This affection, though it somewhat resembles a common boil, and is by some writers considered only such, in an overgrown state, is, nevertheless, far from being identical with it.

While a _boil_ is only a sanitive effort of nature to eliminate the cause of a morbid process, and tends to a spontaneous, healthy termination, the _carbuncle_, on the contrary, is the very essence of disease; its constant tendency being towards the dissemination of diseased action, causing destruction of the parts affected. It, in fact, appears like a parasite, living by the destruction of surrounding tissues, literally absorbing them and "thriving on death." It begins with a red, livid color, slight aching and burning pains, the part swells and is elevated some like a boil, except that it does not "point," but has a broad base rising like a cone and flattened at the top. It feels soft and spongy, and will appear to fluctuate, but if punctured, blood only flows. The pain and burning increases rapidly, and sooner or later several openings appear upon the top, varying from three or four to half a dozen or more, looking like the holes in a sponge, out of which issues a fluid like thin gruel. Instead of becoming easier after the suppuration begins, as is the case with a boil, the burning increases to an alarming and unbearable extent; cold chills, loss of appet.i.te, great depression of spirits, general nervous and muscular debility come on. The tumor continues to discharge, turns purple; gangrene beginning in the carbuncle extends to other parts and death follows.

The disease is nearly always confined to quite feeble persons and those past the meridian of life; but I have seen it on younger though feeble patients. It is generally located on the back, occasionally on the head, where it is very dangerous from its liability to affect the brain.

TREATMENT.

If treated very early, _strong tincture of Arnica_ applied to the surface of the carbuncle, by cloths wet and laid over the tumor, will often arrest it so that the swelling will not be developed to the suppurative stage. However, to reap any benefit from _Arnica_, it must be applied while the pain is not severe, and the parts only feel bruised and tender to pressure, like a common bruise.

After the ulceration occurs, _a.r.s.enic.u.m_ is the great remedy to be relied on. It should be given at the second or third attenuation as often as every three hours, when the pain is severe, and applied to the surface of the carbuncle freely by cloths laid over it, wet in the first dilution, or by sprinkling the first trituration of the oxyde (1-10) freely upon the open surfaces, so that it may penetrate into the open mouths or orifices. Over this powder apply an emolient poultice, or soft cloths wet in water hot as can be endured. This will soon allay or greatly lessen the pain. It should be repeated as often as any of the burning pain peculiar to the carbuncle returns, until the tumor suppurates in a tolerably healthy manner; then lessen the strength of the _Ars._ applications, and continue them until it has the appearance of a healthy abscess, when only simple dressings are necessary. Some may suppose such strong applications injurious, but I can a.s.sure them from abundant experience, that there is not the slightest danger. The carbuncle should _never be punctured_ or _cut into_. Such operations always make them worse, and induce a more rapid approach to gangrene.

The patient should have nourishing food, and good native wine may be taken in moderate quant.i.ties, by a very feeble person, with decided advantage.

Though the knife operations for the removal of carbuncle are always injurious, the chemical effect of _Potash_ is frequently most beneficial. I have, in repeated instances, applied to the ulcerated surface, _caustic potash_ freely, allowing the dissolved caustic to penetrate to the very "core" by running into the orifices. At first it would produce some smarting, but the pain is different from that of the carbuncle, and the change is agreeable rather than otherwise. Soon after the application all pain ceases, and the tumor, under the use of a poultice, begins to slough off in a few days, leaving a raw surface, disposed to heal kindly. Occasionally, however, the healing process is tardy, when _a.r.s.enic.u.m_, at the third, applied and taken internally, will soon effect a cure.

I have occasionally used _Hepar Sul._ with good effect in the latter stage.

Felon--Whitlow.

For this disease, in the early stage, when the sensation is that of sharp, sticking pain, feeling as though a brier or thistle was in the finger, immerse the part in water as hot as possible, into which put common salt as long as it will dissolve; hold it in this _hot_ salt bath for an hour or more at a time, and when removed, apply finely pulverized salt, wet in _Spirits of Turpentine_; bind on the salt with several thicknesses, and keep it constantly wet with the sp'ts turpt. for twenty-four hours, when, if all symptoms of felon are gone, no further treatment is necessary. As a general rule, the hot bath should be repeated three times a day, especially if the symptoms have existed for several days and there is much pain or swelling, and the dressings should be kept on as above directed for several days, more or less, until all symptoms disappear.

I am quite confident that a large majority, if not all, of the cases if thus treated at any time before pus is formed, will be discussed and cured. If pus has begun to form before the treatment is commenced, this will not _cure_ the felon, but it is good treatment, especially the hot bath, as it will greatly lessen the pain.

By holding it in hot water for an hour or two each day, the suppurative process will be hastened, and as soon as the pus can be felt at any point, fluctuating, puncture and let it out; then continue the hot bath, with _Calendula_ (_Marygold_) flowers in the water, keeping the part all the time warm and moist.

For the restless and nervous irritability that frequently occurs, especially in females, _Aconite is the best remedy_. It should be given, one drop of the tincture to a gill of water, in teaspoonful doses, once in one or two hours, and the same applied to the sore.

DISEASES OF FEMALES

Suppression of the Menses, (Amenorrhoea.)

For sudden suppression from taking cold, as by wetting the feet, there being headache, more or less fever, the pulse frequent and variable, pains in the small of the back and cramp like pains in the pelvic region, give, in alternation, _Aconite_ and _Pulsatilla_, as often as every fifteen or twenty minutes in a violent case, and at longer intervals as the patient begins to get easy. Putting the feet into hot water, or taking a hot Sitz bath is very useful. If the patient is sick at the stomach, as is often the case, give lukewarm water freely and let her vomit; after which let her drink freely of water as hot as it can be safely swallowed, adding milk and sugar to make it palatable. The good effects that are often attributed to and experienced from the use of various hot teas in this affection, are, in my opinion, attributable more to the hot fluid alone than to any specific medicinal virtue in the substance of which tea is made. At all events, very _hot_ drink with nothing but water, milk and sugar, is equally efficacious, and my medicine (a few grains of sugar of milk) put into the hot water, seasoned as above, has often obtained great credit, when the _hot water_ was alone worthy. Rubbing the loins and abdomen briskly downwards with the hands of a healthy and vigorous nurse, will often excite the menstrual flow after a sudden suppression. If the head is hot, the face full and red, and the arteries of the neck and temples beat violently, give _Bell._ with _Pulsatilla_, and if the lungs are oppressed, use also _Bryonia_, giving the three in rotation. If, after the menstrual flow begins, there is still much pain in the pelvic region, give _Caulophyllin_, which will immediately afford relief.

_Apis mel._ is very servicable in suppressed menses of several days, or even weeks duration, where there is fever, redness of the face, and pain in the head, and pains in the hips extending to the limbs, especially if there is any tendency to bloating of the abdomen and swelling of the limbs or feet. It acts _promptly_ and _efficiently_.

If the suppression has been caused by sudden fright or any strong mental emotion, _Veratrum_ should be given in connection with the two former medicines. Should there be great fullness of the vessels of the head, or bleeding at the nose, _Bryonia_ with _Pulsatilla_ are to be used.

_Bell._ is also useful in this case if the pain in the head is throbbing, especially if any delirium is present.

For suppression in young females, of several months duration, I have used, with much success, _Podophyllin_ and _Macrotin_, one at night, the other in the morning, giving them for two or three weeks before the proper time for a return, and a day or two prior to the time, give also _Pulsatilla_, and give the three in rotation, a dose every six hours.

This practice has been successful with me in cases of long standing and apparently obstinate character. Where there is other disease, as an affection of the liver, lungs or stomach, this must be treated and cured, or the menses will not probably return. Great care should be exercised to keep the patient's feet and limbs warm, as upon this may depend her future health.

Dysmenorrhoea.--Painful Menstruation.

For this disorder, I know of no one remedy so valuable as the _Caulophyllin_, but _Pulsatilla_ in many cases is efficacious, and as they do not prevent each other's action, I prescribe them in alternation, giving a dose every half hour, for a short time during the paroxysm, or until the pain abates to some extent, then every hour.

If there is pain in the head, sickness at the stomach, a kind of sick headache, as is often the case, with painful menstruation, _Macrotin_ should be used with the others; _Ipecac_ is the _Specific_ for an excessive flow of the menses with great pain, especially if the stomach is nauseated. It should be given as low as the first dilution, and the tincture, in water, in the proportion of thirty drops to half a pint, injected into the v.a.g.i.n.a quite warm.

The application of extract of _Belladonna_ to the neck of the uterus will often produce immediate and perfect relief. After the patient is relieved from the painful paroxysm, she should be treated so as to prevent a return of the pains at the next monthly period. _Pulsatilla_, _Caulophyllin_ and _Podophyllin_ are the three medicines that are most certain to effect this object. They are to be given, one medicine each day, a dose at night for three weeks, then morning, noon and night, until the time for the return of the menses, when they should be used oftener if there is pain. If the patient is inclined to be costive, _Nux_ should be given at night for a few days before the menstrual period, in place of _Pulsatilla_.

Menorrhagia--Profuse Menses--Flowing.

For this affection, _Ipecac_ and _Hamamelis_ are the specifics. They should be taken alternately, at intervals of from half an hour to two hours apart, according to the urgency of the symptoms, and the _Hamamelis_ injected into the v.a.g.i.n.a. These will nearly always arrest the flooding immediately. _Secale_ should be used either alone or with the above medicines, if there are bearing down pains like labor pains, and sickness at the stomach in spite of the Ipecac. _Ipecac_ alone is often sufficient.

Nursing Sore Mouth.

Sore mouth of nursing women, as the name of the disease indicates, is peculiar to women who are suckling children. It is an inflammation of the mouth, tongue and fauces, which sometimes comes on during pregnancy, several months or but a few days before the birth of the child. It generally, however, makes its first appearance when the child is a few weeks old, and sometimes not till after the lapse of several months. In some cases the tongue and inside of the mouth ulcerate, and the irritation extends to the stomach and bowels, producing distressing and dangerous inflammation of these parts, with severe and obstinate diarrhoea.

For the sore mouth, before diarrhoea begins, give _Eupatorium Aro._ and _Hydrastin_, in alternation, a dose once in three hours, and wash the mouth with the same, each time. After the diarrhoea occurs, use _Podophyllin_ with the other medicines, giving them in rotation, three hours apart. It is best to give a dose of _Podophyllin_ night and morning.

I have treated very bad cases of this disease that had been running for more than a year, and been treated with the ordinary remedies directed in the h.o.m.oeopathic authorities without any permanent benefit, curing them perfectly in ten days with _Podophyllin_ and _Leptandrin_, giving them in alternation at the 1st attenuation in half grain doses, at intervals of from four to eight hours according to the frequency of the evacuations. These two remedies are almost certain to arrest _Chronic Dysentery_ where there is ulceration of the lower portion of the r.e.c.t.u.m, a peculiar distress felt at the stomach just before stool, with _sudden_ rush of the evacuations and inability to control the inclination even for a few minutes, with a feeling of faintness after the stool.

_Leptandrin_ is the specific for the Dysentery that often succeeds cholera, and these two, _Pod._ and _Lept._, are almost certain to relieve the "Mexican Diarrhoea," as well as that connected with the fevers along the Mississippi river.

Mammary Abscess,

(_Ague in the breast--Inflamed breast_.)

This is a disease peculiar to nursing women. The first symptom is a slight pain or soreness in some part of the "breast," which continues to increase for a day or two, when a chill, more or less severe, sets in, followed by high fever and quick pulse, headache and great restlessness.

The gland swells and becomes very painful. This is generally a disease of rather slow progress, running eight or ten days and sometimes two or three weeks before abscess forms and "points" to the surface.

TREATMENT.

_Phosphorus_ is to be taken internally, and the first dilution put in water, twenty drops to one gill, and applied to the surface by means of cloths wet in the mixture, as hot as it can be borne, and laid over the whole breast. If this is done and the medicine given internally every hour, as early as the first and frequently as late as the second or third day, it is quite sure to remove the disease and prevent an abscess. It is best to use it even much later. In fact it often succeeds as late as the fifth or sixth day, and if it does not prevent the abscess, it so far palliates the severe symptoms as to render the pain but slight and keep the patient comfortable.

An application of the Tincture of Cantharides diluted with water and applied to the breast by cloths wet in it, to the extent of producing considerable redness and even eruptions, and the second dilution of the same taken in drop doses every three hours, has proved successful in subduing the inflammation after _Phos._ had failed, and it was supposed an abscess would form in spite of any treatment.

I recently succeeded in giving perfect relief with _Apis Mel._ internally, applying it externally after the pain and swelling was very great. I am of opinion that the _Apis_ is a valuable remedy.

_After abscess forms_ as soon as the pus can be felt at any point, soft and fluctuating under the skin, _puncture_ and let it out, then poultice it for a few days until it heals, giving _Phosphorus_ and applying it to the sore. In _puncturing_, always be _very particular_ to have the lancet or knife enter so that the edge will look towards the point of the nipple, so as not to cut _across_ the milk ducts, which all run toward that point, and if cut off will close up so that the milk which may be secreted at any future time cannot get out, and swelling, pain and severe inflammation, abscess and ulceration will be the consequence; whereas, if the cut is made lengthwise of the ducts, very few, if any will be cut off, and all future danger will be avoided. Apply an elm poultice from the beginning to the end of treatment. For malignant ulcers of the b.r.e.a.s.t.s, the _Cornus Sericea_ is a most potent remedy. It is to be taken internally at the first dilution, and applied in strong infusion or diluted _Tr._ of the bark to the sore.

Sore Nipples.

This affection of nursing women frequently comes on before the birth of the child, but generally does not make its appearance until after the suckling has continued for a week or more. It seems in some cases to be connected with the aphthae (sore mouth) of the child, or at least to be aggravated by contact with the sore mouth; on the other hand it sometimes seems as though the sore nipples produced the sore mouth of the child.