Part 29

Individual Prevention.--A mother with pulmonary tuberculosis should not nurse her child. An infant born of tuberculosis parents or of a family in which consumption prevails, should be brought up with the greatest care and guarded most particularly against catarrhal affections of all kinds. Special attention should be given to the throat and nose, and on the first indication of mouth breathing or any affection of the nose, a careful examination should be made for adenoids. The child should be clothed in flannel, and live in the open air as much as possible, avoiding close rooms. It is a good practice to sponge the throat and chest night and morning with cold water. Special attention should be paid to the diet and to the mode of feeding. The meals should be given at regular hours, and the food plain and substantial. From the onset the child should be encouraged to drink freely of milk. Unfortunately in these cases there seems to be an uncontrollable aversion to fats of all kinds. As the child grows older, systematically regulated exercise or a course of pulmonary (lung) gymnastics may be taken. In the choice of an occupation, preference should be given to an out of door life. Families with a predisposition to tuberculosis should, if possible, reside in an equable climate. It would be best for a young person belonging to such a family to remove to Colorado or Southern California, or to some other suitable climate before trouble begins. The trifling ailments of children should be carefully watched. In convalescence from fevers, which so frequently prove dangerous, the greatest care should be exercised to prevent from catching cold. Cod-liver oil, the syrup of iodide of iron and arsenic may be given. Enlarged tonsils should be removed. "The spontaneous healing of local tuberculosis is an every-day affair. Many cases of adenitis (inflammation of the glands) and disease of the bone or joints terminate favorably. The healing of pulmonary (lung) tuberculosis is shown clinically by the recovery of patients in whose sputa elastic tissue and bacilli have been found."

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General Measures.--The cure of tuberculosis is a question of nutrition; digestion and assimilation control the situation; make a patient grow fat, and the local disease may be left to take care of itself. There are three indications:

First, to place the patient in surroundings most favorable for the greatest degree of nutrition; second, to take such measures as in a local and general way influence the tuberculosis process; third, to alleviate the symptoms. This is effected by the open air treatment with the necessary feeding and nursing.

At Home.--In the majority of cases patients must be treated at home. In the city it has many disadvantages. The patient's bed should be in a room where he can have plenty of sunshine and air. Two things are essential--plenty of fresh air and sunshine. While there is fever he should be at rest in bed. For the greater part of each day, unless the weather is blustering and raining, the windows should be open. On the bright days he can sit out-doors on a balcony or porch, in a reclining chair. He must be in the open air all that is possible to be. A great many patients spend most of the time out in the open air now. In the country places this can be easily carried out. In the summer he should be out of doors from eleven to twelve hours; in the winter six to eight at least. At night the room should be cool and thoroughly ventilated. "In the early stages of the disease with much fever, it may require several months of this rest treatment to the open air before the temperature falls to normal." The sputum is dangerous when it becomes dry. As long as sputum is moist the germs are held in the sputum; but when it is dry they are released and roam at will in the atmosphere and are inhaled. They are then ready to lodge themselves in suitable soil. Always keep the sputum (expectoration) moist, and then there is no danger.

Diet. Treatment.--The outlook in this disease depends upon the digestion. Nausea and loss of appetite are serious obstacles. Many patients loathe foods of all kinds. A change of air or a sea voyage may promptly restore the appetite. When this is not possible, rest the patient, keep in the open air nearly all day and feed regularly with small quantities either of buttermilk, milk, or kumiss, alternating if necessary with meat juice and egg albumin. Some cases which are disturbed by eggs and milk do well on kumiss. Raw eggs are very suitable for feeding, and may be taken between meals, beginning with one three times a day, and can be increased to two and three at a time. It is hard to give a regular diet. The patient should be under the care of a physician who will regulate the kind of diet, amount and change. When the digestion is good there is less trouble in feeding. Then the patient can eat meat, poultry, game, oysters, fish, animal broths, eggs. Nothing should be fried. Avoid pork, veal, hot bread, cakes, pies, sweet meats, rich gravies, crabs, lobsters.

[INFECTIOUS DISEASES 215]

Diet in Tuberculosis furnished us by a Hospital.--

May Take.--Soups.--Turtle or oyster soup, mutton, clam, or chicken broth, puree of barley, rice, peas, beans, cream of celery or tomatoes, whole beef tea; peptonized milk, gruel.

Fish.--All kinds of fresh fish boiled or broiled, oysters or clams, raw, roasted or broiled.

Meats.--Rare roast beef or mutton, lamb chops, ham, fat bacon. sweetbreads, poultry, game, tender steaks, hamburger steak rare.

Eggs.--Every way except fried.

Farinaceous.--Oatmeal, wheaten grits, mush, hominy, rice, whole wheat bread, corn bread, milk toast, biscuits, muffins, gems.

Vegetables.--Potatoes baked, boiled, or creamed, string beans, spinach, onions, asparagus, tomatoes, green peas, all well cooked, cresses, lettuce, plain or with oil dressing, celery.

Desserts.--Farina, sago, tapioca, apple or milk pudding, floating island, custards, baked or stewed apples with fresh cream, cooked fruits, rice with fresh cream.

Drinks.--Fresh milk, cool, warm, or peptonized, cocoa, chocolate, buttermilk, pure water, tea, coffee, panopepton.

Must Not Take.--Fried foods, salt fish, hashes, gravies, veal, pork, carrots, parsnips, cabbage, beets, turnips, cucumbers, macaroni, spaghetti, sweets, pies, pastry, sweet wines.

WHAT EVERY PERSON SHOULD KNOW ABOUT TUBERCULOSIS, WHETHER HE HAS THE DISEASE OR NOT.

Tuberculosis is caused by a germ.

Tuberculosis is communicable and preventable.

Consumption of the lungs is the most common form of tuberculosis.

Consumption of the bowels is the next most common form.

The germ causing tuberculosis leaves the body of the person who has the disease by means of the discharges; by the sputum coughed up from the lungs, by nasal discharge, by bowel excrement, by urine, by abscesses.

If the sputum of the consumptive is allowed to dry, its infected dust floats in the air, and is breathed into the lungs.

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Any person breathing such air is in danger of contracting tuberculosis. It is best not to stand near a person suffering with tuberculosis who is coughing, because in this act finely divided droplets of saliva are thrown from the mouth, and may be carried for a distance of three feet. These may contain large numbers of the bacilli. They are also sometimes thrown out in forcible speaking. The ordinary breath of a consumptive does not contain them.

If the bowels or other discharges from the tuberculous person are not disinfected, but are thrown into a sewer, privy, river or buried they are a source of danger, and may pollute a source of drinking water.

Impure milk, that is, milk from a tuberculous cow or milk exposed to infected dust is a common source of tuberculosis. Milk from suspected sources should be boiled. The all-important thing to do to prevent tuberculosis from spreading from one person to another, and from one part of the body to another, is immediately to destroy all discharges from the body of a person who has tuberculosis.

Destroy by fire or by disinfectant all sputum, all nasal discharges, all bowel excrement, all urine as soon as discharged. For such a purpose use a five per cent solution of carbolic acid (six and three-fourths ounces of carbolic acid to one gallon of water).

No person, well or sick, should spit in public places or where the sputum cannot be collected and destroyed.

Flies carry sputum and its infection to food, to your hands, your face, clothes, the baby's bottle, from which the germs are taken into the mouth, and thus gain access to the stomach or lungs.

Spitting on the sidewalk, on the floor, on the wall, on the grass, in the gutter, or even into a cuspidor containing no disinfectant is a very dangerous practice for a consumptive to indulge.

The person infected with tuberculosis should protect himself, his family, his associates and the public by not spitting in public places, and by promptly destroying all discharges.

The well person should defend himself by insisting that the tuberculous person shall destroy all discharges.

Well persons should set the example of restraint and themselves refrain from spitting promiscuously. A person may appear quite healthy and yet be developing tuberculosis without knowing it.

Such a person, if he spits where he pleases, may be depositing infected sputum where it can endanger the health and lives of other persons.

Do not sleep with a person who has tuberculosis, nor in the room occupied by a tuberculous person, until that room has been thoroughly disinfected.

[INFECTIOUS DISEASES 217]

Any person is liable to contract tuberculosis, whether he is well or not. Sickly persons, or those having bad colds, influenza bronchitis or pneumonia or any general weakness are much more liable to contract tuberculosis than a perfectly well or robust person. If you have a cough that hangs on consult at once a reliable physician who has ability to diagnose tuberculosis.

Prevention is possible; it is cheaper and easier than cure.

Any person having tuberculosis can recover from the disease if he takes the proper course in time.

Advanced cases of tuberculosis, that is, those cases where the disease is well developed, are the most dangerous to the public and the most difficult to cure.

Every advanced case of tuberculosis should be in a sanatorium.

Sanatoria offers the best chance, usually the only chance, of cure to an advanced case.

They also protect well citizens from danger of infection from advanced stages of tuberculosis. There are fewer deaths from tuberculosis in those localities where sanatoria are established for the care of tuberculous persons.

One person out of every seven who die, dies from tuberculosis.

One child out of every ten dies from tuberculosis.

Homes and school-houses greatly need more fresh air supplied to their occupants.

Day camps are city parks, vacant lots or abandoned farms where the tuberculous persons of a community may go and spend the entire day in rest, receiving instructions in proper hygiene and skillful treatment. Such camps are supplied with tents, hammocks, reclining chairs, one or more nurses, milk, eggs and other nourishment.

Dispensaries are centers of sanitary and medical instruction for local tuberculous persons.

Every locality should establish and maintain a dispensary for the benefit of tuberculous persons; for their instruction how to prevent the disease from spreading, and how to conduct themselves to insure relief and cure.

Householders are required by law to report a case within their households to the local health officers. The local health officer has certain duties to perform under the law, and co-operation with him by the householder and tuberculous person, works for the suppression of this disease.

Do not consider a tuberculous person an outcast, or one fit for the pesthouse. Your crusade is against tuberculosis, not against the person suffering from the disease.

Give the freedom of a well person to the tuberculous who is instructed and conscientious in the observance of necessary precautions. Be very much afraid of the tuberculous person who is ignorant or careless in the observance of necessary precautions.

[218 MOTHERS' REMEDIES]

PNEUMONIA (Lobar) Lung Fever.--Inflammation of the lungs. This is an acute infectious disease characterized by an exudative inflammation of one or more lobes of the lungs, with constitutional symptoms due to the absorption of toxins (poison), the fever terminating by crisis (suddenly). In speaking of pneumonia you frequently hear the expression "the lungs are filling up." This is the real condition. The structures surrounding the air cells are inflamed and from the inflamed tissues a secretion exudate is poured out into the cells. This is expectorated, thrown out, by coughing; but it is poured out into the cells faster than it can be spit up and consequently it remains in some of the cells and fills them up.

The air does not get into such cells and they fill, with many others, and make that section solid. When the patient is improving he keeps on spitting this up, until all is out and the air cells resume their normal work. Sometimes they remain so and we have chronic pneumonia.

Causes of Pneumonia.--Pneumonia occurs frequently as a complication of other diseases, such as typhoid fever and measles. Yet the majority of cases occur spontaneously. Many times the disease seems to be induced by exposure to the cold, and there can be no doubt that such exposure does at least promote the development of this affection. It seems, however, probable that there is some special cause behind it without which the exposure to cold is not sufficient to induce this disease. Pneumonia may occur at any period of life, and is more common among males than females. It occurs over the entire United States, oftener in the southern and middle, than in the Northern States; it is more frequently met with during the winter and spring months than at other times in the year.

Symptoms.--The onset is usually abrupt with a severe chill and chills lasting from fifteen minutes to an hour, with the temperature suddenly rising and an active fever. There is usually intense pain in a few hours, generally in the lower part of the front of the chest, made worse by breathing and coughing. The patient lies on the affected side so as to give all chance for the other lung to work, cheeks are flushed, with anxious expression; the wings of the nostrils move in and out with each breath. The cough is short, dry and painful. Rapid, shallow, jerky breathing, increasing to difficult breathing. On the first day the characteristic expectoration mixed with blood appears (called rusty). Pulse runs from 100 to 116, full bounding, but may be feeble and small in serious cases. After three or four days the pain disappears, the temperature keeps to 104 or 105, but falls quickly the seventh, fifth, eighth, sixth and ninth day in this order of frequency. In a few hours, usually twelve, the temperature falls to normal or below, usually with profuse sweating and with quick relief to all symptoms. This relief from distressing symptoms is, of course, a time of rejoicing to both patient and friends and the patient and nurse may feel inclined to relax a little from the strict observance of rules followed up to this time. Do not, under any circumstances, yield to such folly. Keep patient properly covered, as he is weak from the strain and the pores are open.

[INFECTIOUS DISEASES 219]

Convalescence is usually rapid. A prolonged rise of temperature after the crisis may be regarded as a relapse. Death may occur at any time after the third day from sudden heart failure, or from complications such as pleurisy, nephritis, meningitis, pericarditis, endocarditis, gangrene of the lungs.

MOTHERS' REMEDIES.--1. Lungs, Salt Pork for Inflammation of.--"Salt pork dipped in hot water, then covered thick with black pepper. Heat in the oven and lay or bind on the throat and lungs."

2. Lungs, Raspberry Tincture for Inflammation of.--"Take one-half pound of honey, one cup water; let these boil; take off the scum; pour boiling hot upon one-half ounce lobelia herb and one-half ounce cloves; mix well, then strain and add one gill of raspberry vinegar. Take from one teaspoonful to a dessertspoonful four times a day. Pleasant to take."

3. Lungs, Herb Ointment for Congestion of.--

"Oil of Turpentine 1/2 ounce Oil of Hemlock 1/2 ounce Oil of Peppermint 1/2 ounce Oil of Feverweed 1/2 ounce

Mix this with one cup warm lard."

Rub this ointment on throat or lungs and apply a flannel over it. Heat it through thoroughly with hot cloths. If used thoroughly and the cold is taken in time will prevent pneumonia.

4. Lungs, Mullein for Congestion.--"The mullein leaves may be purchased at any drug store or gathered in the fields. Make a tea of the leaves by steeping them. Add enough water to one tablespoon mullein to make a pint, which will be three doses, taken three times a day." This is a very good remedy.

5. Lungs, Salve for Weak.--

"Bees Wax 1 ounce Rosin 1 ounce Camphor Gum 1 ounce Lard about the size of an egg."

The beeswax forms sort of a coating and may remain on for several hours.

This is very good.

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PHYSICIANS' TREATMENT FOR LUNGS.--The home treatment should be to put the patient to bed and try to produce sweating. This will cause the blood to leave the congested lung and return to the full regular circulation. By doing this, you not only relieve the congested lung, but also the pain. If the patient is stout and strong, give him the "corn sweat" under La Grippe (see index); or you can put bottles of hot water about the patient. Use fruit jars, wrap cloths around them so that you will not burn the patient. Always put one to the feet. If you have a rubber water bag, fill that and put it to his affected side over the pain. After you get him into a sweat you can remove a little, of the sweating remedy at a time and when all are removed give him a tepid water sponging. By this time the physician will be at hand. If you give medicine you can put fifteen drops of the Tincture of Aconite in a glass one-half full of water and give two teaspoonfuls of this every fifteen minutes for four doses. Then give it every one-half hour. Water can be given often, but in small quantities; plain milk alone, or diluted, or beaten with eggs will make a good diet and keep up the strength.

Fomentations.--Cloths wrung out of hot hop tea are often applied to the affected part with good effect. Be careful about wetting the patient. Flaxseed poultices are used.

If used they must be moist and hot. Some doctors are opposed to them. An antiphlogistine poultice is good. Apply it hot. For children you can grease the whole side of the chest, back and front, with camphor and lard and put over that an absorbent cotton jacket. In the early life of the country, home treatment was necessary. Men and women were posted on herbs, etc. Teas made of them were freely and successfully used. A great mistake made was the indiscriminate use of lobelia in too large doses. We have learned that the hot herb drinks in proper doses are of help. Teas made of boneset, hoarhound, pennyroyal, ginger, catnip, hops, slippery elm, etc., were good and are now. They produced the desired result--sweating--and relieved the congestion of the internal organs and re-established the external or (peripheral) circulation. So in the home treatment of pneumonia, etc., if you are so situated that you cannot get a physician use teas internally for sweating, fomentations upon the painful part and if done properly and not too excessively, they will accomplish the desired result. With the corn sweat, I have saved many lives.

ERYSIPELAS.--Erysipelas is an infectious disease, and it is usually caused by a germ which we call "streptococcus pyogenes." The disease shows itself by its local symptoms, pain, swelling, etc., and also by general or constitutional symptoms such as fever, headache, etc., as hereafter given.

Causes.--It is a disease that occurs at any time, and is sometimes epidemic, that is, attacks many persons at a time, like La Grippe. It occurs more often in the spring; it is contagious, and can be carried by a third person or in bedding, etc.

Symptoms.--The type that appears upon the face is the most common. The incubation lasts from three to seven days and it usually comes suddenly with a chill, followed by an active fever and with the local inflammation. In some cases the local condition appears first. There is at first redness, usually of the bridge of the nose and it rapidly spreads to the cheeks, eyes, ears, etc. It is red, shiny hot, drawing, but with a distinct margin at its edges, showing how much skin is inflamed. It may take the form of vesicles. The eyelids may be so swollen as to close, the face and scalp greatly swollen with watery swelling of the eyelids, lips, eyes, ears, etc. The glands under the jaw may become enlarged. The general or constitutional symptoms may be severe. The fever may rise to 104 to 106 and terminates suddenly. The parts that were first affected become pale and more normal, as other parts are involved. It occurs also on other parts of the body. A sting of an insect sometimes looks like it at first; but it does not spread like erysipelas. It seems to me to be more dangerous around the head.

[INFECTIOUS DISEASES 221]

MOTHERS' REMEDIES. 1. Erysipelas, Slippery Elm Bark for.--"Slippery elm used as a wash and taken as a drink." Slippery elm is a very good remedy for this on account of its soothing effect to the affected parts. It is very good to take internally, as it cleanses the system by acting on the bowels and kidneys.

2. Erysipelas, Bean Poultices for.--"White navy beans boiled soft and applied as a poultice to the affected parts and renewed frequently is a sure cure for erysipelas if taken in time." This is a very good and effective poultice, but care should be taken not to use it too long, as the parts will become too soft and might slough.

3. Erysipelas, Soda Wash for.--"Put about a tablespoonful of baking soda in one pint of water and bathe parts several times a day," This is an extremely simple remedy for such a serious disease, but has been known to do good in many cases. The baking soda is soothing.

4. Erysipelas, Easy Remedy for.--"Keep parts well bathed with witch-hazel." A good preparation should be bought. By applying this freely to the affected parts it will be found to have a very soothing effect.

5. Erysipelas, Copperas Liniment for.--"A few cents' worth of common copperas. Make a solution and keep applying it. This kills the poison as it comes on and relieves the pain. I knew of a very bad case to be cured by this treatment."

6. Erysipelas, Cranberry Poultice for.--"Take cranberries and stew them and make a poultice of them." This is a remedy that cannot be beaten for this disease. It gives relief in a very short time and saves the patient a great deal of suffering. If the whisky is used to wet the poultice it is much better, as it keeps the poultice moist longer. All that is necessary is simply to put on more whiskey and it will not be necessary to change the poultice so often.

PHYSICIANS' TREATMENT for Erysipelas.--It is best to separate the patient from the others in the family. Some people very easily take this disease. I know one who cannot be in the room where such a patient is for even five minutes without contracting it.

Local Treatment.--1. Wash the parts with a solution of boric acid, one-half teaspoonful to eight teaspoonfuls of tepid water, put this on the inflamed parts. Then apply a poultice of bruised cranberries. Wash the face each time with the solution before applying the cranberry poultice afresh.

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