Part 20

"Fluid Extract Cascara Sagrada 1 ounce Fluid Extract Wahoo 1 ounce Neutralizing Cordial 2 ounces

Mix."

Adults may take a teaspoonful of this mixture before retiring, this will be found very effective in the most stubborn cases of constipation.

11. Constipation, Remedy from a Mother at Lee, Massachusetts.--

"Senna Leaves 1/2 pound English Currants 1/2 pound Figs 1/4 pound Brown Sugar 1 large cup

Chop all together fine. Dose:--One-fourth to one-half teaspoonful every night. Do not cook. The best remedy I know."

12. Constipation, Fruit and Hot Water Cure for.--"Drink a pint of hot water in the morning before eating. Eat fruit, plenty of apples, eat apples in the evening, and they will loosen the bowels. Chew them fine, mix with saliva."

13. Constipation, Herb Tea for.--"One ounce senna leaves steeped in one-half pint of hot water, with a teaspoonful of ginger powdered; strain. This is a most certain and effective purge, and mild in its action upon the bowels. Dose:--A cupful at bedtime. This is far superior to salts."

14. Constipation, Purshiana Bark Tea Without an Equal for.--"An infusion of one ounce of purshiana bark to one pint of boiling water; infuse for one hour and strain. It stands without an equal in the treatment of constipation in all its varied forms. Dose:--One teaspoonful, morning and evening according to symptoms or until the bowels are thoroughly regulated." This is fine for constipation, especially if of long standing. It may be used in connection with cascara. This will give relief when other remedies fail.

PHYSICIANS' TREATMENT for Constipation.--Too much reliance has been placed upon medicine in the treatment of this disease and too little attention given to diet, and the establishment of regular habits in eating, exercising, sleeping and attending to the calls of Nature. Also, local disease of the rectum has been overlooked until of late years. Remedies of a laxative and cathartic nature soon lose their power and the dose must be repeated or a new remedy must be given. This method of treatment is well recommended and is very good.

1--Stretching of the sphincter.

2--Frequent rectal and abdominal massage.

3--Copious injection of warm water (in the beginning only).

4--Application of electricity over the abdomen and in the rectum.

[140 MOTHERS' REMEDIES]

In addition to this treatment which must be carried out by a physician the patient must observe the following rules: Go to stool daily, and as near the same time as is convenient, correct errors of diet. Drink an abundance of water and eat sufficient fruit. Take plenty of outdoor exercise; take a cold bath every morning followed by a thorough rubbing. Dress warmly in winter and cool in summer. Change of temperature or climate if the case demands it. Be temperate in all things affecting the general health. Stretching the sphincter must be done carefully, but in a thorough manner. It can only be done properly by an experienced person. Stretching of the sphincter closes the opening so that the feces are not passed at all times. It is circular in shape. Sometimes this grows larger, stiffer, or it acts spasmodically. The opening is often so tight in some people that it is difficult to introduce even a finger, and it frequently produces a spasm of pain in the bowels, stomach and head to do so. This kind will produce constipation or make it worse. In such cases it should be stretched thoroughly but carefully so that the muscle will be able to close the opening and the bowel contents will not pass at any time unhindered. There are two methods of stretching the muscle--forcible or gradual. The forcible method is generally done by inserting the two thumbs into the anus and stretching the muscle thoroughly in every direction until there is no resistance. (Dilators are made for this purpose, but unless they are very carefully used they will tear the muscle). The forcible method should be done under an anesthetic. Gradual stretching is done when an anesthetic cannot be used. It is better to do too little than to do too much at the first sitting. The muscle is very stubborn sometimes, and it requires careful handling or the irritability will be increased. An instrument in the hands of a careful man is all right. They can be stretched by the fingers or the Wales' bougie, thus: Patients should come to the office two or three times a week, the instrument (bougies) are introduced and allowed to remain within the bowel until the muscle resistance is overcome, and many times their withdrawal will soon be followed by a copious stool. Forcible stretching is seldom required more than once, if a large sized instrument is used from time to time afterward, just as in gradual stretching; when thorough dilatation has been accomplished, the muscle instead of acting as an impassable barrier to the discharge of the feces, now offers only passive resistance, but sufficiently strong, however, to prevent any unpleasant accidents, yet not strong enough to resist the power of the expulsory muscles when the latter are brought into full play during stool. Large quantities of feces do not now accumulate; consequently the pressure upon the mucous membrane and neighboring nerves is eliminated, and the bowel regains its normal sensibility and strength. There are now sold dilators in sets for self use in almost every drug store. These when used continuously do good and successful work.

[DIGESTIVE ORGANS 141]

Abdominal Massage. (Kneading, Rubbing, etc.).--This is an essential feature in the treatment. It was practiced by Hippocrates hundreds of years ago. Place the patient in the recumbent position upon a table which can be so manipulated that the head may be raised or lowered, the body rolled from side to side. Gentle but firm pressure is then made with the palm of the hand and the ball of the thumb over the large intestine beginning in the lower right groin region. Then go up to the ribs on the right side, then over the body to the same place on the left side and down to the left lower side and center, accompanying the pressure by kneading the parts thoroughly with the fingers. Repeat this several times for about ten to twelve minutes. At first this should be practised every day; later twice a week. Special treatment should be given the small intestines and liver when the bile and intestinal secretion are lessened. In children gentle rubbing of the abdomen with circular movements from right to left with a little oil for ten minutes daily will help to increase the action of the bowels and often bring on a normal movement.

Copious Warm Water Injections.--This is good at the beginning of the treatment when the feces become packed. They soften the mass and aid its discharge. The water must go above the rectum into the colon. To do this a colon tube from eighteen to twenty-four inches long, a good syringe (the Davidson bulb) hard rubber piston or a fountain syringe, the nozzle of which can be inserted into the tube, are required. The patient is placed in the lying down position on the left side with knees drawn up, with the hips elevated. Oil the tube and pass it gently and slowly up the bowel for a few inches until it meets with a slight obstruction. A few ounces of water are then forced through the tube and at the same time pressure is made upward with the tube; by these means the obstruction will be lifted out of the way each time the tube meets with resistance; the procedure must be repeated until the tube is well within the colon. Attach the syringe to the tube and allow the water to run until the colon is distended. A quart to a gallon of warm water can be used depending upon the age and amount of feces present. The water should be retained as long as possible.

The injections should be continued daily until all the feces has been removed. They should not be used for weeks as has been recommended. If soap suds are used in the enema, green or soft soap should be used, not the hard soap.

Electricity.--One pole may be placed over the spinal column and the other moved about over the course of the colon, or one over the spine and the other over the rectum.

Again constipation is caused by the womb lying upon the rectum. Change this condition. (See diseases of women).

[142 MOTHERS' REMEDIES]

Rules.--Patients should go to stool daily at the same hour, usually after the morning meal. You can educate the bowel to act daily at the same hour or after breakfast; or on the other hand not more than once in two or three days in those who are careless in their habits. Some patients need to have two or three movements daily in order to feel well. It may take time to educate the bowels to do this, but it can be done in many cases and many persons become constipated because they put off attending to the educated bowel's call, and often produce constipation by carelessness. It is surprising how many educated people put off this duty; Nature neglected, soon ceases to call. If constipated persons will persevere in going to the closet at or near the same time every day and devote their entire time while there to the expulsion of the fecal contents, and not make it a reading room, they will bring about the desired result. Patients are apt to become discouraged at first; they should be informed that the final result of the treatment is not influenced by the failure of the bowel to act regularly during the first few days. Do not strain to expel the stool.

Corrections of Errors in Diet.--This is one of the necessary features in the treatment. All kinds of foods known to disagree should be discarded. The foods should be easily digested. In children the diet should be rich in fats, albuminoids and sugar, but poor in starches. A reasonable amount of fruits such as apples, oranges, and figs should be allowed. Meals should be at regular hours. Foods that can be used:

May Take--

Soups.--Meat broths, oyster soup.

Fish.--Boiled fish of all kinds, raw oysters.

Meats.--Almost any fresh tender meat, poultry, game, not fried.

Farinaceous.--Oatmeal, wheaten grits, mush, hominy, whole wheat bread, corn bread, graham bread, rye bread.

Vegetables.--Boiled onions, brussels sprouts, spinach, cauliflower, potatoes, asparagus, green corn, green peas, string beans, salads with oil.

Desserts.--Stewed prunes, figs, baked apples with cream, ripe peaches, pears, oranges, apples, melons, grapes, cherries, raisins, honey, plain puddings, fig puddings, apple charlotte.

Drinks.--Plenty of pure water, cold or hot, new cider, buttermilk, orange juice, unfermented grape juice.

Must Not Take--

Salt, smoked, potted or preserved fish or meats, pork, liver, eggs, new bread, puddings of rice or sago, pastry, milk, sweets, tea, nuts, cheese, pineapple, spirituous liquors.

Foods classed as laxatives are honey, cider, molasses, and acid fruits, such as apples, pears, peaches, cherries, and oranges. Berries are effective laxatives on account of the acids and seeds they contain. (Huckleberries are constipating). Prunes, dates and figs are good and effective, also fruit juices.

[DIGESTIVE ORGANS 143]

Drinks.--There are few laxatives better than a glass of cold water or preferably hot water, taken upon an empty stomach before breakfast; water prevents the feces from becoming dry and massed, and stimulates the intestinal movements. A pinch of salt added to the water increases its effectiveness.

Out-door Exercise.--This should be taken regularly and freely.

Bathing.--The best time is before breakfast, and in as cold water as possible. The bath should be followed by a thorough rubbing of the skin with a Turkish towel.

Clothing.--Warm clothing in winter; cool clothing in summer. Cold weather induces constipation, and warm weather diarrhea. Moderate manner of living is everything.

PHYSICIANS' TREATMENT for Constipation. 1. One year to three years.--For infants one teaspoonful or less of black molasses or store syrup, or of olive oil; and Mellin's food eaten dry, is good for babies a year and older.

2. Small Children.--Increase cream in the milk, give oatmeal or barley water. Castile soap suppository, enema, massage, castor oil, or citrate of magnesia if drugs are needed.

3. Older Children.--In older children, fruit, oatmeal, etc. Black molasses is good for children, one to two teaspoonfuls.

4. Fluid Extract of Cascara Sagrada.--Dose: ten to sixty drops at night. This is good for a great many cases and sometimes it cures the trouble, but on the other hand it seems to injure some people.

5. The Aromatic Cascara is also good; doses are larger and pleasant to take. This is more agreeable for children.

6. The Compound Licorice Powder is a mild, simple laxative and effective. It is composed of senna eighteen parts, licorice root powder sixteen parts, fennel eight parts, washed sulphur eight parts, sugar fifty parts. Dose:--One to two teaspoonfuls.

7. For one dose, or one capsule, the proportions would be:

ONE AMOUNT FOR CAPSULE ONE DOZEN Aloin 1/4 grain 3 grains Extract of Belladonna 1/8 grain 10 grains Extract Nux Vomica 1/4 grain 3 grains Powdered Gentian 3 grains 36 grains

Mix and put up in twelve capsules and take one at night.

There are many tablets and pills made that can be bought at any drug store. No doubt some of them are first class, though perhaps not attaining to that high degree of virtue claimed in their advertising columns.

[144 MOTHERS' REMEDIES]

ITCHING OF THE ANUS. (Itching Piles) (Pruritus ani).Causes.--An inherited or an acquired nervous constitution. Disease of the colon, rectum or anus. Improper diet. Skin affections in that region. Operations about the rectum and anus with resulting discharge sometimes. Diseases in the neighboring organs. Disease of the general system. Diarrhea, discharge of mucus and pus, fissure, etc. Irregular habits and dissipation. Over-seasoned foods such as lobster, salmon, shell-fish and foods containing much grease or starch are especially conducive to it; the same is true of tea, coffee, cocoa, strong alcoholic drinks. Skin diseases, lice, pin worms often cause it.

After Operations.--Some part has not healed, and there is left an irritating discharge.

Symptoms.--There is intense itching at the anus, increased by warmth, and contact of the buttocks. The itching grows worse after the patient becomes warm in bed. It may spread and extend to the scrotum, down the limbs and sometimes over the lower back.

PHYSICIANS' TREATMENT FOR ITCHING OF ANUS. Preventive and Palliative.

DIET.--May Take.--Strong drink must be prohibited; tea, coffee, cocoa, if used at all should be sparingly used. A light diet such as bread, milk, eggs, nourishing soups, kumiss and a little fresh fish, broiled steak, etc., may be used.

May Not Take--Hot cakes, pastry, parsnips, cheese, pickles, beans, cucumbers, cabbage, oatmeal, pork, shell-fish, salmon, lobster, salt fish, confectionery and starchy or highly seasoned foods are to be prohibited. Regular meals, no lunches between meals, and the patient must not over-eat at any time. Long course dinners and over-indulgence in highly seasoned foods and wines aggravate it.

Remedies for Bath.--The bowels should move daily and the parts should be kept clean. The parts should be bathed with hot water or weak solutions of carbolic acid, alcohol or listerine, the heat being especially soothing. Bathing the parts with bran, oatmeal, flaxseed, salt, rice, slippery elm teas, or tar water adds much comfort to these parts. Do not wash much with soapy water.

1. Separate the Buttocks with Gauze, a thin layer of cotton or a piece of soft cloth. This eases the soreness, pain and itching by absorbing the secretions and preventing irritations while walking. The patient should not scratch the parts. Direct pressure over the itching parts with a soft cloth, or by drawing a well oiled cloth across the sore parts several times gives relief.

2. Dr. Allingham Recommends the introduction of a bony or ivory nipple-shaped plug into the anus before going to bed. It is self retaining, about two inches in length, and as thick as the end of the index finger. He claims it prevents the night itching by pressing upon the many veins and terminal nerve fibres of the parts. When the rawness is extensive and the parts are highly inflamed, the patient should be kept to bed and kept on his back with the limbs separated until the irritation is allayed.

3. Local Applications.--Soothing remedies: These can be used when the parts are inflamed and raw. Lead and opium wash, or boric acid, or linseed oil, or starch, or cocaine, and zinc stearate with boric acid. This form of zinc adheres to the parts when rubbed on, and is thus more valuable.

[DIGESTIVE ORGANS 145]

4. The following is good to dust in the parts:--

Boric Acid 2 drams Stearate of Zinc 2 drams Talcum 1 dram

Apply as a dusting powder.

5. The following is good for the raw parts:--

Carbolic Acid 1 scruple Menthol 10 grains Camphor 10 grains Suet enough to make 1 ounce

Mix. Apply freely two or three times daily after cleansing the parts. Melt the suet and when partially cold, add the other ingredients.

6. The following is good for the itching and to heal the raw surfaces:--

Carbolic acid 1 dram Zinc oxide 1 dram Glycerin 3 drams Lime water 8 ounces

Mix and apply once or twice daily to relieve the itching.

7. Carbolic acid 1 dram Calamin prep 2 drams Zinc oxide 4 drams Glycerin 6 drams Lime water 1 ounce Rose water enough to make 8 ounces

Mix. Keep in contact with the itching area by means of gauze or cotton while the itching is intense.

8. For injections into the rectum for rawness of the mucous membrane, the following is well recommended. Use three drams of this at one time.

Fluid extract Witch Hazel 2 ounces Fluid extract Ergot 2 drams Fluid extract Golden Seal 2 drams Compound tincture Benzoin 2 drams Carbolized Olive or Linseed Oil 1 ounce Carbolic acid 5 per cent

Mix and shake well before using.

9. For the same purpose:-- Ichthyol 1 dram Olive oil 1 ounce

Mix and apply in the rectum on a piece of cotton.

[146 MOTHERS' REMEDIES]

PILES. (Hemorrhoids).--Hemorrhoid is derived from two Greek words, meaning blood and flowing with blood. "Pile" is from a Greek word meaning a ball or globe. Hemorrhoids, or piles, are varicose tumors involving the veins, capillaries of the mucous membranes and tissue directly underneath the mucous membrane of the lower rectum, characterized by a tendency to bleed and protrude. They were known in the time of Moses.

Varieties.--There are the external (covered by the skin) and the internal (covered by mucous membrane).

Causes.--Heredity. More frequent in males. Women sometimes suffer from them during pregnancy. Usually occurs between the ages of twenty-five and fifty. Sedentary life, irregular habits, high-grade wines and liquors, hot and highly seasoned and stimulating foods. Heavy lifting. Those who must remain on their feet long or sit on hard unventilated seats for several hours at a time. Railway employees, because they take their meals any time and cannot go to stool when Nature calls, causing constipation. Purgatives and enemata used often and for a long time. Constipation is perhaps the most frequent cause: when a movement of the bowels is put off for a considerable time the feces accumulate and become hard and lumpy and difficult to expel. If this hard mass is retained in the rectum, it presses upon the blood vessels interfering with their circulation and by bruising the vessels may induce an inflammation of the veins when the hardened feces are expelled; straining is intense, the mass closes the vessels above by pressure and forces the blood downward into the veins, producing dilatation when the force is sufficient. One or more of the small veins near the anus may rupture and cause a bloody (vascular) tumor beneath the mucous membrane or skin.

External Piles.--Two kinds, venous piles and skin or simple enlarged tags of skin. Venous piles usually occur in robust persons. They come on suddenly and are caused by the rupture of one or more small veins during the expulsion of hardened feces. There may be one or more, and may be located just at the union of the mucous membrane and the skin. Their size is from a millet-seed to a cherry, livid or dark blue in color, and appear like bullets or small shots under the skin. At first they cause a feeling of swelling at the margin of the anus; but as the clot becomes larger and harder, there is a feeling of the presence of a foreign body in the lower part of the anal canal (or canal of the anus). The sphincter muscle resents this and occasionally contracts, spasmodically at first, producing a drawing feeling; later these contractions become longer and more frequent, and there is intense suffering caused by the pile being squeezed, and this suffering may be so great that sleep is impossible without an opiate. Because of the straining, irritation of the rectum and pain in the sphincter, the piles soon become highly inflamed and very sensitive. The clot may be absorbed without any treatment. Occasionally it becomes ulcerated from the irritation, infection takes place and an abscess forms around the margin of the anus terminating in a fistula.

[DIGESTIVE ORGANS 147]

Skin Piles. (Cutaneous).--These are enlarged tags of the skin. They frequently follow the absorption of the clot in the venous piles where the skin is bruised and stretched. There may be one or many and usually have the skin color. These cause less suffering than the venous variety, and sometimes they exist for years, without any trouble, providing care is taken; but when bruised from any cause, such as a kick or fall, sitting on a hard seat, stretching of the parts during stool, or when they become irritated by discharges from the rectum or vagina, they become inflamed and cause much annoyance and pain. When they are acutely inflamed they swell greatly, are highly colored, swollen, painful, and extremely sensitive to the touch and cause frequent spasmodic contractions of the sphincter muscle and may finally result in an abscess. The pain is usually confined to the region of the anus, but may go up the back, down the limbs or to the privates.

MOTHERS' REMEDIES FOR PILES. Sulphur and Glycerin for.--"Equal parts of sulphur and pure glycerin. Grease parts." This preparation is very healing, and will often give relief even in severe cases.

2. Piles, Strongly Recommended Remedy for.--

Extract Belladonna 15 grains Acetate lead 1/2 dram Chloretone 1 dram Gallic acid 15 grains Sulphur 20 grains Vaseline 1 ounce

Mix.

In protruding, itching and blind piles, this ointment will give you almost instant relief. If kept up several days it will promote a cure."

3. Piles, Good Salve for.--"Red precipitate two and one-half drams, oxide of zinc one dram, best cosmoline three ounces, white wax one ounce, camphor gum one dram." It is much better to have this salve made by a druggist, as it is difficult to mix at home. This it a splendid salve and very good for inflammation.

4. Piles, Smartweed Salve for.--"Boil together two ounces of fresh lard and half an ounce smartweed root. Apply this to the piles three or four times a day." This is very healing, and has been known to cure in many cases when taken in the early stages.