Chapter 31

ANTHRAX. (Charbon, Wool Sorters' Disease, Splenic Fever).--This is "an acute infectious disease of animals, transmitted to man by inoculation into the wounds, or by inhalation of, or swallowing the germs." Butchers, tanners and shepherds are most liable to it. The exciting cause is the bacillus anthracis (anthrax bacillus). The local skin condition is a pustule containing the bacilli, which may also invade the general circulation. If the germs are inhaled, there is broncho-pneumonia; if swallowed, areas of inflammation and local death occur in the intestines. The spleen and lymph nodes are enlarged.

[INFECTIOUS DISEASES 231]

Symptoms. 1. External anthrax, malignant pustule. This begins in a papule (pimple) at the point of inoculation turning into a vesicle and then a pustule, (blister-like pimple) surrounded by an inflammatory area (space) with marked watery swelling. The nearby glands are enlarged and tender. At first the temperature rapidly rises; later it may be below normal. The fever symptoms may be severe. Recovery takes place slowly. Death occurs in three to five days.

MALIGNANT ANTHRAX (swelling).--In this lesion is a pustule, with very marked swelling. It most frequently occurs on the eyelid and face and the swelling may terminate in fatal gangrene.

2. Internal anthrax.--(a) Internal anthrax is caused by the introduction of the bacteria into the alimentary canal in infected meat, milk, etc. The invasion is marked by a chill, followed by moderate fever, vomiting, diarrhea, pain in the back and legs and restlessness. Sometimes convulsions occur and hemorrhages into the skin from the mucous membranes. The spleen is swollen. Prostration is extreme and it often ends in death.

(b) Charbon or Wool Sorter's disease occurs among those employed in picking over wool or hair of infected animals--the germs being inhaled or swallowed. The onset is sudden with a chill, then fever, pain in the back and legs, and severe prostration. There may be difficulty of breathing and signs of bronchitis, or vomiting and diarrhea. Death is a common termination, sometimes within a day. Death rate is from five to twenty-six per cent. Greatest when the swelling is near the head.

Treatment.--The wound or swelling should be cauterized and a solution of carbolic acid or bichloride of mercury injected around it and applied to its surface. Stimulants and feeding are important.

LOCKJAW. (Tetanus).--Tetanus or lockjaw, as it is commonly called, is an infectious disease and is characterized by painful and violent contractions of the voluntary muscles; it may be of the jaw alone or of a considerable part of the body.

Causes.--The intelligence and mental faculties are not impaired. In most cases it follows a wound or injury, although in others there seems to be no exciting causes. Fourth of July celebrations furnish a great many of our lockjaw cases. Ten to fifteen days usually elapse after the wound before lockjaw really sets in.

[232 MOTHERS' REMEDIES]

Symptoms.--It comes on occasionally with a chill or chilly feelings; usually by rigidity (stiffness) of the neck, jaw and face. On arising in the morning there is sometimes a stiffness of the muscles at the back of the head. It is not unusual on taking a slight cold to have a stiff neck and often the patient's attention is not attracted by this symptom. Sometimes this stiffness begins or soon extends to the muscles of the lower jaw; the throat becomes dry and is painful and gradually the stiffness increases to a continuous contraction, spasm, and extends to the muscles of the trunk and extremities. The body becomes rigid in a straight line or bent backward, forward or sidewise. This spasm occurs after any slight irritation and is extremely painful. Temperature is usually low. During the first spasms the patient may attempt to open his mouth as he may naturally be suspicious of the trouble that is coming; he succeeds with difficulty and even finds it hard to swallow; soon the jaws may be firmly closed, and it is from this feature of the disease that it gained the name of lockjaw. The contractions in some cases do not extend beyond the neck and face muscles. During the contractions the face may be drawn into frightful contortions. Food can be given only through such spaces as may exist between the teeth, as often the patient cannot open his mouth himself, nor can it be pried open by any force that would be allowable. When the muscles of the trunk are affected the abdomen may be drawn inward, become very hard and stiff, chest movements are affected, making it difficult to breathe, sometimes almost to suffocation. Sometimes the body becomes bent like a bow, as in some cases of spinal meningitis, so that only the head and heels support the weight of the body. The body may become so rigid that it can be lifted by a single limb as you would a statue. It is fortunate that there are few cases, comparatively, of lockjaw as the distorted face and general contractions of the body are painful to witness.

Recovery.--The mortality in lockjaw cases runs about eight per cent. Sometimes death is caused by exhaustion from the muscular exertions; the patient is seldom able to sleep and sometimes wears out in a few days. Sometimes suffocation brings a sudden end to his sufferings and usually one or two days to ten or twelve days is the limit. Among the lower classes where sanitary science is seldom observed, and even among the better classes, lockjaw has been known to occur in infants. It usually comes on, in ten to fifteen days after birth, and the child seldom lives more than a few days, It is hard to account for such cases which may come on suddenly from the slightest excitement such as sudden noises, etc.

MOTHERS' REMEDIES.--l. Lockjaw, Successful Remedy for.--"A very good and successful remedy for this disease, is to apply a warm poultice of flaxseed meal, saturated with laudanum and sugar of lead water, to the jaws and neck."

2. Lockjaw, Smoke as a Cure for.--"Smoke the wound for twenty minutes in the smoke of burnt woolen cloths. This is considered a never failing remedy."

[INFECTIOUS DISEASES 233]

PHYSICIANS' TREATMENT.--If from a wound cut open and use antiseptics. Isolate the patient and have absolute quiet. Antitoxin is used with success in some cases of lockjaw, but this and other remedies or measures must be handled by a physician, Opium is sometimes given and stimulants such as brandy, whisky, etc. As it is a case of life or death in a very short time, we cannot advise depending upon home treatment. A preventive caution that must always be observed is the use of antiseptics and the strictest care of all injuries and wounds that might result in lockjaw. This is a disease where an ounce of prevention is worth a thousand pounds of cure, because by the time the disease is recognized as lockjaw and has really made an appearance, it may be too late for medical skill. While you are waiting for the doctor you may apply cold cloths or even an ice bag to the spine. If the spasms are severe let the patient inhale chloroform to kill the pain and quiet him. In the meantime secure the best physician within your reach, and follow his directions carefully, be calm and self- possessed when in the presence of the patient, for you must remember that he has full possession of his mental faculties and will notice every evidence of fear or worry in the faces of those who are nursing him. This will only add to his sufferings, affect his nervous system and undermine his general vitality. Read carefully the nursing department in this book and you will gain some valuable hints and knowledge regarding the sick room.

GLANDERS.--This is an acute disease of the horse and occasionally of man. It is called "glanders" when the affection appears in the nostrils, and is called "farcy" when in the skin.

Causes.--The bacilli is usually introduced from infected horses through the nose, mouth and cheek, mucous membranes or skin abrasions (rubbing off of the skin). There are large or small lumps in the skin, mucous membrane of the nose and mouth.

Symptoms. Acute Glanders.--1. Incubation lasts from three to four days. There are signs of inflammation at the site of infection and general symptoms. In two or three days, small lumps appear on the mucous membrane of the nose, and ulcerate, with a discharge of mucus and pus. Sometimes these nodules die locally, and their discharge is then foul. The glands around the neck are enlarged. An eruption appears over the face and joints. Inflammation of the lungs may occur. Death may take place in eight to ten days.

2. Chronic Glanders.--This may last for months. It acts like chronic cold with ulcer in the nose. Some recover.

3. Acute Farcy.--The local and general signs are those of an infection, with necrosis (local death) at the site (in the skin) of inoculation; nodules, (lumps) known as "farcy buds" form along the lymphatics (glands) and form pus. There may be pus collections in the joints and muscles. Death often occurs in one to five days.

Chronic Farcy.--Tumors in the skin of the extremities, containing pus. The process is local, the inflammatory symptoms light, and the duration may be months or years.

[234 MOTHERS' REMEDIES]

Treatment of Glanders.--This disease does not often occur in man; it is an awful affliction. All infected horses must be killed, it is dangerous for man to be around one. If seen early, the wound should be cut out or burned out with caustics, and afterwards dressed like any wound. The "farcy buds" should be opened early. There is very little hope in acute cases of glanders. In chronic cases recovery is possible, but it will be after a long tedious time. There must be proper nourishing food and tonic medicines. Each case should be treated according to the indications. It is safe to say the parts should be thoroughly cut or scraped out and then treated with antiseptics and the general system built up, by tonics and stimulating remedies, if needed. As stated before, acute glanders and acute farcy are almost always fatal.

BIG-JAW OR LUMP-JAW. (Actinomycosis).--This is an infectious disease of cattle, less frequently of man, and it is caused by what is called the "ray fungus." This grows in the tissues and develops a mass with a secondary chronic inflammation.

This disease is widespread among cattle, and also occurs in the pig. In the ox it is called the "big jaw." The infection may be taken in with the food, and it locates itself often in the mouth or surroundings. Oats, barley, and rye may carry the germ to the animals. The fungus may be found even in decayed teeth.

Alimentary Canal Type.--The jaw has been affected in man. One side of the face is swollen or there may be a chronic enlargement of the jaw, which may look like a sarcoma (tumor). The tongue also is sometimes affected and shows small growths. It may also occur in the intestines and liver. There is at first a tumor (lump), and this finally suppurates.

In the Lungs.--They also can be affected. It is chronic here and there is cough, fever, wasting and an expectoration of mucus and pus, sometimes of a very bad odor (fetid). It sometimes acts like miliary tuberculosis of the lungs, and this is quite frequent in oxen. Other diseases of the lungs and bronchial affections occur and abscesses and cavities are formed that may be diagnosed during life.

Symptoms.--If in the jaw there may be toothache, difficulty of swallowing and of opening the jaw. The adjacent muscles may be hardened (indurated). A swelling appears at the angle of the jaw and this quickly passes into suppuration; later it opens first outside, then inside--into the mouth and discharges pus containing little yellow masses. It will extend down even into the bowels unless it is properly treated. Then there will be stomach disturbances and diarrhea. It may ulcerate through the bowels and cause peritonitis. The liver, spleen and ovaries may also become affected.

The Skin.--There may be chronic suppurating ulcers of the skin and the "ray fungus" can be found in them.

Diagnosis.--The "ray fungus" can be found. There is a wooden hardness of the tissues beyond the borders of the ulcers; there are the little yellow granules in the pus. The course is chronic. Mild cases recover in six to nine months or earlier, the mouth form being the most favorable.

[INFECTIOUS DISEASES 235]

Treatment.--Surgical. Remove the parts involved. Internally, iodide of potash in large doses is recommended. The food should be plenty and nourishing. In this case we must recommend you to a physician instead of the home treatments.

GONORRHEA (Urethritis).--This can be called an infectious inflammation of the urethra, caused by the gonococcus, a microbe or germ, causing a specific inflammation of the mucous membrane of the urethra or vagina.

Incubation.--The time that elapses between the exposure and development of the symptoms in the urethra is variable, extending from a few hours to twelve or fourteen days. In the great majority of cases, however, the disease appears during the first week. The patient notices a drop of milk-like fluid at the opening of the urethra, which is slight, red and puffed or turned out; a tickling sensation is often felt in this locality, and the next time urine is passed it is attended with a feeling of warmth at the end of the canal, or with actual scalding. After this the symptoms increase rapidly in number and severity, so that within forty-eight hours, or even sooner, the disease may be described as having passed its first or increasing stage, the characteristic phenomena of which are as follows:

Changes in the meatus (opening). There are redness, eversion (turning out), ulceration and eating away and often erosion of the lips of the opening of urethra. Sometimes, but rarely, so much swelling that the person can hardly pass the urine, which drops away. The other symptoms are too well-known by those who have had this disease to need a description.

Prognosis.--It is now considered more than a cold, and it is the cause of terrible sickness in both sexes, among the innocent as well as the guilty.

Treatment.--It may be cured perhaps in a short time, and yet no one can be certain of its absolute cure. This disease is better understood now, and the treatment is entirely different from formerly. The strong injections are now considered not only useless but dangerous to the future health of the patient. The best treatment is mild antiseptic injections, irrigation carefully done by an expert person; remaining quietly in bed, being careful to use food and drink that are not stimulating, keeping the bowels open by proper diet and mild laxatives and the urine mild by soothing diuretic remedies. Unfortunately those affected want quick work and they get it, frequently to their future sorrow. The following are good injections. Before each injection the urine should be passed and an injection of an antiseptic like listerine, etc., one dram to an ounce of boiled water, to cleanse the canal. You can use twice a day the following:

Fluid Extract Hydrastis (colored) 1 dram Water 1 ounce

Use one dram of this for each injection. It stains the clothes so you must be careful. This is good and healing.

[236 MOTHERS' REMEDIES]

GONORRHEAL ARTHITIS. (Gonorrheal Rheumatism, Inflammation of the Joints).--This is more common in men than women. Occurring during, and at the end of or after inflammation of the urethra. It usually involves many joints, such as the temporal, maxillary and collar bone. The effusion in the joints is usually serious.

Symptoms.--Variable joint pains may be the only one. The attack may resemble an acute articular rheumatism of one joint, or a subacute rheumatism of one or more.

Sometimes there is a chronic one-jointed inflammation usually of the knee. The tendon sheaths and bursae may be involved alone, or with the joints. Gonorrheal septicemia may result from arthritis. This is protracted. Iritis is a most frequent complication. The urethra source of the infection must be cured.

Treatment.--Keep the joint quiet and you can use an ice cap for the pain. Tonic treatment with quinine, iron, and arsenic in chronic cases is needed. The joints should be kept at rest in acute cases. In chronic cases massage and slight motion. The tonics must be chosen for each individual case. One afflicted with this must be under treatment for a long time.

HIP JOINT DISEASE. (Morbus Coxarius).--This is more common in children than in adults.

Cause.--It is usually tubercular.

Symptoms. First stage.--It may be overlooked; slight lameness, a little stiffness is noticed at times. The muscles begin to dwindle.

Second stage.--Child limps very perceptibly, dwindling is more apparent. Pain appears.

Treatment.--Absolute rest. Lying down treatment if begun early arrests this disease often. Build up the system. Splints and brace are needed sometimes.

KNEE JOINT DISEASE. (White Swelling).--This is simply a tuberculous knee.

Treatment.--Rest. Stop motion of the joint by some form of splint or plaster of Paris cast. Get a good physician at the beginning in these cases and you will save lots of after worry and blame for yourself. It does not pay to wait. These joint diseases will progress, and often treatment is begun months after trouble is seated. It ought to be criminal negligence and dealt with accordingly to neglect such diseases. Parents should never forget that they have endowed their children with such a constitution, and they should be glad and willing to correct it as far as they can.

[INFECTIOUS DISEASES 237]

LEPROSY. Definition.--Leprosy is a chronic infectious disease, caused by what is called the "Bacillus Leprae," and is characterized by the presence of tubercular nodules in the skin and mucous membranes (tubercular leprosy), or by changes in the nerves (anaesthetic leprosy). These forms are separate at first, but ultimately they are combined and there are disturbances of sensation in the characteristic tubercular form.

History.--Leprosy is supposed to have originated in the Orient, and to be as old as the records of history. It appears to have prevailed in Egypt even so far back as three or four thousand years before Christ. The Hebrew writers make many references to it, and it is no doubt described in Leviticus. The affection was also known both in India and China many centuries before the Christian era. The old Greek and Roman physicians were familiar with its manifestations, ancient Peruvian pottery represent on their pieces deformities suggestive of this disease. The disease prevailed extensively in Europe throughout the middle ages and the number of leper asylums has been estimated at, at least, 20,000. Its prevalence is now restricted in the lands where it still occurs while once it was prominent in the list of scourges of the old world.

It is now found in Norway and to a less extent in Sweden, in Bulgaria, Greece, Russia, Austro-Hungary and Italy, with much reduced percentage in middle Europe; it is the rarest of diseases in England where once it existed. In India, Java, and China, in Egypt, Algiers, and Southern Africa, in Australia and in both North and South America, including particularly Central America, Cuba, and the Antilles, it exists to a less extent. It has been recognized in the United States chiefly in New Orleans, San Francisco, (predominantly among the Chinese population of that city). The disease has steadily decreased among the latter colonists in Minnesota, Wisconsin and Iowa. Isolated cases have been recognized in almost every state, and leprous cases are presented at the public charities of New York, Philadelphia, Boston, etc. The estimated number of lepers a few years ago in the United States varied between two hundred and five hundred. It is represented as diminishing in frequency in the Hawaiian Islands, Porto Rico and the Philippines. In the Hawaiian Islands it spread rapidly after 1860, and strenuous attempts have been made to stamp it out by segregating all lepers on the island of Molokai. There were 1,152 lepers in that settlement in 1894. In British India, according to the leprosy commission, there were 100,000 lepers in 1900.

Cause.--The bacillus, discovered by Hansen, of Bergen, in 1874, is universally recognized as the cause of leprosy. It has many points of resemblance to the tubercle bacillus. These bacilli have been found in the dwellings and clothing of lepers as well as in the dust of apartments occupied by the victims.

[238 MOTHERS' REMEDIES]

The usual vehicle by which the disease is transmitted is the secretions of a leprous patient containing bacilli or spores. The question of inheritance of leprosy is regarded now as standing in the same position as that relating to the inheritance of tuberculosis; no foetus, no new-born living child, has been known to exhibit the symptoms of either disease. Several cases have been cited where infants but a few weeks old exhibited symptoms of leprosy. It affects men more than women. Infection is more common after the second decade, though children are occasionally among its victims. When it occurs in countries where it had not previously existed, its appearance is invariably due to the infection of sound individuals by lepers first exhibiting symptoms where the disease is prevalent.

Neisser states this: "The number of lepers in any country bears an inverse ratio to the laws executed for the care and isolation of infected persons. The disease appears to spread more rapidly in damp and cold, or warm and moist, climates than in temperate countries. It is not now regarded as contagious. The leprosy of the book of Leviticus not only includes lepra, as that term is understood today, but also psoriasis, scabies and other skin affections," The leper, in the eye of the Mosaic law, was ceremoniously unclean, and capable of communicating a ceremonial uncleanness. Several of the narratives contained in the Bible bear witness to the fact that the Oriental leper was seen occasionally doing service in the courts of kings, and even in personal communication and contact with officers of high rank.

Symptoms.--Previous symptoms: Want of appetite, headache, chills, alternating with mild or severe feverish attacks, depression, nosebleed, stomach and bowel disturbances, sleeplessness. The durations of these symptoms is variable. Some patients will remember that these symptoms preceded for years the earliest outbreak of lepra (leprosy). In other cases only a few weeks elapsed. These earlier skin lesions are tubercular, macular (patches), or bullous elevations of the horny layer of the skin. It may then be divided into three varieties tuberculous, macular and anaesthetic.

LEPRA TUBEROSA. (Tuberculated, Nodulated or Tegumentary (skin) Leprosy).-- This nodular type comprises from ten to fifty per cent of cases. After the occurring of the symptoms just mentioned spotted lesions appear, which are bean to tomato in size, reddish brown or bronze-hued patches, roundish, oval or irregular in contour, well defined, and they occur upon the face, trunk and extremities. The skin covering them is either smooth and shining, as if oiled, or is infiltrated, nodulated and elevated. The surface of the reddened spots is often oversensitive.

[INFECTIOUS DISEASES 239]