Project Gutenberg's An Epitome of Homeopathic Healing Art, by B. L. Hill This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.net Title: An Epitome of Homeopathic Healing Art Containing the New Discoveries and Improvements to the Present Time Author: B. L. Hill Release Date: June 4, 2008 [EBook #25692] Language: English Character set encoding: ISO-8859-1 *** START OF THIS PROJECT GUTENBERG EBOOK EPITOME OF HOMEOPATHIC HEALING ART *** Produced by Bryan Ness and the Online Distributed Proofreading Team at http://www.pgdp.net AN EPITOME OF THE Homoeopathic Healing Art, CONTAINING THE NEW DISCOVERIES AND IMPROVEMENTS TO THE PRESENT TIME; DESIGNED FOR THE USE OF FAMILIES, FOR TRAVELERS ON THEIR JOURNEY, AND AS A POCKET COMPANION FOR THE PHYSICIAN. BY B. L. HILL, M. D., Professor of General, Special, and Surgical Anatomy Late Professor of Surgery, Obstetrics, and Diseases Females and Children, in the W. H. College, Author of the "Homoeopathic Practice of Surgery," &c., &c. CLEVELAND, OHIO: JOHN HALL, 72 SUPERIOR STREET. CHICAGO, ILL. HALSEY & KING, 162 CLARK STREET. 1859. Entered according to Act of Congress, in the year 1859, By B. L. HILL, M. D., In the Clerk's office of the District Court in and for the Northern District of Ohio. PINKERTON & NEVINS' Print, Cleveland, O. * * * * * TABLE OF REMEDIES. In this table I have affixed to the remedies figures designating the dilutions or the attenuations, at which, under ordinary circumstances, I would advise their use. The strongest, or mother tinctures, marked with an apha (0), the dilutions or triturations to be of the decimal degrees of attenuation, are marked 1, 2, 3, &c., to designate that they are to be used at 1-10th, 1-100th, 1-1000th, &c., the strength of the pure drugs. The list for a full FAMILY CASE contains all the remedies recommended in this book for diseases that may be safely trusted to unprofessional hands. The TRAVELER'S CASE needs only such medicines as are prescribed for the diseases which he would be most liable to contract on his journey; though I have put in the principal ones used in domestic practice, so that the Case will do for family use. The CHOLERA CASE is only supplied with such remedies as are particularly applicable to that disease; useful, however, for many other complaints. TRAVELER'S CASE. 1 Aconite p 3|15 Hydrastus Can. p 1 2 Apis Mellifica p 3|16 Ipecac p 3 3 Arsenicum p 3|17 Mercurius sol. p 3 4 Arnica tr 0|18 Mercurius cor. tt 2 5 Arum triphyllum tt 2|19 Macrotin tt 1 6 Belladonna p 3|20 Nux Vom. p 3 7 Baptisia p 1|21 Phosphorus p 3 8 Bryonia p 3|22 Phos. acid p 3 9 Colocynth p 3|23 Podophyllin p 2 10 China Sul. tt 1|24 Rhus toxicod. p 3 11 Chamomilla p 3|25 Secale p 3 12 Copaiva p 2|26 Tartar emetic p 3 13 Cuprum p 3|27|Veratrum p 3 14 Eupatorium Aro. p 1| CHOLERA CASE. 1 Aconite p 3|8 Laurocerasus p 4 2 Arsenicum p 3|9 Opium p 3 3 Belladonna p 3|10 Merc. cor. p 3 4 Camphor tr 0|11 Phosphorus p 3 5 Carbo Veg. p 5|12 Phos. acid p 3 6 Cuprum p 3|13 Secale p 3 7 Ipecac p 3|14 Veratrum p 3 FULL FAMILY CASE. Tr. is used for tincture, Tt. trituration, P. pellets. REMEDIES. |CONTRACTIONS. | 1 Aconitum. |Aconite Tr 0 1 p 3 2 Althæa. | 3 Apis mellifica. |Apis mel. 0 p 2 3 4 Arsenicum. |Arsenicum 0 p 3 5 Arnica. |Arnica, 0 p 3 6 Arum triphyllum. |Arum triphyllum, 0 tt 2 7 Belladonna. |Bell. tr 1 p 4 8 Baptisia tinctoria. |Baptisia, tr 0 2 9 Bryonia. |Bryonia, tr p 3 10 Carbo. Vegetabilis. |Carbo. Veg. tr p 4 11 Cantharides. |Cantharides, tr 0 p 3 12 Colocynthis. |Colocynth, tr or p 3 13 China Sulphuricum. |China Sul. tt 1 14 Chamomilla. |Chamomilla tr or p 3 15 Copaiva. |Copaiva tr 1 p 2 16 Cauloph. Thalictroides.|Caulophyllum tr 1 17 Cuprum. |Cuprum, p 3 18 Cuprum Aceticum. | 19 Cornus Sericea. |Cornus sericea, tr 0 p 2 20 Conium maculatum. |Conium mac. tr 0 p 3 21 Coffea. |Coffea p 4 22 Eryngium Aquaticum. |Eryngium Aquaticum 2 23 Eupatorium aromaticum |Eupatorium aro. tr 0 p 2 24 Hepar Sulphur. | 25 Hydrastus Canadensis. |Hydrastin tr 0 p 2 26 Hamamelis Virginica. |Hamamelis Vir. tr 0 p 3 27 Ipecacuanha. |Ipecac tr 0 p 2 3 28 Laurocerasus. |Laurocerasus p 3 29 Mercurius solubilis. |Merc. tr 3 30 Mercurius corrosivus. |Mercurius cor. tt 2 p 3 31 Macrotys Racemosa. |Macrotin, tr 2 32 Nux Vomica. |Nux p 3 33 Opium. |Opium p 3 34 Phosphorus. |Phosphorus, tr 2 p 3 35 Phosphoric acid. |Phos. acid, tr 2 p 3 36 Podophyllum peltatum. |Podophyllin, tt 1 p 3 37 Pulsatilla. |Pulsatilla 3 38 Rhus Toxicodendron. |Rhus Tox. p 3 39 Secale cornutum. |Secale, tr 1 p 3 40 Santonine. |Santonine, tr 1 41 Spongia. |Spongia, p 4 42 Tartar Emetic. |Tartar emetic tr 2 p 3 43 Thuya. | 44 Veratrum alba. |Veratrum. p 3 AN EPITOME OF THE HOMOEOPATHIC HEALING ART. Introduction. This work contains in a _condensed form_ a very large portion of all that is practically useful in the treatment of the diseases ordinarily occurring in this country. The symptoms are given with sufficient minuteness and detail to enable any one of ordinary capacities of observation to distinguish the complaint; and the treatment is so _plainly_ laid down, that no one need make a mistake. If strictly followed, it will, in a very large proportion of cases, effect cures, even when administered by those unacquainted with the medical sciences generally. It has been written from necessity, to meet the demands of community for a more definite work in a concise form, that should contain remedies of the most reliable character, with such directions for their use as can be followed by the _traveler on his journey_, or by families at home, when no physician is at hand. It might seem to some preposterous to speak of a _demand_ for another _domestic_ Homoeopathic Practice, when half a score or more of such works are now extant, some having come out within a very short time. The demand arises, not from the want of Books, but from the defects of those that exist. There is in most of them, too little point and definiteness in the prescriptions, and a kind of vague doubting recommendation noticeable to all, which carries the impression at once to every reader, of a want of _confidence_ by the author in his own directions. Again, in some of the works there is too much confusion, the symptoms not being laid down with sufficient clearness to indicate the best remedy. Some of the works are unnecessarily large and cumbersome, while the real amount of valuable practical matter is comparatively meager, obliging the reader to pay for paper and binding without the contained value of his money. I do not claim entire perfection for this work, yet I do claim it to be several steps in advance of the books now extant. * * * * * This work is my own, being the result of my practical experience and observation. I have introduced several remedies that, though they are familiar to me, and have been used in my practice for many years, are, nevertheless, comparatively strange and new to most of the profession. Of some we have no extensive provings yet published, still the provings have been made, both upon the healthy and the sick. Their use, as directed in this work, is in strict accordance with their Homoeopathic relation to the symptoms for which they are prescribed. Some may object to my practice of giving several remedies in alternation or rotation and in quick succession. To such I would say, When you try this mode of practice and on comparing it with the opposite one of giving only one remedy, and that at long intervals between the doses, find my mode to be less successful than yours, _then_ it will be time for you to make your objections. _You_ may rely upon the vague hypotheses of the books, and give your high dilutions singly, at long intervals, and let your patients die for want of _real_ treatment, while I will use lower dilutions and give two or more remedies in quick succession and cure mine. I only speak what is in accordance with universal observation, where the two modes are compared on equal footing, when I affirm that, while the former _may_ effect some cures, _most_ of the recoveries under it, are spontaneous and unaided, the latter _does_ cure; the disease being arrested by the medicine, and the proportion of unfavorable terminations is much less under the latter than the former course. I know many learned and successful practitioners who have substituted low dilutions and the giving of several remedies in quick succession for the old mode of high attenuations and long intervals of single remedies, all of whom still adhere to the low, while I have yet to hear of the man who has gone _back_ to high single remedies and long intervals. My reason then, for the course here laid down, is, that it will _cure_ with more promptness and certainty. If others are so prejudiced as not to _try it_, they will still remain in ignorance of the _best practice_, and their patients will be the sufferers. In reference to the fear that is expressed that if one medicine is given too soon after another, it will antidote the former, I have simply to say, I have no confidence in the hypothetic antidotal powers of the medicines one over another, as laid down in the books. It has not been verified by experience, and has no foundation in truth. It is true that one medicine will remove morbid symptoms that might be produced by an overdose of another; but both being given in the ordinary medicinal doses, neither of them to such an extent as to produce sensible symptoms, if given alone, would not, if given in quick succession, prevent each other from acting to remove their own peculiar symptoms that exist in the system at the time. So if we have the symptoms that are found in two or more different remedies present in the same attack, as is often the ease, we may give these several remedies one after another, with confidence in their curative effects for the symptoms they represent. This has been my practice, and it has been _eminently successful_, and therefore I commend it to others, treating with pity the infirmity of those who ignorantly condemn it, as "They know not what they do." ADMINISTRATION OF REMEDIES. The remedies are either in the form of tinctures saturated, more or less dilute, in Pellets or Powders. The _Pellets_ may be taken dry upon the tongue, allowed to dissolve and swallowed. The dose for an adult is from 4 to 7; for an infant, from birth to one year old, 1 to 3; from one to three years, 2 to 4; from three to ten years, 3 to 5 pellets; after ten, same as an adult. 15 or 20 pellets may be dissolved in a gill of water, and a tea-spoonful dose given at a time, being particular to stir it until all are perfectly dissolved, stirring it each dose. _Powders_ may be taken in the same manner, upon the tongue, a dose when dry, being about the same bulk as of the pellets as nearly as practicable. If put into water, to a gill of water add of the powder about what would lie on a three cent piece. If the liquid medicine is used, add 1 drop to a gill of water, and use tea-spoonful doses as above directed. The length of time between the doses should be, in Dysentery and Diarrhoea, regulated by the frequency of the discharges, giving a dose as often as the evacuations occur. In acute and violent diseases, the doses should be repeated oftener than in milder cases--about once an hour as a general rule is often enough, though in some cases they should be given in half an hour or oftener. In mild cases, once in two or three hours is often enough, and in chronic cases, once or twice a day. Bathing. The surface of the body should be kept clean, as far as possible, and to this end, in summer, should be well bathed at least once a day. In winter, though useful, it is not so indispensable; still no one should neglect the bath more than a week, and all ought to bathe at least twice a week, if not oftener, even in winter. The bath should be of a temperature that is agreeable, and the room warm, especially for a feeble person. It should be so applied as not to give a general chill, as such shocks are always hurtful. The _teeth_ should be kept clean and free from tartar. They should be cleaned every morning and after each meal. The feet, legs and arms should be warmly clothed, especially the _arms_, as an exposure of them to cold is liable to induce affections of the lungs, and to aggravate any existing disease of those organs. By exposure of the feet and legs to cold, diseases and derangements of the female organs, even in young girls, are induced; and one prolific cause of female weakness is to be found in improper dressing of the feet and legs, while the _lung affections_ of females, now so fearfully prevalent, are traceable in a great degree to the fashion that has prevailed for a few years, of exposing the arms to cold. Diet. The diet of the sick should he nutricious, but at all times simple, free from greasy substances, and from all stimulating condiments whatsoever, as well as from vinegar, or food in which vinegar is used. In short, let the food be nutritious, easily digested, small or moderate in quantity, and free from all "seasoning," except salt or sugar; and if salt is used at all, let the quantity be very small, much less than would be used in health. Diarrhoea. This disease consists in a looseness of the bowels, generally accompanied with pain in the abdomen, more or less severe. It sometimes occurs without pain, but is _then_ attended with a sense of weakness, and a general feeling of uneasiness. It prevails mostly in the warm seasons, but may occur at any time. It is not usually considered a very dangerous affection, except during the prevalence of _Cholera_, or in children during hot weather. TREATMENT. _Veratrum_ and _Phos. acid_, given alternately, at intervals, as frequently as the discharges from the bowels occur, will generally be sufficient. If there is nausea or vomiting, or cramping pains in the bowels, give _Ipecac_ in alternation with one or both the former. If thirst and a burning of the stomach or bowels exist, use _Arsenicum._ This last medicine may be given in alternation with either of the others, but is most frequently indicated in connection with _Veratrum._ The intervals between the doses should be regulated by the frequency of the evacuations in all cases, lengthening them as the evacuations become less frequent, until they cease. In _children_, where the discharges are greenish or slimy, and contain undigested food, give _Chamomilla_ and _Ipecac_ alternately, as above directed. If the discharges are dark, or yellow, with distress in the stomach, give _Podophyllin._ The dose is from 3 to 6 pellets. In all cases of diarrhoea, adults should abstain from all kinds of food until cured, if possible, and eat but little at first, when food is taken. Children should be fed carefully, and but a small quantity at a time, being particular both for adults and children to use as little _liquid_ as possible; drink water in _small_ quantities, not very cold. Avoid exercise, and lie on the back quietly, when that is practicable. In a large majority of cases, _Veratrum_, if given in the early stages of the disease, will arrest it at once, and in many chronic diarrhoeas of weeks or months standing, it is the surest remedy. In chronic diarrhoea of females, _Podophyllin_ should be used in alternation with _Veratrum_. Dysentery. This disease is caused by inflammation of the mucous membrane of the colon and rectum, (the large intestine) generally confined to the lower part of the bowel. It is always painful. There is griping and straining in the lower part of the abdomen, and generally great bearing down when at stool, with a peculiar distress after the evacuation, called tormina. The discharges often commence like a common diarrhoea, with copious liquid evacuations, but there is more or less griping pain, low down, from the beginning. The evacuations sooner or later become lessened, slimy or bloody, or both, the pain increasing accompanied with more or less fever, often quite severe. Sometimes the patient is costive, and has been so for several days, the dysentery coming on without being preceded by looseness. At others, especially in summer, when fevers are prevailing, the dysentery begins with a severe chill, followed by fever and the dysenteric symptoms above described. TREATMENT. If it begins with looseness without blood, give _Arsenicum_ and _Veratrum_ alternately, once an hour, or oftener if the evacuations are more frequent. If the discharges are bloody, use _Mercurius cor._ in place of the _Arsenicum_. If there is any sickness of the stomach, or the discharges are dark or yellow, use _Podophyllin_ with _Mercurius cor._ If there are colic pains in the bowels, use _Colocynthis_ alternately with the others, giving it between them. If the patient was costive previous to the attack, and the dysentery came on without much looseness, _Nux Vomica_ should be given alternately with _Mercurius cor._ If the disease comes on with a chill, or a chill occurs at any time during the attack, followed by fever, _Aconite_, _Baptisia_ and _Podophyllin_ should be used in rotation half an hour apart until a free perspiration is produced, and the pain diminishes; or if bloody stools appear, use _Mercurius cor_, with the _Aconite_ and _Baptisia_. A large proportion of the dysenteries of hot weather in miasmatic regions, will be arrested in a few hours by these three or four remedies, especially if the patient keeps still, and generally even if he keeps about his business. In very bad cases, much benefit will be derived from injections of Gum Arabic water, or mucillage of Slippery Elm thrown into the bowel in quantities of a pint or more at a time, as warm as can possibly be endured. I have often relieved patients immediately with injections of a strong solution of Borax in Rice water, as hot as bearable. _Never apply cold water_ to _any_ inflamed surface, much less a _mucous_ surface. All food should be withheld as far as practicable and not starve, until the symptoms abate. Colic. The symptoms of this are cramping pains in the abdomen, without fever or looseness of the bowels. The colic sometimes occurs after the cessation of a diarrhoea that had been induced by severe cathartics. The pains are cutting and straining, drawing the bowels into knots, relieved temporarily by pressure. TREATMENT. For a male, _Nux Vom._, and for a female, _Pulsatilla_ will generally afford immediate relief. In children, especially, where diarrhoea exists, _Chamomilla_ should be used. If it is the result of severe cathartics, or if there is a soreness or a bruised feeling, _Colocynth_ is the remedy. Hot injections into the rectum, and large quantities of warm water taken into the stomach, will often _cure colic_. Bilious Colic. This disease, in addition to the symptoms of cutting, cramping pains in the bowels, as in common colic, has great distress in the stomach, with nausea and vomiting, the bowels being costive, the feet and hands cold, sometimes cold sweats occur. There is also considerable fever, and frequently headache is present. The substance vomited is at first dark bilious matter, but if the case continues a long time, stercoraceous (fecal) matter will be thrown up. TREATMENT. _Colocynth_ is the most important remedy, and should be given early and constantly. _Podophyllin_ is next in importance, and it should be given in alternation with the former, the dose to be repeated as often as every half hour at first, and as the patient becomes easy, at longer intervals. In this, as in the former case, great benefit will be derived from large injections of quite warm water, and let it be taken into the stomach freely, as hot as can be safely swallowed. I have given a gallon of hot water in the course of two hours, to a patient suffering under this disease, the first half pint being rejected, but the balance remaining, perfect relief having been experienced. If fever continues after the colic and nausea cease, _Baptisia_ and _Aconite_ should be given alternately every hour until the fever subsides. If the patient is, and has been, for some time, costive, _Nux Vomica_ should be given once in six or eight hours until the bowels move. Injections may also be used. Cholera Morbus. This disease generally comes on at night, in hot weather, and is, in many cases, induced by over eating while the patient is suffering from diarrhoea and a deranged state of the liver. It is essentially of a bilious character. It sets in with great pain in the bowels, sickness at the stomach, and vomiting of large quantities of dark greenish bitter tasting substance. At first, the vomiting will seem to afford relief, but sooner or later the stomach and bowels cramp, and the cramping may extend to other parts of the body, the feet, hands, calves of the legs, and the arms, cold sweats come on, and death terminates his sufferings. TREATMENT. _Ipecac_ and _Colocynthis_ are to be given in alternation, and repeated as often as every 30 minutes, for the first three or four doses, then as the patient gets easier, at longer intervals. A dose every hour will suffice as soon as the symptoms begin to abate. The application of hot cloths or even mustard, over the abdomen, frequently palliates the sufferings, and does not interfere with the action of the medicines. Fever of a low typhoid type some times sets in after an attack of cholera morbus, and terminates fatally. This ought never to occur under Homoeopathic treatment. For such fever give _Baptisia_, a dose every hour until the fever subsides, which will occur generally in six or eight hours; if not, and the patient complains of headache, or is delirious, or dizzy, or feels a fullness in the head, give _Macrotin_ in alternation with the _Baptisia_. Keep the patient very quiet and free from noise, as far as possible. _Sleep_ is a great restorer in any case, but particularly so in this. FEVERS. Intermittent Fever, Ague or Chill Fever. This comes on with pains in the head and back, aching in the joints, yawning, followed by coldness of the hands and feet, blueness of the nails and skin of the hands, general chilliness, sometimes "shaking." This lasts from a few minutes in some cases, to several hours in others. The chill is followed by a fever, which is generally severe and long continued, in proportion to the length and severity of the chill. The fever is followed by free perspiration, when it subsides and leaves the patient in a comfortable condition. This state is called the _Intermission_. This continues from a few hours to twenty-four, or longer, when another chill comes on followed by fever and sweats as before. During the chill and fever, the patient often suffers great pain, and is sometimes delirious. Young children frequently have convulsions when the chill sets in. _These_ convulsions of children, though alarming, are not often dangerous. TREATMENT. As soon as the first symptoms of the chills appear, such as the headache, pain in the back and bones, coldness of the hands, nose and ears, give _Aconite_ and _Baptisia_ alternately, giving the first three doses every ten minutes, the next three doses every fifteen minutes, and then once in half an hour until the patient begins to sweat freely, when the medicines should be discontinued. If there is nausea or vomiting present, let the patient have lukewarm water freely in large draughts, until he vomits it up several times. As soon as the sweating commences, give _Arsenicum_ and _Macrotin_ alternately every hour during the intermission, except during sleeping time. On return of the chill, should it appear a second time, use the _Aconite_ and _Baptisia_ as before, and follow them with _Arsenicum_ and _Nux Vom._ every two hours. This course of treatment will cure a majority of cases, but some require _Cinchonia_. That Cinchonia is a specific for intermittent fevers in many of their forms, no one will deny. It is the Homoeopathic remedy for many cases, and should be prescribed. The injurious effects that are often attributed to Quinine, are, I have no doubt, attributable not to that remedy, but to the _drugs_ that are used prior to giving the _Chinium Sul_. I have used it in more than two thousand cases, and have never been able to see any evil consequences follow its _proper_ use. It should be given _from the beginning of the chill to the end_ of the paroxysm, and continued during the whole time of the intermission: _i. e._ until the time arrives for the next chill, _time_ being important in the use of this remedy. Use the first decimal trituration, and give grain doses (equal to 1-10th of a grain of the drug) every half hour till the time the next chill would occur, if it pursued its regular course, allowing the patient six or seven hours time in each twenty-four, for sleep.[1] Though from two to four grains of the pure _Chinium Sulphuricum_ is all the patient would get, very few cases that do not yield to a course of the former treatment here recommended, will have the third paroxysm after this _China_ treatment is commenced and pursued as here directed. For children the dose may be one-half or one-fourth that of the adults. If a trituration of the medicine cannot be got conveniently, four grains of the _Quinine_ may be put into a four ounce vial of water, shaken well every time, and a teaspoonful taken at a dose. Abstinence from food as far as practicable, and quiet is of much importance in this disease, but the patient may use water freely. [1] NOTE.--The Eclectic Physicians use equal parts of Quinine and Prussiate of Iron, with marked success in agues, giving from one to three grains of the mixture at a dose, every two hours, or oftener, for ten or twelve hours, and some times more, during the intermission. An intelligent Homoeopathic Physician informs me that he has used with _uniform_ success, a _trituration_ of this mixture of Quinine and Prussiate of Iron, in proportion of ten grains of the Sugar of Milk to one of the Mixture, giving the trituration in doses of about one grain every hour through the chill, fever and intermission. Very few cases had a second chill after taking the prescription. I have used this trituration successfully in a few cases. In some cases, the chill is irregular and indistinct, the patient is thirsty during the chill, and the cold stage is long in proportion to the length of the fever, the surface pale and more or less bloated. _Arsenicum_ is the remedy, and should be given from the commencement of the chill, and every hour until the fever subsides, then every three hours during the intermission. In chronic cases, where the patient has been drugged with mercurials and cathartics, together with larger doses of Quinine, and is still suffering under the disease, _Pulsatilla_ and _Macrotin_ in alternation, will, in nearly every case, effect a cure. Bilious Fever. This fever may be either intermittent, remitting, or continued, and typhoid. It is distinguished from common intermittent, by the great derangement of the stomach, as nausea and vomiting of bilious matter, yellow coated tongue, bitter taste in the mouth, foul breath, loss of appetite, high colored urine, and frequently distress and fullness in the right side, (though this last is not in every case present,) the skin and white of the eyes soon become yellowish, the chills are often imperfect, the fever being disproportionably long. TREATMENT. _Podophyllin_ and _Merc._ should be given in ease of intermittents of this character, during the paroxysm, and in rotation with the other remedies for intermittents, giving a dose every three hours during the intermission. It is well also to continue these remedies night and morning, alternately, for a week or so, after the cessation of the chills and fever, or until all bilious appearances cease. * * * * * A REMITTING FEVER is one that goes nearly off, but not so entirely as an intermittent, returning again by a paroxysm of chill more or less distinct, sometimes hardly perceptible, and an increase of the fever following, from day to day, until arrested. * * * * * CONTINUED FEVERS are generally of a Bilious character, except in winter, when they are more or less connected with irritation of the lungs, or with Rheumatic affections, when they are termed Catarrhal or Rheumatic Fevers. If the bilious symptoms prevail, give _Aconite_ and _Baptisia_ during the chills and high febrile stage, at intervals of an hour, and during the declining stage of the fever, give _Podophyllin_ and _Mercurius_ until a perfect intermission is produced, when the same treatment should be adopted as in intermittents. But should it take the form of Catarrhal Fever, the head being "stuffed up," pain in the head, the lungs oppressed, cough and sneezing, the eyes and nose suffused with increased secretion of tears and mucus, pain in the back or loins, almost constant chilly sensations, use in rotation _Baptisia_, _Copaiva_ and _Phosphorus_, giving a dose every hour until the fever begins to abate and perspiration comes on, then leave off the _Baptisia_, and give in its stead _Macrotin_, lengthening the interval between the remedies to two hours or longer. For the _chronic cough_ that sometimes follows catarrhal fever, _Copaiva_, _Macrotin_ and _Phosphorus_ should be used morning, noon and night, in the order here named. Should the fever be a Rheumatic Fever, (_Rheumatism_,) the patient complaining of soreness of the muscles, of the chest, back and limbs, with or without lameness of the joints, _Aconite_, _Macrotin_ and _Nux Vom._ are the remedies for a male patient, and the two former, with _Pulsatilla_, for a female, (or for a _male_, of light hair, delicate skin, feminine voice and mild temper,) to be used in rotation one hour apart. These remedies are to be taken in a severe acute case, every half hour until the symptoms begin to abate; then every hour or two hours as the case progresses. _Baths_ properly administered, are of great importance in all forms of fever. The surface of the patient should be washed and thoroughly _rubbed_ in water quite warm, into which a sufficiency of the ley of wood ashes has been put to make it feel quite slippery. This should be done twice daily in all fevers. But in Rheumatism, In addition to the medicines directed under the head of _Rheumatic Fever_, the most decided benefit can be derived from _Alcoholic Vapor Baths_, which, while they do not in the least interfere with the action of the medicines, tend greatly to mitigate the pains, and produce an equal state of the circulation by stimulating the surface; abridging in many cases, the disease one-half the time it would run under the long interval treatment alone. This is to be applied by filling a tea cup with alcohol, placed in a saucer of water to insure against danger from an overflow while burning. Place both under a solid wood bottom chair, elevated about the thickness of a brick under each post, strip the patient naked, and after giving him the alkaline bath, and rubbing his surface dry, place him upon the chair, enveloping him completely, except his head, with a woollen sheet or blanket, (as there is no danger of the wool taking fire,) letting the blanket enclose also the chair and come down to the floor. Then set fire to the alcohol, and if the heat is too great, raise the edge of the blanket and let it become reduced. Continue this until he sweats freely, or becomes too much fatigued to sit longer. Let the patient often drink freely of cold water, during the process. Remove him from the chair to his bed and cover him warmly. It is well to place the feet in hot water during this process. This is a delightful operation for a rheumatic patient, and no one will object to a repetition of it. Whatever Physicians may think or say of this operation, I _know_ it is a most potent agent for the _cure_ of _inflammatory_ rheumatism, and is a valuable agent in the chronic form of this disease. Typhoid Fever. This is a dangerous, and with the ordinary allopathic treatment, a very fatal disease. It generally comes on insidiously, the patient feeling a dull head ache, more or less pain in his joints, back and shoulders, with loss of appetite, restless and disturbed sleep, slight chilly sensations, with a little fever, dry skin, and a general languid feeling. These symptoms continue from four or five days in some cases, to two or three weeks in others, gradually getting worse until the patient is prostrated, or if he takes no drugs, and keeps still, avoiding food as far as practicable, he may escape prostration, and after lingering for eight or ten days, and sometimes longer, just on the point of prostration, he begins slowly to get better, and recovers about as slowly and imperceptibly as he grew sick. This is in accordance with observation of cases under my own eye, and I have no doubt those cases of spontaneous recovery, had they taken a single dose of active cathartic medicine or any of the active drugs, they would have been immediately laid upon a bed of sickness from which a recovery would have been extremely doubtful. I believe that two-thirds of the deaths from typhoid fever are the direct results of medication, and that those who recover, do so in spite of the cathartics and the active drugs when such are used. Some cases, however, will not thus spontaneously recover, and require proper treatment; and it is safest to treat all cases, at as early a day as possible. Some cases come on more rapidly and run into the prostrating or critical stage, in a very few days. Delirium is a symptom that comes on early in these cases. When the disease is fully established, and even sometimes in the early stage, diarrhoea sets in and runs the patient down rapidly. TREATMENT. In the early stage, that which might be called premonitory, while the patient is yet able to be about his business, but is complaining of the symptoms above named, he should, as far as possible, abstain from exercise and food, and take of _Baptisia_ and _Phosphorus_ alternately, a dose once in three hours. These will almost invariably produce amendment in a few days, and as soon as he improves _any_, leave off the medicines. Should there be diarrhoea present, use _Phos. acid_ instead of Phosphorus. If the patient is delirious or has fullness and redness of the face, the eyes red, and headache, give _Belladonna_ in rotation with the other two. For the foul breath that comes on, use _Mercurius cor._, especially if the diarrhoea assumes a reddish tinge, like beef brine. Should the fever at any time rise high, the pulse being full and hard, give _Aconite_, but it rarely happens that Aconite is useful in the later stage. If the patient complains of pains in the back, and fullness of the head, give _Macrotin_. This is particularly useful for persons who have rheumatic pains in the limbs or back, during the fever. If the evacuations from the bowels are dark, or yellow and consistent, or there is bilious vomiting, _Podophyllin_ is the remedy. From some cause or other, to me wholly unaccountable, the writers generally have laid down _Rhus_ and _Bryonia_ as _the_ remedies in typhoid fever. I must confess I have no confidence in them for this fever as it prevails, and has for several years past, in this country. They have proved a failure, and I discard them altogether, as I am confident, from thorough trial, we have much more reliable remedies as a substitute for Rhus in the _Podophyllin_, and for Bryonia in the _Macrotin_. In the early stage, or at any time to arrest febrile and inflammatory symptoms, the _Baptisia_ is much more potent than Aconite, its symptoms corresponding peculiarly with typhoid fever. If the discharges become slimy or bloody, give _Leptandrin_ and _Nit. acid_. It is important to bathe in this disease. Scarlet Fever.--Scarlatina. This fever assumes two principal forms: Simple or mild, and Malignant. In the _Simple form_, there is great heat of the surface, extremely quick and frequent pulse, headache, and some sense of pain and soreness in the throat. After a day or two, there appears upon the surface, bright scarlet patches, in some cases extending over the whole limbs, the skin smooth and shining, and somewhat bloated or swollen; upon pressure with the finger, a white spot is seen, which soon disappears on removal of the pressure. As the disease subsides, the cuticle comes off (_desquamates_) in patches. In the simple form of this disease, the throat, though often more or less sore, does not ulcerate. In some cases, notwithstanding the fever is high, the pulse frequent, and the throat sore, there may be no external redness, but the mouth and tongue will have a scarlet hue, indicating the existence of disease more dangerous than when it appears externally. _In the malignant form_, the same symptoms are present, the patient suffers more pain in the head; the back and throat, root of the tongue, tonsils and soft palate become ulcerated, turn black, and sometimes gangrenous, proving fatal in a few days, or slough out in large portions, the ulcers destroying the parts extensively. The breath becomes foul and fetid, and the effluvia from the ulcerated surface, is very sickening to the patient and all around him. This disease rarely attacks adults, but occasionally, and for the last six or eight months, in one region where I am acquainted, where Scarlatina of a malignant type has prevailed among children, adults have been affected with an epidemic soreness of the mouth and throat, strongly resembling the worst form of the _angina_ in malignant Scarlatina, together with a low typhoid form of fever. TREATMENT. In simple scarlatina, all that is necessary is to keep the child quiet, in a room of uniform temperature, as far as practicable; let it drink cold water only, and give _Aconite_, _Belladonna_ and _Pulsatilla_ in rotation, a dose every hour until the fever subsides. If any soreness of the throat remains, give a few doses of _Mercurius_. If the fever subsides, and the soreness remain, _Hydrastin_ or _Eupatorium arom._ will soon complete the cure. In the _malignant_ form, with ulcerated, dark colored, or red and purulent throat, and typhoid form of fever, give _Aconite_ and _Belladonna_ in alternation, every hour, and, at the same time, gargle the throat freely with _Hydrastin_. Some of the tincture may be put in water, about in the proportion of ten drops to a teaspoonful, or a warm infusion of the crude medicine may be used. This can be applied with a camel's hair pencil, or a swab, to the parts affected, once in two hours, and will soon bring about such a state as will result in speedy recovery. After the active fever has subsided, the _Aconite_ and _Bell._ may be discontinued, and _Eupatorium arom._ used instead, once in three hours until convalescence is complete. I would remark that, with these remedies applied as here recommended, my brother, Dr. G. S. HILL, of Erie County, Ohio, has, during the last four months, treated a large number of those malignant sore-throats, (the "Black tongue Erysipelas,") and been universally successful, relieving them in a few hours, when the symptoms were of the most alarming character, and the disease in some cases, so far advanced that the patients were considered by their friends and attendants, "at the point of death." The _Hydrastin_ is a most potent remedy in putrid ulcerations of the mucous surfaces, and much the same may be said of _Eupatorium aromaticum_. Yellow Fever. [As I have never practiced farther South than Cincinnati, and have seen but few cases of this disease, my experience with it has not been sufficient to be relied upon as authority. Therefore, I shall give a brief description of the disease, with the proper and _successful treatment_, furnished me by A. H. BURRETT, M. D., of New Orleans, who is not only a Physician of more than ordinary learning and skill in his profession generally, but is one who has spent his time in New Orleans among the sick of Yellow Fever, through three of the most fatal epidemics that ever scourged any city. He is a man for the times, a man of resources, who draws useful lessons from experience and observation. Hence he has been able to select such remedies as have enabled him to cope most successfully with the pestilence, saving nearly all his patients, while, under other treatment, a majority have died. I therefore, attach great value to his treatment, and recommend its adoption with the most implicit confidence.] * * * * * When this Fever prevails as an epidemic, as it usually does, in the southern part of the United States, it is a disease of the most malignant character. The proportion of _fatal_ cases under the Allopathic course of treatment, has been equal to, and, in some places, as in New Orleans, and some Towns in Virginia, has exceeded that of _Asiatic_ Cholera. It is almost entirely confined to Southern regions, and only prevails in hot weather, after the continuance of extreme heat for some weeks. It usually begins with premonitory symptoms somewhat like those of ordinary fever, but with this difference: the patient, instead of losing his appetite, has often a morbidly increased desire for food. He complains of severe pains in the back, and more or less headache. Both the head and backache are of a peculiar character: the pains resembling rheumatic pains, the head feeling full and too large, the eyes early turn red, almost bloodshot and watery, a chill comes on, which may be distinct and quite severe, lasting for an hour or more, or, it may be slight, and hardly perceptible. The chill is followed by high fever, the pain in the head and back increasing, the eyes becoming more red and suffused, the forehead and face extremely red and hot, and the heat of the whole surface very great, the carotids beat violently, the pulse very frequent, and usually, at first, full and strong, though sometimes it is feeble from the beginning. However the pulse may be in the beginning, it very soon becomes small, but continues to be frequent. The tongue is at first covered with a white paste-like coating, which afterwards gives place to redness of the edges and tip, with a dark or yellow streak in the center. The stomach is very irritable, rejecting every kind of food, and all drinks, except, perhaps, a few drops of ice water. There is a peculiar distressed feeling in the stomach, often a burning sensation, so that, if suffered to do so, he would take large quantities of ice or water. One remarkable feature of the cases noticed in the epidemic, as it existed in New Orleans the past season, was, that the patients had a great desire for food, notwithstanding the nausea and distress at the stomach. Sooner or later, varying from a few hours to several days, in the ordinary course of the disease, the fever subsides. From this time the patient may recover without any further symptoms, but this is, by no means, the usual result. If the subsidence of the fever is accompanied by natural pulse, a free, but not profuse or prostrating perspiration, a genial warmth of the surface, natural appearance of the countenance, eyes, and tongue, with little or no soreness on pressure over the stomach, we may safely look for a speedy recovery. But if, on the contrary, the eyes, face, and tongue, become yellow, or orange-colored, the epigastrium is tender to pressure, the urine has a yellow tinge, the pulse becomes unnaturally slow, with the least degree of mental stupor, we have reason to know, full well, that the lull of the fever is only the calm preceding a more destructive storm. The fever has subsided, only because exhausted nature could re-act no longer. It may be in a few hours, or not until twelve or twenty-four have elapsed, the pulse becomes quickened, even to the frequency of 120 to 140 in a minute, but very feeble, the extremities of the fingers and toes turn purple or dark, the tongue becomes brown and dry, or is clean, red, and cracked, sordes may be on the teeth, the stomach become more irritable, nausea and vomiting are extreme, the substances vomited being, at first, reddish, afterwards watery, containing floculæ, like soot, or coffee grounds; the breath becomes foul, and the whole surface emits a sickening odor. The pulse becomes very small, though the carotid and temporal arteries beat violently. The urine fails to be secreted, and later, blood is discharged from the mucous surfaces, involuntary discharges from the bowels, clammy sweats; and death follows. The disease runs its course in from three to seven days, sometimes proves fatal in less than a day, and at others, assumes a typhoid form, and runs for weeks. Occasionally it sets in without any of the premonitory symptoms, the chill being first, the fever following, succeeded immediately by the black vomit, going through all the stages in a single day, or two days. Again, it sometimes begins with the black vomit, the patient being immediately prostrated. In all cases, however it may begin, the peculiar head-ache and back-ache as described in the beginning, as well as the extreme heat of the head and face, redness of the eyes, the gnawing sensation at the stomach, and peculiar nausea are present. These seem to be characteristic symptoms that mark the Yellow Fever, and those which should guide in the search for the proper remedies. TREATMENT. The remedies that proved successful in arresting the disease during the early or forming stage, before the chill or fever had set in, while the symptoms were pain, fullness, and throbbing of the head, with more or less dizziness, rheumatic pains in the back, and redness of the eyes, were _Aconite_ and _Bell._, at low attenuations, once in two to four hours, according to the violence of the symptoms. For the fullness of the head, pressing outwards, as though it would split, with pains of a rheumatic character, _Macrotin_ 1st, given in one grain doses, every hour or two hours, proved specific. These three remedies, _Aconite, Bell._ and _Macrotin_, would, in nearly all cases, arrest the disease in the forming stage, so that no chill or fever would occur, or, if fever did come on after this treatment, it was mild. When the fever sets in, and the pain in the head and back increases, the eyes, forehead and face are extremely red, or purple and hot, the pulse frequent and full, the tongue coated white, _Aconite_, _Belladonna_ and _Macrotin_ are still to be relied upon, but they should be given every half hour, in rotation, at low attenuations. If the tongue is red, in the early stage, use _Bryonia_ in place of the _Belladonna_. In a later stage, when sickness or distress at the stomach had become prominent, with the quick pulse, and hot skin, _Ipecac_ and _Aconite_, both at the 1st attenuation, a dose given every half hour alternately, generally arrested the symptoms, and brought on perspiration of a healthful character, followed by subsidence of the fever and convalescence. Sponge baths, with half an ounce of _Tr. Ipecac_ in two quarts of tepid water, applied to the whole surface freely, under the bed clothes, so as not to expose him to the air, contributed much towards bringing on perspiration and subduing the fever, as well as allaying the nausea. When called to patients in the stage of _Black Vomit_, whether that came on as an early symptom, or at a later stage, _Nit. acid_, _Veratrum virid._ and _Baptisia_, all at the first dilution, were administered every hour, in rotation, with great success, the symptoms yielding in a few hours. For the great oppression, as of a load, in the stomach, without vomiting, _Nux_ was found sufficient. In the later stage, when there seemed to be no secretion of urine, _Canabis_ and _Apis mel._, gave relief. The remedies most successful for the cases that assumed a typhoid character, with dry, cracked tongue, sordes on the teeth, and low sluggish pulse, were _Baptisia_ and _Bryonia_, given every two hours, alternately. _Nitric acid_ given internally and injected into the rectum, when bloody discharges appear, is generally quite successful. Good nursing is of the utmost importance, and the patient should be visited frequently by his Physician, as great changes may occur in a short time. Three times a day is none too often to see the patient. As soon as the fever comes on, the patient should be stripped of his clothes, and dressed in such garments as he is to wear in bed through the attack. He should be put to bed and lightly covered, but have sufficient to protect him from any sudden changes in the atmosphere, and the room should be well ventillated all the time. The baths should always be applied under the bed clothes. The diet should be very spare and light, after the fever subsides, and while the fever exists no food should be taken. Thin gruel, in teaspoonful doses, once in half an hour, is best. After a day or two, the juice of beef steak may be given in small quantities but give none of the meat. No "hearty food" should be allowed for eight or ten days after recovery. A relapse is most surely fatal. As _Prophylactics_ (_preventives_) of the fever, _Macrotin_, _Bell._ and _Aconite_ should be taken, a dose every eight to twelve hours, by every one that is exposed. These will, no doubt, often prevent an attack, and if they do not, they will so modify it, that it will be very mild, of short duration, and very easily arrested. Pregnant females, and young children were sure to die if attacked, when treated by the Allopathic medication; but, by the use of these remedies as _preventives_, their attacks were rendered so mild as to be amenable to remedies, and all recovered. Pleurisy--Pleuritis. This is inflammation of the Pleura of one or both lungs, generally confined to one side. It is known by sharp pain in the side of the chest, increased by taking a long breath, or coughing, or by pressing between the ribs. The cough is dry and painful, the patient makes an effort to suppress it, from the pain it gives him; the fever is of a high grade, the pulse full, hard and frequent, with more or less pain in the head. TREATMENT. _Aconite_ is a sovereign remedy. It should be given at intervals proportionate to the severity of the disease, once in half an hour, for about three doses, then every hour until the patient is easy and perspires freely. This is the course I have generally pursued, and scarce ever failed of relieving in a few hours. Other means may often be used with advantage at the same time, and not interfere with the action of the medicine. Put the feet and _hands_ into water as hot as it can be endured, and apply to the affected side very hot cloths, hot bags of salt, or mustard. There is no harm in this, and it relieves the pain. Let the patient drink freely of _hot_ water, into which you may put milk and sugar to render it palatable. If the case seems to linger, and perspiration is tardy in appearing, give, in alternation with _Aconite_, _Eupatorium arom._ This will soon relieve. Inflammation of the Lungs--Pneumonia. This disease is often connected with Pleurisy, and consists of inflammation of the substance of the lungs. As in the former case, it may attack only one, but may exist in both sides at the same time. If the pleura is also affected, there will be all the symptoms of pleurisy, together with those peculiar to inflammation of the lungs proper. They are, pain in the lungs, oppressed breathing, cough, causing great distress on account of the soreness of the affected parts: at first, expectoration from the lungs is nearly wanting, the cough being dry, but after a time, there is a rattling sound on coughing, and more or less mucous substance is with difficulty raised. This is, at first, white or brownish, but soon becomes reddish and frothy, tinged with blood. The patient lies on the affected side, and cannot rest on the sound side. The pulse is full, hard and frequent, the fever high, pain in the head, and sometimes delirium. If the disease is not arrested, the patient generally dies from suffocation, by the lungs filling up, hepatized, or abscess and ulceration come on, and then what is called "quick Consumption" carries him off. TREATMENT. In the early stage, _Aconite_ and _Phosphorus_ should be used at intervals of from half an hour to one hour, in alternation, until the fever abates, and the oppression in the chest is relieved. If, however, there is bloody expectoration, _Bryonia_ may be used in place _of Phosphorus_, though I prefer to use it in rotation with the two others. These will soon, in all ordinary cases, subdue the most distressing symptoms, and effect a perfect cure in a day or two. _Belladonna_ should be used, when there is much delirium, or great pain in the head. Occasionally, the cough from the beginning, is apparently loose; there being a rattling sound, but the expectoration is difficult, the fever high, with some chilly sensations, or at least, coldness of the knees, feet and hands, a white or brownish fur upon the tongue, and pain in the bowels, For such symptoms, especially with the pain in the bowels, as though a diarrhoea would come on, give _Tartar emet._ It is often one of the best remedies in this disease, affording relief when others have failed. After subduing the high febrile symptoms, if there remains cough, indicating much irritation, or inflammation of the lungs, _Macrotin_ should be used in place of Aconite, with _Phosphorus_ and _Copaiva_, the three in rotation, two hours between doses. Acute Bronchitis, _Inflammation of the Bronchial Tubes._ This is attended with distressing cough, profuse expectoration, oppressed breathing, pain in the forehead, and general catarrhal symptoms. _Baptisia_, _Copaiva_ and _Eupatorium arom._ given every hour, in rotation, will, in general, relieve from the acute affection in a short time; but the Chronic Bronchitis requires the use of _Copaiva_, _Macrotin_ and _Arum triphyllum_, to be taken morning, noon, and night, in the order named; or, if the cough be severe, they should be used every three hours. These will be sufficient to effect a cure. Coughs Generally, unless they arise from consumption, yield readily to the alternate use of _Copaiva_, _Phosphorus_ and _Macrotin_, a dose given once in from three to six hours. If, however, there is soreness of the throat, redness and soreness of the tonsils, palate, and fauces, or soreness of the larynx, with hoarseness, _Arum triphyllum_ and _Hydrastus Can._ are the surest remedies. They rarely ever fail of effecting a complete cure in a few days. They should be used three or four times a day. They may be used with the other medicines recommended for coughs. In acute Sore Throat, arising from sudden cold, _Arum triphyllum_ and _Eupatorium aromaticum_ are the remedies to be relied upon. If the tonsils seem to be mainly involved, constituting Quinsy--Tonsilitis, _Belladonna_ and _Aconite_ should be given, while there is high fever, then substitute for them, _Arum tri._ and _Phosphorus_; or, these may be used in rotation with the former, a dose every hour or oftener. Inflammation of the Bowels.--Enteritis. This consists in inflammation of the muscular and peritoneal coats of the intestines, sometimes also involving the mucous coat. The pain in the abdomen is constant, intense and burning in its character, felt most at the navel; the abdomen is extremely tender to pressure, and often bloated or tympanetic. Thirst is intense, but cold drinks distress and vomit the patient. The pulse is small, feeble and frequent, and the bowels costive. This is a very dangerous disease. It is sometimes connected with inflammation of the stomach, then called gastro-enteritis. The tongue is then red and pointed, the nausea and vomiting are more violent and constant, the thirst burning and insatiable. TREATMENT. The same medicines are applicable to both _Gastritis_ and _Enteritis_. _Aconite_, _Arsenicum_ and _Baptisia_ should be used one following the other every half hour until the symptoms begin to subside, then let the intervals be lengthened. In addition to these remedies, I allow the patient to drink often and freely of hot water, as hot as can be swallowed, and though it is at first almost instantly rejected by the stomach, by repeating it in a few minutes in moderate quantities, it gives relief and will soon so allay the irritation as to remain. In some cases the vomiting is severe, the bowels are loose, and pain burning. For such, _Tart. Emet._ is the proper remedy. Cold drinks should not be taken. Cloths wet in cold water, ice water if it is at hand, and wrung out so as not to drip, should be laid over the whole abdomen and instantly covered with two or three thicknesses of warm dry flannel, and the patient's feet kept warm. This may be considered harsh treatment, but there is no danger in it; on the contrary I have, in the worst and most alarming cases of _gastritis_ and _peritonitis_, made such applications, and in less than an hour have seen my patient easy and beginning to perspire freely, all danger having passed. It always affords more or less relief and is never attended with danger. Covering the wet cloths immediately with plenty of dry ones is very essential. After the acute inflammation has subsided, it is well to have the bowels moved, but don't give drastic cathartics. _Nux Vomica_ given at night and repeated morning and noon, will generally serve to cause an evacuation. Injections may be used. Croup. This is a disease of children. Comes on in consequence of a sudden cold. Children suffering from Hooping Cough are more subject to it. The cough is of a peculiar whistling kind, like the crowing of a young chicken, with rattling in the throat and difficult breathing, fever is present, and often very violent. It is properly an inflammation of the Larynx, but the inflammation may also exist in the Pharynx, the tonsils may be involved, and it may extend to the trachia, (wind pipe). A false membrane forms in the larynx if the disease is not arrested, and so obstructs the breathing as to cause death from suffocation. TREATMENT. Give at first _Aconite_, _Phosphoric Acid_, and _Spongia_, giving them in the order here named once in ten minutes in a very violent case, and as the patient improves at intervals of half an hour, and then an hour. Should the fever subside, and still the tightness in the throat and cough continue to be troublesome, give _Ipecac_ in place of Aconite. And when the cough seems to be deep seated use _Bryonia_ instead of spongia. The patient should be kept in a warm room, and free from exposure to currents of cold air. The application of a cloth wrung out of cold or ice water to the throat, covered immediately with dry warm flannels so as to exclude the air from the wet cloth, will often exert a decidedly beneficial effect, and there is no danger if managed as here directed. The feet should be kept warm and the head cool, but _don't_ put _cold_ water on a child's head. Asthma. If an attack comes on from sudden cold, take _Aconite_ and _Ipecac_ every hour for a day, and if any symptoms remain, in place of the Aconite use _Copaiva_, _Arsenicum_ and _Phos. Acid_ with the _Ipecac_, giving them in rotation, a dose every hour. In _Chronic Asthma_, where the patient is liable to an attack at any time, great benefit will be derived from taking these four in rotation about two hours apart for a day or two, at any time when symptoms of an attack begin to appear. I have recently succeeded in alleviating several bad cases, at once, by these four remedies in succession as here recommended, on whom (some of them) I had at various times tried all of them, as well as other medicines, singly at longer intervals, as directed in the Books, without any decided benefit. After trying these in succession, as here directed, I found no trouble in arresting the paroxysm in a few hours, and I am strong in the faith that with some, at least, I have effected _cures_. It is worth much to _arrest_ the _paroxysm_ if no more. Hooping Cough. According to my experience, though this disease may not be entirely arrested in its course, and not generally much abridged in its duration, still the use of appropriate medicines will greatly modify it, and render it a comparatively trifling affection. In treatment, give at the commencement of the attack _Bell._ and _Phos. acid_ alternately every twelve hours for a week, then once in six hours, and if the child should take cold so as to bring on fever, give one every hour. Continue these, as above directed, for the first two or three weeks, then, in their stead, after the cough becomes loose, and the patient vomits easily, give _Copaiva and Ipecac_ in the same manner as directed, for the two former remedies. Dyspepsia. This term is applied so loosely and so indiscriminately to all chronic derangements of the stomach, that it is difficult to define it. I shall therefore point out some of the more common ailments of the stomach and their proper remedies. For sour eructations with hot, burning, scalding fluid rising up in the throat, with or without food, give _Phos. acid and Pulsatilla_ in alternation every half hour, until the stomach is easy. For a feeling of weight and pain in the stomach, with dull pain in the head, with or without dizziness, give _Nux. Vom._ every hour until it relieves. If there is a _burning_ feeling in the stomach as well as the heavy load, _without_ eructations and rising of fluid, _Arsenicum_ should be alternated with the _Nux. Vom._, at intervals of two hours. There are persons who, from imprudence in eating or drinking or both, or which is more frequent, from _harsh drug medication_, have so enfeebled their stomachs, that, though by care in selecting their food, and prudence in taking it, they may suffer but little, are, nevertheless, when from home or on special occasions, liable to overeat or take the wrong kind of food, from which unfortunate circumstance they are made to suffer the most tormenting and intolerable distress in the stomach and bowels, which may last, more or less severe, for several days. Soon after the unfortunate meal, perhaps the next morning, or, it may be, in a few hours, the stomach begins to bloat, by accumulating gas within, which is belched up every few minutes in large quantities; the stomach and bowels are racked with the most torturing pains; cold sweat stands on the brow, and he is the very picture of misery. Thus he may roll and tumble all night, and remain in misery the next day and several days longer, before the food will digest. It often passes from the stomach without digestion, and on its way through the bowels inflicts constant pain. If he does not take some emetic substance, he is not apt to vomit, his stomach cramping so as to prevent it. I have here described one of the bad cases, but bad as it is they are by no means _very_ rare. There are such cases in abundance, of all grades from the one here described down to a slight derangement. They all require a similar course of _treatment_. It is useful for such patients to take at once large quantities of lukewarm water, and repeat the draught every ten to fifteen minutes, until free and thorough vomiting is induced, so as to throw off all the food from the stomach. But even this does not often cure these bad cases. If it did, it is not always convenient to do it. The medicine that is quite certain to afford relief at once is _Podophyllin_. Let it be given, and the dose repeated in an hour. A third dose is rarely necessary. After relief from this attack, the medicine should be taken night and morning for a month or more until the stomach is restored. In the meantime care should be taken not to overload the stomach. Constipation. The medicine for this affection is _Nux vom._, to be taken at night on retiring. If there is fulness and pain in the head from costiveness, _Bell._ should be used in the morning, and at noon. Let the patient contract a habit of drinking _cold water_ freely on rising in the morning, at least half an hour before eating. The patient _should not take physic_. For constipation of children, _Nux_ and _Bryonia_ are to be given Nux at night and Bryonia in the morning. _Opium_ is useful. Much needless alarm is often felt by persons on account of a costive state of the bowels. If no pain is felt from it, there is no cause for alarm. "Heartburn." This peculiar burning and distressed feeling at the stomach depends on imperfect digestion, but is _not_ ordinarily, as is generally supposed, connected with a sour or acid state of the fluids in the stomach. The condition of the fluids is alkaline, in most cases, though it is sometimes acid. If it depends upon biliary derangement, _Nux Vomica_ and _Podophyllin_ are the remedies for a male; _Pulsatilla_ and _Podophyllin_ for a female. Erysipelas. This is a disease of the skin, producing redness, burning and itching pains, appearing in patches, in adults, most apt to appear about the head and face, but in children, upon the limbs, or in very young children, beginning at the umbilicus. It sometimes begins at one point, and continues to spread for a time, then suddenly disappears, and reappears at some other point. _Simple Erysipelas_ only affects the surface, with redness and smarting. _Vessicular_, produces vessicular eruption, or blisters filled with a limpid fluid, somewhat like the blisters from a burn. The _Phlegmonous Erysipelas_ affects the whole thickness of the skin and cellular tissues beneath it, producing swelling, and not unfrequently, resulting in suppuration, ulceration or gangrene and sloughing of the parts. It is a dangerous disease, especially when on the head. TREATMENT. For the simple kind, _Bell._ is all that will be needed, unless there should be considerable fever, when _Aconite_ should be alternated with the _Bell._ For the _vessicular_ kind, where there are blisters, _Rhus tox._ should be used with _Bell_. For the _Phlegmonous_, with deep seated swellings, _Apis mel_ is the most important remedy. I prefer to use three of these remedies, giving them in rotation, beginning with the _Bell._, followed with _Rhus_, and then by _Apis mel._ giving them one hour apart. In a mild case, or after the patient begins to recover, give them at longer intervals. The _Apis_ alone will often be sufficient. During the whole time, the affected parts should be kept covered with dry, superfine flour, some say Buckwheat flour acts most favorably. The diet should be very spare. Eat as little as possible, until the disease begins to subside. A very important part of the treatment of this affection is to keep the patient in a room that is comfortably warm, say at a temperature of from 65 to 75°, and keep the temperature _uniformly the same_, as nearly as possible, night and day. Do not, by any means, expose him suddenly to cold air, or a cold breeze, as on going into a cold room, going out into cold air, or undressing or dressing in a cold room. Uniformly warm temperature is of great importance. Burns and Scalds. No matter what the nature and extent of the burn may be, the very best of all medicines of which I have any knowledge, is _Soap_. If the parts affected, are immediately immersed or enveloped in Soft Soap, the pain will be greatly lessened, and the inflammation that would otherwise follow, will be essentially modified, if not entirely prevented. It acts like magic; no one who has never tried it can have any idea of its potency for the relief of pain, together with the prevention of bad consequences following severe burning. Under the influence of the _Soap_ applications, burns and scalds will often be rendered comparatively insignificant injuries. Instead of endangering the life of the sufferer from the excessive pain, or the ulceration, or gangrene and sloughing that would follow if the pain in the first instance does not destroy life, the pain ceases, or becomes bearable in a short time, and either little or no suppuration or sloughing takes place, or the sore assumes the appearance of healthy suppuration, and heals kindly--avoiding those unsightly deformities that so commonly follow severe burning. If practicable, the soap, as before suggested, should be applied immediately after the burn, the sooner the better. The part may be put into soft soap, or cloths saturated with it can be wrapped around or covered over the affected surface, to any desirable extent. The parts should not be exposed to the air for a single moment, when possible to prevent it. During the first two or three days, dressings need not be removed, unless they cause irritation after the first severe pain has subsided. They should be kept all of the time moist, and as far as practicable, in a condition to be impervious to the air. When it is necessary to remove them, let the affected surface be immersed in strong soap suds, at a temperature of about 75 or 80°, and the dressing removed while it is under water, and others applied while in the same situation. In ordinary cases, however, even of extensive burns, after the fever consequent upon it has subsided, and the part is tolerably free from pain and smarting, the dressings may be removed in the air, but others should be in readiness and applied as speedily as possible. The soap dressings are to be continued from the beginning until the inflammation has subsided and the sore has lost all symptoms that distinguish it from an ordinary healthy suppurating sore. After the first few days, or in case of a slight burn at the beginning, an excellent mode of applying the soap, is to make a strong thick "_Lather_" with soft water and good soap, such as Castile, or any other good hard soap, as a barber would for shaving, and apply that to the affected part with a soft shaving brush; apply it as carefully as possible, so as to cover every part of the surface, and go over it several times, letting the former coat dry a little before applying another, forming a thick crust impervious to the air. In small burns, and even in pretty extensive and severe ones, this is the best mode of application, and the only one necessary. In many cases of very severe and dangerous burns, under the influence of this application, the inflammation subsides, and after a week or more, the crust of lather comes off, exposing the surface smooth and well. Although it is important to apply the _soap_ early, and the case does much better if that has been done, still I have found it the best remedy even as late as the second or third day. In such a case, the _lather_ application is the best. For the fever and general nervous disturbance, _Aconite_ and _Bell._ should be given alternately, as often as every half hour, and the _Aconite_ should be given in appreciable doses; it acts powerfully as an anodyne. The soap treatment, or at least, the mode of applying it was first suggested to me by Dr. J. TIFFT, of Norwalk, Ohio, some six or seven years ago, since which time I have had opportunities of testing its virtues in all forms of burns and scalds, some of which were of the severest and most dangerous character, and I am quite sure in several cases, no other remedy or process known to the medical profession, could have relieved and restored as this did. The application of finely pulverized common salt, triturated with an equal part of superfine flour, acts very beneficially on burns. It seems to have the specific effect to "extract the heat," literally putting out the fire. It is particularly useful for deep burns where the surface is abraded. Some may suppose this would be severe and cause too much pain when applied to a raw surface, but so far from that being the case, it is a most soothing application. It often so changes the condition of even the severest burns, in a short time, as to render them of no more importance and no more dangerous than ordinary abrasions to the same extent, by causes unconnected with heat. _Urtica urens_ is directed for burns, and is useful, but the _Urtica dioica_ is better. For Chilblains, That follow freezing or chilling the feet, causing most distressing uneasiness and itching of the feet and toes, take these remedies, _Rhus_ and _Apis_, the former at night and the latter in the morning. In bad cases, they should be used once in six hours. Applications of _Oil of Arnica_ to the affected parts at night, warming them before a fire, will serve greatly to palliate the sufferings, and frequently effect a perfect cure. The _Urtica Dioica_ will relieve recent cases, immediately, and is one of the best remedies for the chronic affection. It should be taken at the 2d dilution, and the tincture applied to the affected part every night. Hoarseness. This arises generally, from inflammation of the mucous membrane of the _Larynx_, in ordinary cases but slight. It is a frequent accompaniment of Bronchitis. The remedies most useful, and those which will, in almost all ordinary cases, remove this affection at once, are _Arum tri._ and _Copaiva_, to be taken a dose every three hours in alternation. If there is present a dry hacking cough, it will be well to take _Bell._ in the interval between the other medicines, for a day, or until the cough is relieved, or changed to a moist condition. Inflammation of the Brain. _Brain Fever._ Though this affection is not strictly what is called "brain fever," it is attended with more or less general fever, while in what is called "Brain fever," there is great irritation of the brain, requiring in many respects similar treatment. As the treatment proper for inflammation of the brain, with some slight modifications in relation to the existing fever, will be applicable to both, I shall treat of them under one head. Some of the principal symptoms are delirium and drowsiness, fullness of the blood vessels of the head, beating of the temporal arteries, redness and fullness of the face, the pupils dilated, (though in the very early stage they may be contracted.) If the membranes of the brain be the seat of the disease, the pain is more intense, and frequently the limbs are in a palsied state. The patient sometimes vomits immoderately, and the pulse is slow and irregular, but full. The breathing becomes stertorous. The fever is very considerable, and the head hot. TREATMENT. _Aconite_, _Belladonna_ and _Bryonia_ should be given in rotation, one dose every hour in a violent case, lengthening the intervals as the symptoms abate. Applying _hot cloths_ to the head, removing them occasionally to let the water evaporate, will greatly palliate and will not in the least, interrupt the action of the medicines. Never apply cold to the head of any person, when hot or inflamed, much less to that of a child. Children are often killed by the application of ice to the head, producing congestion and paralysis of the brain. Hot applications are Homoeopathic to the state then existing, and always beneficial. The feet may also be placed in hot water, but children should never be put into a hot or warm bath when sick, so as to cover more than the lower extremities. Convulsions of Children--Fits. These generally occur, either from the irritation of worms, or as precursors of ague, or they may arise from diarrhoeal irritation, affecting the brain. They sometimes occur in hooping cough. If convulsions occur from worms, the child appearing to be choked, give at once some salt and water, and as soon as the first paroxysm is over, give a dose of _Bell._, and after an hour a dose of _Santonine_. If they come on at the commencement of an ague chill, give _Aconite_ and _Bell._ every half hour for three or four doses alternately, then leave off the _Bell._ and give _Baptisia_. If diarrhoea is the cause, give _Bell._ and _Cham omilla_. If from hooping cough, _Bell._ alone should be used. Measles. This is a contagious disease, and always begins with symptoms like a cold, with high fever, and a severe dry cough, thirst and restlessness. _Pulsatilla_ is the proper medicine to palliate and regulate the symptoms. If the fever is high, _Aconite_ should be used every two hours alternately with _Puls._ Should the eruption subside suddenly, give _Bryonia_ with _Pulsatilla_ until it reappears. Let the child drink freely of cold water, and avoid stimulants of every kind. If the eruption is tardy in its appearance, a hot bath may be administered, being careful to have the room quite warm, and to rub the patient dry, very suddenly after the bath. Frictions by the healthy hand over the surface, will do much towards bringing out measles. After the eruption is out, quiet, freedom from sudden exposure to cold, cold water and light diet is all that is necessary. In some of the most obstinate cases, where the eruptions failed to appear in the proper time, as well as where they had receded too soon, I have been able to bring them out in a short time with an infusion of Sassafras root, sweetened and taken quite warm, in doses of half an ounce in fifteen to thirty minutes. It is a remedy for measles well worth attention. Mumps. This is a contagious disease, consisting in an inflammation of the Parotid gland. There is, at first, a sense of stiffness and soreness on moving the jaw, soon after the gland begins to swell, and continues to be sore and painful, with more or less headache, and general fever for from six to eight days. It is not ordinarily a dangerous disease, unless translated to some other part. It may remove from the original seat to the brain, the testicles, or in females to the breasts. TREATMENT. _Mercurius_ should be given three times a day during the attack. If the brain becomes affected, use _Bell._ and _Apis mel._ in alternation. Should it recede to the testicles, or to the female breasts, _Apis mel._ is _the_ remedy. _Mercurius_ may be used in connection with the _Apis_ as soon as the violent symptoms have subsided, in order to prevent permanent glandular swellings. Stings of Insects. The effect produced by the sting of Bees, Wasps, and Hornets of all kinds, is so nearly, if not quite identical, that I shall make no distinction between them. There are very few, if any persons, who do not know the symptoms, at least the local effects of the Bee sting. Pungent, stinging, aching pain, redness and swelling of the part. The wound has at first, and for some time, a white spot or point where the sting entered, surrounded by an areola of bright scarlet, growing fainter and paler as it recedes. The swelling is not pointed, but a rounded elevation, with a feeling of hardness. If upon the face, it not unfrequently causes the whole face to swell so as to nearly if not entirely close the eyes. In some instances, the brain becomes affected and death ensues. TREATMENT. I have for many years, used but _one remedy_, and that has in all cases, and under all circumstances, when applied at any stage of the affection, produced prompt and perfect relief; therefore I shall recommend no other. It is the common garden _Onion_, (_Allium cepa_) applied to the spot where the sting entered. I cut the fresh Onion and apply the raw surface to the spot, changing it for a fresh piece every ten to fifteen minutes, until the pain and swelling, and all disagreeable symptoms disappear. If it is applied immediately after the stinging, the first application will afford perfect relief in a few minutes, and no further effect from it will be experienced. Applied later, it must be continued longer, and this may be done one or two days after the stinging, with just as much certainty of removing whatever symptoms may still exist. I treated one case when three days had elapsed, the patient (a young lady) was delirious and speechless, the whole face was so swollen as to entirely disfigure her features, raising the cheeks to a level with the nose, and closing the eyes. Her life was almost despaired of. The surface of a freshly cut onion was applied to the point where the sting entered, and changed about once an hour for a fresh piece. In a few hours consciousness returned, and a rapid recovery followed. All the swelling and disagreeable symptoms were gone in three days. _Ledum_ is highly recommended by some Physicians, and is doubtless of some value, but it is not to be compared with the _Allium_. The most potent and certain remedy for the poison caused by the Bite of the Rattlesnake is _Alcohol_, in the ordinary form, or in common Whisky, Brandy, Rum or Gin. Let the patient drink it freely, a gill or more at a time, once in fifteen to twenty minutes, until some symptoms of intoxication are experienced, then cease using it. The cure will be complete as soon as enough has been taken to produce even slight symptoms of intoxication. It is remarkable how much alcohol a patient suffering from the poison of the Rattlesnake will bear. An intelligent medical friend of mine in Kanawha County, Virginia, gave a little girl of ten years, who had been bitten by a Rattlesnake, over three quarts of good strong Whisky, in less than a day, when but slight symptoms of intoxication were produced, and that seemed to arise entirely from the last drink. She recovered from the intoxication in a few hours, and suffered no more from the poison of the serpent. Instances of cures with whisky are numerous, and I have never heard of a failure, when it was used as here directed. I presume it will do the same for the poison of other serpents. Headache. This symptom or affection, (if it can be classed as a disease) may depend upon so many causes, and be so very different in its effects, degrees of intensity, and the kind of pain or sensation attending it, that one will find it very difficult to mark out any definite treatment. I shall, therefore, only point out some of the more frequent cases, and the indications for certain remedies. What is called "_sick headache_," or "nervous headache," begins by a sense of blindness or blur, before the eyes, of green or purple colors, dazzling or swimming in the head, without, for some time at first, any positive aching or pain. In the course of an hour, a longer or shorter time, the dimness of vision goes off, and the head begins to ache. This may or may not be accompanied with nausea and vomiting. Some persons are always more or less sick at the stomach, when these "nervous headaches" come on, others are not thus affected. TREATMENT. If taken as soon as the first blur before the eyes is noticed, or before any pain is felt in the head, _Nux Vomica_ will, in nearly all cases, arrest the disease at once. It may be necessary to take two or three doses at intervals of an hour. Later in the case, though _Nux_ may palliate, it will not cure. If headache with sickness comes on, _Macrotin_ and _Podoph._ should be given in alternation, every half hour, if the symptoms are very severe, and the nausea great; but in a mild case, give it once an hour, lengthening the interval as the symptoms abate. If the feet are cold, as is often the case, putting them into hot water will palliate the symptoms, and not interfere with the medicines. If the head feels hot, apply _hot_ water to it. Never apply cold to the head, when there are any symptoms of congestion, as of fullness of the blood vessels. For Common Headache, If the face is red, and the arteries of the neck and temples throb violently, give _Bell._ If there is paleness and faintness, _Pulsatilla_ is the remedy, especially if the forehead is principally affected. If the pain is mostly in the back of the head, _Nux_ is to be used; if in the front, and is sharp, affecting the eyes, _Aconite_; if at the angles of the forehead, with a sense of pinching, _Arnica_; if a sense of fullness and pressing outwards, or with an enlarged feeling, _Macrotin_; if intermitting or remitting, _Mercurius_; if there is ringing in the ears, _China_. Headache from fright should have _Aconite_. For that kind of _headache_ that often occurs during the prevalence of fevers, and is not unfrequently a premonitory symptom of an attack of fever, I have found _Baptisia_ and _Podophyllin_ to be specifics. I give them alternately, every two hours a dose, until the headache ceases. It often subsides in a few minutes after the first dose of either, though I have sometimes failed with one alone and succeeded in the same cases afterwards with both in alternation. _I have no doubt_ but that they act in many cases, as _Prophylactics_, entirely warding off and preventing fevers, or at least arresting them at the premonitory stage. _Podophyllin_ is a most valuable remedy for headache. Nose Bleed--Epistaxis. If it arises from fullness of the vessels of the head, with throbbing of the temples, redness of the face and eyes, _Belladonna_ is the remedy. If fever is present, _Aconite_ must be alternated with _Bell._ In females or children who have habitual nose-bleed, _Pulsatilla_ and _Podophyllin_ are to be used alternately, night and morning. During the paroxysm of bleeding, _Arnica_ should be used, one dose repeated in a half hour if it continues. If it is produced by over-exertion, _Rhus_ is the proper remedy. If it occurs in the _early stage_ of fever, _Aconite_ and _Bell._; in the latter stage, _Rhus_ and _Phos._ are to be used. _Hamamelis_ will frequently arrest nose-bleed _immediately_ after one or two doses. Worms. It is difficult to determine the presence of _worms_ in children, much more in adults, yet both are affected by them occasionally. In children, there is more or less fever and restlessness, screaming out in sleep, starting, pain in the bowels, vomiting, choking, diarrhoea, picking at the nose, fetid breath, voracious and variable appetite. TREATMENT. _Santonine_ is a remedy which I have used for years, and I have treated many hundreds of cases, with such unvariable success, that I feel disinclined to use or to recommend any other. It brings away the worms entire, and relieves the patient of all morbid symptoms immediately, or in much less time than any other remedy of which I have any knowledge. It seems to act specifically upon the worms, causing them to leave the bowels by being evacuated with the feces, without producing any sensible impression upon the bowels, the evacuations remaining natural, if they were so, or becoming so, if deranged, and the worms coming away not quite lifeless. I have often prescribed this remedy for children suffering under intermittent or remitting, and even typhoid fever, in the summer season, when there were not present any well defined symptoms of worms, and yet the fever would soon abate, and in due time worms appear in the fecal evacuations. It often arrests entirely intermittent fever, when worms are present, and are the probable cause of the fever. I give either the crude salt in from one-fourth to one-half grain doses, or a trituration of one grain to four of sugar, giving in the latter case, from one to two grains of the trituration. Give one dose at bed-time, or in an urgent case at any other time, but never repeat the dose under thirty-six hours, and in an ordinary case, under forty-eight hours. This is _the_ medicine _par excellence_ for worms. It may be repeated once a week, when there is a tendency in the patient to the development of worm symptoms, or, in other words, the breeding of worms. The idea held out by some that it is hurtful, or unimportant to remove the worms, in itself considered, is simply _nonsense_, and _worse_, for children are sometimes sacrificed to this idea. Earache--Otalgia. This may arise from various causes, but a common one is sudden cold. If it arises from cold, and there is general fever, or if the ear is red, or the side of the head and ear hot, _Bell._ and _Baptisia_ should be given in alternation, every hour, or in a violent case, more frequently. These remedies will soon relieve such cases. Cloths wrung out of hot water should be laid over the ear, or the side of the head steamed, or it may be laid into water quite warm, with good effect. Where the disease is a chronic affection, and the patient is subject to frequent attacks of pain in the ear, especially on a change of the weather, from dry to moist, _Mercurius_ is the proper remedy, especially if it is worse at night, when warm in bed. If it arises from a shock or blow, _Arn_. is to be used. In scrofulous persons, whether there is ulceration or not, _Phosphorus_ and _Pulsatilla_ are the remedies. Children and even adults, not unfrequently suffer from earache, without any known cause sufficient to account for it. On examination into the ear you will often find either the cavity filled or nearly so, with a hard black substance, (the inspissated "earwax") almost as hard as horn, or else the ear will be quite empty, and the sides of the cavity _dry_ and red, though perhaps not properly in a state of inflammation. The natural condition of the cavity as it can be seen by straining the ear outwards and backwards a little in a strong sun light, is moist, the surface covered slightly with a yellowish, greasy, soft substance (the cerumen) "earwax." When this is wanting or in excess, or its character changed, it is evidence of disease, and pain is likely to occur. The TREATMENT for this condition is to remove the accumulation when that exists, as the first step. But this must be first softened by pouring some warm oil, pure olive oil, or good pure sperm oil, into the ear, and repeat it two or three times a day for several days, until it is so far softened as to be easily removed with the probe end of common small tweezers, having a spoon-bowl point. When there is dryness, moisten the surface with oil. In either case, it is best, for a while, to protect the delicate surface from the air, by putting oiled wool into the external ear. If the ear was filled, give _Mercurius_ once a day until there appears a natural secretion. If dry, use _Belladonna_. Toothache. It is difficult to determine the cause of toothache, and more difficult to select the remedy. It often depends upon decay of the tooth, and exposure of the nerve to air, and contact with food or drinks, or even saliva, which irritate and produce pain. _Pulsatilla_ will as often relieve such cases as any other remedy, yet if it has been aggravated by a recent cold, _Bell._ and _Nux V._ may be better. If the nerve is not exposed, and there is a disposition to a return of the pain on exposure to cold air, or a change of weather, the pain being of a _rheumatic_ character, give _Rhus_ and _Macrotin_ in alternation. These will relieve many cases. For decayed teeth, the pain being dull aching, with soreness, use _Chamomilla_. The body of the tooth, that is the dentine, sometimes becomes very sensitive when there is no decay or cavity, the pain being experienced when some hard substance hits, or the air or water, either cold or hot, comes in contact with the tooth. The temporary pain will generally yield to _Arnica_, and in most instances, the daily use of _Arnica_ at the first decimal dilution, applied to the surface, and upon the jaws, will effect a cure. The _chloride of Zinc_ applied to the surface of such teeth for a few moments will destroy the sensitiveness of the dentine. Teeth that are ulcerated at the roots, or have ulcerated gums around them, the teeth being decayed, should be extracted at once, for, besides the pain and inconvenience they cause, they are a _very prolific_ source of _disturbance_ to the digestive organs, from the positive poison generated by the decaying process. If people will use soft brushes upon the teeth with soap and water, followed by rinsing with simple water only, after each meal, brushing both inside and out and crossways, so as to clean between them, they will be saved much pain and decay, and disease of other parts, arising from foul and diseased teeth. Teething of Children. Affections arising from teething of children, are often of a serious character. The most prominent of which is _Diarrhoea_. _Fever_ frequently accompanies the diarrhoea, and _convulsions_ occasionally occur. _Aconite_ and _Chamomilla_ should be used in alternation, every one or two hours, according to the violence of the fever, and if convulsions occur, or are threatened, as will be known by twitching, starting, and screaming, use _Nux_ and _Bell_. These may be given in rotation with the others, following the remedies, one after the other, every hour. I have relieved the most alarming cases in a day by this method of procedure, that had not yielded to either of the single remedies for several days, given as directed in the books; the patient growing worse continually. If the gums over the teeth look white and the teeth, (one or more,) are near the surface, the gums should, by all means, be cut. Press the point of a lancet or penknife down upon the top of the gum, until the tooth is plainly felt, and be sure to make the cut as wide as the tooth. Rub the gums with _Arnicated water_ once or twice a day. _Pulsatilla_ should be given at night and _Chamomilla_ in the morning, during the whole summer while the child is teething, as a prophylactic against the fever and diarrhoea that is likely to occur. It will generally save all trouble. If the diarrhoea is profuse, watery and light colored or brown, give _Phos. acid_ and _Veratrum_ alternately, as often as the discharges occur. For the restlessness of infants at night, _Coffea_ is the specific. Apthæ--Thrush. This is a disease peculiar to nursing children. The mouth becomes sore, and the tongue, lips, and fauces are covered with a white crust, looking like milk curds, which, when removed, leaves the surface red, inflamed and very tender. It sooner or later, extends to the stomach and bowels, producing severe and dangerous diarrhoea. TREATMENT. Of all the medicines known to our Materia Medica, none, according to my experience, will in the least, compare with the _Eupatorium aromaticum_. It is almost, if not quite certain to relieve speedily in all cases. I say this, not only from my own experience and observation, but from the testimony of several other Homoeopathic Physicians, who have, within the last year, used it. It should be given at the first or second dilution, once in four or six hours, and three or four drops of the tincture put into a teaspoonful of water, and the mouth occasionally washed with the mixture. In summer, where agues prevail, and the child is feverish and restless, _China_ will aid in the cure, to be given once in six hours between the doses of the _Eupatorium_. If the diarrhoea is obstinate, the discharges colored, and the child is sick at the stomach, give _Podophyllin_ with the other remedies. Inflammation of the Eyes--Ophthalmia. For common Ophthalmia, in the early stages, while there is more or less fever and headache, with flushed face, bloodshot eyes and throbbing of the temporal arteries, _Bell._ and _Aconite_ should be used alternately every two hours, and a wash made with ten drops of tincture of Aconite to one gill of pure water, applied to the eyes as hot as the patient can bear. This application should be repeated every two hours, in a violent case, until the eyes are easy, and then about twice a day until all inflammation and redness pass off. This will relieve a large proportion of cases in from one to four days. If, however, the case continues obstinate for a longer time, or has been of a week or more standing before the treatment is commenced, in the place of Bell., or after using it one or two days, use _Hydrastus_ with the _Aconite_, giving them alternately at intervals of two to six hours, according to the stage of the case--more frequently as the symptoms are more urgent, using washes prepared of each separately, as directed for Aconite, except that the Hydrastus wash may be twice as strong; and apply each about half as often as the same medicine is taken internally. The wash should, in all cases of acute inflammation of the eyes, be as hot as it can be borne. Let it be put into the eyes so as to come directly in contact with the inflamed surface. Simple hot water applied to inflamed eyes for hours together, allowing short intervals between the applications, will often cure most painful cases. _Never apply cold_ to inflamed eyes. It always aggravates. When the inflammation is in a scrofulous person, especially in infants, it assumes a purulent character, and may leave the cornea in clouded (nebulous) condition, and the sight more or less obliterated. For this condition use _Conium_ first, and apply it _in tinct._, half water, to the eyes every four hours. Wounds and Bruises. On this subject, I must necessarily be very brief. When a wound is inflicted, the first and most important thing to be done is to _arrest the flow of blood_. Every one should know how to do this. The bleeding is to be stopped, and the wounded vessels to be secured, so that no further flow can take place. First, then, to stop the bleeding, _pressure_ is to be made upon the artery leading to the wound. If the wound is in the leg or foot, pressure is to be made, either on the vessel above and near the wound, or, where that cannot be easily found and compressed, make firm pressure with the thumb or some hard substance, in the groin, about two and a half inches at one side of the center of the pelvis, (wounded side) just below the lower margin of the belly, towards the inner side of the thigh, where the great artery (Femoral artery) can be felt pulsating. By pressing firmly upon this artery, the blood is arrested in its flow into the limb, and of course the bleeding from the wound soon ceases. If the wound is in the arm or hand, _pressure_ is to be made, either just above the wound, or on the inside of the arm, about one-third of the way from the shoulder to the elbow, where the artery (Brachial) can be felt. To secure the parts from further bleeding, the wounded artery must be taken up and tied. Let it be seized by forceps, or the point of a needle may be thrust into it, and the vessel stretched out a little, a thread put round it and tied; cut off one end of the tie, and let the other hang out of the wound, until it comes out by the vessel sloughing off. Bring the lips of the wound together, and if it is large, put in stitches enough to hold them, and put on an adhesive plaster, compress of cloths, and bandages to keep it from straining the stitches, and protect it from the air. The _Arnica_ plaster, made by JOHN HALL, of Cleveland, is the best adhesive plaster of which I have any knowledge. Give the patient _Aconite_ once in two hours, for a day after the accident. _Slight Cuts_ about the joints, especially the knee, are dangerous, from their liability to affect the ligaments, inflame, and produce _Lockjaw_. Therefore, such wounds, ever so slight, are of great importance. They should be at once closed up, whether they bleed or not, and covered with an adhesive plaster, (Arnica plaster is the best) a bandage, and the knee should not be bent, even when walking or sitting, until the wound is healed. It is best to apply a splint from the hip to the heel, and bandage the limb to it, so as to prevent bending of the joint. _Bruises_ are to be treated with _Arnica_, applied to the part affected, by putting twenty drops of the tincture into a gill of water, if the skin is _not_ ruptured, or three drops into the same if it is, and bathing freely. The _Arnica_ is to be taken internally at a higher dilution. Keep the parts covered with cloths and wet in _Arnica_ water. If a blow is received upon the head, by a fall, or in any other way, producing a "stunning" effect, (concussion of the brain) so that the patient appears lifeless for a time, and delirious when he begins to come to, there is great danger of inflammation of the brain, and death from the re-action, or in some cases, the shock is so great that the patient will never revive unless he has the proper aid. _Arnica_ is the great remedy to bring on reaction, arouse the patient, and prevent _dangerous_ inflammation or congestion of the brain. When a patient is "stunned" by a blow or fall, he should be conveyed soon as possible, to some _quiet_ place, and as little noise as practicable made about him, and the room kept darkened. _Arnica_ 3d should be given immediately, and the nostrils wet with strongly arnicated water. If fever arise after he comes to, _Aconite_ should be given with _Arnica_, and if the head aches, or becomes hot, _Bell._ is to be used. This will prevent or arrest all symptoms of inflammation. _Torn and Mangled_ wounds should not be handled much. If they bleed, the blood must be stopped as in any other case. If they are dirty, warm water may be gently applied to cleanse them. The wound should be covered with some soft cloths, and kept constantly wet in Arnicated water of the strength of four drops of the _tincture_ to a pint of water. Piles--Hemorrhoids. One important matter in all cases of habitual piles, is, to keep the bowels regular. Much can be done for this purpose by diet and regimen. On rising from bed in the morning drink freely, from a gill to half a pint of cold water, at least half an hour before breakfast; use such diet as is easily digested, and drink no alcoholic beverages. To relieve the bowels when costive, take a dose of _Nux Vomica_ at night, and _Podophyllin_ in the morning. This may be repeated from day to day until the proper effect is produced. To relieve from a severe attack of Piles, use _Bell._ and _Podophyllin_ in alternation every four hours, and apply to the tumors when inflamed, cloths wrung out of hot water, or sit in hot water for a time. A poultice made of fine-cut _Tobacco_ wet in hot water and crowded firmly up against the pile-tumors, secured by a T bandage, will relieve the most desperate cases for the time, and is attended with no danger or disagreeable symptoms except in rare cases, when it produces sickness at the stomach, which soon subsides on the poultice being removed. _Oil of Arnica_ is an excellent application for inflamed Piles. A most important point in the management of Piles, and one often neglected, is to replace the prolapsed tumors. The tumors will be protruded from within the anus by the act of evacuating, and if left in that condition, will be pressed upon by the external parts, chafed and inflamed. In all such cases, the patient should take particular pains to return the tumors into the rectum; and to aid in that process a little oil may be applied when they will be easily pushed back, and the sphincter of the bowel will close below them, preventing any chafing, and the consequent inflammation. For _Bleeding Piles_, _Ipecac_ and _Bell_. are very efficient remedies. They may be alternated every half hour, or oftener if the bleeding is severe, or at longer intervals when it is only slight. _Hamamelis V._, (Witch Hazel,) will in nearly all cases arrest the bleeding at once. It should be applied to the parts and taken internally at the same time. Drop doses to be put on the tongue once in fifteen or twenty minutes. An infusion of the _Hamamelis_ may be taken internally in doses of half a teaspoonful, and the same injected into the bowel with excellent effect. The most effectual way, and the best for obtaining permanent relief from Piles when the tumors have become hard, and remain all the time so as to pass out of the anus at every evacuation, being constantly more or less tender and painful, and often becoming inflamed, is to have them taken off. But never let that be done with a knife. The bleeding would, in such a case, be very excessive, and most likely fatal. The history of knife operations for the excision of Pile tumors is written in blood, and the tombstone stands as a monument of condemnation of the practice. No trustworthy surgeon will at this day attempt it. But however dangerous may be the knife operation, there is no danger at all to be apprehended from removing the tumors by a _ligature_. To accomplish this, take a soft cork about three-fourths of an inch in diameter, and one inch long--make a hole through the center from end to end, about one-eighth of an inch in diameter--cut crucial grooves in the top of the cork about an eighth of an inch deep, bevel down the lower end nearly to an edge, make a cord of saddler's silk, three fold twisted together and waxed, about eight or ten inches long, double this in the middle and pass the loop down through the cork out at the sharp end, the two loose ends of the string being out at the grooved end. Make a strong hickory stick about three-sixteenths of an inch in diameter, and just long enough to pass across the square end of the cork. Now have the patient protrude the Pile tumors as far out as possible, being placed on his knees with the head bent to the floor, pressing out firmly as if to evacuate the bowels. Let the tumors be dried as much as possible by gently pressing a soft, dry cloth to them; then let the loop of the string projecting from the flattened end of the cork, be pushed on over the largest tumor, and held down at its base, while an assistant places the stick in one of the grooves, ties the two ends of the cord firmly down over the stick, or _toggle_, by a square bow knot; then turn the stick round once, twice, or more, until the pressure upon the tumor is sufficient to strangulate it perfectly, and prevent the string from slipping off. Care should be taken to keep the cord down to the base of the tumor while it is being tied and tightened, as in many cases the base is much the larger part of the tumor, and the cord tends to slip up. After the ligature is applied and tightened, apply arnicated water to the parts, and a large, warm poultice of superfine slippery elm bark, wet so as not to be too soft and slippery, on the face of which Arnica may be put. Keep it on with a T bandage. The patient must be put to bed and kept quiet until the ligature and tumor come off, which will be in about six or seven days, sometimes sooner. Once a day the "toggle" must be turned part, or the whole of a circle or more, to tighten the cord as the patient can bear. This will be very painful from beginning to end of the ligating, but any, even the most sensitive, patient can bear it. The patient must have quite warm hip baths two, three, or more, times a day, or as often as the pain is severe, the poultice being replaced after each bath, and kept constantly on. If there are several tumors protruding, apply ligatures to two of the largest, when these are removed, the others will disappear. Injections of mucillage of slippery elm should be carefully used to move the bowels daily, or at least once in two days. Let the diet be of corn or oat meal mush, or rice. As the tumor gradually sloughs off, the surface heals, so that, though the base where the ligature was applied, may have been an inch or more across it, there will not be a raw surface of over an eighth of an inch in diameter, to which _Calendula Cerate_ should be applied. The patient must keep quiet for a few days longer. Though this is a painful operation, it is not in the slightest degree dangerous. I have effected complete and permanent cures by this mode in numerous instances. Sea-Sickness. _Nux Vomica_ should be used once in about four hours, for twelve hours before sailing, as a preventive to sea-sickness. If, however, symptoms, such as dizziness or blur before the eyes, and headache, begin to come on, a dose of _Nux_ should be taken, followed in an hour with _Pulsatilla_. If the nausea comes on, _Ipecac_ and _Arsenicum_ should be taken alternately between the paroxysms of vomiting, should that symptom appear. If practicable, the patient should lay still upon the back until the sickness passes off. I have removed sea-sickness immediately in several instances with _Pulsatilla_ alone, and the last time I had an opportunity to prescribe for this affection I gave _Podophyllin_. It removed all the symptoms in a few minutes. That is the only time I ever tried it, but from the provings I am satisfied it is one of the best remedies. Asiatic Cholera. I was practicing in Cincinnati during the prevalence of Cholera in the years 1849, and 1850, and in Northern Ohio in 1854, and had abundant opportunity to observe and treat it. The disease generally begins with a diarrhoea, which may continue for several days, or only a few hours before other symptoms set in, such as vomiting, then cramping in the stomach and muscles of the legs, arms, hands and feet, followed by cold sweats, great prostration, restlessness, excessive and burning thirst, drinks being immediately rejected. These symptoms continue, the patient sinking rapidly into _collapse_, when the skin looks blue and shriveled, the eyes sunken, the surface covered with a cold, clammy sweat, the extremities, nose, ears, tongue and breath cold, the voice hollow and unnatural. This condition continues from two to eight or ten hours, the patient regularly failing, sometimes becoming delirious before he dies. In some cases the vomiting and diarrhoea set in simultaneously, and the other symptoms follow, as above described, in rapid succession. In others the cramping may be the first symptom, the others following it. In a large proportion of cases, the disease takes the course first described above, the diarrhoea, called the _premonitory symptoms_, or sometimes _cholerine_, coming on several hours, if not a day or more, before any other symptoms. The diarrhoea is not usually painful, hence the patient may not be alarmed so as to attend to it until the more dangerous symptoms appear. It begins in some cases with pain and some griping, the discharges rather consistent, having a bilious appearance, so that the patient supposes it to be an ordinary bilious diarrhoea, which is not dangerous, his fears being thus quieted. But however the diarrhoea begins, it becomes sooner or later, copious, watery, and light colored, (rice water) painless but rapidly prostrating. TREATMENT. In the early stages of the diarrhoea, _Veratrum_, taken about twice as often as the evacuations occur, will frequently arrest it in a few hours, especially if the patient lies down and keeps quiet. But if not, and it increases in frequency, or becomes more copious, or any sickness is felt at the stomach, the patient should, at once, be laid upon a bed and _strong tincture of Camphor_ should be given in drop doses, once in five minutes, for one hour or more, and as the symptoms abate, once in ten, fifteen or twenty minutes, for six or eight hours. A teaspoonful of the _Camphor tincture_ may be put into a tumbler of cold water, ice water if at hand, and the water agitated until it becomes clear, giving a teaspoonful of this camphorated _cold_ water as a dose, stirring the water each time. I think this is better than to give the pure tincture. After the patient becomes quiet and easy, _Veratrum_ should be given in alternation with Camphor, a dose in four to six hours for several days, or oftener if he feels any symptoms like a threatened return of the disease. These two medicines serve as _prophylactics_ (preventives) of Cholera. If, however, the disease continues in spite of the Camphor and Veratrum, in the first instance, or later, (as the Camphor may be given in many cases with success in the advance stage,) you must resort to other remedies. If vomiting comes on with burning in the stomach give _Ipecac_ and _Arsenicum_ in alternation as often as the vomiting occurs, and if the diarrhoea continues give _Veratrum_ between the doses of the other two, in a violent case, as often as every ten to fifteen minutes, and at longer intervals when the disease is slow in its progress. If the vomiting and diarrhoea, or either, occur with a kind of explosion, the vomiting ceasing suddenly for the time, after the first _gush_, or the discharges from the bowels are involuntary, _Secale_ is the specific remedy. For the cramping, _Cuprum_ and _Veratrum_ are the remedies to be given alternately. If, however, the _cramping_ comes on as the first symptom, which is sometimes the case, the patient being suddenly seized with it before any other alarming symptoms occur, _Camphor_ is _the great remedy_, and in this case it may be given in doses of double or treble the quantity before directed. If he sinks into the _collapse_ and lies quiet, indifferent to everything, the pulse sinking, or he is pulseless, _Carbo Veg._ will sometimes arouse and restore him, hopeless as the case appears. It should be given once in half an hour until the pulse begins to rise. If, however, instead of being quiet he is restless and thirsty, give _Arsenicum_ in alternation with _Carbo Veg._, repeating the dose as above directed. In some cases, after all the active symptoms cease, the patient will become quiet and drop to sleep, and instead of the pulse rising, as it will if he is recovering, it sinks, or does not appear if he has been pulseless, and the breathing becomes irregular and feeble--he is sinking. If aroused, he sinks back into the stupor in a few moments as before. _Laurocerasus_ is a specific for this condition. It should be given once an hour until he is aroused. If, however, besides the stupor, the head is hot, the face red, the breathing oppressed, the pulse slow and sluggish, _Opium_ is to be used, and may be given in alternation with _Laurocerasus_. 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 space 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 identity 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 sexes, 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 _Causticum_. 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 molasses, to be taken in small quantities. 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 principal 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 penis, _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 substitute, 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, _Arsenicum_ 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 _Arsen._ 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 Arsenicum. _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 appetite, 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 nobody 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 Potassium_, the common Hepar Sulphur (sulphuret of Potassa) 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. 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 appetite, 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, _Arsenicum_ 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 assure 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 quantities, 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 _Arsenicum_, 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 vagina 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 vagina. 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 Homoeopathic 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 rectum, 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 breasts, 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 aphthæ (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. TREATMENT. I treat both the nipple and the child's mouth with the same remedy _Eupatorium aro._, applied at the strength of 6 drops of the tincture, to a teaspoonful of water, the application being made by a soft cloth, wet and laid over the nipple; give drop doses of the same strength internally every three hours, which will, in nearly all cases effect a cure in one or two days. The child's mouth should be wet with the same each time just before nursing. The oil from the pit of the butter nut, (Juglan's Cinerea,) obtained by heating the pit and pressing out the oil, applied to the nipple, will generally cure it after 3 or 4 applications about six hours apart. The child may take hold when the oil is on, without danger. This remedy is sufficient in nearly all cases. Leucorrhoea and Prolapsus Uteri--Whites, Female Weakness. The disease depends in all cases upon _inflammation_ of the uterus, or vagina, or both. The inflammation may be simply in the neck of the uterus extending to the posterior surface of the vagina, or the latter may not be affected; or it may extend to the whole internal surface of the uterus, producing swelling of that organ, both the fundus and neck. The swelling may be confined mostly to the fundus, causing it to be too large for the space it ordinarily fills, hence there will be more or less _displacement_ of the womb, and crowding upon other parts, as the bladder or rectum. In some cases, the swelling is more on one side than on the other, so that it will be crowded over to the opposite side. These displacements are often called _prolapsus uteri_, or "_falling of the womb_," carrying the idea that the difficulty depends upon a morbid relaxation of the ligaments that support the organ. Not one case in a hundred is of this latter character, but nearly, if not all, depend upon the inflammation and swelling above mentioned. How futile then, not to say _hurtful_, must be all instruments for, and all attempts at replacing and supporting it by _force_! All such mechanical meddling is injurious, and should, with all the "supporters," be condemned and discarded. They may afford temporary relief, but this is at the expense of future health. Cure the disease, relieve the inflammation, and nature will replace the organ. Leucorrhoea is always present where there is ulceration of the neck of the womb, and this ulcerated condition exists to a greater or less extent, in many cases where it is not suspected by the patient. It is vastly more prevalent than is generally supposed. The _symptoms_ are numerous. Among the more prominent are a sense of weight and bearing down in the pelvis, pains extending down the limbs, aching and weakness of the small of the back, headache, more or less gastric disturbance, dyspepsia, the food souring on the stomach. There is often, especially when there are ulcers on the parts, a distressing sense of heat or a smarting sensation. The menstrual function is frequently deranged, the bowels costive, the urethra, by being pressed, becomes irritable and burns and smarts whenever the urine is evacuated. The sleep is disturbed and unrefreshing, and the whole nervous system is unstrung. The discharge from the diseased surfaces, in an ordinary case without ulceration, is of a mucous or muco-purulent character, not unlike an ordinary catarrhal secretion. When ulceration exists it is dark, fetid or bloody, or sanious and purulent, sometimes it is acrid, excoriating the parts. TREATMENT. Inflammation or ulceration, either acute or chronic, in these parts does not differ essentially in its characteristics from the same affection in other mucous surfaces. The proper treatment for a catarrh of other mucous surfaces will be applicable to these, though there is no doubt but that some medicines are more specifically adapted to these than to other organs. In the early stage of the complaint, while the inflammation is acute, or sub-acute, the discharge thin or white, _Copaiva_ and _Macrotin_ are to be given once in 6 hours alternately. During the same time let injections into the vagina of warm soap and water be used twice a day, to cleanse the parts of the secretion, followed in half an hour by a wash of warm water, into which _tr. of Macrotys_ has been put in proportion of 40 drops to half a pint. The application should be made with an 8 ounce or at least 6 ounce curved pipe syringe, so as to throw it with considerable force. If there is a burning sensation, use the washes quite warm, until the heat of the parts is allayed. Avoid the use of _cold_ injections as long as any inflammation exists. If the bearing down is present with burning in the parts, _Bell._ is to be used in rotation with the two former remedies. If the sensation is that of smarting, _Cantharis_ is to be used in place of Bell. Where the disease comes on soon after child-birth, _Podophyllin is the Specific_. It is to be given at the first attenuation three times daily in half gr. doses of the trituration. In this case let the parts be freely washed daily with a solution of borax, quite warm. In the _chronic_ form of the disease, especially where _barrenness_ exists, _Macrotin_, _Podophyllin_ and _Hydrastin_, given morning, noon and night, in the order named, will, in nearly all cases, afford relief. For females who have never borne children, give _Phos. acid_, 2d and _Eryrgium Aquaticum_ 1, night and morning for a week, and then give them at the 3d dilution until the symptoms subside. If there are headache and derangement of the stomach, _Macrotin_ and _Podophyllin_ should be used, each once a day, between the latter remedies. When the discharge is colored and the pains darting, cutting or smarting, indicating ulceration, or if ulceration is discovered by examination, use _Macrotin_ and _Hydrastin_ internally, injecting the latter upon the affected parts freely. The ulcerated surfaces should be well washed off every day with soap and water, or a solution of borax, and the medicine (_Hydrastin_) in form of infusion, used half an hour after the other wash. If the neck of the womb looks dark, and is ulcerated, or is hard and painful to the touch, especially on probing the cavity, _Cornus Sericea_ must be used both as a wash to the parts, and at the first dilution internally, using them twice a day. This remedy will often cure malignant cases. It takes a long time in some instances to cure a chronic case, but if persevered in, these remedies will not be likely to fail.[2] [2] NOTE.--The late Prof. Morrow was remarkably successful, and became justly celebrated for curing hard cases of Leucorrhoea ulceration and "Prolapsus uteri." Almost his entire reliance in their treatment were the _Macrotys_ and _Caulophyllum_, given internally and by injection upon the parts. He gave the Macrotys in the form of tincture every day to the extent of producing specific head symptoms when he discontinued it till the next day, using the Caulophyllum in the meantime in small doses. He rarely if ever failed. Morning Sickness of Pregnant Females. The most efficient and certain remedy for this symptom is _Macrotin_. It should be taken at the first attenuation, a dose before rising in the morning, and one every six hours during the day, as long as the sickness is troublesome. It will generally relieve in a few days. If the stomach is sour use _Pulsatilla_ with the _Macrotin_. As a _preparation for labor_, a dose (one grain) of _Macrotin_ at the first attenuation given in the morning, and the same of _Caulophyllin_ at evening, is of great service. Whatever others may think or say in relation to any preparatory treatment for labor, I have reason to know as well as anything in medicine be known, that patients treated as here directed, pass through labor much quicker, frequently in one-fourth the usual time. Their sufferings are comparatively trifling, and the length of time for recovery to ordinary health after labor is abridged from three-fourths to nine-tenths that of former labors. I am quite confident that the medicines produced this difference. For _irregularity of labor pains_, and for distressing _after pains_, the _Caulophyllin_ is specific. During labor it should be given at the 2d attentuation in about half grain doses, every half hour, until the pains are regular. Two or three doses at most, and generally one will suffice. For the after pains it may be given in alternation with _Ipecac_ or _Aconite_ if there is flooding, or with _Pulsatilla_ when the flooding is not troublesome, a dose once in half an hour, until the pains are checked. For _Rigidity_ of the soft parts and severe, _retarded and long protracted labor_, where the pains are strong and irregular, and great pain and exhaustion is experienced on account of the unyielding condition of the parts, _Lobelia Inflata_ given in drop doses of the tr. in water, once in twenty minutes, in alternation with _Caulophyllin_ as above directed, will in a short time produce the proper condition of the parts, while they render the pains stronger, regular and progressive. In urgent cases I have given the medicines every 5 or 10 minutes, with decided benefit. A Useful Hint to Mothers. Children push beans, peas, corn, &c., into the nose and ear, causing much alarm. To remove such a body take a syringe that works tightly, put the end of the pipe against the bean, shot, or other substance, draw back the piston so as to _suck_ up the article firmly as the pipe is withdrawn from the cavity. LOCAL APPLICATIONS. That medicines act locally, that is, manifest their symptoms by peculiar derangement or disturbance of some particular part of the system, more prominently than of any other part, for the time, no one will deny. That each one has some particular locality or tissue upon which its action is more perceptible than anywhere else, is equally undeniable, and that the prominent symptoms are often external and local, is also true. Yet, with these truths clearly demonstrated, there are those of our school who discard the external or local application of all remedies except _Arnica_. Why this is done, is difficult to determine, unless we can believe that such physicians suppose it to be _heresy_ to make use of any remedy in a different manner from what was recommended by the "Father of Homoeopathy," and abjure all possibility of _improvement_ in our practice. That nearly if not all medicines, may be applied externally with advantage, when there are local manifestations similar to those produced by the drugs, there can be no doubt in the mind of any sensible man. That they will act favorably when so used is _reasonable_, as a matter of theory, and that they do, as a matter of fact, has been _proven_ to my mind, by abundant experience in their use. Therefore, I hesitate not to recommend the practice to others. Medicines must act either by combination with the affected part, or by _Catalysis_, changing the molecular action of the living tissues. In either case, they must come directly in contact with the part to be affected. This _must_ be done through the circulation, when taken internally, or it _may_ be done by direct application of the remedy to the diseased tissue, when that is so situated as to be reached. The difference is greatly in favor of the latter mode when that is practicable, from the greater certainty of its results. This assertion is based, not upon vague hypothesis, but upon _actual practice_. Entertaining these views, however heretical they may be pronounced, I shall proceed to mention some of the remedies I have learned to use thus, and the cases for which they are prescribed. I would remark that, in selecting a remedy, it must be done with as much certainty of its homoeopathic relation to the local or general symptoms for external as for internal use. I have found, however, that much lower attenuations are requisite and admissible. ARNICA is highly applicable to _bruises_, and is valuable also when applied to lacerated or mangled surfaces, to the surface of the limb where a bone is fractured, also about the joint when it has been dislocated. It is to be used in the form of _Arnicated water_, by putting one or two drops to a gill of water for application where the skin is ruptured or the surface raw, and ten to twenty drops to the gill, upon parts where the skin is sound. It is useful also, for _boils_, and _carbuncles_ in the _early stage_, the _strong tincture_ to be applied when the surface is sound, and (to boils) when the surface is open, one drop to a gill of water. Aconite Is applicable to inflamed eyes, in the early stage, where the disease is in the conjunctiva, (that portion which lines the lids and covers the front of the ball), especially if there is a sense of scratching, as though some foreign substance is in the eye, great intolerance of light, chilly sensations, with more or less fever, and quick pulse. Put three or four drops to a gill of warm water, and apply it freely. It is also very valuable for _Neuralgia_, applied strong and warm, along the course, or at the origin of the affected nerve. In neuralgia of the face, apply it upon the side of the face, also just behind and below the ear of the affected side. It is of much value as a remedy for neuralgic affections of the womb. I have relieved the most distressing symptoms of neuralgia of the womb, in a few minutes, by injecting warm water containing twenty to forty drops of _tr. Aconite_ to the pint. By repeating this application at every paroxysm, patients recover rapidly, each succeeding attack being lighter, and the interval between being longer, until they cease entirely. It may be used with much benefit in the same manner, for _Hysteritis_, as well as recent cases of _Leucorrhoea_. It is the most valuable remedy applied to the _Eye_ for a _wound_ of that organ. In _Gonorrhoea_, it is more valuable as a local remedy, than most of those now in use. It will frequently cure alone. In this case, it is to be used with an equal part of the _tr_. and warm water. Belladonna has great power as a local remedy in _Erysipelas_, to be applied with water in proportion of ten drops of the _tr._ to a gill of warm water. It is also of much value applied to the surface of inflamed breasts; also injected when there is inflammation of the _uterus_, with pressing pains as though the bowels would be pressed out. _Very valuable_ in parturition where there is rigidity of the _os uteri_, with fullness of the head and throbbing of the temples. It has the specific power to relax circular fibres without affecting the longitudinal. Calendula, is applied to wounds, _incised_ and _lacerated_, promoting healing by the first intention. It is a valuable application for wounds in scrofulous persons, which tend to suppurate rather than heal by the first intention. It is also useful in old sores. The _Calendula Cerate_ is one of the best of dressings for any abraded surface. Conium is valuable as a _palliative_ upon cancerous tumors. As a _curative remedy_ it is useful in chronic ophthalmia, especially the purulent of children; useful also for _indurated_ swellings. Thuya is a specific when locally used for _Sycosis_, also for fungoid cancerous tumors. I have cured well-marked cases of _Fungus Hæmatodes_ with the tinct. Thuya applied to the surface of the tumor. The _Thuja Cerate_ is a valuable application for malignant ulcers. Cornus Sericea will often cure malignant ulcers both of the breast and uterus, used as a wash. Arsenicum acts favorably on cancers, and is a specific when applied to the surface of _carbuncle_. Ipecac acts very beneficially when applied to the surface where there is high fever, with nausea and vomiting. Half an ounce of _tr._ Ipecac to two quarts of tepid water, applied with a sponge to the whole surface, acts like magic in yellow fever, allaying the nausea, producing free and health-restoring perspiration. Rhus Tox, applied, with water at the strength of thirty drops of the _tr._ to a gill, to parts affected with _Rheumatism_, acts very beneficially. It is also a most valuable application at half the above strength upon parts affected with Erysipelas, when the surface is swollen, and there are vessicles filled with fluid like a blister in burns. It is also useful for sores that exist as the chronic effects of burns when the proper treatment had not been used in the beginning, and the healing process was never perfected. _Rhus Cerate_ is a very useful application to irritable ulcers. Hepar Sulphur is a specific for _Itch and Scald Head,_ applied in form of a wash with twenty to thirty drops of _tr. Hepar Sul._ to a gill of water. Also for ill-conditioned scrofulous ulcers, generally. Cuprum Aceticum. (_Acetate of Copper Verdigris_) applied to _Cancerous_ ulcers of the face, _Lupus_ or _Noli-me-tangere_, in the early stage, will in most cases effect a perfect cure, especially if for a week previously the part has been wet daily with _tr. Thuja_. The best mode of applying the _acetate_ is to mix the impalpable powder, as prepared for paint, with some substance to form a cerate, as equal parts of bees-wax and mutton suet, with 1-50 to 1-100 part of the pure _acetate_ as found in the bottom of the can, when prepared in oil for paint; heat all together and stir until cool. This forms a good plaster for covering and shielding the sore while its medicinal property is in the _Cuprum Aceticum_ diluted as above. It is quite useful for any ill conditioned ulcer. Acetic Acid is a most efficient remedy applied to old irritable _varicose ulcers_ on the limbs of females who have suffered from _Phlegmasia Dolens_, (milk leg.) It may be applied as a wash to the part once or twice a day at the strength of 1-20th of the acid with water, or in the form of good cider vinegar. The manufactured vinegar of the cities does _not_ usually contain acetic acid. ARUM TRIPHYLLUM is a specific to allay the inflammation and excessive pain in _scrofulous swellings_ of the neck, (_Kings Evil_.) The pure drug in powder, wet with warm water, or the green root bruised so as to form a poultice, is to be applied over the swelling. It soon discusses the swelling, or if pus has already formed, allays the the pain, and brings the pus to the surface, and if continued, disposes it to heal rapidly. BAPTISIA TINCTORIA applied as a poultice either in the powdered drug, or with some other substance wet with the infusion or _tr._, _arrests gangrene_ in a short time. It is especially useful for threatened or actual gangrene arising from _lacerated_ wounds or scalds with wounds, as in accidents connected with the explosion of steam boilers; when we often have scalds and lacerations in the same wound. HYDRASTUS CANADENSIS used as a gargler in a putrid state of the throat in malignant _Scarlet fever_, arrests the destructive process _at once_. It is also a most excellent application for inflamed eyes in the second or sub-acute stage. * * * * * PROPHYLACTICS. (_Preventives of Disease._) TO PREVENT SCARLET FEVER Give Belladonna at the 3d attenuation, three to six pellets, according to the age of the child, every morning, during the prevalence of the epidemic. This is for the common or mild form of the disease. If the prevailing epidemic is of the _malignant_ kind, producing fatal ulcerations of the throat, give _Bell._ once in two days and _Mercurius Corrosivus_ at the 3d attenuation on the alternate day. While _Bell._ is a very certain preventive of the common eruptive Scarlatina, it is not as certain to prevent the _malignant_ form. Though it renders the latter much more mild, the _Merc. Cor._ is necessary to ward it off entirely, or so modify as to divest it of the dangerous features. TO PREVENT YELLOW FEVER Take _Aconite_, _Belladonna_ and _Macrotin_, 1st in rotation one dose a day. If there is any headache, or pains occur in other parts of the body, or a languid feeling, take a dose twice or three times a day in rotation. TO PREVENT BILIOUS FEVER OR AGUE Take _Podophyllin_, _Baptisia_ and _Gelseminum_ 1st in rotation, one dose at night, and if symptoms of fever, as headache and loss of appetite, or bad taste in the mouth in the morning appear, take a dose three times a day, and refrain entirely from food for one or two days. TO PREVENT TYPHOID FEVER When exposed, as in nursing the sick, take _Baptisia_ 2d, and _Macrotin_ 2d, a dose three times a day. TO PREVENT SMALL-POX Use _Macrotin_ 1st night and morning, and if nursing or exposed frequently, use it every four hours. TO PREVENT CHOLERA. _Camphor_ (_pellets medicated_ with the pure tincture) _Veratrum_ 3d, and _Arsenicum_ 3d, should be taken in rotation--a dose morning, noon and night, in the order named; so as to take a dose of each every twenty-four hours. If any sense of weakness or trembling comes on, use the _Camphor_ oftener; if pain or uneasiness in the bowels threatening diarrhoea, use the _Veratrum_, and for increased thirst with uneasiness at the stomach _Arsenicum_ more frequently. TO PREVENT DIARRHOEA Where it is prevailing as an _epidemic_, _Ipecac_ at night, and _Veratrum_ in the morning will often _suffice_. For _teething children_ give _Ipecac_ and _Chamomilla_ in the same manner. TO PREVENT DYSENTERY In hot weather when bilious diseases prevail, use _Mercurius_ 3d, _Podophyllin_ 2d, and _Leptandrin_ 1st in rotation, giving one dose a day. In the winter, or when _Typhoid fevers_ prevail, use _Mercurius_ and _Rhus_ tox. alternately a dose every day. TO PREVENT ITCH. A dose of _Sulphur_, or rubbing a little flour of sulphur on the hands, will generally suffice. TO PREVENT COLDS Keep the _arms_, _hands_ and _chest_ well clothed and warm. _Affecting_ the _head_ as _catarrh_, or the pelvic regions keep the _feet and ankles warm and dry_. Affecting joints and muscles as Rheumatism--protect the _Spine_ (back) from colds and currents of air. After an accidental exposure as by getting the feet wet, or being caught in a shower, drink _bountifully_ of cold water, and take a dose of _Nux_; followed in an hour by _Aconite_, if any chilliness is felt, or _Copaiva_ if the head is "stuffed up." In winter and spring when the weather is mild, but there is snow, or the ground is damp, more clothes are necessary than when it is freezing hard and the air is dry. * * * * * PREPARATION OF MEDICINE. As it often becomes necessary for the practitioner to make more or less of his own dilutions and attenuations, some brief instructions especially to new beginners, may not come amiss. Medicine is prepared by mixing it with distilled water, or purified 98 per cent. Alcohol; or if solid and dry, by reducing it to powder and triturating (rubbing) it in a mortar with pure sugar or Sugar of Milk. The liquid is called _dilution_, the powder _trituration_. The attenuations are mostly made at the decimal (1-10,) or centecimal (1-100) ratio and numbered 1, 2, 3, &c., by putting ten drops of the liquid with ninety drops of Alcohol, or ten grains of the powder with ninety grains of Sugar for the 1st, and ten grains or drops of the 1st with ninety more of Alcohol or Sugar, as the case may be, for the 2nd, and so on to any desirable extent. If the centecimal attenuation is adopted, one grain or drop is used instead of ten, as in the decimal. I prefer the decimal to the centecimal ratio. Not that there can possibly be any difference in the action of the medicines, at the same attenuation, whether it was brought to that state through a series of 1-10, or 1-100; the 3d at the 1-100 ratio of dilution being _precisely the same_ as the 6th at 1-10. My preference for the decimal ratio is based upon the greater convenience and accuracy of measuring larger quantities. _Accuracy_ is very desirable, but the practice of _guessing_ at the amount as pursued by some, is anything but accurate. When one makes his dilutions by putting the fluid into a vial and "_pouring it all out_," _guessing_ that he has a _drop_ left which is to medicate the ninety-nine drops of Alcohol or water, he may put in by guess, I am inclined to _guess_ that he knows nothing, _accurately_ as to what dilution he is making. (See Hull's Laura, introduction, also Jahr & Possart's Pharmacopoeia and Posology.) For if the vial is small and quite smooth there may not be a drop left, or if it is rough, there may be several drops. Yet some physicians make their dilutions thus, and insist upon the superiority of the centecimal over the decimal attenuations. Whatever ratio is adopted, should be _accurately_ followed. Have true scales for weighing solids, and a graduated measure marked from ten drops up to one hundred for liquids; then _always_ weigh or measure _accurately_ the medicine, as well as the substance with which it is to be attenuated. The measure and mortar, after using them for one medicine, can be cleaned preparatory for another, with scalding water, rinsing them with purified Alcohol, then drying. Never smoke or chew Tobacco in any place, but if you are such a _slave_ to habit, that you must do it despite your good sense and better judgment, never do either, or have tobacco or any other odoriferous substance about your person when you are preparing medicines, or they are exposed to the air. Keep the medicines excluded from the light and air as far as practicable. Triturate the powders thoroughly for an hour or more upon each, and shake the dilution from fifty to one hundred times, more for the higher attenuations. It is better to medicate pellets in large bottles, filling them half or two-thirds full, put in just liquid enough to wet every one, but not so as to dissolve any. Shake them until all are equally wet, and let them stand for four or five days, if practicable, shaking them up two or three times a day until all are dry. INDEX. Administration of Remedies, 11 Ague, 22 Ague, preventive treatment of, 153 Asthma, 57 Aphthæ, 90 Asiatic Cholera, 104 Amenorrhoea, 129 Ague in the breast, 135 Attenuation of medicines, 151 Bathing, 12 Bilious Fever, 26 Preventive treatment of, 153 Bronchitis, 51 Burns and Scalds, 64 Bilious Colic, 19 Brain Fever, 70 Bee stings, 75 Bite of Rattlesnake, 77 Bruises, 95 Cholera Case, 3 Colic, 18 Colic, Bilious, 19 Cholera Morbus, 21 Cholera, Asiatic, 104 Preventive treatment of, 153 Chill Fever, 22 Continued Fever, 28 Catarrhal Fever, 28 Cough, 52 Colds, 57 Colds, Preventive treatment of, 154 Croup, 55 Constipation, 62 Chilblains, 69 Convulsions of Children, 72 Crusta Lactea, 122 Carbuncle, 122 Diarrhoea, 14 Preventive treatment of, 154 Dysentery, 16 Preventive treatment of, 154 Diet, Rules for, 13 Dyspepsia, 58 Diseases of Females, 129 Dysmenorrhoea, 131 Enteritis, 53 Erysipelas, 62 Epistaxis, 81 Earache, 84 Foreign Substances in the Ear or Nose, 144 Fevers, 22 Intermittent, 22 Chill, 22 Fits of Children, 72 Felon, 126 Flowing, 132 Female weakness, 198 Gastritis, 54 Hooping Cough, 58 Heartburn, 62 Hoarseness, 70 Headache, 78 Sick, 80 Introduction, 5 Intermittent Fever, Ague, 22 Inflammation of the Lungs, 49 Inflammation of the Brain, 70 Inflammation of the Bowels, 53 Inflamed Eyes, 91 Incontinence of Urine, 117 Involuntary urination (nightly), 117 Itch, 120 Itch, preventive treatment of, 154 Inflamed Breast, 135 Inflammation of the Uterus, 140 Jaundice, 120 Local application of Remedies, 145 Leucorrhoea, 138 Mammary Abscess, 135 Menorrhagia, 132 Measles, 73 Mumps, 74 Morning sickness of pregnant females, 143 Nursing Sore-mouth, 133 Nosebleed, 81 Neuralgia, 118 Nightly urination of Children, 117 Otalgia, 84 Ophthalmia, 91 Preparation of medicine, 155 Pleurisy, 48 Prolapsus Uteri, 138 Pneumonia, 49 Piles, 97 Painful urination, 117 Painful menstruation, 131 Profuse menstruation, 132 Preventives of Disease, 151 Quinsy, 53 Rheumatism, 30 Rheumatic Fever, 29 Remitting Fever, 27 Rattlesnake bite, 77 Scarlet Fever, 35 Preventive treatment of, 151 Sore Throat, 52 Scalds, 64 Stings of Insects, 75 Sick Headache, 79 Sore-mouth of Children, 90 Sea Sickness, 103 Small-Pox, 110 Preventive treatment of, 153 Scald Head, 122 Suppression of the menses, 129 Sore Nipples, 139 Table of Remedies, 3 Traveler's Case, 3 Typhoid Fever, 31 Tonsillitis, 53 Toothache, 86 Teething of children, 88 Thrush, 90 Ulceration of the Uterus, 140 Urination painful, 117 Urination, Involuntary, 110 Variola, 117 Varioloid, 117 Worms, 82 Wounds, 93 Whitlow, 126 Yellow Fever, 38 Preventive treatment of, 153 APPENDIX ON THE USE OF GELSEMINUM SEMP. IN FEVERS. BY J. S. DOUGLAS, A. M., M. D., Prof. of Mat. Med. and Special Pathology, in the Western Homoepathic College, Cleveland; author of "Treatment of Intermittents," &c. Such has been the general result of the treatment of the fevers of this country, that most Homoeopathic physicians deny the possibility of _breaking up_ a fever when once established. Those who labor under this impression, will be soon convinced of the error by properly employing the _Gelseminum semper virens_, or yellow Jasmine. Having proved this drug repeatedly on myself and seven or eight others, it was impossible to avoid the conviction that it would be homoeopathic to the ordinary fevers of this country. The pathogenetic symptoms, almost uniformly experienced, are the following, the dose being from one to five drops: Within a few minutes, sometimes within two or three, a marked depression of pulse, which becomes 10, 15 or 20 beats less in the minute, if quiet, but greatly disturbed by movement. Chilliness, especially along the back, pressive pain of the head, most generally of the temples, sometimes in the occiput, at others, over the head. The chilliness is soon followed by a glow of heat and prickling of the skin, and quickly succeeded by perspiration which is sometimes profuse and disposed to be persistent, continuing from twelve to twenty-four hours. As soon as the re-action takes place after the chill, the pulse rises as much above the normal standard, as it was before depressed below it. With these symptoms is a puffy, swollen look and feeling of the eye-lids, slimy and disagreeable or bitter taste in the mouth, languid feeling of the back and limbs, and sleepiness. As example affords the best illustration, we will give one to illustrate the usual action of this drug in fevers: P. W., aged 21, sanguine temperament, had been complaining of languor, and want of appetite for three weeks. For a week has been unable to attend to business. Took a cathartic, and was, of course, worse. For the last thirty-six hours had been seriously sick. June 30, 1858, had the following symptoms: Pulse rather full, but weak and vascillating, about 100 per minute. Tongue red and dry; hands tremulous when extending them; tongue trembles when protruded; the mind wanders; he reaches after imaginary objects; lips dry and parched; he is uneasy, restless. Now this, all will recognize as a case which had been long in coming on, and was fairly established, and was not likely to be _broken up_ by ordinary means. He took one drop of _Gelseminum tincture_ to be repeated every hour, if needed. The next morning he reported that he had been in a perspiration ever since fifteen minutes after taking the first dose, had slept quietly during the night, the tongue and lips were moist, mind clear, pulse 80, and steady. The next day I found him dressed and down stairs, with good appetite and free from disease. I could give sixty cases of equally prompt results from this precious drug, in fevers which make their attack rather suddenly, whether from cold or otherwise, and attended with chilliness, pain in the limbs, head and back, variously disordered taste of the mouth, with great restlessness. The almost uniform effect, in these cases is, a cessation of the chills, within from two to five minutes, quickly followed by a glow of heat and prickling of the surface; and within from five to twenty minutes, perspiration with progressive abatement of all the pains and restlessness. The patient falls asleep, and after a longer or shorter time, wakes with a consciousness that his disease is _broken up_--and this proves to be the truth. Like all other drugs, the dose must be various, generally one drop repeated every half hour, till the desired effect is produced repeated afterwards as occasion may require. In simple cases of fever, I regard it as _the_ remedy, not only, but _the only_ remedy required. There are, of course, many cases of fever, with local complications, as inflammation of the liver, &c., &c., where other remedies will be necessary. Half a drop, or even a quarter, is often sufficient. The largest I have yet given is five drops, and this in only one case. Several Homoeopathic physicians to whom I have recommended it, have made equally favorable reports of it. My experience has been, that not a few of our Western fevers, especially if neglected beyond the incipient stages, are accompanied by such gastric and bilious disorder, as to require _Mercurius_, _China_, or _Podophyllin_, after the general febrile symptoms are removed by _Gels._ But at an early stage, the _Gels._ alone will prevent the development of these complications. The drug seems to me to act specifically and energetically, not only upon the circulatory system, but equally so upon the nervous system, allaying nervous irritability more effectually in fevers, than _Coff._, _Cham._, _Bell._, _Nux_, or any other drug we possess. As it acts very quickly, the first dose may be soon repeated and increased, if no effect is observed. +---------------------------------------------------------------+ |Transcriber's note: | | | |Inconsistent punctuation in headings in this book are as in the| |original. | | | +---------------------------------------------------------------+ End of the Project Gutenberg EBook of An Epitome of Homeopathic Healing Art, by B. L. Hill *** END OF THIS PROJECT GUTENBERG EBOOK EPITOME OF HOMEOPATHIC HEALING ART *** ***** This file should be named 25692-8.txt or 25692-8.zip ***** This and all associated files of various formats will be found in: http://www.gutenberg.org/2/5/6/9/25692/ Produced by Bryan Ness and the Online Distributed Proofreading Team at http://www.pgdp.net Updated editions will replace the previous one--the old editions will be renamed. Creating the works from public domain print editions means that no one owns a United States copyright in these works, so the Foundation (and you!) can copy and distribute it in the United States without permission and without paying copyright royalties. Special rules, set forth in the General Terms of Use part of this license, apply to copying and distributing Project Gutenberg-tm electronic works to protect the PROJECT GUTENBERG-tm concept and trademark. Project Gutenberg is a registered trademark, and may not be used if you charge for the eBooks, unless you receive specific permission. If you do not charge anything for copies of this eBook, complying with the rules is very easy. You may use this eBook for nearly any purpose such as creation of derivative works, reports, performances and research. They may be modified and printed and given away--you may do practically ANYTHING with public domain eBooks. Redistribution is subject to the trademark license, especially commercial redistribution. *** START: FULL LICENSE *** THE FULL PROJECT GUTENBERG LICENSE PLEASE READ THIS BEFORE YOU DISTRIBUTE OR USE THIS WORK To protect the Project Gutenberg-tm mission of promoting the free distribution of electronic works, by using or distributing this work (or any other work associated in any way with the phrase "Project Gutenberg"), you agree to comply with all the terms of the Full Project Gutenberg-tm License (available with this file or online at http://gutenberg.net/license). Section 1. General Terms of Use and Redistributing Project Gutenberg-tm electronic works 1.A. By reading or using any part of this Project Gutenberg-tm electronic work, you indicate that you have read, understand, agree to and accept all the terms of this license and intellectual property (trademark/copyright) agreement. If you do not agree to abide by all the terms of this agreement, you must cease using and return or destroy all copies of Project Gutenberg-tm electronic works in your possession. If you paid a fee for obtaining a copy of or access to a Project Gutenberg-tm electronic work and you do not agree to be bound by the terms of this agreement, you may obtain a refund from the person or entity to whom you paid the fee as set forth in paragraph 1.E.8. 1.B. "Project Gutenberg" is a registered trademark. It may only be used on or associated in any way with an electronic work by people who agree to be bound by the terms of this agreement. There are a few things that you can do with most Project Gutenberg-tm electronic works even without complying with the full terms of this agreement. See paragraph 1.C below. There are a lot of things you can do with Project Gutenberg-tm electronic works if you follow the terms of this agreement and help preserve free future access to Project Gutenberg-tm electronic works. See paragraph 1.E below. 1.C. The Project Gutenberg Literary Archive Foundation ("the Foundation" or PGLAF), owns a compilation copyright in the collection of Project Gutenberg-tm electronic works. Nearly all the individual works in the collection are in the public domain in the United States. If an individual work is in the public domain in the United States and you are located in the United States, we do not claim a right to prevent you from copying, distributing, performing, displaying or creating derivative works based on the work as long as all references to Project Gutenberg are removed. Of course, we hope that you will support the Project Gutenberg-tm mission of promoting free access to electronic works by freely sharing Project Gutenberg-tm works in compliance with the terms of this agreement for keeping the Project Gutenberg-tm name associated with the work. You can easily comply with the terms of this agreement by keeping this work in the same format with its attached full Project Gutenberg-tm License when you share it without charge with others. 1.D. The copyright laws of the place where you are located also govern what you can do with this work. Copyright laws in most countries are in a constant state of change. If you are outside the United States, check the laws of your country in addition to the terms of this agreement before downloading, copying, displaying, performing, distributing or creating derivative works based on this work or any other Project Gutenberg-tm work. The Foundation makes no representations concerning the copyright status of any work in any country outside the United States. 1.E. Unless you have removed all references to Project Gutenberg: 1.E.1. The following sentence, with active links to, or other immediate access to, the full Project Gutenberg-tm License must appear prominently whenever any copy of a Project Gutenberg-tm work (any work on which the phrase "Project Gutenberg" appears, or with which the phrase "Project Gutenberg" is associated) is accessed, displayed, performed, viewed, copied or distributed: This eBook is for the use of anyone anywhere at no cost and with almost no restrictions whatsoever. You may copy it, give it away or re-use it under the terms of the Project Gutenberg License included with this eBook or online at www.gutenberg.net 1.E.2. If an individual Project Gutenberg-tm electronic work is derived from the public domain (does not contain a notice indicating that it is posted with permission of the copyright holder), the work can be copied and distributed to anyone in the United States without paying any fees or charges. If you are redistributing or providing access to a work with the phrase "Project Gutenberg" associated with or appearing on the work, you must comply either with the requirements of paragraphs 1.E.1 through 1.E.7 or obtain permission for the use of the work and the Project Gutenberg-tm trademark as set forth in paragraphs 1.E.8 or 1.E.9. 1.E.3. If an individual Project Gutenberg-tm electronic work is posted with the permission of the copyright holder, your use and distribution must comply with both paragraphs 1.E.1 through 1.E.7 and any additional terms imposed by the copyright holder. Additional terms will be linked to the Project Gutenberg-tm License for all works posted with the permission of the copyright holder found at the beginning of this work. 1.E.4. Do not unlink or detach or remove the full Project Gutenberg-tm License terms from this work, or any files containing a part of this work or any other work associated with Project Gutenberg-tm. 1.E.5. Do not copy, display, perform, distribute or redistribute this electronic work, or any part of this electronic work, without prominently displaying the sentence set forth in paragraph 1.E.1 with active links or immediate access to the full terms of the Project Gutenberg-tm License. 1.E.6. You may convert to and distribute this work in any binary, compressed, marked up, nonproprietary or proprietary form, including any word processing or hypertext form. However, if you provide access to or distribute copies of a Project Gutenberg-tm work in a format other than "Plain Vanilla ASCII" or other format used in the official version posted on the official Project Gutenberg-tm web site (www.gutenberg.net), you must, at no additional cost, fee or expense to the user, provide a copy, a means of exporting a copy, or a means of obtaining a copy upon request, of the work in its original "Plain Vanilla ASCII" or other form. Any alternate format must include the full Project Gutenberg-tm License as specified in paragraph 1.E.1. 1.E.7. Do not charge a fee for access to, viewing, displaying, performing, copying or distributing any Project Gutenberg-tm works unless you comply with paragraph 1.E.8 or 1.E.9. 1.E.8. You may charge a reasonable fee for copies of or providing access to or distributing Project Gutenberg-tm electronic works provided that - You pay a royalty fee of 20% of the gross profits you derive from the use of Project Gutenberg-tm works calculated using the method you already use to calculate your applicable taxes. The fee is owed to the owner of the Project Gutenberg-tm trademark, but he has agreed to donate royalties under this paragraph to the Project Gutenberg Literary Archive Foundation. Royalty payments must be paid within 60 days following each date on which you prepare (or are legally required to prepare) your periodic tax returns. Royalty payments should be clearly marked as such and sent to the Project Gutenberg Literary Archive Foundation at the address specified in Section 4, "Information about donations to the Project Gutenberg Literary Archive Foundation." - You provide a full refund of any money paid by a user who notifies you in writing (or by e-mail) within 30 days of receipt that s/he does not agree to the terms of the full Project Gutenberg-tm License. You must require such a user to return or destroy all copies of the works possessed in a physical medium and discontinue all use of and all access to other copies of Project Gutenberg-tm works. - You provide, in accordance with paragraph 1.F.3, a full refund of any money paid for a work or a replacement copy, if a defect in the electronic work is discovered and reported to you within 90 days of receipt of the work. - You comply with all other terms of this agreement for free distribution of Project Gutenberg-tm works. 1.E.9. If you wish to charge a fee or distribute a Project Gutenberg-tm electronic work or group of works on different terms than are set forth in this agreement, you must obtain permission in writing from both the Project Gutenberg Literary Archive Foundation and Michael Hart, the owner of the Project Gutenberg-tm trademark. Contact the Foundation as set forth in Section 3 below. 1.F. 1.F.1. Project Gutenberg volunteers and employees expend considerable effort to identify, do copyright research on, transcribe and proofread public domain works in creating the Project Gutenberg-tm collection. Despite these efforts, Project Gutenberg-tm electronic works, and the medium on which they may be stored, may contain "Defects," such as, but not limited to, incomplete, inaccurate or corrupt data, transcription errors, a copyright or other intellectual property infringement, a defective or damaged disk or other medium, a computer virus, or computer codes that damage or cannot be read by your equipment. 1.F.2. LIMITED WARRANTY, DISCLAIMER OF DAMAGES - Except for the "Right of Replacement or Refund" described in paragraph 1.F.3, the Project Gutenberg Literary Archive Foundation, the owner of the Project Gutenberg-tm trademark, and any other party distributing a Project Gutenberg-tm electronic work under this agreement, disclaim all liability to you for damages, costs and expenses, including legal fees. YOU AGREE THAT YOU HAVE NO REMEDIES FOR NEGLIGENCE, STRICT LIABILITY, BREACH OF WARRANTY OR BREACH OF CONTRACT EXCEPT THOSE PROVIDED IN PARAGRAPH F3. YOU AGREE THAT THE FOUNDATION, THE TRADEMARK OWNER, AND ANY DISTRIBUTOR UNDER THIS AGREEMENT WILL NOT BE LIABLE TO YOU FOR ACTUAL, DIRECT, INDIRECT, CONSEQUENTIAL, PUNITIVE OR INCIDENTAL DAMAGES EVEN IF YOU GIVE NOTICE OF THE POSSIBILITY OF SUCH DAMAGE. 1.F.3. LIMITED RIGHT OF REPLACEMENT OR REFUND - If you discover a defect in this electronic work within 90 days of receiving it, you can receive a refund of the money (if any) you paid for it by sending a written explanation to the person you received the work from. If you received the work on a physical medium, you must return the medium with your written explanation. The person or entity that provided you with the defective work may elect to provide a replacement copy in lieu of a refund. If you received the work electronically, the person or entity providing it to you may choose to give you a second opportunity to receive the work electronically in lieu of a refund. If the second copy is also defective, you may demand a refund in writing without further opportunities to fix the problem. 1.F.4. Except for the limited right of replacement or refund set forth in paragraph 1.F.3, this work is provided to you 'AS-IS' WITH NO OTHER WARRANTIES OF ANY KIND, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO WARRANTIES OF MERCHANTIBILITY OR FITNESS FOR ANY PURPOSE. 1.F.5. Some states do not allow disclaimers of certain implied warranties or the exclusion or limitation of certain types of damages. If any disclaimer or limitation set forth in this agreement violates the law of the state applicable to this agreement, the agreement shall be interpreted to make the maximum disclaimer or limitation permitted by the applicable state law. The invalidity or unenforceability of any provision of this agreement shall not void the remaining provisions. 1.F.6. INDEMNITY - You agree to indemnify and hold the Foundation, the trademark owner, any agent or employee of the Foundation, anyone providing copies of Project Gutenberg-tm electronic works in accordance with this agreement, and any volunteers associated with the production, promotion and distribution of Project Gutenberg-tm electronic works, harmless from all liability, costs and expenses, including legal fees, that arise directly or indirectly from any of the following which you do or cause to occur: (a) distribution of this or any Project Gutenberg-tm work, (b) alteration, modification, or additions or deletions to any Project Gutenberg-tm work, and (c) any Defect you cause. Section 2. Information about the Mission of Project Gutenberg-tm Project Gutenberg-tm is synonymous with the free distribution of electronic works in formats readable by the widest variety of computers including obsolete, old, middle-aged and new computers. It exists because of the efforts of hundreds of volunteers and donations from people in all walks of life. Volunteers and financial support to provide volunteers with the assistance they need, is critical to reaching Project Gutenberg-tm's goals and ensuring that the Project Gutenberg-tm collection will remain freely available for generations to come. In 2001, the Project Gutenberg Literary Archive Foundation was created to provide a secure and permanent future for Project Gutenberg-tm and future generations. To learn more about the Project Gutenberg Literary Archive Foundation and how your efforts and donations can help, see Sections 3 and 4 and the Foundation web page at http://www.pglaf.org. Section 3. Information about the Project Gutenberg Literary Archive Foundation The Project Gutenberg Literary Archive Foundation is a non profit 501(c)(3) educational corporation organized under the laws of the state of Mississippi and granted tax exempt status by the Internal Revenue Service. The Foundation's EIN or federal tax identification number is 64-6221541. Its 501(c)(3) letter is posted at http://pglaf.org/fundraising. Contributions to the Project Gutenberg Literary Archive Foundation are tax deductible to the full extent permitted by U.S. federal laws and your state's laws. The Foundation's principal office is located at 4557 Melan Dr. S. Fairbanks, AK, 99712., but its volunteers and employees are scattered throughout numerous locations. Its business office is located at 809 North 1500 West, Salt Lake City, UT 84116, (801) 596-1887, email business@pglaf.org. Email contact links and up to date contact information can be found at the Foundation's web site and official page at http://pglaf.org For additional contact information: Dr. Gregory B. Newby Chief Executive and Director gbnewby@pglaf.org Section 4. Information about Donations to the Project Gutenberg Literary Archive Foundation Project Gutenberg-tm depends upon and cannot survive without wide spread public support and donations to carry out its mission of increasing the number of public domain and licensed works that can be freely distributed in machine readable form accessible by the widest array of equipment including outdated equipment. Many small donations ($1 to $5,000) are particularly important to maintaining tax exempt status with the IRS. The Foundation is committed to complying with the laws regulating charities and charitable donations in all 50 states of the United States. Compliance requirements are not uniform and it takes a considerable effort, much paperwork and many fees to meet and keep up with these requirements. We do not solicit donations in locations where we have not received written confirmation of compliance. To SEND DONATIONS or determine the status of compliance for any particular state visit http://pglaf.org While we cannot and do not solicit contributions from states where we have not met the solicitation requirements, we know of no prohibition against accepting unsolicited donations from donors in such states who approach us with offers to donate. International donations are gratefully accepted, but we cannot make any statements concerning tax treatment of donations received from outside the United States. U.S. laws alone swamp our small staff. Please check the Project Gutenberg Web pages for current donation methods and addresses. Donations are accepted in a number of other ways including including checks, online payments and credit card donations. To donate, please visit: http://pglaf.org/donate Section 5. General Information About Project Gutenberg-tm electronic works. Professor Michael S. Hart is the originator of the Project Gutenberg-tm concept of a library of electronic works that could be freely shared with anyone. For thirty years, he produced and distributed Project Gutenberg-tm eBooks with only a loose network of volunteer support. Project Gutenberg-tm eBooks are often created from several printed editions, all of which are confirmed as Public Domain in the U.S. unless a copyright notice is included. Thus, we do not necessarily keep eBooks in compliance with any particular paper edition. Most people start at our Web site which has the main PG search facility: http://www.gutenberg.net This Web site includes information about Project Gutenberg-tm, including how to make donations to the Project Gutenberg Literary Archive Foundation, how to help produce our new eBooks, and how to subscribe to our email newsletter to hear about new eBooks.