Part 39

Glioma. "Glue-tumor." They come from tissue forming the basis of the supporting framework of the nervous tissue. This kind occurs often in the young.

Sarcoma and Cancer are rare.

Symptoms.--The most of the growths start in the membranes of the brain, and by compressing a certain part of the brain they produce their special symptoms such as headache, vomiting, inflammation of the nerves of the eye, double vision, blindness, the memory impaired, dullness and apathy, an irritable temper, and sometimes become demented. There is often vertigo or a sense of giddiness. There may be convulsions, and paralysis of some muscles. A general tuberculosis tendency or history of syphilis will help to make the diagnosis. In children it is more likely to be tuberculous. The result is more favorable in tuberculous growths in children and syphilitic tumors in adults. It may last from a few months to three years in a bad case.

Treatment.--For gumma, caused by syphilis, iodide of potash and mercury should be given. In both kinds, syphilitic and tuberculous, a nutritious diet and general tonic treatment, such as cod-liver oil, iron, arsenic, and quinine should be given. The bowels must be kept open and special attention given to the digestion.

For headache.--Ice bags, cold to the head, mustard to the nape of the neck.

For Vomiting.--Mustard over the stomach. Surgery is necessary for some tumors that can be reached. You will naturally depend upon your attending physician for advice and treatment.

SYPHILIS OF THE BRAIN. Causes.--The symptoms of syphilis of the brain, belong to the third stage of the disease, and are rarely ever observed until at least one year or longer from the time of the first lesion (chancre). It may be from ten to twenty years coming on. Both sexes are equally liable, and it may come at any age. Syphilis may produce a circumscribed tumor, a disease of the arteries or a general hardened infiltration of the brain. The tumors are small, yellowish, and cheesy in the center. They originate in the "Dura Mater" (covering) and spread to the brain structure proper. The disease of the arteries causes a thickening of these vessels, a narrowing of the blood channel in them, thus producing a clot.

Symptoms.--Of gumma (syphilis tumors) at the base of the brain, are persistent headache, worse at night; sleeplessness, depression of the mind, memory impaired, vertigo, sometimes vomiting and paralysis of some of the nerves (third and sixth pairs). Violent convulsions, like epilepsy, appear in some cases.

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Symptoms when arteries are diseased.--Temporary loss of speech, numbness or weakness in one limb, the sight is disturbed, or vertigo; and, when the clot (thrombus) appears, symptoms of apoplexy, This is a common variety of syphilis of the brain.

How to tell what the disease is.--The history of the patient will help. An apoplexy in a young person would suggest syphilis.

Recovery.--The chances are better when the disease forms gumma (tumors) than when the blood vessels are diseased.

Treatment.--Should be begun and properly carried on when the person has the primary sore (chancre), and then these after troubles may not follow. This is one of the diseases where the victim reaps a big harvest on account of the sexual sin, and in order to escape the bad results for himself, etc. he should go through a regular course of treatment when he first contracts the disease, perhaps for a year or more, This treatment should last as a rule for some years. It is late to begin when the brain symptoms show brain involvement. For this there must be radical and careful treatment with mercury and iodide of potash; with tonics and general building up treatment, and then even if the patient lives he may be a nuisance to himself and others.

GENERAL PARESIS. (Paretic dementia. General Paralysis of the Insane. Softening of the Brain).--This belongs under diseases of the mind, but there are so many cases that a description of this disease may be instructive and interesting. One author says: "General paresis is a chronic, progressive, diffuse, encephalitis (inflammation of the brain), resulting in structural changes in the cerebral (brain) tissue, with involvement of the cortical, and meningeal, (covering) blood and lymph vessels, presenting characteristic symptoms, with progressive course and fatal termination usually within three years." There are three stages:--1. The period of incubation (the prodromal stage). 2. A stage of pronounced mono-maniac activity with symptoms of paralysis. 3. Stage of extreme enfeeblement with diminution and final loss of power. These stages run into each other. First stage in a typical case:--There are tremblings and slight trouble in speech and expression of the face. The mind has exalted and excited spells, etc.

Symptoms.--The patient is irritable. The mental and moral character is unstable. His affairs are in confusion. He uses bad language, neglects his family, goes with drunkards and bad women, makes indecent proposals to respectable women of his acquaintance without realizing that it is improper. He cannot keep his mind on one thing. Speech is a little thick, indistinct and hesitating. Syllables are dropped or repeated, speech finally becomes undistinguishable. He is very excited; he thinks he is persecuted. He is a big fellow generally. He is a king, he is rich and mighty. This is the usual run. As the disease progresses he becomes feeble-minded more and more so continually. Persistent insomnia comes on early and frequently recurring, one-sided headache often goes with it. Sometimes there is an uncontrollable desire to sleep. Loss of consciousness is an early symptom. After severe attacks there may be one-sided paralysis (hemiplegia) which usually disappears in a few hours or days. Convulsions like epilepsy may appear early, but usually occur in the later stages. The pupils are mostly dilated, rarely contracted, and they are often unequal and react slowly to light. When the tongue is protruded it trembles and is put out in a jerky manner. The hands tremble, in the advanced stage. The speech is jerky and slow. Syllables are dropped and repeated. One early symptom is retention of the urine. There is another annoying symptom--a constant grinding of the teeth. The walk is very spasmodic, but in advanced stages it becomes slouching or dragging. The skin may be red or blue. When the feeble-mindedness is fully developed the mind does not perceive anything accurately. He sees imaginary things, and things that he does see do not appear to him as they are. Finally he has no mind.

Treatment.--The end is sure. You can relieve the distress partly. Personal attention by a physician is needed.

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INSOMNIA.--Insomnia is not a disease, but a symptom of disease. It may, however, become so active, prominent, and important a symptom as to constitute a condition which merits individual management and treatment.

Definition.--Insomnia is the term employed to denote actual or absolute sleeplessness, and also lack of fully restful sleep, which might be termed relative sleeplessness.

Causes.--Organic causes. Disease of the brain and spinal cord. Toxic causes due to poison circulating in the blood which by irritation of the brain and cord (axis) and especially of the brain, cause such diseases as nephritis (chronic), jaundice, typhoid fever and consumption.

Primary causes. Depend upon insanity.

Nervous or simplest causes.--These are present in nervous persons and comprise the two conditions of congestion and anemia of the brain. The brain congestion is typified by the nerve-tire of the student; over-study and anxiety bring too much blood to the brain and necessarily too much activity and then insomnia. Anemia of the brain acts in the opposite manner. The brain cells are not properly nourished and hence irritated, and sleeplessness follows.

SLEEPLESSNESS. Mothers' Remedies. 1. Hop Pillow Stops.--"People affected in this way will be very much benefited by the use of a pillow composed of hops, or cup of warm hop tea on retiring. The hops have a very soothing effect upon the nerves."

2. Sleeplessness, Easy and Simple Remedy for.--"On going to bed, take some sound, as a clock-tick or the breathing of some one within hearing, and breathe long breaths, keeping time to the sound. In a very short time you will fall asleep, without any of the painful anxieties attending insomnia."

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3. Sleeplessness, Ginger at Bedtime for.--"Ginger tea taken at bedtime soothes one to sleep," This is a very good remedy when the stomach is at fault. It stimulates this organ and produces a greater circulation, thereby drawing the blood from the head. This will make the patient feel easier and sleep will soon follow.

4. Sleeplessness, Milk Will Stop.--"Sip a glass of hot milk just before retiring. This is very soothing to the nerves, and a good stimulant for the stomach,"

PHYSICIANS' TREATMENT.--Remove the cause and be careful in using drugs. In the organic kind the treatment is not very successful. In the toxic kind drugs must be given to correct other diseases and also tonics given. For brain congestion and anemia kind other means must be used first, and the drugs as the last resort. Treatment of the congestive insomnia.--1. Hot or warm general body-baths are very advantageous to stimulate the circulation and restore its balance alike in congestion and anemic cases. After such baths the patient must go to bed at once and not get chilled in cold rooms or by drafts. They must be properly covered and kept warm.

2. Cold spongings, cold shower baths, or cold plunge baths are given when the hot or warm bath does not produce the correct result. If this does not depress it is better than the warm bath. The person should be rubbed with warm rough towels until the skin is aglow. If he feels rested and quieted, the reaction is proper; if depressed, the treatment is too vigorous and not suitable.

3. The patient should stand ankle deep in a tub of hot water and a "drip sheet," from water at 75 to 80 degrees temperature, thrown over him. Then rub the patient's back and abdomen hard and a general brisk rub-down immediately after leaving the tub. This treatment should quiet, not excite or depress.

4. The cold abdominal pack is valuable. Flannel is wrung out in water, 75 to 80 degrees temperature and laid in several thicknesses upon the abdomen; place a dry towel over this, cover all with oiled silk, overlapping widely in order to protect the bed. Tie or bandage all this firmly. The effect of this work is first that of a cold then of a warm poultice.

5. Exercise. This should be in the open air when possible. A fast walk, horseback ride or ride on bicycle for a half hour before bedtime, followed by a rub-down will frequently give a good sleep. Dumb-bell, Indian club exercise, chest weight, are good in some cases.

Diet.--A light easily digested supper is often better than a heavy meal. Sometimes a little eaten before bed-time will give sleep. A piece of toast, for instance. It draws the blood from the brain and more to the stomach.

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Medicines. If you must use them.--The bromides are the best. Sodium and strontium bromide are first choice. Twenty to thirty grains in water one-half hour before retiring. Chloral hydrate should not be used often. Sulphonal, trional, etc., should always be given with a little food-never alone. Sometimes bread pills do just as well.

ANEMIC CONGESTION. Diet.--A light supper before retiring, like hot milk, broths, milk punch, etc., will very frequently promote sleep by removing the cause and quickening the circulation. Give nutritious, easy food to digest. The baths are not so valuable for this kind of insomnia. A cold sponge bath or plunge may be of service.

Medicines.--Tonics are needed here as in regular anemia. The patient must be carefully treated, and very many of these cases can be cured. The patient must render all the aid he can give, and the physician should gain his confidence. If he does he will not need to give much medicine to put the patient to sleep, and if he does give it he can frequently use a Placebo with the same effect. Mind has an influence over mind. By "Placebo" is meant any harmless substance, as bread-pills, given to soothe the patient's anxiety rather than as a remedy.

SLEEP WALKING.--There is a tendency to sleep walking in some families, often more than one child will do this to a greater or less extent. It is very extreme in some cases, and the next morning they do not know anything about it. The person is very seldom hurt and he can do some dizzy things. Many persons walk about in their sleeping room or simply get out of bed. Fatigue, worry, poor sleep, restlessness, nervousness, a hearty late dinner are aggravating causes. As age advances and the person becomes stronger, the patient will do less of it.

Treatment.--Avoid over-eating, worry, over-study. The evening should be spent quietly. Such persons had better drop parties, late hours or anything that tends to cause worry, fatigue or nervousness.

STAMMERING.--This may be inherited to some extent; excitement, nervousness, bodily fatigue, want of rest, etc., make it worse.

MOTHER'S REMEDY. 1. Stammering, Easy Cure for.--"Read aloud in a room an hour each day. Repeat each word slowly and distinctly."

PHYSICIANS' TREATMENT.--The person should be taught early to talk slowly, and to do everything to control himself and not get nervous. There are schools for this trouble, and they seem to do good work. They teach the patients how to speak slowly, distinctly and to keep their minds off of themselves.

HICCOUGH.--This is caused by intermittent, sudden contraction of the diaphragm; obstinate hiccough is a very distressing symptom and sometimes it is hard to control.

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Causes.--Inflammatory causes. It is seen in gastritis, peritonitis, hernia, appendicitis, and in severe forms of typhoid fever. Irritative causes. Swallowing hot substances, local disease of the gullet near the diaphragm, and in many cases of stomach trouble and bowel disorder, especially when associated with gas (flatus). Specific causes: Gout, diabetes or chronic Bright's disease. Nervous (Neurotic) causes. Hysteria, epilepsy, shock, or brain tumors.

MOTHERS' REMEDIES. 1. Hiccough. Vinegar for.--"One teaspoonful vinegar sipped carefully (so it will not strangle the patient) will stop them almost instantly."

2. Hiccough, Sugar and Vinegar Stops.--"A few drops of strong vinegar dropped on a lump of sugar and held in the mouth until dissolved, will stop most cases of hiccoughs."

3. Hiccough, Sugar Will Relieve Patient of.--"Place a little dry sugar on the end of the tongue and hold the breath. I have tried this remedy after others have failed and obtained instant relief."

4. Hiccough, Simple Remedy for.--"Have patient hold both ears closed with the fingers, then give them three swallows cold water while they hold their breath."

5. Hiccough, Home Remedy to Stop.--"Take nine swallows of cold water while holding the breath."

6. Hiccough. Vinegar Stops.--"One teaspoonful of vinegar thickened with sugar and eaten slowly."

7. Hiccough, Cinchona Bark in Peppermint Stops.--"Put about one-fourth teaspoonful of cinchona bark, powdered in two ounces of peppermint water, and give one teaspoonful every five or ten minutes until relieved, or three drops of camphor and aqua ammonia in wineglassful of water," These remedies are very good when the stomach is at fault, as they have a stimulating effect.

PHYSICIANS' TREATMENT.--Sudden start may check it in the light forms. Ice, a teaspoonful of salt and lemon juice may be tried. Inhalations of chloroform often relieve. Strong retraction of the tongue may give immediate relief. Spirits of camphor, one teaspoonful. Tincture of cayenne pepper one to two drops in water. Ten grains of musk by the rectum. Hoffman's anodyne one teaspoonful in ice water is very good.

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INJURIES TO THE HEAD. Concussion or Laceration of the Brain.--The brain may be injured by a blow on the head, or indirectly by falling fully upon the feet or sitting down hard upon the buttocks.

Symptoms.--The person who is injured may lose his balance and fall, become pale, confused, and giddy, may have nausea and vomiting and recover. If the injury is more severe and there is a tear of the membranes of the brain or the brain itself, the patient will fall and lie quietly with a feeble and fluttering heart, cold, clammy skin, and apparent unconsciousness; he can be roused by shouting but will not reply intelligently. He will be able to move his limbs. The urine and contents of the bowels will be passed involuntarily. As he gets better he may vomit. He may soon return to entire consciousness, but still suffer from some headache, feel wearied, and tired, and not feel like exerting himself. This may continue for some time. Occasionally the results are more serious even after a long time has passed, and an abscess of the brain should be watched for, sometimes epilepsy or insanity follows. If the patient grows worse instead of recovering, either deep seeming sleep sets in or symptoms of inflammation of the covering (meninges) or the brain itself follows. Such injuries must be carefully watched, for you can not tell at first how severe they may prove to be.

TREATMENT. What to do First.--Put the patient to bed without any pillow, and put around his body hot water bottles or bags, suitably covered. He should be kept quiet and free from excitement, and sleep should be encouraged. Hot water or ice water, when awake, as is most agreeable to the patient, may be given. Aromatic spirit of ammonia, during the shock is better for the patient to take than alcohol, for alcohol excites the brain; dose, one-half to two drams; the former can be given every ten minutes in a little water for about three doses. Surgical treatment may be necessary at any time.

INJURIES OF THE SPINAL CORD. Concussion of the Spine.--A severe jarring of the body followed by a group of spinal symptoms supposed to be due to some minute changes in the cord, of an unknown nature.

Causes.--Severe concussion may result from railway accidents or violent bending of the body, fall from a house, blow on the back, jumping, etc.

Symptoms.--May come on suddenly, when it is due to a jar of the brain as well as the cord. Loss of consciousness, complete paralysis, small pulse, collapse, and within a few hours death may follow. In other cases improvement, though very slow, follows. Walking is difficult and the upper extremities are weak in these cases. There are pain and tenderness along the spine. Brain symptoms, such as headache, dizziness and fainting, may be present or absent.

Treatment.--Absolute rest from the beginning, stimulants if necessary, electricity is useful.

TRAUMATISM OF THE CORD. (Blows, etc.).--(Fractures and dislocations, gunshot and stab wounds, etc.).

Symptoms.--They differ according to the place where the cord is injured. The motion and feeling power may be disturbed. There may be sudden complete paralysis of the upper and lower extremities depending on how severely the cord is injured, and how high up the injury is. The bladder and rectum may not act properly. The contents may be retained or "run-away." Death follows sooner or later if the injury is extensive. In some cases the symptoms are slight in the beginning, but increase in a few days, or they may suddenly increase a few months afterwards. In other cases, bad symptoms at first may gradually abate which is due to the blood clot having been absorbed.

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Recovery depends upon the extent of the injury and the constitution of the patient. It is always well to be careful about expressing an opinion about this injury.

Treatment. Immediate.--Surgical treatment is necessary. Absolute rest is a necessity, and must be had for weeks according to the severity of the case. It may seem long and become tedious, but the case must have rest for a long time.

ORGANIC DISEASES OF THE SPINAL CORD. Caisson Disease; Divers' Paralysis. Causes.--This affection occurs in divers, bridge builders, and others who are subject to increased atmospheric pressure. The symptoms develop on coming suddenly to the surface when the atmospheric pressure is greatly lessened.

Symptoms.--They usually occur on the return to the surface of the water, or after a few hours have passed. There are pains in the ears and joints and nose-bleed. The pulse is slow and strong. Neuralgia of the stomach and vomiting often occur. Paralysis of one side, or of the lower extremities may occur. Brain symptoms may develop and death may follow in a few hours. In most cases recovery takes place in a few days or weeks.

Treatment.--Persons who are engaged in such work should change very gradually from a great depth to the surface, and should not go into the outer air suddenly.

MYELITIS.--Myelitis is an inflammation of the spinal cord.

Causes.--It may occur at any age, and is more common in male than in female. The exciting causes are prolonged exposure to severe colds, too great mental and physical exertion, sexual excess, blows, bleeding into the cord, alcoholic excess, acute infectious diseases, syphilis, etc.

Symptoms.--These depend upon the location of the inflammation and the severity. The onset may be sudden or gradual--when it is sudden, there may be a chill followed by a fever of 101 to 103 degrees--general feeling of illness, loss of appetite, with coated tongue and constipation. There may be over-sensitiveness to pain and touch. Pain may radiate from the back into the limbs, with numbing and tingling of the limbs. The urine may be retained or may dribble away. Usually there is obstinate constipation. There is frequently the feeling of a band around the body. Paralysis may follow in the lower extremities and higher up, sometimes, depending upon how high up in the cord the inflammation exists. This paralysis may cause no motion of the limbs or produce an exaggerated contracting of the affected muscles, the knees being drawn up on the abdomen and the heels touching the buttocks.

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Recovery.--Chances for recovery depend upon the cause. Most cases are chronic and may last for years.

Treatment.--Treatment depends also upon the cause. Rest in bed; counter-irritation, wet cupping, with care on account of bed sores. A water-bed from the first may prevent bed-sores. The urine must be drawn if it is retained. The medical treatment must be carefully given and a physician of experience should be obtained.

LOCOMOTOR ATAXIA. Tabes dorsalis. Posterior Spinal Sclerosis).--A hardening (sclerosis) affecting the posterior parts of the spinal cord and characterized by incoordination, which means a condition where a person is unable to produce voluntary muscular movements; for instance, of the legs, etc., loss of deep reflexes to bend them back; disturbances of nutrition and sensation, and various affections of sight.

Causes.--This is a disease of adult life, persons under twenty-five being rarely affected, and is more common in men than women (ten to one). Sometimes children suffering from hereditary syphilis have it. The chief predisposing cause is syphilis which precedes it in from seventy to eighty-five of the cases according to various authorities. Exposure to cold and wet, sexual and alcoholic excesses, mineral poisoning, and great physical exertion also exciting causes.

Symptoms.--These are numerous. They appear in succession and with the same regularity.

Stages.--Stages of pain; the stage of ataxia, peculiar gait; and the state of paralysis.