Part 19

2. Soda.--The bowels must be kept open by laxatives, Sodium Phosphate or Sodium Sulphate, (Glauber's) salt.

3. Olive Oil.--Olive oil is used very extensively. I do not know whether it does any good; some people think it does. From two to ten ounces daily, if possible. The phosphate or sulphate of sodium should be taken daily in one to two teaspoonfuls doses each day. Some claim these salts prevent formation of gall stones.

4. Powder for the Itching.--For the intolerable itching you may use the following powder, dust some of it over the skin:

Starch 1 ounce Zinc Oxide 1/2 ounce Camphor 1-1/2 drams

Mix into a powder.

Diet.--This must be thoroughly regulated. The patient should avoid the starchy and sugar foods as much as possible. He or she should also take regular exercise. If a person afflicted with gall stones keeps the stomach and bowels in good condition, they will be better. Pure air, sunshine, exercise, and diet are big factors in the treatment of chronic diseases. A woman so afflicted should not wear anything tight around the stomach and liver, corsets are an abomination in this disease; olive oil if taken must be continued for months.

Surgery.--The operation is indicated when the patient is suffering most of the time from pain in the liver region or when the person is failing in health, or during an acute attack. When there are symptoms of obstruction or when there is fever, sweating shows that there is pus in the gall bladder. Also an operation is then necessary, and in most cases it results satisfactorily.

[DIGESTIVE ORGANS 131]

CANCER OF THE GALL BLADDER, AND BILE DUCTS. Causes.--It usually occurs between forty and seventy years of age. The cases that originate here show no percentage in either sex; but those that appear here as secondary cancers are three times as frequent in women as in men. Chronic irritation by gall stones is an important cause. They are hard to diagnose and, of course, fatal in the secondary kind. For the primary kind early complete removal may cure if you can get at them.

CIRCULATORY DISTURBANCES OF THE LIVER. (Acute Hyperemia or Congestion).--This occurs normally after meals, and in acute infections, diseases, etc.

CHRONIC CONGESTION OR NUTMEG LIVER.--This is due to an obstruction of the blood circulation in the liver by chronic valvular heart disease with failure of heart action. Lung obstruction in the trouble called Emphysema, Chronic Pneumonia, etc., may cause it. The cut section of a liver shows an appearance like a nutmeg, due to a deeply congested central vein and capillaries. In a later stage the liver is contracted, central liver cells are shrunk and the connective tissue is increased.

ACUTE YELLOW ATROPHY. (Malignant Jaundice).--This is fortunately a rare disease. There is rapid progress, and it is fatal in nearly all cases. The liver is very small and flabby. The symptoms are many and are hard to differentiate. You must depend upon your physician. The only thing for him to do is to meet the symptoms and relieve them if possible.

CIRRHOSIS OF THE LIVER. (Sclerosis of the Liver, Hobnail Liver, Gin Drinkers Liver, Hard Liver).--This occurs most often in men from forty to sixty years old. It is not uncommon in children.

Cause.--It is usually due to drinking of alcohol to excess, especially whisky, brandy, rum or gin. The liver is small and thin; hard, granular, white bands run through it and press on the liver cells and destroy them.

Symptoms.--These are few as long as proper circulation in the heart is maintained. Fatty cirrhosis is often found in post-mortems. The first symptoms are the same as those accompanying chronic gastritis, dyspepsia, They are:--Appetite is poor, nausea, retching and vomiting, especially in the morning; distress in the region of the stomach, constipation or diarrhea. These increase and vomiting of blood from the stomach may occur early and late. Bleeding from the stomach and bowels, etc., cause the stools to look like tar. Nosebleed and piles are common and profuse; bleeding may cause severe lack of blood. The epigastric and mammary veins are enlarged. Ascites (dropsy in the abdomen) usually occurs sooner or later and may be very marked, and it recurs soon after each tapping. The feet and genital organs may be oedematous (watery swelling), jaundice is slight and does not occur until late. During the late stage the patient is much shrunken, face is hollow, the blood vessels of the nose and cheeks are dilated, abdomen is greatly distended. Delirium, stupor, coma or convulsions may occur at any time.

[132 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Cirrhosis of the Liver.--It is usually fatal; sometimes even after temporary improvements. No coffee or alcohol; simple diet, bitter tonics, keep bowels open, A physician must handle such a case.

ABSCESS OF THE LIVER. Hepatic Abscess: Suppurative Hepatitis.--This is a circumscribed collection of pus in the liver tissue. If there is only one abscess it is in the larger lobe in seventy per cent of the cases. The amount of fluid contained in such an abscess may be two or three quarts and its color varies from a grayish white to a creamy reddish-brown; when the abscess is caused by a type (amebic) of dysentery, there is generally only one abscess, occurring more often in the right lobe, whereas other forms due to septic infection give rise to many abscesses.

Causes.--This disease is rare even in tropical climates. When it is excited by gall stones, it is invariably septic in character and the infecting material reaches the interior through the liver vessels or bile passages. Stomach ulcers, typhoid fever, appendicitis, may bring on such an abscess. Pus wounds of the head are sometimes followed by a liver abscess. The most common method of infection is through the portal vein. Other causes that may be mentioned are foreign bodies traveling up the ducts, as round-worms and parasites.

Symptoms.--Hectic temperature, pain, tenderness, and an enlarged liver, and often slight jaundice. In acute cases the fever rises rapidly, reaching 103 or 104 in twenty-four hours. It is irregular and intermittent, and it may be hectic, that is, like the fever of consumption. Shakings or decided chills frequently are present with the rise of fever and when the fever declines there may be profuse sweating. The skin is pale and shows a slight jaundice, the conjunctiva being yellowish. Progressive loss of strength with disturbance of the stomach and bowels is present. The bowels are variable and constipated and loose. Dropsy of the abdomen (Ascites) may develop, on account of pressure on the big vein, inferior vena-cava. Lung symptoms, severe cough, reddish-brown expectoration are often present.

THE ABSCESS.--May break into the pleural cavity, bronchial tubes, lungs and stomach, bowels, peritoneum or through the abdominal wall.

Recovery.--The result is unfavorable as it generally goes on to a rapid termination. The abscess should be opened and evacuated when its location can be detected. The death rates ranges from fifty to sixty per cent.

Treatment.--Open it if you can, Sponge liver region with cool water. For the pain, mustard poultices, turpentine stupe or hot fomentations prove beneficial. Keep up strength by stimulation and quinine.

[DIGESTIVE ORGANS 133]

Diet in Liver Troubles sent us from Providence Hospital (Catholic), Sandusky, Ohio:

May Take--

Soups--Vegetable soups with a little bread or cracker, light broths.

Fish--Boiled fresh cod, bass, sole or whiting, raw oysters.

Meats--Tender lean mutton, lamb, chicken, game, (all sparingly).

Farinaceous--Oatmeal, hominy, tapioca, sago, arrowroot (well cooked), whole wheat bread, graham bread, dry toast, crackers.

Vegetables--Mashed potato, almost all fresh vegetables (well boiled), plain salad of lettuce, water-cress, dandelions.

Desserts--Plain milk pudding of tapioca, sago, arrowroot or stewed fresh fruit (all without sugar or cream), raw ripe fruits.

Drinks--Weak tea or coffee (without sugar or cream), hot water, pure, plain or aerated water.

Must Not Take--

Strong soups, rich made dishes of any kind, hot bread or biscuits, preserved fish or meats, curries, red meats, eggs, fats, butter, sugar, herrings, eels, salmon, mackerel, sweets, creams, cheese, dried fruits, nuts, pies, pastry, cakes, malt liquors, sweet wines, champagne.

ACUTE GENERAL PERITONITIS. (Inflammation of the Peritoneum, Lining of the Abdominal Cavity).--Causes. Primary; Occurs without any known preceding disease, and is rare. Secondary; Occurs from injuries, extension from inflamed nearby organs, such as appendicitis or infection from bacteria, without any apparent lesion (disease of the bowel). Perforation causes most of the attacks of peritonitis. Peritonitis may accompany acute infections or accompany chronic nephritis, rheumatism, pleurisy, tuberculosis and septicemia. Peritonitis occurs from perforation of the bowel in typhoid fever also, and it frequently occurs after appendicitis and sometimes after confinement.

Symptoms.--This is often the history of one of the causes mentioned above, followed in cases with perforation or septic disease by a chill or chilly feeling and pain, varying at first, with the place where the inflammation begins. The patient lies on his back, with the knees drawn up, and the body bent so as to relax the muscles of the abdomen, which are often rigidly contracted,--stiff at first on the side where the pain starts. The pain may be absent. The abdomen becomes distended, tympanitic (caused by gas). An early symptom is vomiting and it is often repeated. There is constipation; occasionally diarrhea occurs. The temperature may rise rapidly to 104 or 105 and then become lower; it is sometimes normal. The pulse is frequent, small, wiry and beats 100 to 150 per minute; the breathing is frequent and shallow. The tongue becomes red and dry and cracked. Passing the urine frequently causes pain; sometimes there is retention of urine. The face looks pinched, the eyes are sunken, the expression is anxious, and the skin of the face is lead colored or livid. Hiccoughs, muttering, delirium or stupor may be present.

[134 MOTHERS' REMEDIES]

Recovery, Prognosis, etc.--The action of the heart becomes weak and irregular, respiration is shallow, the temperature taken in the rectum is high, the skin is cold, pale and livid, death occurs sometimes suddenly, usually in three to five days; less often thirty-six to forty-eight hours; or even after ten days. The results depend mainly upon the cause of the inflammation, and the nature of the infection, infectious disease that produces it, being usually very bad after puerperal sepsis (after confinement), induced abortion, perforation of the bowel or stomach, or rupture of an abscess.

LOCAL PERITONITIS.--This may come from local injury, but it is usually secondary to empyema, tuberculosis, or cancer, abscess, perforation of the stomach or bowel, ulcer, etc.

Symptoms.--Onset is usually sudden. There is sudden local pain, increased by any movements; tenderness, and vomiting; then chills, irregular fever, sweating, difficult breathing, emaciation.

TREATMENT OF THE ACUTE PERITONITIS.--There must be absolute rest, morphine by hypodermic method, one-fourth to one-half grain to relieve the pain. Ice cold and hot fomentations with some herb remedy like hops, smartweed, etc.; or cloths wrung out of hot water with five to ten drops of turpentine sprinkled on them. This is very good when there is much bloating from gas.

The turpentine should be stopped when the skin shows red from it. The cloths should not be heavy or they will cause pain by their weight. Ice water can be used when cold cloths are needed.

For vomiting.--Stop all food and drink for the time and give cracked ice.

Diet.--Should be hot or cold milk with lime water or peptonized milk if necessary. If the feeding causes vomiting, you must give food by the rectum. For the severe bloating enemas containing turpentine should be given, one to two to six ounces of water used with ten to thirty drops of turpentine in it; sometimes it is necessary to resort to surgery.

TUBERCULAR PERITONITIS.--This may occur as a primary trouble or secondary to tuberculosis of the bowels, lungs, and Fallopian tube. It is most frequent in males between twenty and forty.

[ DIGESTIVE ORGANS 135]

Symptoms.--These are variable. It may occur like acute peritonitis with sudden onset of high fever, pain, tenderness, bloating, vomiting and constipation; these symptoms passing into those of chronic peritonitis. Often there are gradual loss of strength and flesh, low and irregular fever; frequently the temperature goes below normal with a little ascites tympanites, constipation, diarrhea and masses in the abdomen which consist of the omentum (apron covering the bowels) rolled up and matted into a sausage-shaped tumor in the upper part of the abdomen, or of thickened or adherent coils of the bowel, enlarged mesentric lymph nodes, etc. Spontaneous recovery may occur, or the course of the disease may resemble that of a malignant tumor.

Treatment.--If there is effusion and few adhesions, cutting in and removing the fluid may help. In other cases good nourishing diet with cod liver oil is best.

ASCITES. (Hydroperitoneum. Abdominal Dropsy).--This is an accumulation of serous fluid in the peritoneal cavity. It is but a symptom of disease.

Local Causes.--Chronic peritonitis, obstruction of the portal (vein) circulation as in cirrhosis of the liver, cancer or other liver disease, from heart disease, tumors, as of the ovaries or enlarged spleen. All these mentioned may produce this dropsy.

General Cause.--Heart disease, chronic nephritis, chronic malaria, cancer, syphilis, etc.

Symptoms.--Gradual increasing distention of the abdomen, causing sometimes a sense of weight, then difficulty of breathing from pressure. The abdomen is distended, flattened at the sides unless it is very full. The skin may be stretched tense, superficial veins are distended. The navel may be flat or even protrude and around it the vessels may be greatly enlarged. There is fluctuation when you tap sharply at one side, while holding your hand on the other side you feel a wavy feeling.

PHYSICIANS' TREATMENT for Ascites.--First treat the disease causing it. Sometimes it is necessary in order to prolong life to repeatedly tap the patient as in cirrhosis of the liver. When it is caused by the heart or kidneys, give cathartics that carry away much liquid, hydragogue cathartics. One dram of jalap at night followed by a big dose of salts before breakfast. Cream of tartar and salts are good, equal parts. Or cream of tartar alone, one to two drams, with lemon juice in water in repeated doses. Digitalis and squill, of each one grain to cause great flow of urine. Infusion of digitalis is also good to increase flow of urine, when the heart is the real cause of the ascites. These treatments take the liquids away through the proper channels, the bowels and kidneys.

[136 MOTHERS' REMEDIES]

Ascites caused by an Ovarian Tumor.--The tumor must be removed. I am not in favor of indiscriminate operating, but operations often save lives. I remember one case in which I very strongly urged the lady to have an operation performed. It was a case of ascites, caused, as I was sure, by a tumor of the ovary. The lady, as almost all people do,--and I do not blame them for it,--dreaded even the thought of an operation, but she was finally compelled to have an operation or die. She filled so full that it was almost impossible for her to breathe. She went away from home in terrible shape, almost out of breath, and returned home a well woman and has remained so. Such cases formerly died. But not all cases of ascites can be cured by an operation, it depends upon the cause. In many cases all one can do is to doctor the cause, if that cannot be removed, make the patient's remaining days as comfortable as possible.

DISEASES OF THE RECTUM AND ANUS.--The lower part of the alimentary canal is called the rectum, originally meaning straight. It is not straight in the human animal. It is six to eight inches long. The anus is the lower opening of the rectum. In health it is closed by the external Sphincter (closing muscle). Disease may wear this muscle out and then the anus remains open, causing the contents of the bowel to move involuntary.

CONSTIPATION. Causes.--1. Mechanical obstruction.

2. Defective motion of the bowels.

3. Deficient bowel secretions.

4. Other causes. Mechanical obstruction.--Anything that will hinder the free and easy passage of the feces (bowel contents). Too tight external sphincter (rectum) muscle, stricture, tumors, etc. Bending of the womb on the bowel.

Defective Worm-like Bowel Movement.--Irregular habits of living head the list causing this defective action. Everyone should promptly attend to Nature's call. Some people wait until the desire for stool has all gone, and in that way the "habit" of the bowels is gradually lost. Everyone should go to stool at a certain regular time each day, and at any other time when Nature calls. If a person heeds this call of Nature, the call will come regularly at the proper time, say every morning after breakfast. If these sensations (Nature's calls) are ignored day after day, the mucous membrane soon loses its sensitiveness and the muscular coat its tonicity, and as a result, large quantities of fecal matter may accumulate in the sigmoid (part of the bowel) or in the rectum without exciting the least desire to empty the bowels. Again, irregular time for eating and improper diet are liable to diminish this action also. Foods that contain very little liquid and those that do not leave much residue are liable to accumulate in the bowel and at the same time press upon the rectum hard enough to produce a partial paralysis.

Deficiency of the Secretions.--Many of the causes that hinder worm-like motion are also likely to lessen the normal secretions of the bowel. Some kinds of liver diseases tend to lessen the secretions of the bowel, because the amount of bile emptied into the bowel is lessened. Sometimes the glands of the intestine are rendered less active by disease and other causes.

Sundry Causes.--Diabetes, melancholy, insanity, old age, paralysis, lead poisoning and some troubles of local origin, like fissure of the rectum, ulceration, stricture and polypus.

[DIGESTIVE ORGANS 137]

Symptoms.--Headache, inattention to business, loss of memory, melancholy, sallow complexion, indigestion, loss of appetite, nervous symptoms. Spasmodic muscular contraction of the external sphincter. The bowel contents press upon it; spasm of this sphincter muscle is frequently brought on by the presence of a crack in the mucous membrane, caused by injury inflicted during expulsion of hardened feces. Instead of aiding a bowel movement, the muscles now present an obstruction beyond control of the will and aggravate the condition. The most frequent cause of disease of the rectum is constipation and anyone of the following local diseases of the rectum and anus may be a symptom of constipation. (1) Fissure or crack of the anus. (2) Ulceration. (3) Hemorrhoids (piles). (4) Prolapse (falling). (5) Neuralgia. (6) Proctitis and periproctitis.

Fissure of the anus is a common local symptom of constipation. The feces accumulate when the bowels do not move for a few days, the watery portion is absorbed; they become dry, hard, lumpy, and very difficult to expel, frequently making a rent (tear) in the mucous membrane and resulting eventually in an irritable fissure. Ulceration of the rectum and the sigmoid (part of the bowel) is a symptom of persistent constipation, because the pressure exerted upon the nourishing blood vessels by the fecal mass causes local death of the tissues.

Hemorrhoids (Piles) may be produced by constipation in several ways; first by obstruction to the return of the venous (dark) blood. Second, by venous engorgement (filling up) of the hemorrhoidal veins during violent and prolonged straining at stool. Third, as a result of the general looseness of the tissues in those suffering from constipation.

Prolapse (Falling of the Bowel).--This falling of the rectum may be partial or complete, and may be caused by straining or by the downward pressure exerted by the fecal mass during the emptying movement of the bowel. It may also be the result of a partial paralysis of the bowel caused by pressure of the feces upon the nerves.

Proctitis and Peri-Proctitis.--Inflammation of the rectum and surrounding tissue that may or may not terminate in an abscess and fistula, sometimes follows injury to the very sensitive mucous membrane by the hardened feces.

Neuralgia of the Rectum.--This may sometimes result from the pressure of the fecal mass upon the nearby nerves causing pain in the sacrum coccyx (bones).

MOTHERS' REMEDIES.--1. Constipation, a Good Substitute for Pills and Drugs.--"Two ounces each of figs, dates, raisins, and prunes (without pits) one-half ounce senna leaves. Grind through meat chopper, and mix thoroughly by kneading. Break off pieces (about a level teaspoonful) and form into tablets. Wrap each in a wax paper and keep in covered glass jars, in a cool place. Dose.--One at night to keep the bowels regular. Very pleasant to take."

[138 MOTHERS' REMEDIES]

2. Constipation, Substitute for Castor Oil.--"Take good clean figs, and stew them very slowly in olive oil until plump and tender, then add a little honey and a little lemon juice, and allow the syrup to boil thick. Remarks.--Keep this in a covered glass jar and when a dose of castor oil seems necessary, a single fig will answer every purpose. Not unpleasant to take."

3. Constipation, Hot Water for.--"A cup of hot water, as hot as one can drink it, a half an hour before breakfast." The hot water thoroughly rinses the stomach and helps the bowels to carry off all the impurities.

4. Constipation. Excellent Nourishment for Old People.--"A tablespoonful of olive oil three times a day internally for weak or very old people: it can be injected,--used as an enema." Olive oil will be found very beneficial for young people as well as old. It acts as a food for the whole system and is very nourishing.

5. Constipation, Salt and Water for.--"A pinch of salt in a glass of water taken before breakfast every morning. I have found it a very good remedy." This is a remedy easily obtained in any home and will be found very helpful. Few people seem to realize how valuable salt is as a medicine. It acts as a stimulant and loosens the bowels.

6. Constipation, Water Cure for.--"Drink a quantity of water on retiring and during the day." This simple home remedy has been known to cure stubborn cases of constipation if kept up faithfully.

7. Constipation, Tonic and Standard Remedy for.--"Calomel one ounce, wild cherry bark one ounce, Peruvian bark one ounce, Turkish rhubarb ground one ounce, make this into one quart with water, then put in sufficient alcohol to keep it." Dose:--Take a small teaspoonful each morning when the bowels need regulating, or you need a stimulating tonic.

8. Constipation, Glycerin and Witch-Hazel Remedy Where Castor Oil Failed-- "Equal parts of glycerin and witch-hazel." Dose :--One teaspoonful every night at bedtime. In severe cases where you have been unable to get a movement of the bowels by the use of other cathartics, take a teaspoonful every two hours until the bowels move freely. This remedy has been known to cure when castor oil and other remedies have failed.

9. Constipation, Well-known Remedy for.--

"Fluid Extract Cascara Sagrada 1 ounce Syrup Rhubarb 1 ounce Simple Syrup 2 ounces

Mix."

One teaspoonful at night or fifteen drops four times a day for an adult.

[DIGESTIVE ORGANS 139]

10. Constipation, Effective Remedy, in the most Stubborn Cases of.--