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.

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.

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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.

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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.]

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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.

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.

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