[INFECTIOUS DISEASES 241]

Treatment.—The main treatment is the isolation and segregation of all lepers from contact with the well; wholesome laws are enforced in some countries where leprosy prevails, and provision is made not only for the isolation and segregation, but also for their care. On account of its relative variety America has not yet awakened and legislation only forbids the entry of infected persons. At Molokai, in the Hawaiian Islands, provision is made for the care of lepers. Many of the public hospitals for the care of the sick poor refuse to receive lepers. The child of a leprous woman should be removed from the mother after birth and not nursed by another woman. No medicines are known to have any curative effect. An immediate change of residence and climate should be made if the patient happens to live in a district where the disease prevails. A highly nutritious diet should be taken.

The outlook.—The future is in general dark for the leper. It is often of a malignant character, and a fatal result is the rule. A change of climate and conditions may help. Scandinavian lepers who have removed to the United States have been greatly benefited by the change, but there is no known cure. The isolation should be as effective as that for tuberculosis. It is not contagious but infectious.



HYDROPHOBIA.—Rabies and hydrophobia are two different terms, meaning the same disease, the former meaning to rage or become mad. This term applies more especially to the disease as it exists in the maniacal form in the lower animals, while hydrophobia comes from the Greek, meaning "dread of water." As we occasionally find this dread of water only in the human subject, the term is properly used in such a case. The lower animals frequently attempt to drink water even though the act brings on a spasmodic contraction of the swallowing (deglutitory) muscles. Hydrophobia is an acute infectious disease communicated to man by the bite of an animal suffering from rabies. It is due to a definite specific virus which is transmitted through the saliva by the bite of a rabid animal. Its natural habitat (location) is the nervous system, and it does not retain its virulence when introduced into any other system of organs. It is essentially a nervous disease and transmitted by the saliva of rabid animals. When inoculated into a wound this virus must come in contact with a broken nerve trunk in order to survive and reproduce itself. If by accident it attacks the end of the broken nerve trunk, it slowly and gradually extends to the higher nerve centers and eventually produces the disease.

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The incubation, or the time it takes for the disease to develop, varies, but usually is from three to six months. There is a recorded case where the person began to show symptoms of the disease thirteen days after having received a severe wound on the head. The incubation period is seldom longer than six months. The symptoms of the disease in the human being vary within narrow limits. There are three classic symptoms usually encountered, and these are fear, apprehension or excitement, together with deglutitory (swallowing) spasms, terminating in general paralysis. The patient remains conscious of his agony to the end, but the period of illness is of short duration, lasting from one to three days.

The bites of rabid dogs cause ninety per cent of the cases in man and animals. The cat is the next important factor in spreading the disease and about six per cent of the cases are caused by this animal. For other cases four per cent come from bites of horses, wolves, foxes, etc. The wolf in Russia, or other animals like it, may be the chief cause there; but dogs cause ninety per cent, taking all the cases found. Man, dog, cat, horse, cattle, sheep, goat, hog, deer, etc., are subject to the disease either naturally or experimentally. The disease is confined commonly to dogs, because the dog naturally attacks animals of his own species and thus keeps the disease limited mainly to his own kind. Naturally the dog follows this rule, but on the other hand, in the latter stages of the disease he usually goes to the other extreme and even attacks his own master, etc. The dogs that are the most dangerous and do the greatest damage are of the vicious breeds.

The rabbit or guinea pig is used for demonstration in the laboratory. Guinea pigs respond to the virus more rapidly than do other animals and therefore they are especially useful in diagnostic work. Rabbits, however, on account of the convenient size and ease with which they are operated upon, are usually the choice in the production of material used in treating patients.

The director of one Pasteur Institute says, "We have two classes of patients to deal with in the Pasteur institute. The larger class, of course, are those inoculated by the bite of rabid animals, but we also have a few who are infected by the rabid saliva accidentally coming in contact with wounds already produced. In these accidental eases the disease is almost as likely to result as in those to whom the virus is directly communicated by the bite." The wounds considered most dangerous are the recent fresh wounds. The possibility of infection decreases with the formation of the new connective tissue which protects the ends of the broken nerve fibres. One must remember, however, that wounds over joints, especially on the hands, are likely to remain open for some time. A dog ill of this disease can give the disease to man through licking a wound. Such a case has been recorded. This dog licked the child's hands before it was known to be mad. The child died from the disease. As stated before ninety per cent of the cases are inoculated by the bites of rabid animals.

[INFECTIOUS DISEASES 243]

The wounds are considered according to their severity and location. Lacerating, tearing wounds upon uncovered surfaces, especially the head, are the most dangerous. This is due to the fact of the closeness of the brain and the large amount of infection in such a wound, and for this reason treatment should be immediately given. But smaller wounds should also be treated for the smallness of the wound furnishes no sure criterion as to the future outcome of the disease. All possible infections should be regarded as dangerous when considering the advisability of taking the Pasteur Treatment. The small wound has usually a longer period of incubation, because of the small amount of infection, still it may cause a fatal termination. A dog never develops rabies from a lack of water or from being confined or overheated during the summer months. A spontaneous case of rabies has never been known. It must be transmitted from animal to animal and the history of the case will point to a previous infection by a diseased animal.

Where rigid quarantine rules exist the disease does not occur. In Australia they quarantine every dog, that comes to that country, for six months, and in consequence they have never had a case of rabies. In Russia they have had many cases. In Constantinople the disease frequently "runs riot." France has lost as many as 2,500 dogs in one year. Before the Pasteur Treatment was instituted (in 1885) there was an average of sixty deaths in human beings in the Paris hospitals.

Belgium and Austria average one thousand dogs annually. There was a yearly average in Germany of four hundred dogs, dying of rabies, until the law requiring the muzzling of dogs was strictly enforced and since that time the disease is practically unknown. We do not have strict quarantine laws against dogs, and the result is death from hydrophobia in many states annually. It was formerly believed that rabies was a hot weather disease. The number of cases during the winter months of late years has disproved that belief, for the records of the institute for treatment of hydrophobia at Ann Arbor have shown a decrease of cases during the summer months. This was before 1908. This shows that rabies is not a hot weather disease.

[244 MOTHERS' REMEDIES ]

Ordinarily cases of rabies occur here and there (sporadic), but if the conditions are favorable epidemics break out. One dog may bite several dogs and these dogs bite others and thus spread the disease to many. Not every animal bitten by a mad dog develops the disease. The disease does not always follow the bite. Only about forty per cent of all animals bitten by a mad dog contract the disease. This is given by a noted authority. Statistics also show that in man the disease develops in only about twenty per cent of the cases in those who have been bitten by rabid dogs. But in dealing with those who have been bitten such measures should be taken as would be if they were certain of developing the disease; one cannot tell how much poison enters the system in such cases and preventive procedures should be taken. There are reasons why everyone who is bitten does not contract the disease.

The location and character of the bite must be considered. Bites on the head, neck and hands have been recognized as more dangerous, from early times, and such bites produce fatal results quicker than do bites on other parts of the body, and the reason is largely due to the fact that the other parts of the body are more or less protected by the clothing, and this clothing prevents the entrance of so much poison into the system. Bites on the head give a high mortality rate and are rapidly fatal. The close proximity to the brain is one reason.

The part the clothing plays in protection is clearly shown by the following quotation from an eminent authority: "In India where the natives dress very scantily, the mortality was exceedingly high up to a few years ago, at which time the British introduced the Pasteur laboratories. The clothing protects the body and it holds back the saliva and can be looked upon as a means of filtering the saliva of the rabid animal, most of the saliva is held back as the teeth pierce the clothing, so that upon entering the flesh the teeth are practically dry, and only a portion of the virus is introduced. Upon entering the wound this small amount of virus is further diluted by the tissue juices to the non-infectious point. We know from actual experimental work in the laboratory that the higher dilution will not kill."

If a portion of the brain of an animal dead from street virus is taken and made up in a dilution of one to five hundred, and this is injected, we find that it does not produce death. But a dilution of one to three hundred will invariably kill. This is practically what very often happens when one is bitten through the clothing. The saliva may be filtered and held back so that a small amount is introduced; perhaps a dilution of one to five hundred of the virus may get into the wound, but this is usually not enough to cause the disease. There is no possible way of estimating the amount of the inoculation. In such cases one's chances of never contracting the disease are only decreased; that is all we can say.

The treating of individuals, bitten by rabid animals, in the Pasteur Institutes, is simply the practical application of results obtained by Pasteur from his original work on rabies virus. Pasteur was a French chemist living in Paris, and he began his search for the cause and cure of rabies in 1880. He hoped to find a sure method of preventing the development of the dread disease, even if he could not find a cure for it after it had developed. While he was pursuing this research Pasteur had access to the cases of rabies in the Paris hospitals, and these numbered sixty each year. He had practically an unlimited supply, for France could furnish him with twenty-five hundred more mad dogs, and a large number of other animals each year.

[INFECTIOUS DISEASES 245]

Pasteur devoted the remainder of his life to the study of this subject. He collected some saliva from the mouth of a child, on December 11, 1880, who had died at the Hospital Trousseau four hours before. This saliva he diluted with distilled water, and this mixture he injected into rabbits, and they all died, and the saliva taken from these rabbits when injected into other rabbits caused their death with rabies. He found also that saliva from rabid dogs almost always caused the disease. The incubation period varied within wide limits, and very often the animals lived. He then used the blood of rabid dogs for inoculation, but these blood inoculations always failed to produce the disease. Pasteur was convinced after careful study of rabid animals during the many months necessary to complete his experiments, that rabies was a disease of the nervous system, and that the poison (virus) was transmitted from the wound to the brain by the way of the nerve trunks. Then to prove his theory Pasteur removed a portion of the brain of a dog that had died of rabies. A part of this was rubbed up in sterile water and used to inoculate other animals; and subcutaneous inoculations with this material almost always produced death.

After this Pasteur tried a new method and injected directly into the nervous system, either into the nerve trunk or directly into the brain, after trephining, and all such injections produced rabies in the injected animal and death. He also found that rabbits inoculated in the brain always died in the same length of time. When he injected into the nerve trunk the inoculation period was longer, depending upon the distance from the brain. Two problems now remained for Pasteur to solve, and these were, how could he obtain the definite virulence and how could he reduce the virulence regularly and gradually, so that it could be used by inoculation safely as a vaccine to produce immunity to rabies in healthy animals, and also to prevent the development of rabies in animals bitten by rabid animals. He first tried successive inoculations. These inoculations were made, after trephining, directly to the brain, and he used a portion of the brain as a virus each time. He inoculated rabbit number one with a portion of brain taken from a rabid dog, and this rabbit died on the fifteenth day. He then inoculated rabbit number two with a portion of the brain of rabbit number one; from the brain of rabbit number two the virus was supplied for inoculating rabbit number three, and thus the brain of each inoculated rabbit was taken, after its death, for material to inoculate the next rabbit in the series. This experimentation showed him that each rabbit in the series died a little sooner, showing that the virus was becoming more virulent, till no increase in activity of the poison was shown after the fiftieth successive inoculation. "Rabbits inoculated with a brain suspension of rabbit number fifty all died in seven days." This caused Pasteur to name the virus of number fifty "virus fixe," a virus of definite length. He now had obtained a virus of definite strength and the next question was, how could the virulence be gradually and definitely reduced.

[246 MOTHERS' REMEDIES]

This he accomplished after many experiments. He proved that pieces of the "medulla oblongata" suspended in sterile tubes which contained fragments of caustic potash, steadily and gradually reduced their virulence as they dried, till the fourteenth day, when they were practically inert. New specimens were prepared each day and cords which had dried in one day Pasteur called "one-day virus;" cords which had dried in two days, "two day's virus," and so on up to the fourteenth day. With this graduated virus he now experimented on dogs, and the injection he used on the first day consisted of an emulsion of fourteen-day virus; for the second day, the thirteen-day virus, thus using a stronger virus each day, until on the fourteenth day he used the full strength virus. This treatment produced what is called immunity in the dog, and even the direct inoculation into the brain of the strong virus would not produce death.

After Pasteur had thoroughly satisfied himself by repeated trials, he announced his wonderful discovery, and it was in 1886 that Pasteur considered the preventive inoculation in human beings as resting upon a satisfactory experimental basis. During these five years this eminent man proved that it was possible to protect or immunize the lower animals, rabbits and dogs, against inoculation with the virulent virus.

The efficiency of this immunity was given trials by different methods of inoculation. It was found that sixty per cent of dogs inoculated under the "dura" (a membrane of the brain) were saved if treatment was given the second day. This test is more severe than is required to meet the ordinary infection of rabies. Pasteur, after a series of these final tests were so convincing, prescribed the preventive inoculations in human beings and on July 6th, 1886, the first human patient received the first treatment of his series of inoculations.

The method of obtaining the attenuated virus used in the treatment is as follows: A rabbit is inoculated by the brain method before described, each day, with suspension of the fresh, fixed virus. These rabbits die in six days after the inoculation. In this way a rabbit dies each day; the spinal cord is removed, divided into sections, and suspended in a flask containing potassium hydrate. The action of potassium hydrate is drying (desiccating). A series of these cords, which have been hung on fourteen successive days, are always kept in stock for the treatment of patients. The virus becomes less active with each successive day of exposure to drying (desiccation) and finally the virulence is altogether lost.

When the patient comes for treatment the fourteenth and thirteenth-day cords are used for the first inoculation, and on each successive day the patient receives inoculation, the strength of which has been regulated by the number of days the cord has been hanging. During the first four days patients receive injections of six cubic centimeters of emulsions made from cords aging from fourteen to seven days, and from the fifth day until the completion of the course of treatment patients receive emulsions from cords of higher immunizing properties, but no cords desiccated for less than four days are used.

[INFECTIOUS DISEASES 247]

Death rate from 1878-1883 before Pasteur treatment was instituted taken from documents in the department of the Seine:

1878 143 bitten. 24 deaths. 1879 76 " 12 " 1880 68 " 5 " 1881 156 " 22 " 1882 67 " 11 " 1883 45 " 6 "

Average of one death to every six bitten, or seventeen per cent mortality.

Incubation period from eleven days to thirteen months, average one hundred and twenty days, depending upon location of bite. Pasteur Institute records during the years 1886-1887 and first half of 1888, show that Pasteur had under his supervision 5,374 persons bitten by animals either proven or thought to have been mad. Mortality for 1886 was 1-34 per cent, during 1887 it was 1-12 per cent, during 1888 it was 77/100 per cent. With the later treatment the mortality has decreased to 3-10 per cent in 1908. The Pasteur method of treatment is a process of immunization which must be completed before the development of the disease. It is of no value after the symptoms have appeared.

Those who have not been affected can be immunized the same as those who have been bitten. The individual who has been bitten by a mad dog realizes when and how severely he has been bitten, and were it not for the so-called period of latent development of the virus, it would not be possible to carry out the Pasteur treatment. The patient may, if he will, take advantage of this fact and be immunized by treatment before the disease has developed. Deep and severe bites are most dangerous, but the disease may develop simply from a rabid dog licking a scratch of the skin. As before stated bites on exposed or uncovered surfaces, are more dangerous than those through clothing. There is a very easy access of the saliva to the wound in the unprotected part, while in the protected parts the teeth in passing through the protection, clothing, are freed of their saliva at least partially. The virus is conveyed from the bitten part or inoculation to the central nervous system through the nerve trunk, and the rapidity of extension depends upon the resistant powers of the patient, the virulence and the amount of virus deposited in the bitten part at the time the person was bitten. This disease develops only in nerve tissues. Virus can be found in the nerves of the side bitten, while the corresponding nerves on the opposite side are free from it. It can be ascertained that the virus is present in the medulla oblongata before the lower portion of the cord.

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Comparative danger.—A wound of the hand after a delay of three weeks is as dangerous as a bite on the head exposed only a few days. There is always a possibility of an accumulative action and extension of the virus along the nerve trunk to the central nervous system during the interval of exposure, and this should be always borne in mind. It is stated by authority that the virus is not transmitted by the bite of a rabid animal until two days previous to the appearance of the first symptoms. It is with some difficulty that a decision is reached in advising patients who are bitten to take treatment early in the course of the disease. The symptoms are often so very obscure and slight that they are not recognized. If a dog which is not naturally vicious suddenly bites without any cause it should be tied securely and watched for seven days; and should it develop symptoms of the disease during this period the bite should be considered dangerous.

Immediate treatment of the wound.—A temporary measure is the cauterization of the wound; do not neglect this because a few hours have passed since the person was bitten, for wounds may be cauterized with advantage even after two or three days have elapsed. Of course the earlier it is done the better. If they are thoroughly laid open and scrubbed it is more effective. Nitric acid used freely is the best method to use. Wash the wound freely with boiled water after the acid has been applied; ninety-five per cent carbolic acid may be used if nitric acid cannot be obtained.

If carbolic acid is used it is necessary that it be washed from the wound by the free use of absolute alcohol, followed by boiled water and a dressing of bichloride of 1-7000. This prevents the ulceration of the wound by the carbolic acid. Cauterization thoroughly done destroys a part of the inoculated virus. Thorough cauterization is especially necessary with large wounds in which large quantities of the virus is inoculated.

When to send patients to an Institute.—Send them immediately, if there is good reason to believe the animal had rabies. It is not wise to wait until the animal dies; it is very important that treatment is begun as soon as possible, especially in severe bites.

What to send for examination.—The entire head may be sent by express, or better, the health officer should bring it in person. This saves time and relieves anxiety; or a portion of the brain may be removed under thoroughly clean conditions and placed in a sterilized twenty per cent solution of glycerin and water. In this way the virus retains its virulence and putrefaction is diminished. The first method is the best, taking the head directly. The head after it reaches the laboratory is examined microscopically for "negri bodies," and if there is no contamination the microscopic findings are verified by animal inoculations. The presence of negri bodies in a specimen is of great value owing to the rapidity with which a diagnosis can be made. In one case a positive diagnosis was reported within twenty minutes after the specimen entered the laboratory and within the next hour and a half the patient bitten by the dog the same day had begun her course of protective injections and was saved.

[BLOOD AND DUCTLESS GLANDS 249]

Protection.—To stamp out this disease city authorities, etc., can enact laws. All ownerless dogs should be killed, and the keeping of useless dogs should be discouraged by taxation. All dogs should be thoroughly muzzled where the disease prevails. This article is made up from an article written by an acknowledged authority on this disease, a man in charge of a Pasteur Institute.

Cities where Pasteur Institutes are located: Ann Arbor, Michigan. Baltimore, Maryland. Chicago, Illinois. Austin, Texas. Minnesota. Toronto, Ont. New York City.



DISEASES OF THE BLOOD AND DUCTLESS GLANDS.

Anaemia, or Anemia.—This may be defined as a reduction of the amount of blood as a whole or of its corpuscles, or of certain of its more important constituents, such as albumin and haemoglobin. Primary or essential anemia includes chlorosis and pernicious anemia; secondary anemia results from hemorrhages, poor nourishment or intoxications, poisons. Chlorosis, a primary anemia chiefly of young girls, characterized by marked relative decrease of haemoglobin.

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

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

[250 MOTHERS' REMEDIES]

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

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

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

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

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

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



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

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

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

[BLOOD AND DUCTLESS GLANDS 251]

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

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

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

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

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

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

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

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

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

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

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

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

Treatment.—The same as for Pernicious Anaemia.



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

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

[BLOOD AND DUCTLESS GLANDS 253]

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

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



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

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

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

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

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

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

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



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

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

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

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

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



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

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

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

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

[BLOOD AND DUCTLESS GLANDS 255]

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

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

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

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

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

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

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

[256 MOTHERS' REMEDIES]

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

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

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

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

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

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

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

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

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

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

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

3. Blood Purifier, Herb Tea Used as.—

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

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

[BLOOD AND DUCTLESS GLANDS 257]

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

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

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

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

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

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

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

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

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

[258 MOTHERS' REMEDIES]

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



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

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

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



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

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

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

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

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

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

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



[BLOOD AND DUCTLESS GLANDS 259]

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

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

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

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

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

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

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

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

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

Mix thoroughly and shake bottle before using.

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

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

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

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

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

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

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



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

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

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

[BLOOD AND DUCTLESS GLANDS 261]

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

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

Symptoms.—Are the same as that of cretinism.

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



DISEASES OF THE NERVOUS SYSTEM.

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

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

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

[262 MOTHERS' REMEDIES]



[NERVOUS SYSTEM 263]

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

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

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

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

4. Neuralgia, Four Ingredient Remedy for.—

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

Beat egg and stir all together."

5. Neuralgia, Good Liniment for.—

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

Mix and shake well before using."

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

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

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

[264 MOTHERS' REMEDIES]

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

1. For the Cure of an Attack—

Antipyrine 30 grains Citrate of Caffeine 20 grains

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

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

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

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

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

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

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

[NERVOUS SYSTEM 265]

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

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

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

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

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



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

[266 MOTHERS' REMEDIES]

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

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

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



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

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

NERVOUS SYSTEM 267

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

(See Mothers' Remedies under Neuralgia above).

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

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

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

3. Nervousness, Effective Remedy for.—

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

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

[268 MOTHERS' REMEDIES]

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

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

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

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

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

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



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

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

[NERVOUS SYSTEM 269]

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

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

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



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

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



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

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

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

Wet the top of the head with it.

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

Shake the bottle and apply a little of the liquid to the place. Horseback riding and walking are good for nervous girls and women.



NEURALGIC HEADACHE.—This commonly comes periodically, usually, one- sided. It may occur at the same hour for several days in succession. The pains are of all kinds. It may start in the morning or at any time. It involves more especially the eyes, side of the head, face, and goes into the teeth and neck. It comes in persons subject to neuritis in other parts or neuralgia.

Treatment.—Build up the system with tonics in the interval. Lead a quiet restful life. Acetanilid in five-grain doses frequently relieves it. This is a dangerous medicine to use, except under a doctor's supervision. Spigelia in doses of one-twelfth of a drop of the tincture is good for left-sided attacks; two doses are enough, one-half hour apart.



STOMACH OR GASTRIC HEADACHE.—This, as the name indicates, is due to some acute or chronic trouble with the stomach. It is caused by over-loading the stomach, or eating food that does not agree, such as fat meat, gravies, starchy food, warm bread, pastry, etc., or it may be due to dyspepsia. The tongue is generally coated, the mouth tastes bitter. If it is acute and the stomach is full, take a common emetic like warm water, salt water or mustard water. If it is due to decomposed food, drink lots of warm water and take an enema and also a dose of salts. If there is much gas in the stomach, take some baking soda in a glass of warm water; one drop doses of tincture of nux vomica every half hour for three hours often relieves.

[NERVOUS SYSTEM 271]

HEADACHE FROM CONSTIPATION.—This is frequent. There is generally a dull, heavy feeling in the forehead, the head feels full and sometimes dizzy, the patient feels blue and morose, the tongue is coated on its back part, mouth tastes bitter, patient is drowsy and stupid and work goes hard. A free passage from the bowels relieves the headache.

Treatment.—Cure the constipation as directed in another part of the book. Take a good full enema of warm soap suds and water, and one drop of tincture of nux vomica every hour for six hours during the attack.



BILIOUS HEADACHE.—This is so-called because the bilious symptoms are the most prominent. It may be caused by violent anger, disputes, excessive eating causing congestion of the liver; abuse of spirits; some persons are of a bilious constitution and the least error in diet and habit produces such an attack. The pain may be violent or dull, the head may throb terribly; the whites of the eyes have a yellowish look, and the face may be of a dark brown hue, the patient may vomit bile. The vomiting causes more brain distress. The mouth is bitter, the tongue coated yellowish, the breath smells badly. Bowels may be irregular.

Treatment.—A free movement of the bowels often relieves. First take an enema and then one-half ounce of epsom salts. Do not eat anything but drink all the water you may wish. A tea made of blue flag is often of benefit. The diet should be regulated so as not to overload the stomach and liver and the bowels should move freely daily.

WOMB HEADACHE.—Women who suffer from womb troubles such as leucorrhea, torn cervix, falling womb displacements and diseases of the inner womb, ovaries and tubes, suffer from all kinds of headache. The pain may be in the nape of the neck, the back part of the head and on the top behind (occiput). It may come on suddenly when the womb is displaced by a sudden fall or over-lifting, etc. The woman should then go to bed and lie down with her arms crossed over her chest, with the knees drawn up and weight resting upon them and chest with the buttocks elevated, (knee-chest- position). This replaces the womb. The other troubles should be corrected or these headaches will keep on. The womb and its appendages are the cause of many kinds of headaches, neuralgias, dyspepsia, and constipation; correct the troubles and the headache will disappear.



MENSTRUAL HEADACHES.—These are very common. They may be regular every month, and they are then caused by some trouble with the womb or ovaries, or may be due to a run-down condition or heredity. It comes sometimes from suppression of the menses as a consequence of some violent emotion, fright, anger, grief, or by exposure to wet, draughts of air, privations, over-fatigue, etc. It may last for several days. The headache may be mild or severe.

Treatment.—A foot bath or sitz bath is very good, with free drinking of pennyroyal tea after the bath, and when in bed. Place warmth to the feet, moist heat over the abdomen, such as a hot water bag or fomentations. Remain quietly in bed. If constipated, take an enema. Frequently a free bowel movement gives much relief in this trouble. During the interval doctor the patient for the trouble causing the headache for which see another part of this book, "Diseases of Women."

[272 MOTHERS' REMEDIES]

MOTHERS' REMEDIES, 1. Headache, Paregoric and Soda for.—"A teaspoonful of paregoric, with one-half teaspoonful of baking soda in a tumbler of water, May be taken all at once or sipped slowly."

2. Headache, Hops Good for.—"Make a strong decoction of hop tea, and take a wineglassful every half hour until relieved." This is an old tried remedy and a good one.

3. Headache, Mustard Excellent for.—"Place a mustard plaster on the back of the head, also bathe the feet in mustard water and stay in a darkened room, and avoid all excitement and noise." The one essential thing is to get the nerves quieted; take as little food as possible for twenty-four hours, giving the stomach an opportunity to rest, as most of the headaches come from a disordered stomach.

4. Headache, Peppermint Beneficial for,—"Bathe the head in strong peppermint. Then apply cloths wrung from water as hot as can be endured." Hot or cold applications are known to be very beneficial. After the cloths are taken off, the soothing effect can be further enhanced by gentle rubbing of the forehead.

5. Headache, Cold Application in Case of.—"Apply cold applications on the forehead and over the eyes." These cold applications have been known to give relief in a very few minutes to many people suffering with severe headaches. It is well to continue the treatment; even after relief has been obtained, for at least a half hour. Gentle rubbing of the head is very good, also.

6. Headache, Castor Oil Will Relieve.—"One tablespoonful of castor oil. Have used this and found relief." This remedy gives relief as the castor oil carries off the food that is distressing the stomach. It is well to take two tablespoonfuls of lime-water in a glass of milk three times a day for about a week after the castor oil has operated.

SICK HEADACHE. (Migraine. Hemicrania).—Migraine is a peculiar form of severe paroxysms of unilateral (one side) headache often associated with disorders of sight.

Causes.—It is frequently hereditary, and it has occurred through several generations. Women and members of nervous families are usually attacked. Many of the headaches from eye-strain are of this type, It is often inherited, and may last from puberty to the menopause. Some authors claim that decay of the teeth without toothache will cause it. Adenoid growths in the pharynx and particularly abnormal conditions of the nose will cause it. Many of the attacks of severe headaches in children are of this nature, and the eyes, nose and throat should be examined when children or older persons suffer from this complaint. Mental emotion, physical or mental fatigue, disorders of the female genital organs, eye-strain, etc., loud noises, toothache, act as predisposing causes. Some think it a poisonous condition due to the absorption of poisons from the stomach and intestines, and others regard it as a nervous condition due to anemia and all conditions which weaken the resistance of the nervous system.

[NERVOUS SYSTEM 273]

Symptoms.—The premonitory symptoms, which may last a few hours or a day or more, are sleepy feelings of discomfort, uneasiness, weariness, chills, vertigo (dizziness), disturbance of the sight or disturbances of the senses. The real attack may follow quickly, beginning with the characteristic headache, at first one sided, located in one spot in the temple, eye or back of the head, but spreading, as it increases in severity, until it involves all of one side of the head and occasionally both sides. The pain is usually constant and of great severity and it is increased by motion, noises, light, or mental strain. The skin over the painful part is very sensitive. There are loss of appetite, nausea and vomiting. If the stomach has a great deal of food in it, vomiting relieves the pain sometimes. In the spasmodic form the affected side is painful, the skin is cool, the pupil is dilated, and the flow of saliva is increased. In the paralytic form the affected side is flushed, hot, the vessels are dilated and the pupils are contracted. There is great weakness, prostration and depression. The urine may be abundant or suppressed, temporarily. The results of treatment in this disease are uncertain, as the attacks are likely to occur in spite of treatment. They usually cease in old age, and in women they may stop after the menopause. The attacks in women are likely to occur at or near the menstrual periods.

First Thing to do in Sick Headache.—It is well to remain in a darkened room away from noise, etc. If the head throbs and beats very hard, either a cold ice bag or hot applications often bring relief. A mustard plaster at the base of the brain with a hot foot-bath often helps. Some people by stroking the forehead and temples have the power to ease the pain, producing quiet and sleep. If the bowels are costive, salts should be taken to move them, or they can be moved by an enema, if salts are not at hand. If the stomach is full, or tastes sour, drink a lot of warm water and vomit, or produce vomiting by tickling your throat with your finger, after having taken a large quantity of warm water for sometimes warm water thus taken fails to cause vomiting. If there is no food in the stomach, but there is sour and bilious vomiting, the warm water will frequently help. For a sour stomach or when it is full of gas, a teaspoonful of baking soda in some hot water will often feel very pleasant and grateful. The patient should keep absolutely quiet after these are done, and often they fall into a refreshing sleep.

[274 MOTHERS' REMEDIES]

EMERGENCY MEDICINES.—If anemia is the cause, give tonics such as iron and arsenic. If the patient feels faint and nauseated, a small cup of strong hot coffee gives relief, sometimes. Antipyrin, given early in doses of two and one-half grains often relieves. Take another dose in one-half hour if necessary. But such remedies are hard on the heart.

TREATMENT. Preventive in Sick Headache.—The patient is often aware of the causes that bring on an attack. Such causes should be avoided. A great many people who are afflicted with this trouble are not only careless in their eating, eating anything and everything and at all times—at meal time and between meals—but also careless in their habits of life. Patients should avoid excitement, like card parties, etc., staying up late, or reading exciting books. The meals should be regular, no food taken that is hard to digest. Pies, cakes, puddings, gravies, ham, pork, sausage, and fried foods must be avoided. Rich, greasy foods will not do for such persons to eat. Strong tea and coffee are bad. Plenty of water should be taken between meals. At meals it is better to take no water unless it is hot water. Every morning on arising it is well to drink a large quantity of either cold or hot water. This washes out the stomach, bowels and kidneys, and stimulates them to better perform their functions. The bowels must be kept regular, one or more passages a day and at a regular hour. Sometimes, especially in younger persons, the eyes are at fault and may need glasses. Frequently it is caused by overwork in school in young girls, especially during their menstrual periods. Social duties cause them in many women, and then strong tea or coffee, or headache powders, or tablets, are taken to keep up or to stop the pain, making the patient more liable to the attacks in the future; and then still more tea, coffee, and headache remedies are taken until the patient is a slave to the remedies taken to help her. A great many of these headaches can be helped by simple measures, and the time between the attacks, in about all cases, made longer if the patient will but work with the physician, not only at the time of the attack, but in the interval. The clothing should be comfortable. The feet should always be kept dry. This applies especially to neuralgia. In fact the above measures of prevention and care apply to all kinds of headaches and neuralgias. Prevention is worth more than the cure.

MOTHERS' REMEDIES. 1. Sick Headache, Hop Tea Will Relieve.—"Hop tea is very good if a good strong decoction is made. A wineglassful may be taken every half hour or hour until relieved." This is very easily prepared, as the hops may be purchased at any drug store.

2. Sick Headache, a Favorite Remedy for.—"Aconite liniment or aconite rubbed on the forehead will relieve the pain in the head almost instantly. One drop of the tincture of nux vomica in a teaspoonful of water every five or ten minutes will quickly relieve." Nux vomica is good only when the headache comes from constipation and stomach trouble and too high living.

[NERVOUS SYSTEM 275]

3. Sick Headache, Aromatic Spirits of Ammonia for.—"For a nervous headache there is nothing better for immediate relief than fifteen or twenty drops of the aromatic spirits of ammonia." This relieves the pain and quiets the nerves and stimulates the heart.

4. Sick Headache, Camphor Application for.—"A very simple but effective remedy is a cloth wet with spirits of camphor and sprinkled with black pepper applied to the head gives almost instant relief."

5. Headache, Soda and Peppermint for.—"One teaspoonful (level) of soda in two-thirds glass of hot water, add five or eight drops of oil of peppermint and a little sugar. Drink quite warm. This has been often tried and proven to be a success." The soda will relieve any gas in the stomach and the peppermint aids digestion and relieves sickness of the stomach.

6. Sick Headache, Lemon Good for.—"One lemon before breakfast will help to keep off sick headache. Have never found a remedy to cure sick headaches. A sack of hot salt will always help the pain." The lemon will help to tone up the stomach and the salt applied to the head will help the pain by relieving the congestion. It is always well to take a good cathartic after a spell of sick headache.

PHYSICIANS' TREATMENT for Sick Headache.—

1. Antipyrine 25 grains Citrate of Caffeine 10 grains Bromide of Potash 25 grains

Mix and make into five powders. One powder as needed. (You might take second one in three hours.) This is not good when it is bilious sick headache. In fact, it would make it worse. It is good for sick headache and neuralgia due to eye or nerve strain, but then the first remedy, antipyrine, can be left out. It is not needed. I would then put twice as much of the bromide of potash, fifty grains, and take a powder every two hours until better.

2. Citrate of Caffeine 1/2 dram (30 grains) Phenacetine 60 grains Bicarbonate of soda 60 grains Aromatic powder 12 grains

Mix and make twelve powders. Take one every three hours. This is good. Sometimes it is depressing on the heart for some people, due to the phenacetine. Acetanilid can be substituted in same dose.