Chapter 21

5. Piles, the Cold Water Cure for.--"Take about a half pint of cold water and use as an injection every morning before trying to have a movement of the bowels." This simple treatment has cured many cases where the stronger medicines did not help.

6. Piles, Simple Application and Relief from.--"Mix together one tablespoonful plain vaselin and one dram flower of sulphur. Apply three times daily and you will get relief."

7. Piles, Steaming with Chamomile Tea for.--"A tea made of chamomile blossoms and used as a sitz bath is excellent; after using the sitz bath use vaselin or cold cream and press rectum back gently."

[148 MOTHERS' REMEDIES]

PHYSICIANS' TREATMENT for Piles.--What to do first.--The palliative treatment of both varieties of external piles is the same. In all cases the patient should lie flat on his back in bed and remain there for a few days. Highly seasoned foods and stimulants, tea, coffee, whisky, wine, etc., must be discarded. Secure a daily half liquid stool by the use of small doses of salts, Hunyadi or Abilena water. Cleansing the parts with weak castile soap water is essential to allay the pain, reduce the inflammation and soothe the sphincter muscle; cold, or if it is more agreeable, hot applications may be kept constantly on the parts. Hot fomentations of hops, smartweed, wormwood, or poultice of flaxseed, or slippery elm, or bread and milk give almost instant relief in many cases; while in others soothing lotions, and ointments or suppositories are needed.

The lead and laudanum wash is always reliable.

Lead and Laudanum Wash.--

Solution of Subacetate of Lead 4 drams Laudanum 20 drams Distilled water enough to make 4 ounces

Mix thoroughly and apply constantly ice cold on cotton to the sore parts.

The following ointments, lotions, and suppositories to be used freely within the bowels and to the piles, are effective in relieving the pain, reducing inflammation and diminishing pain and spasm in the sphincter.

1. Ointment of Stramomium 1-1/2 drams Ointment of Belladonna 2-1/2 drams Ointment of Tannic Acid 1/2 ounce

Mix thoroughly and apply inside and outside the anus.

2. Camphor Gum 1 dram Calomel 12 grains Vaselin 1 ounce

This must be thoroughly mixed. Apply freely within the anus and to the piles. Good for the pain.

3. For External Piles cleanse them well with a sponge dipped in cold water, and then bathe them with distilled extract of witch hazel.

4. If there is much itching with the piles use the following salve:--

Menthol 20 grains Calomel 30 grains Vaselin 1 ounce

Mix and apply to the piles.

5. I use quite frequently the following for sore external piles:

Chloroform and Sweet oil in equal parts

Apply freely with cotton or on to the piles. Ten cents will buy enough to use.

[DIGESTIVE ORGANS 149]

Operation for Piles.--When these measures do not relieve the pains or the piles become inflamed from slight causes and often, it is best to operate. This can be done in a few minutes with a local anesthetic and the patient frequently goes to sleep afterward, almost free from pain. Inject a three per cent solution of eucaine, or six per cent solution of cocaine. Thoroughly cleanse the part and hold the buttocks apart, pierce the pile at its base with a thin sharp-pointed curved knife, laying it open from side to side. Remove the clot with a curette, cauterize the vessel and pack the cavity with gauze to prevent bleeding and to secure drainage.

Cutaneous (skin) piles are operated upon as follows.--Each one is grasped in turn with a pair of strong forceps and snipped off with the scissors, or removed with a knife. Close the wound with sutures, if necessary, and dress it with gauze. Small ones need no sutures. Be careful not to remove too much tissue. Much after-pain can be prevented by placing in the rectum a suppository containing one-half grain of opium or cocaine before either of the above operations are performed. The after treatment is quite simple. Keep the patient quiet, cleanse the parts frequently, and secure a soft daily stool. Cleanse with tepid boiled water with clean sterilized gauze and give salts in small doses, one to two drams to produce a stool.

INTERNAL PILES. Symptoms.--The two prominent symptoms are bleeding and pain. The bleeding is usually dark. It may be slight and appear as streaks upon the feces or toilet paper; it may be moderate and ooze from the anus for some time after a stool, or it may be so profuse as to cause the patient to faint from loss of blood while the "bowels are moving." Death may follow in such a case unless the bleeding is stopped. The blood may look fresh and fluid or if retained for some time, it looks like coffee grounds, sometimes mixed with mucus and pus. Patients who bleed profusely become pale and bloodless, and are very nervous and gloomy and they believe they are suffering from cancer or some other incurable trouble. The first the patient notices he has internal piles is when a small lump appears at the end of the bowel during a stool and returns spontaneously; afterwards the lump again protrudes after the stool and others may appear. They become larger and larger, come down oftener and no longer return spontaneously, but must be replaced after each stool. As a result of this handling, they grow sensitive, swollen, inflamed and ulcerated, and the sphincter muscle becomes irritable. Later on one or more of the piles are caught in the grasp of the sphincter muscle and rapidly increases in size. It is then hard to relieve them, and when returned they act as foreign bodies, excite irritation and they are almost constantly expelled and the same procedure goes on at each stool. The sphincter muscle contracts so tightly around them as to cause strangulation and unless properly treated they become gangrenous and slough off.

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Recovery, Pain, etc.--The pain is not great in the early stages, but when the muscle grasps and contracts the pile or piles it becomes terrible and constant. Piles rarely end fatally. Palliative treatment does not afford a permanent cure. They frequently return, but by care and diet many can be kept from returning so frequently. They should be treated upon their first appearance when the chances of a permanent cure without an operation are much better.

PHYSICIANS' TREATMENT for Internal Piles.--What to do first. The cause should be removed. Restore a displaced womb. Regulate the bowels, liver, diet, and habits. Much can be accomplished by these measures if properly used, in allaying inflammation diminishing pain and reducing the size of the piles. These measures will not cure them if they are large, overgrown and protruding. When the piles are inflamed, strangulated or ulcerated, the patient should remain in bed in a recumbent position and hot fomentations of hops, etc., and hot poultices, of flaxseed, slippery elm, bread and milk, the ice bag, or soothing applications and astringent remedies, should be applied to the parts. In some cases cold applications are the best. The cold or astringent applications give the best results where the piles are simply inflamed and the sphincter muscle does not act spasmodically, jerkily. But when the piles are strangulated, "choked tight" by the sphincter muscle, hot fomentations, poultices and soothing remedies give the most relief, because they reduce spasmodic contractions of the muscle and allay the pain. Instead of the poultices and fomentations, the "sitz" bath can be used. Put in the steaming water, hops, catnip, tansy, pennyroyal, etc., and the steam arising will frequently give great relief. This can be given frequently; ten to twenty drops of laudanum can be added to the poultices when the piles are very painful.

1. For inflamed piles, the following combinations may be used:--

Gum Camphor 1 dram Calomel 12 grains Vaselin 1 ounce

Mix thoroughly and apply freely around the anus and in the rectum on the piles.

The external parts should always be bathed with hot water, thoroughly, before using.

2. Gum Camphor 2 drams Chloretone 1 dram Menthol 20 grains Ointment of Zinc Oxide 1 ounce

Mix and apply directly to the piles.

3. When there is a slight bleeding, water of witch-hazel extract, one to two ounces to be injected into the rectum. This witch-hazel water freely used is good for external piles also. This is good and well recommended.

[DIGESTIVE ORGANS 151]

4. If the protruded pile is inflamed and hard to push back, the following is good and recommended highly:--

Chloretone 1 dram Iodoform 1 dram Gum Camphor 1 dram Petrolatum 1 ounce

Mix and use as a salve.

5. An ointment composed of equal parts of fine-cut tobacco and raisins, seedless, chopped fine and mixed with enough lard, makes a good ointment to apply on both external and internal piles.

6. Tea of white oak bark, boiled down so as to be strong, and mixed with lard and applied frequently, is good as an astringent, but not for the very painful kind. It will take down the swelling.

7. Take a rectal injection of cold water before the regular daily stool. This will soften the feces and decrease the congestion.

Preventive Treatment.--This is very important and includes habits and diet and other diseases. If the patient is thin and pale give tonics. Correct any disease of any neighboring organ. Attend to any disease that may be present.

For Constipation.--Take a small dose of salts or hunyadi water so as to have one semi-solid stool daily. If necessary remove any feces that may even then be retained, by injections of soap suds or warm water containing oil. Discontinue injections as soon as a daily full stool can be had without it.

Habits.--Full-blooded people should not use upholstered chairs as the heat of the body relaxes the tissues of the rectum. A cane seated chair is best or an air cushion with a hollow center. It is best to rest in bed, if possible, after stool for the rest relieves the congestion and soreness. An abundance of out-door exercise, when the piles are not present, or bad, consisting of walking or simple gymnastics may usually be indulged in; violent gymnastics and horseback riding must be avoided. A daily stool must be secured.

Diet.--Such patients should avoid alcoholic beverages, spiced foods, strong coffee, and tea, cheese, cabbage, and old beans.

Foods Allowed.--Potatoes, carrots, spinach, asparagus, and even salads, since they stimulate intestinal action and thus aid in keeping the stool soft. Stewed fruits, including grapes, oranges, pears, and apples. Water is the best to drink. Meats: tender broiled, boiled or baked beef--do not eat the inside part to any great amount. Other meats, but no pork or ham, fresh fish, chicken. The foods should not be too highly seasoned; vinegar is not to be used to any extent and this excludes pickles, etc.

PERIPROCTITIS. Abscess Around the Anus and Rectum. (Ano-rectal) (Ischio- rectal Abscess).--This is an inflammation of the tissues around the rectum which usually terminates in the above named abscess. It occurs mostly in middle-aged people. Men are affected more often than women.

[152 MOTHERS' REMEDIES]

Causes.--Sitting in cold, damp hard seats; horseback riding, foreign bodies in the rectum such as pins, fish-hooks, etc., blows on the part, kicks, tubercular constitution, etc.

Symptoms.--Inflammation of the skin, like that of a big boil, some fever, throbbing pain, swelling of the part, heat and fullness in the rectum, these symptoms increase until the pus finds an outlet into the rectum.

PHYSICIANS' TREATMENT for Periproctitis.--Little can be done in a palliative way. It generally terminates in an abscess. Make the patient as comfortable as possible, by applying cold or hot things to the part, rest in bed, mild laxatives to keep the bowels open. Cut it open as soon as possible, and it should be laid wide open, so that every part is broken up. Then it should be thoroughly washed and scraped out. Sometimes it is necessary to use pure carbolic acid to burn out the interior. The dressing should be as usual for such wounds and removed when soiled and the wound washed out with boiled water and then gauze loosely placed in the bottom and in every corner of the wound. The dressing should be continued until all has been healed from inside out. Be sure to leave no cotton in to heal over it. Such patients should be built up with nourishing foods, and should remain quietly in bed. Cod liver oil is good for some patients. Iron, etc., for others. Keep the bowels regular. Outdoor life and exercise. If treated right it should not return.

FISTULA IN ANUS.--This usually follows the abscess. It has two openings, one upon the surface of the body near the anus, and the other in the rectum. There are a great many varieties of fistula, but it is unnecessary to name them. What can be done for them?

PHYSICIANS' TREATMENT.--If the general health is good an operation is the best thing to do, but patients in the last stage of consumption, nephritis, diabetes, or organic heart disease, are not apt to receive much benefit from an operation. The patient in poor condition should be given the treatment suitable to his condition, according to the advice of a trusted physician.

[KIDNEY AND BLADDER 153]

DISEASES OF THE KIDNEYS AND BLADDER.

KIDNEYS.--The kidneys are deeply placed and cannot be felt or distinctly identified when normal. They are most accessible to pressure just below the last rib, behind. The right kidney usually lies lower than does the left, but even then, the lower part of this kidney is an inch above the upper part of the hip bone, or an inch above a line drawn around the body parallel with the navel. The kidney is about four inches long. The long axis of the kidneys corresponds to that of the twelfth rib; on an average the left kidney lies one-half inch higher than the right.

As stated before, each kidney is four inches long, two to two and one-half in breadth, and more than one inch thick. The left is somewhat longer, though narrower, than the right. The kidney is covered with what is called a capsule. This can be easily stripped off. The structure of the kidney is quite intricate. At the inner border of each kidney there is an opening called the pelvis of the kidney, and leading from this, small tubes penetrate the structure of the kidney in all directions. These tubes are lined with special cells. Through these tubes go the excretions (urine) from the body of the kidneys, to the pelvis, and from the pelvis through the ureters, sixteen inches long, to the bladder.

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KIDNEY TROUBLE. MOTHERS' REMEDIES.--1. Kidney Trouble and Inflammation of the Bladder, Cornsilk for.--"Get cornsilk and make a good strong tea of it by steeping slowly, and take one ounce three or four times a day. This acts well on the kidneys, and is a harmless remedy to use."

2. Kidney Trouble, Flaxseed and Lemons for.--"Make a tea by placing the flaxseed in a muslin or linen bag, and suspend it in a dish of water, in the proportion of about four teaspoonfuls for each quart of water. After allowing the seeds to soak for several hours remove the same and tea will be ready for use. The addition of a little lemon juice will improve the flavor. Give in quantities as may be found necessary."

3. Kidney Trouble, Temporary Relief for.--"Rub witchhazel on stomach and back; use freely." This is an old-time remedy, and can be relied upon to at least give temporary relief. The witch hazel has a very soothing effect upon the parts affected.

4. Kidney and Bladder Trouble, Buchu Leaves for.--"Get five cents' worth of buchu leaves at any drug store, and make a good strong tea of it by steeping. This acts nicely on the kidneys. This remedy is easily prepared, and is not expensive."

5. Kidney Trouble, Common Rush Root for.--"Take a handful of the root of common rush in one and one-half pints of water, boil down to one pint. Dose:--One tablespoonful every two or three hours. For a child ten years, give one teaspoonful four times a day. For a child of four to six years, one-half teaspoonful four times a day."

6. Kidney Trouble, Effective and Easy Cure for.--

"Fluid Extract of Cascara Sagrada 1 ounce Fluid Extract of Buchu 2 ounces Fluid Extract of Uva Ursi 2 ounces Tincture Gentian Comp 1 ounce Simple Syrup 1 pint

Mix the above ingredients and give a teaspoonful four times a day. This is a very good remedy, as the cascara sagrada acts on the bowels and the buchu and uva ursi acts on the kidneys, carrying off all the impurities that would otherwise be retained in the system and cause trouble."

7. Kidney Trouble, Sheep-Sorrel Excellent for.--"Make a decoction of sheep sorrel, one ounce to pint of water; boil, strain and cool. Give wineglassful, three or four times a day. If necessary apply the spinal ice bag to kidneys." The sheep sorrel is a good kidney remedy, and the ice bag by continuous application will relieve the congestion.

[KIDNEY AND BLADDER 155]

MOVABLE KIDNEY. (Floating Kidney. Nephroptosis).--Causes.--This condition is usually acquired. It is more common in women than in men, possibly due to lacing and the relaxations of the muscles of the abdomen from pregnancy. It may come from wounds, lifting too heavy articles, emaciation.

Symptoms.--They are often absent. There may be pain or dragging sensation in the loins, or intercostal neuralgia; hysteria, nervousness, nervous dyspepsia and constipation are common. The kidney can be felt. A dull pain is caused by firm pressure. Sometimes there are attacks of severe abdominal pain, with chill, fever, nausea, vomiting and collapse. The kidney becomes large and tender. The urine shows a reddish deposit and sometimes there is blood and pus in the urine.

Treatment.--If the symptoms are not present, it is best for the patient not to know the true condition, as nervous troubles frequently follow a knowledge of its presence. If the symptoms are present, replace the kidney while the patient is lying down and retain it by a suitable belt. Also treat the nervous condition. If the symptoms are of the severe kind an operation may be needed to fasten the kidney in its proper condition. This is quite generally successful, and does away with much suffering and pain. The pain may be so severe at times as to require morphine. Sometimes the pain is due to uric acid or oxalates in the urine. For this regulate the diet.

Diet for Movable Kidney.--The diet should be such as to produce fat. Milk is excellent where it is well borne; if not well borne give easily digested meats, such as chicken, roast beef, broiled steak and lamb chop; fish of various kinds and vegetables, such as spinach, carrots, asparagus and cauliflower; of fats, butter, cream, and chocolate; for constipation, cider, buttermilk, grape-juice, fruits and honey.

ACUTE CONGESTION OR HYPEREMIA OF THE KIDNEYS.--This occurs at the beginning of acute nephritis; in acute infectious diseases, after taking turpentine, chlorate of potash, cantharides, carbolic acid, alcohol, etc.; after one kidney has been removed.

Kidney.--The kidney is enlarged, dark red, while the covering is very tight (tense). The urine is scanty, and there is increased specific gravity (normal is 1015 to 1020) and contains albumin and a few casts.

Treatment.--The cause should always be removed if possible. Rest in bed, and as a diet use only milk; if the congestion is bad, use dry cupping over the kidneys and inject large quantities of hot normal salt solution in the bowels. Hot fomentations of wormwood or smartweed are of benefit. If you can get the patient into a sweat the congestion will be somewhat relieved by it.

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CHRONIC CONGESTION OF THE KIDNEYS. Causes.--Diseases of other organs and obstruction to the return of the circulation in the veins. Cirrhosis of the liver causes it. The kidney is enlarged dark red, the urine is diminished, with albumin and casts and sometimes blood.

Treatment.--Remove the cause if possible. Fluid diet, like milk, broths, etc. Dry cupping or sweating materials can be used. Rest in bed if possible. The bowels should be kept open, and the kidneys should rest.

BLOOD IN THE URINE. (Haematuria). Causes.--The congestion of the kidneys, pernicious malaria, etc., nephritis, tuberculosis, kidney stones. The urine looks smoky and dark, or bright red.

Treatment.--This depends upon the cause. The patient must rest in bed and the kidneys should not be stimulated. Cold applications to the loins. Hot applications would injure.

URAEMIC TOXAEMIA.--This means poison in the blood occurring in acute and chronic nephritis (inflammation of the kidneys). The cause is unknown. The disease is acute and chronic.

ACUTE URAEMIA. Symptoms.--The onset may be sudden or gradual. The headache is severe, usually on the back top of head (occipital) and extending to the neck; there is persistent vomiting with nausea and diarrhea attending it. This may be due to inflammation of the colon. Difficulty in breathing, which may be constant or comes in spells. This is worse at night, when it may resemble asthma; fever if persistent, is usually slight until just before death. General convulsions may occur. There may be some twitching of the muscles of the face and of other muscles. The convulsions may occur frequently. The patient becomes abnormally sleepy, before the attack, and remains so. One-sided paralysis may occur. Sudden temporary blindness occurs sometimes. There may be noisy delirium or suicidal mania. Coma (deep sleep) may develop either with or without convulsions or delirium, and is usually soon followed by them; sometimes by chronic uraemia or recovery.

CHRONIC URAEMIA.--This develops most often in cases of Arterio-sclerosis or chronic interstitial nephritis, (one kind of Bright's disease). The symptoms are less severe than those of acute uraemia, but similar, and of gradual onset, sometimes with symptoms of the acute attack. There is often constant headache and difficult breathing; the tongue is brown and dry, sometimes there is nausea, vomiting, diarrhea, sleeplessness, cramps of the legs and much itching may be present. It may last for years. Death may occur when the patient is in coma (deep sleep). There may have been mania, muscular twitchings or convulsions before death.

Treatment.--Found under "Chronic Interstitial Nephritis."

[KIDNEY AND BLADDER 157]

ACUTE BRIGHT'S DISEASE. (Acute Inflammation of the Kidneys. Acute Nephritis).--This occurs chiefly in young people and among grown men. Exciting causes are exposure to cold, wet, burns, extensive skin tears (lesions), scarlet fever, diphtheria, typhoid fever, measles and acute tuberculosis, poisons; and pregnancy is one cause when it occurs in women.

Symptoms.--After exposure or scarlet fever the onset may be sudden, sometimes with chills or chilliness, variable fever, pain in the loins, watery swelling of the face and extremities, then of other portions of the body like the abdomen, then general dropsy. Sometimes there is nausea, vomiting, headache, delirium, or very deep sleep. The urine is scanty, dark colored, of increased "specific gravity" and contains albumin, cells and casts. Anemia is marked. After some fever disease, the onset is gradual with anemia, swelling of the eyelids, face and extremities; scanty thickish urine containing casts, then headache, nausea, vomiting, little or no fever, dry skin. In these cases there may be gradual recovery, attack of uraemia, or they may end in chronic nephritis.