CHAPTER I.
HINTS IN REGARD TO THE TREATMENT OF COMMON DISEASES.
It is my design in a subsequent part of this work, under the head of emergencies, to refer to those exceptional cases in which there is peculiar danger, where some prompt action, something done immediately may either save life or save from protracted disease. In such cases the well instructed nurse may often do something without assuming undue responsibility.
But I now intend to give such instruction in regard to the treatment of minor ailments and complaints which are liable to arise in every family daily, as will enable the mother or nurse to often relieve present distress, and prevent future sickness and suffering. But I hope it is fully understood that while I give such instruction as is founded upon many years of study, and experience, and observation, I do not expect that any one can become a doctor by the perusal of this small treatise, or that the student of this book will ever set herself in opposition to those who have devoted years to the study of the healing art. With the understanding, then, that the mother is to prescribe medicine only in such cases as mothers usually do prescribe, I will now give some directions that will enable the nurse or mother to act with promptness and assurance and efficiency.
Some medicine should be kept in every house, and I suggest the following as a good list: Aconite, veratrum, paregoric, aromatic ammonia, spirits camphor, essence peppermint, spirits nitre, syrup ipecac, witch hazel, adhesive plaster, chlorate of potash, gum arabic, compound licorice powder, carbolic acid, and the sanguinaria powder.
The last, which is the medicine that I always use in diphtheria, may be prepared according to the following formula: Take of pulverized blood root ½ ounce, Ferri sulphas Exsiccata ½ ounce. Triturate together. Dose, 1 grain put on the tongue dry every four hours. The medicine should be kept dry and is best kept in a phial corked.
All the medicines should be labeled with the name and ordinary dose.
A small quantity of medicine will suffice to keep in the house. I suggest the following amounts and labels: ½ oz. tinct. aconite. Dose, 1/20 of a drop (or less) every hour. Poison. ½ oz. veratrum viride. Dose, ½ drop every two hours. 1 oz. paregoric. Dose, 1 drop to a teaspoonful. 1 oz. aromatic ammonia. Dose, 20 drops diluted in water. 1 oz. ess. peppermint. Dose, 10 drops. 1 oz. spirits camphor. Dose, 1 to 5 drops. 1 oz. syrup ipecac. Dose, 5 drops to a teaspoonful. 1 oz. spirits nitre. Dose, ¼ teaspoonful in water. ½ oz. fld. ex. witch hazel. Dose, 1 drop every hour. ½ oz. chlorate potash. ¼ lb. compound licorice powder. Dose, 1 teaspoonful. 1 oz. gum Arabic. ¼ yd. adhesive plaster. 1 oz. carbolic acid and glycerine. Poison. 1 oz. sanguinaria powder. Dose, 1 grain.
I will now give my treatment of diphtheria which is mostly by the use of the Sanguinaria powder, as this very well illustrates the benefit of having some mild safe medicine in the house, and using it early in the disease. Nearly thirty years ago I was so well satisfied of the efficacy of this medicine, that I advised all the families with which I was acquainted and where I was their physician, to keep the powder in the house and use it whenever any of them had sore throat; very many of them did so, and it has happened that so far as I know, there has not been a fatal case of diphtheria among them.
I advise that it be given in all cases of sore throat, for although it is not so important a remedy in all these cases, it will very generally be useful in a greater or less degree, and as the sore throat is usually the first thing complained of in diphtheria, its early application is thereby assured.
A very small dose will suffice, but there is no objection to taking two or three grains for a dose every 4 hours, except the disagreeable taste. I advise that it be taken alone, and not covered up, as I believe that it acts locally perhaps directly upon the organism or germ that is the cause of the disease. I have not, however, relied exclusively upon the one medicine, but have always directed that they should give about a teaspoonful of the saturated solution of chlorate of potash every hour, and that they keep kerosene applied on the outside of the throat or neck. Give plenty of milk and other nourishing diet, and but little other medicine is usually required.
The SANGUINARIA (bloodroot) POWDER is properly given in other cases besides diphtheria. A small dose given three times a day is not only a good worm medicine, but will prevent the subsequent developement and growth and multiplication of worms for some time. It is also a cure for a cough that is dependent on an irritated state of the fauces.
Three grains taken after each meal is a good remedy in chlorosis or suppression of the menses. In these cases it can be taken covered up in wafers or in rice paper, thereby avoiding the bitter taste.
ACONITE should be kept in the house, and very small doses given in cases where there is a little feverishness, and no marked symptoms of disease. It is useful when there is an ordinary cold, and may be given two drops of the tincture in half a glass of water, one teaspoonful every hour. These small doses may be given to a little child, and yet they have some effect upon older persons.
ORDINARY COLDS, however, require more efficient treatment, and I often direct the following: A teaspoonful ginger, a teaspoonful cream of tartar, and three large teaspoonfuls of sugar in a small glass of water, to be drank as one draught after being stirred. Heat the feet and keep them warm especially at night. The combination of ginger, cream of tartar, &c., opens all the secretions so that the lungs, liver, bowels, skin, and kidneys act in a natural manner, and there is immediate benefit.
VERATRUM has already been mentioned as a remedy in inflammation. If good extract or tincture is used it can always be relied on to reduce the force and frequency of the pulse. It is frequently applicable because in most of our diseases the force and frequency of the pulse is increased. The pulse should be counted when it is first given, and counted occasionally afterwards, and when the pulse becomes less frequent the dose must be diminished or omitted. If an overdose is given it is commonly vomited, otherwise it might be dangerous. Ordinarily half a drop every two hours of the fluid extract is sufficient, but for adults two drops may sometimes be given and repeated in an hour. We have so many maladies that are inflammatory, where the pulse is full and hard, that the indications for its use are frequent. Even in the commencement of fevers, when the pulse is full and quick—where it was formerly the practice of physicians to bleed, veratrum should be given till it has a decided effect upon the pulse. In intermittent fever the effect of this sedative upon it, given at the commencement of the fever or hot stage, is as salutary as is the effect of quinine given during the intermission.
Moderate doses are not liable to do harm except to those who have become quite weak and low. A convenient way of administering it is to prepare twenty drops of the extract in twenty teaspoonfuls of water, and the dose can be easily regulated.
Croup may generally be cured if veratrum is given early and in efficient doses. It is of no avail to administer it at an advanced stage when there is apnœa; the pulse becoming feeble and intermitting, the lips blue, the skin losing its heat; and when drowsiness, coma or other fatal symptoms are coming on. When cough, hoarseness, catarrh, and loss of voice are noticed in a young child, it should be narrowly watched and protected against all circumstances likely to aggravate inflammation; it should be kept in the house, and a warm, moist air should be kept in the room (about 65°), its diet should be milk or farinaceous food; the functions of the bowels and skin should be attended to; some aconite should be given; if there is a slight, ringing cough, place the patient in a warm bath for ten minutes, then confine it to bed; keep the air of the room moist by the evaporation of boiling water; give castor oil or other physic, and small doses of syrup ipecac, and spirits nitre. If the respiration becomes sonorous and difficult, the voice hoarse and gruff, the cough croupy and brassy as it is called, you have the characteristic symptoms of croup. But the peculiar breathing, making a sort of crowing sound with each inspiration, will always distinguish it, and there will always be some fever attending it. Croup sometimes commences with sore throat, and I believe that the sanguinaria powder will usually be efficacious in its cure; but prompt doses of veratrum are still more effectual. At the early stages you may give two drops of the extract, and the dose may be repeated in half an hour, and perhaps repeated afterwards. If there is not evident improvement an ounce of syrup of ipecac or a teaspoonful of sugar and alum pulverized together, may be given if necessary to make the child vomit.
In the meantime hot fomentations should have been applied to the throat. A sponge the size of a large fist, dipped in water as hot as can be borne, should be squeezed half dry and applied under the child’s chin so as to cover the larynx, and the temperature maintained by resoaking it every two or three minutes.
Baths may be used during the second stage of the croup; if the child has a temperature of 104°, a warm bath ought to be administered, and the child immersed in it up to its chin for fifteen or twenty minutes.
After the breathing is relieved, still give small doses of syrup of ipecac, or alum, or veratrum, sufficient to keep up nausea for a time. After there is a decided amelioration of the symptoms, give the following: To a teacupful of ginger tea add a teaspoonful of aromatic ammonia, and a teaspoonful syrup of ipecac, and give a teaspoonful every hour.
VERATRUM is the medicine upon which you must rely in croupy cases; this disease requires vigorous treatment, but vigorous measures in the start will generally save the life of the patient.
PAREGORIC is a useful medicine for pain, diarrhœa, cough and restlessness, and may generally be given advantageously when two of these symptoms are present. Opium has some beneficial effect in inflammation, and very generally paregoric can be given where there is febrile excitement. I would never give it when the child is only cross and irritable, as a bad habit may thereby be engendered. There is always danger of giving an overdose of any opiate; and although an adult may sometimes take as much as two ounces of paregoric when he is suffering severe pain, I do not advise that it be given to children often in doses that exceed five drops.
DIARRHŒA may be treated in the following manner: To four ounces of ginger tea add one teaspoonful paregoric, one teaspoonful aromatic ammonia, one teaspoonful ess. peppermint, one half teaspoonful spirits camphor, and two ounces of mucilage of gum arabic, and shake the whole together. This is good medicine for all forms of summer complaint, diarrhœa, dysentery, or cholera morbus. One-half teaspoonful of this is a dose, but it can be given efficiently in a larger or smaller dose. It acts by correcting the disordered state of the stomach, and it is upon this usually that these diseases depend.
If the diarrhœa continues for a day or two, some mild astringent may be given; perhaps three drops every two hours of the extract of witch hazel. The diet is important, and it is well in these cases to have some wheat flour boiled. (F. 47.) The flour grated from it and sifted, and made into a gruel, may be profitably used with milk.
A thin solution of GUM ARABIC with milk affords both food and drink, and is one of the most useful, and safe, and efficient remedies.
Such medicines as F. 74, 77, 79, 80, may be given in almost every case with benefit. The alkalies neutralize the acids in the stomach, and the aromatics have a grateful action. If the pain continues, a warm bath may be given. Should the gums be swollen, they should be cut down to the teeth.
But there are many cases of diarrhœa where my prescription would be the following: Give no kind of food save that of the milk of the mother, and that only once in four hours. Should the thirst require more fluid to satisfy it, give from time to time a teaspoonful of cold water; put flannel on its body, and woolen stockings on its legs; rub the abdomen three or four times a day with the bare warm hand; do not ever wake the child when asleep; when awake give it five drops paregoric every two hours.
In the preliminary stage of CHOLERA INFANTUM, besides giving the diarrhœa mixture with ar. ammonia, I would enjoin absolute rest in the recumbent position, with warmth to the surface and extremities; perhaps total abstention from mother’s and cow’s milk, and would order either condensed milk or arrow root prepared with water. I would also make counter irritation over the abdomen by poultices and sinapisms.
DYSENTERY when first coming on is attended with more fever than diarrhœa is. It will be distinguished by the character of the pain and the discharges. The patient is tormented by a sensation as if there was some excrement to be dislodged; he goes often to the night chair, and strains to get rid of the irritation; he discharges but little, and what is voided is either a jelly like or bloody mucus; perhaps mixed with films and membranous shreds. The pulse is hard and frequent, the skin hot, the face flushed, and the patient complains of headache and thirst.
You may give some veratrum at first; one-half drop of the extract every two hours for one day; and to allay the thirst, give cold water in which some wheat flour has been stirred.
My principal remedies if the diarrhœa mixture does not cure, is to give the sour drops (elixir vitriol), and either large or small doses of ipecac. I also use injections of starch and laudanum, and rectal suppositories. (F. 155, 160.)
You may find much benefit from some domestic remedies. Give either occasional doses of strong table tea, or spoonful doses of vinegar and table salt, or freshly prepared melted mutton suet.
AROMATIC SPIRIT OF AMMONIA is useful in hysteria, flatulent colic and nervous debility. It is not a powerful medicine to overcome disease, but it is a medicine that ought to be at hand to relieve many little ailments that are liable to occur, when much medicine cannot be given. I advise those that are suffering from sick headache to take 30 or 40 drops of it as a stimulant antacid. It may be well also to take a teaspoonful of paregoric, and to lie down till sleep gives relief. FAINTING FITS or FAINTING may demand a remedy, and 15 drops ar. spts. ammonia may give the desired relief, if the sufferer lie down and a little cold water be sprinkled in her face also.
This medicine is a grateful antacid in cases of SOUR STOMACH, and it will usually give some relief in the flatulence and distress of DYSPEPSIA.
It may often be used as a slight stimulant, but as it is an alkaline remedy it should not be given conjoined with acids.
ESSENCE PEPPERMINT and SPIRITS CAMPHOR are often used in ailments similar to those in which I use aromatic ammonia, and this may be given in combination with them. Some persons have a decided preference for essence cinnamon, or wintergreen, and these may be substituted for peppermint; aromatics also, such as sweet flag, will have a similar effect.
Spirits nitre is often a grateful stimulant to the stomach, but it is also used in febrile affections, and inflammatory complaints. Four parts of spirits nitre to one of ar. ammonia is diuretic, diaphoretic, and is well suited to certain states of febrile disease.
When given to promote the action of the kidneys, a half teaspoonful or more may be given every two hours in a spoonful of water. Scanty and high colored urine, especially when it is acrid and burning, is an indication for its use.
SYRUP OF IPECAC is used as an expectorant and emetic in colds and coughs. If given to a child, one teaspoonful is an emetic dose, to be repeated every fifteen minutes till it operates. If given to loosen a cough, five or six drops repeated every half hour will suffice; but it may be given in much larger doses. It is often given in combination. (F. 137, 139.)
WITCH HAZEL. Pond’s Extract Hamamelis is kept by many people in the house, and as it is usually accompanied with directions, I shall refer to it very briefly. The ordinary fluid extract is perhaps five times as strong as Pond’s extract, and when used may be diluted accordingly. It is astringent, and a medicine of that kind is often useful both internally and externally. A few drops taken each day may prevent bleeding, when there is a tendency to hemorrhage, although ergot would be a more efficient remedy if given for immediate effect.
CHLORATE OF POTASH is very generally given in diphtheria, and is generally safe; no harm can come from the advice to keep it constantly in the house; it is not very soluble, and the saturated solution is not too strong for use. It is a good way to put a half teaspoonful of it in a glass, and keep a little water on it all the time, and give ten or twelve teaspoonful doses of the solution a day for any kind of sore throat or mouth.
COMPOUND LICORICE POWDER (F. 108) is a mild laxative, and may be given to a young child in half teaspoonful doses. In larger doses it will serve well for older persons for physic. While I think it well to keep this in the house and to occasionally administer it, some other sort of cathartic may at times properly be preferred. A great variety of this sort of medicine is attainable, no one kind is always the best; this powder is however a good laxative, in doses of a teaspoonful repeated in eight hours if necessary.
GUM ARABIC is not often kept in the house as a medicine, but I think it eminently proper to keep it; scarcely any other medicine is so safe and harmless either in large or small doses, and few are more decidedly useful than this in some cases. Made into an emulsion and taken either alone or in combination with other medicine, or used as food, it is good in every variety of bowel complaint. A teaspoonful of the mucilage stirred into a cup of cold water and drank by the patient, may serve as medicine and drink and sustenance when he can take no other food. It may properly be added to expectorant and diuretic medicines; but the beneficial effects are most obvious when it is administered for inflammatory affections of the gastric and intestinal mucous membrane. Slippery elm and flaxseed tea have a similar effect, but are not so decidedly beneficial.
CARBOLIC ACID nine parts and GLYCERINE one part may be kept mixed together; not because the glycerine assists or modifies the action of the carbolic acid, but because it renders the acid soluble in the water, so that the solution may be of any strength desired. CARBOLIC ACID is not much used internally; it is so powerful that it ought to be regarded as a poison; its effect is good, however, if given in small doses very much diluted. It is believed to be destructive to disease germs, and may very properly be given in bad cases of diarrhœa and dysentery. Two drops of the acid in a glass of water is a weak solution, and may be given without harm; a half teaspoonful every two hours.
There is not space in this work to describe particularly the various cases in which it may be used externally. A solution one part in 100 of water, may be applied advantageously to any inflamed part or to any CUTANEOUS ERUPTION, or may be used as a wash or gargle in any SORE MOUTH or SORE THROAT. To cure sores or eruptions, however, it is often necessary to apply it much stronger. I apply a 1 to 5 solution to the sores once or twice, and to burns a solution 1 to 30 for a few days.
I will give more particular directions for its use in HEMORRHOIDS or PILES. Apply the acid and glycerine (9 to 1) to the piles by dropping 3 drops upon a bit of tissue paper and pressing it against the tumors, and into the anus. Repeat this each day for three days, then use a mild ointment or suppositories. (F. 206.)
A few doses of the compound licorice powder will be useful for piles if the bowels are not regular.
I have already given some specific directions in regard to some diseases in very young children; what further instructions I give will be of a general character.
HOME REMEDIES AND APPLIANCES FOR SICK CHILDREN.
DENTITION predisposes to sickness, if it does not cause it, and it may call into activity latent tendencies to disease. It may cause such symptoms as the following: redness, heat, and tenderness of the gums; an increase of saliva; starting as if in fright; restlessness, or interrupted sleep; eruptions on the head or body; derangement of the digestive organs, and sometimes convulsions. During the period of dentition, be especially careful that the child has its food and sleep regularly, and that it is restricted to suitable quantities of food at a time. Keep the head cool and the feet warm; wash the child daily in cold water, and allow it to be much in the open air. If a child is worrisome and irritable it will be necessary to cut the gums. Lance them at the elevated points, cutting them down to the teeth. At the same time, aconite can be given, and perhaps a warm bath; and if there is considerable fever give ordinary doses of veratrum. These remedies are so generally useful where there is fever, that I will venture to recommend them when either THRUSH, MEASLES, GERMAN MEASLES, MUMPS, SCARLET FEVER, CHICKEN POX, or WHOOPING COUGH is coming on or suspected. Each of these diseases have a natural course which they must run before they terminate, and it is best, as in diphtheria, not to give medicines powerful enough to interfere with the natural course of the disease. Do not give physic. (F. 121, 122.)
So in OPTHALMIA it is better to have nothing but a little salt in the water than it is to use harsh things to bathe the child’s eyes. Do not rub the eyes; let a small stream of tepid water trickle onto them, and wipe the discharges away with a soft rag. Burn the rag, wash your own hands, and keep them away from your own eyes, on account of the danger from contagion. (F. 210, 211.)
CONSTIPATION cannot be treated in all cases without giving some aperient medicine. (F. 108, 109.) Oat meal gruel as a diet may be helpful; and fresh vegetables—cabbages, turnips, onions, ripe fruit; oatmeal porridge with molasses, and brown bread may be taken freely. Infants may be partly fed on corn starch, and older children may have cracked wheat (F. 35), or peas, beans, squashes, and other fresh vegetables and fruits in their season. A good draught of water on rising and retiring is advisable; and a teaspoonful of soda and molasses mixed together and taken daily for a week may cure a costive habit. A suppository of castile soap may induce a movement in a child, or it may be best to give an injection of tepid water, or soap and water.
For CHAFINGS bathe the parts well in tepid water, dry with soft cloths, and apply by means of a soft sponge, F. 212.
The following diseases are inflammatory, and demand at first mild treatment with aconite, veratrum, and warm baths:
In TONSILITIS (quinsy), use the blood root powder and bicarbonate of soda. The patient can apply the bicarbonate of soda to the inflamed tonsil with his finger, or it can be blown into his throat through a quill, or through a hollow roll of stiff paper that contains a few grains. For the chronic form of tonsilar enlargement use F. 213.
CORYZA or snivels is an inflammatory affection of the mucous lining of the nose, attended with an abnormal secretion. Sometimes the child can only breathe through its mouth; in such cases you may draw the breast milk, and feed the child by means of a spoon. Give aconite, and as a local application the inside of the nose may be often smeared with vaseline, or cold cream, or carbolated cosmoline.
Bronchitis, pneumonia, pleurisy, and other inflammatory diseases, may not show their distinctive character in their incipient stage, but there will be at first sufficient fever to indicate the need of aconite, veratrum, and perhaps the warm bath. Accessary means may be used, such as the following: the patient should be placed in a warm room (about 65°) and have only light bed clothing; if the child is taken out of bed he must have on a warm wrapper, or be otherwise well covered; he should not lie flat in bed, but he should be somewhat propped up with pillows; and it may be best to keep on a continuous poultice to the chest in front and back. The patient should be kept very quiet, have mucilaginous drinks and farinaceous diet; and the air of the room should be moistened by steam or the evaporation of wafer; and the ventilation of the apartment must not be neglected. They must have frequent sips of cold water to allay thirst, besides marshmallow, slippery elm, or flaxseed tea, and revulsives must be used as well as poultices and fomentations.
By the aid of a CLINICAL THERMOMETER many diseases may be distinguished even in the incipient stage.
If a person without any premonitory symptoms is seized with a chill, followed by rapid breathing, a dull pain in the chest, cough, high fever, and comparatively slow pulse; if the thermometer indicates a temperature of 104° or 105°, and the pulse does not beat over 110 a minute, the case is one of ACUTE PNEUMONIA. Sometimes the temperature is below 90°; if it exceed 120° it is almost certain to be fatal.
AGUE. CHILLS recurring regularly for a few days indicate the intermittent nature of a disease. But during the first chill if the thermometer is applied, we may know that a case is one of fever and ague, if while the skin is yet cold the thermometer rises to 105°, and later to 107°, and during the stage of sweating the instrument shows a decline of 2° every fifteen minutes till it has reached 98½°. This rapid rise and decline is due only to malaria, and quinine is indicated. (F. 182.)
TUBERCULAR PHTHISIS. If a patient has been losing flesh of late and been troubled with a short, dry cough, take his temperature at about six P. M. for a few evenings. If the thermometer records 99° to 100°, and no other cause exists for this regular nightly increase of temperature, the case can be put down as one of incipient consumption, especially if tuberculosis has been in the family. Endeavor to improve the general nutrition by attention to the quantity and quality of the food (as generous diet as can be taken without disturbing the stomach or increasing the feverish symptoms); by enjoining a residence in a healthy climate; by exercise in the open air; by warm clothing; by daily tepid sponging, with friction of the skin; and by cod-liver oil or petroleum emulsion with hypophosphites. An animal diet is generally necessary. If digestion fails and there is acidity of the stomach, give pepsin. (F. 72.) Add a teaspoonful of sweetened lime water to a tumbler full of milk, and if this agrees with his stomach, he can take that amount four times a day.
In TYPHOID FEVER the patient may complain of lassitude, headache, pain in the back, etc., for several days before he is feverish. Then his temperature is 99°, and it may be one degree higher each night, until on the sixth and seventh evening it is 104°; it being each morning one degree less than at night. Even if there is no diarrhœa, tympanitis, or eruption, we may by observing the temperature, feel sure that we have a case of typhoid fever. If it is a moderate case the temperature will be 104° at night, and 103½° in the morning, till the fourteenth day, when it may decline one degree in the morning, and half a degree or one degree in the evening. After that it may decline regularly till on the 21st day it may be 98½°. Relapse or chest difficulty may modify this regular decline, and the nurse must carefully note and report to the physician the temperature each morning and night.
In TYPHUS FEVER the temperature reaches its height, 104° or 105°, within thirty-six hours. It continues at that height, with morning remissions of one-half degree, till the eleventh or thirteenth day, when it rapidly falls to the normal; a sweat or a long sleep ushering in the favorable termination.
SCARLET FEVER. If a child is suddenly taken ill with a chill, vomitings, very rapid pulse, and the thermometer records 105° or more, very early in the disease, it denotes scarlet fever; and from this sign alone, even without any sore throat or eruption, a diagnosis may be made. This disease may very frequently go on well without any danger till the eruption subsides, but danger arises from exposure of the child to cold any time during the subsequent four weeks.
HYSTERIA. There may be pain perhaps in the bowels, abdominal tenderness, and vomiting; or there may be symptoms of inflammation in some other part; if the thermometer does not register more than 98½° it is probably hysteria. Assafœtida, valerian, and such remedies will probably cure.
APOPLEXY. In this disease the thermometer soon after the attack shows a temperature of only 97°, and lower still if there should be a second effusion to still more compress the brain. On the contrary, in a fully developed case of sunstroke, the thermometer will not record less than 107°.
It would be a good thing if every nurse and every mother kept a clinical thermometer.