; and keep child as quiet as possible." This is a remedy recommended and used by a number of physicians and has cured many severe cases.

Diets and Drinks.—Stop ordinary feeding at once. A little cream and water, or barley water and cream may do. If the breast milk excites the stomach and the bowels, stop it for a few hours. You can give a few drops of raw beef juice or a little brandy and water. To satisfy the thirst, wrap up a small bit of ice in a linen cloth and let the baby mouth it. Dilute the milk or stop entirely and give only water, or lime water and milk, barley water. Give all the water the child can drink boiled and cooled.

PHYSICIANS' TREATMENT for Cholera Infantum.—1. Washing out of the bowel frequently by injection controls the diarrhea. Use water of a temperature of 107. Elevate the tube about two feet above the bed, use one-half pint at one time. As the half pint flows in disconnect the funnel attached to the tube and the contents of the bowel are allowed to escape. Then allow another one-half pint to flow in. Some may escape and this is not an unfavorable sign. Keep on until a quart is given. This treatment is to wash and clean out the gut and stimulate the heart. The salt solution should be used, if necessary. Give only two daily.

2. For Vomiting.—Wash out the stomach through a tube or by giving a great deal of water.

3. Subcarbonate of bismuth for the vomiting and straining; two or three grains in powder every two or three hours. If there is much colicky pain, add one-half grain of salol to the bismuth powder.

[DIGESTIVE ORGANS 115]

4. Castor oil; one teaspoonful may be needed if the bowels have any fecal matter in them.

5. Mustard poultice or spice poultice on the belly is useful.

Vomiting.—This is simply a symptom; many diseases cause it, as scarlet fever, tuberculosis, meningitis, acute dyspepsia, biliousness, chronic dyspepsia, indigestion, neuralgia of the bowels, appendicitis, ulcer and cancer of the stomach, pregnancy, etc. Many persons with dyspepsia vomit their food.

MOTHERS' REMEDIES for Vomiting.—1. Spice Poultice to Stop.—"Make a poultice of one-half cup of flour and one teaspoonful of each kind of ground spice, wet with alcohol or whisky. Apply over the stomach." This acts as a counter irritant and has the same action on the system as a mustard plaster, only not so severe and can be left on for hours, as there need be no fear of blistering. This kind of a poultice should always be used when it is necessary to leave one on any length of time.

2. Vomiting, Mustard Plaster to Stop.—"Plaster of mustard on pit of stomach." Be very careful not to allow the plaster to remain on too long, as it will blister, and this would be worse to contend with than the vomiting.

3. Vomiting, Parched Corn Drink to Stop.—"Take field corn and parch it as brown as you can get it without burning. When parched throw in boiling water and drink the water as often as necessary until vomiting is stopped."

4. Vomiting, Peppermint Leaves Application for.—"Bruise peppermint leaves and apply to the stomach." This can be found in any drug store in a powder form, and is easily prepared by crushing the leaves and applying to the stomach. If you have the essence of peppermint in the house, that will answer about the same purpose taken internally and rubbed over abdomen.

5. Vomiting, to Produce, Mustard and Water for.—"To produce vomiting take two tablespoonfuls dry mustard, throw luke warm water over it and let stand a minute, then drink." This is an old, tried remedy that we all know about.

6. Vomiting, to Produce, Warm Water for.—"Drink a quart of warm water and you will easily find relief at once." The warm water remedy is very good as the water helps the patient by removing all decomposed food.

PHYSICIANS' TREATMENT for Vomiting.—The only way to treat it is to treat the disease that causes it. Here I may mention a very simple remedy; a tea made from wood soot is frequently helpful. It is the creosote in the wood soot that gives it its medical virtue.

2. For nervous vomiting; two to five drops of garlic juice is good. Dose of syrup for a child [is] one teaspoonful. Dose of syrup for an adult is four teaspoonfuls.

[116 MOTHERS' REMEDIES]

3. A little brandy on cracked ice is often good.

4. Oil of cloves, one-half to one drop, helps in some cases.

5. Lime water added to milk is good in babies.

6. Vinegar fumes, saturate a cloth and inhale the fumes.

7. Seidlitz powder often settles the stomach, soda also.

8. Mustard plaster over the stomach is good in all cases.

9. One-tenth of a drop of ipecac is good for nausea and vomiting.

10. One-half of a drop of Fowler's solution every two hours is useful in nausea following a spree. So also one drop dose of nux vomica every half hour.



APPENDICITIS.—Inflammation of the vermiform appendix is the most important of acute bowel troubles. Sometimes the appendix may contain a mould of feces, which can be squeezed out readily. Sometimes foreign bodies like pins are found there; in about seven per cent of cases foreign bodies are found.

It is a disease of young persons. Fifty per cent occur before the twentieth year. It is most common in males. Persons who do heavy lifting are quite subject to the disease. Some cases follow falls or blows. Indiscretions of diet are very apt to bring on an attack, particularly in those who have had it before. Pain in the appendix in such persons, frequently follows the eating of food hard to digest. Gorging with peanuts is also a cause.

Symptoms.—In a large proportion of cases the following symptoms are present:—Sudden pain in the abdomen, usually referred to the right groin region. Fever often of moderate form or grade. Disturbances of the stomach and bowels, such as nausea, vomiting and frequently constipation. Tenderness or pain in the appendix region. The pain in fully one-half of the cases is localized in right lower part of the abdomen, but it may be in the central portion, scattered, or in any part of the abdomen. Even when the pain is not in the region of the appendix at first, it is usually felt there within thirty-six or forty-eight hours. It is sometimes very sharp and colic-like; sometimes it is dull. The fever follows rapidly upon the pain. It may range from 100 to 102 and higher. The tongue is coated and moist usually,—seldom dry. Nausea and vomiting are commonly present. It rarely persists longer than the second day in favorable cases. Constipation is the rule, but the attack may start with diarrhea.

Local Signs.—Tenderness of the rectus muscle (to the right of the centre of the abdomen) and tenderness or pain on deep pressure. The muscle may be so rigid that a satisfactory examination cannot be made. Sometimes there is a hardness or swelling in the appendix region. Tenderness, rigidity and actual pain on deep pressure; with the majority of cases, a lump or swelling in the region of the appendix.



[DIGESTIVE ORGANS 117]

Recovery.—Recovery is the rule. It frequently returns. General peritonitis may be caused by direct perforation of the appendix and death in appendicitis is usually due to peritonitis.

Surgeons have declared that sudden pain in the region of the appendix, with fever and localized tenderness, with or without a lump almost without exception means appendix disease. Rest in bed, take measures to allay the pain; ice bag applied to the part is very effective.

Operation.—Dr. Osler, of Oxford, England, says.—"Operation is indicated in all cases of acute inflammatory trouble in this region, whether the lump is present or not, when the general symptoms are severe, and when by the third day the features of the case points to a progressive (condition) lesion. An operation after an acute attack has disappeared is not fraught with much danger."

Diet.—All food should be withheld for a few days if possible. Liquids, such as egg albumen, weak tea, thin broth, barley or rice water, or milk diluted with lime water may be given in small quantities if necessary. When the acute symptoms have subsided, milk may be taken undiluted, and eggs may be added to the broth. When the pain and fever have disappeared entirely, gruels made of rice or barley, soft-boiled egg, scraped beef, stewed chicken, toast, and crackers may be added to the list; still later, mashed potatoes and vegetables, finely divided and strained, may be allowed and, finally, when well, usual diet resumed.

APPENDICITIS, Mothers' Remedies.—Home Treatment Found Good for.—"To allay the pain and stop the formation of pus in appendicitis it is recommended that a flannel cloth be saturated with hot water, wrung out, drop ten to fifteen drops of turpentine on it and apply to the affected parts as hot as the patient can bear. Repeat until relief is obtained. Then cover the bowels with a thin cotton cloth, upon which place another cloth wrung out of kerosene oil. This sustains the relief and conduces to rest and eventual cure. It is an essential part of the absorbent cure for appendicitis, and since its adoption doctors do not resort to a surgical operation half so often." The above is a standard remedy and will most always give relief.

PHYSICIANS' TREATMENT for Appendicitis.—The bowels should at first be moved by an enema, The patient should be perfectly quiet in bed. The ice-bag should be applied to the part, but wrapped in flannel and flannel also on the skin, It must not be allowed to make the flesh too cool. This coolness relieves the inflammation of the part. Small doses, from one-tenth to one drop, of aconite can be given for the fever and inflammation the first twenty-four hours. Dose every one to three hours. But little medicine is now given in appendicitis.

[118 MOTHERS' REMEDIES]

Caution.—Keep the bowels regular, especially if you have ever had appendicitis before, also be careful of your eating. This disease will attack high livers, hearty eaters and those with constipated bowels more quickly than others.



INFLAMMATION OF THE BOWELS. Mothers' Remedies.—1.—Inflammation of the Bowels, Excellent Remedy for.—"First bathe the abdomen with warm salt water, then lay over the navel a piece of lard the size of black walnut. Hold the hand over this until it softens; then rub well into the bowels. This often relieves when pills and powders fail." The massaging brings about action of the bowels without a cathartic usually. Sweet oil or olive oil instead of lard, will do as well.

2. Inflammation of the Bowels, Red Beet Poultice for.—"Take red beets; chop up, put in bag, warm a little and put across the stomach. This will draw out the inflammation quickly and makes a very good poultice."

3. Inflammation of the Bowels, Hop Poultice for.—"Take hops, strain them and put in a sack. Lay across the stomach and bowels."

4. Inflammation of the Bowels, Griddle Cake Poultice for.—"Apply hot griddle cakes on bowels. This acts as a poultice, and should be replaced as soon as cold." This remedy saved my life when I was seventeen years of age. Am now fifty. This remedy will be found very good, but care should be taken not to burn the patient.

5. Cold or Pain in the Bowels, Spice Poultice for Child or Adult.—"Take a cloth sack large enough to cover abdomen; take all kinds of ground spices, put in the bag and tie up, sprinkle bag lightly with alcohol, just enough to dampen spices; lay this on abdomen." This serves as a poultice and is an excellent remedy for this trouble. This may be used for a child as well as an adult.

6. Inflammation of the Bowels, Simple Remedy Always at Hand for.—"Apply hot woolen cloths to abdomen as hot as can be wrung out, change every few minutes. My life was saved twice when I was several hundred miles from a doctor by this treatment." This simple but never failing remedy is easily prepared and, as we all know, heat is the most essential thing for this trouble, especially moist heat.

7. Inflammation of the Bowels, a Rather Unique Remedy for.—"Cut the head off of a hen, cut open down the breast, take out the inwards, pound flat and roll with rolling pin and apply to the bowels. This will draw out all inflammation, but must be done in as little time as possible." The above remedy can do no harm. Many people use it. Perhaps other poultices would be easier to prepare, just as effective and save the hen.

8. Inflammation of the Bowels, Marshmallow Leaves, a Canadian Remedy for.—"Green marshmallow leaves (dry will do). Wet flannel and apply hot." Make a strong tea of the marshmallow leaves and while hot dip flannels and apply to abdomen.

[DIGESTIVE ORGANS 119]

9. Inflammation of the Bowels, Syrup of Rhubarb for.—"Add to three pints of simple syrup one and three-fourths ounces of crushed rhubarb, one-fourth ounce each of crushed cloves and cinnamon, one dram of bruised nutmeg, one pint of diluted alcohol, evaporate liquid by a gentle heat to one-half pint. Excellent in bowel complaint in one-half dram (one-half teaspoonful) doses every hour until it operates." The rhubarb moves the bowels and casts out all irritating matter. The oil of cloves stimulates the membranes of the bowels and the cinnamon and nutmeg are astringents.

MOTHERS' REMEDIES for Toothache, Dry Salt and Alum for.—1. "Equal parts. Take common salt and alum. Mix and pulverize these together, wet a small piece of cotton and cause the mixture to adhere to it and place in the hollow tooth. At first a sensation of coldness will be produced, which will gradually disappear, as will the toothache. This is an excellent remedy and should be given a trial by any person suffering with this trouble."

2. Toothache, Oil of Cloves Quick Relief for.—"If the tooth has a cavity take a small piece of cotton and saturate with oil of cloves and place in tooth, or you may rub the gum with oil of sassafras." These are both good remedies, and will often give relief almost instantly.

3. Toothache, Home-Made Poultice for.—"Make a poultice of a slice of toast, saturate in alcohol and sprinkle with pepper and apply externally. This will give almost instant relief."

4. Toothache, Clove Oil and Chloroform for.—"Clove oil and chloroform, each one teaspoonful. Saturate cotton and apply locally."

5. Toothache, Sure Cure for.—

"Peppermint water 1/2 ounce Nitre 1/4 ounce Chloroform 1 dram Ether 1 dram Oil of mustard 10 drops

Remark: This remedy will give relief where all others fail. Not only for toothache, but for neuralgia pains in any part of the body, apply with cloth moistened and lay on the parts affected. Continue until relieved."

6. Toothache, Salt and Alum Water for.—"Fill a bottle of any size half full of equal parts of pulverized alum and salt, then fill up the bottle with sweet spirits of nitre. Shake and apply it to the tooth and gums. Apply it freely, as there is nothing to hurt or injure you."

7. Toothache, Oil of Cinnamon for.—"A drop of oil of cinnamon will frequently relieve very serious cases of toothache. Apply to the tooth with a little cotton. This will at least give temporary relief until you can see your dentist and have the tooth treated."

8. Toothache, Reliable Remedy for.—"Chloroform, clove oil, alcohol, one half ounce of each. Mix together and saturate a piece of cotton and place it in the tooth. This is sure to give relief."

[120 MOTHERS' REMEDIES]

9. Toothache, From Decayed Teeth.—"If the tooth is decayed take a small piece of raw cotton, saturate with chloroform and place in cavity."



MOTHERS' TOOTH POWDERS.—1. "The ashes of burnt branches of the common grape vine make a very superior tooth powder. It will clean the blackest of teeth, if continued for a few mornings, to that of pure white."

2. Tooth Powder.—"Precipitated chalk four ounces, powdered orris root eight ounces, powdered camphor one ounce; reduce camphor to fine powder moistening with very little alcohol, add other ingredients. Mix thoroughly and sift through fine bolting cloth." Have used this with great success.

3. Tooth Powder.—"All tooth powders, or anything that has a grit will, with the friction of the brush, scour loose from the enamel of the teeth; and this is far superior to any of them in every respect.

Soap tree bark 1 pound Turpentine 2 ounces Powdered orris root 2 ounces Alkanet root 1/2 ounce

Diluted alcohol, half water, sufficient to make the whole into one gallon. Let it stand in an earthen jar to macerate for fourteen days; stir occasionally, then strain and filter through filtering paper. The alcohol will have no injurious effect. This is an excellent tooth remedy."

4.—Tooth Wash.—"One teaspoonful of boracic acid in a pint of boiling water.

Tincture Myrrh 1/2 teaspoonful Spirits of Camphor 1/2 teaspoonful Essence of Peppermint 1/2 teaspoonful

Use in the water in which you brush your teeth. Let boracic acid water cool, then add last three ingredients."

5. Tooth Powder.—"Precipitated chalk four ounces, pulverized sugar two ounces, powdered myrrh one ounce, pulverized orris root one ounce. Mix and sift through fine bolting cloth. This is fine."

6. Tooth Powder, Commonly Used.—

"Precipitated Chalk 12 drams Rose Pink 2 drams Carbonate of Magnesia 1 dram Oil of Rose 5 drops

Mix all well together and after using it you will find the following mouth-wash fine for rinsing out the mouth."

Antiseptic Mouth Wash.—

"Boric Acid 10 grains Resorcin 4 grains Salol 2 grains Thymol 1/2 dram Glycerin 1/2 dram Pure water 1 ounce

This sweetens and cleanses the mouth."

[DIGESTIVE ORGANS 121]

7. Tooth Powder, Simple and Unsurpassed.—

Cream of Tartar, powdered 3 ounces Cochineal 1 dram Alum, powdered 4 drams Myrrh 1 dram Cinnamon 1 ounce Sugar 1 ounce

Mix and pass through a sieve. This is a preparation that has no superior for cleaning, preserving and whitening the teeth.

PHYSICIANS' TREATMENT for Toothache.—1. Chloretone dissolved in oil of cloves and applied on a cotton wad is very good for toothache.

2. Creosote.—Put on a piece of cotton and put this in the hollow tooth.

3. Toothache in an ulcerated or hollow tooth, caused from wet feet, etc. Take a hot foot bath and drink a hot lemonade, hot ginger, or hot pennyroyal tea, and go to bed and take a good sweat. Aching tooth needs the care of a dentist. It pays to retain your natural teeth in good shape.



INTESTINAL OBSTRUCTION.—Causes.—This may be caused by strangulation, telescope (intussusception) of the bowels, twists and knots, strictures and tumors, abnormal contents.

1. Strangulation is the most frequent cause; this is caused by adhesions and bands from former peritonitis, or following operations. The strangulation may be recent and due to adhesion of the bowels to the abdominal cut or wound, or a coil of the bowel may be caught between the pedicle of a tumor and the wall of the pelvis. These cases are rather common after some operations.

2. Intussusception.—This means that one portion of the bowel slips into an adjacent portion. These two portions make a cylindrical lump varying in length from one-half inch to a foot or more. Irregular worm-like motion of the bowel is a cause of intussusception.

3. Twists and knots.—Most frequent between thirty and forty. (There is an unusually long mesentery.)

4. Strictures and tumors.—These are not very important causes.

5. Abnormal contents.—Fruit stones, coins, pins, needles, false teeth, round worms rolled in a mass. Coins rarely cause inconvenience.

[122 MOTHERS' REMEDIES]

Symptoms of Acute Obstruction.—Constipation, pain in the bowels, and vomiting are the three most important symptoms. Pain sets in early, and may come on abruptly when walking or more commonly when working. It is at first colicky, but soon becomes continuous and very intense, vomiting soon follows and is constant and very distressing. First the stomach contents are vomited, and the greenish bile-stained material, and soon the material vomited is a brownish-black liquid, with a bowel odor. This peculiar vomiting is a very characteristic symptom. Constipation may be absolute, without the discharge of either feces or gas. Very often the contents of the bowel below the obstruction are discharged. The abdomen is usually distended and when the large bowel is involved this is extreme. If it is high up in the small intestine, it may be very slight. At first, the abdomen is not tender, but later it becomes very sensitive and tender. The face is pale and anxious and finally collapse symptoms intervene. The eyes are sunken, the features look pinched and a cold, clammy sweat covers the skin. The pulse becomes rapid and weak. There may be no fever, and it may go below normal. The tongue is dry, parched, and the thirst is incessant.

Recovery.—The case terminates as a rule in death in three to six days, if aid is not given.

Treatment.—Purgatives should not be given. For the pain, hypodermics of morphine are needed. Wash out the stomach for distressing vomiting. This can be done three to four times a day. Thorough washing out of the large bowel with injections should be practised, the warm water being allowed to flow in from a fountain syringe and the amount carefully estimated. Hutchinson recommends that the patient be placed under an anesthetic, the abdomen kneaded, and a copious enema given with the hips placed high or patient in inverted position. Then the patient should be thoroughly shaken, first with the abdomen held downward and subsequently in the inverted position. If this and similar measures do not succeed by the third day surgical measures must be resorted to.

For bloating, turpentine cloths should be used, and other hot, moist applications.

Diet.—Should be very light, if any, for a day or so.



RUPTURE (Hernia).—Hernia means a protrusion of an organ from its natural cavity, through normal or artificial openings in the surrounding structures. But by the term hernia, used alone, we mean the protrusion of a portion of the abdominal contents through the walls, and that is known by the popular term of "rupture."

[DIGESTIVE ORGANS 123]

The most common forms of rupture protrude through one of the natural openings or weak spots in the abdominal walls, as for instance, the inguinal (groin) and femoral canals. The femoral canal is located at the upper and inner part of the thigh, and this place is a seat of rupture, especially in women. Rupture may also occur at the navel, when it is called umbilical hernia or rupture. The contents of a hernia are bowel and omentum (a covering of the bowel) separately or together. The bowel involved in a rupture is usually the lower portion of the small bowel, but the large bowel is sometimes affected. A sac covers the bowel or omentum in a rupture. This sac consists of the protruded portion of peritoneum, which has been gradually pushed through one of the canals (inguinal or femoral) or of the process of peritoneum, which has been carried down by the testicle in its descent, and the connection of which with the peritoneum of the abdomen still continues, not having been obliterated, as it usually is before birth. The former is called an acquired rupture sac; the latter is a congenital rupture sac, and it is found only in groin (inguinal rupture).

Causes.—Rupture is more common in men than in women. It may occur at any time of life. The majority of cases occur before middle age, and the largest number during the first ten years of life, owing to the want of closure of the peritoneum which is carried down by the testicles before birth. Rupture is most frequently strangulated between the ages of forty and fifty.

Location.—The great majority of cases of rupture are groin or inguinal rupture.

Symptoms.—A fullness or a swelling is first noticed in the groin, which is made worse in standing, coughing and lifting. This disappears on lying down and reappears on rising in many cases, even at first; coughing makes the lump or swelling harder. It may come on both sides, when it is called double rupture or hernia.

MOTHERS' REMEDIES.—Rupture, Poultice for.—"Take equal parts of lobelia and stramonium leaves; make a poultice and apply to the parts. Renew as often as necessary. This combination makes a very effective poultice and is sure to give relief."

PHYSICIANS' TREATMENT.—A person should wear a truss (support) that fits perfectly, and this should not cause any pain or discomfort. The truss should be worn all day, taken off at night after going to bed and put on before rising, when still lying down. If it is put on after rising a little of the gut may be in the canal and pressed down by the support. There are many kinds of supports.

Operations now performed for rupture are very successful if the patient takes good care for months afterwards until the parts are thoroughly healed. The operation simply closes a too large opening. The testicles descending through the groin canal from the abdominal cavity before birth and in congenital rupture, left too big an opening. In acquired rupture, these natural openings were enlarged by lifting, falls, etc. The round ligament of the womb goes down through this canal and sometimes there is too large an opening left or acquired by accident.

Irreducible Rupture.—This is when the rupture cannot be returned into the abdominal cavity, and it is without any symptoms of strangulation. They are of long standing and of a large size. This condition is often due to carelessness of a patient in not keeping in a reducible rupture with a proper support. Adhesions form, holding the rupture. Even if it is small, it gives rise to much discomfort and the patient is always in danger of strangulation of the rupture.

Operation for radical cure is generally a success.

[124 MOTHERS' REMEDIES]

Strangulation Hernia or Rupture.—This means the rupture is so tightly constricted that it cannot be returned into the abdominal cavity, and its circulation is interfered with; then there is not only obstruction to the passage of the feces, but also an arrest of circulation in the protruded portion of bowel which, if not relieved, results in gangrene and death. This occurs more often in old than in recent ruptures and more often in congenital than in acquired rupture.

Symptoms.—Sudden and complete constipation with persistent vomiting. The lump may be tense, hard and irreducible. Then there is faintness, collapse; severe abdominal pain, complete constipation, with no gas passing, then vomiting, at first of food, then of the bile-stained fluid and finally of fluid with a bowel odor. All these symptoms increase and the patient gradually sinks from exhaustion in eight or nine days, though in very acute cases the patient may die within forty-eight hours.

MOTHERS' REMEDIES.—Strangulated Hernia, Hop Poultice for.—"A large warm poultice of hops over the abdomen will be found one of the best known means of relieving strangulated hernia."

PHYSICIANS' TREATMENT.—It must be reduced or an operation must be performed and soon.

To reduce.—The patient is put under an anesthetic and placed on his back with the hips (pelvis) raised and the thigh of the affected side flexed, bent up and rotated inward if the rupture be inguinal or femoral. This motion relaxes the parts. The neck of the sac is then seized with the thumb and fingers of one hand, and thus fixed, while with the other hand, the operator endeavors to return the strangulated gut by gentle pressure in the proper direction. In femoral rupture, this is at first downward, to bring the gut opposite the opening then backward and then upward. In groin (inguinal) rupture it is usually slightly upward and outward. It must be coaxed, kneaded and squeezed carefully. Care must be taken. If it cannot be returned in from five to ten minutes no further time should be wasted, but an operation should be performed immediately. This consists in cutting down to the constriction and through it, thus allowing the rupture to be reduced.

The patient should be kept in bed and treated the same way as for other abdominal operations.

Caution.—Persons with rupture must be very careful not to lift or fall. If a support is worn it must fit perfectly and be worn with comfort.

[DIGESTIVE ORGANS 125]

INTESTINAL COLIC. (Enteralgia).—Causes.—Predisposing; poor general condition, worry, over-work, nervous disposition. Exciting causes; exposure, gas in the bowels, mass of feces, undigested or irritating food, cold drinks, green fruit, ice cream when a person is very warm.

Symptoms.—Intermittent pain usually in the umbilical (navel) region, moving from place to place, dull or sharp pain, relieved by pressure or bending forward. Abdomen is distended or drawn back. It lasts a few minutes or many hours, ending gradually or suddenly, after a passage of gas or movement of the bowels.

PHYSICIANS' TREATMENT.—1. Remove cause first if possible. Mild cases; put heat to the abdomen by hot water bag, wring cloths out of hot water and put in them ten drops of turpentine and place over the bowels hot. Give dose of peppermint water or ginger tea.

2. Severe case.—Morphine hypodermically, if necessary, in a severe case; mustard poultice is good, also a spice poultice.

3. Tincture of Colocynth (bitter cucumber) is an excellent remedy for this trouble. I have often used it with great success. Put five drops of it in a glass half full of water and give two teaspoonfuls every fifteen minutes until relieved. A few doses generally relieve the patient.



THE LIVER.—The liver is the largest gland in the body, and is situated in the upper and right part of the abdominal cavity. The lower border of the liver corresponds to the lower border of the ribs in front and to the right side. It weighs fifty to sixty ounces in the male; in the female, forty to fifty ounces. It is about eight to nine inches in its transverse measurement; vertically near its right surface it is six to seven inches, while it is four to five inches thick at its thickest part. Opposite the backbone from behind forward it measures about three inches. The left lobe, the smallest and thinnest, extends to the left, over what is called the pit of the stomach.



BILIOUSNESS.—This condition presents different symptoms in different cases, but it always includes languor, headache or dizziness, perhaps some yellow color of the skin and conjunctiva, and a general sense of want of tone, depression of spirits and discomfort.

Causes.—The liver does not perform its function well, or there is a retention of bile in the bile ducts. Most of the symptoms do not depend directly upon the changes in the bile, but upon failure of proper digestion in the stomach and intestines. Certain poorly prepared foods or improper food for stomach digestion, quickly cause the development of active fermentation and its results irritate the stomach mucous membrane bringing about a faulty stomach secretion of mucus, which causes further trouble. It may end in a sick headache.

TREATMENT. Prevention.—Normal, easily digested food, open bowels. Active exercise, horseback riding, massage of the liver region. Stooping over and bending from side to side and bending back with feet close together are good aids.

[126 MOTHERS' REMEDIES]

Diet.—Do not over-eat. Avoid alcohol in any form. Stimulating foods such as spices, mustard salads, concentrated meat extracts and meat broths, pepper, horseradish are not to be used. Do not use too much salt; strong coffee and tea are harmful. In severe cases milk either diluted with water or lime water or peptonized should alone be used.

Gruels, albumen water, kumiss, buttermilk and oyster broth may be allowed. Orange juice as well as lemonade may generally be given. Fasting is good in biliousness. No one will starve in a few days of fasting.

MOTHERS' REMEDIES.—1. Biliousness, Lemons for.—"One lemon squeezed in a glass of water with a very little sugar, repeat for several days." Lemon is a very good medicine, and it is surprising to know how few people realize what medical properties the lemon contains. This is a good, simple, but very effective remedy.

2. Biliousness, Salt and Water for.—"Take a teaspoonful of salt to a cup of water and drink before breakfast for a few mornings." It is a well-known fact that a little salt in warm water before breakfast is laxative and also cleanses the system and bowels on account of its purifying action.

3. Biliousness, (chronic) Dandelion Tea for.—"Dandelion root is highly recommended for this." The root should be collected in July, August or September. Dose:—A strong tea may be taken freely two or three times a day, or the fluid extract may be purchased at any drug store.

4. Biliousness, a cheap and very safe plan.—"Drink plenty of cold water and exercise freely in the open air." Following the above advice is often better than medicines and spring tonics, also unless doing hard physical labor, cut down on the meat eating. In fact, eat less generally for a time.

5. Biliousness, Salt Lemonade for.—"Hot salt lemonade night and morning. Juice of one lemon and teaspoonful salt to as much hot water as you can drink."

6. Biliousness, Boneset Tea for.—"Pour hot water on boneset and let stand until it is cold. Take a swallow occasionally." This is very good.

PHYSICIANS' TREATMENT. Medicines.—1. Nitro-hydrochloric acid three drops three times a day in half a tumblerful of water is valuable.

2. Twenty drops of fluid extract of Queen's root three times a day.

[DIGESTIVE ORGANS 127]

3. The following combination forms a good pill to be taken every night:

Extract of Chirata 40 grains Podophyllin 4 grains Wahoo 8 grains Culver's root 8 grains Creosote 10 grains

Mix and make into twenty pills. Take one every night.

4. For the Attack.—Take calomel one-sixth grain tablets; one every fifteen minutes until six are taken, and then follow with two to four teaspoonfuls of epsom salts.



JAUNDICE (Icterus).—A symptom consisting in discoloration by bile pigment of the skin, whites of the eyes, other mucous membranes and secretions.

Causes.—Obstruction of the gall ducts, from gall stones, inflammation, tumor, strictures, from pressure by tumors, and other enlarged abdominal organs.

Symptoms.—The skin and the conjunctiva (red membrane of the eyes) are colored from a pale lemon yellow to a dark olive or greenish black. The itching may be intense, especially in a chronic case. The sweat may be yellow. The stools are a pale slate color, from the lack of bile, and are often pasty and offensive. The pulse is slow. Recovery depends upon the cause. Plain, simple jaundice cases recover in a few days or weeks.

MOTHERS' REMEDIES.—1. Jaundice, Sweet Cider Sure Cure for.—"New cider before it ferments at all. Drink all you can." This is a very simple remedy, but a sure one if taken in the early stages of jaundice. It causes the bowels to move freely and carries off any impurities in the system.

2. Jaundice, Lemon Juice for.—"Take a tablespoonful of lemon juice several times a day." This disease is produced by congestion of the liver, and as lemon is excellent as a liver tonic it is known to be an excellent remedy for jaundice.

3. Jaundice, Peach Tree Bark for.—"Take the inner bark of a peach tree, and make a strong tea, and give a teaspoonful before each meal for five days, then stop five days, and if the patient's indications do not warrant a reasonable expectation that a cure is effected repeat the medicine as above. I never knew of a case in which the above medicine failed to cure. Keep the bowels open with sweet oil."

MOTHERS' REMEDIES for Liver Complaint. Mandrake Root for.—1. "Dry and powder the mandrake root (often called may-apple) and take about one teaspoonful." This dose may be repeated two or three times a day, according to the requirements of the case. This is a stimulant, a tonic and a laxative, and is especially good when the liver is in a torpid and inactive condition.

[128 MOTHERS' REMEDIES]

2. Liver Trouble, Dandelion Root Tea for.—"Steep dandelion root, make a good strong tea of it; take a half glass three times a day." This is a very good remedy as it not only acts on the liver, but the bowels as well. This will always cure slight attacks of liver trouble.

3. Torpid Liver, Boneset Tea for.—"Drink boneset tea at any time during the day and at night. It is also good for cleansing the blood." This is a very good remedy, especially for people who live in a low damp region.

4. Liver Trouble, Mandrake Leaves for.—"A very good remedy to use regularly, for several weeks, is to use from one to three grains of may-apple (mandrake) seed, night and morning, followed occasionally by a light purgative, as seidlitz powder or rochelle salts." This is sure to give relief if kept up thoroughly.

5. Liver Trouble, Mullein Leaf Tea for.—"Mullein leaves steeped, and sweetened. Drink freely." This acts very nicely upon the liver.

PHYSICIANS' TREATMENT for Liver Trouble.—1. For the itching, hot alkaline baths with baking soda in water, or dust on the following:—

Starch 1 ounce Camphor, powdered l-1/2 drams Oxide of Zinc 1/2 ounce

Mix and use as a powder, or use carbolic vaselin locally. Move the bowels with salts and do not give much food for a few days. Use nothing but milk.

2. The following is good to move the bowels when the stool is yellow and costive in a child one year old:

Sulphate of Magnesia 2 ounces Cream of tartar 2 ounces

Mix and give one-half teaspoonful in water every three hours until the bowels move freely. Phosphate of soda in one dram doses every three hours is good.

3. Severe Type and Epidemic Form.—Give one to two drops of tincture myrica cerifera (barberry) every two hours for an adult. This I know to be very good.

4. The common simple kind of jaundice will get well readily by moving the bowels freely and keeping the patient on light food.



CATARRHAL JAUNDICE. (Acute catarrhal angiocholitis).—Jaundice caused by obstruction of the terminal portion of the common duct, by swelling of the mucous membrane.

Causes.—This occurs mostly in young people. It follows inflammation of the stomach or bowels, also from emotion, exposure, chronic heart disease. It may be epidemic.

[DIGESTIVE ORGANS 129]

Symptoms.—Slight jaundice preceded by stomach and bowel trouble. Epidemic cases may begin with chill, headache and vomiting. There may be slight pain in the abdomen, the skin is light or bright yellow, whites of the eyes are yellowish, pain in the back and legs, tired feeling, nausea, clay colored stools. Pulse is rather slow, liver may be a little enlarged. It may last from one week to one to three months.

PHYSICIANS' TREATMENT for Catarrhal Jaundice.—1. Restrict the diet if the stomach and bowels are diseased. Sodium phosphate may be given one teaspoonful every three hours to keep the bowels open. Drink large quantities of water and with it some baking soda one-half to one teaspoonful in the water.

2. If you have calomel you may take one-tenth of a grain every hour for four hours, and then follow with the sodium phosphate in one-half teaspoonful doses every two to three hours, until the bowels have fully moved, or epsom salts, two to four teaspoonfuls. Keep in bed if there is a fever or a very slow pulse say of forty to fifty.

GALL STONES. (Biliary Calculi, Cholelithiasis).—Cases of gall stones are rare under the age of twenty-five years. They are very common after forty-five, and three-fourths of the cases occur in women. Many people never know they have them. Sedentary habits of life, excessive eating and constipation tend to cause them. They may number a few, several, or a thousand, or only one.

Symptoms.—There are usually none while the stones are in the gall bladder, but when they pass from the gall bladder down through the (channel) duct into the bowel they often cause terrific pain, especially when the stone is large. Chill, fever, profuse sweating and vomiting, which comes in paroxysms or is continuous. The pain may be constant or only come on at intervals. The region of the liver may be tender, the gall bladder may be enlarged, especially in chronic cases and very tender. In some cases the pain comes every few weeks and then may be scattered, sometimes seeming to be in the stomach, and then in the bowels, or in the region of the liver. When a person has such pains and locates them in the stomach or bowels, and they come periodically, every week or two or more, he ought to be suspicious about it being gall stones, especially if the symptoms do not show any stomach trouble. If the stone is large and closes the common duct, jaundice occurs; the stools are light colored; the urine contains bile. The attacks of pain may cease suddenly after a few hours, or they may last several days or recur at intervals until the stone is passed. The stones may be found in the bowel discharges after an attack. Death may occur from collapse during an attack.

MOTHERS' REMEDIES.—1. Gall Stones, Sweet Oil for.—"Massaging the part over the region of the liver lightly night and morning is very good, following by drinking a wineglassful of sweet oil at bedtime." The patient should take some good cathartic the next morning, such as a seidlitz powder or cream of tartar. Teaspoonful in glass of water each morning. This treatment should be continued for several weeks and is very effective.

[130 MOTHERS' REMEDIES]

2. Gall Stones, Tried and Approved Remedy for.—"Drink about a wineglass of olive oil at bedtime followed in the morning by a cathartic, as seidlitz powder, or cream of tartar and phosphate of soda; teaspoonful each morning in wineglass of water. This treatment to be pursued several weeks. Massage the part over the liver lightly night and morning. If the suffering is intense use an injection of thirty drops of laudanum to two quarts of water." In many cases the cathartic may not be needed as the olive oil will move the bowels freely. Massaging the parts over the liver will cause it to work better and has proven successful in many cases.

PHYSICIANS' TREATMENT for Gall Stones.—1. For the pain. Morphine must be used and by the hypodermic method; one-fourth grain dose and repeated, if necessary, and chloroform given before if the pain is intense, until the morphine can act. Fomentations can be used over the liver.

2. Soda.—The bowels must be kept open by laxatives, Sodium Phosphate or Sodium Sulphate, (Glauber's) salt.

3. Olive Oil.—Olive oil is used very extensively. I do not know whether it does any good; some people think it does. From two to ten ounces daily, if possible. The phosphate or sulphate of sodium should be taken daily in one to two teaspoonfuls doses each day. Some claim these salts prevent formation of gall stones.

4. Powder for the Itching.—For the intolerable itching you may use the following powder, dust some of it over the skin:

Starch 1 ounce Zinc Oxide 1/2 ounce Camphor 1-1/2 drams

Mix into a powder.

Diet.—This must be thoroughly regulated. The patient should avoid the starchy and sugar foods as much as possible. He or she should also take regular exercise. If a person afflicted with gall stones keeps the stomach and bowels in good condition, they will be better. Pure air, sunshine, exercise, and diet are big factors in the treatment of chronic diseases. A woman so afflicted should not wear anything tight around the stomach and liver, corsets are an abomination in this disease; olive oil if taken must be continued for months.

Surgery.—The operation is indicated when the patient is suffering most of the time from pain in the liver region or when the person is failing in health, or during an acute attack. When there are symptoms of obstruction or when there is fever, sweating shows that there is pus in the gall bladder. Also an operation is then necessary, and in most cases it results satisfactorily.

[DIGESTIVE ORGANS 131]

CANCER OF THE GALL BLADDER, AND BILE DUCTS. Causes.—It usually occurs between forty and seventy years of age. The cases that originate here show no percentage in either sex; but those that appear here as secondary cancers are three times as frequent in women as in men. Chronic irritation by gall stones is an important cause. They are hard to diagnose and, of course, fatal in the secondary kind. For the primary kind early complete removal may cure if you can get at them.

CIRCULATORY DISTURBANCES OF THE LIVER. (Acute Hyperemia or Congestion).—This occurs normally after meals, and in acute infections, diseases, etc.

CHRONIC CONGESTION OR NUTMEG LIVER.—This is due to an obstruction of the blood circulation in the liver by chronic valvular heart disease with failure of heart action. Lung obstruction in the trouble called Emphysema, Chronic Pneumonia, etc., may cause it. The cut section of a liver shows an appearance like a nutmeg, due to a deeply congested central vein and capillaries. In a later stage the liver is contracted, central liver cells are shrunk and the connective tissue is increased.

ACUTE YELLOW ATROPHY. (Malignant Jaundice).—This is fortunately a rare disease. There is rapid progress, and it is fatal in nearly all cases. The liver is very small and flabby. The symptoms are many and are hard to differentiate. You must depend upon your physician. The only thing for him to do is to meet the symptoms and relieve them if possible.

CIRRHOSIS OF THE LIVER. (Sclerosis of the Liver, Hobnail Liver, Gin Drinkers Liver, Hard Liver).—This occurs most often in men from forty to sixty years old. It is not uncommon in children.

Cause.—It is usually due to drinking of alcohol to excess, especially whisky, brandy, rum or gin. The liver is small and thin; hard, granular, white bands run through it and press on the liver cells and destroy them.

Symptoms.—These are few as long as proper circulation in the heart is maintained. Fatty cirrhosis is often found in post-mortems. The first symptoms are the same as those accompanying chronic gastritis, dyspepsia, They are:—Appetite is poor, nausea, retching and vomiting, especially in the morning; distress in the region of the stomach, constipation or diarrhea. These increase and vomiting of blood from the stomach may occur early and late. Bleeding from the stomach and bowels, etc., cause the stools to look like tar. Nosebleed and piles are common and profuse; bleeding may cause severe lack of blood. The epigastric and mammary veins are enlarged. Ascites (dropsy in the abdomen) usually occurs sooner or later and may be very marked, and it recurs soon after each tapping. The feet and genital organs may be oedematous (watery swelling), jaundice is slight and does not occur until late. During the late stage the patient is much shrunken, face is hollow, the blood vessels of the nose and cheeks are dilated, abdomen is greatly distended. Delirium, stupor, coma or convulsions may occur at any time.

[132 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Cirrhosis of the Liver.—It is usually fatal; sometimes even after temporary improvements. No coffee or alcohol; simple diet, bitter tonics, keep bowels open, A physician must handle such a case.

ABSCESS OF THE LIVER. Hepatic Abscess: Suppurative Hepatitis.—This is a circumscribed collection of pus in the liver tissue. If there is only one abscess it is in the larger lobe in seventy per cent of the cases. The amount of fluid contained in such an abscess may be two or three quarts and its color varies from a grayish white to a creamy reddish-brown; when the abscess is caused by a type (amebic) of dysentery, there is generally only one abscess, occurring more often in the right lobe, whereas other forms due to septic infection give rise to many abscesses.

Causes.—This disease is rare even in tropical climates. When it is excited by gall stones, it is invariably septic in character and the infecting material reaches the interior through the liver vessels or bile passages. Stomach ulcers, typhoid fever, appendicitis, may bring on such an abscess. Pus wounds of the head are sometimes followed by a liver abscess. The most common method of infection is through the portal vein. Other causes that may be mentioned are foreign bodies traveling up the ducts, as round-worms and parasites.

Symptoms.—Hectic temperature, pain, tenderness, and an enlarged liver, and often slight jaundice. In acute cases the fever rises rapidly, reaching 103 or 104 in twenty-four hours. It is irregular and intermittent, and it may be hectic, that is, like the fever of consumption. Shakings or decided chills frequently are present with the rise of fever and when the fever declines there may be profuse sweating. The skin is pale and shows a slight jaundice, the conjunctiva being yellowish. Progressive loss of strength with disturbance of the stomach and bowels is present. The bowels are variable and constipated and loose. Dropsy of the abdomen (Ascites) may develop, on account of pressure on the big vein, inferior vena-cava. Lung symptoms, severe cough, reddish-brown expectoration are often present.



THE ABSCESS.—May break into the pleural cavity, bronchial tubes, lungs and stomach, bowels, peritoneum or through the abdominal wall.

Recovery.—The result is unfavorable as it generally goes on to a rapid termination. The abscess should be opened and evacuated when its location can be detected. The death rates ranges from fifty to sixty per cent.

Treatment.—Open it if you can, Sponge liver region with cool water. For the pain, mustard poultices, turpentine stupe or hot fomentations prove beneficial. Keep up strength by stimulation and quinine.

[DIGESTIVE ORGANS 133]

Diet in Liver Troubles sent us from Providence Hospital (Catholic), Sandusky, Ohio:

May Take—

Soups—Vegetable soups with a little bread or cracker, light broths.

Fish—Boiled fresh cod, bass, sole or whiting, raw oysters.

Meats—Tender lean mutton, lamb, chicken, game, (all sparingly).

Farinaceous—Oatmeal, hominy, tapioca, sago, arrowroot (well cooked), whole wheat bread, graham bread, dry toast, crackers.

Vegetables—Mashed potato, almost all fresh vegetables (well boiled), plain salad of lettuce, water-cress, dandelions.

Desserts—Plain milk pudding of tapioca, sago, arrowroot or stewed fresh fruit (all without sugar or cream), raw ripe fruits.

Drinks—Weak tea or coffee (without sugar or cream), hot water, pure, plain or aerated water.

Must Not Take—

Strong soups, rich made dishes of any kind, hot bread or biscuits, preserved fish or meats, curries, red meats, eggs, fats, butter, sugar, herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits, nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne.



ACUTE GENERAL PERITONITIS. (Inflammation of the Peritoneum, Lining of the Abdominal Cavity).—Causes. Primary; Occurs without any known preceding disease, and is rare. Secondary; Occurs from injuries, extension from inflamed nearby organs, such as appendicitis or infection from bacteria, without any apparent lesion (disease of the bowel). Perforation causes most of the attacks of peritonitis. Peritonitis may accompany acute infections or accompany chronic nephritis, rheumatism, pleurisy, tuberculosis and septicemia. Peritonitis occurs from perforation of the bowel in typhoid fever also, and it frequently occurs after appendicitis and sometimes after confinement.

Symptoms.—This is often the history of one of the causes mentioned above, followed in cases with perforation or septic disease by a chill or chilly feeling and pain, varying at first, with the place where the inflammation begins. The patient lies on his back, with the knees drawn up, and the body bent so as to relax the muscles of the abdomen, which are often rigidly contracted,—stiff at first on the side where the pain starts. The pain may be absent. The abdomen becomes distended, tympanitic (caused by gas). An early symptom is vomiting and it is often repeated. There is constipation; occasionally diarrhea occurs. The temperature may rise rapidly to 104 or 105 and then become lower; it is sometimes normal. The pulse is frequent, small, wiry and beats 100 to 150 per minute; the breathing is frequent and shallow. The tongue becomes red and dry and cracked. Passing the urine frequently causes pain; sometimes there is retention of urine. The face looks pinched, the eyes are sunken, the expression is anxious, and the skin of the face is lead colored or livid. Hiccoughs, muttering, delirium or stupor may be present.

[134 MOTHERS' REMEDIES]

Recovery, Prognosis, etc.—The action of the heart becomes weak and irregular, respiration is shallow, the temperature taken in the rectum is high, the skin is cold, pale and livid, death occurs sometimes suddenly, usually in three to five days; less often thirty-six to forty-eight hours; or even after ten days. The results depend mainly upon the cause of the inflammation, and the nature of the infection, infectious disease that produces it, being usually very bad after puerperal sepsis (after confinement), induced abortion, perforation of the bowel or stomach, or rupture of an abscess.

LOCAL PERITONITIS.—This may come from local injury, but it is usually secondary to empyema, tuberculosis, or cancer, abscess, perforation of the stomach or bowel, ulcer, etc.

Symptoms.—Onset is usually sudden. There is sudden local pain, increased by any movements; tenderness, and vomiting; then chills, irregular fever, sweating, difficult breathing, emaciation.

TREATMENT OF THE ACUTE PERITONITIS.—There must be absolute rest, morphine by hypodermic method, one-fourth to one-half grain to relieve the pain. Ice cold and hot fomentations with some herb remedy like hops, smartweed, etc.; or cloths wrung out of hot water with five to ten drops of turpentine sprinkled on them. This is very good when there is much bloating from gas.

The turpentine should be stopped when the skin shows red from it. The cloths should not be heavy or they will cause pain by their weight. Ice water can be used when cold cloths are needed.

For vomiting.—Stop all food and drink for the time and give cracked ice.

Diet.—Should be hot or cold milk with lime water or peptonized milk if necessary. If the feeding causes vomiting, you must give food by the rectum. For the severe bloating enemas containing turpentine should be given, one to two to six ounces of water used with ten to thirty drops of turpentine in it; sometimes it is necessary to resort to surgery.

TUBERCULAR PERITONITIS.—This may occur as a primary trouble or secondary to tuberculosis of the bowels, lungs, and Fallopian tube. It is most frequent in males between twenty and forty.

[ DIGESTIVE ORGANS 135]

Symptoms.—These are variable. It may occur like acute peritonitis with sudden onset of high fever, pain, tenderness, bloating, vomiting and constipation; these symptoms passing into those of chronic peritonitis. Often there are gradual loss of strength and flesh, low and irregular fever; frequently the temperature goes below normal with a little ascites tympanites, constipation, diarrhea and masses in the abdomen which consist of the omentum (apron covering the bowels) rolled up and matted into a sausage-shaped tumor in the upper part of the abdomen, or of thickened or adherent coils of the bowel, enlarged mesentric lymph nodes, etc. Spontaneous recovery may occur, or the course of the disease may resemble that of a malignant tumor.

Treatment.—If there is effusion and few adhesions, cutting in and removing the fluid may help. In other cases good nourishing diet with cod liver oil is best.



ASCITES. (Hydroperitoneum. Abdominal Dropsy).—This is an accumulation of serous fluid in the peritoneal cavity. It is but a symptom of disease.

Local Causes.—Chronic peritonitis, obstruction of the portal (vein) circulation as in cirrhosis of the liver, cancer or other liver disease, from heart disease, tumors, as of the ovaries or enlarged spleen. All these mentioned may produce this dropsy.

General Cause.—Heart disease, chronic nephritis, chronic malaria, cancer, syphilis, etc.

Symptoms.—Gradual increasing distention of the abdomen, causing sometimes a sense of weight, then difficulty of breathing from pressure. The abdomen is distended, flattened at the sides unless it is very full. The skin may be stretched tense, superficial veins are distended. The navel may be flat or even protrude and around it the vessels may be greatly enlarged. There is fluctuation when you tap sharply at one side, while holding your hand on the other side you feel a wavy feeling.

PHYSICIANS' TREATMENT for Ascites.—First treat the disease causing it. Sometimes it is necessary in order to prolong life to repeatedly tap the patient as in cirrhosis of the liver. When it is caused by the heart or kidneys, give cathartics that carry away much liquid, hydragogue cathartics. One dram of jalap at night followed by a big dose of salts before breakfast. Cream of tartar and salts are good, equal parts. Or cream of tartar alone, one to two drams, with lemon juice in water in repeated doses. Digitalis and squill, of each one grain to cause great flow of urine. Infusion of digitalis is also good to increase flow of urine, when the heart is the real cause of the ascites. These treatments take the liquids away through the proper channels, the bowels and kidneys.

[136 MOTHERS' REMEDIES]

Ascites caused by an Ovarian Tumor.—The tumor must be removed. I am not in favor of indiscriminate operating, but operations often save lives. I remember one case in which I very strongly urged the lady to have an operation performed. It was a case of ascites, caused, as I was sure, by a tumor of the ovary. The lady, as almost all people do,—and I do not blame them for it,—dreaded even the thought of an operation, but she was finally compelled to have an operation or die. She filled so full that it was almost impossible for her to breathe. She went away from home in terrible shape, almost out of breath, and returned home a well woman and has remained so. Such cases formerly died. But not all cases of ascites can be cured by an operation, it depends upon the cause. In many cases all one can do is to doctor the cause, if that cannot be removed, make the patient's remaining days as comfortable as possible.

DISEASES OF THE RECTUM AND ANUS.—The lower part of the alimentary canal is called the rectum, originally meaning straight. It is not straight in the human animal. It is six to eight inches long. The anus is the lower opening of the rectum. In health it is closed by the external Sphincter (closing muscle). Disease may wear this muscle out and then the anus remains open, causing the contents of the bowel to move involuntary.

CONSTIPATION. Causes.—1. Mechanical obstruction.

2. Defective motion of the bowels.

3. Deficient bowel secretions.

4. Other causes. Mechanical obstruction.—Anything that will hinder the free and easy passage of the feces (bowel contents). Too tight external sphincter (rectum) muscle, stricture, tumors, etc. Bending of the womb on the bowel.

Defective Worm-like Bowel Movement.—Irregular habits of living head the list causing this defective action. Everyone should promptly attend to Nature's call. Some people wait until the desire for stool has all gone, and in that way the "habit" of the bowels is gradually lost. Everyone should go to stool at a certain regular time each day, and at any other time when Nature calls. If a person heeds this call of Nature, the call will come regularly at the proper time, say every morning after breakfast. If these sensations (Nature's calls) are ignored day after day, the mucous membrane soon loses its sensitiveness and the muscular coat its tonicity, and as a result, large quantities of fecal matter may accumulate in the sigmoid (part of the bowel) or in the rectum without exciting the least desire to empty the bowels. Again, irregular time for eating and improper diet are liable to diminish this action also. Foods that contain very little liquid and those that do not leave much residue are liable to accumulate in the bowel and at the same time press upon the rectum hard enough to produce a partial paralysis.

Deficiency of the Secretions.—Many of the causes that hinder worm-like motion are also likely to lessen the normal secretions of the bowel. Some kinds of liver diseases tend to lessen the secretions of the bowel, because the amount of bile emptied into the bowel is lessened. Sometimes the glands of the intestine are rendered less active by disease and other causes.

Sundry Causes.—Diabetes, melancholy, insanity, old age, paralysis, lead poisoning and some troubles of local origin, like fissure of the rectum, ulceration, stricture and polypus.

[DIGESTIVE ORGANS 137]

Symptoms.—Headache, inattention to business, loss of memory, melancholy, sallow complexion, indigestion, loss of appetite, nervous symptoms. Spasmodic muscular contraction of the external sphincter. The bowel contents press upon it; spasm of this sphincter muscle is frequently brought on by the presence of a crack in the mucous membrane, caused by injury inflicted during expulsion of hardened feces. Instead of aiding a bowel movement, the muscles now present an obstruction beyond control of the will and aggravate the condition. The most frequent cause of disease of the rectum is constipation and anyone of the following local diseases of the rectum and anus may be a symptom of constipation. (1) Fissure or crack of the anus. (2) Ulceration. (3) Hemorrhoids (piles). (4) Prolapse (falling). (5) Neuralgia. (6) Proctitis and periproctitis.

Fissure of the anus is a common local symptom of constipation. The feces accumulate when the bowels do not move for a few days, the watery portion is absorbed; they become dry, hard, lumpy, and very difficult to expel, frequently making a rent (tear) in the mucous membrane and resulting eventually in an irritable fissure. Ulceration of the rectum and the sigmoid (part of the bowel) is a symptom of persistent constipation, because the pressure exerted upon the nourishing blood vessels by the fecal mass causes local death of the tissues.

Hemorrhoids (Piles) may be produced by constipation in several ways; first by obstruction to the return of the venous (dark) blood. Second, by venous engorgement (filling up) of the hemorrhoidal veins during violent and prolonged straining at stool. Third, as a result of the general looseness of the tissues in those suffering from constipation.

Prolapse (Falling of the Bowel).—This falling of the rectum may be partial or complete, and may be caused by straining or by the downward pressure exerted by the fecal mass during the emptying movement of the bowel. It may also be the result of a partial paralysis of the bowel caused by pressure of the feces upon the nerves.

Proctitis and Peri-Proctitis.—Inflammation of the rectum and surrounding tissue that may or may not terminate in an abscess and fistula, sometimes follows injury to the very sensitive mucous membrane by the hardened feces.

Neuralgia of the Rectum.—This may sometimes result from the pressure of the fecal mass upon the nearby nerves causing pain in the sacrum coccyx (bones).

MOTHERS' REMEDIES.—1. Constipation, a Good Substitute for Pills and Drugs.—"Two ounces each of figs, dates, raisins, and prunes (without pits) one-half ounce senna leaves. Grind through meat chopper, and mix thoroughly by kneading. Break off pieces (about a level teaspoonful) and form into tablets. Wrap each in a wax paper and keep in covered glass jars, in a cool place. Dose.—One at night to keep the bowels regular. Very pleasant to take."

[138 MOTHERS' REMEDIES]

2. Constipation, Substitute for Castor Oil.—"Take good clean figs, and stew them very slowly in olive oil until plump and tender, then add a little honey and a little lemon juice, and allow the syrup to boil thick. Remarks.—Keep this in a covered glass jar and when a dose of castor oil seems necessary, a single fig will answer every purpose. Not unpleasant to take."

3. Constipation, Hot Water for.—"A cup of hot water, as hot as one can drink it, a half an hour before breakfast." The hot water thoroughly rinses the stomach and helps the bowels to carry off all the impurities.

4. Constipation. Excellent Nourishment for Old People.—"A tablespoonful of olive oil three times a day internally for weak or very old people: it can be injected,—used as an enema." Olive oil will be found very beneficial for young people as well as old. It acts as a food for the whole system and is very nourishing.

5. Constipation, Salt and Water for.—"A pinch of salt in a glass of water taken before breakfast every morning. I have found it a very good remedy." This is a remedy easily obtained in any home and will be found very helpful. Few people seem to realize how valuable salt is as a medicine. It acts as a stimulant and loosens the bowels.

6. Constipation, Water Cure for.—"Drink a quantity of water on retiring and during the day." This simple home remedy has been known to cure stubborn cases of constipation if kept up faithfully.

7. Constipation, Tonic and Standard Remedy for.—"Calomel one ounce, wild cherry bark one ounce, Peruvian bark one ounce, Turkish rhubarb ground one ounce, make this into one quart with water, then put in sufficient alcohol to keep it." Dose:—Take a small teaspoonful each morning when the bowels need regulating, or you need a stimulating tonic.

8. Constipation, Glycerin and Witch-Hazel Remedy Where Castor Oil Failed— "Equal parts of glycerin and witch-hazel." Dose :—One teaspoonful every night at bedtime. In severe cases where you have been unable to get a movement of the bowels by the use of other cathartics, take a teaspoonful every two hours until the bowels move freely. This remedy has been known to cure when castor oil and other remedies have failed.

9. Constipation, Well-known Remedy for.—

"Fluid Extract Cascara Sagrada 1 ounce Syrup Rhubarb 1 ounce Simple Syrup 2 ounces

Mix."

One teaspoonful at night or fifteen drops four times a day for an adult.

[DIGESTIVE ORGANS 139]

10. Constipation, Effective Remedy, in the most Stubborn Cases of.—

"Fluid Extract Cascara Sagrada 1 ounce Fluid Extract Wahoo 1 ounce Neutralizing Cordial 2 ounces

Mix."

Adults may take a teaspoonful of this mixture before retiring, this will be found very effective in the most stubborn cases of constipation.

11. Constipation, Remedy from a Mother at Lee, Massachusetts.—

"Senna Leaves 1/2 pound English Currants 1/2 pound Figs 1/4 pound Brown Sugar 1 large cup

Chop all together fine. Dose:—One-fourth to one-half teaspoonful every night. Do not cook. The best remedy I know."

12. Constipation, Fruit and Hot Water Cure for.—"Drink a pint of hot water in the morning before eating. Eat fruit, plenty of apples, eat apples in the evening, and they will loosen the bowels. Chew them fine, mix with saliva."

13. Constipation, Herb Tea for.—"One ounce senna leaves steeped in one-half pint of hot water, with a teaspoonful of ginger powdered; strain. This is a most certain and effective purge, and mild in its action upon the bowels. Dose:—A cupful at bedtime. This is far superior to salts."

14. Constipation, Purshiana Bark Tea Without an Equal for.—"An infusion of one ounce of purshiana bark to one pint of boiling water; infuse for one hour and strain. It stands without an equal in the treatment of constipation in all its varied forms. Dose:—One teaspoonful, morning and evening according to symptoms or until the bowels are thoroughly regulated." This is fine for constipation, especially if of long standing. It may be used in connection with cascara. This will give relief when other remedies fail.

PHYSICIANS' TREATMENT for Constipation.—Too much reliance has been placed upon medicine in the treatment of this disease and too little attention given to diet, and the establishment of regular habits in eating, exercising, sleeping and attending to the calls of Nature. Also, local disease of the rectum has been overlooked until of late years. Remedies of a laxative and cathartic nature soon lose their power and the dose must be repeated or a new remedy must be given. This method of treatment is well recommended and is very good.

1—Stretching of the sphincter.

2—Frequent rectal and abdominal massage.

3—Copious injection of warm water (in the beginning only).

4—Application of electricity over the abdomen and in the rectum.

[140 MOTHERS' REMEDIES]

In addition to this treatment which must be carried out by a physician the patient must observe the following rules: Go to stool daily, and as near the same time as is convenient, correct errors of diet. Drink an abundance of water and eat sufficient fruit. Take plenty of outdoor exercise; take a cold bath every morning followed by a thorough rubbing. Dress warmly in winter and cool in summer. Change of temperature or climate if the case demands it. Be temperate in all things affecting the general health. Stretching the sphincter must be done carefully, but in a thorough manner. It can only be done properly by an experienced person. Stretching of the sphincter closes the opening so that the feces are not passed at all times. It is circular in shape. Sometimes this grows larger, stiffer, or it acts spasmodically. The opening is often so tight in some people that it is difficult to introduce even a finger, and it frequently produces a spasm of pain in the bowels, stomach and head to do so. This kind will produce constipation or make it worse. In such cases it should be stretched thoroughly but carefully so that the muscle will be able to close the opening and the bowel contents will not pass at any time unhindered. There are two methods of stretching the muscle—forcible or gradual. The forcible method is generally done by inserting the two thumbs into the anus and stretching the muscle thoroughly in every direction until there is no resistance. (Dilators are made for this purpose, but unless they are very carefully used they will tear the muscle). The forcible method should be done under an anesthetic. Gradual stretching is done when an anesthetic cannot be used. It is better to do too little than to do too much at the first sitting. The muscle is very stubborn sometimes, and it requires careful handling or the irritability will be increased. An instrument in the hands of a careful man is all right. They can be stretched by the fingers or the Wales' bougie, thus: Patients should come to the office two or three times a week, the instrument (bougies) are introduced and allowed to remain within the bowel until the muscle resistance is overcome, and many times their withdrawal will soon be followed by a copious stool. Forcible stretching is seldom required more than once, if a large sized instrument is used from time to time afterward, just as in gradual stretching; when thorough dilatation has been accomplished, the muscle instead of acting as an impassable barrier to the discharge of the feces, now offers only passive resistance, but sufficiently strong, however, to prevent any unpleasant accidents, yet not strong enough to resist the power of the expulsory muscles when the latter are brought into full play during stool. Large quantities of feces do not now accumulate; consequently the pressure upon the mucous membrane and neighboring nerves is eliminated, and the bowel regains its normal sensibility and strength. There are now sold dilators in sets for self use in almost every drug store. These when used continuously do good and successful work.

[DIGESTIVE ORGANS 141]

Abdominal Massage. (Kneading, Rubbing, etc.).—This is an essential feature in the treatment. It was practiced by Hippocrates hundreds of years ago. Place the patient in the recumbent position upon a table which can be so manipulated that the head may be raised or lowered, the body rolled from side to side. Gentle but firm pressure is then made with the palm of the hand and the ball of the thumb over the large intestine beginning in the lower right groin region. Then go up to the ribs on the right side, then over the body to the same place on the left side and down to the left lower side and center, accompanying the pressure by kneading the parts thoroughly with the fingers. Repeat this several times for about ten to twelve minutes. At first this should be practised every day; later twice a week. Special treatment should be given the small intestines and liver when the bile and intestinal secretion are lessened. In children gentle rubbing of the abdomen with circular movements from right to left with a little oil for ten minutes daily will help to increase the action of the bowels and often bring on a normal movement.

Copious Warm Water Injections.—This is good at the beginning of the treatment when the feces become packed. They soften the mass and aid its discharge. The water must go above the rectum into the colon. To do this a colon tube from eighteen to twenty-four inches long, a good syringe (the Davidson bulb) hard rubber piston or a fountain syringe, the nozzle of which can be inserted into the tube, are required. The patient is placed in the lying down position on the left side with knees drawn up, with the hips elevated. Oil the tube and pass it gently and slowly up the bowel for a few inches until it meets with a slight obstruction. A few ounces of water are then forced through the tube and at the same time pressure is made upward with the tube; by these means the obstruction will be lifted out of the way each time the tube meets with resistance; the procedure must be repeated until the tube is well within the colon. Attach the syringe to the tube and allow the water to run until the colon is distended. A quart to a gallon of warm water can be used depending upon the age and amount of feces present. The water should be retained as long as possible.

The injections should be continued daily until all the feces has been removed. They should not be used for weeks as has been recommended. If soap suds are used in the enema, green or soft soap should be used, not the hard soap.

Electricity.—One pole may be placed over the spinal column and the other moved about over the course of the colon, or one over the spine and the other over the rectum.

Again constipation is caused by the womb lying upon the rectum. Change this condition. (See diseases of women).

[142 MOTHERS' REMEDIES]

Rules.—Patients should go to stool daily at the same hour, usually after the morning meal. You can educate the bowel to act daily at the same hour or after breakfast; or on the other hand not more than once in two or three days in those who are careless in their habits. Some patients need to have two or three movements daily in order to feel well. It may take time to educate the bowels to do this, but it can be done in many cases and many persons become constipated because they put off attending to the educated bowel's call, and often produce constipation by carelessness. It is surprising how many educated people put off this duty; Nature neglected, soon ceases to call. If constipated persons will persevere in going to the closet at or near the same time every day and devote their entire time while there to the expulsion of the fecal contents, and not make it a reading room, they will bring about the desired result. Patients are apt to become discouraged at first; they should be informed that the final result of the treatment is not influenced by the failure of the bowel to act regularly during the first few days. Do not strain to expel the stool.

Corrections of Errors in Diet.—This is one of the necessary features in the treatment. All kinds of foods known to disagree should be discarded. The foods should be easily digested. In children the diet should be rich in fats, albuminoids and sugar, but poor in starches. A reasonable amount of fruits such as apples, oranges, and figs should be allowed. Meals should be at regular hours. Foods that can be used:

May Take—

Soups.—Meat broths, oyster soup.

Fish.—Boiled fish of all kinds, raw oysters.

Meats.—Almost any fresh tender meat, poultry, game, not fried.

Farinaceous.—Oatmeal, wheaten grits, mush, hominy, whole wheat bread, corn bread, graham bread, rye bread.

Vegetables.—Boiled onions, brussels sprouts, spinach, cauliflower, potatoes, asparagus, green corn, green peas, string beans, salads with oil.

Desserts.—Stewed prunes, figs, baked apples with cream, ripe peaches, pears, oranges, apples, melons, grapes, cherries, raisins, honey, plain puddings, fig puddings, apple charlotte.

Drinks.—Plenty of pure water, cold or hot, new cider, buttermilk, orange juice, unfermented grape juice.

Must Not Take—

Salt, smoked, potted or preserved fish or meats, pork, liver, eggs, new bread, puddings of rice or sago, pastry, milk, sweets, tea, nuts, cheese, pineapple, spirituous liquors.

Foods classed as laxatives are honey, cider, molasses, and acid fruits, such as apples, pears, peaches, cherries, and oranges. Berries are effective laxatives on account of the acids and seeds they contain. (Huckleberries are constipating). Prunes, dates and figs are good and effective, also fruit juices.

[DIGESTIVE ORGANS 143]

Drinks.—There are few laxatives better than a glass of cold water or preferably hot water, taken upon an empty stomach before breakfast; water prevents the feces from becoming dry and massed, and stimulates the intestinal movements. A pinch of salt added to the water increases its effectiveness.

Out-door Exercise.—This should be taken regularly and freely.

Bathing.—The best time is before breakfast, and in as cold water as possible. The bath should be followed by a thorough rubbing of the skin with a Turkish towel.

Clothing.—Warm clothing in winter; cool clothing in summer. Cold weather induces constipation, and warm weather diarrhea. Moderate manner of living is everything.

PHYSICIANS' TREATMENT for Constipation. 1. One year to three years.—For infants one teaspoonful or less of black molasses or store syrup, or of olive oil; and Mellin's food eaten dry, is good for babies a year and older.

2. Small Children.—Increase cream in the milk, give oatmeal or barley water. Castile soap suppository, enema, massage, castor oil, or citrate of magnesia if drugs are needed.

3. Older Children.—In older children, fruit, oatmeal, etc. Black molasses is good for children, one to two teaspoonfuls.

4. Fluid Extract of Cascara Sagrada.—Dose: ten to sixty drops at night. This is good for a great many cases and sometimes it cures the trouble, but on the other hand it seems to injure some people.

5. The Aromatic Cascara is also good; doses are larger and pleasant to take. This is more agreeable for children.

6. The Compound Licorice Powder is a mild, simple laxative and effective. It is composed of senna eighteen parts, licorice root powder sixteen parts, fennel eight parts, washed sulphur eight parts, sugar fifty parts. Dose:—One to two teaspoonfuls.

7. For one dose, or one capsule, the proportions would be:

ONE AMOUNT FOR CAPSULE ONE DOZEN Aloin 1/4 grain 3 grains Extract of Belladonna 1/8 grain 10 grains Extract Nux Vomica 1/4 grain 3 grains Powdered Gentian 3 grains 36 grains

Mix and put up in twelve capsules and take one at night.

There are many tablets and pills made that can be bought at any drug store. No doubt some of them are first class, though perhaps not attaining to that high degree of virtue claimed in their advertising columns.

[144 MOTHERS' REMEDIES]

ITCHING OF THE ANUS. (Itching Piles) (Pruritus ani).Causes.—An inherited or an acquired nervous constitution. Disease of the colon, rectum or anus. Improper diet. Skin affections in that region. Operations about the rectum and anus with resulting discharge sometimes. Diseases in the neighboring organs. Disease of the general system. Diarrhea, discharge of mucus and pus, fissure, etc. Irregular habits and dissipation. Over-seasoned foods such as lobster, salmon, shell-fish and foods containing much grease or starch are especially conducive to it; the same is true of tea, coffee, cocoa, strong alcoholic drinks. Skin diseases, lice, pin worms often cause it.

After Operations.—Some part has not healed, and there is left an irritating discharge.

Symptoms.—There is intense itching at the anus, increased by warmth, and contact of the buttocks. The itching grows worse after the patient becomes warm in bed. It may spread and extend to the scrotum, down the limbs and sometimes over the lower back.

PHYSICIANS' TREATMENT FOR ITCHING OF ANUS. Preventive and Palliative.

DIET.—May Take.—Strong drink must be prohibited; tea, coffee, cocoa, if used at all should be sparingly used. A light diet such as bread, milk, eggs, nourishing soups, kumiss and a little fresh fish, broiled steak, etc., may be used.

May Not Take—Hot cakes, pastry, parsnips, cheese, pickles, beans, cucumbers, cabbage, oatmeal, pork, shell-fish, salmon, lobster, salt fish, confectionery and starchy or highly seasoned foods are to be prohibited. Regular meals, no lunches between meals, and the patient must not over-eat at any time. Long course dinners and over-indulgence in highly seasoned foods and wines aggravate it.

Remedies for Bath.—The bowels should move daily and the parts should be kept clean. The parts should be bathed with hot water or weak solutions of carbolic acid, alcohol or listerine, the heat being especially soothing. Bathing the parts with bran, oatmeal, flaxseed, salt, rice, slippery elm teas, or tar water adds much comfort to these parts. Do not wash much with soapy water.

1. Separate the Buttocks with Gauze, a thin layer of cotton or a piece of soft cloth. This eases the soreness, pain and itching by absorbing the secretions and preventing irritations while walking. The patient should not scratch the parts. Direct pressure over the itching parts with a soft cloth, or by drawing a well oiled cloth across the sore parts several times gives relief.

2. Dr. Allingham Recommends the introduction of a bony or ivory nipple-shaped plug into the anus before going to bed. It is self retaining, about two inches in length, and as thick as the end of the index finger. He claims it prevents the night itching by pressing upon the many veins and terminal nerve fibres of the parts. When the rawness is extensive and the parts are highly inflamed, the patient should be kept to bed and kept on his back with the limbs separated until the irritation is allayed.

3. Local Applications.—Soothing remedies: These can be used when the parts are inflamed and raw. Lead and opium wash, or boric acid, or linseed oil, or starch, or cocaine, and zinc stearate with boric acid. This form of zinc adheres to the parts when rubbed on, and is thus more valuable.

[DIGESTIVE ORGANS 145]

4. The following is good to dust in the parts:—

Boric Acid 2 drams Stearate of Zinc 2 drams Talcum 1 dram

Apply as a dusting powder.

5. The following is good for the raw parts:—

Carbolic Acid 1 scruple Menthol 10 grains Camphor 10 grains Suet enough to make 1 ounce

Mix. Apply freely two or three times daily after cleansing the parts. Melt the suet and when partially cold, add the other ingredients.

6. The following is good for the itching and to heal the raw surfaces:—

Carbolic acid 1 dram Zinc oxide 1 dram Glycerin 3 drams Lime water 8 ounces

Mix and apply once or twice daily to relieve the itching.

7. Carbolic acid 1 dram Calamin prep 2 drams Zinc oxide 4 drams Glycerin 6 drams Lime water 1 ounce Rose water enough to make 8 ounces

Mix. Keep in contact with the itching area by means of gauze or cotton while the itching is intense.

8. For injections into the rectum for rawness of the mucous membrane, the following is well recommended. Use three drams of this at one time.

Fluid extract Witch Hazel 2 ounces Fluid extract Ergot 2 drams Fluid extract Golden Seal 2 drams Compound tincture Benzoin 2 drams Carbolized Olive or Linseed Oil 1 ounce Carbolic acid 5 per cent

Mix and shake well before using.

9. For the same purpose:— Ichthyol 1 dram Olive oil 1 ounce

Mix and apply in the rectum on a piece of cotton.



[146 MOTHERS' REMEDIES]

PILES. (Hemorrhoids).—Hemorrhoid is derived from two Greek words, meaning blood and flowing with blood. "Pile" is from a Greek word meaning a ball or globe. Hemorrhoids, or piles, are varicose tumors involving the veins, capillaries of the mucous membranes and tissue directly underneath the mucous membrane of the lower rectum, characterized by a tendency to bleed and protrude. They were known in the time of Moses.

Varieties.—There are the external (covered by the skin) and the internal (covered by mucous membrane).

Causes.—Heredity. More frequent in males. Women sometimes suffer from them during pregnancy. Usually occurs between the ages of twenty-five and fifty. Sedentary life, irregular habits, high-grade wines and liquors, hot and highly seasoned and stimulating foods. Heavy lifting. Those who must remain on their feet long or sit on hard unventilated seats for several hours at a time. Railway employees, because they take their meals any time and cannot go to stool when Nature calls, causing constipation. Purgatives and enemata used often and for a long time. Constipation is perhaps the most frequent cause: when a movement of the bowels is put off for a considerable time the feces accumulate and become hard and lumpy and difficult to expel. If this hard mass is retained in the rectum, it presses upon the blood vessels interfering with their circulation and by bruising the vessels may induce an inflammation of the veins when the hardened feces are expelled; straining is intense, the mass closes the vessels above by pressure and forces the blood downward into the veins, producing dilatation when the force is sufficient. One or more of the small veins near the anus may rupture and cause a bloody (vascular) tumor beneath the mucous membrane or skin.

External Piles.—Two kinds, venous piles and skin or simple enlarged tags of skin. Venous piles usually occur in robust persons. They come on suddenly and are caused by the rupture of one or more small veins during the expulsion of hardened feces. There may be one or more, and may be located just at the union of the mucous membrane and the skin. Their size is from a millet-seed to a cherry, livid or dark blue in color, and appear like bullets or small shots under the skin. At first they cause a feeling of swelling at the margin of the anus; but as the clot becomes larger and harder, there is a feeling of the presence of a foreign body in the lower part of the anal canal (or canal of the anus). The sphincter muscle resents this and occasionally contracts, spasmodically at first, producing a drawing feeling; later these contractions become longer and more frequent, and there is intense suffering caused by the pile being squeezed, and this suffering may be so great that sleep is impossible without an opiate. Because of the straining, irritation of the rectum and pain in the sphincter, the piles soon become highly inflamed and very sensitive. The clot may be absorbed without any treatment. Occasionally it becomes ulcerated from the irritation, infection takes place and an abscess forms around the margin of the anus terminating in a fistula.

[DIGESTIVE ORGANS 147]

Skin Piles. (Cutaneous).—These are enlarged tags of the skin. They frequently follow the absorption of the clot in the venous piles where the skin is bruised and stretched. There may be one or many and usually have the skin color. These cause less suffering than the venous variety, and sometimes they exist for years, without any trouble, providing care is taken; but when bruised from any cause, such as a kick or fall, sitting on a hard seat, stretching of the parts during stool, or when they become irritated by discharges from the rectum or vagina, they become inflamed and cause much annoyance and pain. When they are acutely inflamed they swell greatly, are highly colored, swollen, painful, and extremely sensitive to the touch and cause frequent spasmodic contractions of the sphincter muscle and may finally result in an abscess. The pain is usually confined to the region of the anus, but may go up the back, down the limbs or to the privates.

MOTHERS' REMEDIES FOR PILES. Sulphur and Glycerin for.—"Equal parts of sulphur and pure glycerin. Grease parts." This preparation is very healing, and will often give relief even in severe cases.

2. Piles, Strongly Recommended Remedy for.—

Extract Belladonna 15 grains Acetate lead 1/2 dram Chloretone 1 dram Gallic acid 15 grains Sulphur 20 grains Vaseline 1 ounce

Mix.

In protruding, itching and blind piles, this ointment will give you almost instant relief. If kept up several days it will promote a cure."

3. Piles, Good Salve for.—"Red precipitate two and one-half drams, oxide of zinc one dram, best cosmoline three ounces, white wax one ounce, camphor gum one dram." It is much better to have this salve made by a druggist, as it is difficult to mix at home. This it a splendid salve and very good for inflammation.

4. Piles, Smartweed Salve for.—"Boil together two ounces of fresh lard and half an ounce smartweed root. Apply this to the piles three or four times a day." This is very healing, and has been known to cure in many cases when taken in the early stages.

5. Piles, the Cold Water Cure for.—"Take about a half pint of cold water and use as an injection every morning before trying to have a movement of the bowels." This simple treatment has cured many cases where the stronger medicines did not help.

6. Piles, Simple Application and Relief from.—"Mix together one tablespoonful plain vaselin and one dram flower of sulphur. Apply three times daily and you will get relief."

7. Piles, Steaming with Chamomile Tea for.—"A tea made of chamomile blossoms and used as a sitz bath is excellent; after using the sitz bath use vaselin or cold cream and press rectum back gently."

[148 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Piles.—What to do first.—The palliative treatment of both varieties of external piles is the same. In all cases the patient should lie flat on his back in bed and remain there for a few days. Highly seasoned foods and stimulants, tea, coffee, whisky, wine, etc., must be discarded. Secure a daily half liquid stool by the use of small doses of salts, Hunyadi or Abilena water. Cleansing the parts with weak castile soap water is essential to allay the pain, reduce the inflammation and soothe the sphincter muscle; cold, or if it is more agreeable, hot applications may be kept constantly on the parts. Hot fomentations of hops, smartweed, wormwood, or poultice of flaxseed, or slippery elm, or bread and milk give almost instant relief in many cases; while in others soothing lotions, and ointments or suppositories are needed.