Chapter 47

Symptoms.--The main symptom is the discharge from the ear. This may be abundant or scanty. It may stop for a time and begin again. The hearing may be slightly or seriously impaired. Such patients are not accepted by life insurance companies.

Treatment.--Cleanliness of the parts and perfect drainage must be secured. Syringing with one to fifty carbolic acid solution (acid one part, warm water fifty parts) is good treatment. The opening in the drum should be made large enough to give free discharge to the pus in the middle ear.

The patient's strength must be built up if necessary.

INFLAMMATION OF THE MASTOID' CELLS. (Acute or Chronic Mastoiditis).--This disease represents one of the most serious terminations of an acute or a chronic suppurative inflammation of the middle ear. This is fortunately a comparatively rare event. There are, however, quite a good many cases of this terrible disease.

Causes.--It occurs as a primary or secondary disease. The first condition is rare and the result from injury, exposure to cold and dampness, or from syphilis or tuberculosis. Secondary disease is catarrhal or pus-like in form. This results from an extension of middle ear disease through the antrum, as a rule. The disease may develop at any time and endanger the life of the sufferer.

Symptoms.--Dull constant pain behind the ear and tenderness on pressure, more severe at night, the tenderness is very apt to be followed in a short time by redness and swelling of the skin in the same region. The pus may drain from the mastoid into the middle ear cavity. If this does not happen it may swell behind the ear and break through some other place. It may involve the structures within the brain. If meningitis develops, the patient has headache and later it becomes very severe. Lights hurts the eyes, The patient is restless, sleepless, may have nausea and vomiting and a constant high temperature. The neck is stiff and rigid. If there is more brain involvement (phlebitis) there will be sudden rise of temperature, followed by a rapid fall of temperature and attended by profuse sweating and chills,--a dangerous condition. There can be abscess of the brain also. In abscess of the brain symptoms are less severe and localized; the rigid neck and fear of light and vomiting are absent.

[366 MOTHERS' REMEDIES ]

Treatment.--If seen early it may be aborted. If an examination of the drum shows bulging, an incision of the drum head should be made. If an opening is there it should be enlarged, if necessary. Cold applications are valuable and should be applied directly over the mastoid behind the ear. Sometimes hot applications are better, hot poultices, cloths, etc., syringing the canal with hot water. These applications, etc., should be constantly used for a day or, so, unless unfavorable symptoms set in, when if a marked improvement, especially in the local tenderness and pain, has not occurred, an operation should be done and the mastoid opened.

The diet should be liquid (milk), nourishing and sustaining. Bowels should be kept open.

This disease must be carefully watched. It is not only dangerous to life, and very quickly, but it is full of disagreeable and dangerous possibilities, lifelong discharge from the ear, an external fistulous opening, a permanent paralysis of the facial nerve, abscess in the brain. Brain symptoms, paralysis and pus symptoms do not now preclude an operation on the mastoid for mastoid disease. The patient should be closely watched and an operation performed as soon as called for.

I have given a longer description of the diseases of the ear than I intended when I began this part of the work. Diseases of the ear are becoming quite frequent, and the subject is important. I did not give much general medical treatment because I consider the local treatment is of more importance in a work of this kind. In treating the baby, I shall give more medical treatment. I shall treat the disease also, especially in relation to the baby. There can be more local applications used than those given. If the hot treatment is thought best, not only hot water and poultices of many kinds can be used, but fomentations of hops, etc., and hot water cloths alone. The intent of such treatment is to keep hot moist applications to the part continually. The use of laudanum in poultices used for ear trouble is not recommended because its soothing power may obscure symptoms that might appear and be dangerous in themselves and need quick and thorough treatment. The syringing of hot water into the external canal is often of great help. Five to ten grains of boric acid can be used in an ounce of water. If there is much odor to the discharge, you can use one part of carbolic acid to fifty parts of boiled water. The water should not be used too hot. One teaspoonful of the acid to fifty teaspoonfuls of water, or that proportion. After using the hot water, the canal should be filled with gauze for protection and drainage. For the fever, the first twenty-four hours, one-tenth to one drop of aconite can be used every one to three hours. By putting one drop in ten teaspoonfuls of water you get one-tenth of a drop at a dose.

[EYE AND EAR 367]

DEAFNESS.--This is usually the result of a disease and is merely a symptom. Diseases of the middle ear, rupture of the drum membrane, and large ulceration of this membrane cause it. Ear wax causes temporary deafness. Diseases of the throat and nose cause it very often, and deafness frequently accompanies catarrh of the nose. Adenoids cause it sometimes, especially in children.

Treatment.--The only way to prevent this trouble is to treat the disease that causes it. Discharge from the ear, due to ear disease should be treated from the first or it may cause permanent deafness in that ear. Many cases of scarlet fever leave deafness behind in one ear at least. This trouble should be closely watched during an attack of scarlet fever, and in other infectious diseases and proper treatment given.

Chronic deafness is hard to cure; so often some of the deeper parts of the ear are diseased. When a person recognizes that his hearing is growing less acute he should have his ear examined. People often let the trouble go too long before beginning treatment.

MOTHERS' REMEDIES. Deafness. 1. Quick and Effective Remedy for.--"Five or ten drops of onion juice put in the ear several times a day is very good. If there is any pain in the ear, add a drop or two of laudanum, or you may just use two or three drops of glycerin with the other ingredients. In about an hour after treating the ear in this manner, syringe it well with warm castile soap suds or warm milk."

2. Deafness. Often Tried Remedy for.--"Take one dram each of tincture of lobelia, tincture of gum myrrh, oil of sassafras, tincture of opium and olive oil, mix and apply lint wet with the liniment in the ear, night, and morning, then syringe out with warm water and castile soap."

3. Deafness, My Mother, in Galt, Found Mullein Good for.--"Small blossoms of mullein, fill bottles and cork, hang in sun till oil forms, drop three drops every third day in the ear for three or four weeks. We tried this successfully in our family."

EARACHE.--The general belief exists that earache is something which is quite harmless and entirely different from a genuine inflammation of the ear. This belief is strengthened by the fact that the great majority of earaches subside without inflicting any harm upon the ear. As soon as a discharge appears, in many cases, there is relief. If a discharge appears, the earache was the result of an inflammation in the ear. So-called earache lasts but a short time, and can be relieved by either hot or cold applications; but when the earache continues for a day or more it is an indication of more than pain in the ear and if a thorough examination is made there will, no doubt, be found disease of the ear that is causing the earache. Then the disease proper should be treated.

[368 MOTHERS' REMEDIES]

Treatment.--Hot or cold applications are of benefit. With the patient lying upon the well ear, fill the canal with hot water (105 degrees F.). Then place over the ear a flaxseed poultice or a roasted onion poultice, four to five inches square and one-half inch thick and spread over all a folded shawl. Bread and milk makes a good poultice also. A hot bran bag or a hot salt bag is good. The heat must be continuous.

MOTHERS' REMEDIES. 1. Earache, Hot Raisin for.--"Hot raisins sometimes relieve earache. Soak them in hot milk and change frequently." This is an excellent remedy. The raisins should be placed in the ear canal, and they are sure to give relief.

2. Earache, Flax and Cornmeal for.--"Flaxseed and cornmeal in oil." Take equal parts of flaxseed and cornmeal and mix together, then add enough sweet oil to moisten this mixture. This should be applied hot and kept so by repeating as each poultice is cold. This will be found very beneficial.

3. Earache, Soothing Home Remedy for.--"Glycerin and laudanum heated and dropped in the ear. Hot poultice of hops inclosed in cotton bag and applied to the ear is very soothing." The glycerin and laudanum will give temporary relief and the hops poultice retains the heat, which is one of the essential things in earache.

4. Earache, Horse-radish Leaves for.--"Steaming the face and ear with crushed horseradish leaves will give relief and soothes one to sleep." When through steaming the face the horseradish leaves should be applied to the face and ear as a poultice. This is very soothing.

5. Earache, Onion Sure Cure for.--"The heart of an onion." Roast the heart of an onion and put in the canal of the ear. Then apply heat to the outside of the ear and relief will soon be obtained.

6. Earache; Temporary Relief for.--

"Gum Camphor 1/2 dram Olive Oil 1/2 ounce Glycerin 1/2 ounce

Mix and drop in ear."

This is good to relieve, but should not be continued, as this oily substance lodges in the ear and may cause trouble.

7. Earache, Sweet Oil and Pepper for.--"Take a piece of cotton batting, cover with sweet oil, then cover that with black pepper, inserting into ear." This is a good remedy.

8. Earache, Steaming With Hot Water for.--"Steam the ear and side of the head with cloths wrung out of hot water; put feet in hot mustard water; do not put anything in the ear but keep steaming it and you will find relief in a few hours, even if it is a gathering."

[Illustraion: SKELETON.]

[DEFORMITIES 369]

9. Earache, Castor Oil for.--"Put a drop of castor oil in the ear. Fill hot water bag and warm the ear that aches."

10. Earache, Fresh Warm Milk for.--"The warm milk from a cow will cure earache and has also been known to cure deafness." While still warm from the cow drop a little in the ear.

DEFORMITIES.

HARE-LIP.--This is due to the fact that the flesh or bony parts do not quite properly unite. It may form a single or double hare-lip, or complicated, or it may involve the soft parts, or the hard (bony) and soft parts at the same time. It is always to one or the other side of the middle line. It is double hair-lip in about one-tenth of the cases, and when double it is frequently complicated with cleft palate.

Symptoms.--Upon examination you notice that there is a split in the lip, either partly through the lip or entirely, so that the bone is exposed; or the slit goes not only through the lip, but also through the bone.

Operation.--This is necessary, and it is quite successful. The best time is between the third and sixth month, especially when it is a simple case. In some cases of double hair-lip, when the child cannot take the breast and has to be fed, early operation should be done if the child is strong. The operation for a simple hare-lip is very easily and quickly done. For complicated cases it takes longer, and of course is not without some danger. It should be done, for a child is a pitiable sight with this deformity. When grown up it is a source of great annoyance and shame.

CLEFT PALATE.--The bones that form the hard palate do not unite in the median line and a longitudinal opening is left in the roof of the mouth. This is called Cleft Palate.

Symptoms.--Of course, upon examination this split is seen. It may involve not only the hard palate, but also the soft palate and uvula. It is then generally accompanied by single or double hare-lip. When the severe forms occur they cause great trouble. Fluids pass freely into the nose, and unless the child is carefully fed by hand it will soon die, as it is unable to suck. In the less severe forms the child soon learns to swallow properly, but when he learns to speak he cannot articulate properly and his voice is nasal.

Treatment.--For this reason an early operation is advisable, not so early as for hare-lip, but before the child has learned to speak, say between the age of three and four when faulty speech (articulation) may be overcome by successful closure of the palate. When the operation is done late, the patient will not be able to overcome the bad habits of articulation acquired in his childhood.

[370 MOTHERS' REMEDIES]

Operation.--The anaesthetic is necessary. The end of one-half of the cleft palate is seized with an instrument and the edge freely pared with a thin bladed sharp knife; same with the other half. Then the stitches are put in of silk worm, gut or wire. The patient is fed on liquid food for three or four days, and afterwards on soft food until the stitches are removed. They are removed about the sixth or eighth day, and the wound should be completely healed.

CROOKED FEET. Talipes.--There are many varieties. The treatment should be begun, under the instructions of a physician, and continued from infancy and many a good foot can be obtained.

KNOCK KNEE. (Genu Valgum).--This is due to an overgrowth of the internal knuckle (condyle) on the knee joint, and curving inward of the shaft of the thigh-bone (femur) in its lower parts, with relaxation and lengthening of the ligaments of the knee joint.

It usually shows itself soon after the child begins to walk, but may not do so until puberty,--rarely later. It is due in the child to rickets; in the latter form, it is caused by an occupation that requires continued standing, by a person of feeble development of the muscles and ligaments. "Flat-foot" is often associated with it and, at times, may be the real cause. It may affect one or both knees, may be so slight as to escape detection, except upon a very careful examination, or so severe as to separate the feet very widely and render walking difficult and wobbling. In children other symptoms of rickets can generally be found. If not severe it may often get better spontaneously as the rickets condition improves and the general strength increases. This result is common in the cases occurring later, from standing if the general condition improves.

Treatment.--Should be begun early and both general and local treatment should be given. The quicker the treatment is begun, the quicker will be the recovery and the deformity will be less. The ordinary medical and hygienic treatment should be given for rickets.

Local Treatment.--This is mechanical, supplemented by baths, rubbing, friction, electricity and preceded, if necessary, by attending to the bones. If the rickets is still active, and the bones are soft and yielding, standing and walking should be forbidden, the limb should be straightened by manipulation and the correct position secured and maintained by an outside splint and bandage. Sometimes operative measures are needed.

BOW LEGS. (Genu Varum).--This is the opposite of knock knees, and the deformity usually affects both limbs, the knees being widely separated. The disease begins in early childhood; the cause is rickets, and the deformity is the direct result of the weight of the body and muscular action.

[DEFORMITIES 371]

Treatment.--Spontaneous recovery occurs; but if the case is at all severe, and the child is young enough that the bones have not become firmly set in the abnormal curves, mechanical treatment should be employed to bring the limbs to a better position. This may be done by plaster of paris or braces. This must be used intelligently and continuously. Children should not be allowed to walk so early, especially those of slow development.

CLUB FOOT (Talipes).--Varieties:

1. The heel may be drawn up and the foot extended (Talipes Equinus).

2. The foot may be flexed, bent up, (Talipes Calcaneus).

3. The foot may be drawn inward, adducted, (Talipes Varus).

4. The foot may be drawn outward, abducted, (Talipes Valgus); or, two may be combined, extended, and drawn inward (Equino Varus).

In the congenital (born with it) variety the displacement is almost always one of adduction, that is, drawn inward, with commonly some elevation of the heel. It generally affects both feet, but it may be confined to one and if only one is affected, the right is oftener affected than the left. The deformity varies. At the time of birth and for some months afterwards the deformity can usually be corrected by proper manipulation, but later, if left to itself, it becomes in greater or less measure fixed, because of the muscular contraction, and developed changes in the shape of the bones.

Cause--It is not known.

Treatment is successful if it is begun early. Each case should be treated as it needs. The treatment should be varied to suit each case. Bandaging or adhesive straps properly applied has been used with success. Sometimes the leg must be kept motionless by plaster of Paris or gutta-percha bandages. They must be frequently removed and reapplied. In older cases the tendons must be cut and braces applied. Parents are careless who neglect such a case for even one month.

INTOXICANTS AND SUN STROKES

ALCOHOLISM. Acute Symptoms.--The face is flushed, the breath has the odor of liquor, the pulse is full and bounding with deep respiration. Reason, memory, judgment and will are first stimulated and then blunted. The drinker's peculiarities are exaggerated, the person becoming affectionate or quarrelsome. There is a loss of coordination as shown by the staggering, swinging, the relaxation of the muscles, and finally deep sleep, with snoring breathing. The person is unconscious, but can be partly aroused and will mutter when questioned or disturbed. The pupils are contracted or dilated, and they will dilate when the face is slapped. The urine is increased, but it is often retained.

[372 MOTHERS' REMEDIES]

CHRONIC ALCOHOLISM.--This results from protracted or periodic "sprees."

Symptoms.--The face is red, the capillaries are dilated, eyes are watery, conjunctiva is congested. There is chronic inflammation of the stomach, which is characterized by morning vomiting; there is often hardening of the liver, trembling of the hands and tongue; the memory is weakened and judgment and will as well, especially until a stimulant has been taken; often the person is irritable, careless, with loss of moral sense and in extreme cases dementia. Peripheral neuritis is more common in men than in women. It begins with sharp pain and tingling in the feet and hands; paralysis affects the lower extremities, then the upper, and is most marked in the further muscles of the limbs. The pain may be very severe, with great tenderness. There is Arteriosclerosis (hardening of walls of the arteries); often heart dilation.

DELIRIUM TREMENS.--This is a brain manifestation of chronic alcoholism occurring in steady drinkers after excessive drinking or sudden withdrawal of alcohol, or after sudden excitement or accident, pneumonia or other illness, or lack of food.

Symptoms.--There are restlessness, insomnia (sleeplessness), mental depression, then active delirium with great restlessness, talking, muttering, hallucination of sight and hearing. He thinks he sees objects in the room such as rats, mice, or snakes, and fancies that they are crawling over his body, has them in his boots, etc. The terror inspired by these imaginary objects is great, and has given the popular name of "horrors" or "snakes" to the disease. You must watch the patient constantly, or he may try to jump out of the window or escape. The patient may think he hears sounds and voices, threats of imaginary enemies. There is much muscular "shakings," the tongue is coated with a thick white fur and, when protruded, trembles. The pulse is rapid and soft, sleeplessness is a constant feature. Favorable cases improve in the third or fourth day, the restlessness abates, the patient sleeps and the improvement sets in. The shakings persist for some days, the hallucinations disappear gradually, and the appetite returns. In the more serious cases, the sleeplessness (insomnia) persists, the delirium is incessant, the pulse becomes more frequent and feeble, the tongue dry, the prostration is extreme and death takes place from gradual heart failure.

Treatment.--In acute alcoholic cases special measures are seldom required, as the patient sleeps off the effect of his "spree." If there is deep profound alcoholic coma, it may be proper to wash out the stomach and if symptoms of collapse occur, the limbs should be rubbed, and hot applications made to the body.

[INTOXICANTS AND SUN STROKES 373]

Chronic Alcoholism.--This is different; withdraw the alcohol and substitute strychnine, one-thirtieth of a grain three or four times a day, nourishing food, confinement in a sanitarium if necessary. Give the bromides for the restlessness and sleeplessness. Drugging of the liquor with apo morphine or tartar emetic.

MOTHER'S REMEDY. Drunkenness. 1. Effective as Cure for.--

"Arsenious Acid 19 grains Bromine Water sufficient Tribromide of Gold 14 grains Distilled Water sufficient

Ten drops of this solution for injection, which equals one thirty-second grain of gold tribromide." This is an active tonic, powerful sedative and destroys the appetite or cravings for alcoholic stimulants; the medicine is to be taken regularly four or five times a day for several weeks until the alcohol is out of the system even though he may appear cured. This is a good remedy, but should be given under the supervision of a doctor.

Treatment.--The patient must be put into a bed and carefully watched; withdraw alcohol at once unless the pulse is too feeble. Procure rest and sleep for the patient. How? In mild cases, thirty grains (one-half dram) of bromide of potassium, combined with tincture of capsicum five to ten drops, may be given every three hours. Call a doctor for the rest. One hundredth grain hyoscine hypodermically is sometimes good; one-fourth grain morphine hypodermically is sometimes given. For heart weakness: Aromatic spirits of ammonia.

MORPHINE HABIT. (Morphinomania--Morphinism).--This is usually acquired by the repeated use of the hypodermic syringe for pain. It is also used by the mouth or opium smoking.

Symptoms.--At first it causes a sense of well-being and exhilaration, but it must be gradually increased to produce the result; when the effect wears off, the person feels weary, mentally and physically; has nausea, slight distress in the stomach region or pain like intestinal colic. Another dose relieves these feelings, eventually the person becomes thin, his face is sallow, the pupils are dilated or unequal, except when he is under the influence of the drug. His appetite is poor with indigestion. Sometimes itching of the skin, restlessness; irritable, disturbed sleep, and a tendency to lie about everything.

Treatment.--The patient must be taken from home and friends and be constantly watched. The drug should be withdrawn gradually and nourishing food given at stated intervals.

COCAINE HABIT.--The drug is taken as a snuff, hypodermically, or in sprays and often the habit is formed when given as sprays, etc., in disease.