For the irritation of the brain, and furious delirium that sometimes sets in after the cessation of cholera symptoms, _Secale_ and _Belladonna_ in alternation will prove specific.

Let the patient have warm or cold drink as he prefers, and let his covering be light or plentiful as is most agreeable. As soon as he gets easy, and the vomiting and purging cease, and his pulse begins to return, keep him quiet as possible, let the room be darkened and everything still, so that he may go to sleep, which he is inclined to do, this being the surest restorer. I am quite sure I have known several patients carried off by a return of the disease, after it had been effectually arrested, in consequence of sleep being prevented by the rejoicing officiousness and congratulations of friends, disturbing and preventing that early and quiet slumber which nature so much needs, and must have, or hopelessly sink. The diet for two or three days after recovery, should be a little oat meal gruel or rice.

Small Pox--Variola.

This disease begins with pain in the head and back, chilly sensations, followed by a high fever, so similar in all respects to a severe attack of Bilious or "winter" fever, that it is difficult or impossible to distinguish it with certainty, as Small Pox. The fact of the prevalence of the disease at the time, and the exposure of the patient, may lead the Physician and friends to suspect Small Pox. There is one very striking symptom of Small Pox, however, that exists from the beginning, which, though it may be present in fever simply, is not uniformly so.

This is a severe and constant aching _pain in the small of the back_.

The headache is also constant.

The Small Pox is of two varieties or degrees, _distinct_ and _confluent_. The _distinct_ is when the pustules are separated from each other, each one a distinct elevation, with more or less s.p.a.ce between them not affected by the eruption.

The _confluent_ is where the pustules spread out from their sides and run together, covering the whole surface as one sore.

It may be distinct on some parts, as on the body, and confluent on others, as the arms, face, and parts most exposed to the air.

In the _Distinct_ variety the fever continues without abatement until the eruption appears, when it entirely subsides, and that quite suddenly. The eruption comes out about the third day of the attack, sometimes not discoverable until the end of the third or beginning of the fourth day. The eruption is at first very slight, beginning with small red pimples on the forehead, upper part of the cheeks, neck and upper part of the breast, extending by degrees to the arms, and other parts of the body and limbs. About the end of the fourth or forepart of the fifth day, the eruption is complete.

There is a symptom, not mentioned in the books, which will often determine the disease before the occurrence of any eruption. It is the appearance of hard shot-like pimples, to be _felt under the skin_ in the palms of the hands, while there is, as yet, no trace of eruption to be seen upon the surface.

On the eighth or ninth day, the eruptions become vessicular, have flattened tops, and contain a limpid fluid. The parts continue to swell, the eruptions to enlarge, and become filled with purulent matter, having a dark color at the top, up to about the fourteenth or fifteenth day, when they begin to flat down, to dry up, and some of the scabs become loose. At this time, some fever arises, often quite severe, with headache and other inflammatory symptoms. If the eruption is very severe, fever will be of corresponding violence, and lighter or wanting when the eruption is mild. This fever rarely lasts more than twenty-four hours, from which time the patient rapidly recovers.

In the _Confluent_ variety, all the symptoms are more violent, the fever continuing after the eruption begins. The pustules burst early, and run into each other, covering nearly or quite the whole skin; the surface swells and turns black or dark brown, the lungs are more or less irritated, producing cough, and not unfrequently the stomach is nauseated, and vomiting ensues.

If the patient survives the irritation up to the fifteenth or sixteenth day, when the _secondary fever_ sets in, he is liable to be taken off by an affection of the brain or lungs, during this fever. If he recovers, his whole surface, especially that part exposed to air, is deeply pitted.

TREATMENT.

As it is not often known for a certainty, in the early febrile stage, that it is the small pox, the treatment will be first adopted that would be proper for a like fever arising from other causes. But in all my observations in this disease, and they extend to several hundred cases, I have not found in a single instance, any of the ordinary fever remedies, such as _Aconite_ and _Bell._, which would be applicable for such symptoms in an ordinary case, to do any good in small pox. They are directed, however, for these symptoms by the authorities, in the febrile stage of the small pox; but I am quite sure they are not the proper remedies.

From the great similarity, the almost absolute ident.i.ty of small pox _headache_ and _backache_, with the same symptoms developed by the _Macrotys racem._ as well as the nausea and restlessness produced by the drug, I was led several years ago to the conclusion that this, or the _Macrotin_ was valuable in small pox. Not only so, but during the prevalence of small pox in Cincinnati, to an extraordinary degree in the winter of 1849-50, I treated about one hundred cases, including both s.e.xes, and all ages, from infants a few weeks old, to very old persons, giving the _Macrotin_ to all, and had the good fortune to see _all_ my patients recover. Since that time I have prescribed it for every case successfully.

Having then, been entirely successful in so many cases, with this medicine, I am not inclined at this time to give any other the preference. I must admit, however, that though my patients all recovered, I was not able to greatly abridge the duration of the disease, nor to prevent the development of all the stages in their proper order, as is _claimed_ by M. TESTE, for his use of _Mercurius cor._ and _Caustic.u.m_. I was satisfied with so far modifying the symptoms, as to enable my patients to live through, and come _out well in the end_. I would then direct, if small pox is suspected, the patient having been exposed to contract it, or from the peculiarity of the symptoms, in the early stage, or when the disease is discovered after the eruption, to give _Macrotin_ at the first trituration, in one grain doses, once in two hours, while the fever, headache and backache continue, after which, during the whole course of the disease, give it three times a day. This will prevent the development of a dangerous secondary fever, as well as irritation of the lungs, stomach or bowels.

In addition to this medicine I give the patients daily, from half an ounce to two ounces of _pure_ (_unrancid_) _Olive oil_. This serves to prevent the development of pustules in the throat, lungs and stomach; is more or less nutritious, and keeps the bowels in a healthy condition.

Wash the surface once a day in weak soap suds, following it with a bath of milk and water, and keep cloths moistened with warm milk and water, constantly upon all parts that are exposed to the air, lubricating the surface with _Olive oil_ after the bath of milk and water. This keeps the surface quite comfortable.

The best diet is corn or oat meal mush and mola.s.ses, to be taken in small quant.i.ties. Cold water is the proper drink, though it should not be very cold.

The room should, at all times, be well ventillated, but in cold or cool weather, sufficient fire must be kept up, to keep the room warm and dry.

A temperature of about 65 is the best. Hardly any thing can be worse for a small pox patient than to be in a cold or damp room, and to breathe _cold_ air. Uniform temperature is important.

If the eruption is tardy about appearing, or after it is out, a recession takes place, the Alcoholic Vapor bath will soon bring it out.

(See Rheumatism **p. 30).

Occasionally the feet and limbs below the knees, will swell prodigiously, and become extremely painful, causing the princ.i.p.al suffering. For this, wrap the feet and legs in cloths wet in a strong solution of Epsom salts, quite warm, and cover with flannels so as to keep them warm. This will afford immediate relief, and reduce the swelling in a day or two. The finely pulverized Epsom salts, dry, sprinkled on the pustules, will very often prevent pitting. It is the safest and surest remedy of which I have any knowledge.

Varioloid

is small pox modified by vaccination. It is to be treated as a mild case of small pox. The _Macrotin_ has been used with apparent success as a prophylactic (preventive) to small pox, taken three times daily.

Painful Urination, Incontinence of Urine,

_Involuntary Urination._

Where the discharge of urine produces smarting and burning of the urethra, _Cantharis_ is the remedy. Where there seems to be an over secretion of acrid urine, producing inflammation of the neck of the bladder, known by pain in the glans p.e.n.i.s, _Copaiva_, and _Apis mel._ are the remedies. If there appears to be a partial palsy of the neck of the bladder, the discharge taking place in sleep, _Podophyllin_ is the surest remedy. I have cured some bad cases by the use of these three remedies, given in rotation three or four hours apart.

Injections of a solution of borax into the bladder, have, in several cases, been sufficient to effect a perfect cure, without any other remedy. This may be used in connection with the other remedies. For painful urination with a distressed feeling in the neck of the bladder, causing a constant disposition to evacuate urine, the _Althoea Officinalis_ is a certain remedy; it acts like a charm. It is an important remedy for inflammation of the bladder. A good mode of using it is in form of a warm infusion in doses of a table spoonful every half hour or hour, according to the urgency of the symptoms. The _Althoea Rosa_ (Hollyhock) may be used as a subst.i.tute, though it is not as good.

Every family should cultivate the _Althoea Officinalis_ (Marsh Mallow), so that the fresh green root, which is the best, can be procured at any time. I have been able to relieve patients with it, especially females, when all other remedies seemed unavailing. It is particularly useful for urinary difficulties of pregnant females.

Neuralgia.

_Aconite_ and _Bell._ are two important remedies in this affection. If given low, and applied directly along the course of the affected nerves, at full strength of the tincture, they will almost always effect a cure. The proper way to use them is to give them internally at the second dilution, at intervals of fifteen to thirty minutes, when the pain is severe and nearly constant, and apply _Aconite tincture_ as hot as practicable over the course of the nerve, by means of wet cloths, for an hour or two hours, and if the pain has not subsided use _Bell._ locally in the same manner.

If the Neuralgia is periodical, coming on at regular intervals, _a.r.s.enic.u.m_ and _China_ are the remedies, and they should be used externally as directed for the others, both at the first dilution, and given internally at intervals, in proportion to the violence of the symptoms, the _a.r.s.en._ at the 3d and the _China_ at the first dilution.

If the patient has used alcoholic drinks to excess, _Nux_ is to be used in place of a.r.s.enic.u.m.

_Periodical Neuralgia_ generally requires the same treatment as ague. In females when there is uterine disease, _Pulsatilla_ and _Macrotin_ are the remedies to be used, as directed above.

Jaundice.

This disease depends upon derangement of the liver. The skin and whites of the eyes become yellow; the patient grows weak, loses his appet.i.te, is dull and sluggish in all his actions, melancholly and discouraged in his moods.

TREATMENT.

_Mercurius_ and _Podophyllin_ given in alternation, each twice a day, will nearly always effect a cure. If the patient is costive, _Nux_ should be taken at night, until his bowels become regular.

Bathing the surface daily, or oftener, is a very important measure in the treatment of this affection. As often as once in two or three days, an alkaline bath should be taken. If the patient has fever every day, or once in two days, ever so slight, _China_ should be used with _Podophyllin_. If he has been drugged with Mercury in any form, in large doses, even six months or a year before, give _Hydrastin_ in place of Mercurius.

Itch.

I shall say but little about this very common and very obstinate affection. Everybody has a "cure for itch" yet n.o.body cures it short of the use of _Sulphur_ in some form. Though the attenuations of Sulphur may sometimes cure itch, it must be acknowledged that such cures are so rare in this country, and the time requisite to accomplish it is so long, as a general rule, that few will trust them.

The most successful remedy, and the one that will always cure quickly, if at all, is _Hepar Sulphurus Pota.s.sium_, the common Hepar Sulphur (sulphuret of Pota.s.sa) of the shops. To succeed with it most certainly, let the patient be thoroughly bathed with warm soap suds, _quite strong_, in a room at the temperature of 90 to 100, continuing the bathing and _rubbing_ for an hour or more, then dry off the surface with soft cloths, and apply the _Hepar sul._ with water, at the strength of thirty drops of the strong alcoholic solution, with a gill of water, wetting every eruption on the whole surface and let it dry on. This causes some smarting, but it is effectual; it kills the _acarus_, (itch animalcule) and in a few days the sores heal, the itching all subsides immediately. If every pustule has not been touched, those left may continue to itch, in which case, a second application is necessary.

_Hepar Sul._ should be given internally at the third dilution, for a month, once a day, after the baths. Avoid greasy food. For the

Scald Head

of children, where there is a discharge of yellow and watery pus from the sores, and the eruption extends to the ears or face, like the disease called the _crusta lactea_ (milk crust), the same washes as for itch, are the most effectual, while at the same time, and for a month or two, the child should have _Hepar Sul._ 5th at night, and _Petroleum_ 3d in the morning. Daily ablutions of the head with warm soap suds, and keeping it covered, are absolutely essential.

Carbuncle.