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Full text of "The people's common sense medical adviser in plain English, or, Medicine simplified"

f^S3^i\JLuM^^ 



THE PEOPLES 

COMMON SENSE 

MEDICAL ADVISEE 

IlSr PLAIN EISraLISH; 

OR, 

MEDICINE SIMPLIFIED. 

BY 

Tl. "V- FIER.OE, 3S^. ID., 

ONE OF THE STAFF OF CONSULTING PHYSICIANS AND STJK6BONS, 

AT THE invalids' HOTEL AND SURGICAL INSTITUTE, AND 

PRESIDENT OF THE WORLd's DISPENSARY 

MEDICAL ASSOCIATION. 



TWENTY- FOURTH EDITION. 

525tli XHOVSAND. 

Carefully Revised by the Author-, assisted by his full Staff of Asso- 
ciate Specialists in Medicine and Surgery, the Faculty of 
the Invalids'' Hotel and Surgical Institute. 



BUFFALO, N. Y. : 

PUBIilSHED AT THE WORLD'S DISPENSARY PRINTING OFFICE AND BINDERY. 

1890. 



Entered according to Act of Conjrress, in the year 1889, by the 

World's Dispensary Medical Association, 
In the oflBce of the Librarian of Congress, at Washington. D. C. 



TO 

MY PATIENTS, 

WHO HAVE SOLICITED MY PROFESSIONAL SERVICES, 

FROM THEIR HOMES 

IN EVERY STATE, CITY, TOWN, AND ALMOST EVERY HAMLET, 

WITHIN THE AMERICAN UNION ; 

ALSO TO THOSE DWELLING IN EUROPE, MEXICO, SOUTH AMERICA. 

THE EAST AND WEST INDIES, AND OTHER 

FOREIGN LANDS, 

I RESPECTFULLY DEDICATE 

THIS WORK. 



PREFACE TO THE PRESENT EDITION. 



The popular favor with which former editions of this work 
have been received has required the production of such a vast 
number of copies, that the original electrotype plates from 
which it has heretofore been printed, have been completely 
worn out. 

The book has been re-produced in London, England, where 
four editions have already been necessary to supply the demand 
for it. 

In order to continue its publication to meet the demand which 
is still active in this country, it has been necessary, inasmuch as 
the original electrotype plates have become worn and useless, to 
re-set the work throughout. This has afforded the Author an 
opportunity to carefully revise the book and re-write many 
portions, that it may embody the latest discoveries and im- 
provements in medicine and surgery. In performing this labor 
he has been greatly assisted by contributions and valuable aid 
kindly supplied by his staff of associate specialists in medicine 
and surgery who constitute the Faculty of the Invalids' Hotel 
and Surgical Institute. 

That part of the book treating of Diseases and Their Reme- 
dies will be found to be thoroughly reliable ; the prescriptions 
recommended therein having all received the sanction and 
endorsement of medical gentlemen of rare professional attain- 
ments and mature experience. 

THE AUTHOR. 

Buffalo, N. Y., January, 1886. 

5 



PREFACE TO THE FIRST EDITION. 



Every family needs a Common Sense Medical Advisee. The 
frequent inquiries from his numerous patients throughout the 
land, suggested to the Author the importance and popular de- 
mand for a reliable work of this kind. Consequently, he has 
been induced to prepare and publish an extensive dissertation 
on Physiology, Hygiene, Temperaments, Diseases and Domestic 
Remedies. It is for the interest and welfare of every person, 
not only to understand the means for the preservation of health, 
but also to know what remedies should be employed for the 
alleviation of the common ailments of life. 

The frequency of accidents of all kinds, injuries sustained by 
machinery, contusions, drowning, poisoning, fainting, etc., and 
also of sudden attacks of painful diseases, such as headache, 
affections of the heart and nerves, inflammation of the eye, ear 
and other organs, renders it necessary that non-professionals 
should possess sufficient knowledge to enable them to employ 
the proper means for speedy relief. To impart this important 
information is the aim of the author. 

Moreover, this volume treats of Human Temperaments, not 
only of their influence upon mental characteristics and bodily 
susceptibilities, but also of their vital and non-vital combinations, 
which transmit to the offspring either health, hardihood, and 
longevity, or feebleness, disease, and death. It clearly points out 
those temperaments which are compatible with each other and 
harmoniously blend, and also those which, when united in mar- 
riage, result in barrenness, or produce in the offspring imbecility, 
deformity, and idiocy. These matters are freely discussed from 
original investigations and clinical observations, thus rendering 
the work a true and scientific guide to marriage. 



PREFACE. 



While instruction is imparted for the care of the body, those 
diseases (alas how prevalent !) are investigated which are sure 
to follow as a consequence of certain abuses, usually committed 
through ignorance. That these ills do exist is evident from the 
fact that the Author is consulted by multitudes of unfortunate 
young men and women, who are desirous of procuring relief 
from the weaknesses and derangements incurred by having 
unwittingly violated physiological laws. 

Although some of these subjects may seem out of place in a 
work designed for every member of the family, yet they are 
presented in a style which cannot offend the most fastidious, and 
with a studied avoidance of all language that can possibly dis- 
please the chaste, or disturb the delicate susceptibilities of 
persons of either sex. 

This book should not be excluded from tbe young, for it is 
eminently adapted to their wants, and imparts information 
without which millions will suffer untold misery. It is a false 
modesty which debars the youth of our land from obtaining 
such information. 

As its title indicates, the Aiithor aims to make this book a 

useful and practical Medical Adviser. He proposes to express 

himself in plain and simple language, and, so far as possible, to 

avoid the employment of technical words, so that all his readers 

may readily compi-ehend the work, and profit by its perusal. 

Written as it is amid the many cares attendant upon a practice 

embracing the treatment of thousands of cases annually, and 

therefore containing the fruits of a rich and varied experience, 

some excuse exists for any literary imperfections which the 

critical reader may observe. 

THE AUTHOR. 

Bttwpa-LO, N. Y., July, 1875. 



INTRODUCTORY WORDS. 



Health and disease are physical conditions upon which pleasure 
and pain, success and failure, depend. Every individual gain 
increases public gain. Upon the health of its people is based 
the prosperity of a nation ; by it every value is increased, every 
joy enhanced. Life is incomplete without the enjoyment of 
healthy organs and faculties, for these give rise to the delightful 
sensations of existence. Health is essential to the accomplish- 
ment of every purpose ; while sickness thwarts the best inten- 
tions and loftiest aims. We are continually deciding upon those 
conditions which are either the source of joy and happiness or 
which occasion pain and disease. Prudence requires that we 
should meet the foes and obviate the dangers which threaten 
us, by turning all our philosophy, science, and art, into practical 
common sense. 

The profession of medicine is no sinecure; its labors are 
constant, its toils unremitting, its cares unceasing. The physi- 
cian is expected to meet the grim monster, " break the jaws of 
death, and pluck the spoil out of his teeth." His ear is ever 
attentive to entreaty, and within his faithful breast are concealed 
the disclosures of the suffering. Success may elate him, as con- 
quest flushes the victor. Honors are lavished upon the brave 
soldiers who, in the struggle with the foe, have covered them- 
selves with glory, and returned victorious from the field of 
battle ; but how much more brilliant is the achievement of those 
who overwhelm disease, that common enemy of mankind, whose 
victims are numbered by millions ! Is it meritorious in the 
physicians to modestly veil his discoveries, regardless of their 
importance ? If he have light, why hide it from the world ? 
Truth should be made as universal and health-giving as sunlight. 
We say, give light to all who are in darkness, and a remedy to 
the afflicted everywhere. 

We, as a people, are becoming idle, living in luxury and ease, 
and in the gratification of artificial wants. Some indulge in the 

9 



X INTBODUCTOKY WORDS. 

use of food rendered unwholesome by bad cookery, and think 
more of gratifying a morbid appetite than of supplying the body 
with proper nourishment. Others devote unnecessary attention 
to the display of dress and a genteel figure, yielding themselves 
completely to the sway of fashion. Such intemperance in diet 
and dress manifests itself in the general appearance of the un- 
fortunate transgressor, and exposes his folly to the world, with 
little less precision than certain vices signify their presence by a 
tobacco-tainted breath, beer-bloated body, rum-emblazoned nose, 
and kindred manifestations. They coddle themselves instead of 
practicing self-denial, and appear to think that the chief end of 
life is gratification, rather than useful endeavor. 

I purpose to expi-ess myself candidly and earnestly on all topics 
relating to health, and appeal to the common sense of the reader 
for justification. Although it is my aim to simplify the work, 
and render it a practical common-sense guide to the farmer, 
mechanic, mariner, and day-laborer, yet I trust that it may not 
prove less acceptable to the scholar, in its discussion of the 
problems of Life. Not only does the method adopted in this 
volume of treating of the Functions of the Brain and Nervous 
System present many new suggestions, in its application to 
hygiene, the management of disease, generation and the develop- 
ment and improvement of man, but the conclusions correspond 
with the results of the latest investigations of the world's most 
distinguished savants. My object is to inculcate the facts of 
science rather than the theories of philosophy. 

Unto us are committed important health trusts, which we 
hold, not merely in our own behalf, but for the benefit of others. 
If we discharge the obligations of our trusteeship, we shall enjoy 
present strength, usefulness, and length of days ; but if we fail 
in their performance, then inefficiency, incapacity, and sickness, 
will follow, the sequel of which is pain and death. Let us, then, 
prove worthy of this generous commission, that we may enjoy 
the sweetest of all pleasuies, the delicious fruitage of honest toil 
and faithful obedience. 



P^RT I. 



PHYSIOLOGY. 



CHAPTER I. 

BIOLOGY. 

In this chapter we propose to consider Life in its primitive 
manifestations. Biology is the science of living bodies, or the 
science of life. Every organ of a living body has a function 
to perform, and Physiology treats of these functions. 

Function means the peculiar action of some particular 
organ or part. There can be no vital action without change, 
and no change without organs. Every living thing has a 
structure, and A7iatomy treats of the structures of organized 
bodies. Several chapters of this work are devoted to Physio- 
logical Anatomy, which treats of the human organism and its 
functions. 

The beginning of life is called generation; its perpetuation, 
reproduction. By the former function, individual life is insured; 
by the latter, it is maintained. Since nutrition sustains life, it 
has been pertinently termed perpetual reproduction. 

Ijatent liift is contained in a small globule, a mere atom 
of matter, in the sperm-cell. This element is something which, 
under certain conditions, develops into a living organism. The 
entire realm of nature teems with these interesting phenomena, 
thus manifesting that admirable adjustment of internal to 
external relations, which claims our profound attention. We 

U 



12 COMMON SENSE MEDICAL ADVISER. 

are simply humble scholars, waiting on the threshold of nature's 
glorious sanctuary, to receive the interpretation of her divine 
mysteries. 

Some have conjectured that chemical and physical forces 
account for all the phenomena of life, and that organization is 
not the result of vital forces. Physical science cannot inform 
us what the beginning was, or how vitality is the result of 
chemical forces; nor can it tell us what transmutations will 
occur at the end of organized existence. This mysterious life- 
principle eludes the grasp of the profoundest scientists, and its 
presence in the world will ever continue to be an astonishing 
and indubitable testimony of Divine Power. 

The physical act of generation is accomplished by the union 
of two cells; and as this conjugation is known to be so generally 
indispensable to the organization of life, we may fairly infer that 
it is a universal necessity. Investigations with the microscope 
have destroyed the hypothesis of "spontaneous generation." 
These show us that even the minutest living forms are derived 
from a parent organization. 

Crencratioil. So long as the vital principle remains in 
the sperm-cell, it lies dormant. That part of the cell which 
contains this piinciple is called the spermatozoon^ which con- 
sists of a flattened body, having a long appendage tapering 
to the finest point. If it be remembered that a line is 
the one-twelfth part of an inch in length, some idea may 
be formed of the extreme minuteness of the body of a hu- 
man spermatozoon, when we state that it is from -^^-^ to -^f^ 
part of a line, and the filiform tail -5*^ of a line, in length. This 
life-atom, which can be discerned only with a powerful magnify- 
ing glass, is perfectly transparent, and moves about by executing 
a vibi-atile motion with its long appendage. Within this speck 
of matter are hidden the multifarious forces which, under 
certain favorable conditions, result in organization. Magnify 
this infinitesimal atom a thousand times, and no congeries of 
formative powers is perceived wherewith to work out the 
wonders of its existence. Yet it contains the principle, which 
is the contribution on the part of the male toward the gener- 
ation of a new being. 

The ovum, or germ-cell, is the special contribution on the 



GENERATION. 



13 



part of the female for the production of another being. The 
human ovum, though larger than the spermatozoon, is also 
extremely small, measuring not more than from ^l to j\ of a 
line, or from -^^q to jIq- of an inch, in diameter. 

Fig. 1. 




A. Human Spermatozoon magnified about 3,800 diameters. 

B. Vertical and lateral views of spermatozoa of man. 

€;, A -Bi -F. Development of spermatozoa within the vesicles of evolution. 

Ot. CeU of the sponge resembling a spermatozoon. 

fl. Vesicles of evolution from the seminal fluid of the dog in the parent cell. 

J. Single vesicles of different sizes. 

J. Human spermatozoon forming in its cell. 

K.. Rupture of the ceU and escape of the spermatozoon. 

The sperm and the germ-cells contain the primary elements of 
all organic structures, and both possess the special qualities and 
conditions by which they may evolve organic beings. Every 
cell is composed of minute grains, within which vital action takes 



14 COMMON SENSE MEDICAL ADVISER. 

place. The interior of a cell consists of growing matter; the 
exterior, of matter which has assumed its form and is less active. 

When the vital jjrinciple is communicated to it, the cell under- 
goes a rapid transformation. While this alteration takes place 
within the cell, deteriorating changes occur in the cell-wall. 
Although vital operations build up these structures, yet the 
animal and nervous functions are continually disintegrating, or 
wasting, them. 

. Throughout the animal kingdom, germ-cells present the same 
external aspect when carefully examined with the microscope. 
No difference can be observed between the cells of the flowers 
of the oak and those of the apple, but the cells of the one 
always produce oak trees, while those of the other always pro- 
duce apple trees. The same is true of the germs of animals, 
there being not the slightest apparent difference. We are 
unable to perceive how one cell should give origin to a dog, 
while another exactly like it becomes a man. For aught we 
know, the ultimate atoms of these cells are identical in physical 
character; at least we have no means of detecting any difference. 

Species. The term species is generally used merely as a 
convenient name to designate certain assemblages of individuals 
having various striking points of resemblance. Scientific writers, 
as a rule, no longer hold that what ai-e usually called species are 
constantly unvarying and unchangeable quantities. Recent 
researches point to the conclusion that all species vary more or 
less, and, in some instances, that the variation is so great that the 
limits of general specific distinctness are sometimes exceeded. 

Our space will not permit us to do more than merely indicate 
the two great fundamental ideas upon which the leading theories 
of the time respecting the origin of species are based. These 
are usually termed the doctrine of Special Creation and the doc- 
trine of Evolution. According to the doctrine of Special Crea- 
tion, it is thought that species are practically immutable produc- 
tions, each species having a specific centre where it was originally 
created, and from which it spread over a certain area until 
its further progress was obstructed by unfavorable conditions. 
The advocates of the doctrine of Evolution hold, on the contrary, 
that species are not permanent and immutable, but that they are 
subject to modification, and that " the existing forms of life are 



THE PKOCESS OF GENERATIOH. 15 

descendants by true generation of pre-existing forms." * Most 
naturalists are now inclined to admit the general truth of the 
theory of evolution, but they differ widely respecting the mode 
in which it occurred. 

THE PROCESS OF GENERATION. 

The vital principle, represented in the sperm-cell by a sperm- 
atozoon, must be imparted to a ^erm-cell in order to effect 
impregnation. After touching each other, separate them im- 
mediately, and obsei-ve the result. If, with the aid of a power- 
ful lens, we directly examine the spermatozoon, it will be per- 
ceived that, for a short time, it preserves its dimensions and 
retains all its material aspects. But it does not long withstand 
the siege of decay, and, having fulfilled its destiny, loses its 
organic characteristics, and begins to shrink. 

If we examine the fertilized germ, we discover unusual activ- 
ity, the result of impregnation. Organic processes succeed one 
another with wonderful regularity, as if wrought out by inexpli- 
cable intelligence. Here begin the functions which constitute 
human physiology. 

Generation requires that a spermatozoon be brought into actual 
contact with a germ that fecundation may follow. If a sperm- 
atic cell, or spermatozoon, together with several unimpregnated 
ova, no matter how near to one another, if not actually touching, 
be placed on the concave surface of a watch-crystal, and covered 
with another crystal, keeping them warm, and even though the 
vapor of the ova envelops it, no impregnation will occur. Place 
the spermatozoon in contact with an ovum, and impregnation is 
instantly and perfectly accomplished. Should this vitalizing 
power be termed nerve-force, electricity, heat, or motion? It is 
.known that these forces may be metamorphosed; for instance, 
nervous force may be converted into electricity, electricity into 
heat, and heat into motion, thus illustrating their affiliation and 
capability of transformation. But nothing is explained respect- 
ing the real nature of the vital principle, if we assert its iden- 
tity with any of these forces; for who can reveal the true nature 
of any of these, or even of matter? 

* Darwin. 



16 



COMMON SENSE MEDICAL ADVISER. 



ALTERNATE GENERATION. 

In several insect families, the species is not wholly represented 
in the adult individuals of both sexes, or in their development, 
but, to complete this series, supplementary individuals, as it 
were, of one or of several preceding generations, are required. 
The son may not resemble the father, but the grandfather, and 
in gome instances, the likeness re-appears only in latter gener- 
ations. Agassiz states: "Alternate generation was fiist observed 
among the Salpae. These are marine mollusks, without shells, 
belonging to the family Tunicata. They are distinguished by 
the curious peculiarity of being united together in considerable 
numbers so as to form long chains, which float in the sea, the 
mouth (m) however being free in each. 

Mg. 2. Mg. 3. 




" Fig. 2. The individuals thus joined in floating colonies pro- 
duce eggs ; but in each animal there is generally but one egg 
formed, which is developed in the body of the parent, and from 
which is hatched a little mollusk. 

" Fig. 3, which remains solitary, and differs in many respects 
from the parent. This little animal, on the other hand, does not 
produce eggs, but propagates, by a kind of budding, which gives 
rise to chains already seen in the body of their parent (a), and 
these again bring forth solitary individuals, etc." 

It therefore follows that generation in some animals requires 
two different bodies with intermdiate ones, by means of which, > 
and their different modes of reproduction, a return to the original 
stock is effected. 

Universality of Aiiiiiialcular Lile. — Living organ- 
isms are universally diffused over every part of the globe. The 
gentle zephyr wafts from flower to flower invisible, fructifying 
atoms, which quicken beauty and fragrance, giving the promise 
of a golden fruitage, to gladden and nourish a dependent 
world. Nature's own sweet cunning invests all living things, 



THE ORIGIN OF LIFE. 17 

constraining into her service chemical affinities, arranging the 
elements and disposing them for her own benefit, in such num- 
berless ways that we involuntarily exclaim, 

" The course of Nature is the art of God." 

The microscope reveals the fact that matter measuring only 
T^uVo^T of an inch in diameter may be endowed with vitality, 
and that countless numbers of animalcules often inhabit a single 
drop of stagnant water. These monads do not vary in form, 
whether in motion or at rest. The life of one, even, is an inex- 
plicable mystery to the philosopher. Ehrenberg writes: "Not 
only in the polar regions is there an uninterrupted development 
of active microscopic life, where larger animals cannot exist, 
but we find that those minute beings collected in the Antarctic 
exjjedition of Captain James Ross exhibit a remarkable abun- 
dance of unknown, and often most beautiful forms." 

Even the interior of animal bodies is inhabited by animalcules. 
They have been found in the blood of the frog and the salmon, 
and in the optic fluid of fishes. Organic beings are found in the 
interior of the earth, into which the industry of the miner has 
made extensive excavations, sunk deep shafts, and thus revealed 
their forms; likewise, the smallest fossil organisms form subter- 
ranean strata man 3^ fathoms deep. Not only do lakes and inland 
seas abound with life, but also, from unknown depths, in vol- 
canic districts, arise thermal spiings which contain living insects. 
Were we endowed with a microscopic eye, we might see myriads 
of ethereal Aoyagers wafted by on every breeze, as we now be- 
hold drifting clouds of aqueous vapoi-. While the continents of 
earth fuinishes evidences of the univei-sality of organic beings, 
recent observations prove that "animal life predominates amid 
the eternal night of the depths of the liquid ocean." 

THE ORIGIN OF LIFE. 

The ancients, rude in many of their ideas, referred the origin 
of life to divine determination. The thought was crudely ex- 
pressed, but well represented, in the following verse : 

" Then God smites his hands together. 
And strikes out a soul as a spark, 
Into the organized glory of things. 
From tlie deeps of the dark." 



18 COMMON SBNSH MEDICAIi ADVISER. 

According to a Greek myth, Prometheus formed a human image 
from the dust of the ground, and then, by fire stolen from heaven, 
animated it with a living soul. Spontaneous generation once 
held its sway, and now the idea of natural evolution is popular. 
Some believe that the inpenetrable mystery of life is evolved 
from the endowments of nature, and build their imperfect theory 
on observations of her concrete forms and their manifestations, 
to which all our investigations are restricted. But every func- 
tion indicates purpose, every organism evinces intelligent design, 
and all proclaim a Divine Power. Something cannot come out 
of nothing. With reason and philosophy, chance is an impossi- 
bility. We, therefore, accept the display of wisdom in nature 
as indicative of the designs of God. Thus " has He written His 
claims for our profoundest admiration and homage all over every 
object that He has made." If you ask: Is there any advantage 
in considering the phenomena of nature as the result of Divinb 
Volition? we answer, that this belief corresponds with the 
universally acknowledged ideas of accountability; for, with a 
wise and efficient Cause, we infer there is an intelligent creation, 
and the desire to communicate, guide and bless. Is responded to 
by man, who loves, obeys, and enjoys. Nothing is gained by 
attriljuting to nature vicegerent forces. Is it not preferable to 
say that she responds to intelligent, loving Omnipotence ? Our 
finiteness is illustrated by our initiation into organized being. 
Emerging from a rayless atom, too diminutive for the sight, we 
gradually develop and advance to the maturity of those conscious 
powers, the exercise of which furnishes indubitable evidence of 
our immortality. We are pervaded with invisible influences, 
which, like the needle of the compass trembling on its pivot, 
point us to immortality as our ultimate goal, wlieni in the sunny 
clime of Love, even in a spiritual realm of joy and happiness, we 
may eternally reign with Him who is all in all. 



CHAPTER II. 



PHYSIOLOGICAL ANATOMY. 



Fig. J,. 



THE BONES. 

All living bodies are made up of tissues. There is no part, 
no organ, however soft and yielding, or hard and resisting, 
which has not this peculiarity of structure. The bones of ani- 
mals, as well as their flesh and fat, are composed of tissues, and 
all alike made up of cells. When viewed under a micros- 
cope, each cell is seen to consist of three distinct parts, a 
nucleolus, or dark spot, in the center of the cell, around which 
lies a mass of granules, called the nucleus^ and this, in turn, is 
surrounded with a delicate, transparent membrane, termed the 
envelope. Each of the granules composing the 
nucleus assimilates nourishment, thereby growing 
into an independent cell, which possesses a triple 
organization similar to that of its parent, and in 
like manner reproduces other cells. 

A variety of tissues enters into the composition 
of an animal structure, yet their differences are 
not always distinctly marked, since the character- 
istics of some are not unlike those of others. We 
shall notice, however, only the more important of Periphery of the 

- . cell, or cell--wall. 

the tissues. g. Nucleus. S. 

The Areolar, or Connective Tissue, is a com- Nucleolus in the 
plete network of delicate fibers, spread over the 
body, and serves to bind the various organs and parts together. 
The fibrous and serous tissues are modifications of the areolar. 

19 




Nucleated cell. 
From Goeber. 1. 



20 



COMMON SENSE MEDICAL ADVISER. 



Fig. 5. 



The Nervous Tissue is of two kinds: The gray, which is 
pulpy and granulated, and the white fibrous tissue. The Adi- 
pose Tissue is an extremely thin membrane, composed of closed 

cells which contain fat. It is found 
]>rincipally just beneath the skin, 
;-;iving it a smooth, plump appear- 
ance. 

The Cartilaginous Tissue consists 
ll^ of nucleated cells, and, with the 
^ exception of bone, is the hardest 
^ part of the animal frame. The 
Osseous Tissue, or bone, is more 
compact and solid than the cartil- 
aginous, for it contains a greater 
The Muscular 







Anuu^tment ot fibers in the . . 

Areolar Tissue. Mag-nifled ia5 dia- quantity 01 lime, 
meters 

Tissue is composed of bundles of 
fibers, which are enclosed in a cellular membrane. 

Various opinions have been entertained in regard to the 
formation, or growth, of bone. Some anatomists have sup- 
posed that all bone is formed 
in cartilage. But this is not -^V- ^• 

true, for there is an intra- 
membranous, as well as an 
introrcartilaginous, formation 
of bone, as may be seen in 
the development of the cran- 
ial bones, where the gradual 
calcification takes place upon 
the inner layers of the fibrous 
coverings. Intra cartilaginous 
deposit is found in the vicin- 
ity of the blood-vessels, within the cartilaginous canals; also, 
there are certain points first observed in tlie shafts of long 
bones, called centers of ossijicatiofi. These points are no sooner 
formed than the cartilage corpuscles arrange themselves in 
concentric zones, and, lying in contact with one another, 
become very compact. As ossification proceeds, the cup-shaped 
cavities are converted into closed interstices of bone, with 
extremely thin lamellae, or layers. These, however, soon increase 




Human Adipose Tissue. 



THE BONES. 



21 



Fig. 7. 



Fig. 8. 



•s^.^of.o: 



,--o 



1. 



V-°1 f 



a 



&A 






■5 <^ 



3*5 



"■Jv 



^# ^g If l^i 



h 






a. » ^ 
^ ^ <=• 






♦ *£^ ^^ 



in density, and no blood-vessels can be observed within them. 

The bony 
plates form 
the boundaries 
of the Haver- 
sian, or nutri- 
tive canals of 
the bones. In 
the s econd 
stage of ossifi- 
cation, the 
cartilage cor- 
puscles are 
2/ converted into 
bone. Becom- 
ing flattened 
against the os- 
seous lamellae Thigh-bone, 
already form- ^^^" "p^" 

'' lengthwise. 

ed, they crowd 
upon one another so as 
to entirely obliterate the 
lines that distinguish 
them; and, simulta- 
3' neously with these 
changes, a calcareous de- 

Fig. 9. 



Vertical section of cartilage near the sui-face of 
ossification. 1. Ordinary appearance of the tem- 
porary cartilage. 1'. Portion of the same more 
highly magnified. 2. The cells beginning to form 
into concentric zones. 2'. Portion more magni- 
fied. S. The ossification is extending in the inter- 
cellular spaces, and the rows of cells are seen 
resting in the cavities so formed, the nuclei being 
more separated than above, 
same more highly magnified. 





Lower end of the thigh-bone 
sa^vn across, showing its central 
cavity. 



place upon 



posit takes 
Portion of the their interior. Bones 
grow by additions to 
their ends and surfaces. In the child, their extremities are 



32 



COMMON SENSE MEDICAL, ADVISER. 



separated from the body of the bone by a layer of car- 
tilage, and the cancellated, or cellular structure, which remains 
for a time in the interior, represents the early condition of the 
ossifying substances. 

The bones contain more earthy matter in their composition 
than any other part of the human body, being firm, hard, and of 
a lime color. They compose the skeleton or frame work, and, 
when united by natural ligaments, form what is known as the 
natural skeleton; when they are wired together, they are called 

an artificial skeleton. 
^9' ^^- ' . The number of bones 

in the human body is 
variously estimated; for 
those regarded as single 
by some anatomists are 
considered by others to 
consist of several distinct 
])iec'es. There ai*e two 
hundred distinct bones 
in the human skeleton 
besides the teeth. These 
may be divided into 
those of the Head, 
Trunk, Upper Extrem- 
ities, and Lower Ex- 
tremities. 

The Bones of the 
Head are classed as 
follows: eight belong- 
ing to the Cranium, and 
fourteen to the Face. 
The bones of the 
Cranium are the occip- 
ital, two parietal, two temi^oral, frontal, sphenoid, and ethmoid. 
Those composing the face are, the two nasal, two superior 
maxillary, two lachrymal, two malar two palate, two infer- 
ior turbinated, vomer, and inferior maxillary. The cranial 
bones are composed of two dense plates, between which there is, 
in most places, a cancellated or cellular tissue. The external 




Tho bones of the skull separated. 1. Frontal, 
only half is seen. 2. Parietal. 3. Occipital, only 
half is seen. h. Temporal. 5. Nasal. 6. Malar. 
7. Superior maxUlary (upper jaw). 8. Lachry- 
mal. 9. Inferior maxillary ( lower jaw). Between 
4 and G a part of the sphenoid or wedge-shaped 
bone, is seen. Another bone assisting to form 
the slcull, but not here seen, is called tho ethmoid 
(sieve-like, from being full of holes), and is situ- 
ated between the sockets of the eyes, forming the 
roof of the nose. 



THE TETJNK. 



23 



plate is fibrous, the internal, compact and vitreous. The skull is 
nearly oval in form, convex externally, the bone being much 
thicker at the base than elsewhere, and it is, in every respect 
admirably adapted to resist any injury to which it may be 
exposed, thus affording ample protection to the brain substance 
which it envelops. The internal surface of the cranium presents 
eminences and depressions for lodging the convolutions of the 
brain, and numerous furrows for the ramifications of the blood- 
vessels. The bones of the cranium are united to one another by 
ragged edges called sutures^ which are quite distinct in the child, 
but which in old age are nearly effaced. Some authorities sup- 
pose that by this arrangement 
the cranium is less liable to be 
fractured by blows; others 
think that the sutures allow 
the growth of these bones, 
which takes place by a grad- 
ual osseous enlargement at the 
margins. The bones of the 
Face are joined at the lower 
part and in front of the cran- 
ium, and serve for the attach- 
ment of powerful muscles 
which assist in the process of 
mastication. Although the soft 
parts of the face cover the 
bony structure, yet they do 
not conceal its principal feat- 
tures, or materially change its 
proportions 

head and face presents some first dorsal vertebra (a bone of the spinal 
..... . column). 5. The last dorsal vertebra. 6. 

remarkable dissimilarities in The first rib. 7. its head. s. its neck. 9. 

rli-ff 4- -.nnaa Its tubcrclc. 10. The scvcnth OF last truB 

ainerenr laces. j.jl3 ii. The cartilage of the third rib. IZ. 

The Trunk has fifty-four ^^" ^°""°^ '"'''• 
bones, which are as follows: The Os Hyoides^ the Sternum, 
twenty-four Ribs, twenty-four vertehrce or bones of the Spinal 
Column, the Sacrum, the Coccyx, and two Ossa Innominata. 
The Os Hyoides, situated at the base of the tongue, is the most 
isolated bone of the skeleton, and serves for the attachment of 




The fii-st bone of the sternum (breast- 
TIio friTm r\^ tlio bone). 2. The second bonc of the stemum. 
j-iie loim oi iiie ^ rpj^g cartilage of the sternum. U. The 



24 



COMMON SENSE MEDICAL ADVISER. 



Fig. U, 



Fig. 12. 




muscles. The Sternum, or breast- bone, in a child is composed 
of six pieces, in the adult of three, which in old 
age are consolidated into one bone. The lUbs are 
thin, curved bones, being convex externally. 
There are twelve on each side, and all are at- 
tached to the spinal column. The seven upper 
ribs, which are united in front of the sternum, are 
termed true ribs; the next three, which are not at- 
tached to the sternum, 
but to one another are 
called false ribs; and 
the last two, which are 
joined only to the ver- 
tebrae, are designated 
as floating ribs. The 
first rib is the shortest, 

and they increase in 

A vertebra of the neok. i. The i„„„fi, og f^- oq tViP. 
body of the vertebra. 3. Thespi- lengtU as rar as ine 
nal canal, i. The spinous process pio-Vitli nftpr whipVi this 

cleft at its extremity. 5. The eigntn, aiier wnicn xnis 

transverse process. 7. The in- ^,.rlor ie rfivpr«prl 
terior articular process. 8. The OlOer IS revcrseo. 
superior articular process. rpj^^ Spinal Column 

or back-bone, when viewed from the front presents 
a perpendicular appearance, but a side view shows 

four distinct curves. 
The bones composing 
it are called vertebrce. 
The body part of a ver- 
tebra is light and 
spongy in texture, hav- 
ing seven projections 
called processes, four 
of which are the artic- 

- ... Back-bone, spinal 

Ular processes, which column, or vertc- 
/. The cartilaginous substance , • i. /? >. • • ^r^l column. All 

which connects the bodies of lUmisn SUriaceS tO lOin animals possessing 
the vertebra;. 2. The body of tbe , ■,.„ . , -, such a row of bones 

vertebra. 3. The spinous pro- tne dltterent Vertebrae are called verte- 
cess. i, 4. The transverse proces- r .i • i i 67-a<e5. Above 6 arc 

ses. 5, 5. The articular processes, or tne spinai COlumn. the cervical (neck) 

'whicVrK'tSn°g«sp^- Two are called trans- 111^'-^^,^^^ or 
^<^^^^- verse, and the remain- t'odfinmbLnioi'ns) 

1 ,^ . nri- i vertebrae ; d to e, sa- 

ing one is termed the spinous, ine transverse crum;eto/,coccyx. 




BONES OF THE UPPEB EXTREMITIES, 



25 



and spinous processes serve for the attachment of the muscles 
belongmg to the back. All these processes are more compact 
than the body of the vertebra, and, when naturally connected, 
are so arranged as to form a tube which contains the medulla 
spinalis, or spinal cord. Between the vertebrae is a highly-elas- 
tic, cartilaginous and cushion-like substance, which freely admits 
of motion, and allows the spine to bend as occasion requires. 
The natural curvatures of the spinal column diminish the shock 
produced by falling, running or leaping, which would otherwise 
be more directly transmitted to the brain. The ribs at the sides, 
the sternum in front, and the twelve dorsal bones of the spinal 
column behind, bound tlie thoracic cavity, wliich contains the 
lungs, heart, and large blood-vessels. 

The Pelvis is an open bony structure, consisting of the Os In- 
nommata, one on either side, and the Sacrum and Coccyx behind. 
The Sacrum, during 
childhood, consists of 
five bones, which in 
later years unite to 
form one bone. It is 
light and spongy in 
texture, and the upper 
surface articulates 
with the lowest verte- 
bra, while it is united 
at its inferior margin 
to the coccyx. The 
Coccyx is the terminal 
bone of the spinal col- 
umn. In infancy it is 
cartilaginous and com- 
posed of several pieces, but in the adult these unite and form one 
bone. The Innominata, or nameless bones, during youth, con- 
sist of three separate pieces on each side ; but as age advances 
they coalesce and form one bone. A deep socket, called the 
acetabulum, is found near theh' junction, which serves for the 
reception of the head of the thigh-bone. 

The Bones of the Upper Extremities are sixty- 
four in number, and are classified as follows: The Scapula, 
2 




A representation of the pelvic bones, e. The 
lumbo-sacral joint. 3. The sacrum. 3. Coccyx.* 1, 
1. The innominata. i, U. Acetabula. 



26 



COMMON SENSE MEDICAL ADVISER. 



Clavicle, Iluraenis, THna, Radius, Carpus, Metacarpus, and 
Phalanges. The /Scapula, or shoulder-hlade, is an irregular, thin, 

triangular bone, situated at 
I'lff. 2o. ^l^^, posterior part of the 

shoulder, and attached to 
the upper and back part 
of the chest. The Clavicle, 
or collar-bone, is located at 
the upper part of the chest, 
between the sternum and 
scapula, and connects with 
both. Its form resembles 
that of the italic letter f, 
and it prevents the arras 
from sliding forward. The 
Humerus, the first bone of 
the arm, is long, cylindrical, 
and situated between the 
scapula and fore-arm. The 
TJlna is nearly parallel with 
the radius, and situated on 
the inner side of the fore- 
arm. It is the longer and 
larger of the two bones, and 
in its articulation with the 
humerus, forms a perfect 
hinge-joint. The Radius^ 
so called from its resem- 
blance to a spoke, is on the 
outer side of the fore-arm, 
and articulates with the 

1. 1. Portions of the back-bone. 2. Cranial boneS of the wrist, forming 
bonea. A. iJreast-bone. 5. Hibs. 7. Collar- ^ • -^^^ rj^,j^g ^^^^ ^^^ j.^. 
bone. 8. Arm-bone (humerus). 9. Shoulder- «• . 

joint. 10, U. Bones of the fore-arm (ulna and dius also articulate With 
radius). 12. Elbow-joint. 13. Wrist-joint. lU. ^^^,^ other at their extrem- 
Bones of the hand. 15, 16. Pelvic bones. 17. . . rin /-i 

Hip-joint. IS. Femur. W, 20. Bones of the itlCS. i hc Carpus, or WTlst, 
knee-joint. 21, 22. Fibula and tibia. 23. Ankle consists of eight boneS, ar- 
bone. 34. Bones of the foot. , . ^ rrru 

ranged in two rows, ihe 

Metacarpus, or palm of the hand, is composed of five bones, 




BONES OF THE LOWER EXTREMITIES, 27 

situated between the carpus and fingers. The Phalanges, four- 
teen in number, are the bones of the fingers and thumb, the 
fingers each having three and the thumb two. 

The Bones of the Lower Extremities, sixty in 
number, are classed as follows : The Femur, Patella, Tibia, Fibula, 
Tarsus, Metatarsus, and Phalanges. The Femur ^ or thigh-bone, 
is the longest bone in the body. It has a large round head, 
which is received into the acetabulum, thus affording a good 
illustration of a ball and socket joint. The Patella, or knee-pan, 
is the most complicated articulation of the body. It is of a round 
form, connects with the tibia by means of a strong ligament, and 
serves to protect the front of the joint, and to increase the 
leverage of the muscles attached to it, by causing them to act at 
a greater angle. The Tibia, or shin bone, is enlarged at each 
extremity and articulates with the femur above and the astragalus, 
the upper bone of the tarsus, below. The Fibula, the small bone 
of the leg, is situated on the outer side of the tibia, and is firmly 
bound to it at each extremity. The Tarsus, or instep, is com- 
posed of seven bones, and corresponds to the carpus of the upper 
extremities. The Metatarsus, the middle of the foot, bears a 
close resemblance to the metacarpus, and consists of five bones 
situated between the tarsus and the phalanges. The tarsal and 
the metatarsal bones are so united as to give an arched apj^ear- 
ance to the foot, thus imparting elasticity. The Phalanges, the 
toes, consist of fourteen bones, arranged in a manner similar to 
that of the fingers. 

We are not less interested in tracing the formation of boije 
through its several stages, than in considering other parts of the 
human system. The formation of the Haversian canals for the 
passage of blood-vessels to nourish the bones, the earlier con- 
struction of bony tissue by a metamorphosis of cartilaginous 
substance, and also the commencement of ossification at distinct 
points, called centers of ossification, are all important subjects, 
requiring the student's careful attention. The bones are pro- 
tected by an external membranous envelope, which, from its 
situation is called the periosteum. The bones are divided into 
four classes, long, short, flat and irregular, being thus adapted to 
subserve a variety of purposes. 

The Long Bones are found in the limbs, where they act as 



28 



COMMON SENSE MHDICAI- ADVISER. 



levers to sustain the body and aid in locomotion. Each long 
bone is composed of a cylinder, known as the shaft, and two 
extremities. The shaft is hollow, its walls being thickest in the 
middle and growing thinner toward the extremities. The extrem- 
ities are usually considerably enlarged, for convenience of con- 
nection with other bones and to afford a broad surface for the 
attachment of muscles. The clavical, humerus, radius, ulna, 
femur, tibia, fibula, the bones of the metacarpus, metatarsus 
and the phalanges, are classed as long bones. 

Where the principal object to be attained is strength, and the 
motion of the skeleton is limited, the individual bones are short 
and compressed, as the bones of the carpus and tarsus. The 
structure of these bones is spongy, except at the surface, where 
there is a thin crust of compact matter. 

Fig. 17. ^9- IS. 





Anatomy of a joint, i, 1. 
Bones of a joint. 2, 2. Car- 
' tilage. 3, 3, 3, 3. Synovial 
• membrane. 



Anatomy of the knee-joint. 
1. Lower end of thiffh-bone. 
3. Knee-pan. 2, '*. Ligaments 
of the knoe-i)an. 5. TTpiJer 
vn<\ of the tibia, or shin-bone. 
6, 12. Cartilages, 



When protection is required for the organs of the body, or a 
broad flat surface for the attachment of the muscles, the bones 
are expanded into plates, as in the cranium and shoulder-blades. 

The irregular or mixed bones are those which, from their 
l)eculiar shape, cannot be classed among any of tlie foregoing 
divisions. Their structure is similar to the others, consisting of 
cancellar tissue, surrounded by a crust of compact matter. 

The verteV>rse, sacrum, coccyx, temporal, sphenoid, ethmoid, 
malar, two maxillary, palate, inferior turbinated, and hyoid are 
known as irregular bones. 

The formation of the joints requires not only bones, but also 



BONKS OP THE LOWER EXTREMITIES. 29 

cartilages, ligaments, and the synovial membrane, to complete 
the articulation. Cartilage is a smooth, elastic substance, softer 
than bone, and invested with a thin membrane, called perichon- 
drmrn. When cartilage is placed upon convex surfaces, the 
reverse is true. The Ligatnents are white, inelastic, tendinous 
substances, softer than cartilage, but harder than membrane, 
Tlieir function is to bind together the bones. The Synovial 
Membrane covers the cartilages, and is then reflected upon the 
ligaments, thus forming a thin, closed sac, called the synovial 
capsule. 

All the synovial membranes secrete a lubricating fluid, termed 
synovia, which enables the surfaces of the bones and ligaments 
to move freely upon one another. When this fluid is secreted in 
excessive quantities, it produces a disease known as " dropsy of 
the joints." There are numerous smaller sacs besides the syno- 
vial, called hursm onucosm, which in structure are analogous to 
them, and secrete a similar fluid. Some joints permit motion in 
every direction, as the shoulders, some in two directions only, as 
the elbows, while others do not admit of any movement. The 
bones, ligaments, cartilages, and synovial membrane, are supplied 
with nerves, arteries, and veins. 

When an animal is pi-ovided with an internal bony structure, 
it indicates a high rank in the scale of organization. An elaborate 
texture of bone is found in no class below the vertebrates. 
Even in the lower order of this sub-kingdom, which is the highest 
of animals, bone does not exist, as is the case in some tribes 
of fishes, such as sharks, etc., and in all classes below that of the 
cartilaginous fishes, the inflexible substance which sustains the 
soft parts is either shell or some modification of bone, and is 
usually found on the outside of the body. True bone, on the 
contrary, is found in the interior, and, therefore, in higher 
animals, the skeleton is always internal, while the soft parts are 
placed external to the bony frame. While many animals of the 
lowest species, being composed of soft gelatinous matter, are 
buoyant in water, the highest type of animals requires not only a 
bony skeleton, but also a flexible, muscular system, for locomo- 
tion in the water or upon the land. Each species of the animal 
kingdom is thus organically adapted to its condition and sphere 
of life. 



CIIAPTEU TTl. 



PHYSIOLOGIC AT. ANATOMY. 



THE MUSCLES. 

The Muscles are those organs of tlie body l)y wliicli motion 
is produced, and are commonly known as flesh. A mixscle is 
composed of fasciculi^ or Lnndles of fibers, parallel to one 
another. They are soft, varying in size, of a redcbsh color, and 
inclosed in a cellular, mcmbi-anous sheath. Each fascicrdus 
contains a number of small libers, which, w^hen subjected to a 
microscopic examination, are found to consist of fihrillm^ or 
little fibers; each of these fibrillte in turn 
being invested with a delicate sheath. The 
libers terminate in a glistening, white tendon, 
or hard cord, which is attached to the bone. 
So firmly ai'e they united, that the bone will 
break before the tendon can be released. 
AVhen the tendon is spread out, so as to 
resemble a membrane, it is called fascia. 
IJeing of various extent and thit;kness, it is 
distributed over the body, as a covering and 
protection for the more delicate parts, and 
aids also in motion, by firmly uniting the 

MiimMilar fibers hig:hly ri'i i . .i 

iimKnificd. muscular fibers. Ihe sjtaccs between the 

muscles are frequently filled with fat, which 
frives roundness and beauty to the limbs. The muscles are of 
various forms; some are longitudinal, each extremity terminat- 
ing in a tendon, which gives them 2. fusiform or spindle-shaped 
appearance; others are either fan-shaped, flat, or cylindrical. 
30 




THE MUSCLES. 



31 




Every muscle has an origin and an insertion. The term 

origin is applied to the more 
Fig. 20. fixed or central attachment of 

a muscle, and the term inser- 
tion to the movable point to 
which the force of the muscle 
is directed; but the origin is 
not absolutely fixed, except in 
a small number of muscles, as 
those of the face, which are 
attached at one extremity to 
the bone, and at the other to 
1. A spindle-shaped muscle, with tendi- t^^e movable integument, or 

nous terminations, i. Fan-shaped muscle, skin. In most instances, the 
S. Pennlform muscle, i. Bipenniform ^^^^^^^ ^^^ f^om either 

muscle. •' 

extremity. The muscles are 
divided into the Voluntary, or muscles of animal Hfe, and the 
Involuntary, or muscles of organic life. There are, however, 
some muscles which cannot properly be classified with either, 
termed Intermediate. 

The Vohmtary Muscles Fig. 21. 

are chiefly controlled 
by the will, relaxing 
and contracting at its 
pleasure, as in the mo- 
tion of the eyes, mouth, 
and limbs. The fibers 
are of a dark red color, 
and possess great 
strength. These fibers 

are parallel, seldom in- striped muscular fibers showing- cleavag-e in 

terlacino- but present- ^'PPOsite directions. l. Long:itudinal cleavage. 

*' " , 2. Transverse cleavage. S. Transverse section of 

ing a striped or striated disc. U. Disc nearly detached. 5. Detached disc, 

appearance; and a mi- showing the sarcous elements. G. FlbrlUae. 7,8. 

^'- , . , Separated flbrilloB highly magnified. 

croscopic examination 

of them shows that even the most minute consist of parallel 
filaments marked by longitudinal and transverse strice, or minute 
channels. The fibers are nearly the same length as the muscles 
to which they belong. Each muscular fiber is capable of 




32 



COMMOK SENSE MEDICAl ADVISEE. 



Fig. 22. 




contraction; it may act singly, though usually it acts in unison 
with others. By a close inspection, it has 
been found that fibers may be drawn 
apart longitudinally, in which case they 
are termed J^"Z*;•^7^ce, or they may be sep- 
arated transversely, forming a series of 
discs. The Sarcoleinma, or investing slieath 
of the muscles, appears to be formed even 
before there are any visible traces of the 
muscle itself. It is a transparent and deli- 
cate membrane, but very elastic. The 
Involuntary Muscles are influenced by the 
sympathetic nervous system, and their 
action pertains to the nutritive functions 
of the body. They differ from the volun- 
tary muscles in not bemg striated, having 
no tendons, and in the net-work arrange- 
ments of their fibers. The Intermediate 
Muscles are composed of stiiated and 
unstriated fibers; they are, tlierefore, botli 
voluntary and involuntary in their func- 
tions. The muscles em- ..,. 

, , . . . Fig. 28. 

ployed m respiration 

are of this class, 
for we can breathe rap- 
idly or slowly, and, for 
a sliort time, even 
suspend their action; 
but soon, however, the 
organic muscles assert 
their instmctive con- 
trol, and respiration is 
resumed. 

The Diaphragm^ 

or midriff, is the mus- 
cular division between 
the thorax and the ab- 
domen. It has been 
compared to an inverted basin, the concavity of wliich is 



Unstriated muscular 
fiber ; at b, in its natural 
state ; at a, showing- the 
nuclei after the action of 
acetic acid. 




A view of the under side of the diaphragm. 



THB MUSCLES. 



33 



Fig. H. 




A representation of the superficial layer of muscles on the anterior 
portion of the body. 



34 COMMON SKNSE MEDICAL ADVISEB. 

directed toward the abdomen- The muscles receive their nour- 
ishment from the numerous blood-vessels which penetrate their 
tissues. The voluntary muscles are abundantly supplied with 
nerves, while the involuntary are not so numei'ously furnished. 
The color of the muscles is chiefly due to the blood which they 
contain. They vary in size according to their respective func- 
tions. For example, the functions of the heart require large 
and powerful muscles, and those of the eye, small and delicate 
ones. There are between four hundred and sixty and five 
hundred muscles in the human body. 

Very rarely is motion produced by the action of a single muscle, 
but by the harmonious action of several. There is infinite variety 
in the arrangement of the muscles, each being adapted to its 
purpose, in strength, tenacity, or elasticity. While some invol- 
untarily respond to the wants of organic life, others obey, with 
mechanical precision, the edicts of the will. The peculiar char- 
acteristic of the muscles is their contractility; for example, Avhen 
the tip of the fijiger is placed in the ear, an incessant vibration, 
due to the contraction of the muscles of the ear, can be heard. 
When the muscles contract, they become shorter; but what is 
lost in length is gained in breadth and thit^kness, so that their 
actual volume remains the same. Muscles alternately contract 
and relax, and thus act upon the bones. The economy of 
muscular power thus displayed is truly remarkable. In easy and 
t^raceful walking, the forward motion of the limbs is not alto- 
gether due to the exercise of muscular power, but ])artly to the 
force of gravity, and only a slight assistance of tlu; muscles is 
required to elevate the leg sufficiently to allow it to oscillate. 

Motion is a characteristic of living bodies. This is true, not 
only in animals, but also in plants. The oyster, although not 
possessing the power of locomotion, opens and closes its shell at 
pleasure. The coral insect appears at the door of its cell, and 
retreats at will. All the varied motions of animals are due to 
a peculiar property of the muscles, termed contractility. Al- 
though plants are influenced by external agents, as light, 
heat, electricity, etc., yet it is supposed that they may move in 
response to inward impulses. The sensitive stamens of the 
barberry, when touched at their base on the inner side, resent 
the intrusion, by making a sudden jerk forward. Venus's 



THE MUSCLES. 



36 



Fig. 25. 




A representation of the superficial layer of muscles on the posterior 
portion of the body. 



;36 COMMON SENSE MEDICAL ADVISER. 

fly-trap, a plant found in North Carolina, is remarkable for the 
sensitiveness of its leaves, Avhich close suddenly and capture 
insects which chance to alight upon them. The muscles of the 
articulates are situated within the solid frame-work, unlike the 
vertebrates, whose muscles are external to the bony skeleton. 
All animals have the power of motion, from the lowest radiate 
to the highest vertebrate, from the most repulsive polyp to that 
type of organized life made in the very image of God. 

The muscles, then, subserve an endless variety of purposes. 
By their aid the farmer employs his implements of husbandry, 
the mechanic deftly wields his tools, the artist plies his brush, 
while the fervid orator gives utterance to thoughts glowing with 
heavenly emotions. It is by their agency that the sublimest 
spiritual conceptions can be brought to the sphere of the senses, 
and the noblest, loftiest aims of to-day can be made glorious 
realizations of the future. 



CHAPTER lY. 



PHYSIOLOGICAL ANATOMT 



THE DIGESTR^ ORGANS. 

Digestion signifies the act of separating or distributing, 
hence its application to the process by which food is made avail- 
able for nutritive purposes. The oi-gans of digestion are the 
Mouth, Teeth, Tongue, Salivary Glands, Pharynx, Esophagus, 
the Stomach and the Intestines, with their glands, the LiA^er, 
Pancreas, Lacteals, and the Thoracic Duct. 

The Mouth is an irregular cavity, situated between the upjjer 
and the lower jaw, and contains ~ 
the organs of mastication. It 
is bounded by the lips in front, 
by the cheeks at the sides, by 
the roof of the mouth and teeth 
of the upper jaw above, and 
behind and beneath by the teeth 
of the lower jaw, soft parts, and 
palate. The soft palate is a 
sort of pendulum attached only 
at one of its extremities, while 
the other involuntarily opens 
and closes the passage from 
the mouth to the pharynx. 
The interior of the mouth, as 
well as other portions of the alimentary canal, is lined with a 
delicate tissue, caUed trmcous membrane. 

The Teeth are firmly inserted in the alveoli or sockets, of 
the upper and the lower jaw. The first set, twenty in number, 
are temporary, and appear during infancy. They are replaced 

37 




A View of the lower jaw. 1. The body. 
3. 2. Rami, or branches. 3, 3. Processes of 
the lower jaw. m. Molar teeth, b. Bi- 
cuspids, c. Cuspids, i. Incisors. 



38 



COMMON SENSE MEDICAX, ADVISER. 



bj permanent teeth, of which there are sixteen in each jaw ; 
four incisors, or front teeth, four cuspids, or eye teeth, four 
bicuspids, or grinders, and four molars, or hirge grinders. Each 
tooth is divided into the crown, body, and root. The croxon is 
the grinding surface ; the hody^ the part projecting from the 
jaw, is tbe seat of sensation and nutrition ; tlie root is that por- 
tion of the tooth which is inserted in the alveolus. The teeth 
are composed of dentine, or ivory, and enamel. The ivory 
forms the greater portion of the body and root, while the 
enamel covers the exposed surface. The small white cords 
communicating with the teeth are the nerves. 

The Ton<jfi,e is a flat oval organ, the base of which is attached 

to the OS hyoides, 
Fig. 27. while the apex, 

the most sensi- 
tive part of the 
body, is free. Its 
surface is cov- 
ered with a mem- 
brane, which, at 
the sides and 
lower part, is 
continuous with 
the lining of the 
mouth. On the 
lower surface of 
the tongue, this 
membrane is thin 

The salivary glands. The largest one. near the oar, is the j^,^,| smooth but 
parotid gland. The next belowitis the siibmaxillarygland. 
The one under the tongue is the sublingual gland. ^^ •^^e upper Side 

it is covered with 
numerous papillae, which, in structure, are similar to the sensitive 
papillae of the skin. 

The Salivary Glands are six in number, three on each side 
of the mouth. Their function is to secrete a fluid called saliva, 
which aids in mastication. The largest of these glands, the 
Parotid, is situated in front and below the ear; its structure, like 
that of all the salivary glands, is cellular. The Submaxillary 
gland is circular in form, and situated midway between the 




THE DIGESTIVE ORGANS. 



39 



angle of tlie lower jaw and the middle of the chin. The iSub- 
lingual is a long flattened gland, and, as its name indicates, is 
located below the tongue, which when elevated, discloses the 
saliva issuing from its porous openings. 

The Pharynx is nearly four inches in length, formed of mus- 
cular and membranous cells, and situated between the base of 
the cranium and the esopliagus, in front of the spinal column. 
It is narrow at the upper part, distended in the middle, contract- 
ing again at its junction with the esophagus. The pharynx 
communicates with the nose, mouth, larynx, and esophagus. 

The Esophagus, a cylindrical organ, is a continuation of the 
pharynx, and extends through the diaphragm to the stomach. 
It has three coats: first, the muscular, consisting of an exterior 
layer of fibers running longitudinally, and an interior layer of 
transverse fibers; second, 

the cellular, which is Fig. 28. 

interposed between the 
muscular and the mu- 
cous coat; tliird, the 
iQucous membrane, or 
internal coat, which is 
continuous with the mu- 
cous lining of the pliar- 
ynx. 

The Stomach is a mus- 
c u 1 o - m e m b r a n o u s , 
conoidal sac, communi- 
cati ng with the 
esophagus by means of 
the cardiac orifice (see 
V\g. 28). It is situated obliquely with reference to the body," 
its base lying at the left side, while the apex is directed toward 
the right side. The stomach is between the liver and spleen, 
subjacent to the diaphragm, and communicates with the intes- 
tinal canal by the jDyloric orifice. It has three coats. The 
peritoneal, or external coat is composed of compact, cellular 
tissue, woven into a thin, serous membrane, and assists in 
keeping the stomach in place. The middle coat is formed of 
three layers of muscular fibers: in the first, the fibres run 




A roprpsentation of the interior of the stomach. 
1. The esophagus. 2. Cardiac orifice opening into 
the stomach. 6. The middle or muscular coat. 
7. The interior or mucous coat. 10. The begin- 
ning of the duodenum. 11. The pjloric orifice. 



40 



COMMON SENSE MEDICAL ADVISER. 



longitiiclinally; in the second, in a circular direction; and in the 
third, they are placed obliquely to the others. The interior, 
or mucous coat, lines this organ. The stomach has a soft, 
spongy appearance, and, when not distended, lies in folds. Dur- 
ing life, it is ordinarily of a pinkish color. It is provided with 
numerous small glands, which secrete the gastric fluid necessary 
for the digestion of food. Tlie lining membrane, when divested 
of mucus, has a wrinkled appearance. The arteries, veins, and 
lymphatics, of the stomach are numerous. 

The Intestines are those convoluted portions of the alimentary 
canal into which the food is received after being partially 

digested, and in which the 
separation and absorption of 
the nutritive materials and the 
removal of the residue take 
place. The coats of the intes- 
tines are analogous to those of 
the stomach, and are, in fact, 
only extensions of them. For 
convenience of description, the 
intestines may be divided into 
the small and the large. The 
small intestine is from twenty 
to twenty-five feet in length, 
and consists of the Duodenum, 
Jejunum, and Ileum, The Duo- 
denum, so called because its 
length is equal to the breadth 
of twelve fingers, is the first 
division of the small intestine. 
If the mucous membrane of 
the duodenum be examined, it 
Avill be found thrown into 
numerous folds, which are 
called valvulce conniventes, the 
chief function of which ap- 
pears to be to retard the course of the alimentary matter, and 
afford a larger surface for the accommodation of the absorbent 
vessels. Numerous villi, minute thread-like projections, will be 




Small and large intestines, i, i, ?, 2. 
Small intestine. 3. Its termination in the 
larfie intestine. '•. Appendix vermi- 
formis, 5, Ctecum. C. Aseendinj? colon. 
7. Tran8\'er8e colon. 8. Descending- colon. 
9, Sigmoid flexure of colon, 10. Rectum. 



THE DIGESTIVE ORGAHS. 



41 



NviSUua 




Villi of the small intestine greatly 
maffnifled. 



found scattered over the surface of these folds, set side by side, 
like the pile of velvet. Each villus contains a net-work of 
blood-vessels, and a lacteal tube, into which the ducts from the 
liver and pancreas open, and pour their secretions to assist in the 

conversion of the chyme into 
Fig. 30. chyle. The Jejunnm, so 

named because it is usually 
found empty after death, is a 
continuation of the duode- 
num, and is that portion of 
the alimentary canal in Avhich 
the absorption of nutritive 
matter is chiefly effected. 
The Ileum, which signifies 
something rolled up, is the 
longest division of the small 
intestine. Although some- 
what thinner in texture than 
the jejunum, yet the differ- 
ence is scarcely perceptible. The large intestine is about five 
feet in length, and is divided into the Caecum, Colon, and 
Rectum. The CcBcum is about three inches in length. Between 
the large and the small 

intestine is a valve, which Fig. 31. 

prevents the return of cx- 
crementitious matter that 
lias passed into the large 
intestine. There is attaclied 
to the caecum an appendage 
about the size of a goose- 
quill, and three inches in 
length, termed the appen- 
dix vermiformis. The Co- 
lon is that part of the large 
intestine which extends 
from the crecum to the 
rectum, and Avhich is di- 
vided into three parts, dis- 
tinguished as the ascending, the transverse, and the descending. 




A section of the Ileum, turned inside out, 
so as to show the appearance and arrang-e- 
ment of the ^illi on an extended surface. 



42 



COMMON" SENSB MBmOAT, ADVISKR. 



The Recttitn is the terminus of the large intestine. The intes- 
tines are abundantly supplied with blood-vessels. The arteries 
of the small intestine are from fifteen to twenty in number. 
The large intestine is furnished with three arteries, called the 
colic arteries. The ileo-colic artery sends branches to the lower 

part of the ileum, the head 
of the colon, and the ap- 
pendix vermiformis. The 
right colic artery forms 
arches, from which branches 
are distributed to the as- 
cending colon. The colica 
media separates into two 
branches, one of which is 
sent to the right portion of 
the transverse colon, the 
other to the left. In its 
course, the superior hemor- 
rhoidal artery divides into 
two branches, which enter 
the intestine from behind, 
and embrace it on all sides, 
almost to the anus. 

The Thoracic Duct is the 
principal trunk of the ab- 
sorbent system, and the canal 
through which much of the 
chyle and lymph is conveyed 
to the blood. It begins by a 
■ rr convergence and union of the 

c, c. HiK^lit and loft snhelavian veins, h. lymphatics On the lumbar 
Inferior vena cava. a. Intestines, d. En- i. u „ • r ^ r ^u 

*• +».. *\.r^cri. 1,.,^ i„fr. < ».„ laff vorteDrse, in front of the 
trance of the thoracic duet into the leit ' 

subclavian vein. A. Mesenteric glands, SJ)inal column, then paSSeS 
tlnough which the lacteals pass t^ the ^ ,^,^,.j through the dia- 
tlioracie duct. ^ ® 

phragm to the lower part of 
the neck, thence curves forward and downward, opening into 
the subclavian vein near its junction with the left jugular vein, 
which leads to the heart. 

The Liver, Avhich is the largest gland in the body, weighs 




THE DIGESTIVE ORGANS. 



43 




about four pounds in the adult, and is located chiefly on the 
right side, immediately below the diaphragm. It is a single 
organ, of a dark red color, its upper surface being convex, while 
the lower is concave. It has two large lobes, the right being 
nearly four times as large as the left. The liver has two coats, 
the serous, which is a complete investment, with the exception 
of the diaphragmatic border, and the depression for the gall- 
bladder, and which 

helps to suspend and J<^g, S3, 

retain the organ in 
position; and the 
fibrous, which is the 
inner coat of the liver, 
and forms sheaths for 
the blood-vessels and 
excretory ducts. The 
liver is abundantly 
supplied with arteries, 
veins, nerves, and lym- 
phatics. Unlike tlie 
other glands of the 
human body, it re- 
ceives two kinds of blood; the arterial for its nourishment, and 
the venous, from which it secretes the bile. In the lower 
surface of the liver is lodged the gall-bladder, a membranous 
sac, or reservoir, for the bile. This fluid is not absolutely 
necessary to the digestion of food, since this process is efl'ected 
by other secretions, nor does bile exert any special action upon 
starchy or oleaginous substances, when mixed with them at a 
temperatui'e of 100° F. Experiments also show that in some 
animals there is a constant flow of bile, even when no food has 
been taken, and there is consequently no digestion to be per- 
formed. Since the bile is formed from the venous blood, and 
taken from the waste and disintegration of animal tissue, it 
would appear that it is chiefly an excrementitious fluid. It does 
not seem to have accomplished its function when discharged from 
the liver and poured into the intestine, for there it undergoes 
various alterations previous to re-absorption, produced by its con- 
tact with the intestinal juices. Thus the bile, after being 



The inferior surface of the liver. 1. Right lobe. 
2. Left lobe. 3. Gall-bladder. 



44 



COMMON 6BN8K MBDIOAL ADVISEB. 



transformed in the intestines, re-enters the blood under a 
new form, and is carried to some other part of the system 

to perfonn its mission. 
Fig.SJ^. rpjjg ^Sp/em is oval, 

smooth^ convex on its 
external, and irregularly 
concave on its internal, 
surface. It is situated 
on the left side, in con- 
tact with the diaphragm 
and stomach. It is of a 
dark red color, slightly 
tinged with blue at its 
edges Some physiolo- 
gists affirm that no 
organ receives a greater 
quantity of blood, ac- 
cording to its size, than 
the spleen. The struc- 
ture of the spleen and 
that of the mesenteric 
glands are similar, al- 
though the former is 
provided with a scanty 
supply of lymphatic ves- 
sels, and the chyle does 
not pass through it, as 
through the mesenteric 
glands. The Pancreas 
lies behind the stomach, 
and extends transversely 
across the spinal column 
to the right of the spleen. 
It is of a pale, pinkish 
color, and its secretion is 
analogous to that of the 
salivary glands; hence it 
has been called the Abdominal Salivary Gland. 

Digestion is effected in those cavities which we have described 




Dig-ostive organs. 3. The tongue. 7. Tarotld 
gland. 8. Sublingual gland. 5. Esophagus. .<>. 
Stomach. W. Liver. U. (Jiill-bladdor. V>. Pan- 
creas. i3, n. The duodeiuun. Tlu^ small and 
large intestines are represented below the 
stomach. 



THE DIGESTIVE ORGANS. 45 

as parts of the alimentary canal. The food is first received 
into the mouth, where it is masticated by the teeth, and, 
after being mixed with mncus and saliva, is reduced to a 
mere pulp; it is then collected by the tongue, which, aided by 
the voluntary muscles of the throat, carries the food backward 
into the pharynx, and, by the action of the involuntary muscles 
of the pharynx and esophagus, is conveyed to the stomach. 
Here the food is subjected to a peculiai', churning movement, by 
the alternate relaxation and contraction of the fibers which 
compose the muscular wall of the stomach. As soon as the 
food comes in contact with the stomach, its pinkish color 
changes to a bright red; and from the numerous tubes upon its 
inner surface is discharged a colorless fluid, called the gastric 
juice, which mingles with the food and dissolves it. When the 
food is reduced to a liquid condition, it accumulates in the 
pyloric portion of the stomach. Some distinguished physiolo- 
gists believe that the food is kept in a gentle, unceasing, but 
peculiar motion, called peristaltic, since the stomach contracts 
in successive circles. In the stomach the food is arranged in a 
methodical manner. The undigested portion is detained in the 
upper, or cardiac extremity, near the entrance of the esophagus, 
by contraction of the circular fibers of the muscular coat. 
Here it is gradually dissolved, and then carried into the pyloric 
portion of the stomach. From this, then, it appears, that the 
dissolved and undissolved portions of food occupy diilerent 
parts of the stomach. After the food has been dissolved by 
the gastric fluid, it is converted into a homogeneous, semi-fluid 
mass, called chyme. This substance passes from the stomach 
through the pyloric orifice into the duodenum, in which, by 
mixing with the bile and pancreatic fluid, its chemical properties 
are again modified, and it is then termed chyle, which has been 
found to be composed of three distinct parts, a reddish-brown 
sediment at the bottom, a whey-colored fluid in the middle, and 
a creamy film at the top. Chyle is different from chyme in two 
respects: First, the alkali of the digestive fli^ids, poured into 
the duodenum, or upper part of the small intestine, neutralizes 
the acid of the chyme; secondly, both the bile and the pancre- 
atic fluid seem to exert an influence over the fatty substances 
contained in the chyme, which assists the subdivision of these 



46 COMMON SENSE MEDICAL ADVISER. 

fats into minute particles. While the chyle is propelled along 
the small intestine by the peristaltic action, the matter which it 
contains in solution is absorbed in the usual manner into the 
vessels of the villi by the process called osmosis. The fatty 
matters being subdivided into very minute particles, but not 
dissolved, and consequently incapable of being thus absorbed 
by osmosis, pass bodily through the epithelial lining of the 
intestine into the commencement of the lacteal tubes in the 
villi. The digested substances, as they are thrust along the 
small intestines, gradually lose their albuminoid, fatty, and solu- 
ble starchy and saccharine matters, and pass througli the 
ileo-cfecal valve into the caecum and large intestine. An acid 
reaction takes place here, and they acquire the usual ftecal smell 
and color, which increases as they approach the rectum. Some 
physiologists have supposed that a second digestion takes place 
in the upper portion of the large intestine. The lacteals, filled 
with chyle, jjass into the mesenteric glands Avith which they 
freely unite, and afterward enter the receptaculum chyli^ which 
is the commencement of the thoracic duct, a tube of the size of 
a goose-quill, wliich lies in front of the backbone. The lym- 
phatics, the function of which is to secrete and elaborate lymph, 
also terminate in the receptaculum chyli, or recei)tacle for the 
chyle. From this reservoir the chyle and lymph flow into the 
thoracic duct, through which they are conveyed to the left 
subclavian vein, there to be mingled with venous blood. The 
blood, chyle, and lymph, are then transmitted directly to the 
lungs. 

The process of nutrition aids in the development and 
growth of the body; hence it has been aptly designated a 
"perj)etual reproduction." It is the jDroccss by which every 
part of the body assimilates portions of the blood distributed 
to it. In return, the tissues yield a portion of tlie material 
which was once a component part of their organization. The 
body is constantly undergoing waste as well as repair. One 
of the most interesting facts in regard to the process of 
nutrition in animals and plants is, that all tissues originate in 
cells. In the higher types of animals, the blood is the source 
from which the cells derive their constituents. Although 
the alimentary canal is more or less complicated in different 



THE DIGESTIVE ORGANS. 47 

classes of animals, yet there is no species, however low in 
the scale of organization, which does not possess it in some 
form.* The little polyp has only one digestive cavity, which 
is a pouch in the interior of the body. In some animals circu- 
lation is not distinct from digestion, in others respiration and 
digestion are performed by the same organs; but as we rise 
in the scale of animal life, digestion and circulation are accom- 
plished in separate cavities, and the functions of nutrition 
become more complex and distinct. 



♦The males of Cryptophialus and Alcippe, species of marine animals, are ap- 
parent exceptions to this rule. They are parasitic, possess neither mouth, stomach, 
thorax, nor abdomen, and are, nccessarDy, short-lived. 



CHAPTER V. 



PHYSIOLOGICAL ANATOMY. 



ABSORPTION. 

Absorption is the vital function by which nutritive materials 
are selected and imbibed for the sustenance of the body. Ab- 
sorption, like all other functional processes, employs agents to 
effect its purposes, and the villi of the small intestine, with 

their numberless projecting 
I*tg. 35. organs, are specially em- 

ployed to imbibe fluid sub- 
stances; this they do with a 
celerity commensurate to the 
importance and extent of 
their duties. They are little 
vascular prominences of the 

JVflH I I l(^^^ I mucous membrane, arising 
BJQb I / I^Jc^ ^ from the interior surface of 
/mjiTO^^*-^ yv'Qi^KA wm the small intestine. Each 

villus has two sets of vessels. 
(1.) The blood-vessels, which, 
by their frequent blending, 
form a complete net-work 
beneath the external epithelium; they unite at the base of the 
villus, forming a minute vein, which is one of the sources of 
the portal vein. (2.) In the center of the villus is another 
vessel, with thinner and more transparent walls, which is the 
commencement of a lacteal. 

The Lacteah origirate in the walls of the alimentary canal, 
48 




Villi of the email intestine gi-eatly 
magnified. 



ABSOKPTION. 49 

are very numerous in the small intestine, and, passing between 
the laminae of the mesentery, they terminate in the receptacidum 
chyli, or reservoir for the chyle. The mesentery consists of a 
double layer of cellular and adipose tissue. It incloses the 
blood-vessels, lacteals, and nerves of the small intestine, to- 
gether with its accessory glands. It is joined to the posterior 
abdominal wall by a narrow root ; anteriorly, it is attached to 
the whole length of the small intestine. The lacteals are known 
as the absorbents of the intestinal walls, and after digestion is 
accomplished, are found to contain a white, milky fluid, called 
chyle. The chyle does not represent the entire product of 
digestion, but only the fatty substances suspended in a serous 
fluid. 

Formerly, it was supposed that the lacteals were the only 
agents employed in absorption, but more recent investigations 
have shown that the blood-vessels participate equally in the 
process, and are frequently the more active and important of 
the two. Experiments upon living animals have proved that 
absorption of poisonous substances occurs, even when all com- 
munication by way of the lacteals and lymphatics is obstructed, 
the passage by the blood-vessels alone remaining. The absor- 
bent power which the blood-vessels of the alimentary canal 
possess, is not limited to alimentary substances, but through 
them, soluble matters of almost every description are received 
into the circulation. 

The Lymphatics are not less important organs in the process 
of absorption. Nearly every part of the body is permeated by a 
second series of capillaries, closely interlaced with the blood- 
vessels, collectively termed the Lymphatic System,. Their 
origin is not known, but they appear to form a lylexus in the 
tissues, from which their converging trunks arise. They are 
composed of minute tubes of delicate membrane, and from their 
net-work arrangement they successively unite and finally ter- 
minate in two main trunks, called the great lymphatic veins. 
The lymphatics, instead of commencing on the intestinal walls, 
as do the lacteals, are distributed through most of the vascular 
tissues as well as the skin. The lymphatic circulation is not 
unlike that of the blood; its circulatory apparatus is, however, 
piore delicate, and its functions are not so well understood. 
3 



50 



COMMON SKNSK MEDICAL, ADVISER. 



Mg. 36. 




A greneral view of the Lymphatic System. 



ABSORPTION. 



51 



Fig. 81. 



The lymph which circulates through the lymphatic vessels 
is an alkaline fluid composed of a plasma and corpuscles. It 
may be considered as blood deprived of its red corpuscles and 
diluted with water. Nothing very definite is known respecting 
the functions of this fluid. A large proportion of its constit- 
uents is derived from the blood, and the exact connection of 
these substances to nutrition is not properly understood. Some 
excrementitious matters are sup- 
posed to be taken from the tissues 
by the lymph and discharged 
into the blood, to be ultimately 
removed from the system. The 
lymph accordingly exerts an im- 
portant function by removing a 
portion of the decayed tissues 
from the body. 

In all animals which possess a 
lacteal system there is also a 
lymphatic system, the one being 
the complement of the other. 
The fact that lymph and chyle 
are both conveyed into the 
general current of circulation, 
leads to the inference that the 
lyraph, as well as the chyle, 
aids in the process of nutrition. 
The body is continuall}^ under- 
going change, and vital action 

implies waste of tissues, as Avell as their growth. Those organs 
which are the instruments of motion, as the muscles, cannot 
be employed without wear and waste of their component parts. 
Renovated tissues must replace those which are worn out, and 
it is a part of the function of the absorbents to convey nutritive 
material into the general circulation. Researches in micros- 
copical anatomy have shown that the skin contains multitudes 
of lymphatic vessels and that it is a powerful absorbent. 

Absorption is one of the earliest and most essential functions 
of animal and vegetables tissues. The simpler plants consist of 
only a few cells, all of which are employed in absorption; but 




1. A representation of a lymphatic 
vessel highly magnified. 2. Lymphatic 
valves. 3. A lymphatic gland and its 

vessels. 



52 COMMON SENSE MEDICAL ADVISER. 

in the flowering plants this function is performed by the roots. 
It is accomplished on the same general principles in animals, 
yet it presents more modifications and a greater number of 
organs than in vegetables. While animals receive their food 
into a sac, or bag called the stomach, and are provided with 
absorbent vessels such as nowhere exist in vegetables, plants 
plunge their absorbent organs into the earth, whence they derive 
nourishing substances. In the lower order of animals, as in 
sponges, this function is performed by contiguous cells, in a 
manner almost as elementary as in plants. In none of the 
invertebrate animals is there any special absorbent system. 
Internal absorption is classified by some authors as follows: 
iiiterstitial, recrementitial, and excrementitial ; by others as acci- 
dentaly venous, and cutaneous. The general cutaneous and 
mucous surfaces exhale, as well as absorb ; thus the skin, by 
means of its sudoriferous glands, exhales moisture, and is at the 
same time as before stated, a powerful absorbent. The mucous 
surface of the lungs is continually throwing off carbonic acid 
and absorbing oxygen; and through their surface poisons are 
sometimes taken into the blood. The continual wear and waste 
to which living tissues are subject, makes necessary the provision 
of such a system of vessels for conveying away the worn-out 
materials and supplying tlie body with new. 



CHAPTER VI. 

PHYSICAL AND VITAL PROP- 
ERTIES OF THE BLOOD. 



Blood is the animal fluid by which the tissues of the Lody 
are nourished. This pre-eminently vital fluid permeates every 
organ, distributes nutritive material to every texture, is essen- 
tially modified by respii*ation, and, finally, is the source of every 
secretion and excretion. Blood has four constituents: Fibrin, 
Albumen, Salts (which elements, in solution, form the liquor 
sanguinis), and the Corpuscles. Microscopical examination 
shows that the corpuscles are of two kinds, known as the red 
and the white, the former being 

by far the more abundant. Fig. 38. 

They are circular in form and 
have a smooth exterior, and are 
on an average ^-jVo P^^^'^ ^^ 
an inch in diameter, and are 
about one-fourth of that in 
thickness. Hence more than ten 
millions of them may lie on a 
space an inch square. If spread 
out in thin layers and subjected 
to transmitted light, they pre- 
sent a slightly yellowish color, 
but when crowded together and 
viewed by refracted light, ex- 
hibit a deep red color. These blood-corpuscles have been 
termed discs, and are not, as some have supposed, solid material, 
but are very nearly fluid. The red corpuscles, although 

53 





Red cori'uscles of human blood, rep- 
resented at a, as they are seen when 
rather beyond the focus of the micros- 
cope; and at b as they appear when 
vyithin the focus. Magnified 400 diam- 
eters. 



54 



COMMON SENSK MEDICAL ADVISER. 




subjected to continual movement, have a tendency to approach 
one another, and when their flattened surfaces come in contact, 
so firmly do they adhere that they change their shape rather 
than submit to a separation. If separated, however, they 
return to their usual form. The colorless corpuscles are larger 
than the red and differ from them in being extremely irregular 
in their shape, and in their tendency to adhere to a smooth 
surface, while the red corpuscles float about and tumble over 
one another. They are chiefly remarkable for their continual 
variation in form. The shape of the red corpuscles is only 
altered by external influences, but the white are constantly 
undergoing alterations, the result of changes taking place 

within their own 
substance. When 
diluted \fith water 
and placed under 
the microscope they 
are found to con- 
sist of a spheroidal 
sac, containing a 
clear or granular 
fluid and a spheroid- 
al vesicle, which is 
termed the nucleus. 
They have been re- 
garded by some 
physiologists as 
identical with those 
of the lymph and 
chyle. Dr. Carpen- 
ter believes that the function of these cells is to convert albumen 
into fibrin, by the simple process of cell-growth. It is generally 
believed that the red coi-puscles ai-e derived in some way from 
the colorless. It is supposed that the red corpuscle is merely 
the nucleus of a colorless corpuscle enlarged, flattened, colored 
and liberated by the bursting of the wall of its cell. When 
blood is taken from an artery and allowed to remain at rest, it 
separates into two parts: a solid mass, called the clot, largely 
composed of fibrin; and a fluid known as the serum^ in which 





Development of human lymph and chyle-corpuscles 
into red corpuscles of blood. A. A lymph, or white 
blood-cori)U8cle. B. The same in ])roccss of conversion 
into a red corpuscle. C. A lymph-eorpuscle with the 
cell-wall raised up around it by the action of water. D. 
A lymph-cor|>uscle, from which the granules have 
almost disappeared. !<>'. A lymph-corpuscle, acquiring' 
color; asing'le g:nunil(", like a nucleus, remains. F. A 
red corpuscle fully developed. 



Physical and vital properties of the blood. r,r) 

the clot is suspended. This process is termed coagulation. The 
serum, mostly composed of albumen, is a transparent, straw- 
colored fluid, having the odor and taste of blood. The whole 
quantity of blood in the body is estimated on an average 
to be about one-nhith of its entire weight. The distinctions 
between the arterial and the venous blood are marked, since in 
the arterial system the blood is uniformly bright red, and in the 
venous of a very dark red color. The blood-corpuscles contam 
both oxygen and carbonic acid in solution. When carbonic acid 
predominates, the blood is dark i-ed; when oxygen, scarlet. In 
the lungs, the corpuscles give up carbonic acid, and absorb a 
fresh supply of oxygen, while in the general circulation the 
oxygen disappears in the process of tissue transformation, and is 
replaced, in the venous blood, by carbonic acid. The nutritive 
portions of food are converted into a homogeneous fluid, which 
pervades every part of the body, is the basis of every tissue, 
and which is termed the blood. This varies in color and com- 
position in different animals. In the polyp the nutritive fluid 
is known as chyme, in many mollusks, as well as articulates, 
it is called chyle, but in vertebrates, it is more highly organized 
and is called blood. In all the higher animal types it is of a 
red color, although redness is not one of its essential qualities. 
Some tribes of animals possess true blood, Avhicli is not red; thus 
the blood of the insect is colorless and transparent; that of the 
reptile yellowish; in the fish the principle part is without color, 
but the blood of the bird is deep red. The blood of the 
mammalia is of a bright scarlet hue. The temperature of the 
blood vai'ies in different species, as well as in animals of 
the same species under different physiological conditions; for 
this reason, some animals are called cold-blooded. Disease also 
modifies the temperature of the blood ; thus in fevers it is 
generally increased, but in cholera greatly diminished. The 
blood has been aptly termed the "vital fluid," since there is 
a constant flow from the heart to the tissues and organs of 
the body, and a continual return after it has circulated 
through these parts. Its presence in every part of the body 
is one of the essential conditions of animal life, and is effected 
by a special set of organs, called the circidatory organs. 



CHAPTER VII. 



PHYSIOLOGICAL ANATOMY. 



CIRCULATORY ORGANS. 



Having considered the formation of chyle, traced it through 
the diojestive process, seen its transmission into the vena cava, 
and, finally, its conversion into blood, we shall now describe how 
it is distributed to every part of the system. This is accom- 
plished through organs which, from the round of duties they 
perform, are called circulatory. These are the Heart, Arteries, 
Veins, and Capillaries, which constitute the vascular system. 

Within the thorax or chest of the human body, and enclosed 
within a membranous sac, called the pericardium, is the great 
force-pump of the system, the heart. This organ, to which all 
the arteries and veins of the body may be either directly or 
indirectly traced, is roughly estimated to be equal in size to 
the closed fist of the individual to whom it belongs. 

It has a broad end turned upwards, and a little to the right 
side, termed its base; and a pointed end called its apex, turned 
downwards, forwards, and to the left side, and lying beneath a 
point about an inch to the right of, and below, the left nipple, 
or just below the fifth rib. Attached to the rest of the body 
only by the great blood-vessels which issue from and enter it 
at its base, the heart is the most mobile oi'gan in the economy, 
being free to move in different directions. 

The heart is divided into two great cavities by a fixed parti- 
tion, which extends from the base to the apex of the organ, 
and which prevents any direct communication between them. 
Each of these great cavities is further subdivided transversely 
56 



CIBCULATOKY ORGANS, 



57 



by a movable partition, the cavity above each transverse parti- 
tion being called the auricle, and the cavity below, the ventricle, 
right or left, as the case may be. 

The walls of the auricles are much thinner than those of the 
ventricles, and the wall of the right ventricle is much thinner 
than that of the 

left, from the fact Fig. Jfi. 

that the ventricles 
have moi-e work 
to perform than 
the auricles, and 
the left ventricle 
more than the 
right. 

In structure, 
the heart is com- 
posed almost 
entirely of mus- 
cular fibers, which 
are arranged in a 
very complex and 
wonderful man- 
ner. The outer 
surface of the 
heart is covered 
with the pericar- 
d i um, which 

closely adheres to the muscular substance. Inside, the cavities 
are lined with a thin membrane, called the endocardium. At 
the junction between the auricles and ventricles, the aper- 
tures of communication between their cavities are strengthened 
by fibrous rings. Attached to these fibrous rings are the 
movable partitions or valves, between the auricles and the 
ventricles, the one on the right side of the heart being called 
the tricuspid valve, and the one on the left side the mitral 
valve. A number of fine, but strong, tendinous chords, called 
chordm tendinecB, connect the edges and apices of these valves 
with column-like elevations of the fleshy substance of the 
walls of the ventricles, called columncB carnece. 




General view ol the heart and lungs, t. Trachea, or 
wind-pipe. a. Aorta. p. Pulmonary artery. 1, 2. 
Branches of the puhnonai-y ai-tery, one going' to the 
right, the other to the left lung. h. The heart. 



COMMON SENSK MEDICAL, ADVISEK. 




The valves are so arranged tliat they present no obstacle 
to the free flow of blood from the auricles into the ven- 
tricles, but if any is forced 
the other way, it gets between 
the valve and the wall of the 
heart, and drives the valve 
backwards and upwards, thus 
foi-ming a transvei-se partition 
between the auricle and ventri- 
cle, through which no fluid can 
pass. 

At the base of the heart are 
given off two large arteries, one 
on the right side, which conveys 
the blood to the lungs, called 
the lyuhnonary artery^ and one 
on the left side, which conveys 

1. The descending vena cava. 2. the blood to the system in gen- 
The ascending vena cava. 3. The , n a ..i . a ^ .i 

right auricle. 4. The opening be- ^''^l' ca^^ed the aoHa. At the 

tween the right auricle and the right junction of each of these great 
ventricle. 5. The right ventricle. G. i -xi -^ i- 

The tricuspid valves. 7. The pui- ^'^ssels With its corresponding 

monary artery, s, 8. The branches ventricle, is another valvular 

of the pulmonary artery which pas.s „„,.„„„tu<? consisfinty of thVee 
to the right and the left lung. 9. The apparaius, consisting oi tnree 

semilunar valves of the pulmonary pouch-like Valves, called the 
artery. 20. The septum between the ^g,,,,-;,,,,^^ valves, iro^ their 
two ventricles ot the heart. 11, 11. _ ' 
The pulmonary veins. 7~'. The left resemblance, ill sliape, to a half- 
auricle. IS. The opening between ^^^^^^^ ^^- placed On a level 
the left auricle and ventricle. Hi. . . , 

The left ventricle. 15. The mitral and meeting in the middle line, 
valves. 16, 16. The aorta. 17. The ^]^^,y entirely prevent the passage 
semilunar valves of the aorta. '^ ,i • i i • i ■, n ■, 

of any fluid which may be forced 

along the artery towards the heart, but, flappmg back, they 
offer no obstruction to the free flow of blood from the 
ventricles into the arteries. 

The Arteries, being always found empty after death, were 
supposed by the ancients, who were ignorant of the circulation 
of the blood, to be tubes contaming air; hence their name, 
which is derived from a Greek word and signifies an air-tube. 
Arteries are the cylindi-ical tubes which carry blood to every 
part of the system. All the arteries, except the coronary 



CIRCULATORY ORGAJSTS. 



59 



which supply the substance of the heart, arise from the two 
main trunks, the pulmonary artery and the aorta. They are 
of a yellowish-white color, and their inner surface is smooth. 
The arteries have three coats. (1.) The external coat, which 
is destitute of fat, and comj)osed chiefly of cellular tissue, 
is very firm and elastic, and can readily be dissected from 
the middle coat. (2.) 



Fig. J,2, 



The middle, or fibrous 
coat, is thicker than 
the external, and 
composed of yellow- 
ish fibers, its chief 
property is con- 
tractility. (3.) The 
internal coat consists 
of a colorless, thin, 
transparent mem- 
brane, yet so strong 
that it can, it is 
thought, better resist 
a powerful pressure 
than either of the 
others. Arteries are 
very elastic as well 
as extensible, and 
their chief extensi- 
bility is in length. 
If an artery of a 
dead body be di- 
vided, although 
empty, its cylindrical 
form will be pre- 
served. 

The Veins are the 
vessels through which the venous blood returns to the auricles 
of the heart. They are more numerous than the arteries, and 
originate from numerous capillary tubes, while the arteries are 
given off from main trunks. In some parts of the body, 
the veins correspond in number to the arteries; while in 




A representation of the venous and arterial 
circulation of the blood. 



60 COMMON SENSE MEDICAL, ADVISER. 

others, there are two veins to every artery. The veins com- 
mence by minute roots in the capillaries, which are everywhere 
distributed through the body, and gradually increase in size, 
until they unite and become large trunks, conveying the dark 
blood to the heart. The veins, like the arteries, have three 
coats. The external, or cellular coat, resembles that of the 
arteries; the middle is fibrous, but thinner than the corre- 
sponding one of the arteries; and the internal coat is serous, 
and analogous to that of those vessels. The veins belong 
to the three following classes: (1.) The systemic veins, which 
bring the blood from different parts of the body and discharge 
it into the vena cava, by means of which it is conveyed 
to the heart; (2), the pulmonary veins, which bring the arterial, 
or bright red blood from the lungs and carry it to the left 
auricle; (3), the veins of the portal system, which originate 
in the capillaries of the abdominal organs, then converge into 
trunks and enter the liver, to branch off again into divisions 
and subdivisions of the minutest character. 

The Capillaries form an extremely fine net-work, and are 
distributed to every part of the body. They vary in diameter 
from -^-^^-^ to Tj^V^ ^^ ^'^ inch. They are so universally 
prevalent throughout the skin, that the puncture of a needle 
would wound a large number of them. These vessels receive 
the blood and bring it into intimate contact with the tissues, 
which take from it the principal part of its oxygen and other 
elements, and give up to it carbonic acid and the other waste 
products resulting from the transformation of the tissues, 
which are transmitted through the veins to the heart, and 
thence by the arteries to the lungs and various excretory 
organs. 

The blood from the system in general, except the lungs, is 
poured into the right auricle by two large veins, called the 
superior and the inferior vena cava; and that returning from 
the lungs is poured into the left auricle by the jpulnionary 
veins. 

During life the heart contracts rhythmically, the contractions 
commencing at the base, in each auricle, and extending towards 
the apex. 

Now it follows, from the anatomical arrangement of this 



CIRCULATORY ORGANS. 61 

organ, that when the auricles contract, the blood contained in 
them is forced through the auriculo-ventricular openings into 
the ventricles; the contractions then extending to the ventricles, 
in a wave-like manner, the great proportion of the blood, being 
prevented from re-entering the auricles by the tricuspid and 
mitral valves, is forced onward into the pulmonary artery from 
the right ventricle, and into the aorta from the left ventricle. 

When the contents of the ventricles are suddenly forced into 
these great blood-vessels, a shock is given to the entire mass of 
fluid which they contain, and this shock is speedily propagated 
along their branches, being known at the wrist as the pulse. 

On inspection, between the fifth and sixth ribs on the left 
side of the chest, a movement is perceptible, and, if the hand 
be applied, the impulse may be felt. This is known as the 
throbbing, or beating of the heart. 

If the ear is j^laced over the region of the heart, certain 
sounds are heard, which recur with great regularity. First 
is heard a comparatively long, dull sound, then a short, sharp 
sound, then a pause, and then the long, dull sound again. 
The first sound is caused mainly by the tricuspid and mitral 
valves, and the second is the result of sudden closux-e of the 
semilunar valves. 

No language can adequately describe the beauty of the 
circulatory system. The constant vital flow through the larger 
vessels, and the incessant activity of those so minute that they 
are almost imperceptible, fully illustrate the perfectness of the 
mechanism of the human body, and the wisdom and goodness 
of Him who is its author. 

Experiments have shown that the small arteries may be 
directly influenced through the nervous system, which regulates 
their caliber by controlling the state of contraction of their 
muscular walls. The effect of this influence of the nervous 
system enables it to control the circulation over certain areas; 
and, notwithstanding the force of the heart and the state of 
the blood-vessels in general, to materially modify the circula- 
tion in different spots. Blushing, which is simply a local 
modification of the circulation, is effected in this way. Some 
emotion takes possession of the mind, and the action of the 
nerves, which ordinarily keep up a moderate contraction of 



(52 COMMON SeJTSK medical ADVlSElt; 

the muscular coats of the arteries, is lost, and the vessels relax 
and become distended with arterial blood, which is a warm 
and bright red fluid; tliereupon a burning sensation is felt, and 
the skin grows red, the degree of the blush depending upon the 
iutensity of the emotion. 

The pallor produced by fright and by exti'eme anxiety, is 
purely the result of a local modification of the circulation, 
brought about by an over-stimulation of the nerves which 
supply the small arteries, causing them to contract, and to thus 
cut off more or less completely the supj)ly of blood. 



CllAPTEK Vil 



PHYSIOLOQICAL ANATOMY, 



THE ORGAXS OF RESPIRATION. 

The Organs of Respiration are the Trachea, or 
windpipe, the Bronchia, foi'med l>y the subdivision of the 
trachea, and the Lungs, with their air-cells. The Trachea is a 
vertical tube situated between the lungs below, and a short 
quadrangular cavity above, called the larynx^ which is "part 
of the windpipe, and used for the purpose of modulating the 
voice in speaking or singing. In the adult, the trachea, in 
its unextended state, is from four and one-half to five inches 
in length, about one inch in diameter, and, like the larynx, is 
more fully developed in the male than in the female. It is 
a fibro-cartilaginous structure, and is composed of flattened 
rings, or segments of circles. It permits the free passage of 
air to and from the lungs. 

The Mronchia are two tubes, or branches, one proceeding 
from the windpipe to each lung. Upon entering the lungs, 
they divide and subdivide until, finally, they terminate in 
small cells, called the hronchial or air-cells, which are of a 
membranous character. 

The Xitmys are irregular conical organs rounded at the apex, 
situated within the chest, and filling the greater part of it, since 
the heart is the only other organ which occupies much space 
in the thoracic cavity. The lungs are convex externally, and 
conform to the cavity of the chest, while the internal surface 
is concave for the accommodation of the heart. The size of 
the lungs depends upon the capacity of the chest. Their 

63 



64 



COMMON SENSE MEDICAJL ADVISER. 



color varies, being of a pinkish hue in cliiklhood but of a 
gray, mottled appearance in the adult. They are termed the 
right and left lung. Each lung resembles a cone with its base 
resting upon the diaphragm, and its apex behind the collar- 
bone. The right lung is larger though shorter, than the left, 

not extending 
Fiy. JfS. so low, and has 

three lobes, 
formed by deep 
fissures, or lon- 
gitudinal divi- 
sions, while the 
left has but two 
lobes. Each 
lobe is also 
made up of 
numerous lob- 
ules, or small 
lobes, connect- 
ed by cellular 
tissue,and these 
contain great 
n u ra b er s of 
cells. The 
lungs are abun- 
dantly supplied 
with blood- 

An ideal representation of the respii-atory organs. S. The vessels, lym- 
larynx. A. The trachea. 5, C. The hrouchia, 9, 9,9, 9. Air- pj^g^tigg ^jl^ 

nerves. The 




cells. 1, 1, 1, 2, 2, 2. Outlines of the lungB. 



density of a lung depends upon the amount of air which it 
contains. Thus, experiment has shown that in a foetus which 
has never breathed, the lungs are aompact and will sink in 
water; but as soon as they become inflated with air, they 
spread over a larger surface, and are therefore more buoyant. 
Each lung is invested, as far as its root, with a membrane, 
called the pleura, which is then continuously extended to the 
cavity of the chest, thus performing the double office of lining 
it, and constituting a partition between the lungs. The part 



THE OEGANS OF EES?lRAT10If. 



65 



of the membrane which forms tliis partition is termed the 
mediastinum. Inflammation of this membrane is called 
pleurisy. The lungs are held in position by the root, which 
is formed by the pulmonary arteries, veins, nerves, and the 
bronchial tubes. Respiration is the function by which the 
venous blood, conveyed to the lungs by the pulmonary artery, 
is. converted into arterial blood. This is effected by the 
elimination of carbonic 

acid, which is expired Fig. JfJt' 

or exhaled from the 
lungs, and by the ab- 
sorption of oxygen 
from the air which is 
taken into the lungs, 
by the act of inspira- 
tion or inhalation. 
The act of expiration 
is performed chiefly by 
the elevation of the 
diaphragm and the de- 
scent of the ribs, and 
inspiration is princi- 
pally effected by the 

\. £ 1, J • representation of the heart and lungs. !*. The 

descent or the dia- heart. 5. The pulmonary artery. S. Aorta. 9,11. 

phragm and the eleva- Upper lotes of the lungs. lO, is. Lower lobes. IS. 

,. f 1 .-, Middle lobe of the right lung. 2. Superior vena 

tion or tne riDS. cava. 3. inferior vena cava. 

When the muscles 
of some portions of the air-passages are relaxed, a peculiar 
vibration follows, known as snoring. Coughing and sneez- 
ing are sudden and spasmodic expiratory efforts, and generally 
involuntary. Sighing is a prolonged deep inspiration, followed 
by a rapid, and generally audible expiration. It is remarkable 
that laughing and sobbing, although indicating opposite states 
of the mind, are produced in very nearly the same manner. 
In hiccough, the contraction is more sudden and spasmodic than 
in laughing or sobbing. The quantity of oxygen consumed 
during sleep is estimated to be considerably less than that 
consumed during wakefulness. 

It is difficult to estimate the amount of air taken into the 




66 



COMMON SENSK MKDlCAL ADVISRR. 



lungs at each inspiration, as tlie quantity varies according to 
the condition, size, and" expansibility of the chest, but in 
ordinary breathing it is supposed to be from twenty to thirty 
cubic inches. Tlie consumption of oxygen is greater when 
the temperature is low, and during digestion. All the respi- 
ratory movements, so far as they are independent of the 
will of the individual, are controlled by that part of the 
brain called the inedulla oblongata. The respiratory, or breath- 
ing process, is not instituted for the benefit of man alone, for 

we find it both 



Fig. J/i. 



in the lower 
order of ani- 
mals and in 
plant life. Na- 
t u 1- e is very 
economical in 
the arrange- 
ment of her 
plans, since the 
carbonic acid, 
which is useless 
to man, is in- 
dispensable to 
the existence of 
plants, and the 
oxygen, leject- 
ed by them, is 
appropiiated to 
his use. In the 
lower order of 
animals, the respiratory act is similar to that of the liigher 
types, though not so complex ; for there are no organs of 
respiration, as the lungs and gills are called. Thus, the higher 
the animal type, the more complex its organism. The effect 
of air upon the color of the blood is very noticeable. If a 
quantity be drawn from the body, thus being brought into 
contact with the air, its color gradually changes to a brighter 
hue. There is a marked difference between the properties of 
the venous and the arterial blood. 




View of the imlmonary circulation. 



THE ORGANS OS' KESPIRATION. 67 

The venous blood is carried, as we have previously described, 
to the right side of the heart and to the lungs, where it is 
converted into arterial blood. It is now of uniform quality, 
ready to be distributed throughout the body, and capable of 
sustaining life and nourishing the tissues. Man breathes by 
means of lungs; but who can imderstand their wonderful me- 
chanism, so perfect in all its parts ? Though every organ is 
subservient to another yet each has its own office to per- 
form. The minute air-cells are for the aeration of the blood; 
the larger bronchial tubes ramify the lungs, and suffuse them 
with air; the trachea serves as a passage for the air to and 
from the lungs, while at its upper extremity is the larynx, 
which has been fitly called the organ of the human voice. At 
its extremity we find a sort of shield, called the epiglottis, the 
office of which is supposed to be to prevent the intrusion 
of foreign bodies. 



CHAPTER IX. 



PHYSIOLOGICAL ANATOMY 



THE SKIN. 

Through digestion and respiration, tlie blood is continually 
supplied with material for its renewal; and, while the nutritive 
constituents of the food are retained to promote the growth 

of the body, those 
Fig. J/B. Av^hich are useless or in- 

jurious are in various 
ways expelled. There 
are, perhaps, few parts 
of the body more ac- 
tively concerned in this 
removal than the skin. 
The skin is a mera- 
branous envelope 
covering the entire 
body. It consists of 
two layers, termed the 
Cutis Vera, or true 
skin, and the Epi- 
dermis, or cuticle. The 
Cutis Vera is com- 
posed of fibers similar 
to those of the cellular tissue. It consists of white and yellow 
fibers, which are moie densely woven near the surface than 
deeper in the structure; the white give strength, the yellow 
68 




An idiMl vifw of tin- papillif*. 1, t. Cutis vera. 
2. ?. Papillary layer. 3, 3. Arteries of the papillic. 
A, i. Nerves of the papillaB. 5, 5. Veins of the 
papillae. 



THE SKIN. 



69 



strength and elasticity combined. The true skin may be 
divided into two layers, differing in their characteristics, and 
termed respectively the superficial or papillary layer, and the 
deep or fibrous layer. Upon the external surface, are little 
conical prominences, known as papillce. The papillae are 
irregularly distributed over the body, in some parts being 
smaller and more numerous than in others, as on the finger- 
ends, where their summits are so intimately connected as to 
form a tolerably smooth surface. It is owing to their perfect 
development, that the finger-tips are adapted to receive 
the most delicate 

impressions of touch. ^''^' "* 

Although every part of 
the skin is sensitive, 
yet the papillae are 
extremely so, for 
they are the principal 
means through which 
the impressions of 
objects are communi- 
cated. Each papilla 
not only contains a 
minute vein and artery, 
but it also incloses A section of the skin, showing its arteries and 

veins. .4, .^. Arterial branches. 5, -B. Capillaries 
a loop of sensitive in which the branches terminate. C. The venous 
nprvps Whpu the trunk into which the blood from the capillaries 

flows. 

body is exposed to 

cold, these papillae can be more distinctly seen in the form 

of prominences, commonly known as "goose-pimples." 

The internal, or fibrous layer of the skin, contains numerous 
depressions, each of which furnishes a receptacle for fat. 
While the skin is supplied with a complete net-work of ar- 
teries, veins, and nerves, which make it sensitive to the slightest 
touch, it also contains numerous lymphatic vessels, so minute 
that they are invisible to the naked eye. 

Among the agents adapted for expelling the excretions from 
the system, few surpass the Sudoriferous Glands. These are 
minute organs which wind in and out over the whole extent 
of the true skin, and secrete the perspiration. Though much 




70 



COMMON SENSE MEDICAL ADVISER. 



of it passes off as insensible transpiration, yet it often ac- 
cumulates in drops of sweat, during long-continued, exercise 

or exposure to a high temperature. 
The office of the perspiration is 
two-fold. It removes noxious mat- 
ter from the system, and diminishes 
animal heat, and thereby equalizes 
the temperature of the body. It 
also renders the skin soft and pli- 
able, thus better adapting it to the 
movements of the muscles. The 
Sebaceous Glands, which are placed 
in the true skin, are less abundant 
where the sudoriferous glands are 
most numerous, and vice versa. 
Here, as elsewhere, nature acts with 
systematic and intelligent design. 
The perspiratory glands are distrib- 
uted where they are most needed, 
— in the eyelids, serving as lubri- 
cators; in the ear passages, to 
produce the cerumen, or wax, which 
prevents the intrusion of small in- 
sects; and in the scalp, to supply 
the hair with its natural pomatum. 
The Epidermis, or Cuticle, so 
called because it is 2^^^^'^^^ upon the 
skin, is the outer layer of the skin. 
Since it is entirely destitute of 
nerves and blood-vessels, it is not 
sensitive. Like the cutis vera, 
it has two surfaces composed of 
A perspiratory gland, highly layers. The internal, or Rete 
magnified. 1, 1. The gland. 2, 2. Mucosum, which Is made up chiefly 

Excretory ducts uniting to form « . n • j j -u 

a tube which tortuously perfor- of pigment cells, IS adapted to the 
ates the cuticle at s, and opens irregularities of the cutis vera, and 
obliquely on its surface at 4. , , , . • ^ 1 1 • . 

sends prolongations into all its 

glandular follicles. The external surface, or epidermis proper, 
is elastic, destitute of coloring matter, and consists of mere 




THE SKIN. 



71 




A representation of oil-tubes from the scalp 
and nose. 



horny scales. As soon as dry, they are removed in the form 

of scurf, and replaced by new ones from the cutis vera. 

These scales may be 
Fig. Jf9. removed by a wet- 

sheet pack, or by 
friction. The cuticle 
is constantly under- 
going renewal. This 
layer serves to cover 
and protect the 
nervous tissue of the 
true skin beneath. 
We may here observe 
that the cuticle con- 
tains the pigment for 
coloring the skin. In 
dark races, as the 
negro, the cuticle is 

very thick and filled with black pigment. The radiation 

of animal heat is dependent upon the thickness and color 

of this cuticle. 

Thus, in the dark Fig. 50. 

races, the pigment 

cells are most 

numerous, and in 

proportion as the 

skin is dark or fair 

do we find these 

cells in greater or 

lesser abundance. 

The skin of the 

Albino is of pearly 

whiteness, devoid 

even of the pink 

orbrown tint Anatomy of the skin. 5, 5. Cutis vera (true skin), 

which that of the i, i. Nervous tissue. 3, 3. Sensitive layer in which are 

European always eee^i the nerves. ^ ^ The layer containing pigment 

^ •' cells. 1, 1. Epidermis (cuticle), 
possesses. This 

peculiarity must be attributed to the absence of pigment cells, 




79 



COMMON SENSE MEDICAL ADVISER. 



which, when present, always present a more or less dark 
color. The theory that climate alone is capable of producing 
all these diversities is simply absurd. The Esquimaux, who 
live in Greenland and the arctic regions of America, are re- 
markable for the darkness of their complexion. Humboldt 
remarks that the American tribes of the tropical regions 
have no darker skin than the mountaineers of the temperate 
zone. Climate may modify the complexion, but it cannot 
make it. 

Hairs are horny appendages of the skin, and, with the 
exception of the hands, the soles of the feet, the backs of the 

Fig. 51. 






structure of the human hair. A. External surface of the shaft, showing the 
transverse striae and jagged boundary, caused by the imbrications of the scaly 
cortex. B. Longitudinal section of the shaft, showing the fibrous character of 
the medullary substance, and the arrangement of the pigmentary matter. C. 
Transverse sections, showing the distinction between the cortical and medullary 
substances, and the central collection of pigmentary matter, sometimes found In 
the latter. Magnified 310 diameters. 

fingers and toes, between the last joint and the nail, and the 
upper eyelids, are distributed more or less abundantly over 
every part of the surface of the body. Over the greater part 
of the surface the hairs are very minute, and in some places 
are not actually apparent above the level of the skin; but the 
hair of the head, when permitted to reach its full growth, 
attains a length of from twenty inches to a yard, and, in rare 
instances, even six feet. A hair may be divided into a middle 
portion, or shaft, and two extremities; a peripheral extrem- 
ity, called the point; and a central extremity, inclosed within 



THE SKIN. 73 

the hair-sac, or follicle, termed the root. The root is some- 
what greater in diameter than the shaft, and cylindrical in 
form, while its lower part expands into an oval mass, called 
the hulh. The shaft of the hair is not often perfectly 
cylindrical, but is more or less flattened, which circumstance 
gives rise to waving and curling hair; and, when the flat- 
tening is spiral in direction, the curling will be very great. 
A hair is composed of three different layers of cell-tissues: 
a loose, cellulated substance, which occupies its center, and 
constitutes the medulla^ or pith; the fibrous tissue, which 
incloses the medulla, and forms the chief bulk of the 
hair; and a thin layer, which envelops this fibrous struc- 
ture, and forms the smooth surface of the hair. The me- 
dulla is absent in the downy hairs, but in the coarser class 
it is always present, especially in white hair. The color of 
hair is due partly to the granules and partly to an inter- 
granular substance, which occupies the interstices of the gran- 
ules and the fibers. The quantity of hair varies according 
to the proximity and condition of the follicles. The average 
number of hairs of the head may be stated at 1,000 in a 
superficial square inch; and, as the surface of the scalp has an 
area of about one hundred and twenty supei-ficial square inches, 
the average number of hairs on the entire head is 120,000. 
The hair possesses great durability, as is evinced by its endur- 
ance of chemical processes, and by its discovery, in the tombs 
of mummies more than two thousand years old. The hair is 
remarkable for its elasticity and strength. Hair is found to 
differ materially from horn in its chemical composition. Accord- 
ing to Vauquelin, its constituents are animal matter, a greenish- 
black oil, a white, concrete oil, phosphate of lime, a trace of 
carbonate of lime, oxide of manganese, iron, sulphur, and silex. 
Red hair contains a reddish oil, a large proportion of sulphur, 
and a small quantity of iron. White hair contains a white oil, 
and phosphate of magnesia. It has been supposed that hair 
grows after death, but this theory was probably due to the 
lengthening of the hair by the absorption of moisture from 
the body or atmosphere. 

The nails constitute anotTier class of appendages of the 
skin. They consist of thin plates of horny tissue, having a 
4 



74 COMMON SENSE MEDICAL ADVISER. 

root, a body, and a free extremity. The root, as well as the 
lateral portion, is implanted in the skin, and has a thin margin 
which is received into a groove of the true skin. The under 
surface is furrowed, while the upper is comparatively smooth. 
The nails grow in the same manner as the cuticle. 



CHAPTER X. 



PHYSIOLOGICAL ANATOMY. 



SECRETION. 

The term Secretion^ in its broadest sense, is applied to that 
process by which substances are separated from the blood, 
either for the reparation of the tissues or for excretion. In 
the animal kingdom this process is less complicated than in 
vegetables. In the former it is really a separation of nutritive 
material from the blood. The process, when effected for the 
removal of effete matter, is, in a measure, chemical, and 
accordingly the change is greater. 

Three elementary constituents are observed in secretory 
organs: the cells, a basement membrane, and the blood-vessels. 
Obviously, the most essential part is the cell. 

The physical condition necessary for the healthy action of 
the secretory organs is a copious supply of blood, in which 
the nutritive materials are abundant. The nervous system 
also influences the process of secretion to a great extent. In- 
tense emotion will produce tears, and the sight of some 
favorite fruit will genei'ally increase the flow of saliva. 

The process of secretion depends upon the anatomical and 
chemical constitution of the cell-tissues. The principal secre- 
tions are (1), Perspiration; (2), Tears; (3), Sebaceous matter; 
(4), Mucus; (5), Saliva; (6), Gastric juice; (7), Intestinal juice; 
(8), Pancreatic juice; (9), Bile; (10), Milk. 

Perspiration is a watery fluid secreted in minute glands, 
which are situated in every part of the skin, but are more 
numerous on the anterior surfaces of the body. Long thread- 
like tubes, only -^\-^ of an inch in diameter, lined with 

75 



76 COMMON SENSE MEDICAL. ADVISER. 

epitheliura^penetrate the skin, and terminate -in rounded coils, 
enveloped by a net-work of capillaries, which supply the 
secretory glands with blood. It is estimated by Krause that 
the entire number of perspiratory glands is two million three 
hundred and eighty-one thousand two hundred and forty-eight, 
and the length of each glandular coil being y'^ of an inch, we 
may estimate the length of tubing to be not less than two 
miles and a third. This secretion has a specific gravity of 
1003.5, and, according to Dr. Dalton, is composed of 

Water, 995.50 

Chloride of Sodium, 2.23 

Chloride of Potassium, 0.24 

Sulphate of Soda and Potassa, 0.01 

Salts of organic acids, with Soda and Potassa, 2.02 



1000.00 



Traces of organic matter, mingled with a free volatile acid, 
are also found in the perspiration. It is the acid which imparts 
to this secretion its peculiar odor, and acid reaction. The pro- 
cess of its secretion is continuous, but, like all bodily functions, 
it is subject to influences which augment or retard its activity. 
If, as is usually the case when the body is in a state of 
repose, evaporation prevents its appearance in the liquid form, 
it is called ijivisible or insensible perspiratio?i. When there 
is unusual muscular activity, it collects upon the skin, and 
is known as sensible perspiration. This secretion performs 
an important office in the animal economy, by maintaining 
the internal temperature at about 100° Fahr. Even in the 
Arctic regions, where the explorer has to adapt himself to 
a temperature of 40° to 80° below zero, the generation of 
heat in the body prevents the internal temperature from fall- 
ing below this standard. On the contrary, if the circulation 
is quickened by muscular exertion, the warmer blood flowing 
from the internal organs into the capillaries, raises the temper- 
ature of the skin, secretion is augmented, the moisture exudes 
from the pores, and perceptible evaporation begins. A large 
portion of the animal heat is thrown off in this process, and 
the temperature of the skin is reduced. A very warm, dry 
atmosphere can be borne with impunity, but if moisture is 



SECRETION. 77 

introduced, evaporation ceases, and the life of the animal is 
endangered. Persons have been known to remain in a tem- 
perature of about 300° Fahr, for some minutes without 
unpleasant effects. Three conditions may be assigned as effect- 
ive causes in retarding or augmenting this cutaneous secretion, 
variations in the temperature of the atmosphere, muscular 
activity, and influences which affect the nerves. The emotions 
exert a remarkable influence upon the action of the perspiratory 
glands. Intense fear causes great drops of perspiration to 
accumulate on the skin, while the salivary glands remain 
inactive. 

Tears. The lachrymal glands are small lobular organs, 
situated at the outer and upper orbit of the eye, and have 
from six to eight ducts, which open upon the conjunctiva, 
between the eyelid and its inner fold. This secretion is an 
alkaline, watery fluid. According to Dr. Dalton, its composition 
is as follows: 

Water, .982.0 

Albuminous matter .5.0 

Chloride of Sodium, 13.0 

Mineral Salts, a trace, 

1000.0 

The function of this secretion is to preserve the brilliancy 
of the eye. The tears are spread over this oi-gan by the 
reflex movement of the eyelid, called winking, and then 
collected in the puncta lachrymalia and discharged into the 
nasal passage. This process is constant during life. The effect 
of its repression is seen in the dim appearance of the eye 
after death. Grief or excessive laughter usually excite these 
glands until there is an overflow. 

Sebaceous Iflatter. Three varieties of this secretion are 
found in the body. A product of the sebaceous glands of the 
skin is found in those parts of the body which are covered 
with hairs; also, on the face and the external surface of the 
organs of generation. The sebaceous glands consist of a group 
of flask-shaped cavities, opening into a common excretory duct. 
Their secretion serves to lubricate the hair and soften the skin. 
The ceruminous glands of the external auditory meatus, or 



78 COMMON SENSE MEDIOAX ADVISER. 

outer opening of the ear, are long tubes terminating in a 
glandular coil, within which is secreted the glutinous matter 
of the ear. This secretion serves the double purpose of moist- 
ening the outer surface of the membrana tympani, or ear-drum, 
and, by its strong odor, of preventing the intrusion of insects. 
The Meibomian glands are arranged in the form of clusters 
along the excretory duct, which opens just behind the roots 
of the eyelashes. The oily nature of this secretion prevents 
the tears, when not stimulated by emotion, from overflowing 
the lachrymal canal. 

IflllCllS. The mucous membranes are provided with minute 
glands which secrete a viscid, gelatinous matter, called mucus. 
The peculiar animal matter which it contains is termed mu- 
cosin. These glands are most numerous in the Pharynx, Esoph- 
agus, Trachea, Bronchia, Vagina and Urethra. They consist 
of a group of secreting sacs, terminating at one extremity in 
a closed tube, while the other opens into a common duct. 
The mucus varies in composition in different parts of the body; 
but in all, it contains a small portion of insoluble animal 
matter. Its functions are threefold. It lubricates the mem- 
branes, prevents their injury, and facilitates the passage of food 
through the alimentary canal. 

Saliva. This term is given to the first of the digestive 
fluids, which is secreted in the glands of the mouth. It is a 
viscid, alkaline liquid, with a specific gravity of about 1005. 
If allowed to stand, a whitish precipitate is formed. Exami- 
nations with the microscope show^ it to be composed of minute, 
granular cells and oil globules, mingled with numerous scales 
of epithelium. According to Bidder and Schmidt, the com- 
position of saliva is as follows: 

Water, 995.16 

Organic matter, 1.34 

Hulpho-(;yanide of Potassium, . . . 0.06 

riiosphates of Sodium, Calcium and Maguesium, . .98 

Chlorides of Sodium and Potassium, ... .84 

Mixture of Epithelium, 1.02 



1000.00 



Two kinds of organic matter are present in the saliva; one, 
termed ptyalin, imparts to the saliva its viscidity, and is 



SBOBBTION. 79 

obtained from the secretions of the parotid, submaxillary and 
sublingual glands; another, which is not glutinous, is distin- 
guished by the property of coagulating when subjected to 
heat. The saliva is composed of four elementary secretions, 
derived respectively, from the mucous follicles of the mouth, 
and the parotid, the submaxillary, and the sublingual glands. 
The process of its secretion is constant, but is greatly aug- 
mented by the contact of food with the lining membrane. 
The saUva serves to moisten the triturated food, facilitate its 
passage, and has the property of converting starch into sugar; 
but the latter quality is counteracted by the action of the 
gastric juice of the stomach. 

Gastric Juice. The minute tubes, or follicles, situated 
in the mucous membrane of the stomach, secrete a colorless, 
acid liquid, termed the gastric juice. This fluid appears to 
consist of little more than water, containing a few saline mat- 
ters in solution, and a small quantity of free hydrochloric 
acid, which gives-nt an acid reaction. In addition to these, 
howevei', it contains a small quantity of a peculiar organic 
substance, termed pepsin, which in chemical composition, is 
very similar to ptyalin, although it is very different in its 
effects. When food is introduced into the stomach, the per- 
istaltic contractions of that organ roll it about, and mingle 
it with the gastric juice, which disintegrates the connective 
tissue, and converts the albuminous portions into the substance 
called chyme, which is about the consistency of pea-soup, and 
which is readily absorbed through the animal membranes into 
the blood of the delicate and numerous vessels of the stomach, 
whence it is conveyed to the portal vein and to the liver. 
The secretion of the gastric juice is influenced by nervous 
conditions. Excess of joy or grief effectually retard or even 
arrest its flow. 

Intestinal Juice. In the small intestine, a secretion is 
found which is termed the intestinal juice. It is the product 
of two classes of glands situated in the mucous membrane, 
and termed respectively, the follicles of Lieherkuhn and the 
glands of JBrunner. The former consist of numerous small 
tubes, lined with epithelium, which secrete by far the greater 
portion of this fluid. The latter are clusters of round follicles 



80 COMMON SENSE MEDICAL ADVISER. 

opening into a common excretory duct. These sacs are com- 
posed of delicate, membranous tissue, having numerous nuclei 
on their walls. The difficulty of obtaining this juice for ex- 
periment is obvious, and therefore its chemical composition 
and physical properties are not known. The intestinal juice 
resembles the secretion of the mucous follicles of the mouth, 
being colorless, vitreous in appearance, and having an alkaline 
reaction. 

Pancrciatic Juice. This is a colorless fluid, secreted 
in a lobular gland which is situated behind the stomach, and 
runs transversely from the spleen across the vertebral column 
to the duodenum. The most important constituent of the 
pancreatic juice is an organic substance, termed pancreatin. 

The Bile. The blood which is collected by the veins of 
the. stomach, pancreas, spleen, and intestines, is discharged 
into a large trunk called tlie portal vein, which enters the 
liver. This organ also receives arterial blood from a vessel 
called the hepatic artery, which is given off from the aorta 
below the diaphragm. If the branches of the portal vein 
and hepatic artery be traced into the substance of the 
liver, they will be found to accompany one another, and to 
subdivide, becoming smaller and smaller. Finally, the portal 
vein and hepatic artery will be found to terminate in capil- 
laries which permeate the smallest perceptible subdivisions of 
the liver substance, which are polygonal masses of not more 
than one-tenth of an inch in diameter, called the lobules. 
Eveiy lobule rests upon one of the ramifications of a great 
vessel termed the hepatic vein, which empties into the in- 
ferior vena cava. There is also a vessel termed the hepatic 
duct leading from the liver, the minute subdivisions of which 
penetrate every portion of the substance of that organ. Con- 
nected with the hepatic duct, is the duct of a large oval sac, 
called the gall-bladder. 

Each lobule of the liver is composed of minute cellular 
bodies known as the hepatic cells. It is supposed that in 
these cells the blood is deprived of certain materials which 
are converted into bile. This secretion is a glutinous fluid, 
varying in color from a dark golden brown to a bright yel- 
low, has a specific gravity ranging from 1018 to 1086, and a 



SBCEETION. 



81 



slightly alkaline reaction. When agitated, it has a frothy- 
appearance. Physiologists have experienced much difficulty 
in studying the character of this secretion from the instability 
of its constituents when subjected to chemical examination. 

miiverdin is an organic substance peculiar to the bile, 
which imparts to that secretion its color. When this constit- 
uent is re-absorbed by the blood and circulates through the 
tissues, the skin assumes a bright yellow hue, causing what is 
known as the jaundice. Cholesterin is an inflammable crystal- 
lizable substance soluble in alcohol or ether. It is found in 
the spleen and all the nervous tissues. It is highly probable that 
it exists in the blood, in some 



Fig. 52. 




state or combination, and as- 
sumes a crystalline form only 
when acted upon by other sub- 
stances or elements. Two 
other constituents, more im- 
portant than either of the 
above, are collectively termed 
biliary salts. These elements 
were discovered in 1848, by 
Strecker, who termed them 
glycocholate and taurocholate 
of soda. Both are crystalline, 
resinous substances, and, al- 
though resembling each other 
in many respects, the chemist 

may distinguish them by their lar vein, s, 3,' s." Lobules, 
reaction, for both yield a pre- 
cipitate if treated with subacetate of lead, but only the glyco- 
cholate will give a precipitate with acetate of lead. In testing 
for biliary substances, the most satisfactory method is the one 
proposed by Pettenkoffer. A solution of cane-sugar, one 
part of sugar to four parts of water, is mixed with the sus- 
pected substance. Dilute sulphuric acid is then added until 
a white precipitate falls, which is re-dissolved in an excess of 
the acid. On the addition of more sulphuric acid, it becomes 
opalescent, and passes through the successive hues of scarlet, 
lake, and a rich purple. Careful experiments have proved 



Section of the Liver, showing the 
ramifications of the portal vein. 1. Twig- 
of portal vein. 2, 2,' 2," 2.'" Interlobii- 



^2 COMMON SENSE MEDICAL ADVISER. 

that it is a constant secretion; but its flow is more abundant 
during digestion. During the passage through the intestines 
it disappears. It is not eliminated, and Pettenkoffer's test 
has failed to detect its existence in the portal vein. These 
facts lead physiologists to the conclusion, that it undergoes 
some transformation in the intestines and is re-absorbed. 

After digestion has been going on in the stomach for 
some time, the semi-digested food, in the form of chyme, 
beo'ins to pass through the -pyloric orifice of the stomach into 
the duodenum, or upper portion of the small intestine. Here 
it encounters the intestinal juice, pancreatic juice, and the 
bile, the secretion of all of which is stimulated by the pres- 
ence of food in the alhnentary tract. These fluids, mingling 
with the chyme, give it an alkaline reaction, and convert it 
into chyle. The transformation of starch into sugar, which is 
almost, if not entirely, suspended while the food remains in 
the stomach, owing to the acidity of the chyme, is resumed 
in the duodenum, the acid of the chyme, being neutralized 
by the alkaline secretions there encountered. 

Late researches have demonstrated that the pancreatic 
juice exerts a powerful effect on albuminous matters, not 
unlike that of the gastric juice. 

Thus, it seems that while in the mouth only starchy, and 
while in the stomach only albuminous substances are digested, 
in the small intestine all kinds of food materials, starchy, 
albuminoid, fatty and mineral, are either completely dissolved, 
or minutely subdivided, and so prepared that they may be 
readily absorbed through the animal membranes into the 
vessels. 

]nilk> The milk is a white, opaque fluid, secreted in the 
lacteal glands of the female, in the mammalia. These glands 
consist of numerous follicles, grouped around an excretory 
duct, which unites with similar ducts coming from other 
lobules. By successive unions, they form large branches, 
termed the lactiferous ducts, which open by ten to fourteen 
minute orifices on the extremity of the nipple. The most im- 
portant constituent of milk is casein; it also contains oily and 
8a(!channe substances. This secretion, more than any other, 
is influenced by nervous conditions. A mother's bosom will 



SECRETION. 83 

fill with milk at the thought of her infant child. Milk is 
sometimes poisoned by a fit of ill-temper, and the infant 
made sick and occasionally thrown into convulsions, which in 
some instances prove fatal. Sir Astley Cooper mentions two 
cases in which terror instantaneously and permanently arrested 
this secretion. It is also affected by the food and drink. Malt 
liquors and other mild alcoholic beverages temporarily increase 
the amount of the secretion, and may, in rare instances, have a 
beneficial effect upon the mother. They sometimes affect the 
child, however, and their use is not to be recommended unless 
the mother is extremely debilitated, and there is a deficiency 
of milk. 



CHAPTEI^ XL 



PHYSIOLOGICAL ANATOMY. 



EXCRETION. 

The products resulting from the waste of the tissues are 
constantly being poured into the blood, and, as we have seen, 
the blood being everywhere full of corpuscles, which, like all 
living things, die and decay, the products of their decomposi- 
tion accumulate in every part of the circulatory system. 
Hence, if the blood is to be kept pure, the waste niaterials 
incessantly poured into this fluid, or generated in it, must 
be as continually removed, or excreted. The principal sets 
of organs concerned in effecting the separation of excrementi- 
tious substances from the blood are the lungs, the skin, and 
the kidneys. 

The elimination of carbonic acid through the lungs has 
already been described on page 66, and the excretory func- 
tion of the skin on page YO. 

The kidneys are two bean-shaped organs, placed at the back 
of the abdominal cavity, in the region of the loins, one on 
each side of the spine. The convex side of each kidney is 
directed outwards, and the concave side is turned inwards 
towards the spine. From the middle of the concave side, 
which is termed the hiltis, a long tube of small caliber, called 
the ureter, proceeds to the bladder. The latter organ is an 
oval bag, situated in the pelvic cavity. It is composed princi- 
pally of elastic muscular fibers, and is lined internally with 
mucous membrane, and coated externally with a layer of the 
peritoneum, the serous membrane which lines the abdominal 
84 



EXCRETION. 85 

and pelvic cavities. The iireters enter the bladder through 
its posterior and lower wall, at some little distance from each 

Fig. 68. 




View of the kidneys, ureters, and bladder. 

other. The openings through which the ureters enter the 
bladder are oblique, hence it is much easier for the secretion 



§^ COMMON SENSE MEDICAL ADVISEE. 

of the kidneys to pass from the ureters into the bladder than 
for it to get the other way. Leading from the bladder to 
the exterior of the body is a tube, called the urethra^ through 
which the urine is voided. 

The excretion of the kidneys, termed the urine^ is an amber- 
colored or straw-colored fluid, naturally having a slightly acid 
reaction, and a specific gravity ranging from 1,015 to 1,025 
Its principal constituents are urea and uric acid, together with 
various other animal matters of less importance, and saline 
substances, held in solution in a proportionately large amount 
of water. The composition of the urine and the quantity 
excreted vary considerably, being influenced by the moisture 
and temperature of the atmosphere, by the character of the 
food consumed, and by the empty or replete condition of the 
alimentary tract. On an average a healthy man secretes about 
fifty ounces of urine in the twenty-four hours. This quantity 
usually holds in solution about one ounce of urea, and ten or 
twelve grains of uric acid. In the amount of other animal 
matters, and saline substances, there is great variation, the 
quantity of these ranging from a quarter of an ounce to an 
ounce. The principal saline substances are common salt, 
the sulphates and phosphates of potassium, sodium, calcium, 
and magnesium. In addition to the animal and the saline 
matters, the urine also contains a small quantity of carbonic 
acid, oxygen and nitrogen. 



CHAPTEU XII. 



PHYSIOLOGICAL ANATOMY. 



THE NERVOUS. SYSTEM. 



Hitherto, we have only considered the anatomy and functions 
of the organs employed in Digestion, Absorption, Circulation, 
Respiration, Secretion and Excretion. We have found the vital 
process of nutrition to be, in all its essential features, a result 
of physical and chemical forces; in each instance we have 
presupposed the existence and activity of the nerves. There 
is not an inch of bodily tissue into which their delicate fila- 
ments do not penetrate, and form a multitude of conductors, 
over which are sent the impulses of motion and sensation. 

Two elements, nerve-fihers and ganglionic corpuscles, enter 
into the composition of nervous tissue. Ordinary nerve- 
fibers in the living subject, or when fresh, are cylindrical- 
shaped filaments of a clear, but somewhat oity appearance. 
But soon after death the matter contained in the fiber coagu- 
lates, and then the fiber is seen to consist of an extremely 
delicate, structureless, outer membrane, which forms a tube 
through the center of which runs the axis-cylinder. Inter- 
posed between the axis-cylinder and this tube, there is a 
fluid, containing a considerable quantity of fatty matter, from 
which is deposited a highly refracting substance which lines 
the tube. There are two sets of nerve-fibers, those which 
transmit sensory impulses, called afferent or sensory nerves, 
and those which transmit motor impulses, called efferent or 
motor nerves. The fibers when collected in bundles are 
termed nerve trunks. All the larger nerve-fibers lie side by 
side in the nerve-trunks, and are bound together by delicate 

87 



88 



COMMON SENSE MEDICAL ADVISER. 



Fig.dU. 




The Nervous System. 



THE CEREBBO-SPINAL SYSTEM. 



89 



connective tissue, enclosed in a sheath of the same material, 
termed the neurilemma. The nerve-fibers in the trunks of the 
nerves remain perfectly distinct and disconnected from one 
another, and seldom, or never, divide thi-oughout their entire 
length. However, where the nerves enter the nerve-centers, 
and near their outer terminations, the nerve-fibres often divide 
into branches, or at least gradually diminish in size, until, 
finally, the axis-cylinder, and the sheath with its fluid con- 
tents, are no longer distinguishable. The investing membrane 
is continuous from the origin to the termination 
of the nerve-trunk. 

In the brain and spinal cord the nerve-fibers 
often terminate in minute masses of a gray or 
ash-colored granular substance, termed ganglia, 
or ganglionic cor^ntscles. 

The ganglia are cellular corpuscles of irreg- 
ular form, and possess fibrous appendages, 
which serve to connect them with one another. 
These ganglia form tlie cortical covering of the 
brain, and are also found in the interior of the 
spinal cord. According to Ko Hiker, the larger 
of these nerve-cells measure only -g-i^ of an 
inch in diameter 
of nervous ganglia. 

Nerves are classified WMth reference to their 
origin, as cerebral — those originating in the brain, 
and sjmial — those originating in the spinal cord. 

There are two sets of nerves and nerve-centers, which are 
intimately connected, but which can be more conveniently 
studied apart. These are tlie cerebrospinal system, consisting 
of the cerebro-spinal axis, and the cerebral and spinal nerves; 
and the sympathetic system, consisting of the chain of sym- 
pathetic ganglia, the nerves which they give ofi^, and the 
nervous trunks which connect them with one another and 
with the cerebro-spinal nerves. 




Division of a 

The brain is chiefly composed °6''^^' showing a 

portion of a ner- 
vous trunk (a) 
and separation of 
its iilameuts (h, c, 
d, e.) 



THE CEREBRO-SPINAL SYSTEM. 

The Ceretoro- Spinal Axis consists of the brain 
and spinal cord. It lies in the cavities of the cranium and 



90 



COMMON SENSE MKDICAIi ADVISBR. 



the spinal column. These cavities are lined ■with a very tough 
fibrous membrane, termed the dura mater, which serves as 
the periosteum of the bones which enter into the formation 
of these parts. The surface of the brain and spinal cord is 
closely invested with an extremely vascular, areolar tissue, 
called the pia mater. The numerous blood-vessels which 
supply these organs traverse the pia mater for some distance, 
and, where they pass into the substance of the brain or 
spinal cord, the fibrous tissue of this membrane accompanies 
them to a greater or less depth. The inner surface of the 
dura mater and the outer surface of the pia mater are 
covered with an extremely thin, serous membrane, which is 
termed the arachnoid membrane. Thus, one layer of the 
arachnoid envelopes the brain and spinal cord, and the other 
lines the dura mater. As the layers become continuous with 

each other at different 
Fig. 56. points, the arachnoid, like 

the pericardium, forms a 
shut sac, and, like other 
serous membranes, it se- 
cretes a fluid, known as 
the arachnoid fluid. The 
space between the internal 
and the external layers of 
the arachnoid membrane 
of the brain is much 
smaller tlian that enclosed by the corresponding layers of the 
arachnoid metiibrane of the spinal column. 

The Spinal Cord is a column of soft, grayish- white 
substance, extending from the top of the spinal canal, where 
it is continuous with the brain, to about an inch below the 
small of the back, where it tapers off into a filament. From 
this nerve are distributed fibers and filaments to the muscles 
and integument of at least nine-tenths of the body. 

The spinal cord is divided in front through the middle 
nearly as far as its center, by a deep fissure, called the 
anterior flssia-e, and behind, in a similar manner, by the pos- 
terior fissure. Each of these fissures is lined with the pia 
mater, which also supports the blood -vessels which supply 




CroBs-scijtiou of spinal cord 






THB SPINAL, CORD. 91 

the spinal coi-d with blood. Consequently, the substance of 
the two halves oJ the cord is only connected by a narrow 
isthmus, or bridge, perforated by a minute tube, which is 
termed the central canal of the spinal cord. 

Each half of the spinal cord is divided lengthwise into 
three nearly equal parts, which are termed the anterior, lateral, 
and posterior columns, by the lines which join together two 
parallel series of bundles of nervous filaments, which compose 
the roots of the spinal nerves. The roots of those nerves, 
which are found along that line nearest the posterior surface 
of the cord, are termed the posterior roots; those which spring 
from the other line are known as the anterior roots. 

Several of these anterior and posterior roots, situated at 
about the same height on opposite sides of the spinal cord, 
converge and combine into what are called the anterior and 
posterior bundles ; then two bundles, anterior and posterior, 
unite and form the trunk of a spinal nerve. 

The nerve trunks make their way out of the spinal canal 
through apertures between the vertebra, called the inter-verte- 
bral foramina and then divide into numerous branches, their 
ramifications extending principally to the muscles and the 
skin. There ai'e thirty-one pairs of spinal nerves, eight of 
which are termed cervical, twelve dorsal, five lumbar, and six 
sacral, with reference to that part of the cord from which 
they originate. 

When the cord is divided into transverse sections, it is 
found that each half is composed of two kinds of matter, a 
white substance on the outside, and a grayish substance in 
the interior. The gray matter, as it is termed, lies in the 
form of an irregular crescent, with one end considerably larger 
than the other, and having the concave side turned outwards. 
The ends of the crescent are termed the horns, or cornua, the 
one pointing forward being called the anterior cornu, the 
other one the posterior cornu. Tlie convex sides of these 
cornua approach each other and are united by the bridge, 
which contains the central canal. 

There is a marked difference in the structure of the gray 
and the white matter. The white matter is composed entirely 
of nerve fibers, held together by a framework of connective 



92 COMMON SENSE MEDICAL ADVISER. 

tissue. The gray matter contains a great number of gang- 
lionic corpuscles, or nerve-cells, in addition to the nerve-fibers. 

When the nerve-trunks are irritated in any manner, whether 
by pinching, burning, or the application of electricity, all 
the muscles which are supplied with branches from this nerve- 
trunk immediately contract, and pain is experienced, the 
severity of which depends upon the degree of the irritation; 
and the pain is attributed to that portion of the body to 
which the filaments of the nerve-trunk are distributed. Thus, 
persons who have lost limbs often complain in cold weather 
of an uneasiness or pain, which they locate in the fingers or 
toes of the limb which has been amputated, and which is 
caused by the cold producing an irritation of the nerve-trunk, 
the filaments, or fibers of which, supplied the fingers or toes 
of the lost member. 

On the other hand, if the anterior bundle of nerve-fibers 
given off from the spinal cord is irritated in precisely the 
same way, only half of these effects is produced. All the 
muscles which are supplied with fibers from that trunk con- 
tract, but no pain is experienced. Conversely, if the posterior 
bundle of nerve-fibers is irritated, none of the muscles to 
which the filaments of the nerve are distributed contract, but 
pain is felt throughout the entire region to which these fila- 
ments are extended. It is evident, from these facts, that the 
fibers composing the posterior bundles of nerve-roots only 
transmit sensory impulses, and the filaments composing the 
anterior nerve-roots only transmit motor impulses; accordingly, 
they are termed respectively the sensory and the motor nerve- 
roots. This is illustrated by the fact that when the posterior 
root of a spinal nerve is divided, all sensation in the parts to 
which the filaments of that nerve are distributed is lost, but 
the power of voluntary movement of the muscles remains. 
On the other hand, if the anterior roots are severed, the power 
of voluntary motion of the muscles is lost, but sensation 
remains. 

It appears from these experiments, that, when a nerve is 
irritated, a change in the arrangement of its molecules takes 
place, which is transmitted along the nerve-fibers. But, if the 
nerve-trunks are divided, or compressed tightly at any point 



REFLEX ACTION OF THE SPENT AL CORD. 93 

between the portion irritated, and the muscle or nerve-centre, 
the effect ceases immediately, in a manner similar to that in 
which a message is stopped by the cutting of a telegraph 
wire. When the nerves distributed to a limb are subjected 
to a pressure sufficient to destroy the molecular continuity of 
their filaments, it "goes to sleep," as we term it. The power 
of transmitting sensory and motor impulses is lost, and only 
returns gradually, as the molecular continuity is restored. 

From what has been said, it is plain that a sensory nerve is 
one which conveys a sensory impulse from the peripheral or 
outer part of a nerve to the spinal cord or brain, and which 
is, therefore, termed afferent \ and that a motor nerve is one 
which transmits an impulse from the nerve centre, or is 
efferent. No difference in structure, or in chemical or physical 
composition, can be discerned between the afferent and the 
efferent nerves. A certain period of time is required for the 
transmission of all impulses. The speed with which an im- 
pulse travels has been found to be comparatively slow, being 
even less than that of sound, which is 1,120 feet per second. 

The experiments heretofore related have been confined solely 
to the nerves. We may now proceed to the consideration of 
what takes place when the spinal cord is operated upon in a sim- 
ilar way. If the cord be divided with a knife or other instru- 
ment, all parts of the body supplied with nerves given off below 
the division will become paralyzed and insensible, while all parts 
of the body supplied with nerves from the spinal cord above the 
division will retain their sensibility and power of motion. If, 
however, only the posterior half of the spinal cord is divided, or 
destroyed, there is loss of sensation alone; and, if the anterior 
portion is cut in two, and the continuity of the posterior part is 
left undisturbed, there is loss of voluntary motion of the lower 
limbs, but sensation remains. 

Reflex Action of the Spinal Cord. In relation to 
the brain, the spinal cord is a great mixed motor and sensory 
nerve, but, in addition to this, it is also a distinct nervous 
centre, in which originate and terminate all those involuntary 
impulses which exert so potent an influence in the preservation 
and economy of the body. That peculiar power of the cord, 
by which it is enabled to convert sensory into motor impulses, 



94 



COMMON SENSE MEDICAL ADVISER. 



Fig. 57. 



is that which distinguishes it, as a central organ, from a nerve, 
and is called reflex action. 

The gray matter, and not the white, is the part of the cord 
which possesses this power. This reflex action is a special func- 
tion of the spinal cord, and serves as a monitor to, and regulator 
of the organs of nutrition and circulation, by placing them, ordi- 
narily, beyond the control of conscious volition. 

If the foot of a decapitated frog is irritated, there is an instant 
contraction of the corresponding limb; if the irritation is intense 
the other limb also contracts. These motions indicate the exist- 
ence, in some part of the spinal cord, of a distinct nerve-centre, 
capable of converting and reflecting impulses. It has been found 
by experiment, that the same movements will take place if the 
irritation be applied to any portion of the 
body to which the spinal nerves are dis- 
tributed, thus giving undoubted evidence 
that the spinal cord in its entirety is 
capable of causing these reflections. 
Fig. 57 represents the course of the nerv- 
ous impulses. The sensory impulse passes 
upward along the posterior root, a, until 
it reaches the imbedded gray matter, b, 
of the cord, by which it is reflected, as 
a motor impulse, do\\Tiward along the 
anterior root, c, to the muscles whence 
the sensation was received. This is the reflex action of the 
spinal cord. There is no consciousness or sensation connected 
with this action, and the removal of the brain and the sym- 
pathetic system does not diminish its activity. Even after 
death it continues for some time, longer in cold-blooded than 
in warm-blooded animals, on account of the difference in tem- 
perature, thus showing this property of the spinal cord. By 
disease, or the use of certain poisons, this activity may be 
greatly augmented, as is frequently observed in the human 
subject. A sudden contact with a different atmosphere may 
induce these movements. The contraction of the muscles, 
or cramp, often experienced by all persons, in stepping into 
a cold bath, or emerging from the cozy sitting-room into 
a chilly December temperature, are familiar illustrations of 




THE BKAIN. 95 

reflex movements. It has been demonstrated that the irri- 
tability of the nerves may be impaired or destroyed, while 
that of the muscles to which they are distributed remains 
unchanged ; and that the motor and sensory classes of fila- 
ments may be paralyzed independently of each other. 

The reflex actions of the spinal cord have been admirably 
summed up by Dr. Dalton, as exerting a general, protective 
influence over the body, presiding over the involuntary action 
of the limbs and trunk, regulating the action of the sphinc- 
ters, rectum, and bladder, and, at the same time, exercising an 
indirect influence upon the nutritive changes in all parts of 
the body to which the spinal filaments are distributed. 

The Brain. The brain is a complex organ, which is 
divided into the medulla oblongata^ the cerebellum, and the 
cerebrum. 

The medulla oblongata is situated just above the spinal cord, 
and is continuous with it below, and the brain above. It has 
distinct functions which are employed in the preservation and 
continuance of life. It has been termed the " vital knot," 
owing to the fact that the bram may be removed and the 
cord injured and still the heart and lungs will continue to 
perform their functions, until the medulla oblongata is 
destroyed. 

The arrangement of the white and gray matter of the 
medulla oblongata is similar to that of the spinal cord; that 
is to say, the white matter is external and the gray internal; 
whereas in the cerebellum and cerebrum this order is reversed'. 
The fibres of the spinal cord, before entering this portion of 
the brain, decussate, those from the right side crossing to the 
left, and those from the left crossing to the right side. By 
some authors this crossing of the sensory and motor filaments 
has been supposed to take place near the medulla oblongata. 
Dr. Brown-Sequard shows, however, that it takes place at 
every part of the spinal cord. The medulla oblongata is 
traversed by a longitudinal fissure, continuous with that of 
the spinal cord. Each of the lateral columns thus formed 
are subdivided into sections, termed respectively the Corpora 
Pyramidalia, the Corpora Olivaria, the Corpora Restiformia 
and the Posterior Pyramids. 



96 



COMMON SENSE MEDICAL ADVISEB. 



The Corpora Fyramidalia (see 1, 1, Fig. 58) are two small 
medullary eminences or cords, situated at the posterior surface 
of the medulla oblongata; approaching the Pons Varolii they 
become larger and rounded. 

The Corpora Olivaria {3, 3, Fig. 58) are two elliptical prom- 
inences, placed exterior to the corpora pyramidalia. By some 
physiologists these bodies are considered as the nuclei, or 
vital points, of the medulla oblongata. Being closely connected 
with the nerves of special sensation, Dr. Solly supposed that 
they presided over the movements of the larynx. 



Fig. 58. 



Fig. 59. 





The Corpora Restiformia {5, 5, Fig. 59) are lateral and pos- 
terior rounded projections of whitish medulla, which pass 
upward to the cerebellum and form the crura cerebelli, so 
called because they resemble a leg. The filaments of the 
pneumogastric nerve originate in the ganglia of these parts. 

The Posterior Pyrarmds are much smaller than the other 
columns of the medulla oblongata. They are situated (^ ^ 
Fig. 59) upon the margin of the posterior ^fissures in contact 
with each other. 

The functions of the medulla oblongata, Avhich begin with 
the earliest manifestations of life, are of an instinctive 



THE BEAIN. 97 

character. If the cerebellum and cerebrum of a dove be 
removed, the bii'd will make no effort to procure food, but if 
a crumb of bread be placed in its bill, it is swallowed natu- 
rally and without any special effort. So also in respiration, 
the lungs continue to act after the inter-costal muscles are 
paralyzed; if the diaphragm loses its power, suffocation is the 
result, but there is still a convulsive movement of the lungs 
for sometime, indicating the continued action of the medulla 
oblongata. 

The Cerebellum, or little brain, is situated in the posterior 
chamber of the skull, beneath the tentorium, a tent-like process 
of the dura mater which separates it from the cerebrum. It 
is convex, with a transverse diameter of between three and one- 
half and four inches, and is little more than two inches in thick- 
ness. It is divided on its upper and lower surfaces into two 
lateral hemispheres, by the superior and inferior vermiform 
processes, and behind by deep notches. The cerebellum is 
composed of gray and white matter, the former being darker 
than that of the cerebrum. From the beautiful arrangement of 
tissue, this organ lias been termed the arbor vitoe. 

The pedtiticles of the cerebellum, the means by which it 
communicates with the other portions of the brain, are divided 
into three pairs, designated as the su2yerior, middle and inferior. 
The first pass upward and forward until they are blended with 
the tubercles of the corpora quadrigemina. The second are the 
crura cerebelli, which unite in two large fascicidi, or pyramids, 
and are finally lost in the pons varolii. The inferior j^eduncles 
are the corpora restiformia, previously described, and consist 
of both sensory and motor filaments. Some physiologists 
suppose that the cerebellum is the som-ce of that harmony or 
associative power which co-ordinates all voluntary movements, 
and effects that delicate adjustment of cause to effect, dis- 
played in muscular action. This fact may be proved by 
removing the cerebellum of a bird and observing the results, 
which are an uncertainty in all its movements, and difficulty 
in standing, walking, or flying, the bird being unable to direct 
its course. In the animal kingdom we find an apparent 
coiTespondence between the size of the cerebellum and the 
variety and extent of the movements of the animal. Instances 
5 



98 COMMON SENSE MEDICAL ADVISEE. 

are cited, however, in which no such proportion exists, and 
so the matter is open to controversy. The general function 
of the cerebellum, therefore, cannot be explained, but the 
latest experiments in physiological and anatomical science 
seem to favor the theory that it is in some way connected 
with the harmony of the movements. This co-ordination, by 
which the adjustment of voluntary motion is supposed to be 
effected, is not in reality a faculty having its seat in the brain 
substance, but is the harmonious action of many forces through 
the cerebellum. 

The Cerebrum occupies five times the space of all the other 
portions of the brain together. It is of an ovoid form, and 
becomes larger as it approaches the jjosterior region of the 
skull. A longitudinal fissure covered by the dura mater sep- 
arates the cerebrum into two hemispheres, which are connected 
at the base of the fissure, by a broad medullary band, termed 
the corpus callosum. Each hemisphere is subdivided into three 
lobes. The anterior gives form to the forehead, the middle 
rests in the cavity at the base of the skull, and the posterior 
lobe is supported by the tentorium, by which it is separated 
from the cerebellum beneath. One of the most pi-ominent 
characteristics of the cerebrum is its many and varied convo- 
hctions These do not correspond in all brains, nor even on 
the opposite sides of the same brain, yet there are certain 
features of similarity in all; accordingly, anatomists enumerate 
four orders of convolutions. The first order begins at the 
substantia perforata and passes upward and around the corpus 
callosum toward the posterior margin of that body, thence 
descends to the base of the brain, and terminates near its 
origin. The second order originates from the first, and 
subdivides into two convolutions, one of which composes the 
exterior margin and superior part of the con-esponding hemi- 
sphere, while the other forms the circumference of the fissure 
of Sylvius. The third order, from six to eight in number, is 
found in the interior portion of the brain, and inosculates 
between the first and second orders. The fourth is found 
on the outer surface of the hemisphere, in the space between 
the sub-orders of the second class. A peculiar fact relating to 
these convolutions is observed by all anatomists: mental 



THE BRAIN. ' 99 

development is always accompanied by an increasing dis- 
similarity between their proportional size. 

The cerebral hemispheres may be injured or lacerated without 
any pain to the patient. The effect seems to be one of stupe- 
faction without sensation or volition. A well-developed brain 
is a very good indication of intelligence and mental activity. 
That the cerebrum is the seat of the reasoning powers, and 
all the higher intellectual functions, is proved by three facts. 
(1.) If this portion of the brain is removed, it is followed by 
the loss of intelligence. (2.) If the human cerebrum is in- 
jured, there is an impairment of the intellectual powers. (3.) 
In the animal kingdom, as a rule, intelligence corresponds to 
the size of the cerebrum. This general law of development 
is modified by differences in the cerebral texture. Men pos- 
sessing comparatively small brains may have a vast range 
of thought and acute reasoning j^owers. Anatomists have 
found these peculiarities to depend upon the quantity of 
gray matter which enters into the composition of the brain. 

In the cerebro-spinal system there are three different kinds 
of reflex actions. (1.) Those of the spinal cord and medulla 
oblongata are performed without any consciousness or sensation 
on the part of the subject. (2.) The second class embraces 
those of the tuber annulare, where the perception gives rise 
to motion without the interference of the intellectual faculties. 
These are denominated purely instinctive reflex actions, and 
include all those oj^erations of animals which seem to display 
intelligent forethought; thus, the beaver builds his habitation 
over the water, but not a single apartment is different from 
the beaver homestead of a thousand years ago; there is no 
improvement, no retrogression. Trains of thought have been 
termed a third class of reflex actions. It is evident that the 
power of reasoning is, in a degree, possessed by some of 
the lower animals: for instance, a tribe of monkeys on a 
foraging expedition will station guards at different parts of 
the field, to warn the plunderers of the approach of danger. 
A cry from the sentinel, and general confusion is followed 
by retreat. Reason only attains its highest development in 
man, in whom it passes the bounds of ordinary existence, 
and, with the magic wand of love, reaches outward into the 



100 



COMMON SKNSE MEDICAL ADVISER. 



Fig. 60. 



vast wnknown, lifting hira above corporeal being, into an 

atmosphere of spiritual and divine Truth. 

The Cranial Nerves. From the brain, nerves are 

given off in pairs, Avhich succeed 
one another from in front back- 
wards to the number of twelve. 
The first pair, the olfactory nerves, 
are the nerves of the sense of smell. 
The second pair are the optic^ or 
the nerves of the sense of sight. The 
third pair are called the niotores 
oculi, the movers of the eye, from 
the fact that they are distributed 
to all the muscles of the eye with 
the exception of two. The fourth 
pair and the sixth pair each sup- 
ply one of the muscles of the eye, 
on each side, the fourth extending 
to the superior oblique muscle, and 
the sixth to the external rectus 
muscle. The nerves of the fifth 
pair are very large; they are each 
composed of two bundles of fila- 
ments, one motor and the other sen- 
sory, and have, besides, an additional 
resemblance to a spinal nerve by 
having a ganglion on each of their 
sensory roots, and, from the fact 
Section of the brain and an ideal that they have three chief divisions, 

view of the pncumogastric nerve . n j .1 ^ • -7 

on one side, with its branches, a. are often Called the trigeminal, or 
Vertical section of the cerebrum, trifacial, nerves. They are nerves 

h. Section of the cerebellum, c. „ . , „ . - 

Corpus caiiosum. d. Lower sec- ^^ special sense, of sensation, and 

tion of medulla oblongata. Above of motion. They are the Sensitive 

tre^lllS^SSr?; nerves which supply the cranh,m 

Superior laryngeal. 3. Branches and face, the motor nerves of the 

to the lungs. A Branches to the ^^^scles of mastication, the Tmcci- 

hver. 5. Branches to the stomach. ' 

nator and the masseter, and their 
third branches, often called the gtcstatory, are distributed 
to the front portion of the tongue, and are two of the 




THK GREAT SYMPATHETIC. 101 

nerves of the special sense of taste. The seventh pair, 
called also the facial nerves, are the motor nerves of the 
muscles of the face, and are also distributed to a few other 
muscles; the eighth pair, termed the auditory nerves, are the 
nerves of the special sense of hearing. As the seventh and 
eighth paii's of nerves emerge from the cavity of the skull 
together, they are frequently classed by anatomists as one, 
divided into the facial, or portio dura, as it is sometimes 
called, and the auditory, or portio mollis. The ninth pair, 
called the glosso-pharyngeal, are mixed nerves, supplying motor 
filaments to the pharyngeal muscles and filaments of the special 
sense of taste to the back portion of the tongue. The tenth 
pair, called the pneumogastric, or p>ar vagum, are very im- 
portant nerves, and are distributed to the larynx, the lungs, 
the heart, the stomach, and the liver, as shown in Fig. 60. 
This pair and the next are the only cerebral nerves which 
are distributed to parts of the body distant fi-om the head. 
The eleventh pair, also called spinal accessory, arise from the 
sides of the spinal marrow, between the anterior and posterior 
roots of the dorsal nerves, and run up to the medulla 
oblongata, and leave the cranium by the same aperture as 
the pneumogastric and glosso-pharyngeal nerves. They supply 
certain muscles of the neck, and are purely motor. As the 
glosso-pharyngeal, pneumogastric, and spinal accessory nerves 
leave the cranium together, they are by some anatomists 
counted as the eighth pair. The twelfth pair, known as the 
hypo-glossal, are distributed to the tongue, and are the motor 
nerves of that organ. 

, THE GREAT SYMPATHETIC. 

A double chain of nervous ganglia extends from the 
superior to the inferior parts of the body, at the sides and 
in front of the spinal column, and is termed, collectively, the 
system of the great sympathetic. These ganglia are intimately 
connected by nervous filaments, and communicate with the 
cerebro-spinal system by means of the motor and sensory fila- 
ments which penetrate the sympathetic. The nerves of this 
system are distributed to those organs over which conscious 
volition has no direct control. 



102 



COMMON SENSE MEDICAL ADVISER. 



Fig. 61. 



Suf tt is^ Ct rviffl tiantf7u 



IStdSti rtnira? Catyli: 
luftrioT OnicaZ Ganglion 




ScUr Ptrmnm 



Sgp'^MMtru PImim 



BtPwmijGamffli 



CMjylggm 



Course and distribution of the grreat Sympathetic Nerve. 



THB ©BEAT SYMPATHSTie, lOS 

Four of the sympathetic centers, situated in the front and 
lower portions of .the head, are designated as the ophthcdmic^ 
spheno-palatine, submaxillary and otic ganglia. The first of 
these, as its name indicates, is distributed to the eye, pene- 
trates the sclerotic membrarie (the white, opaque portion of the 
eyeball, with its transparent covering), and influences the 
contraction and dilation of the iris. The second division is situ- 
ated in the angle formed by the sphenoid and maxillary bone, 
or just below the ear. It sends motor and sensory filaments to 
the palate, and velum palati. Its filaments penetrate the 
carotid plexus, are joined by others from the motor roots of 
the facial nerve and the sensory fibres of the superior max- 
illary. The third division is located on the submaxillary gland. 
Its filaments are distributed to the sides of the tongue, the 
sublingual, and submaxillaiy glands. The otic ganglion is 
placed below the base of the skull, and also connects with the 
carotid plexus. Its filaments of distribution supply the internal 
muscles of the malleus^ the largest bones of the tympanum,^ 
the membranous linings of the tympanum and the eustachian 
tube. Three ganglia, usually designated as the superior, middhy 
and inferior, connect with the cervical and spinal nerves. Their 
interlacing filaments are distributed to the muscular walls of 
the larynx, pharynx, trachea, and esophagus, and also penetrate 
the thyroid gland. The use of this gland is not accurately 
known. It is composed of a soft, brown tissue, and consists 
of lobules contained in lobes of larger size. It forms a spongy 
covering for the greater portion of the larynx, and the first 
section of the trachea. That it is an important organ, is 
evident from the fact that it receives four large arteries, and 
filaments from two pairs of nerves. 

The sympathetic ganglia of the chest correspond in number 
with the terminations of the ribs, over which they are situated. 
Each ganglion receives two filaments from the intercostal 
nerve, situated above it, thus forming a double connection. 
The thoracic ganglia supply with motor fibres that portion of 
the aorta which is above the diaphragm, the esophagus, and 
the lungs. 

In the abdomen the sympathetic centers are situated upon 
the codiac artery, and are termed, collectively, the semilunar. 



JQ4. COM>rON 6KNSR MEDICAT. ADVI8KR. 

coeliac ganglion. Numerous inosculating branches radiate 
from this center and are called, from the method of their dis- 
tribution, the solar plexics. From this, also, originate other 
plexi which are distributed to the stomach, liver, kidneys, 
intestines, spleen, pancreas, supra-renal glands, and to the 
organs of generation. Four other pairs of abdominal ganglia 
connected with the lumbar branches are united by filaments to 
form the semilunar ganglion. 

The sympathetic ganglia of the pelvis consist of five pairs, 
which are situated upon the surface of the sacrum. At the 
extremity of the spinal column this system terminates in a 
single knot, designated as the ganglion impar. 

Owing to the position of the sympathetic ganglia, deeply 
imbedded in the tissues of the chest and abdomen, it is ex- 
ceedincrly difticult to subject them to any satisfactory experi- 
ments. A few isolated facts form the basis of all our knowl- 
edge concerning their functions. They give off both motor 
and sensory filaments. The contraction of the iris is one of 
the most familiar examples of the action of the sympathetic 
system. 

In the reflex actions of the nerves of special sense, the 
sensation is transmitted through the cerebro-spinal system, 
and the motor impulse is sent to the deep-seated muscles by 
the sympathetic system. Physiologists enumerate three kinds 
of reflex actions, which are either purely sympathetic, or 
partially influenced by the cerebro-spinal system. Dr. Dalton 
describes them as folloAvs: 

First. — " Reflex actions taking place from the internal organs, 
through the sympathetic and cerebro-spinal systems, to the 
voluntary muscles and sensitive surfaces. — The convulsions of 
young children are often owing to the irritation of undigested 
food in the intestinal canal. Attacks of indigestion are also 
known to produce temporary amaurosis [blindness], double 
vision, strabismus, and even hemiplegia. Nausea, and a dimin- 
ished or capricious appetite, are often prominent symptoms 
of early pregnancy, induced by the peculiar condition of the 
uterine mucous membrane." 

Second. — "Reflex actions taking place from the sensitive 
surfaces, through the cerebro-spinal and sympathetic systems, 



THE GREAT SYMPATHETIC. 105 

to the involuntary muscles and secreting organs. — Imprudent 
exposuie of the integument to cold and wet, will often bring on 
a diarrhea. Mental and moral impressions, conveyed through 
the special senses, will affect the motions of the heart, and 
disturb the processes of digestion and secretion. Terror, or an 
absorbing interest of any kind, will produce a dilatation of 
the pupil, and communicate in this way a peculiarly wild and 
unusual expression to the eye. Disagreeable sights or odors, 
or even unpleasant occurrences, are capable of hastening or 
arresting the menstrual discharge, or of inducing premature 
delivery." 

Third. — "Reflex actions taking place through the sympa- 
thetic system from one part of the body to another. — The 
contact of food with the mucous membrane of the small 
intestine excites a jjeristaltic movement in the muscular coat. 
The mutual action of the digestive, urinary, and internal gener- 
ative organs upon each other takes place entirely through the 
medium of the sympathetic ganglia and their nerves. The 
variation of the capillary circulation in different abdominal 
viscera, corresponding with the state of activity or repose of 
their associated organs, are to be referred to a similar nervous 
influence. These phenomena are not accompanied by any 
consciousness on the part of the individual, nor by any ap- 
parent intervention of the cerebro-spinal system." 



CHAPTER XIIT. 



THE SPECIAL SENSES. 



SIGHT. 

The eye is the organ through which we perceive, by the 
agency of light, all the varied dimensions relations, positions, 
and visible qualities of external objects. 

The number, position, and perfection of the eyes, vary 
remarkably in different orders, in many instances corresponding 
to the mode of life, habitation, and food of the animal. A 
skillful anatomist may ascertain by the peculiar formation of 
the eye, without reference to the general physical structure, 
in what element the animal lives. Sight is one of the most 
jjerfect of the senses, and reveals to man the beauties of 
creation. The aesthetic sentiment is acknowledged to be the 
most refining element of civilized life. Painting, sculpture, 
arcliitecture, and all the scenes of nature, from a tiny wayside 
flower to a Niagara, are subjects in which the poet's eye sees 
rare beauties to mirror forth in the rhythm of immortal verse. 

In the vertebrates, the organs of vision are supplied with 
filaments from the second pair of cranial nerves. In mammalia, 
the eyes are limited to two in number, which in man are 
placed in circular cavities of the skull, beneath the anterior 
lobes of the cerebrum. Three membranes form the lining of 
this inner sphere of the eye, called respectively the Sclerotic, 
Choroid, and Retina. 

The Sclerotic, or outer covering, is the white, firm membrane, 
which forms the larger visible portion of the eyeball. It is 
covered in front by a colorless, transparent segment, termed 
the cornea, whicli giv(!S the eye its lustrous appearaTice. "Within 
the sclerotic, and lining it throughout, is a thin, dark membrane, 
106 



SIGHT. 



107 



termed the Choroid. Behind the cornea it forms a cur- 
tain, called the iris, which gives to the eye its coloi-. The 
muscles of the iris contract or relax according to the amount 
of light received, thus enlarging or diminishing the size of 
the circular opening called the pupil. The Retina is formed 
by the optic nerve, which penetrates the sclerotic and choroid 
and spreads out into a delicate, grayish, semi-transparent mem- 
brane. The retina is one of the most essential organs of vision, 
and consists of two layers. A spheroidal, transparent body, 
termed the crystalline lens, is situated directly behind the 
pupil. It varies in density, increasing from without inward, 
and forms a perfect re- 
fractor of the light Fig. 62. 
received. The space in 
front of the crystalline 
lens is separated by the 
iris into two compart- 
ments called respec- 
tively the anterior and 
posterior chambers. The 
fluid contained within 
them, termed the aque- 
ous humor, is secreted 
by the cornea, iris, and 

ciliary processess. The space behind the crystalline lens is 
occupied by a fluid, called the vitreous humor. This humor is 
denser than the other fluids and has the consistency of jelly, 
being perfectly transparent, " The function of the crystalline 
lens is to produce distinct perception of form and outline." * 
The transparent humors of the eye also contribute to the 
same effect, but only act as auxiliaries to the lens. 

The figure on the next page represents the course of the 
rays of light proceeding from an object a h, refracted by the 
lens, and forming the inverted image x y on the screen. All 
rays of light proceeding from b are concentrated at y, and 
those proceeding from a converge at x. Rays of light eman- 
ating from the center of the object a b pursue a parallel course, 







* Dalton— Human Physiology. 



108 ' COMMON SENSE MEPICAX ADVISEB. 

and form the center of the image. Rays of light passing 
through a double convex lens converge at a point called the 
focus. In the organ of vision, if perfect, the focus is on the 
retina, which serves as a screen to receive the image or im- 
pression. We have a distinct perception of the outline of a 
distant hill, and also of a book lying before us. The rays of 
light we receive from these objects cannot have the same 
focus. How, then, can we account for the evident accommoda- 
tion of the eye to the varying distances? Various theories have 
been advanced to explain this adjustment; such as changes 
in the curvature of the cornea and lens; a movement of the 
lens, or a general change in the form of the eyeball, by 
which the axis may be lengthened or shortened. 

Two facts comprise all the positive knowledge which we pos- 
sess on this subject. Every person 
^ff- ^^- is conscious of a muscular effort in 

^j---.- ".-^''^v---^ ; directing the eye to a near object, 

J ''"":;- -""V^/- J\ ' T^~"^ ^*7 ^s a book, and of fatigue, if the 
A y^^S^<^\-~ J--^^^^'>^ X attention is prolonged. If, now, 
lOL^:^!!^^^-^--^^^'^^ the eyes be directed to a distant 

^ : . object, there will result a sense 

of rest, or passiveness. By vari- 
ous experiments it has been proved that the accommodation 
or adjustment of the eye for near objects requires a muscular 
effoit, but for distant objects the muscles are in an essen- 
tially passive condition. An increase in the convexity of the 
crystalline lens is now admitted to be necessary for a distinct 
perception of near objects. We may give two simple illus- 
trations, cited by Dr. Dalton in his recent edition of Human 
Physiology. If a candle be held near the front of an eye 
which is directed to a distant object, three reflected images 
of the flame will be seen in the eye, one on each of the anterior 
surfaces of the cornea and lens, and a third on the posterior 
surface of the latter. If the eye is directed to a near object, 
the reflection on the cornea remains unchanged, while that on 
the anterior surface of the lens gradually diminishes and 
approximates in size the reflection on the cornea, thus giving 
conclusive evidence that, in viewing a near object, the anterior 
surface of the crystalline lens become more convex^ and at 



HEAErSTG. 



109 



the same time approaches the cornea. Five or six inches is 
the minimum limit of the muscular adjustment of the eye. 
From that point to all the boxmdless regions of space, to 
every star and nebulae which send their rays to our planet, 
human vision can reach. It is the sense by which we receive 
knowledge of the myriads of worlds and suns which circle 
with unfailing precision throiigh infinite space. 

HEARING. 

Hearing depends upon the sonorous vibrations of the atmos- 
phere. The waves of sound strike the sensitive portions of 
the ear, and their 

impressions upon the Fig. OJf. 

auditory nerves are 
termed the sensa- 
tions of hearing. 
The ear is divided 
into three parts, 
called respectively 
the External, Middle, 
and. Internal ear. 

The external organs 
of hearing are two in 
number, and. placed 
on opposite sides of 
the head. In most 
of the higher cft-der 

of vertebrates thev Internal and external ear. 1. External ear. 2. In- 
' temal auditory meatus. S, Tympanum. A. Labyrinth, 

are so situated as to 5. Eustachian tube. 

give expression and 

proportion to the facial organs, and, at the same time, to 

suit the requirements of actual life. 

The External ear is connected with the interior part by a 
prolongation of its orifice, termed the external auditory meatus. 
In man, this gristly portion of the auditory apparatus is about 
one inch in length, lined by a continuation of the integument 
of the ear, and has numerous hairs on its surface, to prevent 
the intrusion of foreign substances. Between the external 
meatus and the cavity of the middle ear is the memhrana 




110 COM3HON SENSE MEDICAL ADVISBB. 

tympani, which is stretched across the opening like the head 
of a drum. The tyvipanum, or ear-drum, communicates with 
the pharynx by the eiistachian tube, which is a narrow passage 
lined with delicate, ciliated epithelium. On the posterior por- 
tion it is connected with the mastoid cells. Three small bones 
are stretched across the cavity of the tympanum, and called, 
from their form, the malleus, incus and stajyes, or the hammer, 
anvil, and stirrup. Agassiz mentions a fourth, which he terms 
the OS orhictdare. Each wave of sound falling upon the 
membrana tympani, throws its molecules into vibrations which 
are communicated to the chain of bones, which, in turn, trans- 
mits them to the membrane of the foramen ovale. The three 
muscles Avhich regulate the tension of these membranes are 
termed the tensor tympani, laxator tympani, and stapedium 
tympani. 

The Labyrinth, or Internal ear, is a complicated cavity, 
consisting of three portions termed the vestibule, cochlea, and 
semi-circular canals. The vestibule is the central portion and 
communicates with the other divisions. The labyrinth is filled 
with a transparent fluid, termed perilymjjh, in which are sus- 
pended, in the vestibules and canals, small membranous sacs, 
containing a fluid substance, termed endolymph (sometimes 
called vitrine auditive from its resemblance to the vitreous 
Immor of the eye). The filaments of the auditory nerve pen- 
etrate the membranous tissues of these sacs, and also of those 
suspended at the commencenient of the semi-circular canals. 
These little sacs are supposed to be the seat of hearing, and 
to determine, in some mysterious way, the quality, intensity 
and pitch of sounds. 

The determination of the direction of sound is a problem of 
acoustics. Some have contended that the arrangement of the 
semi-circular canals is in some way connected with this sensa- 
tion. But this supposition, together with the theory of the 
transmission of sound through the various portions of the 
cranial bones, has been exploded. 

From the foregoing description, it will be seen that the 
labyrinth and tympanum are the most essential parts of 
the organs of hearing. In delicacy and i-efinement this 
sense ranks next to sight. The emotions of beauty and 



SMELL. 



Ill 



sublimity, excited by the warbling of birds and the roll 
of thunder, are scarcely distinguishable from the intense emo- 
tions arising from sight. It is a remarkable fact, that the 
refinement or cultivation of these senses is always found 
associated. Those nations which furnish the best artists, or 
have the highest appreciation of painting and sculpture, 
produce the most skillful musicians, those who reduce music 
to a science. 

SMELL. 

Next in order of delicacy, and more closely allied with 
the physical functions, is the 

sense of smell. Delicate per- Fig. 65. 

fumes, or the fragrance of 
a flower, impart an exhilar- 
ating sensation of delight, 
while numerous odors excite 
a feeling of disgust. The 
organ of smell is far less 
complicated in its structure 
than the eye or the ear. 
It consists of two cavi- 
ties having cartilaginous 
walls, and lined with a 
thick mucous coat, termed 
the pituitary membrane, 
over which are reflected the 
olfactory nerves. Particles 
of matter, too minute to 
be visible even through the 
microscope, are detached 
from the odorous body and 
come in contact with the 
nerves of smell, which i. Frontal sinus 

transmit the impressions or ^^''^ ganglion and nerves. 4. Nasal branch 

. of the fifth pair. 5. Spheno-palatine gran- 

impulses thus received to giion. e. Soft palate. 7. Hard palate, a. 

the brain. Fig. 65 shows Cerebrum, h Anterior lobes, c. Corpus 

, , . . , . J, , eallosum. d. Septum lucidum. /. Fomlx. 

the distribution or the g, Thalami opticl. h. Corpora striata, 
olfactory nerves in the 

nasal passages. The nose is supplied with two kinds of 




Nasal bone. S. Olfae- 



112 COMMON SENSE MEDICAL, ADVISER. 

filaments which are termed respectively nerves of special and 
nerves of general sensation. Compared with the lower ani- 
mals, especially with those belonging to the carnivorous species, 
the sense of smell in man is feeble. The sensation of smell 
is especially connected with the pleasures and necessities of 
animal life. 

TASTE. 

The sense of taste is directly connected with the preserva- 
tion and nutrition of the body. A delicious flavor produces a 
desire to eat a savory substance. Some writers on hygiene have 
given this sense an instinctive character, by assuming that 
all articles having an agreeable taste are suitable for diet. 
The nerves of taste are distributed over the surface of the 
tongue and palate, and their minute extremities terminate in 
well developed papillm. These jKqnllm are divided into three 
classes, termed, from their microscopic appearance, filiform^ 
fungiform and circumvallate. The organ of taste is the mucous 
membrane which covers the back part of the tongue and the 
palate. The papilhe of the tongue are large and distinct, and 
covered with separate coats of epithelium. The filiform papillae 
are generally long and pointed and are found over the entire 
surface of the tongue. The fungiform are longer, small at the 
base and broad at the end. The circumvallate are shaped like 
an inverted V and aie found only near the root of the tongue; 
the largest of this class of papillae have other very small papillae 
upon their surfaces. It is now pretty satisfactorily established 
that the circumvallate, or fungiform papillae are the only ones 
concerned in the special sense of taste. 

The conditions necessary to taste are, that the substance be 
in solution either by artificial means, or by the action of the 
saliva; and that it be brought in contact with the sensitive 
filaments imbedded in the mucous membrane. The nerves 
of taste are both general and special in their functions. If 
the general sensibility of the nerves of taste is unduly excited, 
the function of sensibility is lost for some time. If a pepper- 
mint lozenge is taken into the mouth, it strongly excites 
the general sensibilities of taste, and the power of distinguish- 
ing between special flavors is lost for a few moments. A 



TOUCH. 113 

nauseous drug may then be swallowed without experiencing 
any disagreeable taste. 

Paralysis of the facial nerve often produces a marked effect 
in the sensibility of the tongue. Where this influence lies 
lias not been fully explained; probably it is indirect, being pro- 
duced by some alteration in the vascularity of the parts or a 
diminution of the salivary secretions. 

TOUCH. 

By the sense of touch, we mean the general sensibility of 
the skin. Sensations of heat and cold are familiar illustrations 
of this faculty. By the sense of touch, we obtain a know- 
ledge of certain qualities of a body, such as form consist- 
ency, roughness, or smoothness of surface, etc. The tip of 
the tongue possesses the most acute sensibility of any portion 
of the body, and next in order are the tips of the fingers. The 
hands are the principal organs of tactile sensation. The nerves 
of general sensibility are distributed to every part of the cuta- 
neous tissue. The contact of a foreign body with the back, 
will produce a similar tactile sensation, as with the tips of the 
fingers. The sensation, however, will differ in degree because 
the back is supplied with a much smaller number of sensitive 
filaments; in quality it is the same. 



CHAPTER XIV. 



CEREBRAL PHYSIOLOGY, 



By means of the nervous system, an intimate relation is 
maintained between mind and body, for nervous energy super- 
intends the functions of both. The fibres of nervous matter 
are universally present in the organization, uniting the physical 
and spiritual elements of man's being. Even the minutest 
nerve-rootlets convey impressions to the dome of thought and 
influence the intellectual faculties. We recognize muscular 
force, the strength of the body, molecular force, niolecules 
in motion, as heat, light, chemical force, electricity, and 
nervous force, a certain influence which reacts between the 
animal functions and the cerebrum, thus connecting the con- 
ditions of the body with those of the mind. We cannot 
speak of the effects of mind or body separately, but we must 
consider their action and reaction i;pon each other, for they 
are always associated. There are many difficulties in under- 
standing this relationship, some of which may be obviated 
by a study of the development of nervous matter, and its 
functions in the lower orders of organization. 

Withiii the plant-cells is found a vital, vegetable substance 
termed bioplasm, or protoplasm, which furnishes the same 
nutritive power as the tissues of the polyp and jelly fish. 
Many families of animals have pulpy bodies, and slight in- 
stinctive motion and sensibility, and in proportion as the nervous 
system is developed, both of these powers are unfolded. Plants 
have a low degree of sensibility, limited motion, respiratory 
and circulatory organs. Animals possess quicker perceptions 
and sensibilities, the power of voluntary motion, and, likewise, 
114 



CEREBSAL PHYSIOLOGY. 



115 




a rudimental nervous system. Some articulates have no bony 

skeleton, their muscles being attached to the skin which con- 
stitutes a soft contracting envelope. One of the simplest forms 

of animal life in which a ner- 
vous system is found, is the five- 
rayed star-fish. In each ray 
there are filaments which con- 
nect with similar nerve-filaments 
from other rays, and form a cir- 
cle around the digestive cavity. 
It probably has no conscious 
perception, and its movements 
do not necessarily indicate sen- 
sation or volition. In some 
worms a rudimentary nervous 
system is sparingly distributed 
to the cavities of the thorax and 
abdomen, and, as in the stai'-fish, 

the largest nerve-filament is found around the esophagus, pre- 

presiding over nutrition. 

A higher grade of organization requires a more complete 

arrangement of nervous substan(;e. Stimulus applied to one 

oi'gan is readily comrauni- 

cated to, and excites 

activity in another. 

The nervous system of 

some insects consists of 

two long, white cords, 

which run longitudinally 

through the abdomen, and 

are dilated at intervals 

into knots, consisting of 

collections of nerve-cells, ^- Nervous system of a Crab, showing its 
Ti J V mi, ganglia. B. The nervous system of a Cater- 

called ganglia. They are puj^r. 

really nerve-centers, which 

receive and transmit impulses, originate and impart nervous 

influence according to the nature of their organic surroundings. 

The ganglia situated over the esophagus of insects correspond 

to the medulla oblongata in man, in which originate the spinal 




116 COMMON SENSE MEDICAI- ADVISER. 

accessory, glosso-pliaryngeal, and pneumogastric nerves. The 
latter possess double endowments, and not only participate 
in the operations of deglutition, digestion, circulation, and 
respiration, but are also nerves of sensation and instinctive 
motion. The suspension of respiration produces suffocation. 
In insects, these ganglia are scarcely any larger than those dis- 
tributed -svithin the abdomen, with which they connect by 
means of minute, nervous filaments. Insects are nimble in 
their movements, and manifest instinct, corresponding to the 
perfection of their muscular and nervous systems. When we 
ascend to vertebrates, those animals having a backbone, the 
amount of the nervous substance is greater, the organic func- 
tions are more complex, and the actions begin to display intel- 
ligence. 

Man jDOssesses not only a complete sympatlietic system, the 
rudiments of which are found in w^orms and insects, and a 
complete spinal system, less perfectly displayed in fishes, birds, 
and quadrupeds, but, superadded to all these is a magnificent 
cerebrum, and, as we have seen, all parts of the body are con- 
nected by the nervous system. The subtle play of sensory and 
motor impulses, of sentient and spiritual forces, indicates a 
perfection of nervous endowments nowhere paralleled, and 
barely approached by inferior animals. This meager reference 
to brainless animals, whose knots of ganglia throughout their 
bodies act automatically as little brains, shows that instinct 
arises simultaneously with the development of the functions 
over which it presides. Here begins rudimentary, uni-easoning 
intelligence. It originates within the body as an inward, vital 
impulse, is manifested in an undeviating manner, and thei-efore 
displays no intention or discretion. While Dr. Carpenter likens 
the human organism " to a keyed instrument, from which any 
music it is capable of producing can be called forth at the will 
of the performer," he compares " a bee or any other insect to a 
barrel organ, which plays with the greatest exactness a certain 
luimber of tunes that are set upon it, but can do nothing else." 
Instinct cannot learn from experience, or improve by practice; 
but it seems to be the prophetic germ of a higher intelligence. 
It is nearly as difficult to draw the dividing line between 
instinct and a low grade of intelligence, as it is to distinguish 



CEREBRAL PHYSIOLOGY. 117 

between the psychical and psychological* functions of the 
brain. 

The intimate relation of instinct to intelligence is admirably 
illustrated in the working honey-bee. With forethought it 
selects a habitation, constructs comb, collects honey, provides 
a cell for the ova, covers the chrysalis, for which it deposits 
special nourishment, and is disposed to defend its possessions. 
It is a social insect, lives in colonies, chastises trespassers, 
fights its enemies, and defends its home. It manifests a degree 
of intelligence, but its sagacity is instinctive. Reason, though 
not so acute as instinct, becomes, by education, discerning and 
keenly penetrative, and reveals the very secrets of profound 
thought. We recall the aptness of Prof. Agassiz's remark: 
" There is even a certain antagotiism between itistinct and 
intelligetice, so that instinct loses its force and jy&cidiar char- 
acteristics, whenever intelligence becomes developedP Animals 
having larger reasoning powers manifest less instinct, and some, 
as the leopard, exercise both in a limited degree. This double 
endowment with instinct and low reasoning intelligence, is indi- 
cated by his lying in ambush awaiting his prey, the hiding- 
plac;e being selected near the haunt of other animals, where 
nature offers some allurement to gratify the appetite. 

Simple reflex action is an instinctive expression, manifesting 
an intuitive perception, almost intelligent, as shown by the 
contraction of the stomach upon the food, simply because it 
impinges upon the inner coats, and thus excites them to action. 
A better illustration, because it displays sympathy, is when 
the skin, disabled by cold, cannot act, and its duties are largely 
performed by the kidneys. Though reflex action is easily 
traced in the lower organic processes, some writers haA-e placed 
it on a level with rational deliberation. Undoubtedly, all 
animals having perception have also what perception implies 
— consciousness — and this indicates the possession, in some 

*In the use of the terms psychical and psychological, we have observed the 
distinction which metaphysicians have recently made. The3' employ the term 
psychical to indicate the relation of the human soul to sense, appetite, pro- 
pensity, etc., and psychological, as indicating- the ultimates of spiritual being'. In 
this manner we use the word psychical as describing the relationship of the soul 
to animal experiences and being-, and psychological as referring to the spiritual 
potencies of the soul. The distinction being introduced, we continue its use 
ratber than coin new words. 



118 COMMON SENSE MEDICAL ADVISER. 

degree, of reason. Compound reflex action extends into the 
domain of thought. /Situple reflex action, or instinct, answers to 
the animal faculties, such as acquisitiveness, secretiveness, selfish- 
ness, reproductiveness, etc., and accomplishes two important 
purposes; self-preservation and the reproduction of the species. 
With many persons, these appear to be the chief ends of life ! 

The psychical functions connect, not only with animal pro- 
pensities, but also with the highest psychological faculties. 
Instinct is the representative of animal conditions, Just as the 
highest spiritual faculties are indicative of qualities and prin- 
ciples. The consistent mean of conduct is an equilibrium 
between these ultimate tendencies of our being. The psycho- 
logical functions render the animal nature subsei'vient to the 
rule of purity and holiness, and deeply influence it by the 
essential elements of spiritual existence. The psychical organs 
sustain an intermediate relation, receiving the impressions of 
the bodily propensities, and, likewise, of the highest emotions. 
Obviously, these extreme influences, the one growing out of 
animal conditions, the other, the result of spiritual relations, 
pass into the psychical medium and are refracted by it, or 
made equivalent to one force. The body requires the qualify- 
ing influences of mind. The tendencies of the animal facul- 
ties are selfish and limiting, those of the emotive, general, 
universal. The propensities, like gravity, expend their force 
upon matter; the emotions poiir forth torrents of feeling, and 
produce rhapsodies of sentiment. The propensities naturally 
restrict their expression to a specific object of sense; the 
emotions respond to immaterial being. The tendencies of the 
former are acquisitive, selfish, gratifying; of the latter, bestow- 
ing, exjianding, diffusing. The one class is restricted to the 
orbits of time and matter, the other flows on through the 
limitless cycles of infinity and immortality. The former is 
satiated in animal gratification, the latter in spiritual beatifi- 
cation. The one culminates in animal enjoyment, the other 
expands to its ultimate conceptions in the perfections of Divine 
Love. 

In the present life, mind and body are intimately connected 
by nervous matter. In this dual constitution, the spiritual, 
mental, and animal functions are made inseparable, and modify 



CEREBRAL PHYSIOLOGY. 119 

one another. The ultimate tendencies of each extreme exist, 
not absolutely for themselves, but for qualifyiug purposes, to 
establish a basis for the deeper economy of life,. By the 
employment of reason, animal and spiritual experiences are 
mutually benefited, and the consciousness rendered account- 
able. The bodily and mental workings are in many senses 
one, and help to interpret each other. 

Every fact of mind has many aspects. A brain force, which 
results in thought, is simultaneously a physiological force, if 
it influences the bodily functions. Likewise, spiritual concep- 
tions take their rise in the same blood that feeds the grosser 
tissues. This vital fluid is momentarily imparting and receiving 
elements from all the bodily organs, and these, in turn, must 
influence the process of thought, and, in a degree, determine 
its quality. The delicate outline, yea, even the substance of 
an idea, may depend upon the condition of the animal organs. 
Thought is subject to the laws of biology, and, therefore, is 
a symbol of health. Morbid conditions of the system hang 
out their signs in words and utterances. "Words which express 
fear are as true symptoms of functional difiiculty as is exces- 
sive palpitation. The organ representing fear sustains a special 
relation to the functions of the heart both in health and disease. 
Bright hopes characterize pulmonary complaints as certainly 
as cough. Exquisite susceptibility of mind indicates equally 
extreme sensibility of body, and those persons capable of fully 
expressing the highest emotions are especially susceptible to 
bodily sensations. Tears are physical emblems of grief, and 
fellow-feeling calls forth sympathetic tears. Excessive anxiety 
of mind produces general excitability of body, which soon 
results in chronic disease. Pleasurable emotions stimulate the 
processes of nutrition, and are restorative. This concomitance 
of mental and bodily states is very remarkable. Joy and Love, 
as well as jealousy and anger, flash in the eye and mould the 
features to their expression. Grief excites the lachrymal, 
and rage the salivary glands. Shame reddens the ears, drops 
the eyelids, and flushes the face; but profligacy destroys these 
expressions. The blush which suffuses the forehead of the 
bashful maiden betrays her love, and maternal love, stirred by 
the appeals of an idolized infant, excites the mammary gland 



120 COMMON SENSE MEDICAL ADVISER. 

to the secretion of milk. The sigh of melancholia indicates 
hepatic torpor, thus shoAving a special relation between the 
liver and respiratory oi'gaiis. These conditions of mind and 
body react upon one another. Even the thought of a luscious 
peach may cause the mouth to water. The thought of tasting 
a lemon fills the mouth with secretions, and a story with un- 
savory associations may completely turn the stomach. 

The relationship of mental and physical functions may be 
illustrated by entirely removing the spleen of an animal, as 
that of a dog. An invariable result of its extirpation is an 
unusual increase of the appetite, for at times the animal will 
eat voraciously any kind of food. The dog will devour, with 
avidity, the warm entrails of recently killed animals, and thrive 
in consequence of such an appetite. Another symptom, which 
usually follows the removal of the spleen, is an unnatural 
ferocity of disposition. Without any apparent provocation, 
the animal will attack others of its own, or of a different species. 
In some instances, these outbursts of irritability and violence 
are only occasional, but the experiments show quite conclusively 
that the spleen moderates combativeness, restrains the appetite, 
and co-operates with the will and judgment in controlling them. 

We shall briefly consider the practical question whether 
the elements of mind can be ideally arranged and presented, 
so as to more completely reveal their relations to, and disclose 
their effects upon the bodily functions. Modern philosophers 
conceive that mind consists of a triad of essentials; Intellect, 
Emotion, and Volition. Physiologists assign to the cerebrum 
its functions, and neurological, as well as phrenological writers, 
have located them as represented in Fig. 68. True, there is 
no structural division between the parts of the cerebrum to 
indicate this diversity of function, nor is there any percepti- 
ble limit between the sensory and motor filaments of the 
same nerve. As no one has any reason for denying that 
separate portions of the brain may manifest distinct functions 
of the mind, we shall assume it as a conceded proposition. The 
regions of the cerebrum, thus ideally represented, occupy but 
little more than half of the arc of a circle, whereas it is 
evident that the base of the nervous mass is not idle, and is 
equally entitled to our consideration. In the posterior chamber 



CEREBRAL PHYSIOLOGY. 



121 



of the skull is the cerebellum, anterior to, and below which, is 
the medulla oblongata, connecting with the spinal cord and 
sympathetic system. These various parts are essential to the 
harmonious blending of mind and body. To this end, two 

conditions are necessary. (1.) 



Fig. 68. 

STTiOt l op. 



All the nervous forces must 
be so related that action and 
reaction may be fully estab- 
lished. (2.) A complete ner- 
vous circuit is requisite for 
the reciprocal influence of 
mind and body. 

Nature answers to mind in 
physical correspondences. 
The planetary system is 
fashioned after a circle. Life 
itself springs from a spherule 
of forces. The perfection of 
an idea, or the completeness 
of a conception may be ex- 
pressed by a circle. The elements of Science, Astronomy, 
Geology, and Natural History, are pictorially represented in 
this manner. How appropriately and logically can a fragment 
of natural history, this epitome of all nature and science — the 
mind — be illustrated by a 

Fig. 69. 
Good. 




Positive. 



Negative. 



simple circle ! Every ele- 
ment must act and react, 
and be equal and opposite. 
Thus may the existence of 
the opposing energies and 
functions of each faculty be 
equally represented. The 
contrast aids us in under- 
standing their ultimate ten- 
dencies, and enables us to 

correctly value and define their nature. Faculties of kindred 
qualities may be grouped together, and their antagonisms rep- 
resented in the opposite arc of the circle. Let us employ a 
circle to represent mind. The conception of the abstract. 




Bad. 



122 COMMON SBNSE MEDICAL ADVISER. 

quality of good^ requires contrast with one of a converse 
nature, bad, (see Fig. 69). Opposite faculties may be portrayed 
in the same manner. The functions of the cerebrimi and spinal 
system may be symbolically represented as those of the highest 
and lowest organs, thus giving rise to the positive and negative 
extremes of feeling. The writer conceives of no other way 
in which the widely contrasted facts of human experience 
can be so perfectly symbolized. Good (Fig. 69) may repre- 
sent moral faculties, and bad, their opposites. Undoubtedly, 
nature is not so arbitrary in her arrangements as we are in 
shadowing forth our imperfect conceptions, yet is not this a 
decided improvement in determining cerebral faculties and 
their relations? We observe how scholars and philosophers 
confound the noblest and most exalted emotions with the 
animal propensities instead of distinguishing between them. 
*' The emotions are a department of the feelings, formed hy 
tlie intervention of intellectxial processes. Several of them 
are so characteristic that they can be known only by individual 
experiences^' as Wonder, Fear, Love, Anger. '''^ See Logic: 
Deductive and Inductive, by Alexander Bain, LL. D., page 508, 
(1874). 

This is not an exceptional, but a common example of classi- 
fying Love, the highest and purest of the emotions, with 
Anger, an animal propensity. Is it not more practical and 
philosophical to group the emotional faculties together, and 
upon an opposite arc represent their antagonistic energies, the 
ultimate tendencies of which are criminal? Both groups are, 
mutually modifying and restraining; the one relates instinc- 
tively to the bodily wants, the other to the requirements of 
mind, and each is essential to a consistent life. Accordingly, 
we deem it philosophi6al to consider words as symbols of 
mental faculties, and to classify together such spiritual unities 
as joy, hope, faith, and love, the tendencies of which are to 
quicken and transform the ultimates of carnal life into the 
rudiments of an immortal one, the beginning of heaven on 
earth. These restrain those opposites, which lead to crime 
and death. Love and Hate are as antagonistic as heat and cold, 
and the usefulness of both depends upon their proper tempera- 
ment. Fig. 70 represents the antagonism of the Intellectual 



CEREBRAL PHYSIOLOGY. 



123 



Fig. 70. 




faculties to the Animal, the Emotional to the Criminal, the 
Volitive to the Enfeebling. It is not essential to discover in 
the nerve-substance the precise power from which an impulse 
originates. We may reasonably interpret the functions of the 
brain, and yet be unable to dis- 
close the duties of any gang- 
lionic corpuscle composing it. 
We may foretell what each 
season of the year will bring 
forth, when we cannot forecast 
the history of a blade of grass 
or a single grain of any kind. 
We may predict the amount of 
rain for a month, and be unable 
to prognosticate correctly, the 
character of any storm, or give 
the history of a special drop of 
water. Although we cannot fol- 
low the movements of indi- 
viduals in a battle, yet we may 
predict the result of the combat; and thus, we judge of the 
functions of the brain without the ability to reveal the actions 
of one of the organic molecules of which it is composed. We 
aim to give a general, reasonable, and popular description of 
cerebral functions and their bearing upon health and disease. 

REGIONAL DIVISIONS. 

The anterior portion of the cerebrum is devoted to intellec- 
tual processes, which freely expend the vital energies. The 
Intellectual faculties are classified as represented in Fig. 71. 
The lower portion of the brain, bounded exteriorly by the 
superciliary ridge, corresponds to the Perceptive, the middle 
region to the Recollective, and the upper to the Reflective 
faculties. (See also Fig. 65, b.) If we divide the forehead 
by vertical lines, as shown in Fig. 71, the divisions thus formed 
represent respectively, the Active, Deliberative, and Contem- 
plative departments of the intellect, all the processes of which 
are sustained by vital changes, the transformation of organized 
materials. No mental eifort can be made without waste of 



124 



COMMON SENSE MEDICAL ADVISER. 



nervous matter. The gardener's hoe wears by use, and so does 
every part of the animal organism. Otherwise, nutrition would 
be unnecessary for the adult. The production of thought 
wears away the cerebral substance. In ordinaiy use, the brain 
requires one-fifth of the blood to support its growth and repair. 
Great mental efforts are attended by a corresponding expendi- 
ture of vital treasures, which aie abstracted from the total 
forces available for the necessities of the system. To repaii- 
the losses thus occasioned, materials are appropriated from 
the blood, which furnishes supplies in proportion to the de- 
mands made by the mental activities. The production of 
thought wears away the gray matter of the cerebrum as surely 

as the digging of 



Fig. 71. 



a canal wears 
away the iron 
particles of the 
spade. The brain 
would soon wear 
out did not the 
nutritive func- 
tions constantly 
make good the 
waste. The in- 
tellect, whiether 
engaged in obser- 
vation, generali- 
zation, or pro- 
found study con- 
sumes the brain and blood, hence intellectual activity implies 
VITAL EXPENDITURE. Expenditure is an emphatic word because 
all functions are essential to the production of this nerve- 
energy, which returns to the system no equivalent. Physical 
exercise, although attended by structural waste, is advantage- 
ous to the circulation of the blood, nutrition, secretion, and, in 
fact, beneficial to all the organic processes. This is not true 
of vigorous and prolonged mental labor, which is not attended 
by any of these incidental advantages. If a child attends a 
school in which mental development supersedes physical cul- 
ture, an inordinate ambition sways the youthful mind, and 




CEREBHAJL PH5rSlOLOGT. 125 

its baneful effects upon the health soon become manifest. 
Rigorous application of the intellectual faculties consumes 
the blood, exhausts the vital forces, weakens the organic 
functions, while j^allor covers the face, and the eyes sparkle with 
a hectic radiance. The family physician pronounces the con- 
dition Ancemia (a deficiency of red corpuscles in the blood), 
and this change in the quality of the blood is owing to the 
undue appropriation by the brain. Conversely, if the blood be 
destroyed, or its vitality reduced, in the Jsame proportion will 
the mental energies be weakened and all the functional powers 
of the physical system enfeebled. In brief, if the intellect be 
unduly exercised, the red corpuscles of the sanguine fluid will 
be gradually destroyed, and the serum allowed to predominate. 
The blood becomes weak and watery, the subject is nervous, 
dropsical, consumptive, and a derangement of the important 
functions follows almost invariably. Excessive intellectual 
activity often produces a weak state of the system, and the 
person thus affected becomes languid, spiritless, and an easy 
prey to disease. This mental cause and its bodily results may 
be classified in the following order. Mental Cause: Excessive 
Mental Exertion, which produces waste of the brain sub- 
stance and blood. 

( Vital Expenditure, 
Bodily results: < Anemia, 

( A Weak Condition. 

This kind of waste is best summed up in the words, Vital 
Expenditure. Upon the forehead, as represented in Fig. 72, 
we will therefore inscribe Intellect, Activity, and Vital 
Expenditure. Intellectual employment is usually accompa- 
nied by sedentary habits, neglect of healthful exercise, and a 
deprivation of pure air, to all of which ill health may be 
attributed. Were the intellectual expenditure arrested, and 
the forces turned into recuperative channels, many a person 
would become beautiful with the ruddy glow of health. With- 
out health there is no use for thought; cultivation of the mind 
is just as natural and essential as the culture of the body, 
and the trained development of both is needed for mutual 
improvement. 



12G 



COMMON SENSE MEDICAL ADVISER. 



EMOTIVE FACULTIES. 

What results follow the natural and the excessive exercise 
of the Emotite Faculties? As distinct organs of the body 
have diverse functions, so, in like manner, different parts of 

Mg. 72. 



^■P 



^^l 



"-^■t,. 



o MORTALITY 
p SYNCOPE 
^ ECSTASY 
< HAPPINESS 
X CALMNESS 






INTELLECT 
ACTIVITY 
VITAL EXPENDITURE 



RESTRAINT 
SLEEP 
NUTRITION 
CONSERVATION 




.-^ 



TAB/ 



ALIWENTATION 
RELAXATION 
FEEBLENESS 
DISEASE 

°^ of Fee^^ 



2^ 









'tt/ 



"<^c> 



'A 



% 



the brain perform the separate operations of the mind. It 
is easier to discriminate between the products of these dissimi- 
lar endowments than to determine the location of the faculties. 
The intellect deals with concrete subjects, and the emotions 
with abstractions; the intellect is exercised with material 
things, the emotions dwell upon attributes; the intellect 
considers the forces of matter, the emotions, the powers of 



CEBKBRAL PHYSIOLOGY. 127 

the soul; the former deliberates upon the truths of science, 
the latter is concerned with duties, obligations, or moral respon- 
sibilities; the first is satisfied only with new truths, original 
ideas, and rational changes, the last rest secui-ely on funda- 
mental principles, moral certainties, and the absolute constancy 
of perfect love. The intellectual faculties are wakeful, question- 
ing, mistrustful; the emotions are blind, hopeful, confiding; 
the one reasoning, exacting, demonstrating; the other, believ- 
ing, inspiring, devout. The intellect sees, the emotions feel; 
and, though these functions may blend, the one can never 
supersede the other. 

The quality of the emotional faculties is repi'esented by 
Benevolence, Sympathy, Joy, Hope, Confidence, Gratitude, 
Love, and Devotion, all of which are the very antitheses of the 
attributes of animal feeling, described as Melancholy, Fear, 
Anger, Hate, Malevolence, and Despair. To the emotions we 
refer the highest qualities of character, while their opposites 
represent the animal or baser impulses. True, the emotions 
modify the propensities, as sympathy softens grief. They may 
siibdue and refine the animal feelings, and thus veil them with 
a delicacy characteristic of their own purity; but the unre- 
strained influences of grief find vent in loud lamentations, 
and the bitter disappointments of the selfish faculties are 
passionate and violent. 

The Emotive Faculties — the organs of spiritual perceptions — 
are impersonal, outflowing, bestowing. The fimction repre- 
sented by Benevolence, is willing, giving. Devotion expresses 
dedication, consecration; Gratitude manifests a warm and 
friendly feeling toward a benefactor. 

" The depth immense of endless gratitude." — Milton. 

Love flames toward its object, is out-pouring, blessing; in- 
deed, all the emotions are gushing, effusive, impetuous, and 
profusely flowing; grand, torrent-like, overwhelming; employ- 
ing ideal, immaterial, spiritual expressions, developing principles 
and perfections while aspiring to happiness and immortality. 
Though beginning with humanity, they embody the Divine. 
They expand to their ultimate conceptions in the sublime 
attributes: the perfections of the God of Love; associating 



128 COMMON SENSE MeWCAL ADVISKK. 

with mortality a divine destiny commencing on earth, extending 
through time, pausing nut at the portals of death, the gateway to 
eternity, but flowing onward into the realms of eternal day. 

We may consider their counteracting influences, for, without 
doubt, by checking the selfish tendencies and restraining the 
animal propensities, they assist in controlling the sensual pas- 
sions, and thus balance the mind and body. Such an equiUb- 
rium we call happiness. If the emotions be acute and vehement, 
they will absorb all other impressions and revel in their culmi- 
nating and delightful experiences. They exhaust all the bodily 
energies, and a functional suspension, termed ecstasy, follows. 
It is a swooning, or fainting, a temporary loss of sensation and 
volition, accompanied by involuntary movements of the arms, 
smiting of the hands, sighing, and short ejaculatory expressions 
of rapture. This condition, occasioned by excessive emotion, as 
in praying, singing, exhortations, and sympathetic appeals, is 
xjontagious, often spreading with mysterious rapidity. Its 
culmination, ecstasy, is popularly termed ^^ the power.'''' When 
gradually induced, it is called trance, and each state is regarded 
by many as supernatural, caused by the immediate influence 
of the Holy Spirit. The explanation is this: when the emotive 
faculties are suddenly and powerfully excited, they quickly 
expend the organic forces, so that the individual swoons from 
sheer exhaustion. Undue expenditure of this class of brain 
functions not only consumes the bodily powers, but exhausts 
and prevents other mental operations. The sudden collapse 
of all voluntaiy functions resembles the fainting produced by 
blood-letting. We may sura up this rapid expenditure of 
energy in one expressive word, Exuaustion, which results in 
Ecstasy, or trance, and which, if carried a degree further, 
terminates in death. Beginning with the natural exercise of 
the emotions, we may state the order of sequences thus: 

Ordinary exercise leads to . . . . Calmness. 

Proper exercise "".... Happiness. 

Increased exercise " " . ... . Ecstasy. 

Excessive exercise " " . . , . Syncope. 

Prolonged exercise " " . . . . Tkance. 

Fatal exercise " " . . • . Mortality. 

Their tendencies are EXHAUSTIVE. 



CEBEBJ8AL PHYSIOLOGY. 129 

VOLITIVE FACULTIES. 

What are the physiological and morbid results attending the 
ordinary and the immoderate exei'cise of the Volitive Fac- 
ulties ? 

The generic term xoill, comprehends those faculties, the 
action of which is termed volition. The faculties of the will 
are Determination, Firmness, Decision, Ambition, Authority, 
and Vigilance, all of which indicate strength and continuity 
of purpose. Bordering upon the emotions are Patience and 
Perseverance, while adjoining the animal faculties are Power, 
Coarseness, and Love of Display. The former exhibit moral, 
the latter animal heroism. A sense of power urges forward, 
whether it be higher or lower, just as the sense of greatness 
makes a man great by inspiring him with confidence to put 
forth exertion. Nature is truthful in her aspirations. We 
know that courage, assurance, and conscious power are neces- 
sary for the fulfillment of purpose, because intention precedes 
action. Will-power is an indication of Health, and the con- 
stant exercise of these mental faculties exerts a steady, regular, 
and strengthening influence over the bodily functions. We 
translate mental energies into physiological industry. These 
faculties impart tone to the system, sustain the processes of nu- 
trition, circulation, assimilation, secretion and excretion, and their 
distinguishing characteristics are vigor, tension, and elasticity. 
They temper each element of character, as well as every vital 
act. They infuse the organism with a resisting power which 
renders it proof against the influence of miasma and malaria, 
and overcomes that passivity and impressionability so favorable 
to disease. Firmness expresses a physiological cohesiveness 
which strongly binds together the fibers of the tissues, and 
renders the organization compact and powerful. He, who can 
skillfully employ these energies, is already master of half of 
the diseases incident to mankind, and wields an indispensable 
adjunct to medicine, in the practice of the healing art. It is 
the key to success, for it unlocks difliculties and opens wide the 
door which leads to favorable results. 

Surplus energy sustains the circulation, increases capillary 
action, as if the excess of nerve-power were discharged from 



130 



COIMON SKNSK MKDICAI. ADVISEK. 



the distant extremity of each nerve and pervaded every tissue. 

The voluntary muscles indicate their participation in this 

energy, and, indeed, the whole organism is exalted by the 

influence of the mental faculties. They oppose the tendencies 

of Feebleness, Relaxation, and Derangement, and modify their 

proclivities to Disease. The will is the servant of the intellect, 

emotions, and propensities, and the executive agent of all the 

faculties. When the volitive faculties are in excess, they may 

overdo the other functions, prematurely break down the bodily 

organs, and, by overtaxing the system, subject it to pain and 

disorder. 

VOLITIVE FACULTIES. 

The natural effect of Firmness is physiological stability. 
The exercise of the volitive faculties displays both mental 
and bodily Energy. 

Temperance, 
Their tendencies are to ■{ Sanity, 

Health. 



ANIMAL FACULTIES. 

Under this generic term we will group those cerebral powers 
which are common to the inferior animals, and closely allied to 



Fig. 73. 



Flij. 7^. 





Fig. 73 is a representation of the cranial conformation of Alexander VI., exhib- 
iting a full development of the conservative faculti(!8. His character, according 
to history, brought rcproacli upon the papal chair. 

Fig. 74 represents Zeno, a profound thinker and moral philosopher. The con- 
trast in their cranial developments was no greater than that of their lives. 

bodily conditions and necessities. As denoting a group of 
animal faculties they relate not only to the organic functions 
and self-preservation, but combat the action of the intellect, 



CEREBRAL PHYSIOLOGY. 



131 



oppose the evolution of new ideas, resist investigation, and 
discredit the vahie of truth. Adhesiveness, being blindly con- 
servative, clings to old ideas and traditionary opinions. The 
animal faculties tend to stifle investigation, and put author- 
ity above truth and science. Having a fixity of nature, a 
stationary attachment, they treat all intellectual developments 
as absurd. When these faculties predominate, thought is 
obscured, intolerance of disposition is manifested, and mental 
progress is arrested. Thus they evince ' their conservative 
nature, and, since they relate to individual interests, they rep- 
resent the elements of instinct. Such are the functions of 
Acquisitiveness, Secretiveness, Selfishness, and Combativeness, 
as well as the Generative powers. If these faculties predom- 
inate, all intellectual advancements are treated as experiments 
or theoretical novelties, and rejected as evanescent and worth- 
less. If the promptings of these be followed, there will be 
no innovation, and the orthodoxy of the dark ages will remain 
the standard for all time The animal faculties coincide with 
Lethargy, Sleep, and Nutrition, thus favoring organic restora- 
tion The intellectual faculties are wakeful, active, irrepressi- 
ble, while the animal powers tend to repose, sleep, and reno- 
vation, and thus suspend the activities of thought, sense, and 
motion The intellect expends the energy of the sensorial 
centers, induces fatigue and suffering, whereas the animal 
faculties overcome the vigils of thought, and produce refresh- 
ing slumber. Dr. Young styles sleep " tired nature's sweet 
restorer." Swedenborg declared that, " in sleep the brain folded 
itself up, and the soul journeyed through the body, repairing 
the wastes of the previous day." When sleep is natural, the 
insane are in a fair way to recovery, the sick become convales- 
cent, ulcers granulate, and lesions are made whole. 

The animal faculties are skeptical, stubborn, and dogmatic, 
readily combining with those of the violent class, the ultimate 
tendencies of which are criminal. They are likewise conceited, 
assuming, and clannish. Any person distinguished by them, 
will cling to old associations, perpetuate the status of existing 
parties, be a stickler for creed, ceremonies, and stale opinions, 
and adhere to ancient orthodoxy in medicine and religion. The 
animal faculties, since they are staid and regular, are naturally 



152 COMMON SJENSE MEDICAL ADVISER. 

antagonistic to genius, sensibility, and originality. Their men- 
tal tendencies have been fairly described and their physiological 
results may be represented as follows: 

f Restraint, 
Sleep, 
The animal faculties produce «| Nutrition, 

I Restoration, 
[ Conservation. 

BASILAR FACULTIES. 

The ultimate tendencies of the faculties, represented by the 
posterior base of the cerebrum, are violent and criminal. 
Being contiguous to the junction of the cerebrum and spinal 
system, they are subject to the influence of animal experiences. 
A large development of these faculties is indicated by an 
unusual breadth and depth of the back part of the base of 
the brain, and a full, thick neck, both of which denote good 
alimentary and digestive powers. Active nutrition, plethora 
of the circulation, vigorous secretion, a well developed muscu- 
lar system, a large heart and lungs, are accessory conditions. 
"VVe do not associate corpulence or surplus of vitality with 
a long, slender neck. The character of cerebral manifestations 
is represented by the baser faculties of mind, such as Combat- 
iveness, Destructiveness, Desperation, Turbulence, Hatred, and 
Revenge. If unrestrained, these culminate in violent and 
criminal acts; if regulated, they are employed in personal 
defense. When unduly excited, they lead to dissipation, ob- 
scenity, swearing, rowdyism, and licentiousness; when perverted, 
they are the source of recklessness, quarrels, frauds, falsehoods, 
robberies, and homicides. They are unlike instinct, inasmuch 
as they are not self-limiting. The intimate relation which 
they sustain to the stomach and nutritive functions is strikingly 
displayed in the habit of alcoholic intoxication. Spirituous 
drinks deprave the appetite, derange and destroy the stomach, 
poison the blood, and pervert all the functions of mind and 
body; and their injurious influence upon the nerves and basilar 
faculties is equally remarkable. They excite combativeness, 
selfishness, irritability, and exaggerate the influence of the ani- 
mal organs. Intemperance results in disputes, fights, brawls, 



CEEEBKAL PHYSIOLOGY, 1^3 

and murders — the legitimate consequences of which are mis- 
understandings, suits at law, criminal proceedings, imprisonment, 
and the gallows. It is, therefore, evident that the ultimate 
tendencies of these faculties are tyrannical, cruel, violent, and 
atrocious. They are opposed to the noble, moral faculties — 
Faith, Love, and Devotion — and, whenever tempation inordi- 
nately allures, the course of life is likely to be characterized 
by dishonorable, deceptive, and treacherous conduct. 

The pangs of hunger cause soldiers to act more like ravenous 
beasts, than rational beings. It is animal instinct which im- 
pels the soldier to seek first for the gratification of his appetite. 
Some persons, instigated by carnivorous desires, yearn for raw 
meat, and will npt be satisfied unless their food is flavored with 
the flesh of animals. Their bodies increase and thrive, even 
to repletion. Contrast these individuals with pale, lean, anaemic 
people, who crave innutritions articles of diet, and eat soft 
stones, slate, chalk, blue clay, and soft coal. Such perversions 
of the appetite are manifested only when there is either a dimi- 
nution in the volume of blood, deficient alimentation, defective 
assimilation, or a general depravity of the nutritive functions. 
Morbid conditions generate vitiating tendencies and destroy 
the natural appetite. 

While alcoholic stimulants affect the medulla oblongata 
principally, opium acts chiefly on the cerebrum, and excites 
reverie, dreamy ideality, optical delusions, and the creative 
powers of the imagination; some of these hallucinations are 
said to be grotesquely beautiful and enjoyable. The effects 
of this agent differ from those of alcoholic intoxication by not 
deadening the moral sensibilities, or arousing the animal pro- 
pensities. Opium smokers are dreamy and abstracted, not 
quarrelsome or violent. Those who use ardent spirits lose 
their moral delicacy, their intellect becomes dull, the reason 
cloudy, and the judgment is overruled by appetite. It is 
conceded that the trophic center is principally in the medulla 
oblongata; the cerebellum and lower cerebral ganglia, how- 
ever, favorably influence the nutritive functions, and, when 
these organs are large and active, a plethoric condition is the 
natural consequence. Redundancy of blood in the body in- 
dicates preponderance of the basilar organs. These faculties 



134 COMMOJf SENSfi MEDICAL ADVlStlll. 

being vehement in character, an excess of animal characteristics 
produces those conditions which result in acute and inflamma- 
tory diseases. We may express these conditions of the system 
as follows: 

The Animal Faculties correspond to the lower instinctive 
manifestations. 

Acquisitiveness, 
The elements of character aie \ Selfishness, 



COMBATIVENESS. 

They tend to \ Turbulence, 



CuiME. 



They relate especially to the J Secretion, 
functions of i Nutrition, 



r Alimentation, 



A large development of them 
indicates 



[ Reproduction. 

' Vitality, 
Plethora, 
Hyperemia (con- 
gestion). 

These naturally give rise to the following diseases: Inflamma- 
tion, Rheumatism, Gout, Convulsions, etc., which, in these con- 
ditions, pursue a violent course. 

REGION OF FEEBLENESS. 

Although the middle lobe of the cerebrum, at the base of the 
brain, does not denote decided force of character, or energy of 
constitution, yet it has a certain sphere of normal action which 
is essential to the harmony of mind and body. If this region is 
largely developed, the constitution is languid, inefticient, sensi- 
tive, and abnormally disposed. But if it be deficient, the 
volitive energies preponderate, and there is a lack of those 
susceptibilities of constitution, which prevent excessive waste. 
The cerebral faculties are Fear, Anxiety, Sensibility, Servility, 
Relaxation, and Melancholy, and their excessive predominance 
indicates a weak, vacillating, irresolute character, and the exist- 
ence of those bodily conditions which produce general excita- 
bility and chronic derangement. A full development of this 
portion of the brain indicates that the person is naturally 
dependent, infeiior, and subservient to stronger characters. Such 
a one is fearful, fretful, complaining, irritable, dejected, morose, 



CfiiRESftAii Physiology. 1'^5 

and, sooner or later, becomes a fit subject for chronic disease.* 
The ultimate result of excessive fear, excitability, and irrita- 
bility, is functional or organic derangement, — the morbid con- 
ditions represented by the word Disease. The medulla oblongata 
and portions of the middle lobe of the brain, the functions 
of which represent Excitability, Anxiety, 
Fear, and Irritability (symbols of physical 
profligacy), are located just between 
the ears (see Fig, 60). Inferior animals 
distinguished for breadth between the 
ears are not only cunning and treach- 
erous, but very excitable and irritable. 
The head of the Fox is remarkable for 
its extreme width at the region of Fear. 
He is proverbially crafty and treacherous, 
always excitable, and so variable in tem- 
per that he can never be trusted. He is Sly Reynard, 
a very timid thief, exceedingly suspicious, 

irregular in habits, and frequently driven by hunger into mis- 
chievous depredations. 

The organ of alimentiveness, located directly in front of the 
ear, indicates the functional conditions of the stomach, which, 
when aroused by excessive hunger, exerts a debasing influence 
upon this and all of the adjacent organs, and is demoralizing to 
both body and mind. In obedience to the instinct of hunger, 
children will slyly plunder gardens and orchards, displaying 
profligate, if not reckless tendencies in the gratification of the 
appetite. In this regional division we include the medulla, the 
posterior and middle portions of which give rise to the pneu- 
mogastric nerve. This nerve receives branches from the spinal 
accessory, facial, liypoglossal, and the anterior trunks of the fii'st 
and second cervical, and its filaments are distributed to the 




♦Certain disturbances of the bodily organs excite fear. The apprehension of 
danger, or simply mental excitement, does not explain what is called "water 
fright," "stage fright," terror excited by the raging of a storm, or the rocking of 
a boat. In such instances the heart may beat heavily, the respiration be irregular 
and attended by precordial oppression, giddiness, weakness, and physical inability 
to articulate a word or recall a thought. These bodily conditions are not subject 
to the control of the will, but arise when individuals are perfectly assured that no 
danger threatens. At other times, as in a fearful tempest upon the sea, although 
the danger be imminent, if the bodily functions are not disturbed, there is not the 
least manifestation of feai-. 



136 COMMON SENSE MEDICAL, ADVlSEft. 

lungs, stomach, liver, spleen, pancreas, and gall bladder (see 
Fig. 60, with explanation) Its agency is necessary to maintain 
the circulation, and the respiration, since, as the medium of 
communication, it conveys from the brain large supplies of 
nervous force to sustain these vital functions. It likewise 
instantly reports the impressions of these i)hysiological processes 
to the brain, and especially to those parts which, by analogy of 
functions. It likewise instantly reports the impressions of these 
physiological processes of the brain, and especially to those 
parts which, by analogy of functions, are intimately related to 
the stomach. Ilcnce, we observe that the conditions of the 
stomach give rise to reflex impulses, which involuntarily excite 
the animal faculties to the gratitication of the appetite. That 
the stomach has an intimate connection with the rest of the 
organism is evident from the fact that when it is inflamed the 
body is completely prostrated. 

We have already alluded to the perverting tendencies of alco- 
holic stimulants. Their peculiar influence upon the cerebellum 
causes the subject to reel and stagger, as though a portion of 
that organ were removed; the group of energetic faculties is 
stupefied, and mental as well as corporeal lethargy is the result. 
The reaction, which inevitably follows, is almost unbearable, and 
relief is sought by repeating and increasing the poisonous 
draughts, the primary influence of wliich is stimulating, the 
ulterior, depressing. Alcoholic stimulants unduly excite the 
nervous centers, the heart, and the arteries, and, consequently, 
the blood is carried to the surface of the body, where it coun- 
teracts the influence of cold and exposure, the frequent atten- 
dants upon drunkenness. The use of alcoholic beverages per- 
verts the appetite, interrupts habits of industry and destroys 
all force of character. Pecuniary, physical, and mental ruin, 
therefore, are sure to follow as the consequences of habitual, 
alcoholic intoxication. 

That ordinary alimentation, which includes the process of 
digestion, the subsequent vital changes involved in the conver- 
sion of food into blood, and its final transformation into tissue, 
causes mental languor and dullness, as well as bodily exhaustion, 
is attested by universal experience. A torpid condition of the 
liver, one of the most inveterate of chronic derangements, is 



CEREBRAT. PHYSIOLOGY, l37 

indicatol l>y sullenness, melaucholy, despondency, loss of in- 
terest in the affairs of life, sluggishness, etc., and the ultimate 
tendency of this morbid state is towards suicide. A broad and 
deep development of the middle lobe of the brain, shown by a 
fullness under the chin, and of the adjacent portion of the neck, 
denotes tendencies to somnambulism, delirium, and insanity. If 
such characteristics of the organization do not culminate in 
mental dei-angement, they exhibit childishness, helplessness, and 
great dependence. Age abates the vigor of the executive fac- 
ulties, and old people manifest not only bodily infirmities, but 
the relaxing and enfeebling influences proceeding from the 
lower portions of the brain. They totter about in their second 
childhood, mentally and physically enervated. Those who be- 
come dissipated by the use of intoxicating beverages are not 
only weak, trifling, and foolish, but walk with an unsteadiness 
which betrays their condition. These illustrations show that this 
part of the brain is destitute of energy. Diseases of the diges- 
tive organs also indicate it. Cholera, whether induced by 
invisible animalcules in the air, or in water, takes the route of 
the alimentary canal, opens the vital gates, and myriads of 
victims are swept down to death. It proves remarkably fatal 
to those having this cerebral conformation. Perhaps enough 
has been said to indicate the relaxing and enfeebling tend- 
encies of this region of the brain. They may be classified as 
follows : , 

EEQION OF FEEBLENESS. 

Sebyility, 
Cautiousness, 
Fear, 
Cerebral Functions: \ Anxiety, 

Sensibility, 

Cunning, 

Profligacy, 

Atonic, 

Excitability, 

Relaxation, 

Feebleness, 

Disease. 



Physiological conditions 
and tendencies: 



This classification shows their tendencies to chronic disease, 
functional derangement, insanity, and suicide. 



138 



COMMON SENSE MEDICAL ADVISEE. 



GENERAL CONSIDERATIONS. 

Before the structure of the brain was understood, Buffon 
spoke of it as a "mucous substance of no great importance." 
Its functional significance was so slightly appreciated that some 
people hardly suspected they had any brains, until an accident 
revealed their existence. Latterly, however, it is generally 
understood that the perfection of an animal depends upon 
the number and the development of the organs controlled by 
the nervous system, the sovereign power of which is symbol- 
ized by a grand cerebrum, the throne of Reason. That animal 
which is so low in the scale of organization as to resemble a 
vegetable, belongs to an ascending series ending in man. The 
lowest species have no conscious perception, and their move- 
ments do not necessarily indicate sensation or volition. Instinct 
culminates in the Articulates^ especially in Insects ; while 
created intelligence reaches its acme in man, the highest repre- 
sentative of the Vertebrates. 

" All things by regular degrees arise— 
From mere existence unto life, from life 
To intellectual power; and each degree 
Has its peculiar necessary stamp, 
Coo-nizable in forms distinct and lines." — Lavater. 

Man, in the faculties of mind, possesses more than a comple- 
ment for instinct; some 



Fig. 70. 



of the lower animals, 
however, seem to share 
his rational nature, and 
to a certain degree be- 
come responsible to 
him. Finally, the man- 
ifestations of mind 
bear a relation to the 
development of cere- 
bral substance, and to 
the bodily organization 
which supplies the 
brain with blood. Fig. 
76 shows the relative 
amount of brain matter in the lower animals, compared with 




Outline of Skulls. 1. European. S. Negro. 
Tiger. A. Hedge Hog. r>. Sloth. 



CEREBRAL PHYSIOLOGY, 139 

that of man; the peculiarities of each agreeing with its cere- 
bral couformation. It is easier to measure the capacity of 
skulls in different races than to procure and weigh their brains. 
The following table has been published. 

CRANIAL CAPACITY OF HUMAN RACES. 

RACE. CUBIC INCHES. 

Swedes, 100.00 

Anglo-Saxon?, 96.00 

Finns, 95.00 

Anglo-Americans, 94,30 

Esquimaux, 86.32 

North America Indians, 84.00 

Native Africans, 83.70 

Mexicans, 81.70 

American Negros, 80.80 

Peruvians and Hottentots, 75.30 

Australians, 75.00 

Gorilla, adult, 34.50 

Idiot, 22.57 

Mr. Davis, of England, having a collection of about eighteen 
hundred cranial specimens obtained from different quarters ol 
the globe, ascertained the relative volume of brain in different 
races, by filling the skulls with dry sand. He found that the 
European averaged 92 cubic inches, the Oceanic 89, the Asiatic 
88, the African 86, the Australian 81. Dr. Morton, of Philadel- 
phia, had a collection of over one thousand skulls, and his con- 
clusions were that the Caucasian brain is the largest, the Mon- 
golian next in size, the Malay and American Indian smaller, 
and the Ethiopian smallest of all. The average weight of 
brain, in 278 Europeans, was 49.50 oz., in 24 "White American 
soldiers, 52.06 oz., indicating a greater average for the Ameri- 
can brain. 

OUNCES. 

The brain of Cuvier, the celebrated naturalist, weighed 64.33 

Ruloff, the murderer and linguist, 59.00 

Dr. Spurzheim — phrenologist, 55.06 

Celebrated philologist, 47.90 

Celebrated mineralogist, 43.24 

Upholsterer, 40.91 

The weight of the human brain varies from 40 to 70 oz. ; 
that of idiots from 12 to 36 and 40 oz. The average of 278 



140 COMMON SKNSIi MEniCAl, AOVISKft. 

male European brains was 494 o/.., wliile that of 191 females 
was 44 oz. If we compare the weight of the female brain with 
that of the body, the ratio is found to be as 1:36.46, while that 
of the male is as 1:36.50; showing that, relatively, the female 
brain is the larger. It appears that neither the absolute nor 
relative size of the cerebrum, but the am^ount of gray matter 
which it contains, is the criterion of mental power. Although 
a large cerebrum is generally indicative of more gray matter 
than a small one, yet it is ascertained that the grey substance 
depends upon the number, and depth of the convolutions of 
the brain, and the deeper its fissures, the more abundant is this 
tissue. It is this substance which is the source of thought, 
while the white portion only transmits impressions. 

We do not wish to underrate any attempt heretofore made 
to classify the functions of mind and assign to them an appro- 
priate nomenclature. It is not unusual for scientists to give 
advice to phrenologists and point out the fallacies of their 
system; but it is hardly worth while to indulge in destructive 
criticism, unless something better is offered, as the day has 
passed for ridiculing endeavors to understand and interpret 
the physiology of the brain. The all important question is, 
not whether phrenologists have properly located and rightly 
named all the faculties of mind, but have their expositions 
been useful in the development of truth. While endeavoring 
to connect each mental power with a local habitation in the 
brain, the system of phrenology may be chargeable with some 
incongruous classification of the faculties, and yet it has 
furnished an analysis of the mind which has been of incal- 
culable service to writers upon mental philosophy. Phre- 
nology, in popularizing its views, has interested thousands in 
their own organizations and powers, who would otherwise 
have remained indifferent. It has called attention to mental 
and bodily unities, has served as a guide to explain the physical 
and psychical characteristics of individuals, and has been 
instrumental in applying physiological and hygienic principles 
to the habits of life, thus rendering a service for which the 
world is greatly indebted. Samuel George Morton, M. D., 
whose eminent abilities and scholarship are unquestionable, 
employs tlio following language: 



cekebraIj physiology. 



141 



"The importance of the brain as the seat of the faculties of 
the mind, is pre-eminent in the animal economy. Hence, the 
avidity with which its structure and functions have been studied 
in our time; for, although much remains to be explained, much 
has certainly been accomplished. We have reason to believe, 
not only that the brain is the center of the whole series of 
mental manifestations, but that its several parts are so many 
organs, each one of which performs its peculiar and distinctive 
office. But the number, locality, and functions of these several 
organs are far from being determined; nor should this uncer- 
tainty surprise us, when we reflect on the slow and devious 
process by which mankind has arrived at some of the simplest 
physiological truths, and the difficulties that environ all inquiries 
into the nature of the organic functions." 

We may here allude to the recent experimental researches 
with reference to the functions of various portions of the brain, 
prosecuted by Dr. Ferrier, of England. He applied the electric 
current to different parts of the cortical substance of the cere- 
brum in lower animals which had been rendered insensible by 
chloroform, and by it could call forth muscular actions expres- 
sive of ideas and emotions. Thus, in a cat, the application of 
the electrodes at 

point 2, Fig. 77, Fig. 77. 

caused elevation 
of the shoulder 
and adduction of 
the limb, exactly 
as when a cat 
strikes a ball with 
its paw; at point 
4, corrugation of 
the left eye-brow, 
and the drawing 
inwardand down- 
ward of the left 
ear; when applied at point 5, the animal exhibited signs of 
pain, screamed, and kicked with both hind legs, especially the 
left, at the same time turned its head around and looked behind 
in an astonished manner; at point 6, clutching movement of the 




Side view of the brain of a Cat. A. Crucial sulcus 

dividing- anterior convolutions. B. Fissiu-e of 

Sylvius. G. Olfactory bulb. 



142 COMMON SENSE MEDICAL ADVISER. 

left paw, with protrusion of the claws; at point 13, twitching 
backward of the left ear, and rotation of the head to the left 
and slightly upward, as if the animal were listening; at point 
17, restlessness, opening of the mouth, and long-continued cries 
as if of rage or pain; at a point on the under side of the hemi- 
sphere, not showni in this figure, the animal started up, threw 
back its head, opened its eyes widely, lashed its tail, panted, 
screamed and spit as if in furious rage; and at point 20, sudden 
contraction of tlie muscles of the front of the chest and neck, 
and of the depressors (muscles) of the lower jaw, with panting 
movements. The movements of the paws were drawn inward 
by stimulating the region between points 1, 2, and 6; those of 
the eyelids and face were excited between V and 8; the side 
movements of the head and ear in the region between points 9 
and 14; and the movements of the mouth, tongue and jaws, with 
certain associated movements of the neck, being localized in the 
convolutions bordering on the fissure of Sylvius (B), which 
marks the division between the anterior and middle lobes of the 
cerebrum. Dr. Ferrier made similar experiments on dogs, 
rabbits, and monkeys. The series of experiments made on the 
brain of the monkey is said to be the most remarkable and inter- 
esting, not only because of the variety of movements and 
distinctly expressive character of this animal, but on account of 
the close conformity which the simple arrangement of the 
convolutions of its brain bears to their more complex disjDo- 
sition in the human cerebrum. It is premature to say what 
import we shall attach to these experiments, but they have 
established the correctness of the doctrine, advanced on page 
105, that thought, the product of cerebral functions, is a class 
of reflex actions. The cerebrum is not only the source of ideas 
but also of those co-ordinate movements which correspond to 
and accompany these ideas. Certain cerebral changes call forth 
mental states and muscular movements which are mutually 
responsive. They indicate that various functions are automatic, 
or dependent upon the will, and, as we have seen, experiments 
indicate that the electric current, when applied to the cerebrum, 
excites involuntary reflex action. We cannot say how far these 
experimental results justify the phrenological classification of 
the faculties of mind, by establishing a causative relation 



CEBEBRAL PHYSIOLOGY. * 143 

between the physical and psychical states. This short and un- 
satisfactory account furnishes one fact which seems to support 
the claim of such a relation : the apparent similarity between the 
motor center of the lips and tongue in lower animals, and that 
portion of the human cerebrum in which disease is so often 
found to be associated with Aphasia, or loss of voice. While 
these experiments are by no means conclusive in establishing a 
theory, yet they favor it. 

It is wonderful that nervous matter can be so arranged as 
not only to connect the various organs of the body, but 
at the same time to be the agent of sensation, thought, and 
emotion. It is amazing, that a ray of light, after traversing a 
distance of 91,000,000 miles, can, by falling upon the retina, and 
acting as a stimulus, not only produce a contraction of the 
pupil, but excite thoughts which analyze that ray, instantly 
spanning the infinitude of trackless space! The same penetra- 
tive faculties, with equal facility, can quickly and surely dis- 
cern the morbid syniptoms of body and mind, become familiar 
with the indications of disease, and classify them scientifically 
among the phenomena of nature. The symptoms of disease 
which follow certain conditions as regularly as do the signs 
of development, and mind itself is no exception to this 
uniformity of nature. Thoughts result from conditions, and 
manifest them as evidently as the falling of rain illustrates 
the effect of gravity. The perceptive and highest emotive 
faculties of man depend upon this simple, but marvelously 
endowed nervous substance, which blends the higher spiritual 
with the lower physical functions. The functions of the body 
are performed by separate organs, distinguished by peculiar 
characteristics. To elucidate the distinctions between dissimi- 
lar, mental faculties, we have assigned their functions, with 
characteristic names, to different regions of the head. As 
they unquestionably influence the bodily organs, we are sus- 
tained by physical analogy, in our classification. Our knowl- 
edge of the structure and functions of the nervous system 
is yet elementary, and we are patiently waiting for scientists 
to develop its facts, and verify them by experimental investi- 
gations and such researches as time alone can bring to per- 
fection. While real progress moves with slow and measured 



144 COMMON SENSE MEDICAL ADVISER. 

foot-steps, the inspirations of consciousness and tlie inferences 
of logic prepare the popular mind for cerebral analysis. No 
true system can contradict the facts of our inner experience; 
it can only furnish a more complete explanation of their rela- 
tion to the bodily organs. It should be expected that such 
careful and pains-taking experiments, as are necessary to estab- 
lish a science, will be preceded by intuitive judgments and 
accredited observations, which may be, for a time, the substi- 
tutes of those more abstruse in detail. 

We have, in accordance with popular usage, treated the 
organs of thought as having anatomical relations. The views 
which we have presented in this chapter may seem speculative, 
but the facts suggesting the theory demand attention, and we 
have attempted to gather a few of the scattered fragments 
and arrange them in some order, rather than leave t&em to 
uncertainty and greater mystery. It is by method and classifi- 
cation that we are enabled to apply our knowledge to practical 
purposes. Possibly, to some, especially the non-professional, 
an allusion to the fact that cerebial physiology contributes to 
successful results in the practice of medicine, may seem to 
be an exaggerated pretension. None, however, who are con- 
versant with the facts connected with the author's experience, 
will so regard this practical reference, for the statement might 
be greatly amplified without exceeding the bounds of truth. 
Physicians generally undervalue the nervous functions, and 
overlook the importance of the brain as an indicator of the 
conditions of the physical system, because they are not suf- 
ficiently familiar with its influence over the bodily functions. 
Pathological conditions are faithfully represented by the 
thoughts, and words, Avhen used to describe symptoms, become 
the symbols of feelings which arise from disease. How few 
physicians there are who can interpret the thoughts, and glean, 
from the expressions and sentences of a letter, a correct idea 
of the morbid conditions which the writer wishes to portray! 
Each malady, as well as every temperament, has its character- 
istics, and both require careful and critical analysis before 
subjecting the patient to the influence of remedial agents. 

In a treatise by Dr. J. R. Buchanan, entitled " Outlines of 
Lectures on the Neurological System of Anthropology," are 



CEREBRAL PHYSIOLOGY. 145 

presented original ideas pre-eminently useful to the physician. 
His researches, and those of later writers, together with our 
own investigations, have greatly increased our professional 
knowledge. It is by such studies and investigations that we 
have been prepared to interpret, with greater facility, the indi- 
cations of disease, and diagnose accurately from symptoms, 
which have acquired a deeper significance by the light of cere- 
bral physiology. We are enabled to adapt remedies to constitu- 
tions and their varying conditions, with a fidelity and scientific 
precision which has rendered our success in treatment widely 
known and generally acknowledged. We annually treat thou- 
sands of invalids whom we have never beheld, and relieve them 
of their ailments. This has been accomplished chiefly through 
correspondence. When patients have failed to delineate their 
sj'^mptoms correctly, or have given an obscure account of their 
ailments, we have been materially assisted in ascertaining the 
character of the disease by photographs of the subjects. 
The cerebral conformation indicates the predisposition of the 
patient, and enables us to estimate the strength of his recuper- 
ative energies. Thus we have a valuable guide in the selection 
of remedies particularly suited to different constitutions. In 
the treatment of chronic diseases, the success attending our 
efforts has been widely appreciated, not only in this, but in 
other countries where civilization, refinement, luxurious habits, 
and effeminating customs, prevail. This fact is mentioned, not 
only as an illustration of the personal benefits actually derived 
from a thorough knowledge of the nervous system, but to show 
how generally and extensively these advantages have been 
shared by others. 

A careful study of cerebral physiology leads us deeper into 
the mysteries of the human constitution, and to the philosophical 
contemplation of the relations of mind and body. Self -culture 
implies not only a knowledge of the powers of the mind, but also 
how to direct and use them for its own improvement, and he 
who has the key to self-knowledge, can unlock the mysteries 
of human nature and be eminently serviceable to the world. 
For centuries the mind has been spreading out its treasury of 
revelations, to be turned to practical account, in ascertaining 
the constitution, and determining better methods of treating 
7 



146 COMMON SENSE MEDICAIj APVJSKR. 

disease. Since comparative anatomists and physiologists have 
revealed the structure of animals and the functions of their 
organs, from the lowest protozoan to the highest vertebrate, the 
physician may avail himself of this knowledge, and thus gain 
a deeper insight into the structure aiid physiology of man. 
An intimate acquaintance with the physical, is a necessary 
preparation for the study of the psychical life, for it leads 
to the understanding of their mutual relations and reactions, 
both in health and disease. 

Consciousness, or the knowledge of sensations and mental 
operations, has been variously defined. It is employed as 
a collective term to express all the psychical states, and is the 
power by which the soul knows its own existence. It is the 
immediate knowledge of any object whatever, and seems to 
comprise, in its broadest signification, both matter and mind, 
for all objects are inse2:)arable from the cognizance of them. 
Hence, the significance of the terms, subjective-consciousness 
and objective-consciousness. Peoi:)le are better satisfied with 
their knowledge of matter than with thck conceptions of the 
nature of mind. 

TPIE NATURE OF MIND. 

Since this subject is being discussed by our most distinguished 
scientists, Ave will conclude this chapter with an extract from a 
lecture delivered by Prof. Burt G. Wilder, at the American 
Institute: 

"There now remains to be disposed of, in some way, the 
question as to the nature and reality of mind, which was rather 
evaded at the commencement of the lecture. The reason was, 
that I am forced to differ widely from the two great physiolo- 
gists whom I have so often quoted this evening. Most people, 
following in part early instruction, in part revelation, in part 
spiritual manifestations, and in part trusting to their own con- 
sciousness, hold that the human mind is a spiritual substance 
which is associated with the body during the life of the latter 
in this world, and which remains in existence after the death 
of the body, and forms the spiritual clothing or embodiment of 
the immortal soul; and that the individual, therefore, lives after 
death as a spirit in the human form; that of this spiritual man, 



CEREBRAL PHYSIOLOGY. 147 

the soul is the essential being, of which may be predicted a 
good or evil nature, while the mind, which clothes it as a body, 
consists of the spiritual substances, affections, and thoughts, 
which were cherished and formed during the natural life. 

Together with the above convictions respecting themselves, 
most people, when thinking independently of theological subli- 
mations, feel willing to admit that animals have, in common 
with man, fewer or more natural affections and thoughts which 
make up their minds, but that the inner and immortal soul, 
which would retain them as part of an individual after death 
of the body, is not possessed by the beasts that perish. In 
short, the vast majority of mankind, when thinking quietly, and 
especially in seasons of bereavement, feel well assured of the 
real and substantial existence of the human mind, independently 
of its temporary association with the perishable body. 

But in antagonism to this simple and comforting faith, stand 
theological incomprehensibilities on the one hand, and scientific 
skepticism on the other. The former would have us believe that 
the soul is a mere vapor, a cloud of something ethereal, of which 
can be expected nothing more useful than 'loafing around the 
Throne,' while the latter asks us to recognize the existence of 
nothing which the eyes cannot see and fingers touch; to cease 
imagining that there is a soul, and to regard the mind as merely 
the product of the brain; secreted thereby as the liver secretes 
bile. Let us hear what the two leading nervous physiologists, 
of this country, have to say upon this point: 

* The brain is not, strictly sj^eaking, the organ of the mind, for 
this statement would imply that the mind exists as a force, inde- 
pendent of the brain; but the mind is produced by the brain 
substance; and intellectual force, if we may term the intellect a 
force, can be produced only by the transmutation of a certain 
amount of matter; there can be no intelligence without brain 
substance.' — Flint. 

* The mind may be regarded as a force, the result of nervous 
action, and characterized by the ability to perceive sensations, 
to be conscious, to understand, to experience emotions, and 
to will in accordance therewith. Of these qualities, conscious- 
ness resides exclusively in the brain, but the others, as is clearly 
shown by observation and experiment, cannot be restricted to 



148 COMMON SENSE MEDICAL ADVISER. 

that organ, but are developed with more or less intensity, in 
other parts of the nervous system.' — Hajvimond. 

Thus do the two extremes of theology and science meet upon 
a common ground of dreamy emptiness, and we who confess our 
comparative ignorance are comforted by the thought that some 
other things have been 'hid from the wise and prudent and 
revealed unto babes.' Yet, while feeling thus, it must be admit- 
ted that the existence of spirit and of a Creator do not yet seem 
capable of logical demonstration. The denial of their existence 
is not incompatible with a profound acquaintance with material 
forms and tlieir operations; and, on the other band, the belief in 
their existence and substantial nature, and in their powers as 
first causes, have never interfered with the recognition of the 
so-called material forces, and of the organisms through which 
they are manifested. At present, at least, these are purely mat- 
ters of faith; but although the Spiritualist (using the term in its 
broadest sense as indicating a belief in spirits), may feel that his 
faith discloses a beauty and perfection in the union, otherwise 
imperceptible by him, there is no reason why this difference in 
faith should make him despise or quarrel with his materialist 
co-worker, for the latter may do as good service to science, may 
be as true a man, and live as holy a life, although from other 
motives. 

The differences between religious sects are mainly of faith, 
not of works, and the wise of all denominations are gradually 
coming to the conviction that they will all do God more service 
by toleraticm and co-operation than by animosity and disunion. 
And so I hold that, until the spiritualist feels himself able to 
demonstrate to the unbeliever the existence of spirit and of 
God, as convincingly as a mathematical proposition, there should 
be no hard words or feelings upon these points. For the pres- 
ent they are immaterial in every sense of the Avord ; and so long 
as he bows to the facts and the laws of Nature, and deals with 
his fellow men as he would be done by, so long will 1 work with 
him, side by side, knowing, even though I cannot tell him so, 
that whether or not he joins me in this world, we shall meet in 
the other world to come, where his eyes will be opened, and 
where his lips will at least acquit me of bigotry and intol- 
erance." 



CHAPTER XV. 

THE HUMAN TEMPERA- 
MENTS. 



Organization implies vital energy, since there can be no 
organization without it. The sperm cell, as we have previously 
seen, exists before the initiation of the life of every individual 
organism. The early history of this fertilizing cell, which is 
composed of infinitesimal molecules which contain the embryo 
powers of life, is only partially written. It is a fact, authenti- 
cated by Faraday, that one drop of water contains, and may 
be made to evolve, as much electricity as, under a different 
mode of display, would suffice to produce a lightning-flash. 
Chemical force is of a higher order than physical, and vital 
force is of a still higher order. Within the iflicroscopic com- 
pass of the sperm cell are a great number of forces acting 
simultaneously, which require the answering conditions of a 
germ cell, and are so blended as to occupy a minimum of space. 
The union of these subtle elements through the agency of their 
physical, chemical, and vital forces, constitutes the initiation of 
life. Elementary matter is transformed into chemical and 
organic compounds, by natural forces, upon the cessation of 
which, it is liberated by nature's great destroyer, and reappears 
in the world of elements. Thus, man is formed out of the 
very dust by means of energies which reconstruct the crude, 
inert matter, and to dust he returns when those energies cease. 

When we enter upon the consideration of the temperaments, 
we should bear in mind one peculiarity of life: that it combines, 
in a small space, many complex powers. In the process of 
reproduction, there is a complex combination of organic 
elements. Structures differ as greatly as their functions. So 

149 



1^50 COMMON SENSE MEDICAL ADVISER. 

likewise do animals vary in their nature and organization, and 
individuals of the same species ai-e, in some respects, dissim- 
ilar. Yet the characteristics which have distinguished the races 
of mankind, are fundamental and faithfully maintained. Time 
does not obliterate them. Within race-limits are found enduring 
peculiarities, and, although each individual is weaving out some 
definite pattern of organization, it follows the tyj^e of the race, 
as well as the more immediate, antecedent condition. 

What then is a Temperament but a m-ixing together of these 
determining forces, a certain blending manifested in the con- 
stitution by signs, or traits, which we denominate character. 
The different races of mankind must haA^e their several stan- 
dards of tenijjerament, for the peculiarities of one are not fully 
descriptive of, and applicable to the other. 

The term temperamont is defined by Dunglison, as being " a 
name sciven to the remarkable differences that exist between 
individuals, in consequence of the variety of relations and 
proportions between the constituent parts of the body. 

For its simplicity and scope, we prefer the following defini- 
tion, suggested by our friend, Orin Davis, M. D.: A Tempera- 
ment IS A combination of organic ELEMENTS SO ARRANGED 
AS TO CHARACTERIZE THE CONSTITUTION. 

This leads ub to consider some of the elements, conditions 
and forces which give character to the organization. External 
circumstances supply necessary conditions to inward activity, 
for without air, food, or sunlight all living animals would 
perish. Everywhere, life is dependent upon conditions and 
circumstances; it is not self-generating. But the conditions of 
reproduction are very complex. External forces are trans- 
formed, and, in turn, becomes vital or formative powers. De- 
velopment is a transmutation of physical and chemical forces 
into vital energy. Although unable to compute the ultimate 
factors of life, yet we may illustrate their reproductive possi- 
bilities and results by comparing them with those of a lower 
order. 

Animal structures are mainly composed of four elements: 
oxygen, hydrogen, nitrogen and carbon. Other constituents, 
such as phosphorus, sulphur, potassium, sodium, calcium, 
magnesium, and iron, enter into their composition, but are 



THE HUMA>r TEMPERAMENTS. 151 

found in much smaller quantities. From these elements is fabri- 
cated an organism which manifests peculiar properties and 
marvelous functions. If the proportion of these chemical 
elements be varied, the organic compound will be changed, or, 
the proportions remaining the same, if the grouping of the 
elements be altered, different compounds will be produced, 
showing that the properties of oi'ganized substances depend 
upon the molecxdar constitution of matter. 

Rising in the scale of organization, we observe that every 
variation of the physical and chemical processes implies a corre- 
sponding modification of the vital. This is verified by the 
peculiarities of the several races of mankind. Individual dif- 
ferences are likewise modifications of these processes. Dynam- 
ical or vital differentiation depends upon these modifications 
for the display of vital energy, and is always associated with 
molecular changes. But it should be borne in mind that an 
effect may not resemble its cause in properties, and the qualities 
of a chemical compound may be quite different from those 
of its individual constituents. Organic matter, although more 
complex, may exhibit properties, both like and unlike its con- 
stituent elements. Within certain boundaries, the elements 
seek to satisfy their aftinities. We discover that there are 
limits between the genera of animals, as well as the races 
of mankind. Not less really, though perhaps not as absolutely, 
are there individual precincts within the sphere of the human 
temperaments, which cannot be passed. 

If we cannot satisfactorily explain, we can at least discover 
a reason for temperamental limitation. It is not designed to 
circumscribe healthful reproduction, but to serve as an effectual 
hindrance to abnormal deviations. We may state our belief 
in more positive terms: that the temperamental variations are 
essential to genesis and fertility, and indispensable to health 
and norinal development. 

Every individual is susceptible to impressions which dispose 
to action. Impressions which excite or increase this disposition, 
are called stimxdi. Vital change implies the existence of 
stimuli and susceptihility to stimulation. The stimulus may not 
be fui'nished because the conditions on which it depends are 
wanting; again, susceptibility may exist at one time and not 



152 



COMMON SENSE MEDICAL ADVISER. 



at another. Stimuli and susceptibility may be present in diifer- 
ent degrees, but for tlie purpose of healthful reproduction they 
must not be impaired. No single class of foods, albuminous, 
starchy, saccharine, or mineral, is sufficient for the nutrition 
of the bodyj but the food must contain substances belonging 
to each of the different classes. If an animal be fed exclusively 
upon albumen, though this substance constitutes the largest 
part of the bodily mass, exhaustion will rapidly follow, since 
the food does not contain all the essential, nutritive elements. 
Again, when the solids of the body have been wasted, they 
lose their susceptibility to stimuli, and the food does no good. 
Thus patients become emaciated during acute attacks of dis- 
ease, upon the cessation of which they are too feeble to recover, 
simply because they have lost the power to digest and assimi- 
late their food. 

In inanimate bodies, as in ciystals^ forces come to rest, but 
the very idea of life implies action and continual change. 
Hence diversity of constitutions and different temperaments 
ai-e essential in order that marriage may result in the re- 
production of vigorous beings. 

VITAL AND NON- VITAL TEMPERAMENTS. 

In the preceding chapter, we attempted to illustrate the 
unique blending of mind and body by means of the nervous 
system, and we now propose to exem- 
plify the physical conditions of the 
organism by certain correspondences, 
observed in the development and con- 
ditions of that system. If nature 
answer to mind in physical cor- 
respondences, she will obaerve 
the same regularity in physical develop- 
ment. The simplest classification of 
the temperaments is represented in Fig. 
78. Not only is mental activity de- 
pendent upon a vital activity in the 
brain, but the development of the cere- 
brum is dependent upon the supply of blood. The growth of 
the intellect requires the same conditions that aided in the 




THE HUMAN TEMPERAMENTS. 15B 

development of Vulcan's right arm: waste and supply; disinte- 
gration and reparation of tissue. Our modern iron forges produce 
many an artisan whose great right arm proclaims him to be a 
son of power as. well as of fire. Thus the fervid intellect, while 
forging out its thoughts, increases in size and strength. The 
difference between the development of the two is this; that 
the exercise of the blacksmith's right arm quickens the activi- 
ties of all the bodily functions, whereas the employment of 
the intellect does not offer any healthy equivalent. Physical 
exercise is a hygienic demand, but intellectual employment 
exerts no salutary influence on the body, while it is constantly 
expending the nutritive energies of the blood. The emotions, 
likewise, make exhaustive draughts upon nutrition to supply 
the waste of brain substance, just as certainly as physical 
labor causes muscular change, and demands reparation. One 
expends cerebral, the other, muscular substance. The one is 
healthful in its general tendencies, the other, comparatively 
wasteful and destructive. 

i DiSlNTEGBATING, 

The intellectual faculties are -| Expending, 

( Deeiving. 

( Engrossing, 
The emotive faculties are < Exhausting, 

( Devitalizing. 

These nervous forces are transformed into spiritual products. 

The base of the anterior lobes of the brain belong to the 
atonic region — the source of those languid, deranging in- 
fluences which coincide with morbidity and disease. A dis- 
turbance of the corporeal organs, which especially influence 
this portion of the brain, naturally tends to the development 
of insanity or imbecility. Morel has traced, through four 
generations, the family history of a youth who was admitted 
to the asylum at Rouen while in a state of stupidity and 
semi-idiocy. The following summary of his investigations 
illustrates the natural course of degeneracy as it extends 
through successive generations: immorality, depravity, alcoholic 
excess, and moral degradation, in the great-grandfather, who 
was killed in a tavern brawl; hereditary drunkenness, mani- 
acal attacks, ending in general paralysis, in the grandfather; 



l/)4 COMMON SENSE MEDICAI. ADVISER. 

sobriety, but hypochondriacal tendencies, delusions of persecu- 
tions, and homicidal tendencies in the father ; defective 
intelligence in the son. His first attack of mania occun-ed 
at sixteen, and was followed by stupidity, and finally ended 
in complete idiocy. Furthermore, there was probably an ex- 
tinction of the family, for the son's reproductive organs were 
as little developed as those of a child of twelve years of age. 
He had two sisters who were both defective physically and 
morally, and were classed as imbeciles. To complete the 
proof of heredity in this case, Morel adds that the mother 
had a child while the father was confined in the asylum, 
and that this child exhibited no signs of degeneracy. Statistics 
show that multitudes of human beings are born with a destiny 
against which they have neither the will nor the poAver to 
contend; they groan under the worst of all tyrannies, the 
tyranny of a bad organization, which is theirs by inheritance. 
We may represent the tendencies of the anterior portion of 
the brain by Fig. 79. The functional exercise of the antei*ior 
and superior portions of the cerebrum is disintegrating and 
devitalizing, while the anterior and inferior portions coincide 
with mental and physical derangement, Tinless counteracted by 
opposing forces. It is therefore evident that in any organiza- 
tion, upon which is entailed a perverted or excessive action 
of this portion of the cerebrum, the tendencies are non-vital, 
i. e., unfavorable to fertility and physical health. 

If the antagonizing regions are well developed, the tendencies 
are favorable to life. 

i Sanity, 
Temperance, 
Hardihood. 
! Nutrition, 
Restoration, 
Conservation. 
i Secretion, 
The basilar faculties instigate ■< Circulation, 

( Vitality. 



The combined action of these 



Energy, 
» ,^. ^ Health, 

faculties express Reproduction. 



If this portion of the brain indicates a full development, we 



THE HUMAN TEMPERAMENTS. 



155 



say of such a temperament that it is vital, because the functions 
of its nerve-centers are favorable to evolution. As degeneration 
observes conditions, so endurance and development conform to 
certain laws, and it is tho duty of all truthful inquirers, who 



Fig, 79. 



%<$>•' 



^/^ DERIVING 
S EXPENDING 
' DISINTEGRATING 



A .A.a^^--r'^gion 



^^-^ 



DEVITALIZING 

EXHAUSTING 

ENGROSSING 

O 



SANITY ®%Sf^ 

SELF-CONTROL "^N^ 
HARDIHOOD V^ 



NUTRITION 



RESTORATION '^\'^ 

13. 
CONSERVATION g 



w 




believe not only in the progress of human intelligence, but in 
physical improvement from generation to generation, to ascer- 
tain and comply with these essential conditions. When the 
anterior and middle lobes of the brain are fully developed at 
their inferior surfaces, it is regarded as an insane temperament, 
i- e., containing the germs of mental and bodily derangement. 



156 



COMMON SENSE MEDICAL ADVISER, 



How shall we distinguish the combination of organic elements, 
if not by the manner in which they characterize the constitution? 
Every human being is distinguished by natural peculiarities, 
both mental and physical. These are indicated not only by the 
color of the eyes, hair, and skin, and the mental expressions, 
but in the conformation and capabilities of the corporeal system. 
The color, form, size, and texture of a leaf, indicate to the 
expert pomologist the nature of the fruit which the tree will 
bear, but how much more important is it to understand the har- 
monies of human development. If Prof. Agassiz could deter- 
mine the form and size of a fish by seeing its scales, and Prof. 
Owen outline the skeleton of an unknown animal by viewing a 
portion of its fossil, why should not the physician understand 
the language of temperaments, since it opens to him the revela- 
tions of human development? The sculptor blends character 
with form, the artist endows the face with natural expression, 
the anatomist accurately traces the nerves and arteries, the 
physiognomist reads character, which the novelist delineates 
and the actor personates, because there are facts behind all 
these, the materials wherewith to construct a science. In or- 
ganization there are permanent forces which operate uniformly, 
thus revealing the order of nature. 



THE TEMPERA3IENTS CLASSIFIED. 



Fig. 80. 



We propose to speak of four constitutional variations entitled 
to separate consideration; the lymphatic, 
the sanguine, the volitive, and the en- 
cephalic. The brain controls all the 
voluntary, and modifies the involuntary 
functions of the body. A particular 
cerebral development modifies the func- 
tions of all the bodily organs, and 
thus tempers the constitution. We 
shall, therefore, base our classification 
of temperaments upon the mental and 
physiological characteristics, which are 
portrayed by cerebral development. 
Such an arrangement is illustrated by Fig. 80. 




THE HUMAN TBMPKEAMENTS. 157 

THE LYMPHATIC TEMPERAMENT. 

The lymphatic temperament predominates when the anterior 
base of the brain and the middle lobe are developed so as to 
exert a preponderating influence over the bodily functions. 
The character of this influence we have described in cerebral 
physiology. It is difiicult to state precisely the normal influ- 
ences and nerve-forces which arise from these faculties, but 
it is evident that they are specially related to nutritive at- 
traction, in opposition to volitive repulsion. It is only their 
excessive influence which produces worthless, miserable, morbid 
characters. A constitution marked by this development is 
indolent, relaxative, and an easy prey to epidemics. This 
treatment is also characterized by a low grade of vitality 
or resistance. When life is sustained by the volitive powers, 
it is distinguished by a softness of the bodily tissues, and the 
prevalence of lymph. The fact that all the organic functions 
are performed indolently, indicates lack of vital power. An 
excellent illustration of this temperament is found in Fig. 81, 
which represents a Chinese gentleman of distinction. In the 
lower order of animals, as in sponges, absorption is performed 
by contiguous cells, which are quite as effortless as in plants. 
Because of their organic indolence, sponges are often classed 
as vegetables. A body having an atonic or a lymphatic tem- 
perament is abundantly supplied with absorbent organs, which 
are very sluggish in their operations. In the lymphatic tem- 
perament, there seems to be less constructive energy, slower 
elaboration, and greater frugality. Lymph is a colorless or 
yellow fluid containing a large proportion of water. It is not 
so highly organized as the blood, but resembles it, when that 
fluid is deprived of its red corpuscles.' In the sanguine tem- 
perament, circulation in the blood-vessels is the most active, 
in the lacteals next, and in the lymphatics the least so, but in 
the lymphatic temperament, this order is reversed. 

Dr. W. B. Powell has observed that a lymphatic man has 
a large head, while a fat man has a small one, and also that 
fat and lymph are convertible, one following the other, i. e., 
"a repletion consisting of fat may be removed, and one of 
lymph may replace it, and vice versa.^'' He could not account 



158 



COMMON SENSE MEDICAL ADVISER. 



for these alternations. The bear goes into his winter quarters, 
sleek and fat, and comes forth in the spring just as plump with 
lymph, but he loses this fat appearance soon after obtaining 
food. This simply indicates that, during lymphatic activity, the 
digestive orgaus are comparatively quiescent. But when these 
are functionally employed again, lymphatic economy is not 
required. It is the duty of the lymphatics to slowly convert 



Fuj. SI. 




the fat by such transformation, that when it reaches the general 
circulation, it may there unite with other organic compounds, 
the process being aided by atmospheric nitrogen, introduced 
during the act of respiration. In this way it may become 
changed into those chemically indefinite, artificial products, 
called proteid compounds. This view is supported by the dis- 
appearance of fat as an organized product in the lymph of the 
lymphatic vessels, indicating that such transformation has oc- 
curred. In this way, by uniting with other organic compounds, 



THE HUMAN TEMPERAMENTS. 1 59 

it appears that lymph may serve as a weak basis for blood; 
that atmospheric nitrogen is also employed in forming these 
artificial compounds, is indicated by the fact that there is some- 
times less detected in arterial than in venous blood. 

This temperament is indicated by lymphatic repletion, soft 
flesh, pale complexion, watery blood, slow and soft pulse, oval 
head, and broad skull, showing breadth at its base. Fig. 82 
illustrates this temperament combined with sanguine elements. 

Fig. 82. 



Judge frreen, of the TTnited States Court. 

In all good illustrations of this temperament, there is a breadth 
of the anterior base of the skull extending forward to the 
cheek bones. There is likewise a corresponding fullness of the 
face under the chin, and in the neck, denoting a large develop- 
ment of the anterior base of the cerebrum. The cerebral 
conformation of the Hon. Judge Green indicates mental 
activity, and we have no reason to suppose that lymph was 
particularly abundant in his brain. 

Wliile this description of the lymphatic temperament is cor- 
rect, when illustrated by the civilized races of men who are 



KiO 



COMMON SENSE MEDICAL ADVISEB. 



accustoined to luxury, ease, and an abundance of food, it does 
not apply with equal accuracy to the cerebral organization 
of the American Indian. His skull, though broad at its anterior 
base, and high and wide at the cheek bones, differs from the 
European in being broader and longer behind the ears. Fig. 
83 is an excellent representation of a noted North American 
Indian. While a great breadth of the base of the brain 
indicates morbid susceptibilities, yet these, in the Indian, are 
opposed by a superior height of the posterior part of the skull. 
Consequently, he is restless, impulsive, excitable, passionate, 
a wanderer upon the earth. The basilar faculties, however, are 

large, and he is noted for instinct- 
Fig. 83. ive intelligence. His habits alter- 

nate from laziness to heroic effort, 
from idleness and quiet to the 
fierce excitement of the chase, from 
vagabondism to war, sometimes in- 
dolent and at other times turbu- 
lent, but under all circumstances, 
irregular and unreliable. In this 
case, lacteal activity is greater than 
lymphatic, as his nomadic life in- 
dicates. Nevertheless, he manifests 
a morbid sensibility to epidemic 
diseases, especially those which en- 
gender nutritive disorders and cor- 
rupt the blood. Figs. 84 and 85 
represent the brain of an American Indian, and that of a Euro- 
pean, and show the remarkable difference in their anatomical 
configuration. Evidently it is a race-distinction. Observe the 
greater breadth of the brain of the Indian, which according to 
cerebral physiology indicates great alimentiveness, indolence, 
morbid sensibility, irritability, profligacy, but also note that it 
differs materially in the proportion of all its parts, from the 
European brain. Judging the character of the Indian from the 
aforesaid representation, we should say that he was cunning, 
excitable, treacherous, fitful, taciturn, or violently demonstra- 
tive. His constitution is very susceptible to diseases of the 
bowels and blood. His appetite is ungovernable, and his 




THE HUMAN TEMPERAMENTS. 



161 



love of stimulants is strong. Syphilitic poison, small-pox, and 
strong drmk will annihilate all these tribes sooner than 
gunpowder. Their physical traits of constitution are no less 
contradictory than their extremes of habit and character, for 
while there is evidence of lymphatic elements, yet it is contra- 





B D 

American Indian. 

(From Morton's CRAiaA Americana.) 

In t'.i2 American Indian, the anterior lobe, lying between A A, and B J5, is small, 
and in the European it is large, in proportion to the middle, lying between B B 
unrt C C. In the American Indian, the posterior lobe, lying between C and D is 
' .uch smaller than in the European. In the Indian, the cerebral convolutions 
on the anterior lobe and upper surface of the brain, are smaller than the 
European. If the anterior lobe manifests the intellectual faculties— the middle 
J0^3 tuC propensities common to man with the lower animals— and the posterior 
-ooe, the conservative energies, the result seems to be, that the intellect of the 
American Indian is comparatively feeble— the European, strong; the animal 
propensities of the Indian will be great— in the European, more moderate ; while 
reproduction, ^'^tal energy, and conservation of the species in the Indian is not as 
great as with the European. The relative proportions of the different parts of 
the brain differ very materially. 

dieted by the color of the hair, eyes, and skin. This peculiar 
organization will not blend in healthful harmony with that of 
the European, and this demonstrates that the race-temperaments 
require separate and careful analytical consideration. 

By physical culture and regulation of the habits, the exces- 
sive tendencies of this temperament may be restrained. Solid 
food should be substituted for a watery diet. If it 'be limited 



162 COMMON SENSE MEDICAL ADVISER. 

in quantity, this change will not only diminish the size, 
but increase the strength of the body. The body should be 
disciplined by daily percussion until the imperfectly constructed 
cells, which are too feeble to resist this treatment, are broken 
and replaced by those more hardy and enduring. Add to this 
treatment brisk, dry rubbing, calisthenic exercises, and daily 
walks, which should be gradually extended. Continue this 
treatment for three months, and its favorable effects upon the 
temperament will surprise the most skeptical; if continued for 
a year, a radical alteration will be effected, and the hardihood, 
health, and vigor of the constitution will be greatly increased. 

This temperament may be improved physiologically, by being 
blended with the sanguine and volitive. The offspring will 
be stronger, the structures firmer, the organization more dense. 
Nutrition, assimilation, and all the constructive functions will 
be more energetic in weaving together the cellular fabric 
of the body. The sanguine temperament will add a stimulus 
to the organic activities, while the volitive will communicate 
manly, brave, and enduring qualities. When this temperament 
is united with the encephalic, if such a union does not result in 
barrenness, it adds expending and exhanstive tendencies to the 
enfeebling ones already existing, and, consequently, the offspring 
lacks both physical power and intellectual activity. 

The peculiarities of this temperament are observed in the 
diseases which characterize it. It is specially liable to derange- 
ments of digestion, nutrition, and blood-making. The blood 
is easily poisoned by morbid products formed within the body, 
as well as by those derived from the body of another. This 
is seen in pyaemia, produced by the introduction of decomposing 
pus, or " matter," into the blood. This condition is most likely 
to occur when the vital powers are low and the energies weak, 
for then the fibrin decreases, the red corpuscles diminish in 
number, the circulation becomes languid, the pulse grows flutter- 
ing and weak, and this increases until death ensues. An indi- 
vidual of this temperament is more easily destroyed than any 
other by the poison of syphilis, small-pox, and other contagious 
diseases. If the blood has received any hereditary taint, the 
lymphatic glands not only reproduce it but often increase the 
virulency of the original disease. This temperament indicates 



THE HUMAK TEMPEEAMKNTS. 163 

a necessity for the employment of stimulating, alterative, and 
anti-septic medicines. The torpid functions need arousing, the 
blood needs depuration, i. e., the elimination of corrupting 
matter, and the system requires alteratives to produce these 
salutary changes. The secretions need the correcting influence 
of cleansing remedies for the purification of the blood. 

Persons of this temperament are more liable to absorption 
of morbid products within the body, which are in a state of 
decomposition, producing an infectioti of the blood, technically 
termed septiccemia. The fatal results which so suddenly follow 
child-bed fever are thus produced. This kind of poisoning 
sometimes takes place from the absorption of decomposed 
exudation in diphtheria, and, though rarelj^, from decomposing 
organic products collected in the lungs. Whenever the absorp- 
tion of poison does take place, fatal consequences usually follow. 

This passive temperament is more likely to sink under acute 
attacks of disease, especially alimentary disorders, such as diar- 
rhea, dysentery, and cholera. It quickly succumbs to their 
prostrating effects, such as depression, congestion, and fatal col- 
lapse which rapidly succeed one another. Venesection and 
harsh purgatives are contra-indicated, and the physician who 
persists in their employment kills his patient. How grateful 
are warmth and stimulating medicines I The most powerful, 
diffusible, and nervous stimulants are required in cholera, when 
the system is devastated by the disease, as the plain is laid 
waste by the fierce tornado. 

THE SANGUINE TEMPERAJyiENT. 

Lymph is the characteristic of the lymphatic temperament, 
and its specific gravity, temperature, and standard of vitality 
are all lower than that of red blood. In the sanguine tempera- 
ment all the vital functions are more active, the blood itself 
has a deeper hue, its corpuscles carry more oxygen, the com- 
plexion is quite florid, and the arterial currents impart to 
every faculty a more hopeful vigor. The blood-vessels are 
the most active absorbents, eagerly appropriating nuti'itive 
materials for the general cii'culation, while the respiration adds 
to it oxygen, that agent which makes vital manifestation 
possible. This temperament exhibits greater sensibility, the 



164 COMMON SENSE MEDICAL ADVISER, 

conceptions are quicker, the imagination more viA'id, the appe- 
tite stronger, the passions more violent, and there is found 
every display of animal life and enjoyment. 

A full development of the basilar faculties, indicated by 
an unusual breadth and depth of the base of the brain, ac- 
companies this temperament. Its cerebral area includes the 
posterior and inferior portions of the cerebrum, the entire 
cerebellum, and that part of the medulla which connects with 
the spinal cord, all of which sustain intimate relations to vital 
conditions. Accordingly, such a development indicates good 
digestion, active nutrition, vigorous secretion, large heart and 
lungs, powerful muscles, and surplus vitality. The violent 
faculties, such as Combativeness, Destructiveness, and Hatred, 
are natural adjuncts, and their excess tends to sensuality and 
crime. They are not only secretive, appropriative, selfish, 
and self-defensive, but Avhen redimdant are aggressive and 
tend to destructiveness, the gratification of animal indulgence, 
intemperance, and debauchery. The corresj^ondence between 
the cerebral conformation and the physical development is 
very obvious. Lower orders of animals possess these faculties, 
and th§ir spontaneous exhibition is called instinct. They 
possess the acquisitive, destructive, and propagative propensi- 
ties, which lead them to provide for their wants and secure 
to themselves a posterity. The exercise of their bodies causes 
a continual waste which demands incessant reparation, and they 
are governed, measurably by these animal impulses. 

All of these lower psychical faculties have a physiological 
significance. Acquisitiveness functionally expresses assimila- 
tion, accretion, animal growth, and tends to bodily repletion. 
Secretiveness expresses concealing, separating, withdrawing, and 
functionally signifies secretive action. Secretion is the separ- 
ating and withdrawing from the blood some of its constituents, 
as mucus, bile, saliva, etc. This latter process indicates com- 
plex conditions of organization, so that the higher and more 
complex the tissue, the greater the number of secretory or- 
gans. Unrestrained selfishness, while it naturally conserves 
the individual interests, in its ultimate tendencies, is the very 
essence of human depravity. Without qualification, clearly, 
it is crime, for blind devotion to the individual must be in 



THE HUMAN TEMPERAMENTS. 



165 



Utter disregard for the good of others. The ultimate tendencies 
of these faculties are, therefore, criminal. 

Exaggerate the faculty of acquisitiveness, and it becomes 
avariciousness. Develop secretiveness and selfishness, and they 
become cunning and profligacy, desperation and crime. Their 
functional development tends to produce physical disorder and 
violent disease. All of these faculties are vehement, conten- 
tious, thriving by opposition. Life itself has been called a 
forced state, because it wars with the elements it appropriates, 
and transmutes their powers into vitality. 

We find men and women of this temperament, who aro 
models of character and organ- 
ization. George Washington is 
an excellent illustration. The 
impression that his presence 
made upon the Marquis de 
Chastellux, is given in the fol- 
lowing words: "I wish only 
to express the impression Gen- 
eral Washington has left on my 
mind; the idea of a pei'fect 
whole, brave without temerity, 
laborious without ambition, 
generous without prodigality, 
noble without pride, virtuous 
without severity." Gen. Scott, 
Lord Cornwallis, Dr. Wistar, 
Bishop Soule, John Bright, 
Jenny Lind Goldsmidt, and Dr. 
Gall are good representatives 
is an excellent illustration of 
balanced, in the person of Madame de Stael. This tem- 
perament requires fewer tonics and stimulants than the lym- 
phatic. This constitution is best able to restore vital losses. 
It is a vital temperament, in other words, it combines favorably 
with all the others, and better adapts itself to their various 
conditions. Some regard it as the best adjusted one in all 
its organs and tissues, and as the most satisfactory and 
serviceable. 




of this temperament. Fig. 86 
it, finely blended and well 



166 



COMMON SENSK MEDICAL, ADVISER. 



Excess of nutrition tends to plethora, to animal indulgence, 
and gross sensuality. Not only do the propensities rouse 
desire, but they excite the basilar faculties, and portray their 
wants in the outlines of the face, mould the features to their 
expression, and flash their significance from the eye. Who 
can mistake the picture of sensuality represented by Fig. 87? 
It is enough to shock the sensibility of a dumb animal, and 
to say that such a face has a beastly look, is an unkind 
reflection upon the brute creation. A large neck and corre- 
sponding development of the occipital half of the brain 
indicate nervous energy, yet nutrition is not absolutely depend- 
ent upon it, for the nutritive processes are active before a 

nervous system is formed. The 
Fig, 87. 






lower faculties of the mind 
exert a remarkable influence 
over nutrition, secretion, and 
the molecular changes incident 
to life. Anger or fear may 
transmute the mother's nourish- 
ing milk into a virulent poison. 
The following incident, taken 
from Dr. Carpenter's Physi- 
ology, illustrates this state- 
ment: "'A carpenter fell into 
a quarrel with a soldier billeted 
in his house, and was set-upon 
by the latter with his drawn 
sword. The wife of the car- 
penter at first trembled from 
fear and terror, and then sud- 
denly threw herself between 
the combatants, wrested the sword from the soldier's hand, 
broke it in pieces, and threw it away. During the tumult, 
some neighbors came-in and separated the men. While in 
this state of strong excitement, the mother took up her 
child from the cradle, where it lay playing, and in the 
most perfect health, never having had a moment's illness; 
she gave it the breast, and in so doing sealed its fate. In 
a few minutes the infant left-off sucking, became restless. 




THE HUMAN TEMPERAMENTS. 167 

panted, and sank dead upon the mother's bosom. The phy- 
sician who was instantly called-in, found the child lying in 
the cradle, as if asleep, and with its features undisturbed; but 
all resources were fruitless. It was irrecoverably gone.' In 
this interesting case, the milk must have undergone a change, 
which gave it a powerful sedative action upon the susceptible 
nervous system of the infant." , 

Anxiety, irritation, hatred, all tend to the vitiation of the dis- 
position and bodily functions, perverting the character and 
constitution at the same time. Depravity of thought and 
secretion go together. Degradation of mind and corruption of 
the body are concomitants. There is a very close affinity 
between mental and moral perversion and physical prostitu- 
tion, of which fact too many are unconscious. Nervous influ- 
ence preserves the fluidity of the blood and facilitates its 
circulation, for it appears that simple arrestment of this in- 
fluence favors the coagulation of the blood in the vessels; clots 
being found in their trunks within a few minutes after the brain 
and spinal marrow are broken down. Habitual constipation is 
the source of many ills. Perversion of the functions of the stom- 
ach, and of the circulation of the blood, produce general disaster. 

Diseases which characterize this temperament are acute, vio- 
lent, or inflammatory, indicating repletion and active conges- 
tion; intense inflammation, burning fevers, severe rheumatism, 
a quick, full pulse, great bodily heat, and functional excitement 
are its morbid accompaniments. These diseases will bear 
thorough depletion of the alimentary canal, active, hydragogue 
cathartics being indicated. Sedatives and anodynes are also 
essential to modify the circulatory forces, and to relieve pain. 
Violent disturbance must be quelled, and among the remedial 
agents required for this duty we may include Veratrum, Ipecac, 
Digitalis, Oj^iura, Conium, and Asclepias. While equalizing the 
circulatory fluids, restoring the secretions, and thoroughly evac- 
uating the system, and thus endeavoring to remove disturbing 
causes, we find that the conditions of this temperament are 
exceedingly favorable for restoration to health. True, many 
chronic diseases are obstinate, yet a course of restorative medi- 
cation persistently followed, promises a fortunate issue in this 
tractile temperament. 



168 COMMON SENSE MEDICAL ADVISER. 

Hygienic management of the lymphatic and sanguine temper- 
aments consists in the vigorous toning of the former, while 
restraint of the latter will greatly exempt it from the anxieties, 
contentions, and vexations which excite the mind, disturb the 
bodily functions, and end in chronic disease. People of the 
latter organization love mental and physical stimulants, are 
easily inflamed by passion, and their excitability degenerates 
into irritability, succeeded by serious functional derangements, 
which prematurely break down the individual with inveterate, 
deep-seated disorder. Serenity, hope, faith, as well as firmness, 
are natural hygienic elements. It is a duty we owe ourselves 
to promptly relinquish a business which corrodes with its cares, 
and depresses with its increasing troubles. Constant solicitude, 
and the apprehension of financial disaster, frustrate the bodily 
functions, disconcert the organic processes, and lead to mental 
aberration as well as physical degeneracy. Melancholy is 
chronic, while despair is acute mania, whose impulses drive the 
victim desperately toward self-destruction. The chronic de- 
rangement of these organs exerts with less force the same 
morbid tendency. Hence the necessity for exercising those 
hygienic and countervailing influences born of resolution, assur- 
ance, and confident trust, and the belief which strengthens all of 
the vital operations. 

Doubtless, this temperament is the source of the reproductive 
powers. It is the corner-stone essential to the foundation of all 
other temperaments. It has been supposed by some that the 
cerebellum is the seat of sexual instinct. The fact appears 
that an ample development of the posterior base of the cere- 
brum and the cerebellum indicates nutritive activity, which 
is certainly a condition most favorable to the display of 
amativeness. In a double sense, then, this temperament is a 
vital one; both by nutritive repletion, and by reproduction. It 
is the blood-manufacturing, tissue-generating, and body-con- 
structing temperament, causing growth to exceed waste, and 
promptly repairing the wear which follows continual labor. 

While the sleazy structures of the lymphatic temperament 
are favorable to the functions of transudation, exhalation, and 
mutual diffusion of liquids, the sanguine, as its name indicates, 
is adapted to promote the circulation of the blood, to favor 



THE HUMAN TEMPERAMENTS. 169 

nutrition and reproduction. The former temperament does not 
move the world by its energies, or impress it vividly with its 
wisdom, and the latter is more enthusiastic, enjoyable, and 
quickening. Each temperament, however, possesses salient qual- 
ities and advantages. 

THE LIFE LINE. 

Dr. W. B. Powell, in his work on "The Human Tempera- 
ments," announces the discovery of a measurement which indi- 
cates the tenacity of life, and the vital possessions of the 
individual. He has observed that some persons of very feeble 
appearance possess remarkable powers of resistance to disease, 
and continue to live until the machinery of life literally wears 
out. Others, apparently stronger and more robust, die before 
the usual term of life is half completed. He also noticed that 
some families were remarkable for their longevity, while others 
reached only a certain age, less »than the average term of life, 
and then died. He remarked also that some patients sank 
under attacks of disease, when, to all appearances, they should 
recover, and that others recovered, when, according to all 
reasonable calculations, they ought to die. He, therefore, not 
only believed that the duration of human life was more defi- 
nitely fixed by the organization than is supposed, but he set 
himself to work to discover the line of life, and the meas- 
ure of its duration. He made a distinction between vital 
vigor, and vital tenacity. Vital vigor he believed to be 
equivalent to the condition of vitality, which is indicated 
by the breadth of the brain found in the sanguine tem- 
perament; and vital tenacity to be measured by the depth 
of the base of the brain. Dr. Powell was an indefatigable 
student of nature, and followed his theory through years of 
observation, and measured hundreds of heads of living per- 
sons, in order to verify the correctness of the hypothesis. His 
method of measuring the head may be stated as follows: 
He drew a line from the occipital protuberance on the back 
of the head to the junct^n of the frontal and malar bones, 
extending it to a poiiit above the center of the external orbit 
of the eye, near the termination of the brow. Then he meas- 
ured the distance between this line and the orifice of the 



170 



COMMON SENSE MEDICAL ADVISER. 




car and thus obtained the measure indicatiiig the vital te- 
nacity or duration of life. Fig. 88 is a representation of 
the skull of Loper, who was executed for murder in Mis- 
sissippi. He might have attained a great age, had not his 
violent and selfish faculties led him into the commission of 

crime. In this illustration, 
Fiij. 88. B represents the occipital pro- 

tuberance, and A the junc- 
tion of the frontal and malar 
bones at the external angle 
of the eye. The distance be- 
tween this line (A B) and the 
external orifice of the ear, is 
the measure of the life-force 
of Loper at the time of his 
execution. 

The tenacity of an individ- 
ual's life, Dr. Powell determined by the following scale of 
measurements: three-fourths of an inch from the orifice of the 
ear to the life-line, is the average length in the adult, and in- 
dicates ordinary tenacity of life. As the distance decreases 
to five-eighths, one-half, or three-eighths of an inch, vital te- 
nacity diminishes. If the 

distance is more than three- ^'-f- ^^' 

quarters of an inch, it de- 
notes great vital endurance, 
excellent recuperative 
powers, and is indicative of 
longevity. If it measures 
less than half an inch, it 
shows that the constitution 
has a feeble, uncertain hold 
upon life, and an acute dis- 
ease is very likely to sunder 
the vital relations. Dr. 

Powell contended that "life force»and vital force are not 
equivalent terms, because much more vital force is expended 
upon our relations, than upon our organization in the preser- 
vation of life. Every muscular contraction, every thought, 




THE HUMAN TEMPERAMENTS. 171 

and every emotion requires an expenditure of vital force." 
He asserted tliar we inherit our life force or constitutional power, 
and that we can determine by this life-line, the amount which 
we so receive. And he believed that it could be increased by 
intellectual effort, just as we can increase vital force by physical 
exercise. Fig. 89 represents the skull of a man who died, at 
nearly the same age as Loper, of consumption, in the Charity 
Hospital, at New Orleans. The measurement of the skull in 
this case gives a space between the life-line and the orifice 
of the ear of one-sixteenth of an inch, showing that the 
consumptive had lived the full term of his life. Dr. Powell 
contended that the depth of a man's brain may be increased 
after maturity; muscular effort, mental activity, and a sense 
of responsibility being favorable to longevity, while idleness 
and dissipation are adverse to it. In justice to the Doctor, we 
have stated fully his theory and his method of determining 
the hardihood and endurance of the constitution, and we 
bespeak for it a candid examination. Without doubt it em- 
bodies a great deal of truth. Hereafter we shall endeavor to 
indicate by cerebral configuration, a better system of judging 
of the vital tenacity, hardihood, and constitutional energies, 
both inherited and acquired. 

THE VOLITIVE TEMPERAMENT. 

By reference to Figs. 7-2 and 80, the reader will be able to 
locate the region .of the volitive faculties, previously described 
under the generic term, loill. This temperament is character- 
ized by ambition, energy, industry, perseverance, decision, vigi- 
lance, self-control, arrogabce, love of power, firmness, and 
hardihood. These faculties express concentration of purpose 
and their functional equivalents are power of elaboration, con- 
structiveness, condensation, firmness of fiber, compactness of 
frame, and endurance of organization. The pulse is full, firm, 
and regular, the muscles are strong and well marked, the hair 
and skin dark, the temporal region is not broadly developed, the 
face is angular, its lines denoting both power of purpose and 
strength of constitution, with resolution and hardihood blended 
in the expression. The volitive temperament is distinguished 
by height of the posterior, superior occipital region, called the 



172 



COMMON SENSE MEDICAL. ABVISEK. 



crown of the back head, and by corresponding breadth from 
side to side. The rule given by Dr. J. R. Buchanan applies not 
only to the convolutions, but to the general development of 
the brain; length gives power, or range of action, and breadth 
gives copiousness, or activity of manifestation. Thus a high, 
narrow back head indicates firmness and decision, but it is 
not as constant and copious in its manifestation as when 
it is associated with breadth. An individual having a nari-ow, 
high head, may determine readily enough npon a course 
of action, but he requires a longer period for its completion 
than one whose head is both high and broad. Such a cerebral 
conformation cannot accomplish its objects without enjoying 
regular rest, and maintaining the best of habits. Breadth of 
this region of the brain indicates amjile resources of energy, 
both psychical and physical. It denotes greater vigor of con- 
stitution, one that continually generates volitive forces, and its 
persistency of purpose may be interpreted as functional tenac- 
ity. Inflexibility of will and 
Fig. 90. . purpose impart their tenacious 

qualities to every bodily func- 
tion. Tlie will to recover is 
often far more potent than 
medicine. "We have often wit- 
nessed its power in restraining 
the ravages of disease. The 
energetic faculties, located at 
the upper and posterior part 
of tlie head, are the invigorat- 
ing, or tonic elements of the 
constitution, imparting hardy, 
firm, steady, and efficient in- 
fluences, checking excess of 
secretion, repressing dissipa- 
tion, and tending to maintain 
self-possession, as well as 
healthy conditions of life. Fig. 90 is a portrait of U. S. Grant, 
which shows a well-balanced organization, with sufiicient voli- 
tive elements to characterize the constitution. 

The old term bilious temperament might possibly be retained 




THE HUMAN TEMPERAMENTS, 173 

in deference to long usage, did it not inculcate a radical error. 
Bilious is strictly a medical term, relating to bile, or to de- 
rangements produced by it, and it was used originally to 
distinguish a temperament supposed to be characterized by 
a predominance of the biliary secretion. In the volitive tem- 
perament, the firm, tenacious, toning, and restraining faculties 
repress, rather than encourage biliary secretion, and hence the 
necessity for administering large doses of cholagogues, remedies 
which stimulate the secretion of bile. When the system is 
surcharged with bile, from a congested condition of the liver, 
we use these agents in order to obtain necessary relief. In 
this temperament there is moderate hepatic development, lack 
of biliary activity, deficiency in the secretion of bile, and a 
sluggish J)ortal circulation. Therefore, to apply the term bilious 
to this temperament is not only unreasonable, but it is calcu- 
lated to mislead. The condition of the bowels is generally 
constipated, the skin dark and sometimes sallow. For these 
and other obvious reasons, we dismiss the word bilious, and 
substitute one which is more characteristic. 

We will not dwell upon the volitive as psychical organs, 
except to show that, when their influence is transmitted to the 
body, they act as physiological organs, and thus demonstrate 
that all parts of the brain have their physiological, as well as 
mental functions. When Andrew Jackson uttered with great 
emphasis the memorable words, " by the eternal," the effect 
was like a shock from a galvanic battery, thrilling the cells in 
his own body, and paralyzing with fear every one in Calhoun's 
organization. This is an illustration of the power or range of 
action of these faculties. Breadth or copiousness is illustrated 
in Gen. Grant's reply, "I propose to fight it out on this 
LINE, IF IT TAKES ALL SUMMER." Such a temperament has a 
proftision of constitutional power, great durability of the life- 
force, and, in our opinion, the combined height and breadth of 
this region correctly indicate the natural hardihood of the body 
and its retentiveness of life. ISTo one need doubt its influence 
upon the sympathetic system, and, through that system, its power 
over absorption, circulation, assimilation, and secretion, as well 
as the voluntary processes. Mental hardihood seems wrought 
into concrete organization. It checks excess of glandular 



174 



COMMON SENSE MEDICAL ADVISER. 



absorption, restrains the impulses of tumultuous passion, tones 
and regulates the action of the heart, and helps to weave 
the strands of organization into a more compact fabric. The 

Fig. 91. 




toning energies of the volitive faculties are better than quinine 
to fortify the system against miasma or malaria, and they 
co-operate with all tonic remedies in sustaining organic action. 
Fig. 91 is a ])ortrait of Prof. Tyndall, the eminent chemist. 



THE HUMAN TEMPERAMENTS. 



175 



Mg. 92. 



whose likeness indicates volitive innervation, showing great 
strength of character and of constitution; he is an earnest, 
thorough, and intense mental toiler; ambitious, but modest; 
brilliant, because persevering; diligent in scientific inquiry, and 
who follows the star of truth, whithersoever it may lead him. 
The expression of his countenance indicates his honest intentions, 
and displays strength of conscientious purpose; his physical 
constitution may be correctly interpreted in all of its general 
characteristics by the analysis of his energetic temperament, 
the great secret of his strength and success. 

We desire to offer one more illustration of a marvelous 
blending of this temperament with large mental and emotional 
faculties. Fig. 92 is a representation 
of the martyred President Abraham 
Lincoln. During an eventful career, 
his temperament and constitution ex- 
perienced marked changes, and while 
always distinguished for strength of 
purpose and corresponding physical 
endurance, he was governed by noble, 
moral faculties, manifesting the deep- 
est sympathy for the down-trodden 
and oppressed, blending tenderness 
and stateliness without weakness, ex- 
hibiting a human kindness, and dis- 
playing a genuine compassion, which 
endeai'ed him to all hearts. He was 
hopeful, patriotic, magnanimoxts 

even, while upholding the majesty of the law and administering 
the complicated affairs of government. The balances of his 
temperament operated with wonderful delicacy, through all 
the perturbating ijifluences of the rebellion, showing by their 
persistence that he was never for a moment turned aside from 
the great end he had in view; the protection and perpetuation 
of republican liberty. His life exhibited a sublime, moral 
heroism, elements of character which hallow his name, and keep 
it in everlasting remembrance. 

We have treated the brain, not as a mass of organs radiating 
from the medulla oblongata as their real center, but as two 




176 COMMON SENSE MEDICAL ADVISER. 

cerebral masses, each of which is developed around the great 
ventricle. We have freely applied an easy psychical and physio- 
logical nomenclature to the functions of its organs, knowing that 
there is no arbitrary division of them by specific number, for 
the cerebrum, in an anatomical sense, is a single organ. The 
doctrine of cerebral unity is true, and the doctrine of its plural- 
ity of function is true also. Whatever effect an organ produces 
when acting in entire predominance, is regarded as the function 
of that organ and is expressed by that name. Although our 
names and divisions are arbitrary and designed for convenience, 
yet they facilitate our consideration of the psychical, and their 
corresponding physiological functions. Every cerebral manifes- 
tation denotes a psychical organ, and in proportion as these acts 
are transmitted to the body it becomes a physiological organ. 
We have ventured to repeat this proposition for the sake of the 
non-professional reader, that he may be able to distinguish 
between the two results of the manifestation of one organ. 
The transmission of the influence of the brain into the body 
enables the former to act physiologically, whereas, if its action 
were confined within the cranium, it would only be psychical. 
In the language of Prof. J. R. Buchanan, " every organ, there- 
fore, has its mental and corporeal, its psychological and physio- 
logical functions — both usually manifested together — either 
capable of assuming the predominance.'''' We have already seen 
to what degree the Will operates upon the organism, or how 
" the soul imparts special energy to single organs, so that they 
perform their functions with more than usual efficiency," and 
thus resist the solicitations of morbific agents. Doubtless our 
best thoughts are deeply tinged by the healthful or diseased 
conditions of such organs as the stomach, the lungs, the heart, 
or even the muscular or circulatory systems, and these impres- 
sions, when carried to the sensoiium, arc reflected by the 
thoughts, for reflex action is the third class of functions, assigned 
to the cerebrum. These reflex actions are either hygienic and 
remedial, or morbid and pernicious. Hence, it is philosophical 
not only to interpret the thoughts as physiological and patholog- 
ical indications, but to consider the cerebrum as exerting real 
hygienic and remedial forces, capable of producing salutary 
leparative, and restorative effects. Wlieu a boiler carries more 



THE HUMAN TEMPERAMENTS. 177 

Steam than can be advantageously employed, it is subjected to 
unnecessary and injurious strain, and is weakened thereby ; so, 
when the body is overtasked by excessive pressure of the volitive 
faculties, it is prematurely enfeebled and broken down. There 
are many individuals who need to make use of some sort of 
safety valve to let off the surplus of their inordinate ambition ; 
they need some kind of patent brake to slacken their speed of 
living; they should relieve the friction of their functional pow- 
ers by a more frequent lubrication of the vital movements, and 
by stopping, for needed refreshment and rest, at some of the 
many way-stations of life. 

THE ENCEPHALIC TEMPERAIVIENT. 

. The encephalic temperament is distinguished by prominence 
and breadth of the forehead, or by a full forehead associated 
with height and breadth at its coronal junction with the 
parietal bones, and extending toward the volitive region. (See 
Fig. 10, the space between 1 and 2 represents the coronal 
region, 1 indicating the frontal bone, and 2 the parietal). 
Prominence and great breadth of the forehead display ana- 
lytical, i. e., scientific powers applicable to concretes, whereas a 
fair intellect, associated with a preponderating development of 
the coronal region, indicates analogical powers, i. e., faculties 
to perceive the relation and the agreement of princiiDles. The 
former classifies and arranges facts, the latter invests them 
with moral and spiritual import. The one treats of matter, its 
physical properties, and chemical composition, the other of 
thoughts and intentions which involve right and wrong, relating 
to spiritual accountability. The intellect is employed upon an 
observable order of things, while the emotive faculties arrange 
the general laws of being into abstract science. 

Fig. 93, a portrait of Prof. Tholuck, is a remarkable example 
of an encephalic organization. Figs. 72 and 79 fairly indicate 
the effects of undue mental activity, the intellect causing 
vital expenditure resulting in the devitalization of the blood. 
While the intellect displays keen penetration, subtle discrimina- 
tion, and profound discernment, the emotions exhibit intense 
sensitiveness, acute susceptibility, and inspirational impressibility. 



178 COMMON SENSE MEDICAL ADVISER. 

The encephalic temperament is characterized by mental ac- 
tivity, great delicacy of organization, a high and broad fore- 
head, expressive eyes, fine but not very abundant haii*, great 
sensitiveness, refined feelings, vividness of conception, and 
intensity of emotion. If the brain is developed on the 
sides, there is manifested Ideality, Modesty, Hope, Sublimity, 
Imagination, and Spirituality. If the brain and forehead pro- 
ject, the Perceptive, Intuitive, and Reasoning faculties pre- 
dominate. If it rises high, and nearly perpendicularly, Liberal- 
ity, Sympathy, Truthfulness, and Sociability are manifested. 

Fig. 93. 




When the emotive faculties are large, Faith, Hope, Love, Philan- 
thropy, Religion, and Devotion characterize the individual. 
It is an artistic, creative, and aesthetic temperament, beautiful 
in conception and grand in expression, yet its sensitiveness is 
enfeebling, and its crowning excellence, when betrayed by 
the propensities, trails in defilement. Its purity is God-like, 
its debauchment. Perdition! 

Fig. 94 is the likeness of Prof. George Bush. His forehead 
is amply developed in the region of Foresight, Liberality, 
Sympathy, Truthfulness, and Benevolence; liis mouth expresses 
Amiability and Cheerfulness, and the whole face beams with 



THE HTTMAJC TEMPERAMJJKTS. 170 

Kindness and Generosity. This philanthropist, who is both 
a preacher and an author, lias published several works upon 

Fig. H, 



theology, which distinguish him for great research and origi- 
nality. 

Fig. 95 represents the sanguine-encephalic temperament, the 
two elements being most happily blended. The portrait is 
that of Emmanuel Swedenborg, the great scholar and spiritual 
divine. The reader will observe how high and symmetrical 
is tlie forehead, and how well balanced appears the entire 
organization. He was remarkable for vivid imagination, great 
scientific acquirements, and all his writings characterize him 
as a subtle reasoner. 

When the encephalic predominates, and the sanguine is 
deficient in its elements, we find conditions favorable to 
waste and expenditure, and adverse to a generous supply and 
reformation of the tissues. A child inheriting this cerebral 
development is already top-heavy, and supports, at an im- 
mense disadvantage, this disproportionate organization. The 
nutritive functions are overbalanced; consequently there is a 



180 



COMMON SENSE MEDICAI. ADVISER. 



predisposition to scrofulous diseases and disorders of the blood, 
various degenerating changes taking place in its composition; 
loss of red. corpuscles, signified by shortness of breath; morbid 
changes, manifested by cutaneous eruptions; exhaustion from 
lack of nourishment, etc., until, finall}^, consumption finishes 
the subject. 

Harmony is tlie support of all institutions, and applies with 




special cogency to the maintenance of health. When the 
mind dwells on one subject to the exclusion of all others, 
we call such a condition monomania. If we have an excessive 
development of mmd, and deficient support of body, the 
result is corporeal derangement. It is unfortunate for any 
child to inherit unusually large brain endowments, unless he 
is possessed of a vigorous, robust constitution. Such training 



TEAJfSMISSION OF LIFE. 181 

should be directed to that body as will encourage it to grow 
strong, hearty, and. thrifty, and enable it to support the cerebral 
functions. The mental proclivities should be checked and the 
physical organization cultivated, to insure to such a child good 
health. Cut off all unneccessary brain-wastes, attend to muscu- 
lar training and such invigorating games and exercises as 
encourage the circulation of the blood; keep the skin clean 
and its functions active, the body warm and well protected, the 
lungs supplied with pure air, the stomach furnished with whole- 
some food; besides have the child take plenty of sleep to in- 
vigorate the system, and thus, by regular habits, maintain tliat 
equilibrium which tends to wholesome efficiency and healthful 

endurance. 

TRANSMISSION OF LIFE. 

As has been already stated in the chapter on Biology, repro- 
duction of the species depends upon the union of a sperm-cell 
with a gei-m-cell, the male furnishing the former and the female 
the latter. It is a well-known fact that the marriage of persons 
having dissimilar temperaments is more likely to be fertile 
than the union of persons of the same temperaments; consan- 
guineous marriages, or the union of persons nearly related by 
blood, diminish fertility and the vigor of the offspring. Upon 
this subject Francis Galton has given some very interesting 
historical illustrations in his well-known work, entitled "He- 
reditary Genius." The half-brother of Alexander the Great, 
Ptolemy I, King of Egypt, had twelve descendants, who suc- 
cessively became kings of that country, and who were also 
called Ptolemy. They were matched in and in, but in nearly 
every case these near marriages were unprolific and the inheri- 
tance generally passed through other wives. Ptolemy II 
married his niece, and afterwards his sister ; Ptolemy IV 
married his sister. Ptolemy VI and VII were brothers, and 
they both consecutively married the same sister; Ptolemy VII 
also subsequently mai-ried his niece; Ptolemy Viil married two 
of his sisters in succession. Ptolemy XII and XIII were 
brothers, and both consecutively married their sister, Cleopatra, 
Mr. Galton and Sir Jas. Y. Simpson have shown that many 
peerages have become extinct through the evil results of inter- 
marriage. Heiresses are usually only children, the feeble product 



182 COMMON SENSE MEDICAL ADVISER. 

of a run-out stock, and statistics have shown that one-fifth 
of them bear no children, and fully one-third never bear more 
than one child. Sir J. Y. Simpson ascertained tliat out of 495 
marriages in the British Peerage, 81 were unfruitful, or nearly 
one in every six; while out of 675 marriages among an agricul- 
tural and seafaring population, only 65 were sterile or barren, 
or a little less than one in ten. 

While the marriages of persons closely related, or of similar 
temperaments are frequently unfruitful, we would not have 
the reader understand that sterility, or barrenness, is usually 
the result of such unions. It is most frequently due to some 
deformity or diseased condition of the generative organs of 
the female. In the latter part of this work may be found a 
minute description of the conditions which cause barrenness, 
together with the methods of treatment, which have proved 
most effectual in the extensive practice at the Invalids' Hotel 
and Surgical Institute. 

The temperaments may be compared to a magnet, the like 
poles of which repel, and the unlike poles of which attract each 
other. Thus similarity of temperament results in barrenness 
while dissimilarity makes the vital magnetism all the more pow- 
erful. Marriageable persons moved by some unknown influence, 
have been drawn instinctively toward each other, have taken 
iipon themselves the vows and obligations of wedlock, and have 
been fruitful and happy in this relation. Alliances founded 
upon position, money, or purely arbitrary considerations, mere 
contracts of convenience, are very apt to prove unhappy and 
unproductive. 

Men may unconsciously obey strong instinctive impulses with- 
out being conscious of their existence, and by doing so, avoid 
those ills, which otherwise might destroy their connubial happi- 
ness. The philosophy of marriage receives no consideration, 
because the mind is pre-occupied with newly awakened thoughts 
and feelings. Lovers are charmed by certain harmonies, feel 
interior persuasions, respond to a new magnetic influence and are 
lost in an excess of rapture. 

If the parties to a marriage are evenly balanced in organic 
elements, although both of them are vigorous, yet it is physio- 
logically more suitable for them to form a nuptial alliance with 



TRANSMISSION OF LIFE. 1 gj^ 

an unlike combination. The cause of the wretchedness attending 
many marriages may be traced to a too great similarity of 
organization, ideas, taste, education, pursuits, and association, 
which similarity almost invariably terminates in domestic unhap- 
piness. The husband and wife should be as different as the 
positive and negative poles of a magnet. When life is begotten 
under these circumstances we may expect a development bright 
with intelligence. 



CHAPTER XVI. 



LOVE. 

" Love is the root of creation ; God's essence ; 

worlds without number 
Lie in liis bosom like children; he nnule them 

for this purpose only. 
Only to love and to be loved again, he breatlird 

forth his spirit 
Into the slumbering dust, and upright standing, it 

laid its 
Hand on its heart, and felt it was warm witli a 

flame out of heaven."' 

— LONGFKLI.OW\ 

Ijove, that tender, inexplicable feeling which is the germi- 
nal essence of the liuman spirit, is the rudimental element of 
the human soul. It is, therefore, a Divine gift, a blessing 
which the Creator did not withdraw from his erring children, 
when they were driven from a paradise of innocence and loveli- 
ness into a world of desolation and strife. He left it as an 
invisible cord by which to draw the human heart ever upward, 
to a brighter home — the heavenly Eden. Love is the very 
essence of Divine law, the source of inspiration, even the 
fountain of life itself. It is spontaneous, generous, infinite. 
To its presence we are indebted for all that is good, true, and 
beautiful in Art and Nature. It endows humanity with count- 
less virtues, and throws a mystic veil over our many faults. 
It is this feeling, this immutable law, which controls the destiny 
of the race. From its influence empires have fallen, scepters 
have been lost. Literature owes to Love its choicest gems. 
184 



LOVE. 



185 



Fig. 96. 



The poet's lay is sweeter when Cupid tunes the lyre. The 
artist's brush is truer when guided by Love. Greece was the 
cradle of letters and art. Her daughters were queens of 
beauty, fitted to inspire the Love of her noblest sons. 

The materialism of the nineteenth century has sought to 
degrade Love; to define it as purely physical. The result has 
been a corresponding degradation of art, and even literature 
has lost much of its lofty idealism. Nudity has become a 
synonym of vulgarity; Love, of lust. "Evil 
be to him who evil thinks." True Love 
never seeks to degrade its object; on the 
contrary, it magnifies every virtue, endows 
it with divinest attributes, and guards its 
chastity, or honor, at the sacrifice of its own 
life. It increases benevolence by opening 
the lover's heart to the wants of suffering- 
humanity. Ideality is the canvas, and imagi- 
nation the brush with which Love delineates 
the beauties of the adored. Love heightens 
spirituality, awakens hope, strengthens faith, 
and enhances devotion. It quickens the per- 
ceptions, intensifies the sensibilities, and re- 
doubles the memory. It augments muscular 
activity, and imparts grace to every move- 
ment. The desire to love and to be loved 
is innate, and forms as much a part of our 
being as bone or reason. In fact. Love may 
be considered as the very foundation of our 
spiritual existence, as bone and reason are 
the essential bases of our physical and in- 
tellectual being. Every man or woman feels the influence of 
this emotion, sooner or later. It is the Kadesh-barnea of human 
existence; obedience to its intuitions insures the richest bless- 
ings of life, while neglect or perversion enkindles God's wrath, 
even as did the disobedience of the wandering Israelites. 

The one great fact which pervades the universe is action. 
The very existence of Love demands its activity, and, hence, 
the highest happiness is attained by a normal and legitimate 
development of this element of our being. The heart demands 




186 COMMON SENSE MEDICAL ADVISER. 

an object iipon which to lavish the largess of its affection. In 
the absence of all others, a star, a flower, or even a bird, will 
receive this homage. The bird warbles a gay answer to the 
well-known voice, the flower repays the careful cultivator by 
displaying its richest tints, the star twinkles a bright "good 
evening "to the lonely watcher, and yet withal there is an 
unsatisfied longing in the lover's heart, to which neither can 
respond; the desire to be loved! Hence, the perfect peace of 
reciprocated love. If its laws are violated, nature seeks 
revenge in the utter depression or prostration of the vital 
energies. Thus has the Divine Law-giver engraven His com- 
mand on our very being. To love is, therefore, a duty, the 
fulfillment of Avhich should engage our noblest powers. 

This emotion manifests itself in several phases, prominent 
among which is filial affection, the natural harmonizer of society. 
Paternal love includes a new element — protection. Greater than 
either, and second only in fortitude to maternal affection, is 

CONJUGAL LOVE. 

" He is blest in Love alone 
Who loves for years and loves but one."' — Hunt. 

With Swedenborg, we may assert, '■'■tliat there is given love- 
truly conjugal, which at this day is so rare, that it is not known 
what it is, and scarce that it is.''"' The same author has defined 
this relation to be a union of Love and Wisdom. The funda- 
mental law of conjugal love is fidelity to one love. God created 
but one Eve, and the essential elements of paternal and ma- 
ternal love pre-suppose and necessitate, for their normal de- 
velopment, the Love of one only. Again, Love is the sun of 
woman's existence. Only under its influence does she unfold 
the noblest powers of her being. Woman's intuitions should 
therefore be taken as the true love-gauge. If she desii-e a 
plurality of loves, it must be a law of her nature; but is 
communism the desire of our wives and daughters? No! 
Every act which renders woman dear to us, denounces sucli 
an idea and reveals the exclusive sacredness of her Love. As 
condemning promiscuity in this relation, we may cite the lovers' 
pledgt^s and oaths of fidelity, the self-perpetuity of Love itself, 



CONJUGAL LOVE. |37 

the common instincts of mankind, as embodied in public senti- 
ment, and the inherent consciousness that first love should be 
kept inviolable forever. Again, Love is conservative. It clings 
tenaciously" to all the memories connected with its first object. 
The scenes consecrated to " Love's young dream " are sacred to 
every heai*t. The woodland with its winding paths and arbors, 
the streamlet bordered with drooping violets and dreamy 
pimpernel, the clouds, and even "the very tones in which we 
spoke," are indelibly imprinted on the memory. There is also 
the "mine and thine" intuition of love. This sentiment is 
displayed in every thought and act of the lover. Every 
pleasure is insipid unless shared by the beloved; selfish and 
exacting to all others, yet always generous and forgiving to the 
adored. "Mine and thine, dearest," is the language of Con- 
jugal Love. 

The consummation desired by all who exijerience this affec- 
tion, is the union of souls in a true marriage. Whatever of 
beauty or romance there may be in the lover's dream, is 
enhanced and spiritualized in the intimate communion of mar- 
ried life. The crown of wifehood and maternity is purer, more 
divine, than that of the maiden. Passion is lost; the emotions 
predominate. 

The connubial relation is not an institution; it was born 
of the necessities and desires of our nature. "It is not good 
for man to be alone," was the Divine judgment, and so God 
created for him "an helpmate." Again, "Male and female 
created He them;" therefore, sex is as divine as the soul. It 
is often perverted, but so is reason, aye, so is devotion. 

The consummation of marriage involves the mightiest issues 
of life. It may be the source of infinite happiness or the seal 
of a living death. "Love is blind" is an old saying, verified 
by thousands of ill-assorted unions. Many unhappy marriages 
are traceable to one or both of two sources; Physical Weak- 
nesses and Masquerading. Many are the candidates for mar- 
riage who are rendered unfit therefor from weaknesses of their 
sexual systems, induced by the violation of well-established 
physical laws. 

We cannot too strongly urge upon parents and guardians the 
imperative duty of teaching those youths who look to them for 



138 COMMON SKNSE MEDICAL ADVISER. 

instruction, in all matters which pertain to their future well-being 
such lessons as are embraced in the chapter of this book entitled, 
"Hygiene of the Reproductive Organs." By attending to such 
lessons as "svill give the child a knowledge of the physiology and 
hygiene of his whole system, the errors into which so many of 
the young fall, and much of the misery which is so often tlie 
dregs of the hymeneal cup, will be avoided. 

]\[asquerading is a modern accomplishment. Girls wear tight 
shoes, burdensome skirts, and corsets, all of which prove very 
injui'ious to their health. At the age of seventeen or eighteen, 
our young ladies are sorry specimens of womankind, and " pal- 
pitators," cosmetics, and all the modern paraphernalia of fashion 
are required to make them appear fresh and blooming. Man is 
equally to blame. A devotee to all the absurd devices of fashion, 
lie practically asserts that "dress makes the man." But physi- 
cal deformities are of far less importance than moral imperfec- 
tions. Frankness is indispensable in love. Each should know 
the other's faults and virtues. Marriage will certainly disclose 
them; the idol falls and the deceived lover is transformed into 
a cold, unloving husband or wife. By far the greater number 
of imhappy marriages are attributable to this cause. In love 
especially, honesty is policy and truth will triumph. 

HISTORY OF MARRIAGE. 

Polygamy and Ifloiioganiy. We propose to give only 
a brief dissertation on the principles and arguments of these 
systems, with special reference to their representatives in the 
nineteenth century. Polygamy has existed in all ages. It is, 
and always lias been, the result of moral degradation or wan- 
tonness. The Garden of Eden was no harem. Primeval nature 
knew no community of love. There was only the union of two 
" and the twain were made one flesh." Time passed; "the sons 
of God saw the daughters of men that they were fair; and they 
took them wives of all which they chose." The propensities of 
men were in the ascendant, and " God repented Him that He had 
created man." He directed Noah to take into the ark, two of 
every sort, male and female. But "the imagination of man's 
heart is evil from his youth," and tradition points to Polygamy 
as the generally recognized form of marriage among the ancients. 



HISTORY OF MARRIAGE. 1^9 

The father of the Hebrew nation was unquestionably a polyga- 
mist, and the general history t of patriarchal life shows that a 
plurality of wives and concubines were national customs. In the 
earlier part of Egyptian history, Menes is said to have founded 
a system of marriage, ostensibly monogamous, but in reality it 
was polygamous, because it allowed concubinage. As civiliza- 
tion advanced, the latter became unpopular, and " although 
lawful, was uncommon," while polygamy was expressly forbid- 
den. Solomon, according to polygamous principles, with his 
thousand women, should have enjoyed a most felicitous condi- 
tion. Strange that he exclaimed " A woman among all these 
have I not found." According to the distinguished Rabbi, 
Maimonides, polygamy was a Jewish custom as late as the 
thirteenth century. When Cecrops the Egyptian King, came to 
Athens (1550, B. C.) he introduced a new system, which proved 
to be another step toward the recognition of Monogamy. 
Under this code a man was permitted to have one wife and a 
concubine. Here dawned the era of Grecian civilization, the 
glory of which was reflected in the social and political principles 
of Western Europe. During the fourth and fifth centuries 
B. C, concubinage disappeared, but, under the new regime, the 
condition of the wife was degraded. She was regarded as 
simply an instrument of procreation and a mistress of the 
household, while a class of foreign women, who devoted them- 
selves to learning and the fine arts, were the admired, and often 
the beloved companions of the husbands. These were the 
courtesans who played the same role in Athenian history, as did 
the chaste matron, in the annals of Rome. When Greece became 
subject to Rome and the national characteristics of these 
nations were blended, marriage became a loose form of monog- 
amy. In Persia, during the reign of Cyi'us, about 5G0 B. C, 
polygamy was sustained by custom, law, and religion. The 
Chinese marriage system was, and is, practically polygamous, 
for, from their earliest traditions, we learn that although a man 
could have but one wife, he was permitted to have as many 
concubines as he desired. 

In the Christian era, the first religious system which incorpo- 
rated polygamy as a principle was Mohammedanism. This 
system, which is so admirably adapted to the voluptuous 



IDU COMMON SKNSE MKDICAL. ADVISER. 

character of the Orientals, has penetrated Western Europe, Asia, 
and Africa. Hayward estimated the number of its adherents to 
be one hundred and forty millions. The heaven of the Moham- 
medan is replete with all the luxuries which appeal to the animal 
propensities. Ravishing Houris attend the faithful, who recline 
on downy couches, in pavilions of pearl. On the Western Con- 
tinent a system of promiscuity was practiced by the Mexi- 
cans, Peruvians, Brazilians, and the barbarous tribes of North 
America. 

The Mormon Church was founded by Joseph Smith, and 
})rofesses to be in harmony with the Bible and a special revela- 
tion to its leading Saint, According to the Mormon code, 
"Love is a yearning for a higher state of existence, and the 
passions, properly understood, are feeders of the spiritual life;" 
and again, "nature is dual; to complete his organization a man 
must marry." The leading error of Mormonism is that it mis- 
takes a legal permission for a Divine command. The Mormon 
logic may be premised as follows: the Mosaic law allowed 
polygamy; the Bible records it; therefore, the Bible teaches 
polygamy. 

A Mormon Saint can have not less than three wives but as 
many more as he can conveniently support. The eight funda- 
mental doctrines of the Mormon Church are stated as follows: 
1. God is a person with the flesh and form of a man. 2. Man 
is a part of the substance of God and will himself become a 
god. 3. Man is not created by God but existed from all 
eternity. 4. Man is not born in sin, and is not accountable 
for offenses other than his own. 5. The earth is a colony of 
embodied spirits, one of many such settlements in space. 

6. God is president of the immortals, having under Him four 
orders of beings: (1.) Gods — i. e., immortal beings, possessed 
of a perfect organization of soul and body, being the final state 
of men who have lived on earth in perfect obedience to the law. 
(2.) Angels, immortal beings who have lived on earth in 
imperfect obedience to the law. (3.) Men, immortal beings in 
whom a living soul is united with a human body. (4.) Spirits, 
immortal beings, still waiting to receive their tabernacle of flesh. 

7. Man, being one of the race of gods, became eligible, by 
means of marriage, for a celestial throne, and his household of 



HISTORY OF MARRIAGE. 191 

wives and children are his kingdom, not only on earth but in 
heaven. 8. The kingdom of God has been again founded on 
earth, and the time has now come for the saints to take posses- 
sion of theu' own; but by virtue, not by violence; by industry, 
not by force. This sect has met with stern and bitter opposi- 
tion. It was successively located in New York, Ohio, Missouri, 
and Illinois, from the last of which it was expelled by force of 
arms, and in 1848 established in Utah. Its adherents number, 
at the present time, more than two hundred thousand. 

Another organization, differing from the Mormons, in many of 
its radical principles, is that of the " Communists," popularly 
termed "Free Lovers." It is located at Lennox, Madison Co., 
N. Y. Its members advocate a system of " complex marriage " 
which they claim is instituted with a conscientious regard for 
the welfai'e of posterity. They disclaim " promiscuity," and 
assert that the tie which binds them together is as permanent 
and as sacred as that of marriage. Community of property is 
commensurate with freedom of Love. They define love to be 
" social appreciation," and this element in their code of civiliza- 
tion, which they deem superior to all others, is secondary to 
" bodily support." The principles upon which their social status 
is founded may be briefly summarized as follows: "Man offers 
woman support and love (unconditional). Woman enjoying 
freedom, self-respect, health, personal and mental competency, 
gives herself to man in the boundless sincerity of an unselfish 
union. State — , Communism." In this, as in all forms of polyg- 
amous marriages, love is made synonymous with sexuality, 
and its purely spiritual element is lost. In every instance this 
spiritual element should constitute the basis of marriage, which, 
without it, is nothing more than legal prostitution. Without it, 
the selfish, degrading, animal propensities run rampant, while 
the emotions with all their boundless sweetness lie dormant. 
Woman is regarded as only a plaything to gratify the animal 
caprice. 

That Monogamy is a law of nature is evident from the fact 
that it fulfills the three essential conditions which form the basis 
of true marriage: (1.) The development of the individual. 
(2.) The welfare of society. (3.) The reproduction of the 
species. 



192 COMMON SENSE MEDICAL ADVISER. 



THE DEVELOPMENT OF THE INDIVIDUAL. 

Phtsically. Reciprocated love produces a general exhila- 
ration of the system. The elasticity of the muscles is increased, 
the circulation is quickened, and every bodily function is stimu- 
lated. The duties of life are performed with a zest and alacrity 
never before experienced. " It is not possible for human beings 
to attain their full stature of humanity, except by loving long 
and perfectly. Behold that venerable man ! He is mature in 
judgment, perfect in every action and expression, and saintly 
in goodness. You almost worship as you behold. What ren- 
dered him thus perfect ? What rounded off his natural as- 
perities, and m.oulded up his virtues? Love mainly. It per- 
meated every pore, so to speak, and seasoned every fiber of his 
being, as could nothing else. Mark that matronly woman. In 
the bosom of her family, she is more than a queen and goddess 
combined. All her looks and actions exjjress the outflowing 
of some or all of the human virtues. To know her is to love 
her. She became thus perfect, not in a day or a year, but by 
a long series of appropriate efforts. Then by what? Chiefly 
in and by love, which is specifically adapted thus to develope 
this maturity." But all this occurs only when there is a normal 
exercise of the sexnal propensities. Excessive indulgence in 
marital pleasures deadens all the higher faculties, love included, 
and results in an utter prostration of the bodily powers. The 
Creator has endowed man and woman with passions, the sup- 
pression of which leads to pain, their g'-atification to pleasure, 
their satiety to disgust. Excessive marital indulgence produces 
abnormal conditions of the generative organs and not unfre- 
quently leads to incurable disease. Many cases of uterine dis- 
ease are traceable to this cause. 

Morally and Intellectually. In no country where the 
polygamous system prevails do we find a code of political and 
social ethics which recognizes the rights and claims of the 
individual. The condition of woman is that of the basest slave, 
a slave to the caprice and tyranny of her master. Communism 
raises her from the slough of slavery, but subjects her to the 
level of prostitution. An inevitable sequence of polygamy is 
a decline of literature and science. The natural tendency of 



THE WELFARE OF SOCIETY. 193 

each system is to sensualism. The blood is diverted from its 
normal channels and the result is a condition which may be 
appropriately termed mental starvation. Sensualism is in its 
very nature directly opposed to literary attainments or ad- 
vancement. Happily there is a golden mean, an equalization of 
those elements which constitutes the acme of ijidividual en- 
joyment. 

THE WELFARE OF SOCIETY. 

The general law of ethics, that " whatever is beneficial to the 
individual, contributed to the highest good of society and vice 
versa,'''' applies with equal force to the hygienic conditions of 
marriage. Each family, like the ancient Roman household, is 
the prototype of the natural government under which it lives. 
Wherever the marriage relation is regarded as sacred, there 
you will find men of pure hearts and noble lives. Of all 
foreign nations the Germans are celebrated for their sacred 
regard of woman, and the duties of marriage, and all scholars 
from the age of Tacitus to the present day, have concurred in 
attributing the elevation of woman to the pure-minded Teutons. 
In America, the law recognizes only Monogamy; but domestic 
unhappiness is a prominent feature of our national life; there- 
fore, argues the would-be free-lover, monogamy does not accord 
with the best interests of mankind. The fallacy lies in the 
first premise. Legally, our marriage system is monogamous but 
socially and practically it is not ! Prostitution is the source 
of this domestic infelicity. The "mistress" sips the sweet 
nectar that is denied to the deceived wife. Legislators have 
battled with intemperance, but have done comparatively little 
to banish from our midst this necessary (?) evil. They recoil 
with disgust from this abyss of iniquity and disease. Within it 
is coiled a hydra-headed monster, which invades our hearth- 
stones, contaminates our social atmosphere, and whose very 
breath is laden with poisonous vapors, the inexhaustible source 
of all evil. 

The perverted appetites of mankind are mistaken for the 
natural desires and necessities of our being; and, accordingly, 
various arguments have been advanced to prove that monogamy 
is not conducive to social developement. It is curious that no 
one of these arguments refers to the health and well-being of 
9 



194 COMMON SENSE MEDICAL ADVISER. 

the individual, thus overlooking, perhaps willfully, the great 
law of social economy. Even a few medical writers sometimes 
advocate the principles of this so-called liberalism. In a re- 
cently published work, there are enumerated only tioo demerits 
of polygamy and six of monogamy. These six demerits which 
the author is pleased to term a " bombshell," he introduces on 
a(;count of his moral convictions no less than humanitarian 
considerations. The same author terms monogamy a " worm- 
eaten and rotten-rooted tree." The wox-m that is devastating 
tlie fairest tree of Eden and draining its richest juices is 
what our contemporary thinks, may be ^'■plausibly termed, a 
necessary eviV It is claimed that monogamy begets narrow 
sympathies and leads to selfish idolatry. The fallacy of this 
argument lies in the misapprehension of the term selfishness. 
Self-preservation is literally selfishness, yet who will deny that 
it is a paramount duty of man. If perverted, it may be 
vicious, even criminal; but selfishness, in so far as it is generated 
by monogamy, is one of the chief elements of social economy; 
furthermore, it favors the observance of the laws of sexual 
liygiene. As we have said elsewhere, true love increases 
benevolence, and correspondingly expands and develops the 
sympathies. Selfish idolatry is preferable to social neglect. 
This argument will not bear a critical examination; for it is 
asserted that in a happy union, "love is so exclusive that there 
is hardly a liking for good neighbors, and scarcely any love 
at all for God." If the "good neighbors" were equally blessed, 
they would not suffer from this exclusiveness, and it is prac- 
tically true that there is no higher incentive to love and obey 
our Maker than the blessing of a happy marriage. 

THE PERPETUATION OF THE SPECIES. 

The third essential object of marriage is the perpetuation 
of the species. The desire for offspring is innate in the heart 
of every true man or woman. It is thus a law of our nature, 
and, as such, must have its legitimate sphere. The essential 
features of reproduction proclaim monogamy to be the true 
method of procreation. Promiscuity would render the mother 
unable to designate tlie fntlicr of her children. Among lower 
animals, pairing is an instinctive laAv whenever the female is 



TllK I'EKPKTUATION OF THE SPECIES. 195 

incapable of protecting and nourishing her offspring alone. 
During at least fifteen years, the child is dependent for food 
and clothing upon its parents, to say nothing of the requisite 
moral training and loving sympathy, which, in a great measure, 
mould its character. Fidelity to one promotes multiplication. 
It has been argued by the advocates of polygamy that such 
a system interferes with woman's natural right to maternity. 
Of the many marriages celebrated yearly, comparatively few 
are sterile. The statement that many single women are de- 
sirous of having children, would apply only to a very limited 
number, as it is seldom that they would be able to support 
children without the aid and assistance of a father. Pro- 
miscuity diminishes the number and vitiates the quality of the 
human products. "Women of pleasure never give to the 
world sons of genius, or daughters of moral purity." 



CHAPTER XVII. 
REPRODUCTION. 



Every individual derives existence from a parent, which word 
literally means one who brings forth. We restrict the meaning 
of the term reproduction, ordinarily, to that function by which 
living bodies produce other living bodies similar to themselves. 
Production means to bring forth; rep>roduction, the producing 
again, or renewing. To protract individual existence, nutrition 
is necessary, because all vital changes are attended by xoear 
and waste. Nutrition is always engaged in the work of j-epar- 
ation. Every organism that starts out upon its career of de- 
velopment depends upon nourishing materials for its growth, 
and upon this renewing process for its development. Nutri- 
tion is all the while necessary to prolong the life of the indi- 
vidual, but at length its vigor wanes, its functions languish, 
and, finally, the light of earthly life goes out. Although the 
single organization decays and passes away, nevertheless the 
species is uninterruptedly continued; the tidal wave of life 
surges higher on the shores of time, for reproduction is as 
constant and stable as the attractive forces of the planetary 
system. 

It is a fact, that many species of the lower order of animals 
which once existed are now extinct. It has been asserted and 
denied, that fossil remains of man have been found, indicating 
that races which once existed have disappeared from the face 
of the earth. The pyramids are unfolding a wonderful history, 
embracing a period of forty-five hundred years, which the 
world of science receives as literally authentic, and admits, 
also, that fifty-four hundred years are probably as correctly 
196 



REPRODUCTION. 197 

accounted for. The extinction of races is not at all improbable. 
At the present time, the aboriginal inhabitants of this continent 
seem to be surely undergoing gradual extinguishment! It, 
therefore, seems to be possible for a weaker race to deteriorate, 
and finally become extinct, unless the causes of their decadence 
can be discovered and remedied. All people are admonished to 
earnestly investigate the essential conditions necessary for their 
continuance, for the rise and fall of nations is in obedience to 
natural principles and operations. Viewed from, this standpoint, 
it is possible that a careful study of the human temperaments 
and their relations to reproduction may be of greater moment 
than has hitherto been supposed, and a proper understanding 
of them may tend to avert that individual deterioration, which, 
if suffered to become general, would end in national disaster 
and the' extinction of the race. 

Until recently, even naturalists believed that descendants were 
strictly like their parents in form and structure. Now it is 
known that the progeny may differ in both form and structure 
from the parent, and that these may produce others still more 
unlike their ancestry. But all these peculiar and incidental 
deviations finally retm-n to the original form, showing that 
these changes have definite limits, and that the alterations 
observe a specific variableness, which is finally completed by its 
assuming again the original form. (See page 16, Figs. 2 and 3). 

Reproduction may be sexual or non-sexual. In some plants 
and animals it is non-sexual. The propagation of species is 
accomplished by buds. Thus the gardener grafts a new variety 
of fruit upon an old stock. The florist understands how to 
produce new varieties of flowers, and make them radiantly 
beautiful in their bright and glowing colors. The bud person- 
ates the species and produces after its kind. Some of the 
annelldes^ a division of articulate animals, characterized by an 
elongated body, formed of numerous rings or annular seg- 
ments, multiply by spontaneous division. A new head is 
formed at intervals in certain segments of the body. (See 
Fig. 97). 

Something similar to this process of budding, we find taking 
place in a low order of animal organization. Divide the fresh 
water polyp into several pieces, and each one will grow into 



198 



COMMON SENSE MEDICAL ADVISER. 



au entire animal. Each piece represents a polyp, and so each 
parent polyp is really a compound animal, an organized com- 
munity of beings. Just as the buds of a tree, when separated 
and engrafted upon another tree, grow again, each preserving 
its original identity, so do the several parts of this animal, 
when divided, become individual polyps, capable of similar re- 
production. 

The revolving volvox likewise increases by growth until it 
becomes a society of animals, a multiple system of individuals. 
There are apertures from the parent, by which water gains 
a free access to the interior of the whole miniature series. 
This monad was once supposed to V)e a single animal, but the 
microscope shows it to be a group of animals connected by 

Fig. 97. 




An annelid dividing spontaneously, a new head having oeen formed toward tiie 
hinder part ol' the body of the parent. 



means of six processes, and each little growing volvox exhibits 
his red-eye speck and two long spines, or horns. These animals 
also multiply by dividing, and thus liberate another series, which, 
in their turn, reproduce other groups. 

Generation requires the concurrence of sthnxli and snscepti- 
hilityy and, to perfect the process, two conditions are also 
necessary. The first is the sperm, which communicates the 
principle of action; the other is the germ, which receives the 
latent life and provides the conditions necessary to organic 
evolution. The vivifying function belongs to the male, that 
of nourishing and cherishing is possessed by the female; and 
these conditions are sexual distinctions. The former represents 
will and understanding; the latter, vitality and emotion. The 
father directs and controls, the mother fosters and en(!0urage8; 



HERMAPHKODITIC KEPRODUCTION. 199 

the former counsels and admonishes, the latter persuades and 
caresses; and their union in holy matrimony represents one; 
that is, the blending of vitality and energy, of love and wisdom, 
— the elements indispensable to the initiation of life under 
the dual conditions of male and female, — one in the functions 
of reproduction. 

Let us consider the modes of Sexual Reproduction, which 
are hermcqyhroditlc and dlaiclous. 

HERMAPHRODITIC REPRODUCTION. 

We have said that two kinds of cells represent reproduction, 
namely, sperm and germ-cells. These may be furnished by 
different individuals, or both may be found in one. When 
both are found in the same individual, the parent is said to be a 
natural hermaphrodite. A perfect hermaphrodite possesses the 
attributes of both male and female — uniting both sexes in 
one individual. Natural hermaphroditic reproduction occurs 
only among inferior classes of animals, and naturalists inform 
us that there are a greater number of these than of the more 
perfect varieties. These are found low in the scale of animal 
organization, and one individual is able to propagate the species. 
In the oyster and ascidians no organs can be detected in the 
male, but in the female they are developed. Polyps, sponges, 
and cystic enlozoa, may also be included among hermaphrodites. 

It is only very low organisms indeed in which it is a matter 
of indifference whether the united sperm-cells and germ-cells 
are those of the same individual, or those of different indi- 
viduals. In more elaborate structures and highly organized 
beings, the essential thing in fertilization is the union of these 
cells specially endowed by different bodies, the unlikeness of 
derivation in these united reproductive centers being the desid- 
eratum for perpetuating life and power. 

In other classes, as entozoa, there appear to be special pro- 
visions whereby the sperm-cells and germ-cells may be united; 
i. e., the male organs are developed and so disposed as to 
fecundate the ova of the same individual. Sexual and non- 
sexual modes of reproduction are illustrated by that well- 
delined group of marine invertebrate animals, called cirripedia. 
Fig. 98 represents one of this genus. 



1>(K) 



COMMON SENSE MEDICAL ADVISER. 




Pollicipes Mitella. 



Fig. 99. 



Some of these are not only capable of self-impregnation, but 
likewise have what are called complemented males attached to 
some of the hermaphrodites. In the whole 
animal kmgdom, it may be doubted if 
there exists another such class of rudi- 
mentary creatures as the parasitic males, 
who possess neither mouth, stomach, 
thorax, nor abdomen. After exerting a 
peculiar sexual influence, they soon die 
and drop off; so that in this class of ani- 
mals may be found the sexual distinctions 
of male, female, and perfect hermaphro- 
dites. 

There is a class of wheel-animalcules termed rotifera, of 
which the revolving volvox is one example. They have ac- 
quired this name on account of the apparent rotation of the 
disc-like organs which surround 
their mouths and are covered with 
cilia, or little hairs. They are 
minute creatures, and can best be 
viewed with a microscope, although 
the larger forms may be seen with- 
out such assistance. They are 
widely diffused on the surface of 
the earth, inhabit lakes as well as 
the ocean, and are found in cold, 
temperate, and tropical climates. 
The rotifera were once supposed 
to be hermaphrodites, but the ex- 
istence of sexes in one species has 
been clearly established. The male, 
however, is much smaller, and far 
less developed than the female. In 
some of these species, germ-cells, 
or eggs, are fo;.nd, which do not 
require fecundation for reproduc- 
tion or development, so that they belong to the non-sexual class. 
Tlie third variety of hermaphrodites embraces those animals 
in which the male organs ai'e so disposed as not to fecundate 




Kotifera; Hraehionus Urceolaris; 
larg-oly magnified. 



HERMAPHRODITIC REPRODUCTION. 201 

the ova of the same body, but reqmve the co-operation of two 
individuals, notwithstanding the co-existence in each of the 
organs of both sexes. Each in turn impregnates the other. 
The common leech, eai*th-worm, and snail, propagate in this 
mamier. 

Unnatural hermaphrodlsm is characteristic of insects and 
crustaceans, in which the whole body indicates a neutral char- 
acter, tending to exhibit the peculiarities of male or female, in 
proportion to the kind of sexual organs which predominates. 
Half of the body may be occupied by male, the other half by 
female organs, and each half reflects its peculiar sexual charac- 
teristics. Some butterflies are dimidiate hermaphrodites; i. e., 
one side of the body has the form and color of the male, the 
other the form and color of the female. The wings show by 
their color and appearance these sexual distinctions. The stag- 
beetle is also an example. We have accounts of dimidiate 
hermaphrodite lobsters, male in one half and female in the 
other half of the body. 

Among the numerous classes of higher animals, which have 
red blood, we have heard of no well-authenticated instance of 
hermaphrodlsm, or the complete union of all the reproductive 
organs in one individual. True, the term hermaphrodite is 
often applied to certain persons in whom there is some malform- 
ation, deficiency, or excess, of the genital organs. These con- 
genital deformities consisting of combined increase or defic- 
iency, supernumerary organs, or transposition of them, which 
usually render generation physically impossible, have been 
called bisexual h^rmaphrodism and classed as monstrosities. 
We have many published accounts of them, hence, further 
reference to them here is unnecessary. We would especially 
refer those readers who may desire to make themselves further 
acquainted with this interesting subject, to the standard physio- 
logical works of Flint, Foster, Carpenter, Bennett, Dalton, and 
others equally eminent in this particular branch of science. 

Certain theories have been advanced concerning conditions 
which may influence the sex of the offspring. One is that the 
right ovary furnishes the germs for males, the left for females; 
that the right testicle furnishes sperm capable of fecundating 
the germs of males, and the left testicle, the germs of the left 



202 COMMON SENSE MEDICAL ADVISEE. 

ovary, for females. That |ecuudatiou sometimes takes place 
from riglit to left and thus produces these abuormal variations. 
We merely state the hypothesis, but do not regard it as account- 
ing for the distinction of sex, or as causing monstrosities, 
though it is somewhat plausible as a theory, and is not easily 
disproved. In the lower order of animals, as sheep and swine, 
one of the testicles has been removed, and there resulted after- 
ward both male and female progeny, so that the theory seems 
to lack facts for a foundation. 

We sometimes witness in the child excessive development, 
as five fingers, a lai'ge cranium, which results in dropsical 
effusion, or deficient brain, as in idiots; sometimes a hand or 
arm is lacking, or possibly there is a dual connection, as in the 
case of the Siamese twins; or, two heads united on one 
body. It is difficult to give any satisfactory explanation of 
these abnormal developments. From age to age, the type is 
constant^ and preserves a race-unity. The crossings of the races 
are only transient deviations, not capable of perpetuation, and 
quickly return again to the original stock. This force is persist- 
ent, for inasmuch as the individual represents the race, so does 
his offspring represent the pai'ental characteristics, in tastes, pro- 
clivities, and morals, as well as in organic resemblances. This 
constancy is unaccountable, and more mysterious than the occa- 
sional malformation of germs in the early period of foetal life. 
If to every deviation from that original form and structure, 
which gives character to the productions of. nature, we apply 
the term monster, we shall find but very few, and from this 
whole class there will be a very small number indeed of sexual 
malformations. If the sexes be deprived of the generative 
organs, they approach each other in disposition and appearance. 
All those who are partly male and partly female in their organ- 
ization, unite, to a certain extent, the characteristics of both 
sexes. When the female loses her prolific powers, many of her 
sexual j)eculiaritie8 and attractions wane. 

DICECIOITS REPRODUCTION. 

Dioecious is a word derived from the Greek, and signifies two 
households; hence, dioeciotis reproduction is sexual generation 
by male and female individuals. Each is distinguished by sexual 



mCECIOUS RBPRODUCTIOK. 203 

characteristics. The male sexual organs are complete in one 
individual, and all the female organs belong to a separate femi- 
nine organization. In some of the vertebrates, impregnation 
does not require sexual congress; in other words, fecundation 
may take place externally. The female fish of some species first 
deposits her ova, and afterwards the male swims to that locality 
and fertilizes them with sperm. 

In higher orders of animals, fecundation occurs internally, the 
conjunction of the sperm and germ cells requiring the conjuga- 
tion of the male and female sexual organs. The sperm-cells of 
the male furnish the quickening principle, which sets in play all 
the generative energies, while the germ-cell, susceptible to its 
vivifying presence, responds with all the conditions necessary to 
evolution. The special laboratory which furnishes spermatic 
matei-ial is the testes, while the stroma of the ovaries contributes 
the germ-cell. Several different modes of reproducing are 
observed when fecundation occurs within the body, which 
vary according to the peculiarities and organization of the 
female. 

modes of DicBcious Reproduction. — A very famil- 
iar illustration of one mode is found in the common domestic 
fowl, the egg of which vivified within the ovarium, is afterward 
expelled and hatched by the simple agency of warmth. This 
mode of reproduction is called oviparous generation. 

The ovaries, as well as all their latent germs, are remarkably 
influenced by the first fecundation. It seems to indicate mon- 
ogamy as the rule of higher sexual reproduction. The farmer 
understands that if he wishes to materially improve his cows, 
the first offspring must be begotten by a better, purer breed, 
and all that follow will be essentially benefited, even if not so 
well sired. Neither will the best blood exhibit its most desir- 
able qualities in the calves whose mothers have previously 
carried inferior stock. So that there are sexual ante-natal influ- 
ences which may deteriorate the quality of the progeny. The 
Jews understood this principle, in the raising up of sons and 
daughters unto a deceased brother. The fact that the sexual 
influence of a previous conception is not lost, is illustrated when, 
in a second marriage, the wife bears a son or daughter resem- 
bling bodily or mentally, or in both of these respects, the former 



204 COMMON SENSE MEDICAL ADVISER. 

husband. This indicates a union for life by natural influences 
which never die out. 

With ?onie species of fish and reptiles, the egg is impregnated 
internally, and the. process of laying commences immediately, 
but it proceeds so slowly through the excretory passages, that it 
is hatched and born alive. This is called ovo-viviparons getier- 
ation. 

As we rise in the scale of organization, animals are more 
completely developed, and greater economy is displayed in their 
preservation. The germ passes from the ovary into an organ 
prepared for its reception and growth, to which, after fecunda- 
tion, it becomes attached, and where it remains until sufficiently 
developed to maintain respiratory life. This organ is called the 
womb, or uteriis, and is peculiar to most mammalia. This mode 
of reproduction is termed vivi^yarous generation. 

The kangaroo and oppossum are provided with a pouch 
attached to the abdomen, which receives the young born at an 
early stage of development. They remain in contact with the 
mammae, from which they obtain their nourishment, until their 
growth is sufficiently completed to maintain an independent 
existence. This is called marsupial generation. The variety of 
reproduction which is most interesting, is that of the human 
species, and is called viniparons generation. It includes the 
functions of copulation, fecundation, gestation, parturition, and 
lactation. 

For the full and perfect development of mankind, both mental 
and physical chastity is necessary. The health demands absti- 
nence from unlawful intercourse. Therefore children should 
not be allowed to read impure works of fiction, which tend to 
inflame the mind and excite the passions. Only in total absti- 
nence from illicit pleasures is there moral safety and health, 
while integrity, peace, and happiness, are the conscious rewards 
of virtue. Impurity travels downward with intemperance, 
obscenity, and corrupting diseases, to degradation and death. 
A dissolute, licentious, free-and-easy life is filled with the dregs 
of human suffering, iniquity, and despair. The penalties which 
follow a violation of the law of chastity are found to be severe 
and swiftly retributive. 

The union of the sexes in holy matrimony is a law of nature 



COMPARISON OP MALE AND FEMALE 



205 



Fig. 100. 



Fig. 101. 




Maie. 



Female. 



206 



COMMON SENSE MEDICAL ADVISER. 



finding sanction in both morals and legislation. Even some of 
the lower animals unite in this union for life, and instinctively 
observe the law of conjugal fidelity with a consistency which 
might put to blush other animals more highly endowed. It is 
important to discuss this subject and understand our social evils, 
as well as tlie unnatural desires of the sexes, which must be 
controlled or they lead to ruin. Sexual propensities are pos- 



Fh/. 102. 




Outline of the Female Urinary and 
Generative Organs. 

sessed by all, and they must be held in abeyance, until they 
are exercised for legitimate purposes. Hence parents ought to 
understand the value of mental and physical labor to elevate 
and strengthen the intellectual and moral faculties of their 
children, to develop the muscular system and direct the energies 
of the blood into healthful channels. Vigorous employment 



DICECIOUS REPRODUCTION. 



207 



of mind and body engrosses the vital energies and diverts them 
from undue excitement of the sexual desires. 

Sexual generation by pairing individuals is the most eco- 
nomical mode of propagating the species. The lower orders 
of animals possess wonderful multiplicative powers and their 
faculty for reproduction is offset by various destructive forces. 
The increased ability for self-maintenance implies diminished 
reproductive energy; hence the necessity for greater economy 
and safety in rearing the young. As certain larvaB and insects in- 



Fiq. lOS. 




Prepuce 



Outline of the Male Reproductive Organs. 



crease, the birds which feed upon them become more numerous. 
When this means of support becomes inadequate, these same 
birds diminish in number in proportion to the scarcity of their 
food. Many have remarked that very prolific seasons are 
followed by unusual mortality, just as periods of uncommon 
prosperity precede those of severe disaster. 

The increased mental and moral cultivation of mankind 
imposes upon them the necessity for greater physical culture. 



208 COMMON SENSE ilEDIOAI. ADVISER. 

" Wiser and weaker," is a trite saying, and means that the 
exercise of the higher nature discloses the equivalent necessity 
of culturing the body, in order to support the increasing expen- 
ditures of the former. Mental and moral discipline are essential 
for a proper understanding how to provide for the body, for 
physical training increases the capacity of tlie individual for 
self-preservation. Constant vigilance is the price of health as 
well as of liberty. 

It is an interesting physiological fact that, while the growth 
and development of the individual are rapidly progressing, 
the reproductive powers remain almost inactive, and that the 
commencement of reproduction not only indicates an arrest 
of growth, but, in a great measure, contributes toward it. 
From infancy to puberty, the body and its individual organs, 
structurally as well as functionally, are in a state of gradual 
and progressive evolution. Men and women generally increase 
in stature until the twenty-fifth year, and it is safe to assume 
that perfection of function is not established until maturity 
of bodily development is completed. Solidity and strength 
are represented in the organization of the male, grace, and 
beauty in that of the female. His broad shoulders represent 
physical power and the right of dominion, while her bosom 
is the b/mbol of love and nutrition. The father encounters 
hai'dshijjs, struggles against difficulties, and braves dangers to 
provide for his household; the mother tenderly supplies the 
infant's wants, finding relief and pleasure in imparting nourish- 
ment, and surrounds helpless infancy with an affection which 
is unwearied in its countless ministering attentions. Her ma- 
ternal functions are indicated by greater breadth of the hips. 
Ph}sical differences so influence their mental natures, that, 
" before experience has opened their eyes, the dreams of the 
young man and maiden differ." The development of either 
is in close sympathy with their organs of i-eproduction. Any 
defect of the latter impairs our fair ideal, and detracts from 
those qualities which impart excellence, and crown the character 
with perfections. Plainly has Nature marked out, in the 
organization, very different offices to be performed by the 
sexes, and has made these distinctions fundamental. 

Likewise, Nature expresses the intention of reproduction. 



OVULATION. 209 

by giving to plants and animals distinctive organs for this 
purpose. These are endowed with exquisite sensibility, so that 
their proper exercise produces enjoyment beneficial to both. 
Excessive sexual indulgence not only prostrates the nervous 
system, enfeebles the body, and drains the blood of its vivifying 
elements, but is inconsistent with intellectual activity, morality, 
and spiritual development. The most entrancing delights and 
consummate enjoyments are of the emotive order, ideal, ab- 
stract, and pure, so inspiring that they overpower the grosser 
sensual pleasures and diffuse their own sweet chastity and re- 
fining influence over all the processes of life. 

Hence, the gratification of the sexual instincts should always 
be moderate. It should be regulated by the judgment and 
will, and kept within the bounds of health. No person has a 
moral right to carry this indulgence so far as to produce injur- 
ious consequences to either party, and he who cannot refrain 
from it is in no proper condition to propagate his species. In 
all culture there must be self-control, and the practice of self- 
denial at the command of love and justice is always a virtue. 
Self-government is the polity of our people, and we point with 
pride and laudable exultation to our political maxims, laws, and 
free institutions. The family is the prototype of society. If 
self-restraint be practiced in th^ marital relation, then the prin- 
ciple of self-control will carry health, strength, and morality 
into all parts of the commonwealth. The leading character- 
istics of any nation are but the reflection of the traits of its 
individual members, and thus the family truly typifies the 
practical morality and enduring character of a people. 

OVULATION. 

The 0»arles are those essential parts of the generative 
system of the human female in which the ova are matured. 
Thei-e are two ovaries, one on each side of the uterus, and 
connected with it by the Fallopian tubes ; they are ovoidal 
bodies about an inch in diameter, and furnish the germs or 
ovules. These latter are very minute, seldom measming j-i-g- of 
an inch in diameter, and frequently are not more than half that 
size. The ovaries develop with the growth of the female, 
so that, finally, at the pubescent period, they ripen and liberate 



210 COMMON SENSE MEDICAL ADVISEE. 

an ovum, or germ vesicle, which is carried into the uterine 
cavity through the Fallopian tubes. With the aid of the 
microscope, we find that these ova are composed of granular 
substance, in which is found a miniature yolk suri-ounded by 
a transparent membrane, called the zona pellucida. This yolk 
contains a germinal vesicle in which can be discovered a 
nucleus, called the germinal spot. The process of the growth 
of the ovaries is very gradual, and their function of ripening 
and discharging an ovum every montli into the Fallopian tubes 
and uterus is not developed until between the twelfth and 
fifteenth years. 

This period, which indicates, by the feelings and ideas, the 
desires and will, that the subjects are capable of procreation, is 
called puberty. The mind acquires new and more delicate per- 
ceptions, the person becomes plumper, the mammoe enlarge, 
and there is grace and perfection in every movement, a con- 
scious completeness for those relations of life for which this 
function prepares them. The period of puberty is also in- 
dicated by 

MENSTRUATION. 

The catamenial discharge naturally follows the ripening and 
liberation of an ovum, and as the ovaries furnish one of these 
each month, this monthly flow is termed the menses (the plural 
of the Latin word mensis, which signifies a month). The 
menstrual flow continues from three to five days, and is merely 
the exudation of ordinary venous blood through the mucous 
lining of the cavity of the uterus. At this time, the nervous 
system of females is much more sensitive, and from the fact 
that there is greater ai)titude to conception immediately before 
and after this period, it is supposed that the seXual feeling is 
then the strongest. When impregnation occurs immediately 
before the appearance of the menses, their duration is generally 
shortened, l)ut not sufficiently to establish the suspicion that 
conception has taken place. The germ is the contribution of 
the female, which provides the conditions which only require 
the vivifying principle of the sperm for the development of 
another being. The jicriod of aptitude for conception ter- 
minates at the time both ovulation and menstruation cease, 



FECUNDATION. 21 1 

which, unless brought about earlier by disease, usually occurs 
about the forty-fifth year of her age. 

FECUNDATION. 

Since in the beginning God created male and female, and 
said unto them, "Be fruitful, and multiply, and replenish the 
earth," it is evident that what was originated by creation must 
be continued by procreation. The process of generation the 
reader will find described on pages 12 and 13. Then com- 
mences a wonderful series of transforming operations, rudi- 
mentary changes preliminary to the formation of tissues, 
structures and functions, which finally qualify the organism 
for independent existence. The ovum, when expelled from the 
ovary, enters the fimbriated, or fringe-like extremity of the 
Fallopian tube, to commence at once its descent to the uterus. 
The process of passing through this minute tube varies in 
different animals. In birds and reptiles, the bulk of the ex- 
pelled ova is so great as to completely fill up the tube, and it 
is assisted in its downward course, partly by its own weight 
and partly by the peristaltic action of the muscular coat of the 
canal. In the human subject, however, the ova are so minute 
that nature has supplied a special agent for their direct trans- 
mission; otherwise they might be retained, and not reach their 
destination. Accordingly, the fimbriated, trumpet-shaped ex- 
tremity of the Fallopian tubes, which is nearest to the ovaries, 
and, consequently from the ovary first receives the ovum when 
expelled ; is provided with a series of small hairs, termed cilia, 
forming the lining or basement membrane of the tubes, and, 
the movements of these cilia being towards the uterus, transmit, 
by their vibrating motion, the ovum from the ovary, through 
the Fallopian tubes, to the uterus. 

The mature ovum, however, is not by itself capable of being 
converted into the embryo. It requires fecundation by the 
spermatic fluid of the male, and this may take place immedi- 
ately on the expulsion of the ovum from the ovary, or during 
its passage through the Fallopian tube, or, according to Bis- 
choff, Coste, and others, in the cavity of the uterus, or even 
upon the surface of the ovary. Should impregnation, however, 
fail, the ovum gradually loses its vitality, and is eventually 



212 COMMON SENSE MEDICAL ADVISER. 

expelled by the uterine secretions. It occasionally happens 
that the descent of the impregnated ovum is arrested, and the 
formation of the embryo commences in the ovary. This is 
termed ovarian pregnancy. Or again, the ovum may be 
arrested in its passage through the Fallopian tube, causing 
what is termed tubal pregnancy; or, after it has been expelled 
from the ovary, it may fail to be received by the fimbriated 
extremity, and escape into the cavity of the abdomen, forming 
what has been termed ventral pregnancy. If the microscopic 
germ lodges in some slight interstice of fiber, during its 
passage through the walls of the uterus, it may be detained 
long enough to fix itself there, and when this occurs, it is termed 
interstitial 2')regnancy. All these instances of extra-uterine 
pregnancy may necessitate the employment of surgical skill, 
in order that they may terminate with safety to the mother. 
Their occurrence, however, is very rare. 

The intense nervous excitement produced by the act of 
coition is immediately followed by a corresponding degi'ee of 
depression, and a too frequent repetition of it is necessarily 
injurious to health. The secretions of the seminal fluid being, 
like other secretions, chiefly under the influence of the nervous 
system, an expenditure of them requires a corresponding 
renewal. This renewal greatly taxes the corporeal powers, 
inducing lassitude, nervousness, and debility. It is a well 
known fact that the highest degree of mental and bodily vigor 
is inconsistent Avith more than a moderate indulgence in sexual 
intercourse. 

To ensure strength, symmetry, and high intellectual culture 
in the human race, requires considerable care. Consideration 
should be exercised in the choice of a companion for life. Con- 
stitutional as well as hereditary ailments demand our closest 
attention. Age has also its judicious barriers. As before 
stated, when reproduction commences, growth, as a rule, ceases; 
therefore, it is inexpedient that matrimony should be consum- 
mated before the parties have arrived at mature stature. 

PREVENTION OF CONCEPTION. 
Much has been written upon the question whether married 
people have a right to decline the responsibilities of wedlock. 



PREVENTION OF CONCEPTION. 218 

The practice of inducing abortion is not only unmoral but 
criminal, because it is destructive to both the health of the 
mother and the life of the embryo being. If both the parties 
to a marriage be feeble, or if they be not temperamentally 
adapted to each other, so that their children would be de- 
formed, insane, or idiotic, then to beget offspring would be a 
flagrant wrong. If the mother is already delicate, possessing 
feeble constitutional powers, she is adequate to the duties of 
maternity, and it is 7iot right to lay such burdens upon her. 
Self-preservation is the first law of nature, which all ought to 
respect. The woman may be able to discharge the duties of a 
loving wife and companion, when she cannot fulfil those of 
child-bearing. If the husband love his wife as he ought, he 
will resign all the pleasure necessary to secure her exemption 
from the condition of maternity. It seems to us, that it is a 
great wickedness, unpardonable even, to be so reckless of con- 
sequences, and so devoid of all feeling, as to expose a frail, 
feeble, affectionate woman to those perils which almost insure 
her death. To enforce pregnancy under such circumstances 
is a crime. Every true man, therefore, should rather practice 
self-control and forbearance, than entail on his wife such 
certain misery, if not danger to life. 

Undoubtedly, the trial is great, but if a sacrifice be required, 
let the husband forbear the gratification of passions which 
will assuredly be the means of developing in his delicate wife 
symptoms that may speedily hurry her into a premature grave. 
Before she has recovered from the effects of bearing, nursing, 
and rearing one child, ere she has regained proper tone and 
vigor of body and mind, she is unexpectedly overtaken, sur- 
prised by the manifestation of symptoms which again indicate 
pregnancy. Children thus begotten are not apt to be hardy 
and long-lived. From the love that parents feel for their 
posterity, from their wishes for their success, from their hopes 
that they may be useful from every consideration for their 
future well-being, let them exercise precaution and forbearance, 
until the wife becomes sufficiently healthy and enduring to 
bequeath her own vital stamina to the child she bears. 

From what has been said on this subject, it behooves the 
prudent husband to weigh well the injurious, nay criminal 



214 COJVtMON SENSE MEDICAL ADVISER. 

results which may follow his hist. Let him not endanger the 
health, and it xuay be the life, of his loving and confiding 
wife through a lack of self-denial. Let him altogether refrain, 
rather than be the means of untold misery and, perhaps, the 
destruction of the person demanding his most cherished love 
and protection. On so important a subject, we feel we should 
commit an unpardonable wrong were we not to speak thus 
plainly and openly. An opportunity has been afforded us, 
which it would be reprehensible to neglect. We shall indeed 
feel we have been amply rewarded, if these suggestive remarks 
of ours tend in any way to remove or alleviate the sufferings 
of an .uncomplaining and loving wife. Our sympathies, always 
susceptible to the conditions of sorrow and suffering, have 
been enlisted to give faithfully, explicitly, and plainly, warnings 
of danger and exhortations to prudence and nothing remains 
for us but to maintain the principles of morality, and leave 
to the disposal of a wise and overruling Providence the 
mystery of all seemingly untoward events. In every condition 
of life, evils arise, and most of those which are encountered are 
avoidable. Humanity should be held accountable for those 
evils which it might, but does not sliun. 

By a statute of the national government, pj-evention of preg- 
nancy is considered a punishable offense; whereas every phy- 
sician is instructed by our standard writers and lecturers on 
this subject, that not only prevention is necessary in many 
instances, but even abortion must sometimes be produced in 
order to save the mother's life. As we view the matter, the 
law of the national government asserts the ruling principle, 
and the exceptions to it must be well established by evidence, 
in order to fully justify such procedure. The family physician 
may, with the concurrence of other medical counselors, be 
justified, in rare cases, in advising means for the prevention 
of conception, but he should exercise this profes^feional duty 
only when the responsibility is shared by other members of 
the profession, and the circumstances fully and clearly warrant 
such a practice. 

After fecundation, the length of time before conception takes 
place is variously estimated. Should impregnation occur at 
the ovary or within the Fallopian tubes, usually about a week 



UTERINE PREGNANCY. 215 

elapses before the fertilized germ enters the uterus, so that 
ordinarily the interval between the act of insemination and 
that of conception varies from eight to fourteen days, 

DOUBLE CONCEPTION. 

If two germs be evolved simultaneously, each may be im- 
})regnated by spermatozoa, and a twin pregnancy be the result. 
This is by no means a rare occurrence. It is very unusual, 
however, to have one birth followed by another after an 
interval of three or four months, and each babe present the 
evidences of full maturity. Perhaps such occurrences may 
be accounted for on the supposition that the same interval of 
time elapses between the impregnation of the two germs as 
there is difference observed in their birth; that after the act of 
insemination, sperm was carried to each ovary; that one had 
matured a germ ready for fecundation, then impregnation and 
conception immediately followed, and the decidua of the uterus 
hermetically sealed both Fallopian tubes, and thus securely 
retained the sperm within the other Fallopian canal. The stim- 
ulus of the sperm so pent up causes that ovary to mature a 
germ, although it may do so slowly, and after two or three 
months it is perfected, fertilized, and a second conception occurs 
within the uterus. If each embryo observe a regular period 
of growth and each be born at maturity, there must be an 
interval of two or three months between their births. But 
it is far more common for the parturition of the first, dis- 
playing signs of full maturity, to coincide with the birth of a 
second which is immature and which cannot sustain respiratory 
life. The birth of the latter is brought about prematurely, 
by the action of the uterus in expelling the matured child. 

UTERINE PREGNANCY. 

There are many who manifest a laudable desire to understand 
the physiology of conception, the changes which take place, 
and the order of their nattiral occurrence. When imjjregnation 
takes place at the ovaries or within the Fallopian tubes, there 
is exuded upon the inner surface of the womb a peculiar 
nutritious substance. It flows out of the minute porous open- 
ings surrounding the termination of the Fallopian tube within 



216 COMMON SENSE MEDICAL ADVISER. 

the Uterine cavity, and, thus, is in readiness to receive the 
germ, and retain it there until it becomes attached. Undoubt- 
edly, the germ imbibes materials from this matter for its 
nurture and growth. This membranous substance is termed the 
decidua, and disappears after conception is insured. Two mem- 
branes form around the embryo; the inner one is called the 
amniofi, the outer one the chorio?i. Both serve for the pro- 
tection of the embryo, and the inner one contains the liquor 
amniiy in which it floats during intra-uterine life. Immediately 
after conception, the small glands in the neck of the uterus 
usually throw out a sticky secretion, tilling the canal, or uniting 
its sides, so that nothing can enter or leave the uterine cavity. 

The fertilized ovum rapidly develops. After its conception 
it imbibes nourishment, and there is a disposition in fluids to 
pass into it, through its delicately-organized membranes. If 
this process is not involuntary, it is, at all events, at the con- 
venience and use of the developing germ. After three months 
the embryo is termed the foetus. Its fluids are then so much 
more highly organized, that some of them are tinged with 
sanguine hues, and thenceforward acquire the characteristics of 
red blood. Out of red blood, blood-vessels are formed, and 
from the incipient development of the heart follow faint lines 
of arteries, and the engineers of nutrition survey a circulatory 
system, perfecting the vascular connections by supplementing 
the arteries with a complete net- work of veins and capillaries. 

THE PLACENTA OR AFTERBIRTH. 

Whenever conception occurs, a soft, spongy substance is 
formed between the uterus and the growing ovum, called the 
placenta. It is composed of membrane, cellular tissue, blood- 
vessels, and connecting filaments. The principal use of this 
organ seems to be to decarbonate the blood of the foetus, and 
to supply it with oxygen. It performs the same function for 
the foetus that the lungs do for the organism after birth. It 
allows the blood of the foetus to come into very close contact 
with that of the mother, from which it receives a supply of 
oxygen, and to which it gives up carbonic acid. This inter- 
change of gases takes place in the placenta, or between it 
and the iiterus, through the intervening membranes. This 



QUICKENING. 217 

decarbonating function requires the agency of the maternal 
hings, for the purpose of oxygenating the mother's blood. 

The placenta is attached tia the uterus by simple adhesion. 
True, in some instances, morbid adhesion takes place, or a 
growing together in consequence of inflammation, but the 
natural junction is one merely of contact, the membranes of 
the placenta spreading out upon the cavity of the uterus, so 
that, finally, the former may be entirely removed without a 
particle of disturbance or injury to the latter. Formerly, it 
was supposed that the placental vessels penetrated into the 
substance of the uterus. We know now there is no such con- 
tinuation of the vessels of the one into the other. The decar- 
bonation of the blood requires the placental and uterine 
membranes to be in contact with each other. 

If the union were vascular, the mother's blood would circu- 
late in the foetal body, and the impulses of the maternal heart 
might prove too strong for the delicate organism of the embryo. 
Besides, the separation of the placenta from the uterus might 
prove fatal to both parent and offspring. The placenta is only 
a temporary organ, and when its functions are no longer re- 
quired, it is easily and safely removed. 

THE UMBILICAL CORD. 

The foetal blood is transmitted to and fro between the body 
of the child and the placenta, by a cord which contains two 
arteries and one vein. This is called the umhilical cord, because 
it enters the body at the middle of the abdominal region, or 
%mxhilicus. It is composed, also, of its own proper membranous 
sheath, or skin, and cellular tissues, besides the blood-vessels. 
Two months after pregnancj'^, this cord can be seen, when it 
commences to grow rapidly. 

QUICKENING. 

Not until the mother feels motion is she said to be quick 
with child. That is, the child must be old and strong enough 
to communicate a physical impulse, which the mother can 
distinctly perceive, before it is regarded as having received life. 
This is a fallacy, for the germ has to be endowed with life 
before organization can begin. The act of impregnation 
10 



218 COMMON SENSE MEDICAL ADVISEB. 

communicates the vital principle, and from that moment it starts 
upon its career of development. A long period elapses after 
this occurs before it can make the mother feel its motions. 
Before quickening, the attempt to destroy the fcetus is not 
considered so grave a crime by our laws, but after this quicken- 
ing takes place, it is deemed a felony. 

THE RIGHT TO TERMINATE PREGNANCY. 

The expediency and the moral right to prematurely terminate 
pregnancy must be admitted when weighty and sufficient 
reasons for it exist. Such a course should never be undertaken, 
however, without the advice and approval of the family phy- 
sician, and, whenever it is possible, the counsel of another medi- 
cal practitioner should be obtained. There may be so great a 
malformation of the pelvic bones as to preclude delivery at 
full terra, or, as in some instances, the pregnant condition may 
endanger the life of the mother, because she is not able to 
retain nourishment upon the stomach. In such cases only, is 
interference warranted, and even then the advice of some well 
informed physician should be first obtahied, to make sure that 
the life of the mother is endangered before so extreme a 
measure is resorted to. 

Those who are qualified for maternal duties should not uncjer- 
take to defeat the intentions of nature, simply because they 
love ease and dislike responsibility. Such persons may be con- 
sidered genteel ladies, but, practically, they are indifferent to 
the claims of society and posterity. How such selfishness con- 
trasts with the glorious, heroic. Spartan spirit of the young 
woman who consulted us in reference to the acceptance of 
a tempting offer of mariiage! She was below medium size and 
delicately organized. She hesitated in her answer, because she 
was uncertain as to her duty to herself, and to her proposed 
husband, and on account of the prospective contingencies of 
matrimony. After she was told that it was doubtful whether 
she could discharge the obligations of maternity with safety 
to herself, and yet that she might prove to her intended hus- 
band a true and valuable wife, she quickly answered, her black 
eyes radiant with the high purpose of her soul; "If I assent 
to this offer, I shall accept the condition and its consequences 



THE DURATION OF PREGNANCY. 219 

also, even if pregnancy be my lot and I know it will cost me 
my life ! " She acceded to the proposal, and years found them 
one in happiness; then a daughter was born, but the bearing 
and nursing were too much for her delicate constitution, and 
she continued to sink until she found rest in the grave. Of 
all • her beautiful and noble sayings, none reflect more moral 
grandeur of spirit than the one in which she expressed her 
purpose to prove true to posterity. 

THE SIGNS OF PREGNANCY. 

The symptoms which indicate pregnancy are cessation of 
the menses, enlargement of the mammae, nausea, especially in 
the morning, distention of the abdomen, and movement of 
the foetus. A married woman has reason to suspect that she 
may have conceived, when, at the proper time, she fails to 
menstruate, especially when she knows that she is liable to 
become pregnant. A second menstrual failure strengthens 
this suspicion, although there are many other causes which 
might prevent the appearance of the menses, such as disease 
of the uterus, general debility, or taking cold, and all of these 
should be taken into account. In the absence of all apparent 
influences calculated to obstruct the menses, the presumj^tion 
ordinarily is that pregnancy is the cause of their non-appear- 
ance. The evidence is still more conclusive when the mammae 
and abdomen enlarge after experiencing morning sickness. 
Notwithstanding all these symptoms, the audible sound of the 
heart, or the movements of the fcetus, are the only infallible 
signs of a pregnant condition., 

THE DURATION OF PREGNANCY. 

The ordinary duration of pregnancy is about forty weeks, or 
280 days. It is difticult to foretell exactly when a pregnancy 
will be completed, for it cannot be known precisely when it 
began. Some gestations are more protracted than others, but 
the average duration is the time we have given. A very 
reasonable way to compute the term, is to reckon three months 
back from the day when the menses ceased and then add 
five days to that time, which will be the date of the expected 
time of confinement. It is customary, also, for women to 



220 COMMON SBNSK MEDICAL ADTISKR. 

count from tlie middle of the month after the last a]>})ear- 
ance of the menses, and then allow ten lunar months for 
the term. This computation generally proves correct, except 
in those instances in which conception takes place immediately 
before the last appearance of the catamenia. A few women 
can forecast the time of labor from the occurrence of quicken- 
ing, by allowing eighteen weeks for the time which has elapsed 
since conception, and twenty-two more for the time yet to 
elapse before the confinement. With those in whom quickening 
occurs regularly in a certain week of pregnancy, this calculation 
may prove nearly correct. 

The English law fixes no precise limit for the legitimacy of 
the child. In France a child is regarded as lawfully begotten 
if bom within three hundred days after the death or departure 
of the husband. There are a sufficient number of cases on record 
to show that gestation may be prolonged two, and even three, 
weeks beyond the ordinary, or average term. The variation 
of time may be thus accounted for: after insemination, a con- 
siderable interval elapses before fecundation takes place, and 
the passage of the fertilized germ from the ovary to the 
uterus is also liable to be retarded. There are many circum- 
stances and conditions which might serve to diminish its ordi- 
nary rate of progress, and postpone the date of conception. 
This would materially lengthen the apparent time of gestation. 

It is likewise diflicult to determine the shortest period at 
which gestation may terminate, and the child be able to survive. 
A child may be born and continue to live for some months, 
after twenty-four or twenty-five weeks of gestation; it was so 
decided, at least, in an ecclesiastical trial. 

We have not the space to describe minutely, or at length, 
the formation and growth of the foetal structures, and trace 
them separately from their origin to their completion at the 
birth of the child. The student of medicine must gain in- 
formation by consulting large works and exhaustive treatises on 
this interesting subject. 

What trifling contingencies defeat vitality ! Conception may 
be prevented by acrid secretions, the result of disease of the 
reproductive organs. Leucorrheal matter may destroy the vital- 
izing power of the sperm-cells. There are many ways, even 



THE DUEATION OF PREGNANCY. 221 

after impregnation, of compromising the existence of the frail 
embryo. Accidents, injuries, falls, blows, acute diseases, insuf- 
ficient nutrition and development, in fact, a great variety of 
occurrences may destroy the life of the embryo, or foetus. 
After birth, numerous diseases menace the child. By what 
constant care must it ever be surrounded, and how often is 
it snatched from the very jaws of death ! 

What, then, is man but simply a germ, evolving higher 
powers, and destined for a purer and nobler existence ! His 
latent life secretly emerges from mysterious obscurity, is in- 
cai'nated, and borne upon the flowing stream of time to a spirit- 
ual destination — to realms of immortality ! As he nears those 
ever-blooming shores, the eye of faith, illuminated by the in- 
spired word, dimly discerns the perennial glories. Quickened 
l)y Faith, Hope, and Love, his spirit is transplanted into the 
garden of paradise, the Eden of happiness, redeemed, perfected, 
and made glorious in the divine image of Him who bath said, 
" I am the Way, the Truth, and the Life." 



P^RT IT. 



HYGIENE. 



CHAPTER I. 

HYGIENE DEFINED.— PURE AIR 

The object of hygiene is the preservation of health. Hith- 
erto, we have considered, at some length, the science of 
functions, or Physiology, and now, under the head of Hygiene, 
we will give an outline of the means of maintaining the func- 
tional integrity of the system. It is difficult to avoid including 
under this head Preventive Medicine, the special province of 
which is to abate, remove, or destroy tlie many causes of disease. 

The Greeks bestowed divine honors upon ^Esculapius, because 
he remedied the evils of mankind and healed the sick. The 
word hygiene is derived from Hygeia, the name of the Greek 
goddess of health. As male and female are made one in wed- 
lock, so Medicine and Hygiene, restoration and preservation, 
are inseparably united. 

Hygiene inculcates sanitary discipline, medicine, remedial dis- 
cijdine; hygiene prescribes healthful agencies, medical theory 
and practice, medicinal agencies ; hygiene ministers with salu- 
brious and salutary agents, medicine assuages with rectifying 
properties and qualities; hygiene upholds and sustains, medical 
practice corrects and heals; the one is preservative and con- 
servative, the other curative and restorative. These discrimi- 
nations are as radical as health and sickness, as distinct as 
]iliysiology and pathology, and to confound them is as unnatural 
;i>^ to look for the beauties of health in the chamber of sickness. 
222 



PURE A IB FOR BESPIBATION. 223 

The time physician brings to his aid Physiology, Hygiene, 
and Medicine, and combines the science of the former with 
the art of the latter, that restoration maybe made permanent, 
and the health preserved by the aid of hygiene. But when 
any one makes Hygiene exclusively the physician, or deals 
wholly in hygienic regulations with little respect for physiology, 
or lavishly advertises with hygienic prefixes, we may at once 
consider it a display, not of genuine scientific knowledge, 
but only of the ignorance of a quack. Some of the modern 
twaddle about health is a conglomeration of the poorest kind 
of trash, expressing and inculcating more errors and whims 
than it does common sense. Many persons dilate upon these 
subjects with amazing flippancy, their mission seeming to be 
to traduce the profession rather than to act as help-mates and 
assistants. We do not believe that there is any real argument 
going on between the educated members of the medical pro- 
fession but rather that the senseless clamor we occasionally hear 
comes only from the stampede of some routed, demoralized 
company of quacks. 

In the following pages we shall introduce to the reader's 
attention several important hygienic subjects, although there 
are many more that ought to receive special notice. Such 
as we do mention, demand universal attention, because a dis- 
regard of the conditions which we shall enumerate, is fraught 
with great danger. Our li^es are lengthened or shortened by 
the observance or neglect of the rules of common sense, and 
these do not require any great personal sacrifice, or the prac- 
tice of absurd precautions. 

PURE AIR FOR RESPIRATION. 

Ordinary atmospheric air contains nearly 2,100 parts of 
oxygen and 7,900 of nitrogen, and about three parts of car- 
bonic acid, in 10,000 parts; expired, air contains about 470 
parts of carbonic acid, and only between 1500 and 1600 parts 
of oxygen, while the quantity of nitrogen undergoes little 
or no alteration. Thus air which has been breathed has lost 
about five per cent, of oxygen and has gained nearly five per 
cent, of carbonic acid. In addition the expired air contains 



"2 "2 4: COMMON SENSE MEDICAI, AI)VISJ':K. 

a greati')- or less quantity of highly decomposable animal 
matter, and, however dry the atmospheric air may he, the 
expired air is always saturated with watery vapor, .and, no 
matter what the temperature of the external air may he, that 
of the exhaled air is always nearly as warm as the blood. 
An adult man on a average breathes about sixteen times in 
a minute and at every inspiration takes in about thirty cubic 
inches of air, and at every exj^iration exhales about the same 
amount. Hence, it follows that about 16f cubic feet of air are 
})assed through the lungs of an adult man every hour, and de- 
prived of oxygen and charged with carbonic acid to the amount 
of nearly five per cent. The more nearly the composition of 
the external air approaches that of the expired air, the slower 
will be the diffusion of carbonic acid outwards and of oxygen 
inwards, and the more charged with carbonic acid and deficient 
in oxygen -will the blood in the lungs become. Asphyxia takes 
place whenever the proportion of carbonic acid in the external 
air reaches ten per cent., providing the oxygen is diminished in 
like proportion, and it does not matter whether this condition 
of the external air is produced by shutting out fresh air from 
a room or by increasing the mmiber of persons Avho are con- 
suming the same air; or by permitting the air to be deprived 
of oxygen by combustion by a fire. A deficiency of oxygen 
and an accumulation of carbonic acid in the atmosphere, pro- 
duce injurious effects, however, long before the asphyxiating 
point is attained. Headache, drowsiness, and uneasiness occur 
when less than one per cent, of the oxygen of the atmosphere 
is replaced by other matters, and the constant breathing of 
such an atmosphere lowers vitality and predisposes to disease. 

Therefore, every human being should be supplied, by proper 
ventilation, with a sufficient supply of fresh au*. Every adult 
individual ought to have at least 800 cubic feet of air-space 
to himself, and this space ought to communicate freely with 
the external atmosphere Jjy means of direct or indirect channels. 
Hence, a sleeping-room for one adult person should not be less 
than nine by ten feet in breadth and length and nine feet in 
heiglith. What occun-ed in the Black Hole at Calcutta is an 
excellent illustration of the effect of vitiated air. One hundred 
and forty-six Englishmen were confined in a room eighteen 



VENTILATION OF SCHOOL ROOMS. 225 

feet square, with two small windows on one side to admit air. 
Ten hours after their imprisonment, only twenty-three were 
alive. 

Ventilation of School Rooni;^. The depression and 
faintness from which many students suffer, after being confined 
in a poorly ventilated school room, is clearly traceable to 
vitiated air, while the evil is often ascribed to excessive mental 
exertion. The effect of ventilation upon the health of students 
is a subject of univei'sal interest to parents and educators, and 
at present is receiving the marked attention of school authori- 
ties. Dr. F. Windsor, of Winchester, Mass., made a few perti- 
nent remarks upon this subject in the annual report of the State 
Board of Health, of Massachusetts, 1874. One of the institu- 
tions, which was spoken of in the report of 1873, as a model, 
in the warming and ventilation of which nmch care had been 
bestowed, was visited in December, 1873. He reports as fol- 
lows: "I visited several of the rooms, and found the air in 
all, offensive to the smell, the odor being such as one would 
imagine old boots, dirty clothes, and perspiration would make 
if boiled down together;" again, in the new model school-house 
the hot air enters at two registers in the floor on one side, and 
makes (or is supposed to make) its exit by a ventilator at the 
floor, on the other side of the room." The master said " the air 
was sup2)osed to have some degree of intelligence, and to knotv 
that the ventilator was its proper exit.'''' Thorough ventilation 
has been neglected by many school officials on account of the 
increased expense it causes. In our climate, during seven months 
at least, pure atmospheric air must be paid for. The construc- 
tion of vertical ducts, the extra amount of fuel, and the 
attendant expenditures are the objections which, in the opin- 
ion of many persons, outweigh the health and happiness of 
the future generation. It is necessary for the proper ventila- 
tion of our school rooms that an adequate supply of fresh air 
should be admitted, which should be warmed before being 
admitted to the room, and which should be discharged as 
contaminated, after its expiration. The proper ventilation of 
the school room consists in the warming and introduction of 
fresh air from without, and the discharge of the expired and 
unwholesome air from within. This may be accomplished by 



226 COMMON SENSE MEDICAL ADVISER. 

means of doors, windows, chimneys, and finally by ventilators 
placed, one near the level of the floor, and the other near the 
ceiling of the room. The ventilators ought to be arranged on 
the opposite sides of the room, in order to insure a current, 
and an abundant supply of air. When trustees and patrons 
realize that pure air is absolutely essential to health, and that 
their children are being slowly poisoned by the foul air of 
school rooms, then they will construct our halls of learning 
with a due regard for the laws of hygiene, and students will 
not droop under their tasks on account of the absence of 
Nature's most bountiful gift, i^ure air. 

Ventilation oi* Factories and Workshops. This 
is a subject which demands the immediate attention of manu- 
facturers and employers. The odors of oil, coal gas, and ani- 
mal products, render the air foul and stagnant, and often give 
rise to violent diseases among the operatives. From two to four 
hundred persons are often confined in workshops six hundred 
feet long, with no means of ventilation except windows on one 
side only. The air is breathed and re-breathed, until the oper- 
atives complain of languor and headache, which they attribute 
to overwork. The real cause of the headache is the inhalation 
of foul air at every expansion of the lungs. If the proprietors 
would provide efficient means for ventilating their workshops, 
the cost of construction would be repaid with compound in- 
terest, in the better health of their operatives and the conse- 
quent increase of labor. Our manufacturers must learn and 
j)ractice the great principle of political economy, namely, that 
the interests of the laborer and employer are mutual. 

Ventilation of onr divellini^s. Not less important 
is the ventilation of our dwellings; each ajjartment should be 
provided with some channel for the escape of the noxious 
vapors constantly accumulating. Most of the tenements occu- 
pied by the poor of our cities are literally dens of poison. 
Their children inhale disease with their earliest breath. What 
wonder that our streets are filled with squalid, wan-visaged 
children ! Charity, indeed, visits these miserable homes, bring- 
ing garments and food to their half-famished inmates; but she 
has been slow to learn that fresh air is just as essential to life 
as food or clothing. Care should be taken by the public 



SITE FOR HOMES. 227 

authorities of every city, that its tenement houses do not de- 
generate into foul hovels, like those of the poor English laborer, 
so graphically portrayed by Dickens. But ill-ventilated rooms 
are not found exclusively in the abodes of the poor. True, 
in the homes of luxury, the effect of vitiated air is modified 
by food, etc. Men of wealth give far more attention to the 
architecture and adornment of their houses, to costly decora- 
tions and expensive furniture, than to proper ventilation. 
Farmers, too, are careless in the construction of their cottages. 
Their dwellings are often built, for convenience, in too close 
proximity to the barn. Because they do not construct a suit- 
able sewer or drain, the filth and refuse food is thrown out 
of the back door, where it accumulates and undergoes putre- 
faction; the vitiated air penetrates the interior of the house, 
and, there being no means of ventilation, it remains to be 
breathed by the occupants. The result is, that for the sake 
of saving a few dollars, which ought to be expended in the con- 
struction of necessary flues and sewers, the farmer often sees the 
child he prizes far more than his broad acres gradually decline, 
or suddenly fall a victim to fevers or malignant disease. 
Parents, make your homes healthy, let in the pure, fresh air 
and bright sunlight, so that your conscience may never upbraid 
you with being neglectful of the health and lives of your little 

ones. 

SITE FOR HOMES. 

jflalaria. When about to construct our residences, besides 
securing proper ventilation and adequate drainage, we ought 
to select the location for a home on dry soil. Low levels, damp 
surroundings, and marshy localities not only breed malaria 
and fevers, but are a prolific cause of colds, coughs, and 
consumption. Care should be taken not to locate a dwelling 
where the natural currents of air, or high winds, will be likely 
to bring the poison of decayed vegetable matter from low 
lands. Certain brooks, boggy land, ponds, foggy localities, 
too much shade, all these are favorable to the development 
of disease. Then the walls of a building should be so con- 
structed as to admit air between the exterior and interior 
surfaces, otherwise the interior of the house will be damp and 
unwholesome. In the dead of winter, in northern latitudes. 



228 COMMON SENSE MEDICAL ADVISER. 

the house ought to be kept slightly tempered with warmth, 
both night and day, a condition very favorable to the intro- 
duction and change of atmospheric currents. The invigorating 
tendencies of a dry, pure atmosphere are remarkably beneficial, 
while air charged with moisture and decay is exceedingly 
baneful, introducing diseases under various forms. 

Neither should the dwelling be shaded by dense foliage. The 
dampness of the leaves tends to attract malaria. Trees growing 
a little distance from the house, however, obstruct the trans- 
mission of unhealthy vapors arising beyond them. Malaria 
generally lurks near the sui-face of the earth, and seems to 
be more abundant in the night time. Persons sleeping in the 
upper story of a house may escape its morbid influence, while 
those occupying apartments on the lower floor, become affected. 

dajmp cellars. 

Damp cellars, under residences, are a fruitful cause of 
disease. Dr. Sanfovd B. Hunt, in an article in the JVewark 
Daily Advertiser, speaking of the recent epidemic of diphtheria 
in New York City, says: 

"Pestilences that come bodily, like cholera, are faced and 
beaten by sanitary measures. Those which come more subtly 
need for their defeat only a higher detective ability and a closer 
study of causes, many of which are known, but hidden under 
the cellars of our liouses, and which at last are only preventable 
by public authority and at public expense in letting out the 
imprisoned dampness which saturates the earth on which our 
dwellings are built. Where wood rots, men decay. This is 
clearly shown in the sanitary map printed in the Times, In 
the great district surrounding Central Park, and which partici- 
pates in its drainage system, there are no cases. On the whole 
line of Fifth Avenue there are none. The exempt districts 
are clearly defined by the character of the soil, drainage, and 
sewerage, and by the topography, which either has natural 
or artificial drainage, but most of which is so dry that only 
surface-water and house-filth — which does not exist in those 
palaces — can affect the health of the residents. But in the 
tenement houses and on the made lands where running streams 
have been filled in and natural springs choked up by earth 



DUST AND DISEASE. 229 

fillings, diphtheria finds a nidus in which to develop itself. 
The sanitary map coincides precisely with the topographic 
map made by Gen. Viele. Where he locates buried springs 
and water-courses, there we find the plague spots of diphtheria 
and in the same places, on previous maps prepared by the 
Board of Health, we find other low types and stealthy diseases, 
such as typhoid and irruptive fevers, and there we shall find 
them again when the summer and autumnal pestilences have 
yielded place to those which belong to the indoor poisoned 
air in the winter. The experience of other cities, notably 
London and Dublin, once plague spots and now as healthy 
as any spot on earth, proves that most of the causations of 
disease are within the control of Ihe competent sanitarj'^ en- 
gineer, even in localities crowded beyond American knowledge, 
and houses built upon soil saturated for centuries with the offal 
of successive and uncleanly generations. Wet earth, kept wet 
by the boiling up of imprisoned springs, is a focus of disease. 
Dry earth is one of the most perfect deodorizers, the best of 
oxydizers and absorbents, destroying the germs of disease with 
wonderful certainty. On those two facts rests the theory of 
public hygiene." 

DUST AKD DISEASE. 

The air we breathe is heavily loaded with minute particles 
of floating dust, their presence being revealed only by intense 
local illumination. Professor Tyndall says: "solar light, in 
passing through a dark room, reveals its track by illuminating 
the dust floating in the air. ' The sun,' says Daniel Culverwell, 
'discovers atoms, though they be invisible by candle-light, 
and makes them dance naked in his beams.' " 

After giving the details and results of a series of experiments 
in which he attempted to extract the dust from the air of the 
Royal Institute by passing it through a tube containing frag- 
ments of glass wetted with concentrated sulphuric acid, and 
thence through a second tube containing fragments of marble 
wetted with a strong solution of caustic potash, which experi- 
ments were attended with perfect failure, the Professor con- 
tinues, "I tried to intercept this floating matter in various 
ways; and on the day just mentioned, prior to sending the 



2'M) COMMON SENSE MEDICAL ADVISER. 

air through llie drying apparatus, I carefully permitted it 
to pass over the tip of a spirit-lamp flame. The floating matter 
no longer appeared, having been burnt up by the flame. It 
was, therefore, of organic origin. I was by no means prepared 
for this result; for I had thought that the dust of our air was, 
in great part, inorganic and non-combustile." In a foot note 
he says, " according to an analysis kindly furnished me by Dr. 
Percy, the dust collected from the walls of the British Museum 
contains fully fifty per cent, of inorganic matter. I have every 
confidence in the results of this distinguished chemist ; they 
show that the floating dust of our rooms is, as it were, win- 
nowed from the heavier matter." Again he says: "the air of 
our London rooms is loaded with this organic dust, nor is 
the country air free from its presence. However ordinary 
daylight may jjermit it to disguise itself, a sufliciently powerful 
beam causes dust suspended in air to appear almost as a semi- 
solid. Nobody could, in the first instance, without repugnance, 
place the mouth at the illuminated focus of the electric beam 
and inhale the thickly-massed dust revealed there. Nor is 
the repugnance abolished by the reflection that, although we 
do not see the floating particles, we are taking them into our 
lungs every hour and minute of our lives." " The notion was 
expressed by Kircher and favored by Linna3us, that epidemic 
diseases are due to germs which float in tlie atmosphere, enter 
the body, and produce disturbance by the development within 
the body of parasitic life. While it was struggling against 
gi'eat odds, this theory found an expounder and a defender 
in the President of this institution. At a time when most 
of his medical brethren considered it a wild drean), Sir Henry 
Holland contended that some form of the genn-theory was 
probably true." Professor Tyndall proposes means by the 
application of which air loaded with noxious particles may 
be freed from them before entering the air passages. The 
following embodies his suggestions on this point: 

COTTON- WOOL RESPIRATOR. 

"I now empty my lungs as perfectly as possible, and placing 
a handful of cotton-wool against my mouth and nostrils, inhale 
through it. There is no difficulty in thus filling the lungs 



LIGHT AND HEALTH. 231 

with air. On expiring this air through a glass tube, its freedom 
from floating matter is at once manifest. From the very 
beginning of the act of expiration the beam is pierced by 
a black aperture. The first puff from the lungs abolishes the 
illuminated dust, and puts a patch of darkness in its place; 
and the darkness continues throughout the entire coui'se of 
the expiration. When the tube is placed below the beam and 
moved to and fro, the same smoke-like appearance as that 
obtained with a flame is observed. In short, the cotto?i-wool, 
when used in sufficient quantity, and with due care, completely 
intercepts the floating matter on its way to the hitigs. 

The application of these experiments is obvious. If a phy- 
sician wishes to hold back from the lungs of his patient, or 
from his own, the germs or virus by which contagious disease 
is propagated, he will employ a cotton-wool respirator. If per- 
fectly filtered, attendants may breathe the air unharmed. In 
all probability the protection of the lungs and mouth will be 
the protection of the entire system. For it is exceedingly 
probable that the germs which lodge in the air-passages, or 
find theu' way with the saliva into the stomach with its absor- 
bent system, are those which sow in the body epidemic disease. 
If this be so, then disease can be warded off by carefully pre- 
pared filters of cotton-wool. I should be most willing to test 
their efficacy in my own person. But apart from all doubtful 
applications, it is perfectly certain that various noxious trades 
in England may be rendered harmless by the use of such filters. 
I have had conclusive evidence of this from people engaged 
in such trades. A foi-m of respirator devised by Mr. Gairick, 
a hotel proprietor in Glasgow, in which inhalation and ex- 
halation occur through two different valves, the one permitting 
the air to enter through the cotton-wool, and the other per- 
mitting the exit of the air direct into the atmosphere, is well 
adapted for this purpose. But other forms might readily be 
devised." 

LIGHT AND HEALTH. 

Our dwellings ought freely to admit the sunlight. Diseases 
which have baffled the skill of physicians have been known 
to yield when the patients were removed from dark rooms to 
light and cheerful apartments. Lavoisier placed light, as an 



232 COMMON SENSE MEDICAL ADVISER. 

agent of health, even before pure air. Plants which grow in the 
shade are slender and weak, and children brought up in dark 
rooms are pale, sallow, and rickety. It is a bad practice to 
avoid the sunlight through fear of spoiling the complexion, since 
the sun's rays are necessary to give to it the delicate tints of 
beauty and health. Air is necessary for the first inspiration and 
the last expiration of our lives, but the purity and healthfulness 
of the atmosphere depend upon the warming rays of the sun, 
while our bodies require light in order that their functions may 
be properly performed. We know that without solar light, there 
can be no proper vegetable growth, and it is equally necessary 
for the beauty and perfection of animal development. Our 
dwellings should therefore be well lighted and made as 
bright and cheerful as possible. Women who curtain the 
windows, soften the light, and tint the room with some mellow 
shade, may do so in order to hide their own faulty complexions. 
The skin of persons confined in dungeons or in deep mines 
becomes pale or sickly yellow, the blood grows watery, the 
skin blotches, and dropsy often intervenes. On the other hand, 
invalids carried out from darkened chambers into the bright 
sunlight are stimulated, the skin browns, nutrition becomes 
more active, the blood improves, and they become convalescent. 
Light is especially necessary for the healthy growth of children. 
There is nothing more beautiful and exhilarating than the 
glorious sunlight. Let its luminous, warming, and physiological 
forces come freely into our dwellings, enter into the chemistry 
of life, animate the spirits, and pervade our homes and our 
hearts with its joy-inspirii«g and health-imparting infiuences. 



CHAPTER II. 

FOOD. BEVERAGES. AL- 
COHOLIC LIQUORS. 
CLOTHING. 



The human body is continually undergoing changes, wliich 
commence with the earliest dawn of existence 'and end only 
with death. The old and worn-out materials are constantly 
being removed to make room for the new. Growth and de- 
velopment, as well as the elimination of worn-out and useless 
matter, continually require new supplies, which are to be de- 
rived from our food. To fulfill these demands it is necessary 
that the nutriment should be of the proper quality, and of 
sufficient variety to furnish all the constituents of the healthy 
body. In order that food may be of utility, like other building 
materials, it must undergo preparation; the crude substance 
must be worked up into proper condition and shape for use, in 
other words, it must be digested. But this does not end the 
process of supply, each different substance must be taken by the 
different bands of workmen, after due preparation in the work- 
shop, to its appropriate locality in the structure, and tliere 
fitted into its proper place; this is assimilation. In reaTity it 
becomes a portion of the body, and is advantageous in main- 
taining the symmetry and usefulness of the part to which it is 
assigned; this constitutes the ultimate object of iood, nutrition. 

Eating is the process of receiving the food into the mouth, 
i. e., prehension^ mastication and insalivation — minutely divid- 
ing and mixing it with the saliva; deglutition — conveying it to 
the stomach. Plenty of time should be taken at meals to 
thoroughly masticate the food and mix it with the saliva, which, 

233 



234 COMMON SENSE MEDICAL ADVISEE. 

being one of the natural solvents, favors its farther solution by 
the juices of the stomach; the healthy action of tlie digestive 
powers is favored by tranquillity of mind, agreeable associ- 
ations, and pleasant conversation while eating. It is proverbial 
of tlie American people that they bolt their food whole, washing 
it down with various fluids, thus forcing the stomach to perform 
not only its own duties, but also those of the teeth and salivary 
glands. This manner of dispatching food, which should go 
through the natural process above described, is not without its 
baleful consequences, for the Americans are called a nation of 
dyspeptics. 

Eating slowly, masticating the food thoroughly, and drinking 
but moderately during meals, will allow the juices of the 
stomach to fulfill their proper function, and healthy digestion 
and nutrition will result. If the food is swallowed nearly 
whole, not only will a longer time be required for its solution, 
but frequently it will ferment and begin to decay before 
nutritive transformation can be effected, even when the gastric 
juice is undiluted with the fluids which the huri-ied eater 
imbibes during his meal. 

Regularity of Ifleals cannot be too strongly insisted 
upon. The stomach, as well as other parts of the body, niust 
have intervals of rest or its energies are soon exhausted, its 
functions impaired, and dyspepsia is the result. Nothing of 
the character of food should ever be taken except at regular 
meal times. Some persons are munching cakes, apples, nuts, 
candies, etc., at all hours, and then wonder why they haA^e 
weak stomachs. They take their meals regularly, and neither 
eat rapidly nor too much, and yet they are troubled with in- 
digestion. The truth is they keep their stomachs almost 
constantly at work, and hence tired out, which is the occasion 
of the annoyance and distress they experience. 

Eating too much. It should always be remembered 
that the nutrition of our bodies does not depend uj^on the 
amount eaten, but upon the amount that is digested. Eating 
too much is nearly as bad as swallowing the food whole. The 
stomach is unable to digest all of it, and it ferments and gives 
rise to unpleasant results. The \innatural distention of the 
stomach with food causes it to press upon the neighboring 



FEEDING INFANTS. 235 

organs, interfering with the proper performance of their func- 
tions, and, if frequently repeated, gives rise to serious disease. 
People more frequently eat too much than too little, and to 
omit a meal when the stomach is slightly deranged is frequently 
the best medicine. It is an excellent plan to rise from the table 
before the desire for food is quite satisfied. 

Late 8lipper8. It is generally conceded that late suppers 
are injurious, and should never be indulged in. Persons who 
dine late have little need of food after their dinner, unless 
they are kept up until a late hour. In such cases a moderate 
meal may be allowed, but it should be eaten two or three hours 
before retiring. Those who dine in the middle of the day 
should have supper, but sufficiently early so that a proper length 
of time may elapse before going to bed, in order that active 
digestion may not be required during sleep. On the other hand, 
it is not advisable to go wholly without this meal, but the 
food eaten should be light, easily digestible, and moderate 
in quantity. Persons who indulge in hearty suppers at late 
hours, usually experience a poor night's rest, and wake the next 
morning unrefreshed, with a headache and a deranged stomach. 
Occasionally more serious consequences follow; gastric disorders 
result, apoplexy is induced; or, perhaps, the individual never 
wakes. 

Feeding' Infants. For at least six or seven months after 
birth, the most appropriate food for an infant is its mother's 
milk, which, when the parent is healthy, is rich in all the 
elements necessary for its growth and support. 'Next to the 
mother's milk, that of a healthy nurse should be preferred; 
in the absence of both, milk from a cow that has recently 
calved is the most natural substitute, in the proportion of one 
part water to two parts milk, slightly sweetened. The milk 
used should be from but one cow. All sorts of paps, gruels, 
panadas, cordials, laxatives, etc., should be strictly prohibited, 
for their employment as food cannot be too severely censured. 
Vomiting, diarrhea, colic, green stools, griping, etc., are the 
inevitable results of their continued use. The child should be 
fed at regular intervals, of about two hours, and be limited 
to a proper amount each time, which, during the first month, 
is about two ounces. From 11 p. m. to 5 a. m. the child 



286 COMMON SENSB MEDICAL ADVISER. 

ehould be nursed bat once. As the child grows older the inter- 
vals should be lengthened, and the amount taken at a time grad- 
ually increased. The plan of gorging the infant's stomach with 
food every time it cries, cannot be too emphatically condemned. 

After the sixth or seventh month, in addition to milk, bits of 
bread may be allowed, the quantity being slowly increased, thus 
permitting the diet to change gradually from fluid to solid 
food, so that, when the teeth are sufficiently developed for 
mastication, the child has become accustomed to various kinds 
of nourishment. Over-feeding, and continually dosing the 
child with cordial, soothing syrups, etc., are the most fruitful 
sources of infant mortality, and should receive the condem- 
nation of every mother in the land. 

Preparation of Food. The production of pure blood 
requires that all the food selected should be rich in nutritious 
elements, and well cooked. To announce a standard by which 
all persons shall be guided in the selection and preparation 
of their food is impossible. Especially is this the case in a 
country the inhabitants of which represent almost every 
nation on the face of the globe. Travelers are aware that 
there is as much diversity in the articles of food and methods 
of cookery, among the various nationalities, as in the erection of 
their dwellings, and in their mental characteristics. In America 
we have a conglomeration of all these peoples; and for a 
native American to lay down rules of cookery for his German, 
French, English, Welsh, and Irish neighbors, or vice versa, is 
useless, for they will seldom read them, and, therefore, cannot 
profit by them. There are, however, certain conditions recog- 
nized by the hygienic writers of every nation. The adequate 
nutrition of the organic tissues demands a plentiful supply of 
pure blood, or the digestive apparatus will become impaired, 
the mental processes deranged, and the entire bony and mus- 
cular systems will lose their strength and elasticity, and be 
incapacitated for labor. 

Different Kind$!i of Food Required. The different 
periods and circumstances of life require their appropriate food, 
and the welfare of mankind demands that it should supply both 
the inorganic and organic substances employed in the develop- 
ment of every tissue, '•"'ho inorganic elements employed in our 



DIFrBRE>'T KINDS OF FOOD RKQUIRKD. 287 

construction, of which Phosphorus, Sulphur, Soda, Iron, Lime, 
and Potash are the most important, are not considered as 
aliments, but are found in the organic kingdom, variously ar- 
ranged and combined with organic materials in sufficient quanti- 
ties for ordinary purposes. When, however, from any cause, 
a lack of any of these occurs, so that their relative normal 
proportions are deranged, the system suffers, and restoration to 
a healthy condition can only be accomplished by supplying 
the deficiency; this may be done by selecting the article of 
food richest in the element Avhich is wanting, or by introducing 
it as a medicine. It must be remembered that those substances 
which enter into the construction of the human fabric, are not 
promiscuously employed by nature, but that each and every 
one is destined to fulfill a definite indication. 

Lime enters largely into the formation of bone, either as a 
phosphate or a carbonate, and is required in much greater quan- 
tities in early life, while the bone is undergoing development, 
than afterwards. In childhood the bones are composed largely 
of animal matter, being pliable and easily moulded. For this 
reason the limbs of young children bend under the weight of 
their bodies, and unless care is taken they become bow-legged 
and distorted. Whenever there is a continued deficiency of 
the earthy constituents, disease of the bones ensues. Therefore, 
during childhood, and particularly during the period of denti- 
tion, or teething, the food should be nutritious and at the same 
time contain a due proportion of lime, which is preferable in 
the form of a phosphate. When it cannot be furnished by 
the food, it should be supplied artificially. Delayed, prolonged, 
and tedious dentition generally arises ftom a deficiency of lime. 

With the advance of age it accumulates, and the bone be- 
comes hard, inelastic, and capable of supporting heavy weights. 
Farther on, as in old age, the animal matter of bone becomes 
diminished, and lime takes its place, so that the bones become 
brittle and are easily broken. Lime exists largely in hard 
water, and to a greater or less extent in milk, and in nearly 
all foods except those of an acid character. 

Phosphorus exists in various combinations in different parts 
of the body, particularly in the brain and nervous system. 
Persons who perform a large amount of mental labor require 



238 COMMON SENSE MEDICAL ADVISER. 

more phosphorus than those engaged in other pursuits. It 
exists largely in the hulls of wheat, in fish, and in eggs. It 
should enter to a considerable extent into the diet of brain 
workers, and the bread consumed by them should be made 
of unbolted flour. 

Sulphur^ IroHy Soda, and Potash are all necessary in the 
various tissues of the body, and deficiency of any one of them, 
for any considerable length of titne, results in disease. They 
are all suj^plied, variously arranged and combined, in both 
animal and vegetable food; in some articles they exist to a 
considerable extent, in others in much smaller quantities. 
Sulphur exists in eggs and in the flesh of animals, and often 
in water. Iron exists in the yolk of eggs, in flesh, and in sev- 
eral vegetables. Soda is supplied in nearly all food, and largely 
in common salt, which is a composition of sodium and hydro- 
chloric acid, the latter entering into the gastric juice. Potash 
exists, in some form or other, in suflScient" quantities for health, 
in both vegetable and animal food. 

Classes of Food. All kinds of food substances may be 
divided into four classes: Proteids, Fats, Amyloids, and J/m- 
erals. Proteids are composed of the four elements, carbon, 
hydrogen, oxygen, and nitrogen, sometimes combined Avith 
sulphur and phosphorus. In this class are included the gluten 
of flour; the albumen, or white of eggs; and the serum of the 
blood; the ^6rm of the blood; syntonm, the chief constituent 
of muscle and flesh, and casein, one of the chief constituents 
of cheese, and many other similar, but less frequent substances. 

Fats are composed of carbon, hydrogen, and oxygen only, 
and contain more hydrogen than would be required to form 
water if united with the oxygen which they contain. All 
vegetable and animal oils and fatty matters are included in 
this class. 

Amyloids consist of substances which are also composed 
of carbon, oxygen, and hydrogen only; but they contain just 
enough hydrogen to produce water when combined with their 
oxygen, or two parts of hydrogen to one of oxygen. This 
division includes sugar, starch, dextrine, and gum. The above 
three classes of food-stuffs are only obtained through the 
activity of living organisms, vegetable or animal, and have 



VARIETY OF FOOD NBCESSABY. 239 

been, therefore, appropriately termed by Prof. Huxley, vital 
food-stuff's. 

The mineral food-stuffs may, as we have seen, be procured 
from either the living or the non-living world. They include 
water and various earthy, metallic, and alkaline salts. 

Variety of Food l^ecessary. No substance can serve 
permanently for food except it contains a certain quantity of 
proteid matter in the shape of albumen, fibrin, casein, etc., and, 
on the other hand, any substance containing proteid matter in 
a shape in which it can be readily assimilated, may serve as a 
permanent vital food-stuff. Every substance, which is to serve 
as a permanent food, must contain a sufficient quantity, ready- 
made, of this most important and complex constituent of the 
body. In addition, it must also contain a sufficient quantity of 
the mineral ingredients which enter into the composition of the 
body. Its power of supporting life and maintaining the weight 
and composition of the body remains unaltered, whether it con- 
tains fats or amyloids or not. The secretion of urea, and, 
consequent! \, the loss of nitrogen, goes on continually, and the 
body, therefore, must necessarily waste unless the supply of 
proteid matter is constantly renewed, since this is the only class 
of foods that contains nitrogen in any considerable quantity. 
There can be no absolute necessity for any other food-stuffs 
but those containing the proteid and mineral elements of the 
body. From what has been said, it will readily be seen that 
whether an animal be carnivorous or herbivorous, it begins to 
starve as soon as its vital food-stuffs consist only of amyloids, 
or fats, or both. It suffers from what has been termed nitrogen 
starvation, and if proteid matters are withheld entirely, it 
soon dies. In such a case, and stUl more in the case of an 
animal which is entirely deprived of vital food, the organism, 
as long as it continues to live, feeds upon itself, the waste pro- 
ducts necessarily being formed at the expense of its own body. 

Although proteid matter is the essential element of food, 
and under certain circumstances may be sufficient of itself to 
support the body, it is a very uneconomical food. The white 
of an egg, which may be taken as a type of the proteids, 
contains about fifteen per cent, of nitrogen, and fifty-three 
per cent, of carbon; therefore, a man feeding upon this, would 



240 c:0MJI10N SENSE MEDICAL ADVISER. 

take ill about three and a half times as much carbon as nitro- 
<T('n. It has been proved that a healthy, adult man, taking a 
fair amount of exercise and maintaining his weight and body 
temperature, eliminates about thirteen times as much carbon 
as nitrogen. However, if he is to get his necessary quantity, 
about 4000 grains of carbon, out of albumen, he must eat 7,547 
grains of that substance; but this quantity of albumen contains 
nearly four times as much nitrogen as he requires. In other 
words, it takes about four pounds of lean meat, free from fat, 
to furnish 4,000 grains of carbon, the quantity required, whereas 
one pound yields the requisite quantity of nitrogen. Thus a 
man restricted exclusively to a proteid diet, must take an 
enormous quantity of it. This would involve a large amount 
of unnecessary physiological labor, to comminute, dissolve, and 
absorb the food, and to excrete the supei-fluous nitrogenous 
matter. Unproductive labor should be avoided as much in 
physiological as in political economy. The universal practice 
of subsisting on a mixed diet, in which proteids are mixed with 
fats or amyloids, is therefore justifiable. 

Fats contain about 80 per cent, of carbon, and amyloids 
about 40 per cent. We have seen that there is sufficient nitro- 
gen in a pound of meat free from fat, to supply a healthy 
adult man for twenty-four hours, but that it contains only 
one-fourth of the quantity of carbon required. About half 
a pound of fat, or one pound of sugar, will supply the quantity 
of carbon necessary. The fat, if properly subdivided, and the 
sugar, by reason of its solubility, pass with great ease into 
the circulation, the physiological labor, consequently, being re- 
duced to a minimum. 

Several common articles of diet contain in themselves all 
the necessary elements. Thus, butchers' meat ordinarily con- 
tains from 30 to 50 per cent, of fat; and bread contains the 
proteid, gluten, and the amyloids, starch and sugar, together 
with minute quantities of fat. However, on account of the 
proportion in which these proteid and other components of 
the body exist in these substances, neither of them, by itself 
is such a physiologically economical food, as it is when combined 
with the other in the proportion of three to eight, or three- 
quarters of a pound of meat to two pounds of bread a day. 



VALUE OF ANIMAL FOOD. 241 

It is evident that a variety of food is necessary for health. 
Animals fed exclusively upon one class, or upon a single article 
of diet, droop and die; and in the human family we know that 
the constant use of one kind of diet causes disgust, even when 
not very long continued. Consequently, we infer that the 
welfare of man demands that his food be of sufficient variety 
to supply his body with all of its component parts. If this 
is not done the appetite is dei'anged, and often craves the 
very article which is necessary to supply the deficiency. 
After the component parts of the organism have assimilated 
the nutritious elements of particular kinds of food for a certain 
length of time, they lose the power of effecting the necessary 
changes for proper nutrition, and a supply of other material 
is imperatively demanded. When the diet has been long re- 
stricted to proteids, consisting largely of salt meats, fresh 
vegetables and fruits containing the organic acids, become in- 
dispensable; otherwise, the scorbutic condition, or scurvy, is 
almost sure to be developed. Fresh vegetables and fruits 
should be eaten in considerable quantities at the proper seasons. 

Value of Animal Food. The principal animal food 
used in this country consists of Pork, Miitton, Beef, and Fish. 
Beef and mutton are rich in muscle-producing material. Al- 
though pork is extensively produced in some portions of this 
country, and enters largely into the diet of some classes, yet its 
use, except in winter, is not to be encouraged. The same 
amount of beef would give far greater returns in muscular 
power. 

In addition to the meats mentioned, Wild Game furnishes 
palatable, nutritious, and easily-digested food. Domestic Fowls, 
when young, are excellent, and with the exception of geese and 
ducks, are easily digested. Wild £irds are considered much 
healthier food than those which are domesticated. All of these 
contain more or less of the elements which enter into the com- 
position of the four classes of foods. 

Veg^etable Foods. Wheat is rich in all the elements 
which compose the four classes, and, when the flour is unbolted, 
it is one of the best articles for su})plying all the elements. 

Barley stands next to wheat in nourishing qualities, but is 
not so palatable. 
11 



24 "2 COMMON SENSE MEDICAL ADVISER. 

Oats are rich in all the elements necessary for nutrition. 
Oat-meal is. a favorite article of diet among the Scotch, and, 
judging from their hardy constitutions, their choice is well 
founded. In consequence of the large propoi'tion of })hos|)horus 
which they contain, they are capable of furnishing a large 
amount of nourishment for the brain. 

Rye is nutritious, but it is not so rich Iji tissue-forming 
material. 

Tndiwi Com is an article well known and extensively used 
throughout the United States, and is a truly valuable one, 
capable of being prepared in a great variety of ways for 
food. It contains more carbon than wheat, and less nitrogen 
and phosphorus, though enough of both to be extremely 
valuable. 

Mice is rather meagre in nutriment; it contains but little 
phosphorous matter, with less carbon than other cereals, and 
is best and most generally employed as a diet in tropical 
countries. 

Beans and Peas are rich in nutritious matter, and furnish 
the manual laborer with a cheap and Avholesome diet. 

The Potato is the most valuable of all fresh vegetables 
grown in temperate climates. Its flavor is very agreeable, and 
it contains very important nutritive and medicinal qualities, 
and is eaten almost daily hy nearly every family in North 
America. Until very recently it, with the addition of a little 
butter-milk or skim-milk, constituted almost the sole diet of the 
Irish people. The average composition of the j^otato is stated 
by Dr. Smith to be as follows: Water 75 per cent., nitrogen 
2.1, starch 18.8, sugar 3.2, fat 0.2, salts 0.7. The relative values 
of different potatoes may be ascertained veiy correctly by 
weighing them in the hand, for the heavier the tuber the more 
starch it contains. 

Turnip and Cabbage are 92.5 per cent, water, and, conse- 
quently, poor in nutrition, though they are very palatable. The 
solid portions of cabbage, however, are rich in albumen. 

It is evident that the quantity necessary to maintain the 
system in pi-oper condition must be greatly modified by the 
habits of life, the condition of the organism, the age, the sex, 
and the climate. The daily loss of substance which must be 



DIGESTIBILITY OF FOOD. 248 

replaced by material from without, as we have seen, is very 
great. In addition to the loss of carbon and nitrogen, about 
four and a half pounds of water are removed from the system 
in twenty-four hours, and it is necessary that about (his quan- 
tity should be hitroduced into the system in some form or other, 
however much it may be adulterated. Professor Dalton states: 
*' From experiments performed while living on an exclusive 
diet of bread, fresh meat, and butter, with coffee and water for 
drink, we have found that the entire quantity of food required 
during twenty-four hours by a man in full health and taking 
free exercise in the open air is as follows: 

Meat, 1() oz., or 1.03 lb. avoir. 

Bread, ....*. 19 " 1.19 •• '• 
Butter or fat, . . . . 3J-^ " 0.22 - 
Water, 52 fluid oz., 3.88 " 

That is to say, rather less than two and a half pounds of 
solid food, and rather over three pounds of liquid food." 

Climate exerts an important influence on the quantity 
and quality of food required by the system. In northern lati- 
tudes the inhabitants are exposed to extreme cold and require 
an abundant supply of food, and especially that which contains 
a large amount of fat. On this account fat meat is taken in 
large quantities and with a relish. The quantity of food con- 
sumed by the natives of the Arctic zone is almost incredible. 
The Russian Admiral, Saritcheff, relates that one of the Esqui- 
maux in his presence devoured a mass of boiled rice and butter 
which weighed twenty-eight pounds, at a single meal, and Dr. 
Hayes states that usuall)^ the daily ration of an Esquimau 
is from twelve to fifteen pounds of meat, one-third of which 
is fat, and on one occasion he saw a man eat ten pounds 
of walrus flesh at a single meal. The intense cold creates a 
constant craving for fatty articles of food, and some members 
of his own party were in the habit of drinking the contents 
of the oil-kettle with great apparent relish. 

Digestibility of Food. Unless an article of diet can 
be digested it is of no value, no matter how rich it may be 
in nutriment. The quantity of food taken, will influence to a 
considerable extent, the time consumed in its digestion The 



244 



COMMON SENSE MEDICAL ADV18EK. 



Stomachs of all are not alike in this respect, aud the subject 
of time has been a difficult one to determine. The experiments 
of Dr. Beaumont with the Canadian, 8t. Martin, who acci- 
dentally discharged the contents of a loaded gun into his 
stomach, creating an external opening through which the pro- 
cess of digestion could be observed, have furnished us with 
the following table, which is correct enough to show rela- 
tively, if iu)t absolutely, the time required for the digestion 
of various articles: 



artii;les of diet. 



Milk ... 
Kggs, fresli 



<'ustard 

( 'odtisli, cured, dry.. 
Trout, salmon, fresli 



Bass, striped. 
Flounder, 
Catfish, 
Salmon, salted 
Oysters, fresh . 



Venison steak 

Vig, sucking- 

Lamb, fn'sh 

Beef, fresli, lean, dry .. 
" with mustard, etc. 
" " salt only... 



" fresh, lean, rare. 

Beefsteak 

Mutton, fresh 



Veal, fresh. 



Porksteak 

Pork, fat and lean... 
" recently salted. 



Mode of 
Preparation. 



Boiled 
Raw 



Whipped /. 

Roasted 

Soft boiled. . 

Hard boiled , 

Fried 

Baked 

Boiled 



Fried .. 
Broiled 
Fried .. 



Boiled . 
Raw 

Roasted . 
Stewed . 
Broiled 
Roasted 
Broiled . 
Roasted . 
Boiled -. 



Fried ... 
Roasted . 
Broiled . 

Boiled -' 
Roasted . 
Broiled . 
Fried... 
Broiled 
Roasted . 

Raw 

Stewed . . 
Broiled . 



S .2 
W S 



2 00 
2 16 
2 00 

1 30 

2 15 
.S 00 
H 30 



30 
45 
00 
30 
30 



3 00 
3 30 

3 30 

4 00 

2 55 

3 15 
3 30 

1 35 

2 30 

2 30 

3 30 
3 10 

3 36 

4 00 
3 00 
3 00 
3 00 



00 
15 
00 
30 
15 
15 
00 
3 00 
3 15 



DIGESTIBILITY OP FOOD. 



245 



-AJITICLES OP DIET. 



Pork, recently salted 

Turkey, wild 

" tame 

Goose, wild 

Chickens, full-grown 

Fowls, domestic 

Ducks, tame 

wild 

Soup, barley 

" bean 

chicken" 

" mutton 

" oyster 

" beef, vegetables, and bread 

" marrow-bones 

Pig's feet, soused 

Tripe, soused 

Brains, animal 

Spinal marrow, animal 

Liver, beef, fresh . 

Heart, animal. _ 

Cartilage 

Tendon 

Hash, meat, and vegetables 

Sausage, fresh 

Gelatine 

Cheese, old, strong 

Green corn and beans 

Beans, pod 

Parsnips 

Potatoes 

u 
n 

Cabbage, head _.. 

" " with vinegar 

Carrot, orange 

Turnips, Hat 

Beets - - 

Bread, corn 

'' wheat, fresh 

Apples, sweet, mellow 

•' sour, " 

hard 



Mode of 
Preparation. 



Fried 

Boiled _ _ . 
Roasted 

a 

Boiled , _ 
Roasted . - . 
Fricasseed 
Boiled . . ^ 
Roasted _ - . 



Boiled 



Broiled 
Fried .. 
Boiled . 



Warmed 
Broiled . 
Boiled . . 

Raw 

Boiled -- 



Roasted . 
Baked . 
Boiled .. 
Raw 



Boiled 

Baked 
Raw _■- 



B 



15 
30 
18 
30 
25 
30 
45 
00 
00 
00 
30 
30 
00 
3 00 
3 30 



30 
00 
15 
00 
00 
45 
40 
00 
00 
15 
5 30 

2 30 

3 20 

2 30 

3 30 
3 45 
2 30 
2 30 
2 30 
2 30 



Milk is more easily digested than almost any other article 
of food. It is very nutritious, and, on account of the variety 
of the elements which it contains, it is extremely valuable as 



24G COMMON SENSE MEDICAL ADVISER. 

article of diet, especially when the digestive powers are 
weakened, as in fevers, or during convalescence from any 
acute disease. Eggs are also very nutritious and easily digested. 
Whipped eggs ai'e digested and assimilated with great ease. 
Fish, as a rule, are more speedily digested than is the flesh 
of warm-blooded animals. Oysters, especially when taken raw, 
are very easily digested. We have known dyspeptics who 
were unable to digest any other kind of animal food, to subsist 
for a considerable period upon raw oysters. The flesh of 
mammalia seems to be more easily digested than that of birds. 
Beef, mutton, lamb, and venison are easily digested, while fat 
roast pork and veal are digested with difficulty. According 
to the foregoing table vegetables were digested in about the 
same time as ordinary animal food, but it should be remem- 
bered that a great part of the digestion of these is effected 
in the small intestine. Soups arc, as a rule, very quickly 
digested. The time required for the digestion of bread is 
about the same as that required for the digestion of ordinary 
meats. Boiled cabbage is one of the most difficult substances 
to digest. 

Cookery. " Cookery," says Mrs. Owen, " Is the art of 
turning every morsel to the best use; it is the exercise of skill, 
thought, and ingenuity to make every particle of food yield 
the utmost nourishment and pleasure, of which it is capable." 
We are indebted to this practical Avoman for many valuable 
suggestions in this art; and some of our recommendations 
are drawn from her experience. 

^OUp!!i. The nutritious properties, tone, and sweetness of 
soup depend in the first place upon the freshness and quality 
of the meat; secondly on the manner in which it is boiled. 
Soups should be nicely and delicately seasoned, according to 
the taste of the consumer, by using parsley, sage, savory, thyme, 
sweet marjoram, sweet basil, or any of the vegetable condi- 
ments. These may be raised in the garden, or obtained at 
the drug stores, sifted and prepared for use. In extracting 
the juices of meats, in order that soups may be most nutritious, 
it is important that the meat be put into cold water, or that 
which is not so hot as to coagulate the albumen (which would 
prevent it from being extracted), and then, by slow heat and 



PORK STEAKS. 247 

a simmering process, the most nutritious properties will be 
brought out, 

Beef* 8oiip may be made of any bone of tlie beef, by 
putting it into cohl water, adding a little salt, and skimming it 
well just before it boils. If a vegetable flavor be desired, 
celery, carrots, onions, turnips, cabbage, or potatoes, may be 
added, in sufficient quantities to suit the taste. 

jflutton 8oup may be made from the fore-quarter, in the 
same manner as described above, thickened with pearl-barley 
or rice, and flavored to suit the taste. 

Boiled Fi$^h. Clean the fish nicely, then sprinkle flour on 
a cloth and wrap it around them; salt the water, and, when it 
boils, put in the fish; let them boil half an hour, then carefully 
remove them to a platter, adding egg sauce and parsley. To 
bake fish, prepare by cleaning, scaling, etc., and let them 
remain in salt water for a short time. Make a stuffing of the 
crumbs of light bread, and add to it a little salt, pepper, butter, 
and sweet herbs, and stir with a spoon. Then fill the fish 
with the stuffing and sew it up. Put on butter, salt, pepper, 
and flour, having enough water in the dish to keep it from 
burning, and baste often. A four pound fish will bake in fifty 
or sixty minutes. 

Broiled Steak. Sirloin and porter-house steaks should 
be broiled quickly. Preserve them on ice for a d^y or two and 
their tenderness is much increased. Never broil them until the 
meal is ready to be served. 

Boiled meat. When meat is to be boiled for eating, 
put it into boiling water, by which its juices are coagulated 
and its richness preserved. The slower it boils, the more 
tender, plump, and white it will be. Meat should be removed 
as soon as done, or it will lose its flavor and become soggy. 

Pork l§teak!$. The best steaks are cut off the shoulder 
— ham steaks being rather too dry. They should be well fried, 
in order to destroy the little living parasites, called Trichinae, 
which sometimes infest this kind of meat. They are intro- 
duced into the stomach by eating ham, pork, or sausages made, 
from the flesh of hogs infested by them. Thorough cooking 
destroys them, and those who will persist in the use of swine's 
flesh, can afford to have it " c?one brown.^^ 



248 <OMMON SENSE MEDIOAI. ADVISER. 

Baked IflllttOIl. To bake mutton well, a person should 
have a brisk, sharp fire, and keep the meat well basted. It 
requires two hours to bake a leg of mutton, weighing eight 
pounds. 

Bread. The health and happiness of a family depend, 

to a certain extent, on good, well-baked bread. At all events, 

our enjoyment would be greater if it were only better prepared. 

We make the following extract fi-ora an article printed by 

the State Board of Health, concerning the food of the people 

of Massachusetts: "As an example of good bread we would 

mention that which is always to be had at the restaux-ant of 

Parker's Hotel, in Boston. It is not better than is found on 

the continent of Europe on all the great lines of travel, and 

in common use by millions of people in Germany and France; 

but with us, it is a rare example of what bread may be. It 

is made from a mixture of flour, such as is generally sold in 

our markets, water, salt, and yeast — nothing else. The yeast 

is made from malt, potatoes, and hops. The dough is kneaded 

from one and a half to tioo hotirs, and is then thoroughly 

bakedy The truth seems to be that the kneading, which in 

this country takes the housewife's time and muscle, in Europe 

is done by the help of machinery. So here, in large villages 

and cities, people might furnish themselves with good bread, 

by means of co-operative associations, even at a less cost than 

at present. 

BEVERAGES. 

^W^ater. The importance of water in the economy of 
nature is obvious to all. It is the most abundant substance of 
which we bave knowledge. It composes four-fifths of the 
weight of vegetables, and three-fourths of that of animals. It 
is essential to the continuance of organic life. Water is uni- 
versally present in all of the tissues and fluids of the body. It 
is not only abundant in the blood and secretions, but it is also 
an ingredient of the solids of the body. According to the 
most accurate computations, water is found to constitute from 
^two-thirds to three-fourths of the entire weight of the human 
body. The following table, compiled by Robin and Verdeil, 
shows the proportion of water per thousand parts in different 
solids and fluids: 



MINEBAL IMPURITIES. ^49 

QUANTITY OF WATER IN 1,000 PARTS. 



Teeth, . 
Bones, 

Cartilage, 
Muscles, . 
Ligaments, . 
Brain, 
Blood, . 
Synovial fluid, 



100 


Bile, 


. 130 


Milk, 


550 


Pancreatic juice 


. 750 


Urine, 


768 


Lympli, 


. 789 


Gastric juice, . 


795 


Perspiration, 


. 805 


Saliva. 



887 
900 
93G 
960 
975 
986 
995 



The ]\atiiral Drink of Iflaii. Water constitutes the 
natural drink of man. No other liquid can supply its place. 
Its presence, however, in the body is not permanent. It is 
discharged from the body in diffei-ent ways; by the urine, 
the feces, the breath, and the perspiration. In the first two, 
it is in a liquid form, in the others in a vaporous form. It is 
estimated that about forty-eight per cent, is discharged in the 
liquid, and fifty-two per cent, in the vaporous form; but the 
absolute as well as the relative amount discharged depends 
upon a variety of circumstances. 

Water is never found perfectly pure, since it holds in solution 
more or less of almost every substance with which it comes 
in contact. Rain falling in the country remote from habitations 
is the purest water that nature furnishes, for it is then only 
charged with the natural gases of the atmosphere. In cities 
it absorbs organic and gaseous impurities, as it falls thi-ough 
the air, and flowing over roofs of houses carries with it soot 
and dust. Water from melted snow is purer than rain-water, 
since it descends in a solid form, and is therefore incapable 
of absorbing gases. Rain-water is not adapted to drinking 
purposes, unless well filtered. All water, except that which 
has been distilled, contains air, and it is due to this fact, that 
aquatic animals can live in it; for example, put a fish in 
distilled water and it will soon die. 

mineral Impurities. Rain-water, which has filtered 
through the soil and strata of the earth, dissolves the soluble 
materials, and carries them down to lower levels, until they 
finally collect in the sea. Common well, spring, and mineral 
waters contain from 5 to 60 grains to the gallon; sea- water con- 
tains 2,600 grains; while in some parts of the Dead Sea there are 



250 COMMON SENSE MEDICAL AJ:>VISER. 

20,000 grains to the gallon. The principal mineral impurities 
of well and spring water are lime, magnesia, soda, and oxide 
of iron, combined with carbonic and sulphuric acids, forming 
carbonates, sulphates, and chloride of sodium, or common salt. 
The most general, however, are carbonate and sulphate of lime. 

Mineral waters are usually obtained from springs w^hich con- 
tain a considerable amount of saline matter. Those waters 
which abound in salts of iron are called chalybeate or ferrxi- 
ginoxis. Those containing salt are termed saline. Those in 
which contain sulphur are termed sulphurous. Water derives 
the quality of hardness from the salts of lime — chiefly the 
sulphates — which it contains. Ilard water, being an imper- 
fect solvent, is unsuitable for washing purposes. There are 
two varieties of hardness, one of which is temporary, being 
due to the presence of carbonic acid gas in the water which 
holds the salts in solution and may be removed by merely 
boiling the water and thus expelling the gas when the salts 
are deposited, while the other is permanent and can only be 
removed by the distillation of the water. It has been ascer- 
tained that twelve pounds of the best hard soap nnist be added 
to 10,000 gallons of water of one degree of hardness before 
a lather will remain and, consequently, 0.12 lb. to 100 gallons 
of water is a measure of one degree of hardness. Since hard 
water is not so useful in cooking and other domestic purposes, 
as soft water, causing a great waste of labor and material, it 
is often highly desirable to soften it, which is effected by the 
addition of lime in what is known as Clark's process. One 
ounce of quicklime should be added to 1000 gallons of water 
for each degree of hardness. It should be first slacked and 
stirred up in a few gallons and then thoroughl}- mixed with 
the entire quantity. Then it should be allowed to remain, 
and will become clear in about three hours, but should not 
be drunk for twelve hours. 

The purity of drinking water is a matter of much impor- 
tance. That which contains a minute quantity of lead will 
give rise to all the symptoms of lead poisoning, if the use of it 
be sufficiently prolonged. An account is given of the poison- 
ing of the royal family of France, many of whom suffered 
from this cause when in exile at Claremont. The amount of 



ORftANlC IMPURITIES. 25l 

lead was only one grain in the gallon. Cai'e should therefore 
be taken to avoid drinking the water which has been contained 
in leaden pipes. It should always be allowed to run a few 
minutes before being used. 

An excess of saline ingredients, w^hich in small quantities 
are harmless, frequently produces marked disorders of the 
digestive organs. A small amount of putrescent matter habitu- 
ally introduced into the system, as in the use of food, is pro- 
ductive of the most serious results, which can be traced to 
the direct action of the poison introduced. A case is recorded 
of a certain locality favorably situated with regard to the 
access of pure air, where an epidemic of fever broke out much 
to the astonishment of the inhabitants. Upon observation it 
was found that the attacks of fever were limited to those 
families who used water from a neighboring well. The dis- 
agreeable taste of the water which had been observed, was 
subsequently traced to the bursting of a sewer, which had 
discharged a part of its contents into the well. When the 
cause was removed, there was no recurrence of the evil effects. 

Organic Impurities. Water is liable to organic con- 
tamination from a multitude of causes, such as drainage from 
dwellings, dust, insects, the decaying of vegetable and animal 
matter. These impurities may be mechanically suspended or 
held in solution in the water. Although organic impurities, 
which are mechanically suspended in water, are poisonous, 
yet they are generally associated with animalculse, and these 
feed upon, and finally consume them. Good water never con- 
tains animalculse. They are never found in freshly fallen rain- 
water, remote from dwellings, biit abound, to a greater or less 
extent in cisterns, marshes, ponds, and rivers. These little 
workers serve a useful purpose since they consume the dead 
organic matter from the water, and, having fulfilled their 
mission, sink to the bottom and die. Water which contains 
organic matter is exceedingly dangerous to health, and its use 
should be carefully avoided. 

In low lands where the current of streams is sluggish, and 
shallow pools abound, the water is apt to be more or less in- 
fected with decaying vegetable substances. Many people living 
in such localities, and wishing to obtain water with as little 



252 COMMON SENSE MEDICAL ADVISEE. 

trouble as possible, dig a hole in the ground, a few feet in 
depth, and allow the stagnant surface water to accumulate. 
This water is used for drinking and cooking. The result is 
that ague prevails in such localities. 

Care should be taken that wells, from which the water is used 
for household purposes, are located at a distance from barn- 
yards, privies, sinks, vaults, and stagnant pools. 

Purification of "Water. There are various methods 
of purifying water. It may be accomplished by distillation, 
which is the most perfect method; by filtration through sand, 
crushed charcoal, and other porous substances, which deprives 
it of suspended impurities and living organisms; by boiling, 
which destroys the vitality of all animal and vegetable matters, 
drives out the gases and precipitates carbonate of lime, which 
composes the crust frequently seen upon the inside of tea- 
kettles or boilers; by the use of chemical agents, which may be 
employed to destroy or precipitate the deleterious substances. 
Alum is often used to cleanse roily water, two or three grains 
in solution, being sufficient for a quart. It causes the impurities 
to settle to the bottom, so that the clear water can be poured 
or dipped out for use. One or two grains of the permanganate 
of potassium will render wholesome a gallon of water con- 
taining animal impurities. 

How to Use liVater, Very little if any water should 
be taken at meal time, since the salivary glands furnish an 
abundance of watery fluid to assist in mastication. When 
these glands are aided with water to " wash down" the food, 
their functions become feeble and impaired. The gastric juice 
is diluted and digestion is weakened. Large draughts of cold 
water ought never to be indulged in, since they cause derange- 
ment of the stomach. When the body is overheated, the use 
of much water is injurious. It should only be taken in small 
quantities. Thirst may be partially allayed, without injury, 
by holding cold water in the mouth for a short time and then 
spitting it out, taking care to swallow but very little. Travelers 
frequently experience inconvenience from change of water. 
If the means are at hand, let them purify their drinking water, 
if not, they should drink as little as possible. Persons who 
visit the banks of the Ohio, Missouri, or Mississippi rivers and 



TEA AKD COFFEE. 253 

similar localities, almost invariably suffer from some form of 
gastric or intestinal disease. Water standing in close rooms 
soon becomes unfit to drink and should not be used. A drink 
of cold water taken on going to bed, and another on rising 
are conducive to health, especially in the case of persons 
troubled with constipation. '■'■Drink tcater" said the celebrated 
Dubois to the young persons who consulted him, " drink water, 
I tell youf'' Du Moulin, the great medical authority of his 
time, wrote, just previous to his death, " / leave two great phy- 
sicians behind me — diet and water?'' 

Tea and Coffee. These substances are almost universally 
used as beverages, and when properly employed, serve a four- 
fold purpose: they quench thii'st, excite an agreeable exhilara- 
tion, repress the waste of the system, and supply nourishment. 
In consequence of being generally used at meal times, their 
stimulant properties are employed to promote digestion, and 
consequently they are not so objectionable as they might other- 
wise be. The liquids introduced into the stomach at meal times 
should not be cold. Tea and coffee are drunk warm, while 
water, except in a few instances, is always drunk cold, the 
effects of which have already been shown. That their inordi- 
nate use may be injurious no body can deny, but this is equally 
true of other beverages, even pure, cold water. Scientific 
investigators inform us that the use of these agents as bev- 
erages, when judiciously employed, is not injurious. It has 
been urged that they are poisonous, but if they are, they are 
very slow in their operation. 

When properly prepared, they are very agreeable beverages, 
and as man will drink more or less at meals, they are allowable; 
for if their use were excluded, some other beverage would be 
sought after, and quite likely one of an alcoholic character 
employed, so of two evils, if this be an evil, let us choose the 
least. Unlike alcoholic stimulants, they exhilarate without 
a depressing reaction after their influence has passed oft'. But 
one cup should be drunk at a meal, and it should be of mod- 
erate strength. The use of large quantities of drink at meals 
retards digestion by diluting the digestive fluids. The exces- 
sive use of large quantities of strong tea or coffee stimulates 
the brain and causes wakefulness, and produces irritability 



254 COMMON SENSE MEDIC.AJ. ADVISEE. 

of the nervous system. Wlieu they are productive of sucli 
effects, their use is injurious, and should be considerably mod- 
erated or wholly discontinued. No criterion can be given by 
which the amount the system will tolerate can be regulated. 
What one person may take with impunity, may be deleterious 
to an other. Individuals differ greatly in this respect. There 
are some Avho cannot tolerate jhem at all, either because of 
some peculiarity of constitution, or on account of disease. And 
sometimes when tea is agreeable and beneficial, coffee disagrees 
with the individual and vice versa. Persons of nervous 
habits whether natural or acquired, are apt to find their wake- 
fulness and irritability increased by the use of ten, particularly 
if strong, while coffee will have a tranquilizing effect. Persons 
of a lymphatic or bilious temperament often find that coffee 
disagrees with them, aggravating their troubles and causing 
biliousness, constipation, and headache, while tea proves agree- 
able and beneficial. Whenever they disagree with the system, 
the best rule is to abandon their use. We find many persons 
who do not use either, and yet enjoy health, a fact which proves 
that they ai'e not by any means indispensable, and, no doubt, 
were it customary to go without them, their absence would 
be but slightly missed. 

Tea and coffee are adulterated to a very great extent, and 
persons using them will be greatly imposed upon. This is an 
evil we cannot remedy. If people make use of them, their 
experience in selecting them must be their guide; however, it 
is believed that the Black and Japan varieties of tea are the 
least apt to be adulterated, and coffee, to insure purity, should 
be purchased in the berry, and ground by the purchaser. 

In preparing tea an infusion should be made by adding boil- 
ing water to the leaves, and permitting them to steep for a few 
minutes only, for a concentrated decoction, made by boiling 
for a long time, liberates the astringent and bitter principles 
and drives off the agreeable aroma which resides in a vola- 
tile oil. 

Coffee should be prepared by adding cold water to the 
ground berry, and raising it slowly to the boiling point. Long- 
continued boiling liberates the astringent and bitter pi-inciples 
upon which its stimulant effects to a great extent depend, and 



ALCOHOLIC LIQUORS. 255 

drives oflf with the steam the aromatic oil from which the 
agreeable taste is derived. 

ALCOHOLIC LIQUORS. 

These are divided into three chisses: malted, fermented, and 
distilled. They all contain more or less alcohol, and their 
effects are, therefore, in some respects similar, and, in the words 
of Dr. B. W. Richardson, the great English authority on 
hygiene: "To say this man only drinks ale, that man only 
drinks wine, while a third drinks spirits, is mei'ely to say, when 
the apology is unclothed, that all drink the same danger. * * 
Alcohol is a universal intoxicant, and in the higher orders of 
animals is capable of inducing the most systematic phenomena 
of disease. But it is reserved for man himself to exhibit these 
phenomena in their purest form, and to present, through them, 
in the morbid conditions belonging to his age, a distinct pa- 
tliology. Bad as this is, it might be worse; for if the evils of 
alcohol were made to extend equally to animals lower than man? 
we should soon have, none that were tameable, none that were 
workable, and none that were eatable." Researches have shown 
that the proportion of half a drachm of alcohol to the pound 
weight of the body, is the quantity which usually produces 
intoxication, and that an increase of this amount to one drachm 
immediately endangers the life of the individual. The first- 
symptom which attracts attention, when alcohol commences to 
take effect upon the body, is an increase in the number of the 
pulsations of the heart. Dr. Parkes and Count Wolowicz con- 
ducted a series of interesting experiments on young adult men. 
They counted the pulsations of the heart, at regular intervals, 
during periods when the subject drank only water; and then 
they counted the beats of the heart in the same individual 
during successive periods in which alcohol was drunk in in- 
creasing quantities. 

The following details are taken from their report: 

" The highest of the daily means of the pulse observed dur- 
ing the first or water period was 77.5 ; but on this day two 
observations were deficient. The next highest daily mean was 
'77 beats. 

If instead of the mean of the eight days, or 73.67, we 



256 COMMON SENSE MEDICAL ADVISER. 

compare the mean of this one day, viz., 77 beats per minute, 
with the alcoholic days, so as to be sure not to over-estimate 
the action of the alcohol, we find: 

On the ninth day, with one fluid ounce of alcohol, the heart beat 
430 times more. 

On the tenth day, with two fluid ounces, 1,872 times more. 
On the eleventh day, with four fluid ounces, 12,960 times more. 
On the twelfth day, with six fluid ounces, 30,672 times more. 
On the thirteenth day, with eight fluid ounces, 23,904 times more. 
On the fourteenth day, with eight fluid ounces. 25.488 times more. 

But as there was ephemeral fever on the twelfth day, it is 
right to make a deduction, and to estimate the number of beats 
in that day as midway between the twelfth and twenty-third 
days, or 18,432. Adopting this, the mean daily excess of beats 
during the alcoholic days was 14,492, or an increase of rather 
more than thirteen per cent. 

The first day of alcohol gave an excess of one per cent., and 
the last of twenty-three per cent. ; and the mean of these two 
gives almost the same percentage of excess as the mean of the 
six days. 

Admitting that each beat of the heart was as strong during 
the alcoholic as in the water period (and it was really more 
powerful), the heart on the last two days of alcohol was doing 
one-fifth more work. 

Adopting the lowest estimate which has been given of the 
daily work done by the heart, viz., as equal to 122 tons lifted 
one foot, the heart, during the alcoholic period, did daily 
work in excess equal to lifting 15.8 tons one foot, and in the 
last two days did extra work to the amount of twenty-four 
tons' lifted as far. 

The period of rest for the heart was shortened, though, 
perhaps, not to such an extent as would be inferred from the 
number of beats; for each contraction was sooner over. The 
beat on the fifth and sixth days after alcohol was left off, and 
apparently at the time when the last traces of alcohol were 
eliminated, showed, in the sphygmographic tracing, signs of 
unusual feebleness; and, perhaps, in consequence of this, when 
the brandy quickened the heart again, the tracing showed a 
more rapid contraction of the ventricles, but less power than 



ALCOHOLIC LIQUORS. 257 

in the alcoliolic period. The brandy acted, in fact, on a heart 
whose nutrition had not been perfectly restored." 

The flush often seen on the cheeks of those who are under 
the influence of alcoholic liquors, and which is produced by 
a relaxed and distended condition of the superficial blood- 
, vessels, is erroneously supposed by many to merely extend 
to the parts exposed to view. On this subject, Dr. Richard- 
son says: " If the lungs could be seen, they, too, would be 
found with their vessels injected; if the brain and spinal 
cord could be laid open to view, they would be discovered in 
the same condition; if the stomach, the liver, the spleen, the 
kidneys, or any other vascular organs or parts could be laid open 
to the eye, the vascular engorgement would be equally mani- 
fest. In the lower animals I have been able to witness this 
extreme vascular condition in the lungs, and once I had the 
unusual, though unhappy opportunity of observing the same 
phenomenon in the brain of a man who, in a paroxysm of 
alcoholic delirium, cast himself under the wheels of a railway 
carriage. The bi-ain, instantaneously thrown out from the 
skull by the crash, was before me within three minutes after 
the accident. It exhaled the odor of spirit most distinctly, 
and its membranes and minute structures were vascular in the 
extreme. It looked as if it had been recently injected with 
vermilion injection. The Avhite matter of the cerebrum, 
studded with red points, could scarcely be distinguished when 
it was incised, it was so preternaturally red; and the pia mater, 
or internal vascular membrane covering the brain, resembled 
a delicate web of coagulated red blood, so tensely were its 
fine vessels engorged. This condition extended through both 
the larger and the smaller brain, cerebrum, and cerebellum, but 
was not so marked in the medulla, or commencing portion 
of the spinal cord, as in the other portions. 

In course of time, in persons accustomed to alcohol, the 
vascular changes, temporary only in the novitiate, become con- 
firmed and permanent. The bloom on the nose which charac- 
terizes the genial toper is the established sign of alcoholic 
action on the vascular structure. 

Recently, physiological research has served to explain the 
reason why, under alcohol, the heart at first beats so quickly, 



258 COMMON SENSE MEDICAL ADVISER. 

why the pulse rises, and wliy the minute hlood-vessels heconrie 
so strongly injected. 

At one time it was imagined that alcohol acts immediately 
upon the heart by stimulating it to increased motion; and from 
this idea, — false idea, I should say, — of the primary action of 
alcohol, many erroneous conclusions have been drawn. We 
have now learned that there exist many chemical bodies which 
act in the same manner as alcohol, and that their effect is not 
to stimulate the heart, but to weaken the contractile force 
of the extreme and minute vessels which the heart fills with 
blood at each of its strokes. These bodies produce, in fact, a 
paralysis of the organic nervous supply of the vessels which 
constitute the minute vascular structures. The minute vessels 
when paralysed offer inefficient resistance to the force of the 
heart, and the pulsating oi'gan thus liberated, like the main- 
spring of a clock from which the resistance has been removed, 
quickens in action, dilating the feebly resistant vessels, and 
giving evidence really not of increased, but of wasted power." 

The continued use of alcoholic liquors in any considerable 
quantity produces irritation and inflammation of the stomach, 
and structural disease of the livei*. Dr. Hammond has shown 
that alcohdl has a special affinity for nervous matter, and is, 
therefore, found in greater quantity in the brain and spinal cord 
than elsewhere in the body. The gray matter of the brain 
undergoes, to a certain extent, a fatty degeneration, and there 
is a shrinking of the whole cerebrum, with impairment of the 
intellectual faculties, muscular tremor, and a shambling gait. 

Large doses of alcohol cause a diminution of the temperature 
of the body, which in fevers is more marked than in the normal 
state. 

In addition to the organic diseases enumerated above, and 
delirium tremens, the following diseases are frequently the 
result of the excessive use of alcoholic liquors: epilepsy, pa- 
ralysis, insanity, diabetes, gravel, and diseases of the heart and 
blood-vessels. 

The physiological deductions of Dr. Richardson are so much 
in accord with our own that we quote them in full: 

" In the first place we gather fi'om the physiological reading 
of the action of alcohol that the agent is narcotic. I have 



ALCOHOLIC LIQUORS. 259 

compared it throughout to chloroform, and the comparison is 
good m all respects save one, viz.: that alcohol is less fatal than 
chloroform as an instant destroyer. It kills certainly in its own 
way, but its method of killing is slow, indirect, and by disease. 

The well-proven fact that alcohol, when it is taken into the 
body, reduces the animal temperature, is full of the most 
important suggestions. The fact shows that alcohol does not 
in any sense act as a supplier of vital heat as is commonly 
supposed, and that it does not prevent the loss of heat as those 
imagine 'who take just a drop to keep out the cold.' It shows, 
on the contrary, that cold and alcohol, in their effects on the 
body, run closely together, an opinion confirmed by the experi- 
ence of those who live or travel in cold regions of the earth. 
The experiences of the Arctic voyagers, of the leaders of the 
great Napoleonic campaigns in Russia, of the good monks of 
St. Bernard, all testify that death from cold is accelerated by its 
ally alcohol. Experiments with alcohol in extreme cold tell 
the like story, while the chilliness of the body which succeeds 
upon even a moderate excess of alcoholic indulgence leads 
directly to the same indication of truth. 

The conclusive evidence now in our possession that alcohol 
taken into the animal body sets free the heart, so as to cause 
the excess of motion of which the record has been given above, 
is proof that the heart, under the frequent influence of alcohol, 
must undergo deleterious change of structure. It may, indeed, 
be admitted in proper fairness, that when the heart is passing 
through these rapid movements it is working under less pressure 
than when its movements are slow and natural; and this allow- 
ance must needs be made, or the inference would be that the 
organ ought to stop at once, in function, by the excess of strain 
put upon it. At the same time the excess of motion is injurious 
to the heart and to the body at large; it subjects the heart to 
irregularity of supply of blood, it subjects the body in all its 
parts to the same injurious influence; it weakens, and, as a 
necessary sequence, degrades both the heart and the body. 

Speaking honestly, I cannot, by any argument yet presented 
to rae, admit the alcohols by any sign that should distinguish 
them from other chemical substances of the paralysing narcotic 
class. When it is physiologically understood that what is called 



260 COMMON 8KNBK MEDICAL ADVISER. 

stimulation or excitement is, in absolute fact, a relaxation, a 
partial paralysis, of one of the most important mechanisms in 
the animal body, the minute, resisting, compensating circulation, 
we grasp quickly the error in respect to the action of stimulants 
in which we have been educated, and obtain a clear solution of 
the well-known experience that all excitement, all passion, 
leaves, after its departui-e, lowness of heart, depression of mind, 
sadness of spirit. We learn, then, in respect to alcohol, that 
the temporary excitement it produces is at the expense of the 
animal force, and that the ideas of its being necessary to resort 
to it, that it may lift up the forces of the animal body into true 
and firm and even activity, or that it may add something useful 
to the living tissues, are errors as solemn as they are widely 
disseminated. In the scientific education of the people no fact 
is more deserving of special comment than this fact, that excite- 
ment is wasted force, the running down of the animal mechanism 
before it has served out its time of motion. 

It will be said that alcohol cheers the weary, and that to take 
a little wine for the stomach's sake is one of the lessons that 
comes from the deep recesses of human nature. I am not so 
obstinate as to deny this argument, There are times in the life 
of man when the heart is oppressed, when the resistance to its 
motion is excessive, and when blood flows languidly to the 
centres of life, nervous and muscular. In these moments alcohol 
cheers. It lets loose the heart from its oppression; it lets flow a 
brisker current of blood into the failing organs; it aids nutritive 
changes, and altogether is of temporary service to man. So far, 
alcohol may be good, and if its use could be limited to this one 
action, this one purpose, it would be amongst the most excellent 
of the gifts of science to mankind. Unhappily, the border line 
between this use and the abuse of it, the temptation to extend 
beyond the use, the habit to apply the use when it is not wanted 
as readily as when it is wanted, overbalance, in the multitude 
of men, tlie temporary value that attaches truly to alcohol as 
a ]>}iysioIogical agent. Hence alcohol becomes a dangerous 
instrument even in the hands of the strong and wise, a 
murderous instrument in the hands of the foolish and weak. 
Ufeil too frequently, used too excessively, this agent, which 
in moderation cheers the failing body, relaxes its vessels too 



ALCOHOLIC LIQUOBS. 261 

extremely; spoils vital organs; makes the force of the circu- 
lation slow, imperfect, irregular; suggests the call for more 
stimulation; tempts to renewal of the evil, and ruins the 
mechanism of the healthy animal before its hour for ruin, by 
natural decay, should be at all near. 

It is assumed by most persons that alcohol gives strength, and 
we hear feeble persons saying daily that they are being * kept 
up by stimulants.' This means actually that they are being 
kept down; but the sensation they derive from the immediate 
action of the stimulant deceives them and leads them to 
attribute passing good to what, in the large majority of cases, 
is persistent evil. The evidence is all-perfect that alcohol gives 
no potential power to brain or muscle. During the first stage 
of action it may enable a wearied or a feeble organism to do 
brisk work for a short time; it may make the mind briefly 
brilliant; it may excite muscle to quick action, but it does 
nothing substantially, and fills up nothing it has destroyed, as 
it leads to destruction. A fire makes a brilliant sight, but 
leaves a desolation. It is the same with alcohol. 

On the muscular force the very slightest excess of alcoholic 
influence is injurious. I find by measuring the power of muscle 
for contraction in the natural state and under alcohol, that so 
soon as there is a distinct indication of muscular disturbance, 
there is also indication of muscular failure, and if I wished 
by scientific experiment to spoil for work the most perfect 
specimen of a working animal, say a horse, without inflicting 
mechanical injury, I could choose no better agent for the 
purpose of the experiment than alcohol. But alas! the readi- 
ness with which strong, well-built men slip into general paralysis 
under the continued influence of this false support, attests how 
unnecessary it would be to subject a lower animal to the 
experiment. The experiment is a custom, and man is the 
subject. 

The true place of alcohol is clear; it is an agreeable temporary 
shroud. The savage, with the mansions of his soul unfurnished, 
buries his restless energy under its shadow. The civilized man 
overburdened with mental labor, or with engrossing care, seeks 
the same shade; but it is shade, after all, in which, in exact 
proportion as he seeks it, the seeker retires from perfect natural 



262 COMMON SENSE MEDICAL ADVISER. 

life. To search for force in alcohol is, to ray mind, equivalent 
to the act of seeking for the sun in subterranean gloom until 
all is night. 

It may be urged that men take alcohol, nevertheless, take it 
freely, and yet live; that the adult Swede drinks his average 
cup of twenty-five gallons of alcohol per year and remains on 
the face of the earth, I admit force even in this argument, for 
I know under the persistent use of alcohol there is a limited 
provision for the continuance of life. In the confirmed alcoholic 
the alcohol is, in a certain sense, so disposed of that it fits, as it 
were, the body for a long season, nay, becomes part of it; and 
yet it is silently doing its fatal work. The organs of the body 
may be slowly brought into a state of adaptation to receive it 
and to dispose of it. But in that very preparation they are 
themselves made to undergo physical changes tending to the 
destruction of their function, to perversion of their structure, 
and to all those varied modifications of organic parts which the 
dissector of the human subject learns to recognize, — almost 
without concern, and certainly without anything more than 
commonplace curiosity, — as the devastations incident to alcoholic 
indulgence." 

The statistics collected from the census of the United States 
for 18G0, and given by Dr. De Marmon, in the Nexo York 
Medical Journal for December, 1870, must carry conviction 
to all minds of the correctness of the foregoing deductions; 

"For the last ten years the use of spirits has, 1. Imposed on 
the nation a direct expense of 600,000,000 dollars. 2. Has 
caused an indirect expense of 600,000,000 dollars. 3. Has 
destroyed 300,000 lives. 4. Has sent 100,000 children to the 
poorhouses. . 5. lias committed at least 150,000 people into 
prisons and workhouses. 6. Has made at least 1,000 insane. 
7. Has determined at least 2,000 suicides. 8. Has caused the. 
loss by fire or violence, of at least 10,000,000 dollars' worth 
of property. 9. Has made 200,000 widows and 1,000 orphans." 

If these were the statistics twenty-four years ago, with our 
greatly increased population, what must they be to-day? We 
will let the reader draw his own conclusions. 

jflalted liiqiiors. Under this head are included all those 
liquors into the composition of which malt enters, such as 



FERMENTED LIQUORS. 2fi8 

beer, ale, and porter. The proportion of alcohol in these liq- 
uors varies greatly. In beer, it is from two to five per cent.; 
in Edinburgh ale, it amounts to six per cent.; in porter, it is 
usually from four to six per cent. In addition to alcohol and 
water, the malted liquors contain from five to fourteen per cent, 
of the extract of malt, and from 0.16 to 0.60 per cent, of 
carbonic acid. They possess, according to Pereira, three prop- 
erties: they quench thirst; they stimulate, cheer, and, if taken 
in sufficient quantity, intoxicate ; and they nourish or strengthen. 
The first of these qualities is due to the water entering into 
their composition; the second, to the alcohol; the third is attrib- 
uted to the nutritive principles of the malt. 

Objections to their use as Beverages. These ar- 
ticles are either pure or adulterated. In their pure state the 
objection to their use for this purpose lies in the fact that they 
contain alcohol. This, as we have seen, is a poisonous sub- 
stance, which the human system in a state of health does not 
need. Its use, when the body is in a normal condition, is 
uncalled for, and can only be deleterious. Beverages containing 
this poison are more or less deleterious to healthy persons, 
according to the amount of it which they contain. 

These liquors are frequently adulterated, and this increases 
their injurious effects. The ingenuity of man has been taxed 
to increase their intoxicating properties; to heighten the color 
and flavor, to create pungency and thirst; and to revive old 
beer. To increase the intoxicating power, tobacco or the seeds 
of the Cocculus indicus are added; to heighten the color and 
flavor, burnt sugar, liquorice, or treacle, quassia, or strychnine, 
coriander, and caraway seeds are employed; to increase the 
pungency, cayenne pepper or common salt is added; to revive 
old beer, or ale, it is shaken up with green vitriol or sulphate of 
iron, or with alum and common salt. 

Fermented liiquors. These are cider and wine. 
Cider contains alcohol to the amount of from five to ten per 
cent., saccharine matter, lactic acid, and other substances. New 
cider may be drunk in large quantities without inducing intoxi- 
cation, but old cider is quite as intoxicating as ale or porter. 

The composition of wine is very complex, the peculiar 
qualities which characterize the different varieties cannot be 



264 . COMMON SENSE MEDICAL ADVISER. 

ascertained by chemical analysis. Wine is a solution of alcohol 
in water, combined with various constituents of the grape. The 
amount of alcohol in wines ranges from six to forty per cent. 
As beverages, these are open to the same objections as those 
manufactured from malt. As a medicine, wine is a useful 
remedy. Concerning its use in this capacity, Prof. Liebig says: 
" Wine is a restorative. As a means of refreshment when 
the powers of life are exhausted — as a means of compensation 
where a misappropriation occurs in nutrition, and as a means 
of protection against transient organic disturbances, it is sur- 
passed by no product of nature or art." That an article is 
useful in medicine, however, is no reason why it should be use'd 
as a beverage by those in health. It is rather an argument 
against such a practice. For it is generally true that the 
drugs used to restore the diseased system to health, are per- 
nicious or poisonous to it when in a normal condition. 

Distilled liiqtiori!^. These are whisky, brandy, and 
the kindred productions of the still. Whisky is a solution 
of alcohol in water, mixed with various other principles which 
impart to it peculiar physical properties. The amount of 
alcohol which it contains varies from forty-eight to fifty-six 
per cent. Old whiskey is more highly prized than the more 
recent product of the still, from the fact that when kept for 
some years certain volatile oils are generated which impart to 
it a mellowness of flavor. 

Brandy is a solution of alcohol in water, together with various 
other substances. It contains from fifty to fifty-six per cent, 
of alcohol. Pure brandy is distilled from wine, 1,000 gallons 
of wine yielding from 100 to 150 gallons of brandy, but a 
very large proportion of the brandy is made with little or 
no wine. It is made artificially from high wines by the addition 
of oil of Cognac, to give it flavor, burnt sugar to give it color, 
and logwood or catechu, to impart astringenc^y and roughness of 
taste. The best brandy is obtained by distillation from the best 
quality of white wines, from the districts of Cognac and Ar- 
magnac. in France. 

THE CLOTHING. 

There is no physical agent which exerts a more constant 
or more powerful influence upon health and life, than the 



THE CLOTHING. 265 

atmosphere. The climate in these latitudes is exceedingly vari- 
able, ranging all the way from lioo Fahr. in summer to 40© 
below zero in the winter season. The body of every individual 
should be so protected from cold, that it can maintain a 
mean temperature of 98 '^ Fahr. 

When the body is warm there is a free and equal circulation 
of the blood throughout all the structures. When the surface 
is subjected to cold, the numerous capillaries and minute vessels 
carrying the blood, contract and diminish in size, increasing 
the amount of this fluid in the internal organs, thus causing con- 
gestion. The blood must go somewhere, and if driven from the 
surface, it retreats to the cavities within. Hence this repletion 
of the vital organs causes pain from pressure and fullness of 
the distended blood-vessels, and the organic functions are em- 
barrassed. Besides, cold upon the surface shuts up the pores 
of the skin, which are among the most active and important 
excretory ducts of the system. It is evident, then, that we 
require suitable clothing, not only for comfort, but to maintain 
the temperature and functions essential to health and life. 

The chief object to be attained by dress is the maintenance 
of a uniform temperature of the body. To attain this end, it is 
necessary that the exhalations of the system, which are con- 
tinually escaping through the pores of the skin, should be 
absorbed or conducted away from the person. These exuda- 
tions occur in the form of sensible or insensible perspiration, 
and the clothing, to be healthy, should be so porous as to allow 
them freely to escape into the air. 

A substance should also be chosen which is known to be a 
poor conductor of heat. That generated by the system will 
thus be retained where it is needed, instead of being dispersed 
into the atmosphere. 

We might add that the better the material for accomplishing 
these purposes, the less will be needed to be worn; for we do 
not wish to wear or carry about with us any more material than 
is necessary. It so happens that all of these qualities are found 
combined in flannel. The value of this article worn next to 
the skin cannot be over-rated, for while it affords protection 
from cold during the winter months, it is equally beneficial 
during the heat of summer, because it imbibes the perspiration, 
" T2 



266 COMMON SENSE MEDICAL ADVISER. 

aud beiug very porous, allows it to escape. The skin always 
feels soft, smooth, and pliable, when it is worn; but, Avhen 
cotton takes its place, it soon becomes dry and harsh. Its 
natural adaptability to these purposes, shows that it is equally 
a comfort and a source of health. Where the skin is very 
delicate, flannel sometimes causes irritation. In such cases a 
tliin fabric of linen, cotton, or silk, should be worn next the 
skin, with flannel immediately over it. Where there is a uni- 
form and extreme degree of heat, cotton and linen are very 
conducive to comfort. But they are unsuitable in a climate or 
season liable to sudden fluctuations in temperature. 

The value of furs, where people are exposed to extreme cold, 
cannot be overestimated. They are much warmer than wool, 
and are chiefly used as wraps on going outdoors. They are too 
cumbrous and expensive for ordinary wear in this latitude, but 
in places near the poles they constitute the chief clothing of the 
inhabitants. 

The quantity of clothing worn is another important item. 
The least that is necessary to keep the body well protected and 
evenly tempered when employed is the rule of health. Some 
people, instead of wearing flannels next to the body, put on 
other material in greater abundance, thus confining the perspira- 
tion to the skin and making the body chilly. The amount of 
clothing is then increased, until they are so heavily clad that 
they cannot exercise. It is far bettei- to wear one thickness of 
flannel next to the skin, and then cotton, or woolen, for outside 
garments, and be able to exercise, thus allowing the blood to 
circulate and to assist in the warming process. 

One great fault in dress consists in neglecting to properly 
clothe the upper extremities. Some people do not reflect upon 
the necessity, while others are too proud to be directed by plain 
common sense. In the winter season, the feet should be covered 
with woolen stockings. The next matter of importance, is to 
get a thick, broad-soled shoe, so large that it will not prevent 
the free circulation of the blood. Then for walking, and 
especially for riding, when the earth is wet and cold, or when 
there is snow on the ground, wear a flannel-lined rubber or 
"Arctic " over-shoe. Be sure and keep the feet comfortable and 
warm at all times. 



THE CLOTHING. 267 

Our next advice is to keep the legs warm. We were called 
not long ago, to see a young lady who had contracted a severe 
cold. She had bfeen to an entertainment where the apartments 
were nicely warmed, and from thence had walked home late 
in the evening. We inquired into the circumstances of the case, 
and ascertained that she wore flannel about her chest, and that 
she also wore rubbers over her shoes, but the other portions of 
the lower extremities were protected by cotton coverings. In 
short, her legs were not kept warm, and she took cold by going 
out from warm rooms into a chilly atmosphere. A good pair of 
woolen leggings might have saved her much suffering. The re- 
sults of insufficient protection of the lower extremities are colds, 
coughs, consumption, headaches, pain in the side, menstrual 
derangements, utei'ine congestion and disorders, besides disable- 
ment for the ordinary and necessary duties of life. All these 
may be prevented by clothing the legs suitably, and wearing 
comfortable flannels. 

Young people can bear a low temperature of the body better 
than old people, because they possess greater power of endur- 
ance. But that is no reason for unnecessary exposure. 

The amount of clothing should be regulated according to the 
heat-generating power of the individual, and also according to 
the susceptibility to cold. No two persons are exactly alike in 
these respects. But it is never proper for young people to 
reject the counsels of experience, or treat lightly the advice 
to protect themselves thoroughly against the cold. Many a 
parent's heart has ached as he has followed the mortal remains 
of a darling child to the grave, knowing that if good advice had 
been heeded, in all human probability, the life would have been 
prolonged. 

The most deleterious mechanical errors in clothing are those 
which affect the chest and body. Tight lacing still plays too 
important a part in dress. It interferes with the free and 
healthy movements of the body, and effects a pressure which is 
alike injurious to the organs of respiration, circulation, and 
digestion. The great muscle of respiration, the diaphragm, is 
impeded in its motion, and is, therefore, unable to act freely. 
The large blood-vessels are compressed, and when the pressure 
is excessive the heart and lungs are also subjected to restraint 



268 COMMON SENSE MEDICAL ADVISER. 

and thrown out of their proper positions. From the compression 
of the liver and stomach, the functions of digestion are impeded, 
a distaste for solid food, flatulency and pain after eating are the 
unmistakable proofs of the injury which is being inflicted. 

The evil effects of such pressure are not confined to actual 
periods of time during which this pressure is applied. They 
continue after it has been removed and when the chest and 
trunk of the body have thus been subjected to long-continued 
pressure they become permanently deformed. These deformities 
necessarily entail great suffering in child-bearing. 

The evil effects of mechanical pressure on other ])arts of the 
body are not uncommon. The leg is sometimes so indented by 
a tight garter that the returning flow of blood through the veins 
is prevented, and a varicose condition of these vessels is produced. 

Irregular and excessive pressure on the foot by imperfectly 
fitting shoes or boots produce deformities of the feet and cause 
much suffering. The high heels which are so common on the 
shoes of women and children inflict more than a local injury. 
Every time the body comes down upon the raised heel with its 
full weight a slight shock or vibration is communicated thi'ough- 
out the entire enitent of the spinal column, and the nervous 
mechanism is thereby injured. Furthermore, displacements of 
the pelvic organs frequently result from these unnatural and 
absurd articles of dress. Women of fashion are subjected to 
much annoyance from wearing long, flowing skirts suspended 
from their waists to trail uselessly on the floor and gather dust. 
It is impossible for the wearers of these ridiculous garments to 
exercise their limbs properly or to breathe naturally. Indiges- 
tion, palpitation, shortness of breath, and physical degeneracy 
are the inevitable consequences of their folly. The skirts 
should always be suspended from the shoulders and not from 
the hips. It is especially important that the clothing of 
chiMren should not fit too tightly. 

It is very important that the clothing should be kept cleaa. 
That which is worn for a long time becomes saturated with the 
excretions and exhalations of the body, which prevent free 
transpiration from the pores of the skin, and thereby induce 
mental inactivity and depression of the physical powers. Un- 
clean clothing may be the means of conveying disease. Scarlet 



THE CLOtHlNG. • 269 

fever has been conveyed frequently by the clothing of a nurse 
into a healthy family. All of the contagious diseases have been 
communicated by clothing contaminated in laundries. 

Certain dyes which are largely used in the coloring of wearing 
apparel are poisonous, and give rise to local disease of the skin, 
accompanied in some instances, with constitutional symptoms. 
The principal poisonous dyes are the red and yellow aniline. A 
case of poisoning from wearing stockings colored with aniline 
dyes, in which there were severe constitutional symptoms, came 
under our obsei-vation at the Invalids' Hotel recently. 



CHAPTER ITT. 

PHYSICAL EXERCISE. MEN- 
TAL CITLTITRE. SLEEP. 

CLEANLHSTESS. 



A well-developed physical organization is essential to perfect 
health. Among the Greeks, beauty ranked next to virtue, 
and an eminent author has said that " the nearer we approach 
Divinity, the more we reflect His eternal beauty." The perfect 
expression of thought requires the physical accompaniments 
of language, gesture, etc. The human form is pliable, and, 
with proper culture, can be made replete with expression, grace 
and beauty. The cultivation of the intellectual powers has 
been allowed to supplant physical training to a great extent. 
The results are abnormally developed brains, delicate forms, 
sensitive nerves and shortened lives. That the physical and 
mental systems should be collaterally developed, is a fact 
generally overlooked by educators. The fullness of a great 
intellect is generally impaired when united with a weak and 
frail body. We have sought perfection in animals and plants. 
To the former we have given all the degree of strength and 
grace requisite to their peculiar duties; to the latter we have 
imparted all the delicate tints and. shadings that fancy could 
picture. We have studied the laws of their existence, until 
we are familiar with every phase of their production; yet it 
remains for man to learn those laws x)f his own being, by a 
knowledge of which he may promote and preserve the beauty 
of the human form, and thus render it, indeed, an image of its 
270 



i*HYSlCAi BXE&CiSE. 27] 

Maker. When the body is tenanted by a cultivated intellect, 
the result is a unity which is unique, commanding the respect 
of humanity, and insuring a successful life to the possessor. 
Students are as a rule pale and emaciated. Mental application 
is generally the cause assigned when, in reality, it is the result 
of insufficient exercise, impure air, and dietetic errors. An 
intelligent journalist has remarked that " many of our ministers 
weigh too little in the pulpit, because they Aveigh too little on 
the scales." The Greek Gymnasium and Olympian Games were 
the sure foundations of that education from which arose that 
subtle philosophy, poetry, and military skill which have won 
the admiration of nineteen centuries. The laurel crown of 
the Olympian victor was far more precious to the Grecian youth 
than the gilded prize is to our modern genius. A popular 
lecturer has truly remarked, that " we make brilliant mathema- 
ticians and miserable dyspeptics; fine linguists with bronchial 
throats; good writers with narrow chests and pale complexions; 
smart scholars, but not that union, which the ancients prized, 
of a sound mind in a sound body. The brain becomes the chief 
working muscle of the system. We refine and re-refine the 
intellectual powers down to a diamond point and brilliancy, 
as if they were the sole or reigning faculties, and we had not 
a physical nature binding us to earth, and a spiritual nature 
binding us to the great heavens and the greater God who 
inhabits them. Thus the university becomes a sort of splen- 
did hospital with this difference, that the hospital cures, 
while the university creates disease. Most of them are in- 
dicted at the bar of public opinion for taking the finest 
young brain and blood of the country, and, after working 
upon them for four years, returning them to their homes 
skilled indeed to perform certain linguistic and mathematical 
dexterities, but very much below par in health and endurance, 
and, in short, seriously damaged and physically demoralized." 
We read with reverence the sublime teachings of Aristotle and 
Plato; we mark the grandeur of Homer and the delicate 
beauties of Virgil; but we do not seek to reproduce in our 
modern institutions the gymnasium, which was the real founda- 
tion of their genius. Colleges which are now entering upon 
their career, should make ample provision for those exercises 



272 COMMON SENSK MEDICAL ADVISEK. 

which develop tho jyhi/slcal tnan. Tliis lack of bodily traininsi^ is 
coiumon with all classes, and its effects are written in indelible 
characters on the faces and forms of old and young. Con- 
strained positions in sitting restrict the movements of the 
diaphragm and ribs and often cause diseases of the spine, or 
uimatural curvatures, which prove disastrous to health and 
happiness. The head should be held erect and the shoulders 
thrown backward, so that at each inspiration the lungs may 
be fully expanded. 

Physical exercise should never be too violent or too pro- 
longed. Severe physical labor, and athletic sports, if indulged 
in to an extreme degree, produce undue excitability of the 
heart, and sometimes cause it to become enlarged. There 
is a form of heart disease induced by undue exertion which 
may be called a wearing out or wasting away of that organ. 
It is common in those persons whose occupations expose them 
to excessive physical labor for too many hours together. This 
feebleness of heart is felt but little by vigorous persons under 
forty years of age, but in those who have passed this age it 
becomes manifest. However, when any person so affected is 
attacked by any acute disease, the heart is more liable to fail, 
and thus cause a fatal termination. 

Aneurism of the aorta or the large arteries branching off 
from it, which is a dilatation of the walls of these vessels, 
caused by the rupture of one or two of their coats, is generally 
induced by excessive physical strain, such as lifting heavy 
Aveights, or carrying weights up long flights of stairs, violent 
horse-back exercise, or hurrying to catch a train or street car. 

An Krcct Carriag'e is not only essential to health, 
but adds grace and beauty to every movement. Although man 
was made to stand erect, thus indicating his superiority over 
all other animals, yet custom has done much to curve that 
magnificent central column, upon the summit of which rests 
the "gi-and dome of thought." Many young persons uncon- 
sciously acquire the habit of throwing the shoulders forward. 
The spinal column is weakened by this unnatural posture, its 
vertebrae become so sensitive and distorted that they cannot 
easily support the weight of the body or sustain its equilibrium. 
It is generally believed that persons of sedentary habits are 



BASE BALL, ETC. 213 

more liable to become round-shouldered than any other class 
of individuals. Observation shows, on the contrary, that the 
manual laborer, or even the idler, often acquires this stooping 
posture. It can be remedied, not by artificial braces, but by 
habitually throwing the shoulders backwards. Deformed trunks 
and crooked spines, although sometimes the effects 
of disease are more frequently the results of care- ^^9' ^^^• 
lessness. Jacques has remarked that " one's stand- 
ing among his fellow-men is quite as important a 
matter in a physiological, as in a social sense." 
Walking is one of the most efficient means of physi- 
cal culture, as it calls all the muscles into action and 
produces the amount of tension requisite for their 
tonicity. Long walks or protracted physical exercise 
of any kind should never be undertaken immediately 
after meals. The first essential to a healthful walk 
is a pleasurable object. Beautiful scenery, rambles 
in meadows rich with fragrant grasses, or along the 
flowery banks of water-courses, affords an agreeable 
stimulus, which sends the blood through the vital 
channels with unwonted force, and imparts to the 
cheeks the ruddy glow of health. Our poets acknowledge the 
silent influence of nature. Wordsworth has expressed this 
thought in his own sublime way: 

" The floating clouds their state shall lend 
To her: for her the willow bend ; 
Nor shall she fail to see, 
E'eu in tlie motions of the storm 
Grace that shall mould the maiden's form 
By silent sympathy. 
The stars of midnight shall be dear 
To her: and she shall lean her ear 
In nianjr a secret place, 
Where rivulets dance their wayward round, 
And beauty, bom of murmuring sound, 
Shall pass into her face." 

Ba^ Ball, Cricket, Boxing, and Fencings, are 

all manly exercises when practiced solely with a view to their 
hygienic advantages, and as such have our approval. 



274 



COMMON SENSE MEDICAL ADVISEE. 



The Art of iSwillllllill^ was regarded by the Greeks 
as an important accoraplishmeut. As a hygienic agency, it 
occupies a high place in physical culture. The varied move- 




MgllO. 

ments impart strength and elasticity to the muscles. It is as 
charming a recreation for women and girls as for men and 
boys. Furthermore, it is not only a means of physical culture, 
but is often essential for self-preservation. Figs. 105 to 108 



SKATING AND ROWING. 



275 



Represent the successive positions assumed in swimming. Figs. 
109 and 110 represent exercises in the water and a safe and 
easy method of learning to swim. 

The Exercises of the Oyninasiuni are especially 
productive of health and longevity. The most important of 
these are balancing, leaping, climbing, wrestling, and throwing, 
all of which are especially 

adapted to the develop- ^W- ^-^-^• 

ment of the muscles. In 
conclusion, we offer the 
following suggestions, viz: 
all gymnastic exercises 
should be practiced in the 
morning, and in the open 
air; extremes should be 
avoided; and it should be 
always borne in mind, 
that their chief object is 
to combine, in a proper 
proportion, mental and 
physical development. In 
every relation of life we 
should cultivate all those faculties which pertain to our physical, 
moral, and mental natures, subdue our passions, and nature will 
bestow upon us her richest rewards of health, beauty, and 
happiness. 

Skating and Roifill^ are exercises which develop the 
muscles of the arms and legs. The former should not be too 
prolonged, and the clothing should always be warm and ap- 
propriate. College regattas are rapidly becoming more popu- 
lar in this country, notwithstanding many severe criticisms 
from the pi-ess. As an exercise for the health and develop- 
ment of our students, rowing should be universally recom- 
mended, but over-exertion should be carefully avoided in this 
as in other athletic sports. It expands the lungs and strengthens 
the muscles of the arms and chest. Every college should be 
located near some body of water, and a boat-house erected and 
provided with the necessary equipments. Exercise is just as 
essential to the sttident as a library or a laboratory. 




The Gymnast's Arm. 



276 



COMMON SENSE MiblCAL ADVlSEK; 



Fig. 112. 




Ridings on Horseback is a fine exercise for both sexefii 
It promotes digestion, improves the circulation, and expands 
and develops the respiratory organs. The pure, 
fresh air, pleasant scenery, and pleasurable excite- 
ment, impart renewed vigor to the equestrian. In 
the Southern States it is a universal accomplish- 
ment, and children are taught to ride as well as 
to walk. 

Dancing. Notwithstanding the fact that 
dancing has been perverted to the basest pur- 
poses, has been made the fruitful source of dissipa- 
tion, and has often laid the foundation for disease, 
it is yet capable of being made to minister to 
health and happiness. As a means of physical 
culture, it favors the development of the muscular 
system, and promotes health and cheerfulness. 
When practiced for this purpose, Jacques terms 
it " the best of all in-door exercises, as it brings to bear upon 
the physical system a great number of energizing and har- 
monious influences." 

MENTAL CULTURE. 

The brain, like all other organs of the body, requires alternate 
exercise and repose; and, in physical endurance, it is subject 
to general physiological laws. When exercised with modera- 
tion it acquires strength, vigor, and an accelerated activity. 
Excessive mental exertion is liable to result in softening of the 
brain, and various nervous diseases, sometimes culminating in 
insanity, and in many instances proving fatal to life. The mere 
votaries of pleasure who avoid all eifort of the mind, fall into 
the opposite error. In all cases of intellectual activity, the 
exertions should be directed to some subject interesting to the 
student. Li this manner duty will become a pleasure, which in 
turn will re-invigorate the mental functions. 

When the mind is confined to one subject for any consider- 
able length of time together, it becomes fatigued, and requires 
relaxation, recreation, rest. This may be obtained by directing 
the attention to some other subject, either study or amusement, 
the latter of which is preferable. The amusement, however, 



MilNTAt CULTURE DURING CHILDHOOD. 2 '7 7 

may be of an intellectual or physical character, or both 
combined, and will, if properly conducted, restore vigor to both 
mind and body. 

Prominent among physical phenomena is the mutual relation 
between the brain and the organs of nutrition. Mental exertion 
should be avoided for at least one hour after a hearty meal, 
and all mental labor which requires concentration of thought 
ought to be accomplished in the earlier portion of the day, when 
the brain is refreshed and repaired by the night's repose. 
Mental, like physical endurance, is modified by age, health, and 
development. A person accustomed to concentration of thought, 
can endure a longer mental strain than one inured to manual 
labor only. One of the most injurious customs, is the cultivat 
tion of the intellect at the expense of the physical powers. 

mental Culture During Childhood. One of the 
greatest mistakes which people make in the management of 
their children, is to overtask their mental faculties. Although 
it is exceedingly gratifying to see children acquire knowl- 
edge, and manifest an understanding far beyond their years, 
this gratification is often purchased too dearly, for precocious 
children are apt to die young. The tissue of the brain and 
nerves of children is very delicate; they have not yet acquired 
the powers of endurance which older persons possess. The 
greater portion of the nutriment assimilated, is required for 
growth and organic development, and they can ill afford its ex- 
penditure for mental manifestations. They receive impressions 
easier and learn much more readily than in after life, but it is at 
the expense of the physical organization. Their mental faculties 
continue to be developed by the expenditure of brain nutriment, 
while physical growth and the powers of endurance are arrested. 
It is much better to give physical development the precedence 
in order that the mental organism may be well supported and 
its operations carried into effect; for it paust be apparent to all 
that an ordinary intellect in a healthy body, is capable of 
accomplishing infinitely more than a strong mind in a weak 
body. Regularity should be observed in exercising the mental 
functions. For this reason a fixed order in the pursuit of any 
literary occupation is very essential. The pursuit of the most 
abstruse studies will thus become habitual and comparatively 



278 COMMON SENSE MEDICAL ADVISER. 

easy, a consequence of systematic application. Mental labor 
should always cease when the train of thought becomes 
confused, and there is the slightest sensation of depression. 
All distracting influences should be absent fiom the mind, in 
order to facilitate intense study, for the intellect cannot attend 
perfectly to two subjects at the same time. Painful sensations 
always have a tendency to paralyze mental exertion. Great 
care should be taken that the head is not subjected to injury 
of any kind, as it is almost invariably accompanied by some 
nervous derangement. Exposure to extreme heat should be 
carefully avoided. An attack of sun-stroke although it may not 
be immediately fatal, may occasion tumors in the brain, or some 
organic disease. 

^ SLEEP. 

For all animated beings sleep is an imperious necessity, as 
indispensable as food. The welfare of man requires alternate 
periods of activity and repose. It is a well-established physio- 
logical fact, that during the wakeful hours the vital energies 
are being expended, the powers of life diminislied, and, if 
Avakefulness is continued beyond a certain limit, the system 
becomes enfeebled and death is the result. During sleep there 
is a temporary cessation of vital expenditures, and a recuperation 
of all the forces. Under the influence of sleep *' the blood is 
refreshed, the brain recruited, physical sufferings are extin- 
guished, mental troubles are removed, the organism is relieved, 
and hope returns to the heart." 

The severest punishment which can be inflicted upon a 
person, is to entirely deprive him of sleep. In China, a few 
years since, three criminals were sentenced to be kept awake 
until they should die. To do this it was necessary to keep 
a guard over them. The sentinels were armed with sharp- 
pointed instruments, with which to goad the victims and thus 
prevent them from sleeping. Life soon became a burden, and, 
although they were well fed during the time, death occurred 
sooner than it would have done had starvation been the pun- 
ishment. 

Slcieping Rooms. The sleeping room should be large 
and well ventilated, and the air kept moderately cool. The 
necessity for a fire may be determined by the health of the 



HO"W TO PUT CHILDEEN TO BED, 0^9 

occupant. Besides maintaining a proper temperature in the 
room, a little fire is useful, especially if in a grate, for the 
purpose of securing good ventilation. The windows should 
not be so arranged as to allow a draught upon the body during 
the night, but yet so adjusted that the inmate may obtain 
plenty of fresh air. 

The Bed should not be too soft, but rather hard. Feathers 
give off animal emanations of an injurious character, and 
impart a feeling of lassitude and debility to those sleeping on 
them. No more coverings should be used than are actually 
necessary for the comfort of the individual. Cotton sheets 
are warmer than linen, and answer equally as well. 

Sleeping; Alone. Certain effluvia are thrown off from 
our persons, and when two individuals sleep together each 
inhales from the other more or less of these emanations. There 
is little doubt that co7isumptio7i, and many other diseases, 
not usually considered contagious, are sometimes communicated 
in this manner. When it is not practicable for individuals 
to occupy separate beds, the persons sleeping together should 
be of about the same age, and in good health. Numerous cases 
have occurred in which healthy, robust children have gradually 
declined and died within a few months, from the evil effects 
of sleeping with old people. Again, those in feeble health 
have been greatly benefited, and even restored, by sleeping 
with others who were young and healthy. 

Time for Sleep. Kight is the proper time for sleep. 
When day is substituted for night, the sleep obtained does not 
fully restore the exhausted energies of the system. Nature 
does not allow her laws to be broken with impunity. 

Children require more sleep than old persons. They are 
sometimes stupefied with " soothing syrups," and prepara- 
tions of opium, in order to get them temporarily out of the 
way. Such narcotics are very injurious and dangerous. We 
have known a young child to be killed by a single drop of 
laudanum. This practice, therefore, cannot be too emphatically 
condemned. 

How to Put Children to Bed. The following char- 
acteristic lines are from the pen of Fanny Fern, and contain 
such good advice that we cannot refrain from quoting them: 



280 COMMON SENSE MEDICAL ADVISER. 

"Not with a reproof for any of the day's sins of omission 
or commission. Take any other time than bed-time for that. 
If you ever heard a little creature sighing or sobbing in its 
sleep, you could never do this. Seal their closing eyelids with 
a kiss and a blessing. The time will come, all too soon, when 
they will lay their heads upon their pillows lacking both. Let 
theui at least have this sweet memorj' of happy childhood, 
of which no future soitow or trouble can rob them. Give 
them their rosy youth. Nor need this involve wild license. 
The judicious parent will not so mistake my meaning. If you 
ever met the man or the woman, whose eyes have suddenly filled 
when a little child has crept trustingly to its mother's breast, 
you may have seen one in Avliose childhood's home 'dignity' 
and * severity' stood where love and pity should have been. 
Too much indulgence has ruined thousands of chijdren; too 
much love not one." 

Poiiiitioil ill Slwp. The proper position in sleep is 
upon the right side. The orifice leading from the stomach 
to the bowels being on this side, this position favors the passage 
of the contents into the duodenum. Lying on the back is 
injurious, since by so doing the spine becomes heated, especially 
if the person sleeps on feathers, the circulation is obstructed 
and local congestions are encouraged. The face should never 
be covered during sleep, since it necessitates the breathing of 
the s.ame air over again, together with the emanations from the 
hodj. 

The AlllOtlllt of Sl<iep. The amount of sleep required 
varies with the age, habits, condition, and peculiarities of the 
individual. No definite rule can be given for the guidance 
of all. The average amount required, however, is eight or 
nine hours out of the twenty-four. Some persons need more 
than this, while others can do with less. Since both body and 
mind are recupei'ated by sleep, the more they are exhausted 
the more sleep is required. A person employed at mental labor 
should have more than one who is merely exijending muscular 
strength. Six hours of unbroken sleep do more to refresh and 
revive than ten when frequently interrupted. If it is too pro- 
longed it weakens and stupefies both body and mind. If an 
insufficient amount is taken the flagging energies are not 



CLEANIJNESS. 281 

restored. Persons who eat much or use stimulants generally 
require more than others. In sleep regularity is desirable. If 
a person goes to bed at a certain hour for -several nights in 
succession, it will soon become a habit. The same holds true 
with regard to rising. If children are put to sleep at a 
stated hour for several days in succession, it will soon become 
a habit with them. 

CLEANLINESS. 

"Cleanliness is next to godliness," and is essential to the 
health and vigor of the system. Its importance cannot be 
overestimated, and it should be inculcated early on the minds 
of the young. " Even from the body's purity, the mind 
receives a secret sympathetic aid." 

When we consider the functions of the skin, with its myriads 
of minute glands, innumerable little tubes, employed in re- 
moving the worn-out, useless matter from the system, we cannot 
fail to appreciate the utility of frequent bathing with soap and 
water. Unless these excretions are removed, the glands become 
obstructed, their functions are arrested, and unpleasant odors 
arise. Many persons think because they daily bathe the face, 
neck, and hands, dress the hair becomingly and remove the dirt 
from their clothing that the height of cleanliness has been 
reached. From a hygienic point of view, bathing the entire 
body is of much greater importance. 

Notwithstanding the necessity for cleanliness of the body, 
we occasionally meet with persons who, although particular 
about their personal appearance, permit their bodies to be for 
weeks and even months without a bath. Such neglect should 
never exceed one week. Plenty of sunlight and at least one 
or two general baths every week are essential to perfect health. 
Cleanliness is necessary to health, beauty, attractiveness, and 
a cheerful disposition. 



CHAPTER TV. 

HYGIENE OF THE REPRO- 
DUCTIVE ORGANS. 



The structure and functious of organized bodies are subject 
to continual alteration. The changes of nutrition and growth, 
which are constantly taking place in the tissues render them at 
the same time the seat of repair and waste, of renovation and 
decomposition, of life and death. The plant germinates and 
blossoms, then withers and decays; animal life, in like manner, 
comes into being, grows to maturity, fades, and dies. It is, 
therefore, essential to the perpetuation of life, that new organ- 
isms be provided to take the place of those which are passing 
out of existence. There is no physiological process which 
presents more interesting phenomena than that of reproduction, 
which includes the formation, as well as the development of 
new beings. 

Since self-preservation is Nature's first law, the desire for food 
is a most powerful instinct in all living animals. Not inferior 
to this law is that for the perpetuation of the race; and for this 
purpose, throughout the animal and vegetable kingdoms, we 
find the Biblical statement literally illustrated: "Male and 
female created He them." 

Health is the gauge by which the prosperity of a people may 
be measured. Were we to trace the history of nations, — their 
rise and fall, — we would find that much of the barbarism and 
crime, degradation and vice, as well as their decline and final 
extinction, was due to licentiousness and sexual excesses. Since 
there is an intimate relation between mind and body, when 
the body is enfeebled the mind becomes enervated. Morbid 
282 



PHYSICAL LABOK MODIFIES THE PASSIOKS. 283 

conditions of the body prevent the highest mental development, 
and, on the other hand, when the mind is debilitated, general 
depravity, physical as well as mental, is the result. The highest 
development of the body results from the equal and harmonious 
cultivation of all the mental powers. The perfect development 
and health of the physical organs is therefore essential to the 
happiness of mankind. But, before health can be insured the 
nature and general functions of the physical system must be 
understood. This being done, the question naturally arises: 
Mow can health be best maintained and longevity secured? 

Influence of Food. We have previously noticed the 
elfects which food, exercise, and other hygienic agencies, have 
upon digestion, circulation, and respiration; and we find that 
they exert a not less potent influence upon the health of the 
generative organs. Excessive stimulation excites the sexual 
passions. For this reason, children should not be immoderately 
indulged in highly seasoned foods. Those persons who have 
great muscular vigor are endowed with violent passions, and 
unless restrained by moral considerations, are very likely to be 
overcome by their animal propensities. 

Alcoholic stimulants have a debasing influence upon the whole 
system, and especially upon the sexual organs; they excite the 
animal and debase the moral nature; they exhaust the vitality, 
and, after the excitement, which they temporarily induce, has 
passed away, the body is left in a prostrated condition. 

Physical Lalbor ]VIodifie«>i the Pas^sions. Labor 
consumes the surplus vitality which a person may possess, and 
no better protective can be found against the gratification of 
the passions, unless it be high moral training, than daily toil 
extended to such a degree as to produce fatigue. Labor 
determines the blood to the surface and to other parts of the 
body, and prevents excitement and congestion of the sexual 
centers. If, by education or association, the passions of children 
be excited, they will be increased. If, on the contrary, they 
be taught to avoid these social or solitary evils, they will be 
abated. Let them be educated to work and the intellectual 
faculties will assert their sway, the moral powers will be 
strengthened, and the body better developed, for purity of mind 
is the result of the perfect development of man. 



284 COMMON SKNSK MEDICAL, ADVISER. 

Influences of Climate. Individualc possess distin- 
guishing peculiarities characteristic of the nation to wliich they 
belong. Climate exerts a powerful influence upon mankind. In 
tropical regions the inhabitants are enervated, effeminate, and 
sensual. The rich live in luxury and ease, vice is unrestrained 
and license unbridled. "When the animal j^ropensities are 
allowed to predominate, the mental faculties are kept in 
subjection. Hence races that inhabit those latitudes rarely 
produce scholars or philosophers. A Avarm climate hastens the 
development of the reproductive organs. Men and women 
become mature at a much earlier age in those regions, than in 
countries where the temperature is lower. In like manner there 
is a tendency to premature enfeeblement, for the earlier the 
system matures, the sooner it deteriorates. 

]?Ian is a .Social JBeing^. History demonstrates tliat 
when man is deprived of the society of woman, he becomes 
reckless, vicious, depraved, and even barbarous in his habits, 
thus illustrating the maxim: "It is not good for man to be 
alone." Social intercourse promotes mental and physical de- 
velopment. The development of the individual implies the 
unfolding of every power, both physical and mental. Nothing 
so regulates and restrains passion as a healthy condition of the 
organs through which it finds exj)ression. And every organ 
of the body is powerful in proportion to its soundness. The 
propensities play a prominent part in the education of the child. 
When properly disciplined and held in subordination to the 
higher faculties, they constitute an important factor in the 
economy of man. Boys are more liable to be morbidly excited 
when secluded from the society of girls, and vice versa. 
Again, when the sexes are accustomed to associate, the passions 
are not apt to be aroused, because of the natural antagonistic 
constitutional elements. The influence of the one i-efines, and 
ennobles the other. Let children be taught to understand their 
natures, and knowing them, they will learn self-government. 
"As man rises in education and moral feeling he propor- 
tionately rises in the power of self-restraint; and consequently 
as he becomes deprived of this wholesome law of discipline 
he sinks into self-indulgence and the brutality of savage life. 

The passions may be aroused by the language, appearance, 



OBSCEISrE LITEKATURE. 285 

or dress of the opposite sex. A word spoken without any 
impure intent is often construed in a very different sense by 
one whose passions color the thought, and is made to convey 
an impression entirely unlike that which was intended by the 
speaker. Also, the dress may be of such a character as to 
excite the sexual passion. The manner in which the apparel 
is worn is often so conspicuous as to become bawdy, thereby 
appealing to the libidinous desires, rather than awakening an 
admiration for the mental qualities. 

Obscene Ijiteratlirc. Literature is a powerful agent 
either for good or evil. If we would improve the morals, 
choice literature must be selected, whether it be that which 
realizes the ideal, or idealizes the real. Obscene literature, or 
books written for the express purpose of exciting or intensifying 
sexual desires in the young, goads to an illicit gratification of 
the passions, and ruins the moral and physical nature. 

It not unf requently happens that a child is born with a vig- 
orous, mental organism which promises a brilliant future, but 
manhood finds him incompetent, debilitated, and totally inca- 
pacitated for mental or manual labor. This may be the result 
of youthful indiscretion, ignorantly committed, but not unf re- 
quently it is the effect of a pernicious literature which inflames 
the imagination, tramples upon reason, and describes to the 
youth a realm where the passions are the ruling deities. 

Many persons are born into the world with disordered organi- 
zations for which they are not themselves responsible. Such 
individuals are entitled to the sympathy of humanity. Dyspep- 
sia, scrofula, consumption, and a thousand ills to which man- 
kind is heir, are inherited from parents, the results of ill-assorted 
marriages. Intoxicated parents often produce offspring utterly 
demented. Children of healthy parents, with good constitu- 
tions, are usually healthy and intelligent. There are marked 
varieties of character in children of the same parents. One 
manifests great precocity, another is below the average in 
mental attainments; one is amiable, another irritable in disposi- 
tion; indeed, there are often as great differences between 
children of the same, as of different families. This is due to 
the physical and mental conditions of the parents, more 
especially the mother, not only at the time of the impregnation 



Ogg COMMON SENSE MEDICAL, ADVISER. 

but also during the period intervening between conception and 
the birth of the offspring. The ancients regarded courage 
as the principal virtue. By us, purity is so estimated. Moral 
purity is an essential requisite to the growth and perfection 
of the character. 

Sclf-Almsc, Untold miseries arise from the pollution of 
the body. Self-pollution, or onanism, is one of the most pro- 
lific sources of evil, since it leads both to the degradation of 
body and mind. It is practiced more or less by members of 
both sexes, and the habit once established, is overcome with 
the greatest difficulty. It is the source of numerous diseases 
which derange the functional activity of the organs involved, 
and eventually impair the constitution. This vicious habit is 
often practiced by those who are ignorant of its dangerous 
results. Statistics show that insanity is frequently caused by 
masturbation. 

Immoderate indulgence in any practice is deleterious to the 
individual. Emphatically true is this with regard to sexual 
excesses. Not unfrequently does the marriage rite " cover a 
multitude of sins." The abuse of the conjugal relation pro- 
duces the most serious results to both parties, and is a prolific 
source of some of the gravest forms of disease. Prostatorrhea, 
spermatorrhea, impotency, hypochondria, and general debility 
of the generative organs, arise from sexual excesses. 

The health of the reproductive organs can only be maintained 
by leading a temperate life. The food should be nourishing 
but not stimulating. Lascivious thoughts should be banished 
from the mind, and a taste cultivated for that literature which 
is elevating in its nature, and the associations should be refining 
and ennol)ling. Let these conditions and the rules of hygiene 
be observed, and virtue will reward her subjects with a fine 
physique and a noble character. 

Woman, from the nature of her organization, has less strength 
and endurance than man. Much, however, of the suffering 
and misery which she experiences arises from insuflScient atten- 
tention to the sexual organs. The menstrual function is gen- 
erally established between the ages of twelve and fourteen. 
For want of proper instruction, many a girl through ignorance 
has caused derangements which have enfeebled her womanhood 



SELF- ABUSE. 287 

or terminated her life. At this critical period the mother 
cannot be too considerate of her daughter's health. Preceding 
the first appearance of the menses, girls usually feel an aching 
in the back, pains in the limbs, chilliness, and general languor. 
The establishment of this function relieves these symptoms. 
Every precaution should be taken during the period to keep 
the feet dry and warm, to freely maintain a general circulation 
of the blood, to avoid exertion, and to refrain from standing 
or walking too much. Menstrual derangements should never 
be neglected, for they predispose to affections of the brain, 
liver, heart, and stomach, induce consumption and frequently 
end in death. Young women should, therefore, properly pro- 
tect themselves, and avoid extremes of heat and cold. 



CHAPTER V. 



PRACTICAL SUMMARY 
OF HYGIENE. 



1. The first step which should be taken for the prevention 
of disease, is to make provision for the health of the un- 
born child. Greater care shmild be exercised with women 
who are in a way to become mothers. Those who are sur- 
rounded by all the luxuries which health can bestow, indulge 
too much in rich food, and take too little exercise; while the 
poor get too little nourishment, and work too hard and too long. 
A woman in this condition should avoid overexertion, and all 
scenes which excite the passions or powerful emotions. She 
should take moderate exercise in the open air; eat moderately 
of wholesome food, and of meat not oftener than twice a day; 
take tea or coffee in limited quantities, and avoid the use of 
all alcoholic liquors; she should go to bed early and take not 
less than nine hours sleep; her clothing should be loose, light 
in weight, and warm. She should take every precaution against 
exposure to contagious or infectious diseases. 

2. There is no better method for preventing the spread 
of contagious diseases than perfect isolation of the infected, 
and thorough disinfection oi< all articles of clothing or bedding 
which have been in contact with the infected. Many persons 
erroneously believe that every child must necessarily have the 
measles, and other contagious diseases, and they, therefore, take 
no precautions against the exposure of their children. The 
liability to infection diminishes as age advances, and those 
individuals are, as a rule, the strongest and best developed who 

288 



PEACTICAL SUMMARY OF HYGIENE. 289 

have never suffered from any of the contagious diseases. Al- 
though vaccination is the great safeguard against-pox, yet it 
should never prevent the immediate isolation of those who are 
suffering from this disease. 

3. To avoid the injurious effects of impure air, the fol- 
lowing rules, should be carefully observed. The admission of 
air which contains anything that emits an unpleasant odor into 
closed rooms should be avoided. The temperature of every 
apartment should be kept as near 10- Fahr. as possible, and 
the air should not be overcharged with watery vapor. Pro- 
visions should be made for the free admission into and escape 
of air from the room at all times. When an apartment is not 
in use, it should be thoroughly ventilated by opening the win- 
dows. Those who are compelled to remain in an atmosphere 
filled with dust, should wear a cotton-wool respirator. 

4. To insure a healthy condition of the body, the diet of 
man ought to be varied, and all excesses should be avoided. 
The total amount of solid food taken in the twenty-four hours 
should not exceed two and a half pounds, and not more than 
one-third of this quantity should consist of animal food. Many 
persons do not require more than one pound and a half of 
mixed food. To avoid parasitic diseases, meat should not be 
eaten rare, especially pork. The amount of drink taken should 
not be more than three pints in the twenty-four hours. The ex- 
cessive use of tea and coffee should be avoided. Pickles, boiled 
cabbage, and other indigestible articles should never be eaten. 

5. To avoid the evil effects of alcoholic liquors, perfect ab- 
stinence is the only safe course to pursue. Although one may 
use spirituous liquors in moderation for a long period of time 
and, possibly, remain healthy, yet such an indulgence is unneces- 
sary and exceedingly dangerous. A person who abstains en- 
tirely from their use is safe from their pernicious influence; a 
person who indulges ever so moderately is in danger; a person 
who relies on such stimulants for support in the hour of need 
is lost. 

6. While the use of tobacco is less pernicious than al- 
cohol in its effects, yet it exerts a profound disturbing influ- 
ence upon the nervous system, and gives rise to various func- 
tional and organic diseases. This is the verdict of those who 

13 



290 COMMON SENSE MEDICAL ABVISER. 

have given the subject the most study, and who have had the 
best opportunities for extensive observation. Suddenly fatal 
results have followed excesses in the use of tobacco. Therefore, 
the habit should be avoided, or if already acquired, it should be 
immediately abandoned. 

7. The clothing should be light and porous, adapted in 
warmth to the season. It is especially important that per- 
sons in advanced life should be well protected against vicissi- 
tudes of heat and cold. Exposure is the cause of almost all 
those inflammatory diseases which occur during winter, and 
take off the feeble and the aged. The under-gaiinents should 
be kept scrupulously clean by frequent changes. Corsets or 
bands which impede the flow of blood, compress the organs of 
the chest or abdomen, or restrict the movements of the body, 
are very injurious, and should not be worn. Articles of dress 
which are colored Mnth irritating dye-stuffs, should be carefully 
avoided. 

8. It matters not how varied a person's vocation may be, 
change, recreation, and rest are required. It is an error to 
suppose that more work can be done by omitting these. No 
single occupation which requires special mental or physical 
work, should be followed for more than eight hours out of the 
twenty-four. The physical organism is not constructed to run 
its full cycle of years and labor under a heavier burden than 
this. Physical and mental exercise is conducive to health and 
longevity, if not carried too far. It is erroneous to suppose 
that excessive physical exertion promotes health. Man was 
never intended to be a running or a jumping machine. In 
mental work, variety should be introduced. New work calls 
into play fresh portions of the brain, and secures repose for 
those ])arts which have become exhausted. Idleness should be 
avoided by all. Men should never retire from business as long 
as they enjoy a fair degree of health. Idleness and inactivity 
are opposed to nature. 

9. The average length of time which a person ought to 
sleep is (nght hours out of the twenty-four, and, as a rule, those 
Avho take this amount enjoy the best health. The most favor- 
able lime for sleep is between the hours of 10 p. m. and 6 a. m. 
All excitement, the use of stimulants, and excessive fatigue 



PRACTICAL SUMMARY OF HTGIBWE. 291 

tend to prevent sleep. Sleeping rooms should be well ven- 
tilated, and the air maintained at a equable temperatui'e of as 
near 60® Fahi*. as possible. An inability to sleep at the proper 
time, or a regular inclination to sleep at other than the natural 
hours for it, is a certain indication of errors of habit, or of 
nervous derangement. 

10. Prominent among all other measures for the mainte- 
nance of Health, is personal cleanliness. Activity in the func- 
tions of the skin is essential to pei-fect health, and this can only 
be secured by thoroughly bathing the entire body. Strictly, a 
person should bathe once every twenty-four or forty -eight hours. 
The body should be habituated to contact with cold water at 
all seasons of the year, so that warm water may not become 
a necessity. The simplest and most convenient bath, is the 
ordinary sponge-bath. An occasional hot-air, or Turkish bath, 
exerts a very beneficial influence. It cleans out the pores of 
the skin and increases its activity. 

11. The emotions and the passions exert a powerful in- 
fluence over the physical organism. It is important, therefore, 
that they be held under restraint by the reasoning faculties. 
This rule applies equally to joy, fear, and grief; to avarice, 
anger, and hatred; and, above all, to the sexual passion. They 
are a prolific source of disease of the nervous system, and have 
caused the dethronement of some of the most gifted intellects. 



T>^RT III. 

RATIONAL MEDICINE. 



CHAPTER I. 

THE PROGRESS OF MEDICINE. 

During the last half century a great cliange has taken place 
in the treatment of disease. Medicine has advanced with rapid 
strides, from the narrow limits of mere empiricism, to the 
broader realm of rationalism, nntil to day it comprehends all 
the elements of an art and a science. Scientific researches and 
investigations have added many valnable truths to the general 
fund of medical learning, but much more has been effected by 
observation and empirical discovery. It is of little or no interest 
to the invalid to know whether the prescribed remedy is organic 
or inorganic, simple, compound, or complex. In his anxiety and 
distress of body, he seeks solely for relief, without regard to the 
character of the remedial agents employed. But this indiffer- 
ence on the part of the patient does not obviate the necessity 
for a thorough, scientific education on the part of the 
practitioner. Notwithstanding all the laws enacted to raise 
the standard of medicine, and thus protect the public from 
quackery, there yet exists a disposition among many to cling to 
all that savors of the miraculous, or supernatural. To insure 
the future advancement of the healing art, physicians must 
instruct mankind in Physiology, Hygiene, and Medicine. When 
the people understand the nature of diseases, their causes, meth- 
ods of prevention and cure, they A\nll not be easily deceived, and 
practitioners will be obliged to qualify themselves better for 
their labors. The practice of medicine is every year becoming 
292 



THK ALLOPATHIC SCHOOL. 293 

more successful. New and improved methods of treating 
disease are being discovered and developed, and the conscientious 
physician will avail himself of all the means, by a knowledge of 
which he may benefit his fellow-men. The medical profession 
is divided into three principal sc^hools, or sects. 

THE ALLOPATinC, REGULAR, OR OLD SCHOOL 
OF MEDICINE. 

Tliis is the oldest existing branch of the profession. To it 
is due the credit of collecting and arranging the facts and 
discoveries which form the foundation of the healing art. It 
has done, and is doing, much to place the science of medicine 
on a firm basis. To the text-books of this school, every student 
who would qualify himself for medical practice must resort, to 
gain that knowledge upon which depends his future success. 
The early practice of this branch of the profession was nec- 
essarily crude and empirical. Conservative in its character, it 
has ever been slow to recognize new theories and methods of 
practice, and has failed to adopt them until they have been 
incontrovertibly established. This conservatism was manifested 
in the opposition to Haiwey when he propounded the theory of 
the circulation of the blood, and to Jenner when he discovered 
and demonstrated the beneficial effects of vaccination. Thus has 
it ever defended its established opinions against innovation ; yet 
out of this very conservatism has grov/n much real good, for, 
although it has wasted no time or energy in the investigation of 
theories, yet it has accepted them when established. In this 
manner it has added to its fund of knowledge only those truths 
which are of real and intrinsic value. 

The history of medicine may be divided into three eras. In 
the first, tlie practice of medicine was merely empiincisna. Igno- 
rant priests or astrologers administered drugs, concerning the 
properties of which they had no knowledge, to appease the wrath 
of mythological deities. In the second or heroic era, the lancet, 
mercury, antimony, opium, and the blister were employed 
indiscriminately as the sme qua noti of medical practice. The 
present, with all its scientific knowledge of the human structure 
and functions, and its vast resources for remedying disease, may 
be aptly termed the liberal era of medicine. The allopathic 



294 COMMON 8BN8B MEDICAL ADVISER. 

diffei*8 from the other schools, mainly in the application of 
remedies. In its ranks are found men, indefatigable in their 
labors, delving deep into the mysteries of natm-e, and who, for 
their scientific attainments and humane principles are justly 
considered ornaments to society and to their profession. 

HOMCEOPATIIY. 

Although this school is of compai*atively recent origin, yet it 
has gained a powerful hold upon the public favor, and numbers 
among its patrons very many intelligent citizens. This fact 
alone would seem to indicate that it possesses some merit. The 
homoeopathic differs from the allopathic school principally in its 
"Zato of cure^'' which, according to HaliRemann, its founder, 
was the doctrine of ^^similui slmilihtis ciiranfur,'^ or "like cures 
like," Its method of treatment is founded upon the assumption 
that if a drug be given to a healthy person, symptoms will 
occm- which, if transpiring in disease, would be mitigated by 
the same drug. While it may be exceedingly difficult for a 
member of another school to accept this doctrine and compre- 
hend the method founded upon it, yet no one can deny that it 
contains some elements of truth. 

Imbued with the spirit of progress, many of its most intelli- 
gent and successful practitioners have resorted to the use of 
appreciable quantities of medicine This school associates hy- 
dropathy with its practi(!e, and usually inculcates rigid dietetic 
and hygienic regulations. Many homceopathio remedies are 
thoroughly trituratec with sugar of milk, whic;h renders them 
more palatable and efficacious. Whether we attribute their 
cures to the infinitesimal doses which many homoBopathists em- 
ploy, to their " law of cure," to good nursing, or to the power 
of nature, it is nevertheless true that their practice is measur- 
ably successfuL No doubt the homoBopathic practice has modi- 
fied that of the other schools, by proving that diseases may be 
aHetiated by smaller quantities of medicine than were formerly 
employed. 

THE ECLECTIC SCHOOL. 

This school, founded by Wooster Beach, instituted the most 
strenuous opposition to the employment of mercury, antimony, 
the blister, and the lancet. The members of this new school 



THE LIBERAL AND INDEPENDENT PHYSICIAN. 295 

proclaimed that the action of heroic and noxious medicines 
was opposed to the operation of the vital forces, and proposed 
to substitute in then* place safer and more efficacious agents, 
derived exclusively from the vegetable kingdom. The eclectics 
have investigated the properties of indigenous plants and have 
discovered many valuable remedies, which a kind and bounteous 
nature has so generously supplied for the healing of her 
children. Marked success attended the employment of these 
agents. In 1852, a committee on "Indigenous Medical Botany," 
appointed by the " American Medical Association," acknow- 
ledged that the practitioners of the regular school had been ex- 
tremely ignorant of the medical virtues of plants, even of those 
of their own neighborhoods. The employment of podophyllin 
and leptandrin as substitutes for mercurials has been so success- 
ful that they are now used by practitioners of all schools. Al- 
though claiming to have been founded upon liberal principles, 
it may be questioned whether its adherents have not been quite 
as exclusive and dogmatic as those whom they have opposed. 
It cannot he denied, however, that the eclectics have added 
many important remedies to the Materia Medica. Their writ- 
ings are important and useful contributions to the physician's 
library. 

THE LIBERAL AND INDEPENDENT PHYSICIAN. 

After this brief review of the various medical sects, the 
reader may be curious to learn to what sect the physicians of 
the Invalids' Hotel and Surgical Institute belong. Among them 
are to be found gi-aduates fi-om the colleges of all the different 
schools. They are not restricted by the tenets of any one sect, 
but claim the right and privilege, nay, consider it a duty, to 
select from all, such remedies as careful investigation, scientific 
research, ani an extensive experience, have proved valuable. 
They resort to any and every agent which has been proved 
efficacious, whether it be vegetable or mineral. 

And here arises a distinction between sanative remedial agents 
and those which are noxious. Many practitioners deplore 
the use of poisons, and advocate innocuous medicines which 
produce only curative results. We agree with them in one 
proposition, namely, that improper medicines not only poison. 



596 coifNroN srnse medioat. AnvisEn. 

but fi'equently utterly destroy the health and t)ody of the 
patient. Every physician should keep steadily in view the final 
effects, as well as present relief, and never employ any agent 
without regard to its ulterior consequences. However, an agent 
which is noxious in healtJi, may prove a valuable remedy in 
disease. When morbid changes have taken place in the blood 
and tissues, when a general diseased condition of the bodily or- 
gans has occurred, then an agent, which is poisonous in health, 
may prove curative. For instance it is admitted that alcohol is 
a j)oison; that it prevents healthful assimilation, solidifies 
pepsin, begets a morbid appetite; that it produces intoxication, 
and that its habitual use destroys the body. It is, therefore, 
neither a hygienic nor a sanative agent, but strictly a noxious 
one; yet, its very distinct antiseptic properties render it valuable 
for remedial purposes, since these qualities promptly arrest that 
fatal form of decomposition of the animal fluids which is occa- 
sioned by snake-venom, which prodiices its deadly effects in 
the same manner as a drop of yeast feraients the largest mash. 
Alcohol checks this poisonous and deadly process and neutralizes 
its effects. Thus, alcohol, although a noxious agent, possesses a 
special curative influence in a morbid state of the human 
system; but its general remedial effects do not entitle it to the 
rank of a hygienic agent. "We believe that medicine is under- 
going a gradual change from the darkness of the past, with its 
ignorance, superstition, and barbarism, to the light of a glorious 
future. At each successive step in the path of progress, medi- 
cine approaches one degree nearer the realm of an exact science. 
The common object of the practitioners of all medical schools 
is the alleviation of human suffering. The only difference 
between the schools is in the remedies employed, the size of 
dose administered, and the results attained. These are in- 
sufficient grounds for bitter sectarianism. We are all fellow 
laborers in the same field. Before us lies a boundless expanse for 
exploration. Tliere are new conditions of disease to be learned, 
new remedies to be discovered, and new properties of old ones 
to be examined. 

We do not deplore the fact, that there are different schools 
in medicine, for this science has not reached perfection, and 
they tend to stinmlate investigation. The remarks of Herbert 



TBK LIBER Al OB DTDEPifiNDENT PHYSICIAIJ. J97 

Spencer on the "Multiplication of Schemes of Juvenile Cnl- 
ture," may be pertinently applied to the different schools in 
medicine with increased force. He says: "It is clear that 
dissent in education results in facilitating inquiry by the 
division in labor. Were we in possession of the true method, 
divergence from it would, of course, be prejudicial; but the 
true method having to be found, the efforts of numerous inde- 
pendent seekers carrying out their researches in different direc- 
tions, constitute a better agency for finding it than any that 
could be devised. Each of them struck by some new thought 
which probably contains more or less of basis in facts — each 
of them zealous on behalf of his plan, fertile in expedients to 
test its correctness, and untiring in its efforts to make known its 
success — each of them merciless in its criticism on the rest — 
there cannot fail, by composition of forces, to be a gradual 
approximation of all towards the right course. Whatever 
portion of the normal method any one of them has discovered, 
must, by the constant exhibition of its results, force itself into 
adoption ; whatever wrong practices he has joined with it must, 
by repeated experiment and failure, be exploded. And by this 
aggregation of truths and elimination of erroi^s, there must 
eventually be developed a correct and complete body of 
doctrine. Of the three phases through which human opinion 
passes — the unanimity of the ignorant, the disagreement of the 
inquiring, and the unanimity of the wise — it is manifest that 
the second is the parent of the third." 

We believe the time is coming when those maladies which are 
now considered fatal will be readily cured — when disease will 
be disarmed of its terrors. To be successful, a physician must 
be independent, free from all bigotry, having no naiTOW preju- 
dice against his fellow-men, liberal, accepting new truths from 
whatever source they come, free from the restrictions of socie- 
ties, and an earnest laborer in the interests of the Great 
Physician. 



CHAPTER n. 
REMEDIEbi FOR DISEASE. 



It will be our aim, throughout this book, to prescribe sucli 
remedies as are within the easy reach of all, and which may be 
safely employed. Many of those of the vegetable class are 
indigenous to this country, and may he procured In their 
strength and purity, at the proper season, by those residing in 
the localities where they grow, while all others advised may be 
obtained at any good drug-store. "We shall endeavor to recom- 
mend such as can be procured and prepared with the least 
trouble and expense to the patient, when it is believed that 
they will be equally as efficacious as more expensive medicines. 

PROPRIETARY MEDICINES. 

Having the invalid's best interests in view, it will often 
liappen that we cannot prescribe better or cheaper remedies nor 
those which are more effective or easily obtained, than some 
of our standard preparations, which are sold by all druggists. 
We are aware that there is a popular, and not altogether 
unfounded prejudice against " patent medicines," owing to the 
small amount of merit which many of them possess. The 
term " Patent Medicine " does not apply to Dr. Pierce's reme- 
dies, as no patent has ever been asked or obtained for them, 
nor have they been urged upon the public as " cure alls." They 
are simply favorite prescriptions, Avhich, in a very extensive 
practice, have proved their superior remedial virtues in the cure 
of the diseases for which they are recommended. 

From the time of Hippocrates down to the present day, 
298 



PKOPBIE'fAEY MEDICINES. 299 

physicians have classified diseases according to their causes, 
character or symptoms. It has been proved that diseases appai'- 
ently different may often be cm-ed by the same remedy. The 
reason for this singular fact is obvious. A single remedy may 
possess a variety of properties. Quinine, among other properties 
has a tonic which suggests its use in cases of debility; an anti- 
periodic, which renders it efficient in ague; and an antifebrile 
property, which renders it efficacious in cases of fever. The 
result produced varies with the quantity given, the time of 
its administration, and the circumstances under which it is 
employed. Every pi'acticing physician has his favorite remedies, 
which he oftenest recommends or uses, because he has the 
greatest confidence in their virtues. The patient does not know 
their composition. Even prescriptions are usually written in 
a language unintelligible to anybody but the druggist. As 
much secrecy is employed as in the preparation of proprietary 
medicines. Does the fact that an article is prepared by a process 
known only to the manufacturer render that article less valuable? 
How many physicians know the elementary composition of the 
remedies which they emj:)loy, some of which never have been 
analyzed? Few practitioners know how morphine, quinine, 
podophyllin, leptandrin, pepsin, or chloroform, are made, or 
how nauseous drugs are transfonned into palatable elixirs; yet 
they do not hesitate to employ them. Is it not inconsistent to 
use a prescription the composition of which is unknown to us, 
and discard another preparation simply because it is accompa- 
nied by a printed statement of its properties with directions for 
its use? 

Various journals in this country, have at different times 
published absurd formuke purporting to be receipts for the 
preparation of " Dr. Sage's Catarrh Remedy " and Dr. Pierce's 
standard medicines, which, in most instances, have not contained 
a single ingredient which enters into the composition of these 
celebrated remedies. 

In the manufacture of any pharmaceutical preparation, two 
conditions are essential to its perfection, viz: purity and strength 
of the materials, and appropriate machinery. The first is 
insured, by purchasing the materials in large quantities, whereby 
the exercise of greater care in selecting the ingredients can be 



,^00 COMMON SENSB MBDIOAL AbVlSfiR. 

afforded; and the second can only be accomplished where the 
business is extensive enough to warrant a large outlay of capital 
in procuring proper chemical apparatus. These facts apply with 
especial force to the manufacture of our medicines, their quality 
having been vastly improved since the demand has become so 
great as to require their manufacture in very large quantities. 
Some persons, while admitting that our medicines are good 
pharmaceutical compounds, object to them on the ground that 
they are too often used with insufficient judgment. We pro- 
pose to obviate that difficulty by enlightening the people as 
to the structure and functions of their bodies, the causes, 
character, and symptoms of disease, and by indicating the 
proper and judicious employment of our medicines, together 
with such auxiliary treatment as may be necessary. Such is one 
of the designs of this volume. 

PROPERTIES OF MEDICINE. 

It is generally conceded that the action of a remedy upon the 
human system depends upon properties peculiar to it. The 
effects produced suggest the naming of these qualities, which 
have been scientifically classified. We shall name the diseases 
from their characteristic symptoms, and then, without com- 
menting upon all the properties of a remedy, recommend its 
employment. Our reference to the qualities of any remedy, 
when we do make a particular allusion to them, we shall 
<^ndeavor to make as easy and familiar as possible. 

Dose. All persons are not equally susceptible to the influence 
of medicines. As a rule, women require smaller doses than men, 
and children less than women. Infants are very susceptible to 
the effects of anodynes, even out of all relative proportion to 
other kinds of medicines. The cii'cumstances and conditions of 
the system increase or diminish the effects of medicine, so that 
an aperient at one time may act as a cathartic at another, and 
a dose that will simply prove to be an anodyne when the patient 
is suffering great pain will act as a narcotic when he is not. 
This explains why the same dose often affects individuals differ- 
ently. The following table is given to indicate the size of the 
dose, and is graduated to the age: 



DOSE. 1 


YEARS. 


UOSE. 


full. \ 


4 . 


1-6 


2-3 1 


2 


1-8 


1-2 ' 


1 


1-12 


1-3 1 


K 


1-20 to 1-30 


1-4 i 







PROPERTIES OF MEDICINE. 301 

YEAKS. 

21 ... . 

15 ... 

12 ... . 

8 . . . 

6 . . . . 

The doses mentioned in the following pages are those for 
adults, except when otherwise specified. 

The Preparation of IVIedicines. The remedies 
which we shall mention for domestic iise are mostly vegetable. 
Infusions and decoctions of these will often be advised on 
account of the fact that they are more available than the 
tinctures, fluid extracts, and concentrated principles, which we 
prefer, and almost invariably employ in our practice. Most of 
these medical extracts are prepared in our chemical laboratory 
under the supervision of a careful and skilled pharmaceutist. 
No one, we presume, would expect, with only a dish of hot 
water and a stew-kettle, to equal in pharmaceutical skill the 
learned chemist with all his ingeniously devised and costly 
apparatus for extracting the active, remedial principles from 
medicinal plants. Yet infusions and decoctions are not without 
their value; and from the inferior quality of many of the fluid 
extracts and other pharmaceutical preparations in the market, 
it may be questioned whether the former are not frequently 
as valuable as the latter. So unreliable are a majority of the 
fluid extracts, tinctures, and concentrated, active principles found 
in the drug-stores, that we long since found it necessary to have 
prepared in our laboratory, most of those which we employ. 
To the reliability of the preparations which we secure in this 
way we largely attribute our great success in the treatment of 
disease. Tinctures and fluid extracts are often prepared from old 
and worthless roots, barks, and herbs which have wholly lost theii- 
medicinal properties. Yet they are sold at just as high prices 
as those which are good. We manufacture our tinctures, fluid 
extracts, and concentrated, active principles from roots, barks, 
and herbs which are fresh, and selected with the greatest care. 
Many of the crude roots, barks, and herbs found in the market 
are inactive because they have been gathered at the wrong 
season. These, together with those that have been kept on 
hand so long as to have lost all medicinal vaiue, are often sold 



J)02 COMMON SENSE MEDICAL ADVISER. 

in large quantities, and at reduced prices, to be manufactured 
into fluid extracts and tinctures. 01" course, the preparations 
made from such materials are worthless. Whenever the dose 
of fluid extracts, tinctures, and concentrated, active principles, 
is mentioned in this chapter, the quantity advised is based upon 
our experience in the use of these preparations, as they are 
made in our laboratory, and the smallest quantity which will 
produce the desired effect is always given. When using most 
of the preparations found in the drug-stores, the doses have to 
be somewhat increased, and even then they will not always pro- 
duce the desired effect, for reasons already given. 

The IAhI of Iflcdicilies which we shall introduce in 
this chapter will be quite limited, as we cannot hope, by making- 
it ext(!nsive, that the non-professional reader would be able to 
prescribe with good judgment any other than the simpler reme- 
dies. Hence, we prefer, since we have no space in this volume 
to waste, to mention only a few of the most common remedies 
under each head or classification. 

Tinctures. Very uniform and reliable tin(;tures may be 
made of most indigenous plants, by procuring the part to be 
employed, at the proper season, while it is green and fresh, 
bruising it well, and covering it with good strong whisky, or 
with alcohol diluted with one part of water to three of alcohol, 
(working tightly, and letting it stand about fourteen days, when 
(he tincture may be filtered or poured off from the drugs, and 
will ])e ready for use. Prepared in this imperfect majiner, they 
will be found to be much more reliable than any of the fluid 
extracts foimd in the drug-stores. An excess of the crude drug 
should be used in preparing the tincture to insure a perfect 
saturation of the alcoliol with its active principles. 

Homceopathic Tinctures. The tinctures prepared by 
several of the German and French pharmaceutists, and called 
by them " Mother Tinctures," to distinguish them from the 
dilutions made therefrom, we have found to be very reliable, so 
much superior to any similar preparations made in this country 
that we purchase from them all we use of Pulsatilla, Staph- 
isagria, Drosera and several others. They are prepared with 
great care from the green, crude material, and although high in 
price, when compared with other tinctures, yet the greater 



ALTERATIVES. 303 

certainty of action which we secure in our prescriptions by 
their employment more than repays for the expense and trouble 
in procuring them, for of what account is expense to the true 
physician when life may depend upon the virtue of the agent he 
employs ? 

InfVlsioilS. These are generally made by adding one-half 
ounce of the crude medicine to a pint of water, which should 
be closely covered, kej^t warm, and used as directed. Flowers, 
leaves, barks, and roots become impaired by age, and it is neces- 
sary to increase or diminish the dose according to the strength 
of the article employed. 

Decoctions. The difference "between a decoction and an 
infusion is, that the plant or substance is boiled in the produc- 
tion of the former, in order to obtain its soluble, medicinal 
((iialities. Cover the vessel containing the ingredients, thus 
confining the vapor, and shutting out the atmospheric air which 
sometimes impairs the active principles and their medicinal 
qualities. The ordinary mode of preparing a decoction is to 
use one ounce of the plant, root, bark, flower, or substance to a 
pint of water. The dose internally varies from a tablespoonful 
to one ounce. 

ALTERATIVES. 

Alteratives are a class of medicines which in some inexplic- 
able manner, gradually change certain morbid actions of the 
system, and establish a healthy condition instead. They stim- 
ulate the vital processes to renewed activity, and arouse the 
excretory organs to remove matter which ought to be eliminated. 
They facilitate the action of the secretory glands, tone them 
up, and give a new impulse to their operations, so that they 
can more expeditiously rid the system of worn-out and effete 
materials. In this way they alter, correct, and purify the 
fluids, tone up the organs, and re-establish their healthy func- 
tions. Alteratives may possess tonic, laxative, stimulant, or 
diuretic properties all combined in one agent. Or we may com- 
bine several alteratives, each having only one of these properties 
in one remedy. We propose to enumerate only a few altera- 
tives, and give the doses which are usually prescribed; the list 
which we employ in our practice is very extensive, but it can- 
not be made available for domestic use. 



804 COMMON SENSE MEDICAL ADVISER. 

ITIandrake {Podophyllum Peltatiwi), also called May- 
apple, is a most valuable alterative. The root is the part 
used. Dose — Of decoction, one to two teaspoonf uls ; of 
tincture, six to eight drops; of fluid extract, three to five drops; 
of its active principle, Podopliyllin, one-tAvelfth to one-eighth 
of a grain. 

Poke {Phytolacca Decandra), also called Skoke, Garget, or 
Pigeon-berry, is a valuable alterative. The root is the part 
used. Dose — Of decoction, one to three teaspoonfuls; ol' fluid 
extract, three to ten drops; of concentrated principle, Pliyto- 
laccin, one-fourth to one grain. 

ITellow Dock {Rumex Crispns). The part used is the 
root. Dose — Of tlie infusion, one to three fluid ounces three 
times daily; of fluid extract, ten to thirty drops; of tincture, 
twenty to forty drops. 

Tag Alder {Alnns Rubra). This is otherwise known as 
the Smooth, Common, or Swamp Aldei-. The bark is the part 

Fiq. Ihi 




Tag Alder. 



used. It is excellent in scrofula, syphilis, cutaneous and all 
blood diseases. Dose — Of decoction, one or two tablespoonfuls. 



ALTERATIVES. 



305 



from three to five times daily; of tincture, one or two teaspoon- 
fuls; of fluid extract, one-half to one teaspoonful; of concen- 
trated principle, Alnuin, one-half to one grain. 

Black Cohosh {3Tacrotys or Cimicifuga Bacemosa). 
The part used is the root. Its other common names are Black 




Black Cohosh. 



Snake-root, or Squaw-root. Black Cohosh is an alterative, 
stimulant, nervine, diaphoretic, tonic, and a cerebro-spinal stimu- 
lant. It is a useful remedy. Dose — Of decoction, one-fourth to 



'Mh) 



COMMON 8ENSK MBDICAL ADVISER. 



one ounce; of tincture, ten to fifteen drops; of fluid extract, five 
to ten drops; of tlie concentrated principle, Macrotin, one-eighth 
to one-half grain. 

Blood-root {Sanguinaria Canadensis), is also known as 
lied Puccoon. The })art used is the root. In minute doses 

Fig. 115. 




Blood-root. 
Blood-root is a valuable alterative, acting upon the biliary 
secretion and improving the circulation and digestion. IJose — 
Of powdered root, one-fourth to one-half grain; of tincture, one 



ALTERATIVES. J^07 

to two drops; of the fluid extract, one-half to one drop. When 
^iven in a fluid form it should be well diluted. 

Burdock {Arctium Lappa). The root is the part used. 
Burdock is a valuable alterative in diseases of the blood. Dose 
— Of tincture, from one teaspoonful to a tablespoonful twenty 
minutes before meals; of fluid extract, one to two teaspoonfuls. 

Blue Flag^ [Iris Versicolor). The part used is the root. 
Dose — Of the tincture, five to ten drops; of fluid extract, three 
to ten drops; of concentrated principle, L*idin, one-half to two 
grains. 

Swt;et Elder {Sambucus Canadensis). Sweet Elder-flow- 
ers are a valuable alterative, diuretic, mucous and glandular 
stimulant, excellent in eruptive, cutaneous, and scrofulous dis- 
eases of children. An infusion, fluid extract, or syrup, may be 
used in connection with the " Golden Medical Discovery." Both 
will be found valuable for cleansing the blood and stimulating 
the functions to a healthy condition. ' Dose — Of the infusion 
of the flowers, from one-half to one ounce, if freely taken, will 
operate as a laxative; of fluid extract, one-fourth to one-half 
teaspoonful. The flowers, or inner bark of the root, simmered 
in fresh butter, make a good ointment for most cutaneous 
affections. 

Iodine. This agent, in the several forms of Iodide of 
Potassium, Iodide of Amtnonium, Iodide of Iron, and Iodide of 
Lime, is largely employed by physicians, and often with most 
happy results. But for domestic use we cannot advise its 
employment, as it is liable to injure the invalid, when its action 
is carried too far, which is apt to be the case, when n(5t admin- 
istered under the supervision of a competent physician. 

JHercury. The various preparations of mercury have a 
profound, alterative effect upon the system. When taken for 
some time, they change the quality and composition of the 
blood; cause a diminution in the number of red blood-cor- 
puscles, and an increase in the various effete materials. In the 
vast majority of cases we prefer the vegetable alteratives, but 
in rare instances they exert a beneficial influence, in small doses. 
None of the preparations of mercury should be taken internally 
without the advice of a skillful physician, therefore, we shall 
not give their doses. 



308 COMMON SKNSE MEDICAL ADVISER. 

THE COMPOUNDING OF ALTERATIVES. 

The efficacy of this class of remedies can be greatly increased 
by properly oombining several of them into one compound. 
This requires a knowledge of Pharmaceutical Chemistry; i. e., 
the preparation of compounds founded on the chemical relation 
and action of their several remedial, active principles. Many 
practitioners make combinations of remedies which neutralize 
each other's influence, instead of extending their efficacy and 
curative power. 

Dr. Pierce's ''troldeii Uledieal Discovery," or 
Alterative Extract. This compound is a highly nutritive and 
tonic preparation, combining the remedial properties of the 
best vegetable alteratives at present known to the medical 
px'ofession. In perfecting this alterative compound, and likewise 
other standard preparations of medicine, we have made an out- 
lay of many thousand dollars for chemical apparatus, and 
special machinery by the aid of which these remedies have been 
brought to their present perfection. Great pains are taken to 
ol)tain the materials at the right season of the year, properly 
cured so that none of their remedial qualities may be impaired. 
We, therefore, can with great confidence recommend Dr. Pierce's 
"Golden Medical Discovery" as one of the best preparations of 
the alterative class. Like all others Of this type, its action is 
insensible, producing gradual changes, arousing the excretory 
glands to remove morbid materials, and at the same time toning 
the secretory organs. The manufacture of this compound is 
under the special supervision of a competent chemist and phar- 
maceutist, and it is now put up in bottles wrapped with full 
directions for its use. We can confidently recommend this 
compound whenever an alterative is required to cleanse the 
})lood, tone the system, increase its nutrition, and establish a 
licaltliy condition. For these reasons we shall often advise its 
(•mployment. 

Dr. Pierce's Pleasant Purgative Pellets. These 
pellets combine the pure, concentrated, active principles of 
several vegetable alteratives, and the result is, that within the 
small compass of a few grains he has most happily blended and 
chemically condensed these properties, so that their action upon 



ACIDS. 30y 

the animal economy is sanative and universal. They awaken 
the latent powers, quicken the tardy functions, check morbid 
deposits, dissolve hard concretions, remove obstructions, pro- 
mote depuration, harmonize and restore the functions, equalize 
the circulation, and encourage the action of the nervous system. 
They stimulate the glands, increase the peristaltic movement of 
the intestines, tone the nutritive processes, while aiding in 
evacuating the bowels. All this they accomplish without cor- 
roding the tissues or vitiating the fluids. Their assistance is 
genial, helping the system to expel worn out materials, which 
would become noxious if retained. Having expended their 
remedial powers upon the various functions of the body, they 
are themselves expelled along with other waste matter, leaving 
behind them no traces of irritation. This cannot be said of 
mercurials, or of other harsh, mineral alteratives. These Pellets 
may be safely employed when the system is feeble, frail, and 
delicate, by giving them in less quantities. Dose — As an alter- 
ative, only one or two Pellets should be taken daily. 

ALKALIES. 

Alkalies. These constitute an important list of remedial 
agents, their administration being frequently indicated. The 
employment of other medicines frequently should be preceded 
by the administration of an agent of this class, to neutralize 
excessive acidity in the stomach and bowels. Unless this be 
done, many medicines will fail to produce their specific effects. 

Sulphite of l^oda {Sodce Stdphis). This salt, as well as 
the Hyposulphite of Soda, is not only generally preferable for 
administration on account of its unirritating character and the 
smallness of the dose required, but also because it is a valuable 
antiseptic agent. The Suljyhite should not be coTifounded with 
the Sulphate of Soda (Glauber's Salt). Dose — This is from 
three to ten grains. 

iSaleratUS {Potassm Bicarbonas). This is a favorite 
domestic antacid. Dose — Five to fifteen grains is the amount. 

ACIDS. 

As alkalies are important and often indicated as reme- 
dial agents, so their re-agents, acids, are also frequently 



3l0 COMMON SENSE MEDICAL ADVISER, 

necessary to meet opposite conditions of the fluids of the 
system. 

Hydrochloric or muriatic Acid. This agent may 
be administered in doses of from five to ten drops, largely 
diluted in water or gruel. 

Aromatic Sulphuric Acid, or Elixir of Vitriol, is the 
most agreeable form of Sulphuric Acid for administration, and 
may be given in doses of from five to fifteen drops, largely 
diluted with water. 

In taking acids, they should be sucked through a straw, and 
not allowed to come in contact with the teeth, as otherwise the 
latter organs will be injured by their effects; or should the acid 
come in contact with the teeth, the mouth should be immedi- 
ately rinsed with a solution of saleratus or soda, to neutralize 
the acid. 

ANODYNES. 

Anodynes are those medicines which relieve pain by blunting 
the sensibility of the nerves, or of the brain, so that it does 
not appreciate the morbid sensation. An anodyne may be a 
stimulant in one dose, and a narcotic in a larger one. The 
proj^erties of different anodyne agents vary, consequently they 
produce unlike effects. The size of the dose required, differs 
according to circumstances and condition. An adult, suffering 
acute pain, requires a much larger dose to produce an anodyne 
effect than one who is a chronic sufferer. An individual accus- 
tomed to the use of anodynes, recjuires a much larger dose to 
procure relief than one who is not. Doses may be repeated, 
until their characteristic effects are produced, after an interval 
of thirty or forty minutes. When the stomach is very sensitive 
and will not tolerate their internal administration, one-sixth 
of a grain of Morphia can be itiserted beneath the skin, by 
means of a hypodermic syringe. Relief is more quickly ex- 
perienced, and the anodyne effect is much more lasting than 
when taken into the stomach. 

Opium {Papaver Somnifenim). Opium is a stimulant, 
anodyne, or narcotic, according to the size of the dose ad- 
ministered. Dose — Of the dry powder, one-fourth to one 
grain; of tincture (Laudanum), five to fifteen drops; of cam- 
phorated tincture (Paregoric), one-half to one teaspoonful; of 



AJJODYNilS. 



811 



Morphine, one-eighth to one-fourth grain; of Dover's Powder, 
three to five grains. 

HyOi^cysinillS {Syoscyamus JViger), commonly known as 
Henbane. The herb is used. It is a powerful narcotic, and 
unlike Opium, does not constipate the bowels, but possesses a 
laxative tendency. Therefore, it may be employed as an 
anodyne for allaying pain, calming the mind, inducing sleep 
and arresting spasms, when opiates are inadmissible. Dose — Of 
alcoholic extract, one-half to two grains; of fluid extract, five 
to ten drops; of the concentrated principle, Hyoscyamin, one- 
twelfth to one-fourth of a grain. 

Poison Hemlock ( Gonimn 3faculatuw). The leaves are 

Fi(j. 116. 




Poison Hemlock. 

the parts used. Poison Parsley, as it is sometimes called, is an 
anodyne, narcotic, and an excellent alterative. Dose — Of fluid 



312 COMMON SENSE MEDICAL ADVISER. 

extract, two to six drops; of solid extract, one-fourth to one-half 
grain. 

Bella<loillia {Atropa Belladonna) or Deadly Nightshade. 
The herb or leaves are a valuable agent. In overdoses, it is an 
energetic, narcotic poison. In medicinal doses it is anodyne, 
anti-spasmodic, diaphoretic, and diuretic. It is excellent in 
neuralgia, epilepsy, mania, amaurosis, whooping-cough, stric- 
ture, rigidity of the os uteri, and is supposed by some to be 
a prophylactic or preventive of Scarlet Fever. Its influence 
upon the nerve centers is remarkable. It relaxes the blood 
vessels on the surface of the body and induces capillary 
congestion, redness of the eye, scarlet apj)eai"ance of the face, 
tongue, and body. Dose — Of fluid extract, one-half to one drop; 
of tincture, one to two drops; of concentrated principle, Atropin, 
one-thirtieth to one-sixteenth of a grain; of the Alkaloid, 
Atropia, one-sixtieth of a giain. Even the most skillful chemists 
are very cautious in compounding these latter active principles, 
and the danger of an overdose is great. 

Camphor. This drug is an anodyne, stimulant, and dia- 
phoretic, and, in large doses, a narcotic and an irritant. It is an 
excellent stimulant for liniments. Dose — Of the powder, one 
to five grains; of the tincture, ten to twenty drops, given in 
simple syrup. 

Hops {Humuhjbs Ltipidus). This is an excellent remedy in 
wakefulness, and may be used when opium is oontra-indicated. 
A l>ag of the leaves, moistened with whisky and placed as a 
pillow under the head, acts as an anodyne. Dose — Of the 
infusion of the leaves, from one to four ounces; of the fluid 
extract, one-fourth to three - fourths of a teaspoonful; of the 
(•((ncentrated ])rijiciple, ITumiilin, one to three grains. 

Dr. Pierce's Coiiipoiiiid Extract of .^iiiart- 

W€*e€l. This anodyne compound is made by uniting several 
of the most valuable agents of this class, and its medicinal 
qualities are rendered still more eificacious by the addition of 
certain stimulating articles. It is free from narcotic properties 
which are liable to produce deleterious results, and has been 
found to be not only harmless in its action, but very genial and 
effectual withal, and most reliable as a stimulant and diaphoretic 
remedy. 



AISTTHBLMINTICS. 313 

ANTHELMINTICS. 

Anthelmintic means " against a worm," and is a term em- 
ployed to designate those medicines which destroy or expel 
worms. It means the same as Vermifuge. Little is understood 
concerning the origin of worms. There are live distinct varie- 
ties described by authors as being more common than others. 
There is the long worm, the short, or pin-woi-m, the thread- 
worm, the tape-worm, and the broad tape-worm peculiar to 
some countries of Europe. Irritation of the alimentary canal, 
from whatever cause, usually produces an abundant secretion 
of mucus, which is thougfit to be a condition favorable for 
their production. Therefore, those medicines which remove 
the cause of this irritation tend to diminish the number, if 
not to entirely destroy the worms. Some medicines kill the 
worms, others expel them alive. The remedies which success- 
fully remove one kind of worm, have little effect upon another, 
and to meet these different conditions, we have a variety of 
worm-destroying medicines. The pin-worm inhabits the rec- 
tum, and may be destroyed by injecting into it a strong 
solution of salt, or decoction of aloes, and when it is allowed 
to pass away, the rectum should be anointed with vaseline, 
butter, or lard. The eggs of this worm are developed around 
the orifice of the large intestine, and when this latter precaution 
is not practiced every time there is a passage from the bowels, 
they will multiply as rapidly as they can be destroyed. Gen- 
erally, vermifuge remedies should be taken when the stomach 
is empty, and should be followed by the administration of a 
cathartic in two hours after the last dose is administered. 

l^antoilill. This is decidedly the most reliable anthel- 
mintic known to the medical profession. It is deservedly a 
popular remedy for worms, and when combined with Podo- 
phyllin, is very efficacious in removing the pin-worm. Dose — 
For an adult, two to three grains of the powdered Santonin, 
repeated every three hours until four or five doses are taken, 
when it should be followed by a cathartic. 

Sage {Salvia Officinalis). Sage is a common and excellent 
domestic remedy for worms. Make an infusion of Sage and 
Senna leaves, and drink freely until it acts as a cathartic. 
14 



ai4 



COMMON SENSB MEDIC AIi ADVISER, 



Pink-root {Splgelia Marilandlca). Piiik-root is one ot 
the most active and certain anthelmintic!- for children. It is 



Mf/. 117. 




Pink-root. 



indigenous to the United States. When taken in too large 
quantities, it is apt to purge, give rise to vertigo, dimness 
of vision, and even to convulsions; therefore, it should be 



ANTIPEBIODICS. 



315 



White or Aspen 
active principles 



combined with some cathartic. Dose — Of the infusion, one 
ounce at night, followed by physic in the morning. 

Common Salt {Chloride of Sodium). Common table 
salt is an anthelmintic, and may be used in an emergency. Salt 
water is a very common domestic remedy for worms. Dose — 
In solution, one-quarter to one-half teaspoonful. 

BallllOIiy ( Chelone Glabra). This is also tonic and anthel- 
mintic, and is valuable in debility, dyspepsia, jaundice, and 
hepatic affections. It also is known as Snake-head. Dose — 
Of the infusion, one to two ounces; of the concentrated prin- 
ciple, Chelonin, from half to one grain. 

Ulale Fern {Aspidium Filix Mas). Male Fern is the an- 
thelmintic which is considered especially effectual in removing 
the tape-worm. Dose — Of the powder, one to two drachms, 
given morning and evening in syrup, followed by a brisk 
cathartic. The dose of the tincture of the buds in ether is 
from eight to thirty drops. 

Poplar {Populus Tremuloides). The 
Poplar is a common tree, and contains 
tei'med Populin and Salicin, both of 
which are tonic. An infusion of the 
bark is a remedy for worms. Dose— 
Of the tea made from the bark, one 
to four ounces; of Populin, from one- 
half to two grains. 

ANTIPERIODICS. 

It is well understood that malarial 
diseases are characterized by a peri- 
odicity which indicates their nature. 
Antiperiodics prevent the recurrence 
of the periodic manifestations, and 
hence their name. 

Quinine {Sulphate of Quitda). 
Quinine is a tonic, febrifuge, and antiperiodic. It should 
generally be administei'ed during the intervals between the 
febrile paroxysms. It is beneficial also in all diseases ac- 
companied by debility. The dose varies from one to six 
grains, according to indications. Frequently it is given in much 



Mg. lis. 




Aspen. 



alH 



COMMON SENSE MEDICAL ADVISER. 



larger quantities, but we cannot advise such for domes- 
tic use. 

Prussian Blue {Ferri Ferrocyanidum). Ferrocyanide of 
Iron is an excellent tonic and antiperiodic remedy, and often is 
combined with quinine. Dose — From two to five grains. 

Boneset [Eupatorium Perfoliatam), or Thoroughwort. This 
is tonic, diaphoretic, aperient, and possesses some antiperiodic 




Koueset. 



properties; the warm infusion is emetic. Dose — Of the infusion, 
one to four ounces; of the fluid extract, from half to one tea- 
spoonful; of the active principle, Eupatorin, one to three grains. 
The *' Golden jfledical Discovery" has gained an 
enviable reputation in malarial districts for the cure of ague. 
From observing its action in the cure of this and other mias- 
matic diseases, and knowing its composition, we are thoroughly 



ANTISEPTICS AND DISINFECTANTS. 317 

satisfied that it contains chemical properties which neutralize 
and destroy the miasmatic or ague poison which is in the 
system, and, at the same time, produces a rapid excretion of the 
neutralized poisons. One strong proof of this is found in the 
fact that persons who are cured with it are not so liable to 
relapse as those in whom the chills are broken with Quinine 
or other agents. No bad effects are experienced after an attack 
of ague which has been cured with the "Golden Medical 
Discovery." This cannot be said of Quinine, Peruvian Bark, 
Arsenic, and Mercurials, which comprise nearly the whole list of 
remedies usually resorted to by physicians for arresting ague. 
The " Golden Medical Discovery " not only has the merit of 
being a certain antidote for miasmatic diseases, but is pleasant 
to the taste, a matter of no small importance, especially when 
administered to children. To break the chills, this medicine 
should be taken in doses cf four teaspoonfuls three times a 
day, and if this treatment pursued for three days, does not 
entirely arrest the chills, these doses may be repeated in 
alternation with five-grain doses of quinine for the three 
succeeding days. But in no case should more than this amount 
of the " Golden Medical Discovery " be given. 

ANTISEPTICS AND DISINFECTANTS. 

Antiseptics prevent, while disinfectants arrest putrefaction. 
Oxygen is a natural disinfectant, but a powerful inciter of 
cliange. Although this element is the cause of animal and 
vegetable decay, yet oxidation is the grand process by whicli 
the earth, air, and sea are purified. A few substances are 
both antiseptic and disinfectant. Heat up to a temperatui-e 
of 140"= Fahr. promotes putrescence, but above that point, is a 
drier or disorganizer, and destroys the source of infection. 

Yeast {Cerevisice Fermentum). Yeast is an antiseptic, and 
is effective in all diseases in which there is threatened putridity. 
Used externally, it is often combined with elm bark and 
charcoal, and applied to ulcers, in which there is a tendency to 
gangrene. Dose — One tablespoonful in wine or porter, once in 
two or three hours. 

Creasote. This is a powerful antiseptic. It is used in a 



818 COMMON SENSE MKDICAI. ADVISER. 

solution of glyceriue, oil, water, or syrup. Dose — One to tAvo 
drops, largely diluted. 

CarlK>lic Acid is a crystalline substance resembling crea- 
sote ill its properties. It is an antiseptic, and is used both 
internally and externally. Dose — One-fourth to one-half drop 
of the melted crystals, very largely diluted. Externally, in 
solution, one to five grains of the crystals to one ounce of the 
solvent. 

White Vitriol {Zinci Sulphas). White vitriol is a valuable 
disinfectant, Jis it will arrest mortification. In solution it is 
employed in ulcers and cancers and also as a gargle in putrid 
sore throat. Dose — One-half to two grains in a pill; in solution, 
one to ten grains in an ounce of water. 

Periliailgaiiate of Potaisih {Potassce Permanganas). 
This substance is an energetic deodorizer and disinfectant. A 
solution containing from one to twenty grains in an ounce of 
water is used as a lotion for foul ulcei's. Dose — One-eighth to 
one-fourth of a grain. 

Wild Indigo {BajJtlsia Tinctoria). Tlu^ root is the part 
used. This plant possesses valuable antiseptic properties. It is 
an excellent lotion for ill-conditioned ulcers, malignant sore 
throat, nursing sore-mouth, syphilitic ophthalmia, etc. It is 
sometimes administered in scarlet and typhus fevers, and in all 
diseases in which there is a tendency to putrescence. Dose — Of 
the infusion, one-fourth to one-half ounce; of the fluid extract, 
from three to ten drops, and of the concentrated, active )>rinoiple 
of the ])lant, Baptisin, from one to two grains. 

ANTISPASMODICS. 

Antispasmodics are a class of remedies which relieve cramps, 
convulsions, and spasms, and are closely allied to nervines. 
Indeed some authors class them together. The following are 
a few of the most important antispasmodics: 

Assafctida {Assafetida Ferula). This is a powerful 
antispasmodic. It is employed in hysteria, hypochondria, 
convulsions, and spasms, when unaccompanied by inflammation. 
Dose — Of the gum or powder, from three to ten grains, usually 
administered in the form of a pill; of the tincture, from one-half 
to one teaspoonful. 



ANTISPASMODICS. 3 1 9 

Yellow Jessamine {Oelseminum Sempervirens). The 
root is the part used. This is a valuable remedy in various 

Fig. 120. ' 




Yellow Jessamine. 



diseases when associated with restlessness and a determination 
of the blood to the brain; also in the neuralgia. Dose — Of the 



•^•_>(> COMMON SENSK MEDICAL ADVISER. 

fluid extract, three to eight drops; of the concentrated prin- 
ciple, Gelsemin, one-fourth to one grain. The use of this drug 
by non-professional persons should be attended with great 
caution. 

Valerian ( Valeriana Offieiyialis). The root is the part 
used. Valerian is an effective remedy in cases of nervousness 
and restlessness. Dose — Of the infusion, (one-half ounce to a 
]nnt of water) one-half ounce; of the tincture, one-half to two 
tablespoon fuls; of the ainmoniated tincture of valerian, from 
one-half to two teaspoonfuls in sweetened water or milk; of the 
valerianate of ammonia, one-half to three grains. 

Yellow Lady's Slipper {Cypr'qyedium Pubescens). 
The root is the part used. This is a useful remedy in hysteria, 
chorea, and all cases of irritability. Dose — Of the powder, 
fifteen to thirty grains; of the infusion, one ounce; of the fluid 
extract, fifteen to thirty drops; of the concentrated principle, 
Cypripedin, one-half to two grains. 

^Wild ITaill {Dioseorea Villosa). The root is the part 
used. This is a powerful antispasmodic, and has been success- 
fully used in bilious colic, nausea, and spasm of the bowels. 
Dose — Of the infusion (two ounces to a pint of water), one 
to two ounces; of the fluid extract, five to fifteen drops; of the 
concentrated principle, Dioscorein, one-half to one grain. 

High Cranberry ( Viburnum Opulus.) The bai'k is tjie 
part used. It is also known as Cramp Bark. This is a powerful 
antispasmodic, and is effective in relaxing spasms of all kinds. 
It is a valuable agent in threatened abortion. Dose — Of 
the infusion, one-half to one ounce; of the fluid extiact, one- 
half to one teaspoonful; of the concentrated principle, Viburnin, 
one-half to two grains. These doses may be increased if 
necessary. 

ASTRINGENTS. 

Astringents are medicines which condense and coagulate the 
tissues, thereby arresting discharges. When taken into the 
mouth, they produce the sensation known as puckering. They 
are used internally and locally. The term styptic is used as a 
synonym of astringent, but is generally employed to designate 
those astringents which arrest hemorrhage, or bleeding. 



ASTRINGENTS. 



321 



IiOg^l¥OOd {Hcematoxylon Campechianum). Logwood is 
a mild astringent, well adapted to remedy the relaxed condition 
of the bowels after cholera infantum. Dose — Of powdered 
extract, five to ten grains; of the decoction, one ounce; of the 
fluid extract, fifteen to thirty drops. 

Blackberry Root [Eubus Villosics). This astringent is 
a favorite, domestic remedy in affections of the bowels. Dose — 
Of the infusion (bruised root), one-half to one ounce, sweetened; 

liWitch-hazel {Hwiiamelis Virginica). The parts used 
are the leaves and bark. This is a most valuable astringent 

Fig. 121. 




Witch-hazeJ. 

and exerts a specific action upon the nervous system^ It arrests 
many forms of uterine hemorrhage with great promptness, 
is a valuable agent in the treatment of piles, and is useful iu 



322 



COMMON SBNSB MEDICAL ADVISER, 



many forms of chronic throat and bronchial affections. Dose — 
Of the infusion, one-fourth to one-half ounce; of the fluid 
extract, eight to fifteen grains; of the concentrated principle, 
Hamamelin, one fourth to one grain. 

Craiie!>$1t>ill {Geranimn Maculatnm). The root is used. 

Mff. 122. 




Cranesbill. 



This plant is also known as Crow-foot, and Spotted Geranium. 
It is a pleasant, but powerful astringent. Dose — Of the fluid 



ASTRINGENTS. 



323 



extract, ten to thirty drops; of the concentrated principle, 
Geranin, one to two grains. 

Hardhack {Spirea Tomentosa), Spirea, or Meadow Sweet. 
The stem and leaves are used. It is a tonic and an astringent, and 



Fig. 128. 



Fig. 12Jf. 





Buple-weed. „ ^, , 

Hardhack. 

is used in diarrhea and cholera-infantum. • Dose — Of the infu 
sion one-half to one ounce; of ihe fluid extract, three to six drops. 
Bugle- weed {Lycopus Vlrginicus). This is variously 
known as Water-hoarhound and Water-bugle. It is sedative 
and tonic, as well as astringent, and is employed in hemorrhages 



324 



OOMMON SKNSK MEDICAL ADVISER. 



and in incipient phthisis. IJose — Of the infusion, one to two 
ounces; of the fluid extract, fifteen to twenty-five drops; of 
the concentrated principle, Lycopin, one-half to one grain. 
Canada Fleabane {En'igeron. Canadense). The leaves 

Mg. 125. 




Canada Fleabane. 



and flowers are used. This plant, sometimes known as Colt's- 
tail, Pride-weed, or Butter-weed, is astringent, and has been 



CARMINATIVES. 325 

efficiently employed in uterine heuiorrhages. Dose — Of the 
infusion (two ounces of the herb to one pint of water), one to 
two ounces; of the oil, five to ten droDS on sugar, repeated at 
intervals of from one to four hours. 

Catechu {Acacia Catechu). A tincture of this plant is a 
pure, powerful astringent, and is especially useful in chronic 
diarrhea, chronic catarrh, and chronic dysentery. Dose — Of 
the powder, five to twenty grains; of the tincture, one-half 
to two teaspoonfuls. 

Tannin {Addum Tannicum). This acid has a wide range 
of application. It is used as an astringent. Dose — One to fi\e 
grains. 

Gallic Acid {Addum Gallicurti). This remedy is used 
chiefly in hemon-hages. Dose — Three to five grains. In severe 
hemorrhages, this quantity should be administei-ed every half 
hour, until the bleeding is checked. 

CARMINATIVES. 

Carminatives are medicines which allay intestinal pain, arrest 
or prevent griping caused by cathartics and exert a general 
soothing effect. They are ai-omatic, and to a certain extent, 
stimulant. 

Ani§e-seed {Pimpinella Anisum). Anise is a pleasant, 
aromatic carminative, and is used in flatulent colic. Dose — 
Of the powdered seed, ten to fifteen grains; of the infusion 
(a teaspoonful of seed to a gill of water), sweetened, may be 
given freely; of the oil, five to ten drops on sugar. 

Fennel-seed {Anethtmi Foenicidum). This is one of our 
most grateful aromatics, and is sometimes employed to modify 
the action of senna and rhubarb. Dose — Same as that ol" 
anise-seed. 

Ging^er {Zingiber Ojjicitiale). The root is the part used. 
This is a grateful stimulant and carminative. Dose — Of the 
powder, ten to twenty grains; of the infusion, one teaspoonful 
in a gill of water; of the tincture, twenty to thirty drops; of 
the essence, ten to fifteen drops; of the syrup, one teaspoonful, 

TW^intergreen {Gaxdtheria Procumbens). The leaves are 
used. This plant possesses stimulant, aromatic, and astringent 
pi'operties. The essence of Wintergi-een is carminative, and is 



326 COMMON SENSE MEDICAL ADVISES. 

used ill colics. Dose — Of the essence, one-half to one teaspoon- 
ful in sweetened water; of the oil, three to five drops on sugar. 

Peppermint {Mentha Piperita). Peppermint is a power- 
ful stimulant, carminative, and antispasmodic. It is used in 
the treatment of spasms, colic, and hysteria. Dose — The infu- 
sion may be used freely. The essence may be taken in doses 
of fifteen to thirty drops in sweetened warm water; of the oil, 
one to five drops on sugar. 

^peArillillt [Mentha Viridis). The carminative properties 
of spearmint are inferior to those of peppermint, and its chief 
employment is for its diuretic and febrifuge virtues. Dose — 
Same as that of peppermint. 

Compound Extract of !$mart-weed. Dr. Pierce's 
Extract of Smart-weed is a valuable carminative and aromatic 
stimulant, and has been employed with marked success in all 
diseases in which this class of remedies is required. 

( ATHAR'ITCS. 

Cathartics, or Purgatives are medicines which act upon tlie 
liowels and increase the secretions and evacuations. In many 
parts of the country, these agents are known as purges, or 
physics. They have been variously divided and sub-divided, 
usually with reference to the energy of their operations or the 
character of the evacuations produced. 

Laxatives, or Aperients, are mild cathartics. I'urgatives act 
with more energy and produce several discharges which are of 
a more liquid character and more copious than the former. 

Drastics are those cathartics which produce numerous evacua- 
tions accompanied by more or less intestinal irritation. 

Hydra^ogues are those purgatives which produce copious, 
watery discharges. 

Gholagogues are those purgatives which act upon the liver, 
stimulating its functions. Cathartics constitute a class of 
remedies which are almost universally employed by families and 
physicians. 

Jalap {Ipomoe.a Jalapxi). The root is used. It is a drastic 
and a hydragogue cathartic. Formerly it was combined witli 
(iqual parts of calomel. From this fact it received the name of 
"ten and ten." Dose — Of the powder, five to twenty grains; 



CATHAKTICS. 



827 



of the fluid extract, ten to fifteen drops; of the solid extract, 

two to four grains; of the concentrated 

principle, Jalapin, one-half to two T^iq. IW. 

grains. 

Oambo^e {Gambogia). The gum 
is used. Gamboge is a powerful 
drastic, hydragogue cathartic, which is 
apt to produce nausea and vomiting. 
It is employed in dropsy. It should 
never be given alone, but combined 
with milder cathartics. It accelerates 
their action while they moderate its 
violence. Dose — Of the powder, one- 
half to two grains. This substance 
combined with aloes and sometimes 
with scammony, constitutes the basis 
of the numerous varieties of large, 
cathartic pills found in the market. 

Clllver's-root. ' {Leptandra Vir- 
ginica). The root is used. This plant, 
known under the various names of Cul- 
ver's Physic, Black-root, Tall Speedwell, 
and Indian Physic, is a certain chola- 
gogue, laxative, and cathartic. Dose — 
Of decoction, one to two fluid ounces; 
of fluid extract, ten to twenty drops; of 
tincture, twenty to thirty drops; of the 
concentrated, active principle, Leptan- 
drin, which is but feebly cathartic, as a 
laxative, two to five grains. 

Rhubarl) [Rheum Palmatuni). 
This is much used as a domestic 
remedy, and by the profession, for its 
laxative, tonic, and asti'ingent effects. 
It is employed in bowel complaints. 
Dose — Of the powder, ten to thirty Cuiver's-root. 

grains; of the tincture, one-half to two 

teaspoonfuls; of the fluid extract, ten to thirty drops; of the 
solid extract, three to five grains; of the syrup, and aromatic 




H28 COMMON SKNSE MKUIOAL AUVISEK. 

syrup, au excellent remedy for children, one-half to one 
teaspoonful. 

Cascara 8agracla {Rhamnus J^urshiana), is a very effi- 
cient remedy in chronic constipation. Dose — Of the fluid 
extract, from ten to twenty drops taken in a tablespoonful 
of water. The unpleasant taste may be disguised with the 
extract of liquorice. 

Castor Oil ( Oleum JRicini). Dose — From one to four 
teaspoonfuls. It may be disguised by rubbing it with an equal 
quantity of glycerine and adding one or two drops of oil of 
anise, cinnamon, or wintergreen. 

Blltteriliit {Juglans Cinerea). The bark is the part used. 
Butternut is a mild cathartic, which resembles rhubarb in its 
property of evacuating the bowels without irritating the 
alimentary canal. Dose — Of the extract, as a cathartic, five to 
ten grains; of the fluid extract, one-half to one tea-spoonful; 
of the concentrated principle, Juglandin, one to three grains. 
As a laxative, one-half of these quantities is sufficient. 

Aloes {Aloe). The gum is used. This cathartic acts upon 
the lower part of the bowels and sometimes causes piles; 
though some late authors claim that in small doses it is a valu- 
able remedy for piles. Dose — In powder or pill, three to ten 
grains; as a laxative, one to three grains. 

Epsom $alts {Magnesia Suljyhas). Its common name 
is " Salts." Much used in domestic practice. Dose — One- 
fourth to one-half ounce. 

Dr. Pierce's Pleasant Pnrg^ative Pellets are 
BO compounded from concentrated, active principles, extracted 
from cathartic roots and herbs, as to combine in a small granule, 
scarcely larger than a mustard seed, as much cathartic power 
as is embodied in any larger pill found for sal(j in the drug 
stores. They are not only pleasant to take, but their operation 
is easy, producing no griping pain or other unpleasant effect. 
From their wonderful cathartic power in proportion to their 
size, people who have not tried them are apt to suppose that 
they are harsh or drastic in effect, but such is not at all the 
case ; the different active, medicinal principles of which they are 
composed are so modified by one another, as to produce a most 
searching and thorough, yet gently operating cathartic. 



CATHARTICS. 329 

We have offered a standing reward to any chemist wlio, upon 
analysis, will find in them any calomel or other form of 
mercury, or any other mineral poison or injurious drug. 

Unlike other cathartics, they do not, after their operation, 
have a secondary tendency to render the bowels more costive. 
This is an important improvement. Every one who has ever 
taken pills or other cathartics for the purpose of overcoming 
constipation, knows that the secondary effect of all such medi- 
cines has been " to render a bad matter worse." These Pellets, 
unlike every other cathartic, produce such a secondary tonic 
effect upon the bowels as to bring about a permanently healthy 
action and increase their peristaltic motions. Hence their great 
value, perseveringly taken in small doses daily, in habitual con- 
stipation and in piles, attended and caused, as they generally 
are, by torpor of the liver and costiveness. They act power- 
fully in arousing all the secretions, especially those of the 
liver, in relieving congestion or inflammation, and in producing 
upon that organ, as well as upon the bowels, a secondary tonic, 
and, hence, a permanently beneficial effect. Being entirely vege- 
table, no particular care is required while using them. They 
operate without disturbance to the constitution, diet, or occu- 
pation. Age does not damage them, as they are so prepared 
as to readily dissolve in the stomach, and, being sugar-coated 
and inclosed in glass bottles, their virtues are preserved for 
any length of time in any climate, so that they are always 
fresh and reliable. This is not the case with the pills found 
in the drug-stores, put up in wooden or paste-board boxes which 
allow them to dry and harden until they are nearly, if not 
quite insoluble in the stomach, or else have lost most of their 
virtues from long exposure to the atmosphere. No pains or 
expense will ever be spai'ed to make the Pellets perfect, and 
to keep up their high standard of excellence. 

Dose — For a thorough cathartic, take from four to six, regu- 
lating size of dose, or number of pellets, according to the suscep- 
tibility of the system to the influence of cathartic medicines. 
If for a child, administer from one to three or four, according 
to age. Evening is the best time for taking them, as they 
do not operate by irritating the stomach and bowels, thus 
rushing through at railroad speed, but take twelve, and, in rare 



380 COMMON SKNSE MJiDIOAT, ADVISKR. 

cases, twenty-four hours to move the bowels, which they 
accomphsh in a physiological manner. They are dissolved 
in the stomach and absorbed directly into the blood. They 
stimulate the flow of bile from the liver, and arouse all the 
glandular secretions, which, being poured into the bowels, 
increase their peristaltic action. In this way, the blood itself, 
as well as the stomach and bowels, is purged and cleansed of its 
impurities. Cathartics which operate speedily produce an irrita- 
tion of the stomach and bowels, causing a flow of serum and 
mucus into them, which runs off from the bowels in watery 
discharges. They never enter the circulation, never act upon 
the liver, do not arouse the secretions, or purify the blood, but 
tend only to shock, and thus debilitate the system, and the 
patient soon finds the function of the bowels destroyed, and 
constipation resulting as the secondary effect of the irritation 
thus produced. Hence, jalap and senna, aloes, scammony, castor 
oil, croton oil, gamboge, elateriura, or Epsom salts, should not 
be taken with the idea that any good effect is going to be 
produced upon the blood, liver, or other glands, as their mode 
of operating precludes such an effect. 

Dr. Pierce's Pleasant Purgative Pellets, on the other hand, 
act upon the bowels, only by taking time to enter the blood, 
and arouse the secretions. Hence, when the bowels are moved 
after a dose of Pellets, we Tcnoxo positively that the liver and 
other glands have been aroused to increased action; and this 
belief is confirmed by the laxative effect of the secretions 
after the operation of the cathartic, which can be best appre- 
ciated by those who suffer from constipation or piles, and 
who have been accustomed to taking other cathartics. 

After taking a cathartic dose of Pellets, if it is desired to 
increase their purgative action, common salt should be eaten 
plentifully. Salt is also a good remedy for the slight nausea, 
griping, or other disagreeable symptoms, wliich ai-e sometimes, 
though i^ery rarely^ produced by the acrid and irritating 
matters dislodged by the Pellets. No such disagreeable symp- 
toms arise after taking the Pellets, unless the system is very 
foul, torpid, and obstructed, as they are so compounded as to 
guard against all such unpleasant effects. 

The greatest benefit is derived in all bilious derangements. 



COUNTER-IRRITANTS, 331 

not by strong cathartic doses, but by small alterative doses, 
continued for several days, say one to three Pellets a day, 
or just enough to keep the bowels slightly relaxed. 

As a promoter of digestion, take one or two after dinner. 

In all chronic or lingering diseases, it is of the utmost im- 
portance to keep the bowels regular, yet severe purgation 
should be avoided, as it tends to debilitate the system by the 
shock which is thus produced. 

Small laxative doses, by their mild but continuous tonic and 
alterative effect, taken daily and continued for a long time, is 
the course which we would recommend as calculated to pro- 
duce the best results. 

CAUSTICS. 

Caustics are substances which have the power of destroying 
or disorganizing animal structures. By their action they destroy 
the tissue to which they are applied, and form a crust, which is 
thrown oif by a separation from the parts beneath. Their 
caustic property may be destroyed by dilution with other 
substances, to such an extent that they will only irritate or 
stimulate, and not destroy. Much care is necessary in their 
employment, and it is not expected that the unprofessional 
reader will have much to do with, them; hence, we have deemed 
it best not to give a list of these agents, 

COUNTER-IRRITANTS. 

Counter-irritants are substances which produce irritation of 
the part to which they are applied, varying in degree from a 
slight redness to a blister or pustule. They are applied to the 
surface with a view of producing an irritation to relieve irri- 
tation or inflammation in some other or deeper seated part. 
They are a class of agents which we very seldom employ, and, 
hence, we shall notice only a couple of the most simple. 

mustard {Sinapis). The flour of mustard, which is best 
adapted foi- domestic use, is employed in the form of a paste 
spread on cloth. It takes effect in a few moments ; the length 
of time it remains in contact with the skin and the strength of 
the mustai-d determine the effect producetj. 

Horse-radish {Cochlear la Armorada). The leaves are 



382 



COMMON SKNSK MEDICAL ADVISKR. 



the parts used. Let them wilt and bind them on tlie part 
affected. They act nearly as energetically as mustard. 

DIAPHORETICS. 

Diaphoretics are medicines Avhich increase perspiration. Those 
which occasion profuse sweating are termed Sudorifii-s. The 
two terms indicate different degrees of the same operation. 
They constitute an important element in domestic pi'actice, on 
account of the salutary effects which generally follow their 
action. Tlieir operation is favored by Avarmth externally, and 
warm drinks, wlien they are not given in hot infusion. 

Pleurisy-root {Asclepias Tuherosa), is also known as 

Fig. mi. 




Plfurisy-root. 



White-root, and Buttprliy-weed. It is a valuable remedy, well 
adapted to break uj) inflammations and diseases of the chest. 



DIAPHOKJETICS. 



333 



Dose — Of infusion, one to two ounces; of fluid extract, one- 
fourth to one-half teaspoonful; of the concentrated principle, 
Asclepin, one to three grains. 

!$alil*Oll {Crocus Sativus). Golden Saffron. Dose — Of 
infusion (one drachm to a pint of water), one to two ounces. 

Sage (Salvia Officinalis). The warm infusion drunk freely 
is a valuable, domestic diaphoretic. 

I'irginia 8nake-root (Aristolochia Serpentaria), is an 

Fig. 128. 




Virginia Snake-root. 



efficient agent. Dose — Of infusion, one to two ounces; of 
tincture, one-fourth to one teaspoonful; of fluid extract, one- 
fourth to one-half teaspoonful.. 



384 



COMMON SENSK MBDIOAL ADVISER. 



Jaboraildi [I^hcarpus Pimiatus). Jaborandi increases 
the flow of saliva, causes profuse perspiration, and lowers the 
temperature of the body. In doses of from twenty to sixty 
drops of the fluid extract, administered in a cup of warm water 
or herb-tea on going to bed, we have found it very effectual for 
breaking up recent colds. We have also found it valuable in 
wliooping-cough, in doses of from three to ten drops, according 
to the age of the child, given three or four times a day. Tlie 
fluid extract may be obtained at almost any drug-store. 

jnay-"Weed {Maruta C'oHtla), is also known as Wild 




May-flower. 



Chamomile, and Dog-fennel. It is not much used, though it 
is a powerful diaphoretic. Dose — Of infusion, one to two 



Catnip (Nepeta Oataria). A desei-vedly popular, domestic 



DILUENTS. 335 

remedy, always acceptable, and certain in its action. The warm 
infusion is the best form for its administration. It may be 
drunk freely. 

Oillger {Zingiber Officinale). The hot infusion may be 
sweetened and drunk as freely as the stomach will bear. 

Dr. Pierce's Compound Extract of Smart- 

iveed. This is unsurpassed as a diaphoretic agent, and 
is much more certain in its operation than any simple dia- 
phoretic. 

DILUENTS. 

Any fluid which thins the blood or holds medicine in solution 
is called a diluent. Pure water is the principal agent of this 
class. It constitutes about four-fifths of the weight of the 
blood, and is the most abundant constituent of the bodily tis- 
sues. Water is necessary, not only for digestion, nutrition, 
and all functional processes of life, but it is indispensable as 
a menstruum for medicinal substances. It is a necessary agent 
in depuration, or the process of purifying the animal economy, 
for it dissol\es and holds in solution deleterious matter, which 
in this state may be expelled from the body. In fevei's, water 
is necessary to quench the thii-st, promote absorption, and in- 
c\te the skin and kidneys to action. Its temperature may be 
varied according to requirements. Diluents are the vehicles 
for introducing medicine into the system. We shall briefly 
mention sonie which prove to be very grateful to the sick. 

Various Tcg^etable acids and jellies may be 

dissolved in water, as apple, currant, quince, grape, or cran- 
berry. 

The juice of lemons, oranges, pine-apples, 

and tamarinds, is also found to be refreshing to fever 
patients. 

Sassafras-pith, slippery-elm bark, flax-seed, 
and g^UlU arable make good mucilaginous di-inks for 
soothing irritation of the bowels and other parts. 

Orei¥ers' yeast mixed with water in the proportion of 
from one-eighth to one-fourth is a stimulant and antiseptic. 

The irhite ashes of hickory or maple wood 

dissolved in water make an excellent alkaline drink in fevers, 
or whenever the system seems surcharged with acidity. 



336 



COMMON SENSE MEDICAL ADVISER. 



DIURETICS. 

Diuretics are medicines which, by their action on the kidneys, 
increase the flow of urine. 

JUarsh-malloW {Althea Officinalis), is used in irritable 

Fig. ISO. 




Mai'sh-mallow. 



conditions of the urinary organs. The infusion may be drunk 
freely. 

OraTel-plant {F^igea JRepens), is also known as Water- 
pink, Trailing-arbutus, or Gravel-root. Dose— Of decoction of 



DIURETICS. 



:^a7 



the plant, one to three ounces ; of fluid extract, one-fourth to 
one-half teaspoonful. 

Stoiie-root {Gollhisonia Canadensis), is also knoAvii as 
Knot-root, Horse-balm, Rich-weed, or Ox-halm. This is a mild 
diuretic, slow in action, yet effective in allaying irritation of the 




stone-root. 

bladder. The root is the part used. Uose — Of infusion, one to 
two ounces; of fluid extract, five to ten drops; of the concen- 
trated principle, Collinsonin, one-half to one grain. 

Foxg^love [Digitaliti purpurea) slows the action of the 
15 



iiH8 COMAIUN SENSE MEDICAL ADVISER. 

heart, lowers the temperature, and acts indirectly as a diuretic. 
It is especially valuable in the treatment of scarlet fever and 
in dropsy. Dose — Of infusion, one-half drachm to one-half 
ounce; of the fluid extract or strong tincture, from two to 
ten drops. It should be used with caution. A poultice made 
of the leaves and placed over the kidneys is an effectual method 
of employing the drug. 

Queen of the Meadow' {Eupatorium Purpureum), is 
also known as Gravel-weed, Gravel-root, or Trumpet-weed. This 
is a most valuable diuretic. Dose — Of the infusion, one to 
three ounces; of fluid extract, one-fourth to one-half teaspoon- 
ful; of the concentrated principle, Eupatorin (Purpu), one-half 
to two grains. 

Buchll {Barosma Crenata). The leaves are used. This 
agent has been extensively employed, generally in compounds.' 

Dose — Of infusion, (steeped for two hours or more) one to 
two ounces; of fluid extract, the same; of the concentrated 
principle, Barosmin, one to three grains. 

PipsisseWJl [Chimaphila Umhellata), or Prince's Pine. 
This is a tonic to the kidneys, as well as a diuretic and altera- 
tive, and is a mild, but very efficient remedy. Dose — Of de- 
coction, one ounce from four to six times a day; of fluid extract, 
one-fourth to one-half teaspoonful; of the concentrated prin- 
ciple, Chimaphilin, one to two grains. 

Waler-iiielon Seeds {Cucurhita Citrullns). Dose — Of 
infusion, the patient may drink freely until the desired effect is 
secured. 

Pailipkin Seeds {Gncurhita Pepo). They are mild, 
unirritating, yet effective diuretics. An infusion of these may 
be drunk freely. 

Sweet Spirit of Witre {Spiritus ^theris Mtros), 
is diuretic and anodyne. Dose — One-fourth to one-half tea- 
spoonful, diluted in water, every two or three hours. 

Saltpetre {Potassce Nitras). Dose — Powdered, Ave to 
ten grains. 

ytcetate of Potasli {Potassm Acetas). />o.se— Ten to 
fifteen grains, largely diluted in water. It is more frequently 
used for this purpose than the nitrate. It is a most valuable 
diuretic. 



. EMETICS. 339 

EMETICS. 

These are medicines which cause vomiting and evacuation of 
the stomach. Some of the agents of this class, tenned irritant 
emetics, produce vomiting by a local action on the stomach, and 
do not affect this organ when introduced elsewhere. Others, 
which may be termed systemic emetics, produce their effects 
through the nervous system, and, therefore, must be absorbed 
into the circulation before they can produce vomiting. In cases 
of poisoning, it is desirable to empty the stomach as quickly as 
possible, hence irritant emetics should be employed, fo^ they act 
more speedily. Draughts of warm water favor the action of 
emetics. 

Mastard (Sinapis) acts promptly and efficiently as an 
emetic, and may be employed in poisoning. Dose — From one 
to two teaspoonfuls of powdered mustard, stirred up in a glass 
of tepid water. It should be quickly swallowed and diluents 
freely administered. 

Sulphate of Copper {Cupri jStdphas) is a prompt, 
irritant emetic. It should be given in doses of ten grains 
dissolved in half a glass of water, and its action assisted by the 
free use of diluents. 

I^nlphate of* Zinc {Zinci Sulphas) is similar in its 
effects to sulphate of copper, but less powerful, and may be 
taken in the same manner, and tlie dose repeated if necessary in 
fifteen minutes. 

Yellow Subsnlphate of Mercury {Hydrargyri 
Sulphas flava), commonly known as Turpeth Mvieral, is an 
efficient and most desirable emetic in membranous croup. It is 
an active poison, but, as it is quickly thrown up with the con- 
tents of the stomach, there is no danger from its administration. 
Dose — It should be given to a child in doses of from three to five 
grains, in the form of powder, rubbed up with sugar of milk. 

Ipecac ( Cephaelis Ipecacuanha). In large doses Ipecac is 
a systemic emetic. In small doses, it exerts a specific influence 
upon the mucous membranes, relieves nausea and irritation, and 
subdues inflammation. In cholera infantum it is an invaluable 
remedy, if given in very small doses. By allaying irritation of 
the stomac.. and restoring tone and functional activity to it and 



340 



COMMON SENSE MEDICAL ADVISER. 



the bowels, it gradually checks the discharges and brings about 
a healthy condition. It is also valuable in dysentery, and is 
borne in large doses. As an emetic the dose is, of powder, five 
to ten grains in waiin water; of fluid extract, ten to twenty 
drops. 

liObeliu (Lobelia Tnjiata), Horaetimes known as Indian 

Fig. J^'Ji. 




Lobelia. 



Tobacco, or Emetic-weed. The herb and seeds are used. This 
is a powerful, systemic emetic but very depressing. lJo.se — Of 



KMMENAGOGUE8. 



341 



the powdered leaves, fifteen to twenty grains; of the infusion, 
one to three ounces; of the fluid extract, ten to fifteen drops, 
Boiie^et {Eupatorimn Perfoliatimi). Dose — Of the warm 
infusion or decoction, two to three ounces; of the fluid extract, 
one teas])oonful in hot Avater: of the concentrated principle, 
Eupatorin, two to five grains. 

EMMENAGOGUES. 

Emnienagogue is a term applied to a clas.s of medicines whicli 
have the power of favoring the discharge of the menses. We 
shall mention only a few of those which are best adapted to 
domestic use. 

Pennyroyal {Hedeoma Pulegioides). Pennyroyal, used 
freely in the form of a warm infusion, promotes perspiration 
and excites the menstrual discharge when 
recently checked. A large draught of 
the infusion should be taken at bed-time. 
The feet should be bathed in warm water 
previous to taking the infusion. 

Black Cohosh {Cimio.ifuya Mace- 
inosa). Black Cohosh, known also as 
Black Snake-root, is an effective remedy 
in uterine difticulties. Dose — Of the 
tincture, twenty drops; of the fluid ex- 
tract, ten drops. 

Xansy [Tanacetum VaUfare). Tansy 
is beneficial in suppressed menstruation. 
Dose — Of the infusion, from one to four 
fluid ounces. 

Ergot {Secale Corntituvi) in very 
small doses acts as an emmenagogue, and 
in large doses it checks hemorrhage. The 
dose as an emmenagogue, of the fluid 
extract, is from two to five drops, and 
to arrest hemorrhage, from half a drachm to two drachms, 
I'epeated in from one to three hours. 

Iiif<B-root (Senecio Gracilis.) Life-root exerts a peculiar 
influence upon the female reproductive organs, and for this 
reason has received th« name of Female Regulator. It is very 




Pennyroyal. 



342 COMMON SENSE MEDICAL ADVISER. 

efficacious in promoting the menstrual flow, and is a a aluable 
agent in the treatment of uterine diseases. Dose — Of the 
decoction, four fluitl ounces three or four times a day; of the 
fluid extract, from one-fourth to one-half teaspoonful. 

Motherwort {Leonurus Canlkicd). MotherAvort is 
usually given in warm infusion, in suppression of the menses 
from cold. Dose — Of the decoction, from two to three fluid 
ounces every one or two hours. 

Dr. Pierce's Favorite Prescription is an efti- 
cient remedy in cases requiring a medicine to regulate the 
menstrual function. Full directions accompany every bottle. 

Dr. Pierce's Compound Extract of l^uiart- 
weed is an excellent emmenagogue. Dr. Eberle, a very 
celebrated, medical "writer, and. author of a work on medicine 
which is very popular with the profession, says that he has used 
the "Extract of Smart-weed" in twenty cases of amenorrhea 
(suppressed menstruation), and aftirms "with no otlier remedy 
or mode of treatment have I been so successful as with this." 
Full directions accompany every bottle. It is sold by all 
druggists. 

EXPECTORANTS. 

Expectorants are medicines which modify the character of the 
secretions of tlie bronchial tubes, and promote their discharge. 
Most of the agents of this class are depressing in their influence 
and thus interfere with digestion and healthy nutrition. Their 
application is very limited, hence we shall dismiss them without 
further consideration. 

LINIMENTS. 

Liniments are medicines designed for external application. 
The benefits arising from their use depend upon their derivative 
f)Ower, as well as upon the anodyne properties which many of 
them possess, rendering them eflicacious for soothing pain. We 
cannot mention a more valuable agent of this class than 

Dr. Pierce's Compound Extract of 8mart- 
weed. As an external application this preparation subdues 
inflammation and reheves pain. For all wounds, bruises, sprains, 
bee-stings, insect and snake-bites, frost-bites, chilblains, caked 
breast, swollen glands, rheumatism, and, in short, for any and 



NARCOTICS. 34.3 

all ailments, whether afflicting man or beast, requu-ing a direct 
external application, either to allay inflammation or soothe pain, 
the Extract of Smart-weed cannot be excelled. 

NARCOTICS. 

A narcotic is a remedy which, in medicinal doses, allays 
morbid sensibility, relieves pain, and produces sleep; but which, 
in overdoses, prodiaces coma, convulsions, and death. The quan- 
tity necessary to produce these results varies in different individ- 
uals. We shall mention a few of those most frequently employed. 

Henbaiie {Ili/oscyaiaus Niger). The leaves and seeds ar* 

Fly. ISJf. 




Henbane. 



used. Henbane, in large doses, is a powerful narcotic and 
dangerously poisonous. In medicinal doses, it is anodyne and 
antispasmodic; it allays pain, induces sleep, and arrests spasms. 



844 



CO&iMOl^ SENsU MKWOAL AbVlsKR. 



l)ose — 01' the fluid extract, live ti> ten drops; of the solid extract, 
trom one-half to one grain; of the concentrated ])rinciple, 
Hyoscyamin, from one-twelfth to oue-fourth of a grain. 

Indian Hemp {Cannabis Indica). An East Indian 
plant. Doxe — Of tlie extract, from one-fonrth to one-half grain; 
of the tincture, from three to eight drops; of the Huid extract, 
from two to five drops. The plant known as Indian Hemp, 
growing in this country, possesses very different qualities. 

^tranionillin {Datura Strammimni). Stramonium, also 

Fu/. U5. 




Stramonium. 



known as Tliorn-apple, in large doses is a powerful narcotic 
poison. In metlicinal doses it acts as an anodyne and antispas- 
modic. Dose — Of extract of the leaves, from one-half to one 
grain; of the fluid extract, from three to six drops. 



NERVINES 



34.5 



NERVINES, 

These are medicines which act on the nervous system, sooth- 
ing excitement and quieting tlxe condition known as ** nejv- 
ousness." 

Hops [Himiulus Lupuhis). Dose — Of infusion, one to 
thi'ee ounces; of the fluid extract, one-fourth to one-half teaspoon- 
ful of the concentrated princijile, Humulin, two to three grains. 

)Scull-Cap {HauteUaria Lateriolin). The herb is used. 




Scull-cap 

It is also known as Mad-dog Weed. This is a valuable 
remedy. Dose — Of infusion, one to two ounces, of the fluid 
extract, ten to twenty drops; of the concentrated principle, 
Scvtdlarin, one to two grains. 
liftdy's Slipper {Cypripedium Piihescens) The root is 



H4<i COMMON SiiNSE MEDICAL ADVISEK. 

used. Dose — Of the infusion, one-lialf to one-ounce; of the 
fluid extract, one-fourth to one-half teaspoonful; of the con- 
centrated principle, Cypripodiu, one to two grains. 

Pllliiatilla {Pulsatilla Nigricans). We employ the German 
tincture, prepared from the green herb. In many of the dis- 
tres8ing nervous complications to which both males and females 
are subject in certain diseases of the generative organs, we 
have found it very effectual. The dose is from two to eight drops. 

Dr. Pierce's Favorite Prescription. This is a 
tonic nervine of unsurpassed efficacy, combined in such a 
manner, that, while it quiets nervous irritation, it strengthens the 
enfeebled nervous system, restoring it to healthful vigor. In 
all diseases involving the female reproductive organs, with 
which there is usually associated an irritable condition of the 
nervous system, it is imsurpassed as a remedy. It is also a 
uterine and general tonic of great excellence. It is sold by all 
druggists. 

SEDATIVES. 

Sedatives are a class of agents which control excitation of the 
circulation, and diminish irritability of the nervous system. 

Aconite {Aconitum Napellxii). The parts used are the root 
and leaves. Aconite slows the ])ulse, diminishes arterial tension, 
and lowers the temperatuie of the body in fevers. It is an 
effectual remedy in acute inflammation of the tonsils and 
throat, in acute bronchitis, in inflammation of the lungs, and 
pleurisy, in the hot stage of intermittent and remittent fevers, 
in the eruptive fevers, in fever arising from a cold, and in some 
forms of neuralgia. Acute suppression of the menses from a 
cold, may be relieved by the tincture of aconite in drop doses 
every hour. Dose — Of the tincture of the root, from one-half 
of a drop to two drops, in a spoonful of water. In acute 
fevers and inflammations, from one-half drop to one drop 
should be administered every half hour or hour, according to 
the severity of the symptoms. 

Peach Tree {Amygdalns Persica). Peach tree leaves 
and bark are slightly sedative, but the chief use which 
we have found for these articles is to control nausea and 
vomiting arising from irritability of the stomach. It also 
possesses mild, tonic properties. Dose — Of infusion of the 



SEDATIVES. 347 

bark of the small twigs or of the leaves, from two to six 
teaspoonfuls. 

American Hellebore ( Veratrum Viride) is also known as 

Fly. 1S7. 



American Hellebore. 



White Hellebore, Indian Poke, or Swamp Hellebore. The root 
is the part used. It is a most valuable agent with which to 



J) 4 8 OOMMON SENSfi MEDICAL AbVlSJCtt. 

control the frequent, strong, bounding pulse common to many 
febrile and inflammatory diseases. When the pulse is hard, in- 
compressible, and bounding, this remedy is more effectual than 
aconite. Dose — Of the tincture and fluid extract, from one 
to two drops, repeated every half hour to two houi-s, according 
to the severity of the symptoms. This remedy should be given 
in very small doses, frequently repeated, if we would secure 
its best effects. Our favorite mode of administering both 
veratrum and aconite is to add ten drops of the tincture to ten 
or fifteen teaspoonfuls of water, of which one teaspoonful may 
be administered every hour. 

Yellow JessaillillC {Geheminum Sempervirens). The 
root is the part used. Through its controlling effect over 
the sympathetic nervous system, this agent exeits a marked 
influence in controlling morbid excitability of the circulatory 
organs. It allays irritation, and determination of blood to 
the brain, indicated by flushed face, contracted pupils, inita- 
bility, and restlessness, a frequent condition in diseases incident 
to childhood. Its concentrated principle, Gelsemin, is an efli- 
cient remedy in bloody-flux or dysentery. It should be admin- 
istered in very small doses to secure the best results. Only 
one-sixteenth to one-eighth of a grain is required, repeated 
every two hours. It should be triturated with sugar of milk 
or with common white sugar, in the proportion of one grain to 
ten of sugar. Dose — Of tincture, from five to fifteen drops; 
of fluid extract, three to six drops; of Gelsemin, as a sedative, 
one-fourth to one-half grain. 

STIMULAN1\S. 

Stimulants are medicines which have the power of increasing 
the vital activity of the body. Some have a very transient 
action, while others are more permanent in effect. 

Cayenne Pepper ( Capsicum Annuum). Cayenne Pepper 
is a powerful stimulant. Dose — Of the powder, from one to 
six grains, administered in milk; of the tincture, from five to 
ten drops, largely diluted in milk or water. 

Black Pepper {Piper Nigrum). Black Pepper is a 
warm, carminative stimulant. Dose — From five to fifteen 
grains; of the fluid extract, from ten to fifteen drops. 



STIMULANTS. 



349 



Prick ly-asll {XantJioxtjlwn Fraxineum). Priekly-ash 
bark is a stimulant and tonic. The parts used are the bark 
and leaves. Dose — Of the fluid 

extract, from five to fifteen Fa/. 1S8. 

drops; of the tincture, ten to 
twenty drops; of the active 
principle, Xanthoxylin, one to 
two grains. 

Alcohol is a powerful 
stimulant. It is never used in 
its pure state in medicine, but 
when diluted forms a useful 
i-emedy in many diseases. It 
is generally employed in the 
form of whisky, gin, rum, 
brandy, and wine. 

AuilllOUia is an excel- 
lent stimulant. Dose — Of the 
carbonate, from three to five 
grains; of the sesquicarbonate, 
from five to ten grains; this is 
the same as the carbonate, 
which has been exposed to the 
air and slacked (powdered 
hartshorn); of the aromatic 
spirit, from one-half to one tea- 
spoonful. The Aqua Ammonia 
and Liquor Ammonia are of 
such variable strength that they 
are seldom employed internally, 
but may be applied externally 
and taken by inhalation. 

Dr. Pierce'§ Compound Extract of iSniart- 
weed. This quickly diffusible stimulant and genial anodyne 
we have spoken of under the head of Anodynes. But its 
medicinal properties equally entitle it to a place and mention 
under the class of stimulants. As a stimulant it spurs the 
nervous system and arouses the circulatory forces. Congestion 
of the lungs, liver, bowels, or uterus, embarrasses the functions 




Prickly-asli 



350 



COMMON SENSE MEDICAL ADVISEK. 



Fhl. 139. 



of these organs. Frequently this congestive dithculty may be 
entirely obviated, and the circulation of the blood restored to 
the surface of the body, by the administration of a few doses 
of this pleasant remedy. Thus it often acts like magic in 
giving relief, promoting the circulation, and restoring the organs 
to their accustomed functional activity. Full directions accom- 
pany every bottle. 

TONICS. 

Tonics are remedies which moderately exalt the energies of 
all parts of the body, without causing any deviation of healthy 
function. While stimulants are transient in their influence, 
tonics are comparatively permanent. 

White Poplar {Liriodendron Tidipfera), called also 
American Poplar, or White Wood. Tiie 
part used is the inner bark. This is a 
mild but valuable tonic for domestic use. 
Dose — Of the infusion, from one-half to 
one ounce; of tincture, from one to two 
teaspoonfuls. 

ClianiOlllile {Anthemis Nohilis). 
The part used is the flowers. This 
is a mild, unirritating tonic. Dose — Of 
infusion (one -fourth ounce of flowers 
to a pint of water) one-half to one 
ounce. 

Oeiltian {Gentiana Luteci). The 
root is the part used. This is a favoi-ite 
domestic tonic in many localities. Dose 
— Of powdered root, five to ten grains; 
of the tincture, ten to twenty drops; of 
the fluid extract, five to ten drops, four or five times a day. 

IVUX Vomica {Strychnos Niix Vomica), or Dog Button. 
This is a powerful tonic. It increases innervation and is 
particularly valuable in cases marked by feeble circulation and 
general impairment of muscular power. In overdoses it is 
poisonous, and hence must be employed with much caution. 
Dose — Of the tincture, three to five drops; of the fluid extract, 
one to three drops. 




^Vhite Poplar. 



TONICS. 851 

liVillovr {Salix Alba). Willow is a tonic and an astrin- 
gent. Dose — Of the decoction, from one to two fluid ounces; 
of the concentrated principle, Salicin, from two ta four 
grains. 

Dogwood {Cornus Florida). Dogwood, also known as 
Boxwood, is tonic, astringent, and slightly stimulant. Dose — 

Fi(/. 140. 




Dogwood. 

Of the solid extract, from three to five grains; of the infusion, 
from one to two ounces; of the fluid extract, from ten to twenty 
drops. 

"Wafer-ash {Ptelea Trifoliata), also called Swamp Dog- 
wood. The bark is used. This is a pure, unirritating tonic. 
Dose — Of tincture, one-half to one teaspoonful; of fluid extract 
ten to twenty drops; of the infusion, one to two fluid ounces. 



852 



COMMON SENSE MKDIOAL ADVISER. 



Golden Seal {Hydrastis Canadensis). Golden Seal is a 
powerful and most valuable tonic. It is a valuable local remedy 
when used as a general injection in leucorrhea. Dose — Of the 




Golden Seal. 

powder, from ten to thirty grains; of the tincture, from one- 
half to one fluid drachm; of the fluid extract, from ten to 
twenty drops; of the concentrated principle, Hydrastin, from 
two to three grains; of the muriate of hydrastia, from one-half 
to one grain. 



TONIOS. H5?, 

American C'oloillbo {Frasera CaroUnensls). Auierican 
Colombo is a simple tonic. Dose — Of the powdei'erl root, from 

Fiy. IJ^. 




Amerloai) Colombo. 



ten to fifteen grains; of the infusion one-half to one fluid 
ounce, three or four times a day; of the active principle, 
Fraserin,-one to three grains. 



354 



COMMON SENSE MEDICAL ADVISER. 



Oolfl Thread {Coptis Tri folia). Gold Thread is a pure 
and powerful, bitter tonic, and is also efficacious as a wash for 
sore mouth or as a gargle. Dose — Of the decoction, from two 

Fig. US. 




Gold Thread. 

to si.v fluid drachms; of the tincture, from one-half to tAvo 
teaspoon tuls; of fluid extract, from ten to twenty drops. 

Iron {Ferrum). Different preparations of iron are fre- 
quently prescribed by physicians. They are particularly 
valuable in anemic conditions of the system. The following 
are a few of the preparations of this metal most generally 
used : 

Iron by Hydrogen {FerH Redactum). Dost — One to 
two grains. 

Carbonate of Iron {Ferri Carbonax). Dose — One to 
three grains. 

Citrate of Iron (Ferri Citras). Dose — One to three 
grains. 

Pyrophosphate of Iron (Ferri Pyrophosphm). Dose 
— One to three grains. 



TONICS. 355 

Tincture of Jllnriate of Iron (Tinctura Ferri 
Chloridi). Dose — Three to twenty drops. 

Dr. Pierce's Favorite Prescription. The Fa- 
vorite Prescription, in addition to those properties already 
described, likewise combines tonic properties. In consequence 
of the never ceasing activities of the bodily organs, the system 
requires support, something to permanently exalt its actions. In 
all cases of debility, the Favorite Prescription tranquilizes the 
nerves, tones up the organs and increases their vigor, and 
strengthens the system. Directions for use accompany every 
bottle. 

Dr. Pierce's iKolden Medical Discovery. In 
addition to the alterative properties combined in this com- 
pound, it possesses important tonic qualities. While the Fa- 
vorite Prescription exerts a tonic influence upon the digestive 
and nutritive functions, the Golden Medical Discovery acts 
upon the excretory glands. Besides, it tends to retard unusual 
waste and expenditure. This latter remedy tones, sustains, and, 
at the same time regulates the functions. While increasing 
the discharge of noxious elements accumulated in the system, it 
promptly arrests the wastes arising from debility, and the 
unusual breaking down of the cells incident to quick decline. 
It stimulates the liver to secrete, changes the sallow complexion, 
and transforms the listless invalid into a vigorous and healthy 
being. At the same time, it checks the rapid disorganization of 
the tissues and their putrescent change, Avhile it sustains the 
vital processes. It is, therefore, an indispensable remedy in the 
treatment of many diseases. 



CHAPTER lir. 

RATH8 AN!) MOI^rON AS RE- 
MEDIAL AGENTS. 



The remedial etfects ol" bathing are generally underrated. 
This want of appreciation is more often due to the improper 
manner in which it is performed than to an insuffi<^iency of 
curative virtues. The term bathing not only irapiies a clean- 
ing of the body or certain portions of it, but also the a])))lica- 
tion of water in such a maimer as to influence the nervous 
system, and regulate the functiolis of the secretory organs. 
Cleanliness, while it preserves healtVT and promotes recovery, 
has reference only to the hygienic influences of water and not 
to its curative efl^ects. There are sijveral kinds of baths, the 
names of which indicate their character, manner of apj)li«'alion, 
or the part of the body to which they are applied. Among 
others, we have Cold, Cool, l\'nip<'rate. Tepid, Wanii, FTot, 
Hot Air, Russian, Turkish, Vapor, Electric, 8ea, Shower, Sponge, 
Douche, Foot, Sitz, Head, Medicated, Alkaline, Acid, Iodine, 
and Stilphur Baths. Temperature influen(^es the properties 
of any l)ath; thus the sponge, sitz, and alkaline baths may be 
employed warm or cold, according to the effect desired. 

The Cold Bath, used at a temperature of from M)o to 
60- Fahr., is powerfully sedative, and is employed for its tonic 
eftects. If the vital powers are low, or the individual remains 
in it too long (two or three minutes should be the limit), the 
reaction is slow and its effects injurious. While it is highly 
invigorating to robust persons, those who have a low standard 
of vitality should be cautious in its employment. A local bath 
.S56 



BATHS. 357 

ma^ be followed by beneficial results, when a general bath 
would be inadmissible. For these reasons we advise the general 
use of the 

Cool Bath, at a temperature of from 60 « to 75= Fahr. 
If, in any instance, the reaction is slow, we recommend the 

Temperate Bath, at a temperature of from 75 o to 
80© Fahr. The time of remaining in the bath should be regu- 
lated by the strength of the invalid. As a rule, it should not 
exceed three minutes, and the colder the water the less time 
should the patient be immersed. Immediately after emerging 
from any bath, the body should be thoroughly dried and rubbed 
with a moderately coarse towel until a glow is experienced and 
reaction is fully established. The attempt to toughen children 
by exposing them to low temperatures of either air or water, 
cannot be too emphatically condemned. This caution, however, 
does not apply to the employment of moderately cool water 
for ablutions. The cold or cool bath should be taken in the 
early part of the day, but never during digestion. Whenever 
reaction does not follow bathing, artificial means must be 
resorted to, as stimulating drinks, dry warmth, or exercise. 

The Tepid Bath, the temperature of which is from 
85© to 92 c> Fahr., is generally ui^ed for cleansing the body. It 
is prescribed in fevers and inflammatory aflPections for its cool- 
ing effects. It is usually medicated with some acid or alkali. 
The latter unites with the oily secretion of the skin and forms 
a soapy compound easily removed by the water. The tempera- 
ture should be regulated accoi-ding to the vitality of the patient, 
and the bath may be repeated two or three times a day. It 
removes superfluous heat, and keeps the skin in a condition 
favorable for excretion. 

The IVarill Bath, at a temperature varying from 92© to 
98® Fahr., is always agreeable and refreshing. It equalizes the 
circulation and softens the skin, by removing all impurities. 
It moderates pain and soothes the whole system. It does not 
weaken or debilitate the person, but is in every way beneficial. 
It is an efficient, remedial agent in many chronic diseases, con- 
vulsions, spasmodic affections of the bowels, rupture, rheu- 
matism, and derangement of the urino-genital organs. It 
should be employed immediately before going to bed unless 



358 COMMON SENSE MEDICAI. ADVISER. 

urgent symptoms demand it at other times. It may be medi- 
cated or- not, as circumstances require, but should always be 
taken in a warm room. 

The Hot Bath at a temperature of from 98© to 110© Fahr. 
is a powerful stimulant. It excites the nerves, and tlirough 
them the entire system. It causes a sense of heat and a con- 
striction of the secretory organs; but perspii'ation, languor, 
and torpor soon follow. In the sudden retrocession of cuta- 
neous diseases, it restores the eruptions to the surface and gives 
speedy relief. The hot bath may be applied locally when cir- 
cumstances require. 

The Rll!!»!^ian Bath consists in the application of hot 
vapor, at a temperature varying from 112° to 200'= Fahr. 
The patient is first subjected to a moderately warm temper- 
ature, wliich is gradually increased as he becomes inured to it, 
the head being surrounded with cloths wet in cold water. 
Upon emerging from it, the bather is plunged into cold water 
or receives a cool, shower bath. In rheumatic and cutaneous 
diseases, chronic inflammations, and nervous affections, the 
Russian bath is an effective remedy. 

The Turkish Bath is a dry, hot-air bath. The 
bather passes from one a))artment to another, each one being of 
a higher temi)erature than the preceding. He undergoes a 
thorough shampooing, and, although the person may be scru- 
piilously clean, he will be astonished at the amount of effete 
matter removed by this process. The bather then returns 
through the various apartments, and, upon emerging from that 
of the lowest temperature, he experiences a delightful sensation 
of vigor and elasticity. 

As a hygienic agent, the hot-air bath has been constantly 
growing in favor. Its value is now recognized by all physicians 
throughout the world. The judicious use of the Turkish bath 
serves to secure perfect equalization of the circulation. Gland- 
ular activity is increased, elasticity and power given to the 
muscles, and a permanent, stimulating and tonic influence 
imparted to the system, a condition at once conducive to the 
enjoyment and prolongation of life. Dr. Erasmus Wilson, of 
England, says, in a paper read before the London Medical 
Association: "The inhabitant of a large city would live as 



BATHS. 359 

healthy, immured within city walls, as amid the fields and 
meadows of the country. His bath would be to him in the 
place of a country house or horse — it would give him air, 
exercise, freshness, health, and life." 

"The bath that cleanses the inward as well as the outward 
man; that is applicable to every age; that is adapted to make 
health healthier, and alleviate disease, whatever its stage or 
severity, deserves to be adopted as a national institution, and 
merits the advocacy of all medical men; of those whose especial 
duty it is to teach how health may be preserved, and how 
disease may be averted." 

The hot, dry atmosphere of the Turkish bath promotes rapid 
evaporation from the surface of the body, and it is well known 
that rapid evaporation from the surface is a cooling process. A 
person's finger may be frozen in one minute's time, by throwing 
upon it a constant, fine spray of rhigolene or sulj)huric ether. 
The rapid evaporation of the light fluid congeals the liquids of 
the tissues and a film of ice is rapidly formed upon the part. 
In a less intense degree the same cooling process is carried on 
over the whole surface of a person, when in the hot room, or 
sudatorium, of the Turkish bath. The evaporation from the 
surface is so rapid that one can hardly appreciate the profuseness 
of the perspiration going on. The evaporation fi-om the surface 
so rapidly carries off the heat from the body that one finds 
himself able, with little or no inconvenience, to remain in a room 
heated to from 180© to 200© or even 220© Fahr. 

As a hygienic measure to be regularly or occasionally 
employed by persons in fair health, the Turkish or hot dry-air 
bath is far superior to the Russian or vapor-bath. (1.) It 
produces more profuse perspiration, and is therefore more depur- 
ating, or cleansing, in its effects. (2.) It does not relax the 
system, but rather produces a tonic effect, and fewer precautions 
are, therefore, necessary to guard against taking cold after 
employing it. (3.) The Turkish bath can be better ventilated 
than the Russian. While the air is heated to a high tempera- 
ture, it can be readily kept pure by constant changes. In the 
Turkish hot-rooms, or sudatorium, of the Invalids' Hotel and 
Surgical Institute, provision is made for bringing underneath the 
floors a current of fi-esh air from without. This column of 



*^H0 COMMON SENSE MEDICAL ADVISER. 

fresh air is carried under tiie centre of each room where it 
escapes from the conductor, is warmed, and rises into the room, 
from which extraction of air is constantly going on through 
registers opening into tubes, communicating with large ventilated 
shafts which are kept hot, siiramer and winter, to insure a 
draught through them. In this manner, thorough ventilation of 
our Turkish hot-rooms is insured. 

The Turkish bath not only combines a most agreeable luxury 
with a decidedly invigorating aad tonic influence, but also, by 
its stimulating power, induces proper glandular and cellular 
activity, producing a healthy condition. 

Sallowness, tan, and freckles, the result of local or general 
increase of the pigment granules of the skin, soon disappear 
under the stimulating influence and regular use of the Turk- 
ish bath, which causes rapid development of new and trans- 
parent cells. The colored granules are thus gradually re- 
placed and the skin assumes a beautiful clearness and purity 
of appearance, which transcends immeasurably the unhealthy 
hue that follows the frequent employment of the various cos- 
metics. 

The value of an agent which thus iniproves the general 
health, insures immunity from coughs, colds, and other diseases, 
and at the same time produces a healthy and permanent beauty 
of complexion, is at once apparent. The purity of person, per- 
fect circulation, increase of healthy nutrition and glandular 
activity produced by the Turkish bath, serve to make it of 
the most lasting utility. 

The eminent Dr. Madden has said, and his experience is 
confirmed by every regular patron of the bath, that, " Wherever 
the Turkish bath was a national institution the hair of the 
women was peculiarly luxurious and beautiful. I can vouch 
for it that the use of the bath rendered the complexion more 
delicate and brilliant; that the eyes became clearer and 
brighter; all the personal charms were enhanced. I can recom- 
mend no hygienic measure more beneficial or effectual in pre- 
serving the health and an attractive personal appearance." 

Pimples, blotches, eruptions, and other disfigurations of the 
skin are removed by the frequent use of the Tuikish bath, 
leaving the integument smooth and soft. 



BATHS. 



361 



How the Turkish Bath is Administered at the 
InYalid's Hotel and Surgical Institute. The hot- 



Fhj. lU. 




Fii'St Hot-iooiii ul tlie Turkish liath. 



rooms, of which there 
are two, are exactly 
similar in every 
respect except as re- 
gards temperature. 
The first room has a 
temperature of from 
I lOo to 120= Fahr. 
The bather is sup- 
plied by the attend- 
ant every few minutes 
with copious draughts 
of cool watei-. Grad- 
ually the relaxing in- 
fluence of the elevated 
temperature manifests 
itself. The capillaries slowly dilate, the veins enlarge under its 
gentle stimulus, and small points of perspiration appear upon 
the surface, which assumes a slight, 
rosy blush. A delightful calm, a feel- 
ing of perfect rest and luxurious ease 
is imparted to the senses. From this 
room, after an appropriate interval, the 
bather enters the second room, in which 
the atmosphere is higher by from 20° 
to 30 c, and it may be made still 
higher, its regulation requiring but an 
instant. 

A thorough sweating occurs while 

the subject remains in these rooms, 

during a period of from ten to forty 

minutes. The secretions of the skin, 

at first impure and loaded with the 

debris of dead cells and extraneous 

matter, gradually become purer, and clearer, until, finally, all 

trace of color disappears and the pearly drops of sweat come 

full and free. Soon the attendant appears and leads the 

16 



.Fig. IJfB. 




One of the Shampooing- 
rooms. 



*^0*J COMMON SENSE MEDICAL ADVISER, 

way to the shampooing-room, where, lynig upon a warm marble 
slab, massage is applied most thoroughly to every portion of 
the body. 

By the massage, shampooing, or rubbing, the superficial veins 
are thoroughly emptied of their contents, the muscles are given 
elasticity and tone, and glandular activity is promoted. In- 
numerable dead epithelial cells, together with other impurities, 
are rolled off in flakes under the skillful manipulation of the 
attendant. 

After a thorough shampooing, the shower bath is applied, 
to secure a contraction of the capillaries and a diminution of 
the perspiration. 

The Spirit Vapor-bath is very effective Avhen em- 
ployed in the earlier stages of acute, febrile, inflammatory, and 
painful diseases. In many forms of chronic diseases the admin- 
istration of a spirit vapor-bath once in from three to fifteen 
days, is a valuable adjunct to the treatment of these affections. 
It exerts an exceedingly beneficial influence upon the entire 
system, and, when habitually employed, may ward off disease. 

The body should be moistened with an alkaline solution before 
the administration of a spirit vapor-bath. After the perspir- 
ation which it occasions has subsided, which wnll usually be in 
from three to four hours, sponge the liody with a mixture of 
the following ingredients: water, three gills; alcohol, one gill; 
salt, one teaspoonful. By this method the patient experiences 
none of the unpleasant effects which generally follow the em- 
ployment of diaphoretics. Various kinds of apparatus have 
been devised to facilitate the application of the spirit vapor- 
baths. Most of them are cumbersome and expensive, and, 
consequently, are seldom used except in hospitals or sanitariums. 

The following method described by Dr. J. King, may be 
advantageously employed, 

" The patient is undressed, ready for getting into l^ed, having 
removed the clothing worn through the day and })Ut on a night 
shirt or other clothing to be worn while sweating, and during 
the night, if the bath is taken at bed-time. He is then seated 
on a high Windsor or wooden -bottomed chair, or instead 
thereof, a bench or board may be placed on a common open- 
bottomed chair, care being taken that the bottom is so covered 



BATHS. 860 

that the flame will not burn hhn. After seating himself, a large 
coverlet or blanket is throAyn around him from behind, covering 
the back of his head and body, as well as the chair, and another 
must be passed around him in front, which last is to be pinned 
at the neck, loosely, so that he can raise it and cover his face, or 
remove it down from the face from time to time as occasion 
demands during the operation of the bath. The blankets must 
reach down to the floor, and cover each other at the side, so as 
to retain the vapor. This having been done, a saucer or tin 
vessel, into which is put one or two tablespoonfuls of whisky, 
brandy, alcohol, or any liquor that will burn, is then placed upon 
the flooi', directly under the centre of the bottom of the chair, 
raising a part of the blanket from behind to place it there; 
then light a piece of paper, apply the flame to the liquor, and 
as soon as it kindles let down the part of the blanket which has 
been raised, and allow the liquor to burn until it is consumed, 
watching it from time to time to see that the blankets are not 
burned. As soon as consumed, put more liquor into the saucer, 
about as much as before, and again set it on fire, being careful 
to put no liquor into the saucer while the flame exists, as there 
would be danger of setting fire to the blanket, and producing 
injury to the patient. Continue this until the patient perspires 
freely, which, in a majority of cases, will be in five or ten 
minutes," 

" If, during the operation, the patient feels faint or thirsty, 
cold water must be sprinkled or dashed in his face, or he may 
drink one or two swallows of it, — and in some cases the head 
may be bathed with cold water. As soon as free perspiration is 
produced, wrap the blankets around him, place him in bed, and 
cover him up warm, giving him about a pint of either some 
good store tea, ginger, or some diaphoretic herb tea to drink, 
as warm as he can take it. After two or three hours, remove 
the covering, piece by piece, at intervals of twenty or twenty- 
five minutes each, that he may gradually cease perspiring." 

The above method may be improved by using an ordinary 
hoop skirt, ten to twelve inches below the bottom of which is 
suspended a larger and stronger hoop. The upper and smaller 
hoops should rest upon the patient's shoulders. A woolen 
blanket, large enough to reach and rest upon the floor, and 



364 COMMON SENSE MEDICAL ADVISER. 

envelop the whole person, is thrown over the hoops. Unle8s the 
bath is employed to diminish the qnantity of fluids in the body 
(as in dropsy), the patient may drink some simple, diaphoretic 
infusion, to hasten or facilitate perspiration. When he perspires 
freely, small quantities of cold water may be frequently given. 
" There is little or no danger of taking cold after this jirocess, if 
ordinary precaution is observed, and it is easy, agreeable, safe, 
and effectual." 

" Occasionally we will meet with patients, upon w lioni it is 
almost impossible to produce the slightest moisture, much less 
perspiration. The skin of such persons is generally dry and 
harsh, communicating an unpleasant sensation' to the touch. In 
most instances the skin may be restored to its normal condition, 
by adopting the following course: 1st. Anoint the whole 
surface of the body and limbs with olive oil every night upon 
retiring to bed. 2nd. Every moi-ning wasli the whole surface 
with a warm, weak, alkaline solution, employing considerable 
friction while drying. 3rd. Every two weeks administer a 
spirit va])Or-bath. A perseverance in this course for a few 
n)onths will accomplish the desired result." 

Frequent reference to spirit vapor-baths will be made by the 
author of this work, in speaking of those diseases in which its 
employment will pi'ove beneficial. 

Sea Bathing' is an excellent, remedial agent in chronic 
disorders, particularly in those of an atonic character, such as 
nervous prostration, dyspepsia, and general debility. 

Much of the benefit attributed to this mode of bathing is 
undoubtedly due to other influences, such as pure air, exercise, 
change of scenery, diet, and associations which surround the 
patient during his sojourn at the sea-shore. 

At first, the duration of a sea-bath should not exceed three or 
five minutes, but it may be gradually prolonged to fifteen or 
twenty minutes. If the patient is very feeble, one or two baths 
a week are sufficient, and the most robust person should never 
take more than one a day. They should always be taken in the 
earlier portion of the day, before breakfast if possible, and 
never during digestion. 

Before entering this bath, a moderate degree of exercise 
should always be taken, enough to arouse the vital energies, but 



BATHS. 3t>5 

not to produce fatigue. Suitably dressed, the patient plunges 
into the water, in which he remains during the prescribed time. 
Immediately after emerging from the bath, the patient should 
be thoroughly di'ied and dressed and then moderate exercise 
should be taken to induce reaction. If the reaction is slow, a 
mild stimulant may be taken and the duration of the bath must 
be diminished the next time. When sea-bathing is beneficial 
improvement is soon manifested. The blood becomes richer, the 
whole system is strengthened and the functions are performed 
with more regularity. To the rich, sea-bathing is a luxury, but 
it is a remedy beyond the reach of the poorer classes unless 
they live near the sea-shore. 

The Shower Bath produces a shock to the nervous 
system by suddenly coming in contact with the skin. Numerous 
streams of cold water fall upon the neck, shoulders, and body of 
the patient who stands beneath the hose or reservoir. When the 
patient is plethoric, feeble, or nervous, or when some internal 
organ is diseased, the cold, shower bath should not be employed. 
In simple debility unaccompanied by inflammation or symptoms 
of internal congestion, its use proves advantageous. By moder- 
ating the force of the shower, and substituting tepid water, tho 
most delicate persons can endure it and profit thereby. The 
usual means for inducing a good reaction, friction, and exercise, 
should be employed. 

The Douche Bath consists of a stream of water, dashed 
or thrown upon the patient from a moderate heighth or distance, 
with considerable force. The size, temperature, and force of 
the stream may be modified to suit the exigencies of the case. 
It is locally employed as a remedy for sprains, weak or stiff 
joints, old swellings, etc. The cold, douche bath is more power- 
ful than the shower bath and should be given with the same 
pj-ecautions which govern the application of the latter. 

The Spong^e Bath admits of extensive employment 
in both acute and chronic diseases, and its simplicity renders it 
of untold value. It consists in a general or local application of 
water (medicated or not) at any desired temperature. The 
(piantity may be great or small to suit the requirements of the 
case. If it is applied in acute diseases at a temperature agree- 
able to the patient, it is exceedingly grateful and may be 



366 COMMON SENSE MEDICAL ADVISER. 

repeated as often as necessary. It may be rendered alkaline by 
the addition of some compound of soda, in the proportion of a 
teaspoonful to a quart of water. A portion of the body may 
be bathed at a time, and quickly dried, thus avoiding any ex- 
posure to cold. It removes excessive animal heat, relaxes the 
capillaries, equalizes the circulation, and produces comfort, tran- 
quility, and sleep. 

Nothing is more conduciA'e to the health and comfort of 
laboring men in summer than a daily bath, and it is a matter of 
i-egret that there are so few conveniences for the purpose in 
most homes, especially those in the country. Farmers in par- 
ticular need bathing facilities, and yet in most cases they are 
almost entirely without them. For their benefit we will de- 
scribe a device which we can recommend to all who want a 
cheap, convenient, and easily managed apparatus for sponge 
bathing in the bed-room. 

The articles required are a piece of rubber-cloth a yard and a 
quarter square, four slats, two inches wide ' and three feet long, 
notched at the ends so as to lock together in the form of a 
square, and a large sponge. Tlie slats are placed upon the floor 
and the rubber cloth is spread over them (there is no need of 
fastening it to the slats), forming a shallow square vessel a yard 
wide. In this the bather stands and applies the water with a 
sponge from a basin or bowl on a stand placed conveniently 
near. There need be no danger of wetting the carpet, or spoil- 
ing the furniture. 

When the bath is finished, gather three corners of the rubber 
cloth in the left hand, take the fourth corner in the right in 
such a Avay as to form a spout when lifted or held over the slop- 
jar or bucket. The water may be poured out in a moment, 
when the cloth should be spread over the back of a chair to dry, 
and the slats unlocked and set away in a closet. 

The Foot Bath is frequently employed, as a means of 
causing diaphoresis, in colds, attacks of acute diseases, and also 
to draw the blood from the head or some internal organ. It is 
a powerful auxiliary in the treatment of those chronic diseases 
in which inflammation, congestion, and a feeble circulation are 
prominent symptoms. The water should be as hot as it can be 
borne, and the temperature kept up by additions of hot water. 



BATHS. 367 

It may be Aade stimulating by the addition of salt, mustard, 
ginger, or cayenne pepper. 

The iSitz Bath. A tub is so arranged that the patient 
can sit do^vTl in it while bathiug. In this manner the lower 
part of the abdomen, hips, and upper part of the thighs, 
are immersed in whatever fluid the bath is composed of. It 
is applicable in diseases of the pelvic organs, and may be hot, 
wai"m, cool, cold, or medicated, according to the effect desired. 

The bath tub should be large enough to permit a thorough 
rubbing and kneading of the diseased parts, and the patient 
may remain in it from ten to thirty minutes. The clothing may 
be wholly or partially removed, as agreeable to the individual. 
A toartn, sitz bath is an effective, remedial adjunct in menstrual 
suppi'ession and in painful menstruation, gravel, spasmodic and 
acute inflammatory affections generally. The cold, sitz bath is 
used as a tonic in cases of relaxed tissues of the pelvis, in de- 
bility of the urino-genital organs, in piles, prolapsus of the 
rectum, and in constipation. 

The Head Bath. A shallow basin contains the fluid for 
the bath; and the patient, assuming a recumbent position, 
immerses a portion of the head, generally the back part. The 
temperature may be warm, cool, or cold, as desired. 

Ifledicated Bathii^ are infusions of vegetable or other 
substances in water. They are sometimes applied with the 
sponge, though generally the patient is immersed. The temper- 
ature at which they are usually employed is that of the tepid 
bath. The nature and strength of the medication depends upon 
the character of the disease for which it is employed. 

The Alkaline Bath is prepared by dissolving half a 
pound of carbonate of soda in sixty gallons of water. It is 
useful in those diseases in which the fluids of the body are 
abnormally acid, as in rheumatism. 

The Acid Bath is prepared by adding two pounds of 
muriatic or hydrochloric acid to sixty gallons of water. A 
much smaller quantity of the acid is sometimes used, and in 
some instances vinegar is substituted. 

ScoU''s Acid Bath is composed of nitro-muriatic acid (aqua 
regia) and water. It should be prepared in a wooden tub, and 
a sutticient quantity of acid used to give the water a sour taste. 



,",(l,S COMMON SENSE MEDICAL ^VBVISEE. 

It is I'xtt'iisivi^ly used in India as a remedy for disi^rdfi-s of tin- 
liver. 

The Iodine Bath is composed of the following ingre- 
dients: tincture of iodine, two drachms; iodide of potassiimi, 
four drachms; water, forty gallons. It should be prepared in 
a wooden tub. It reddens the skin. For children, a nmch 
weaker solution must be employed. Its use is genei-ally re- 
stricted to scrofulous and tubercular aflFections. 

The Sulphur Bath is prepared l)y dissolving eight 
ounces of sulphuret of potassium and two ounces of dilute sul- 
phuric acid in sixty gallons of water. The acid may be omitted. 

A l^lllphlir Vapor-hath is often employed in cities 
where the necessary apparatus can be procured. It may be 
improvised by placing sulphur on a shovel over hot coals. The 
l)atient should be prepared as in the spirit vapor-))ath, and 
burning sulphur substituted for the liquor. The patient is then 
enveloped in the fumes of sulphurous oxide. Heating a mixture 
of sulphur and sulphuric acid, produces the same result. If the 
gas is inhaled in large quantities it causes irritation of the 
respiratory passages, and suffocation. It is therefore necessary 
that the coverings should be securely fastened at the neck, and 
that the room be one which can be quickly filled with pure air 
This bath is u^ed in cutaneous, rheumatic, and syphilitic dis- 
orders. 

Fomentations consist of the general or local application 
of woolen cloths wrung out of hot water. They should not 
be so light as to be ineffectual, nor so heavy as to be burden- 
some. They should not be wet enough to drip, noi- ap})lied 
so as to expose the body to the surrounding air. A fresh cloth 
should bo ready for application before the first one is re- 
moved, and the change quickly effected. Fomentations are 
effectual in relieving congestion and inflammation. 

The Wet Sheet Pack. As this remedial appliance will 
he frequently recommended in the pages following, its mode of 
application is here described. Take a pail half filled with cold 
water, gather together one end of a common cotton sheet, and 
immerse it, allowing it to remain while preparing the bed, 
which may be done as follows: remove all the bed-clothes 
except a coverlet and the pillows, then spread upon it, in 



MOTION AS A REMEDIAL AGENT. 369 

the following order, two ordinary comforters, one woolen 
blanket, one woolen sheet, (or two woolen sheets if a woolen 
blanket is not at hand) ; then wring out one-half or two-thirds 
of the water from the wet sheet, spread it smoothly upon the 
blanket, and the patient being undressed, places himself on 
the sheet, with his arms extended, while an assistant wraps him 
closely and tightly with it, as quickly as possible. Each arm 
may be thus covered by the wet sheet, or may lie outside of 
it, and be covered by wet towels, prepared in the same manner 
as the sheet. Then quickly and tightly cover with the blankets 
and comforters, tucking snugly from head to foot. The head 
should also be covered with a wet towel, and a bottle of warm 
water placed to the feet, or near enough to keep them warm. 

After the first shock of the chill is over, the pack is very 
pleasant and refreshing, and the patient should go to sleep, 
if possible. The ordinary time for a patient to remain in a 
pack is about sixty minutes. Thirty or forty minutes is suffi- 
cient, if he is in a feeble condition. Never wring the sheet 
out of warm water, for one of its principal benefits comes from 
the vigorous reaction induced by its cold temperature. After 
remaining in the pack from thirty to sixty minutes, allow the 
patient to stand on his feet, if he is able, and have the whole 
surface of his body bathed. Rub briskly, and dry with towels, 
or by throwing over the body a dry sheet and then rubbing 
him. The dry sheet retains the bodily warmth and is more 
comfortable, but interferes with the completeness and vigor 
of the rubbing of the body. Be sure and establish full 
reaction, which may be known by the warmth of the surface. 
Frequently, when the patient is released from the pack, and is 
being bathed, rolls of scales, scurf, and skin-debris come off, 
thus giving palpable evidence of the utility of the pack in 
freeing the myriads of pores of the skin of effete matter. It 
is efficient in fevers, and for breaking up colds, and is a very 
valuable, remedial agent in most chronic diseases, assisting in 
removing causes which depress the bodily functions. 

MOTION AS A REMEDIAL AGENT. 

The stability of the planetary system depends upon the con- 
certed motion of its parts. So in the human system, motion 



370 COMMON SENSE MEDICAL ADVISER. 

is a fuudameiital principle which underlies every vital process. 
Health consists in normal, functional activity. The human 
system is the arena of various kinds of motions, both of 
fluids and of solids, and life and health depend upon these 
physiological movements. There are the movements incident 
to respiration, the expansion and contraction of the walls of 
the chest, bringing the oxygen of the air into contact with the 
blood as it circulates throiigh the lungs. Corresponding with 
the movements of the chest are the viotio/ts of the abdomiiial 
7oalls, which promote the functions of the organs of the abdom- 
inal cavity. 

There are motions of the heart and arteries, which urge the 
blood out to the extremities and diffuse it through every part 
of the system, and also motion of the blood hi the capillaries, 
by which the blood is circulated through the tissues, that the 
latter may be built up from its nutritive constituents. Then 
there is the motion of the vital current in the veins returning 
towards the heart, and urged forward by the muscular and 
pump-like action of the chest and abdominal walls. The 
peristaltic motions of the stomach and bowels urge onward 
digesting materials, exposing them successively to different 
solvents and aiding the absorption of nutritive matter. No less 
essential to life and health are numerous other minute operations 
or motions, on which vital power in all its manifestations of 
muscular and nervous energy depends. Many other m.otions 
are consequent upon decay, growth, and repair. Oxygen, 
carbonic acid, watery vapors, and other gaseous matter are 
constantly being exchanged between the system and atmos- 
phere. Then, the human system being a complex, chemical 
laboratory, there are rnotiotis consequent upon chemical actiony 
constantly going on within it. 

Muscular motion, under the direction of the will, is also 
absolutely necessary for the maintenance of good health. 

Animal heat and muscular and nervous power are dependent 
upon motions of the minutest particles composing the body. 
The body is composed of fluid and semi-fluid matter, permitting 
great freedom of motion. Health requires that there shall be 
a constant change of place, an active transmission of material 
to and from vital organs and parts, through the medium of 



MOTION AS A REMEDIAL AGENT. 371 

blood-vessels, as well as outside such vessels ; that is, motion of 
interstitial fluids. 
IVatiire's Ifloile of Sustaining Health. The act 

of transforming latent, non-vital force which exists pent-up in 
food, as heat is in coal, into vital energy, requires the simul- 
taneous elimination from the system of a like amount of 
worn-out matter. Assimilation of nutritive materials is impos- 
sible, unless a like amount of matter be eliminated from the 
system. Muscular and nervous energy are dependent upon 
activities which cause waste. Not only is this true in a general 
way, but it is also true that the energy produced by the 
operations of the vital system has a strict relation to the wasting 
products — that full energy is only attained by perfected waste. 
Use, waste, and power, then, sustain definite and dependent or 
corresponding relations, since waste is as essential to health as 
is supply. 

Without waste, disturbance is at once produced in the system 
similar to that resulting from the introduction of foreign matter. 
These disturbances constitute disease. The more obvious effects 
of lack of waste and elimination are mechanical. The circula- 
tion is loaded with effete and useless matter, the vessels being 
thereby weakened and distended, and the circulation retarded. 
The capillaries become clogged and vital action is diminished. 
Local congestions, inflammations, effusions, morbid growths, and 
other pathological results follow. 

Deranged or suppressed action characterizes, and, indeed, 
constitutes all departures from health which we call disease. 
Sufferiug indicates action, but action which is perverted into 
wrong channels, or action in one part at the expense of motion 
in other parts, constituting a disturbance in the equilibrium of 
forces, from which the system suffers. 

Value of mechanieal Hovenients and IVIanipu- 
lations for the Treatment of €hi*onic Diseasi^!^. 
To correct and restore deranged movements, thereby producing 
normal, functional activity of every organ and part of the sys- 
tem, must therefore be the chief object of the physician. All 
remedies, of whatever school or natui'e, imply motion, and 
depend for their eflicacy upon their ability to excite motion in 
some one or more elements, organs, or parts of the system. 



872 COMMON SKNSK MEDICAL ADVISKR. 

While Ave do uot wish to detract from the real merits ol" 
medicine as a curative agent, yet we must admit that the reme- 
dial power of motion, transmitted either manually or mechani- 
cally, is founded upon rational and physiological principles. All 
systems of medicine, however much they may differ supei-ficially, 
])ropose, as the chief end to be attained by the administration of 
medicine, or by other treatment, that tnotions identical with 
physiological activity should be incited or promoted. How best 
to accomplisli this result, and with least cost to vitality, is an 
important consideration. Bearing in mind the conservation of 
forces, that energy or power is as indestructible as matter, that 
it* may be changed into other forais but never lost, it is plain 
that mechanical force may be applied to the living system and 
transformed into vital energy; that chemical action, animal heat., 
and magnetism may represent in the system the mechanical force 
transmitted to the body. Keeping in view the transformable 
nature of force, and the need that our systems have of auxiliary 
power in different departments, when normal activity is impaired 
by disease, we can readily understand how undoubted, curative 
effects result from either the manual or the mechanical adminis- 
tration of motion. 

Rll1l)t>ill|^ is a process universally employed by physicians 
of every school for the relief of a great diversity of distressing- 
symptoms, is instinctively resorted to by sympathizers and 
attendants upon the sick, and constitutes one of the chief duties 
of the nurse. Uncivilized people resort to this process as their 
principal remedy in all forms of disease. 

The difficulty in administering motion as a remedial, agent 
by manual eff<»rt, such as rubbing, kneading, oscillating, flexing, 
and extending tht^ limbs, lies in the impossibility of supplying 
the amount, intensity, and variety of movement required to 
make it most effective. The power of the arm and the strengtli 
of the operator are exhausted before the desired effect is pro- 
duced. Inventive genius has at last overcome the obstacles to 
the sticcessful and perfect administration of motion as a curative 
agent. We have now a series of machines propelled by 
mechanical power, by the use of which we rub, knead, ma- 
nipulate, and apply in succession a great variety of movements 
to all parts of the body. These machines transmit motion to 



MOTION AS A REMEDIAL AGENT. 87 B 

the body from inexhaustible sources, never tire, but are ever 
ready for new, remedial conquests. The movements admin- 
istered by their use, while entirely under the control of the 
patient, are never disagreeable, and are far more rapid and 
intense than can possibly be given by the hands. By the appli- 
cation of short, quick movements of from twelve to fifteen hun- 
dred vibrations a minute, deep-seated organs and parts are 
reached, to which motion is transmitted and in which vital 
energy is thereby generated. The hands have not the power, 
by kneading, manipulating, or rubbing to impress the system 
except in a very mild degree, and deep-seated organs and parts 
are scarcely influenced by the comparatively slow movements 
thus administered. Among the most important, mechanical in- 
ventions devised for administering motion as a remedial agent, 
is one which has received the name of the manipulator. 

The manipulator. With this machine motion can be 
applied to any organ or part of the system, and intensity of the 
application regulated to a nicety. The rapidity of motion 
necessary to produce active exhilaration of any part of the 
body is easily secured by the use of the manipulator, but is far 
beyond the power of the hands. The degree of circulation 
given to the fluids, both inside and outside of the vessels, and 
of energy imparted to the organs and parts opei'ated upon by 
the manipulator, is also unapproachable by the application of 
manual power. 

Effects Upon the Circulation and Nutrition. 
The influence of motion on these functions is as follows: The 
contents of the blood-vessels are moved onward by the pressure 
and motion transmitted by the manipulator, all backward move- 
ment of the blood being prevented by the valves of the veins 
and by the propelling power of the heart and arteries. Fluids 
outside these vessels pass through their walls, to take the place 
of the stagnant blood that has been movgd onward. Other 
blood flows into the part, and thus active and healthy circu- 
lation is induced, and nutritive material, capable of affording 
vital support is also brought to refresh the local part. 

We have foimd mechanical movements especially effectual in 
paralysis, neuralgia, sleeplessness, and other nervous affections; 
in derangements of the liver, constipation, and dyspepsia; in 



374 COMMON SENSE MEDICAL ADVISER. 

displacements of the uterus, and congestion, and inflammation 
of the pelvic organs. 

For a complete description of the mechanical movements 
and the machinery employed in the treatment of diseases at the 
Invalids' Hotel and Surgical Institute, the reader is refen-ed to 
the appendix to this work. 



CHAPTER IV. 

HYGIENIC TREATMENT OF 
THE SICK. 



There are two essentials requisite to the successful treatment 
of the sick: (1.) Medical skill; (2.) Good nursing. The former 
is necessary in order that the condition of the patient be fully 
understood, and the proper means be employed to effect his 
recovery. The latter is essential, in order that all influences 
favoring the production and development of disease may be 
removed, the tendencies to restoration be promoted by every 
possible means, and the directions of the physician be properly 
observed. 

Success in the treatment of the sick requires good nursing. 
Without it, the most skillful physicians fail to effect a cure; 
with it, the most unqualified may succeed. If certain hygienic 
agencies are essential to the maintenance of health, how much 
more necessary it is that they be employed in sickness ! If 
cei"tain conditions cause disease, how great the necessity is that 
such conditions be obviated and hygienic ones substituted! 

Notwithstanding the importance of good nursing, in the rural 
districts it is frequently difficult to find a professional nurse, 
or, if one can be obtained, it is often impossible for the 
invalid to procure such services, on account of the expense 
which must necessarily be incurred. Hence, this office usually 
devolves upon some relative who is considered to be the best 
qualified for the position; or, as is often the case, necessity 
demands that the patient be left to a change of nurses. A 
woman is generally selected for this important position. Her 

375 



;^76 COMMON SENSK MED1<;A1, ADVISER. 

soft hand and .soothing voice, her kindly, sympathetic, and 
provident nature, together with her scrupulous cleanliness, 
render her man's equal, if not his superior, in the capacity of 
nurse. There are circumstances, however, in which the ser- 
vices of a man are indispensable; hence the necessity that 
all should be qualified to care for the sick. 

A nurse should be attentive to the requirements of physician 
and patient, for she sustains an intimate relation to both. She 
should obsei-ve the directions of the physician, and faithfully 
perform them. She should note all the symptoms of the pa- 
tient, and do everything in her power to promote comfort and 
recovery. She should anticipate the wishes, and not cause 
the patient to ask for everything Avhich is desired. So far as 
practicable, let the wishes be gratified. The senses of the 
sick often become morbidly acute, and those things which in 
health would pass unnoticed, in sickness are so magnified as 
to occasion annoyance and vexation. Sick persons are not 
all alike, and the peculiarities of each must be studied separ- 
ately. The nurse must be kind, but firm, and not yield to 
such whims of the patient as may be detrimental to recovery; 
neither must she arouse dislike or anger by opposition, but 
endeavor to loin the patient from all delusions. The feelings 
of the patient should never be trifled with, for idealities 
become realities. 

The nurse should possess an inexhaustible store of patience. 
Disease affects the mind of the patient and fills it with strange 
delusions. The sick are often querulous, fretful, and unreason- 
able, and should be treated with kindness, forbearance, and 
sympathy. The nurse should always be cheei-ful, look on 
the bright side of every circumstance, animate them with 
encouragement, and inspire them with hope. Hope is one 
of the >)e8t of tonics. It stimulates the flagging, \ital energies, 
and imparts new life to the weak and exliausted forces. 
Gloom, sadness, and despondency depress the vital forces and 
lead to death. We have seen patients rapidly sinking, who 
had given up all hope, and were quietly awaiting the coming 
(»f death, snatched, as it were, from its grasp, and restored to 
health, by words of cheer and encouragement. 

The nurse should possess moral pri?iciples, which alone can 



THE BED. ,S77 

win the confidence of the patient. She should have judgment, 
circumspection, intelligence, forethought, alacrity, carefubiess, 
and neatness. In a word she should exercise common sense. 

We deem it but justice to say a word in behalf of the nurse. 
She, too, is a human being, subject to disease, and, unless 
hygienic conditions be observed, Avill soon be stricken low by 
its presence. She must be relieved occasionally and get rest, 
or she cannot long withstand the combined influence of fatigue 
and disease. Her ofiice is an arduous one at best, and the long, 
weary hours of night-watching should be compensated by 
exercise in the open aii", as AveU as by sleep during the day. 
Unless this be done, the system will become exhausted, and sleep 
will intrude itself upon her at the time when the greatest 
diligence is required for the welfare of the patient, when the 
vital powers are at their lowest ebb. She should be supplied 
with plenty of suitable food during the night, to sustain her and 
to serve as a safeguard against the invasion of disease. She 
should be ti'eated with kindness and respect, else her disposition 
may become morose and reflect itself upon the patient, causing 
peevishness and despondency. 

The Sick-room should be as comfortable, cheerful, and 
pleasant, as circumstances will allow. Let the room be large 
and airy, and furnished with a stove, or better still, a fireplace. 
All articles of clothing and furniture, not necessary to the com- 
fort of the patient, should be removed from the room, and in 
malignant or cotitagious diseases the carpets, even, should not 
be pei-mitted to remain. The surroundings beget happiness or 
gloom, in proportion as they are pleasant or disagreeable. A 
tidy attendant, a few flowers and books, wonderfully enhance 
the cheerfulness of the room. Permit no unnecessary accumu- 
lation of bottles, or any thing that can in any way render the 
room unpleasant. Medicines, drink, or nourishment should 
never be left uncovered in the sick-room, since they quickly 
absorb the gaseous emanations from the patient, and become 
unfit for the pui'pose which they were intended to serve. Their 
presence gives the room an initidy appearance, suggestive of 
filth and slovenliness, and imparts to the patient a feeling of 
loathing and disgust for articles of diet. 

Xbe Ded should not be of feathers, on account of their 



878 COMMON SENSE MEDICAL ADVISER. 

undue waiinth, which causes a sensation of languor throughout 
the system. A husk or sea-grass mattress, or even a straw bed, 
covered with a cotton quilt, is far preferable. The bedding 
should be cluinged frequently. It is better that the bed should 
be away from the wall, so as to admit of greater freedom of 
movement about it. 

Pure Ail*. Tlie air in the sick-room should bo kept as 
pure as possible. That which is so necessary in health, is indis- 
pensable in sickness. The importance, therefore, of a perfect 
and free ventilation of the sick-room cannot be too thoroughly 
impressed; and yet to properly secure this end, may call forth a 
considerable amount of ingenuity on the part of the nurse. A 
window should be open, but the current of air must not be 
allowed to blow directly upon the patient. One window may 
be raised from the bottom and another lowered from the top. 
This will permit the enti'ance of pure air from without, and the 
exit of the vitiated air from within. The patient, if sufficiently 
covered in bed, is not liable to take cold from a proper ventila- 
tion of the room. Especially is this true, when the bodily 
temperature is raised by febrile or inflammatory affections. 
The temperature of a room is no indication of the purity of 
the air. It is a prevalent, but mistaken notion, that when a 
i-oom is cold, the air must be pure. Cold air is as readily 
contaminated with impurities as wanii air, therefore, it is not 
sufficient that the room be kept cool, but the air should be 
frequently changed. During convalescence, great care is nec- 
essary to pi'Otect the patient from taking cold. Air which is 
admitted into the sick-room should not be contaminated by 
passing over foul drains, privies, or other sources of infec- 
tion, since, instead of invigorating, it depresses the physical 
forces and generates disease. 

l<ight is as necessary to health as is pure air. Banish either 
for any continuous period of time, and serioiis results follow. 
The strong, robust man, when deprived of light, soon degen- 
erates into a feeble, sickly being, and finally dies. 

According to the investigations of the Massachusetts Medical 
Society, it was found that absence of sunlight, together with 
moisture, not only favor the development of tubercular con- 
sumption, but act as an exciting cause. It is well known that 



WARMTH. 379 

persons living in shaded dwellings often suffer from forms of 
disease which resist all treatment until proper admission of 
light is secured. 

The physician to the Emperor of Russia found upon examin- 
ation that patients confined in well lighted wards, were four 
times as liable to recover as were those in poorly lighted rooms. 
Children reared away from the sunlight are apt to be deformed 
and idiotic, while those partially deformed have been restored 
by being admitted to the light. 

Patients sometimes wish to have their rooms darkened, 
because the light is painful to their weak and sensitive eyes. It 
is far better to shade the eyes and admit the sunlight into the 
room, since its rays cause chemical changes to take place, which 
favor the return of health. Many invalids can ascribe tlieir 
recovery to the influence of a sun bath. There are, however, 
conditions in which the patients should be screened from the 
light. In such cases a little arrangement of the curtains or 
shutters will accomplish all that is to be desired. 

Patients convalescing from acute, or suffering from chronic 
diseases, should receive the influence of light in the open air, 
and be iii it several hours every day. Light and pure air 
stimulate a healthful development, induce cheerfulness, hope, 
and recovery, while darkness begets gloom, sadness, despon- 
dency, disease, and ultimately death. 

Warmth is essential to the well-being of the patient, and 
it is necessary that a proper temperature be maintained in the 
room. Except in very warm weather, a little fire should be kept 
in the room, and at the same time fresh air should be admitted 
from without, and a uniform tempei'ature thus presen'ed. This 
arrangement is especially necessary in localities where great 
variations in temperature are experienced during the day and 
night. 

The normal temperature of the body ranges from 98o to 
990 Fahr. The minimum occurs from 2 to 6 a. m.; the maxi- 
mum, from 1 to 6 p. m. The deviation of a few degrees from 
this standard indicates disease, and the greater the deviation, 
the greater is its severity. During the early stages of acute 
diseases, the animal heat is generally increased, and should be 
allayed by bathing, and cooling or acidulated drinks. In the 



J^gQ COMMON SBN8K MKDICAL AMVISKK. 

latter stages, the temperature becoiues diminished and the con- 
dition of the system is favorable to congestions, which are most 
likely to occur between the hours of 2 and 6 a. m., when the 
vital powers are lowest. The patient then becomes feeble, his 
extremities grow cold, and he has what is termed a " sinking- 
spell," and perhaps dies. It is during these hours that ad- 
ditional covering, the application of hot bricks to the feet, and 
bottles of hot water to the lin)bs and body, friction upon the 
surface, stimulating drinks, and increased vigilance on the part 
of the nurse will often save the patient's life. But, unfortu- 
nately, at these hours the nurse is apt to get sleepy and inat- 
tentive, the demands of the patient go unheeded, and a saciifice 
of life is the result. 

Persons suffering from dironic diseases, or those in feeble 
health, should preserve their vital energies by dressing warmly, 
by wearing flannels next to the skin, and by carefully protect- 
ing the feet from cold and moisture. 

Cleanliness cannot be too thoroughly impressed upon the 
minds of those who have the care of the sick. Filthiness is 
pioductive of disease and favoiable to its development. Bath- 
ing at least once a day, with pure, soft water and toilet-soap, is 
strongly urged, and as this is designed for cleanhness, the tem- 
perature of the bath should be made agreeable to the patient. 

The Clothing: an<l Bedding of the Patient in 
acute diseases, should be changed frequently and thoroughly 
aired, if not washed. As soon as removed, these articles should 
be taken from the room, replaced by others viell aired and 
warmed. The hands and face of the patient should be bathed 
frequently, the hair combed, the teeth brushed, the nails cleaned, 
the lips n\oistened, and everything about him kept clean and 
tidy. These observances, although in themselves trifling, pro- 
mote comfort and cheerfulness, and contribute largely to the 
recovery of the sick. All excretions from the patient should 
be buried, and not committed to ]>rivies to communicate disease 
U) thoKt- who frequent them. 

The Diet contains a very important relation to health. 
During the process of acute disease, the appetite is generally 
much impaired, if not entirely absent. It should then })e the 
studv of the nurse to devise such articles of nourishment as will 



BEEF TEA. 381 

be acceptable to the patient and suitable to the condition. 
The food should be light, nutritious, and easy of digestion. 

Each individual disease requires a diet adapted to its pecul- 
iarities. Those of an inflammatory character require an un- 
stimulating diet, as gruel, barley-water, toast, etc. An ex- 
hausted or enfeebled condition of the brain, unattended by 
irritability, demands a stimulating diet, as beef, eggs, fish, 
Gi-aham bread, oysters, etc. In wasting diseases, in which the 
temperature of the system is low, beef, fatty substances, rich 
milk, sweet cream, and other carbonaceous articles of diet arc 
recommended. In the various forms of chronic ailments, the 
diet must be varied according to the nature of the disease and 
the peculiarities of the patient. Deranged digestion is gen- 
erally an accompaniment of chronic disease. A return to normal 
digestion should be encouraged by selecting appropriate articles 
of food, paying due regai-d to its quantity and quality, as well 
as to the manner and time of eating. The appearance of food, 
and the manner in which it is offered, have much to do with 
its acceptance, or rejection by the patient. Let the nourishment 
be presented in a nice, clean dish, of a size and shape ap})ro- 
priate to the quantity. More food than can be eaten by the 
patient shovild not be placed before him at one time, since a 
great quantity excites disgust and loathing. In taking nourish- 
ment, drink, or medicine, the patient, if feeble, should not be 
obliged to change his position. 

jflilk is one of the most important foods in fevers and acute 
diseases attended with great prostration, and in which the 
digestive powers are enfeebled. It contains within itself all 
the elements of nutrition. 

Beef Tea furnishes an excellent nourishment for the sick, 
but thei'e are few, even among professional nurses who know 
how to properly prepare it. We give three good recipes. 
One method is to (rhip up lean beef, put it in a porcelam or 
tin saucepan, cover it with cold water, and bring it up to just 
below the boiling point, at which temperature retain it for ten 
minutes, then season and serve. Another method is similar to 
the foregoing, with this diffei'ence, that the juices of the meat 
are squeezed through a piece of muslin or crash, making the 
tea richer. Another way, which we consider preferable to 



38- COMMON SENSE MEDICAL ADVISER, 

either of tlic above, is to take lean beef, cut it into fine bits, 
put them in a tightly covered vessel, Avhieh is j>lacecl in a kettle 
of water kept boiling. Thus the whole strength of the juice 
will be obtained from the meat without losing any of its prop- 
erties. It can be seasoned to the taste, and reduced with water 
to suit the needs of the patient. 

Sleep is "Nature's grand restorer, a balin to all mankind; 
the best comforter of that sad heart Avliom fortune's spite 
assails." It is necessary in health, and doubly so in sickness. 
During sleep, the vital energies recuperate, the forces arc less 
rapidly expended, and the strength increases. It is the great 
source of rest and refreshment. Often a day's rest in bed, free 
from the cares and anxieties of an active life, is sufficient to 
ward oflF the approach of disease. If quiet and rest are essential 
to recuperation in health, their necessity in disease must be 
apparent. Life frequently depends on tranquility and repose, 
and the least noise or confusion disturbs the sufferer and 
diminishes the chances of recovery. Nothing annoys sick or 
nervous persons more than whispering and the rustling of 
newspapers. If conversation be necessary, let the tones be 
modified, but never whisper. In sickness, when the vital forces 
are low, the more natural rest and sleep the patient obtains, the 
greater is the prospect for recovery. As a rule, a patient should 
never be nwakened when sleeping quietly; not even to take 
medit'ine, unless in extreme cases. If the patient does not sleep, 
the cause should be ascertained and the appropriate remedies 
employed; if it arise from rush of blood to the head, cooling 
lotions should be applied, and warmth to the feet; if, from 
restlessness or general irritability, a sponge bath, followed by 
friction should be administered; if the wakefulness is due to 
noise or confusion, quiet is the remedy. When these means 
fail, anodynes, or nervines, should be employed. Lying on the 
side instead of on the back should be practiced. Patients 
afflicted with chronic diseases, on rising, should take a cold 
bath, dry the surface quickly with a coarse towel, followed by 
friction with the hand. Great benefit may be derived by fol- 
lowing these suggestions when the nature of the disease is not 
such as to forbid it. 

Exercise and rest necessarily alternate with each other. 



VISITING THE SICK. 38o 

Exercise, so necessary to health, in many forms of disease 
greatly contributes to recovery. It sends the sluggish blood 
coursing through the veins and arteries with increased force 
and rapidity, so that it reaches every part of the system, 
supplying it with nourishment. It increases the waste of old 
material and creates a demand for new. 

Convalescing patients, or those suffering from chronic dis- 
eases, whenever the weather will permit, should take exercise 
every day in the open air. This should be done with regu- 
larity. The amount of exercise must be regulated by the 
strength of the patient; never take so much as to produce 
fatigue, but, as the strength increases, the exercise may be 
increased proportionately. Some interesting employment, com- 
mensurate with the patient's strength, should be instituted, 
so that the mind may be agreeably occupied with the body. 

When unable to take active exercise, the invalid, properly 
protected by sufficient clothing, should ride in a carriage or 
boat, and each day a new route should be chosen, so that a 
change of scenery may be observed, thus arousing new trains 
of thought, which will be exhilarating and prove beneficial 
to him. 

Sexual Influences. During the progress of disease or 
convalescence, entire continence must be observed. It is then 
necessary that all of the vital energies should be emjiloyed 
in effecting a recovery from disease, without having the addi- 
tional tax imposed of overcoming the debilitating effects of 
sexual expenditure. This holds true with regard to all diseases, 
and especially those of the nervous system and genito-urinary 
organs. 

Vifiiiting^ the Sick may be productive of good or evil 
results. Mental impressions made upon the sick exert a power- 
ful influence upon the termination of disease. The chances 
of recovery are in proportion to the elevation or depression of 
spirits. Pleasant, cheerful associations animate the patient, 
inspire hope, arouse the vital energies, and aid in his recovery; 
while disagreeable and melancholy associations beget sadness 
and despondency, discourage the patient, depress the vital 
powers, enfeeble the body, and retard recovery. 

Unless persons who visit the sick can carry with them joy, 



384 COMMON SKN.se medical ADVISEK. 

hope, mirtli, and animation, they had better stay away. This 
applies equally in acute and chronic diseases. It does not 
matter what a visitor may think with regard to the patient's 
recovery, an unfavorable opi?iion should never find expressiov 
in the sick-room. Life hangs upon a brittle thread, and often 
that frail support is hope. Cheer the sick by words of 
encouragement, and the hold on life will be strengthened; dis- 
courage, by uttering such expressions as, "How bad you look!" 
*' Why, how you have failed since I saw you last!'' "I would 
have another doctor; one who knows something ! " " You 
can't live long if you don't get hel]»!" etc., and the tie which 
binds them to earth is snapped asunder. The visitor becomes 
^murderer! Let all persons be guided by this rule: Never 
go into the sick-room loithout carrying with you a few rays 
of sunshine! 

If tlie patient is very weak the visitor may injure him by 
staying too long. The length of the visit should be graduated 
according to the strength of the invalid. Never let the sufferer 
be wearied by too frequent or too lengthy visits, nor by ha\ ing 
too many visitors at once. Above all things, do not coniine 
your visitations to Sunday. Many do this and give themselves 
credit for an extra amount of piety on account of it, when, 
if they would scrutinize their motives more carefully, they 
, Avould see that it was but a contemptible resort to save time. 
The sick are often grossly neglected during the week only 
to be visited to death u})on Sunday. 

The use of Tobacco and Opium. The recovery of 
the sick is often delayed, sometimes entirely prevented, by 
the habitual use of tobacco or opium. In acute diseases, the 
appetite for tobacco is usually destroyed by the force of the 
disease, and its use is, of necessity, discontinued; but in chronic 
ailments, the appetite remains unchanged, and the patient 
continues his indulgence greatly to the aggravation of the 
malady. 

The use of tobacco is a pernicious habit in whatever form it 
is introduced into the system. Its active principle, Nicotin, 
which is an energetic poison, exerts its specific effect on the 
nervous system, tending to stimulate it to an unnatural degree 
of activity, the final result of which is weakness, or even 



THE USE OF TOBACCO AND OPIUM. 385 

paralysis. The horse, under the action of whip and spur, may- 
exhibit great spirit and rapid movements, but urge him beyond 
his strength with these agents, and you inflict a lasting injury. 
Withhold the stimulants, and the drooping bead and moping 
pace indicate the sad reaction which has taken place. This 
illustrates the evils of habitually exciting the nerves by the 
use of tobacco, opium, narcotic or other drugs. Under their 
action, the tone of the system is greatly impaired, and it 
responds more feebly to the influence of curative agents. 
Tobacco itself, when its use becomes habitual and excessive, 
gives rise to the most unpleasant and dangerous pathological 
conditions. Oppressive torpor, weakness or loss of intellect, 
softening of the bi'ain, paralysis, nervous debility, dyspepsia, 
functional derangement of the heart, and diseases of the liver 
and kidneys are not uncommon consequences of the excessive 
employment of this plant, A sense of faintness, nausea, gid- 
diness, dryness of the throat, tremblings, feelings of fear, 
disquietude, and general nervous prostration must frequently 
warn persons addicted to this habit that they are sapping the 
very foundation of health. Under the continued operation of 
a poison, inducing such symptoms as these, what chance is 
there for remedies to accomplish their specific action ? With 
the system already thoroughly charged with an influence 
antagonistic to their own, and which is sure to neutralize their 
effect, what good can medicine do ? 

Dr. King says, "A patient under treatment should give up 
the use of tobacco, or his physician should assume no responsi- 
bility in his case, further than to do the best he can for him." 
In our own extensive experience in the treatment of chronic 
diseases, we have often found it necessary to resort to the 
same restriction. 

The opium habit, to which allusion has also been made, is 
open to the same objections, and must be abandoned by all 
who would seek recovery. 
17 



DISEASES AND THEIR REME- 
DIAL TREATMENT. 



INTRODUCTION. 



Knowledge which is conducive to self-preservation is of pri- 
mary importance. That great educator, profound thinker, and 
vigorous writer, Herbert Spencer, has pertinently said that, 
"As vigorous health and its accompanying high spirits, are 
larger elements of happiness than any other things whatever, 
the teaching how to maintain them is a teaching that yields to 
no other whatever. And therefore we assert that such a course 
of physiology as is needful for the comprehenision of its 
general truths and their bearings on daily conduct is an all- 
essential part of a rational education." 

Believing that the diffusion of knowledge for the prevention 
of disease is quite as noble a work as the alleviation of physical 
suffering by medical skill, we have devoted a large portion of 
this volume to the subjects of physiology and hygiene. These 
we have endeavored to present in as familiar a style as possible, 
that they may be understood by every reader. Freely as we 
have received light upon these subjects have we endeavored to 
reflect it again, in hopes that a popular presentation of these 
matters made plain and easy of comprehension to all people, 
may lead the masses into greater enjoyment of life — the result 
of a better preservation of health. This we do in part as a 
public acknowledgment of our obligations to society, to whom 
every professional man is a debtor. He belongs to it, is a part 
of its common stock, and should give as well as receive 
386 



TNTRODUCTION. 387 

advantages, return as well as accept benefits. We know of no 
better way to signify our appreciation of the public confidence 
and patronage, so generously accorded to us, than to offer this 
volume to the people at a price less than the actual cost for an 
edition of ordinary size. This we do as a token of the cordial 
reciprocation of their good will. In giving to the people whole- 
some advice, by which they may be enabled to ward off disease 
and thus preserve the health of multitudes, we believe we shall 
receive their hearty approval, as well as the approbation of our 
own conscience, both of which are certainly munificent rewards. 
We believe that good deeds are always rewarded, and that the 
physician who prevents sickness manifests a genuine and earnest 
devotion to the common interests of humanity. 

We have no respect for the motives of those medical men 
who would withhold that information from the peojile which 
will direct the masses how to take care of themselves, and 
thereby prevent much sickness and suffering. Nor is the diffu- 
sion of such knowledge antagonistic to the best interests of the 
true and competent jjhysician. The necessity for his invaluable 
services can no more be set aside by popularizing physiological, 
hygienic, and medical truths, than we can dispense with those 
of the minister and lawyer by the inculcation of the principles 
of morality in our public schools. The common schools do not 
lessen the necessity for colleges or universities, but rather 
contribute to their prosperity. Nor are we so presumptuous as 
to anticipate that we could possibly make this volume so 
instructive as to render "every man his own physician." No 
man can with advantage be his own lawyer, carpenter, tailor, 
and printer; much less can he hope to artfully repair his own 
constitution when shattered by grave maladies, which not only 
impair the physical functions, but weaken and derange the 
mental faculties. What physician presumes to prescribe for 
himself, when suddenly prostrated by serious illness? He very 
sensibly submits to the treatment of another, because he realizes 
that sickness impairs his judgment, and morbid sensations 
mislead and unfit him for the exercise of his skill. If this is 
true of the physician, with how much greater force does it 
apply to the unprofessional! If a sick sea-captain is unfit to 
stand at the helm and direct his ship, how utterly incompetent 



388 COMMON SENSE MEDICAL ADVISER. 

must the raw sailor be when similarly disqualified! Nor is the 
physician as competent to treat those near and dear to him, 
when they are suffering from dangerous illness, as another 
medical man not similarly situated, whose judgment is not 
liable to be misled by intense anxiety and affectionate sym- 
pathy. 

Notwithstanding all these facts, however, a knowledge on 
the part of the unprofessional, of something more than physi- 
ology and hygiene, and appertaining more closely to medicine 
proper, will many times prove valuable. 

In the first stage of many acute affections which, if unheeded, 
gradually assume a threatening aspect, endangering life and 
demanding the services of the most skilled physician to avert 
fatal results, the early administration of some common domestic 
remedy, such as a cathartic, or a diaphoretic herb, associated 
with a warm bath, a spirit vapor-bath, or a hot foot-bath, will 
very often obviate the necessity for calling a family physician, 
and frequently save days and weeks of sickness and suffering. 

So, likewise, are there numerous, acute diseases of a milder 
character which are easily and unmistakably recognized without 
the possession of great medical knowledge, and which readily 
yield to plain, simple, medical treatment which is within the 
ready reach of all who strive to acquaint themselves with the 
rudiments of medical science. But in sudden and painful 
attacks of acute disease, life may be suddenly and unexpectedly 
jeopardized, and immediate relief prove necessary. While 
under these circumstances the prompt application of such do- 
mestic treatment as good common-sense may dictate, guided by 
a knowledge of those first principles of medical learning which 
we shall hereafter endeavor to make plain, may result in speedy 
and happy relief, yet at the same time there should be no delay 
in summoning a competent physician to the bedside of the 
sufferer. 

Then, and not the least important, there are the various chronic 
or lingering diseases, from all of which few individuals indeed, 
who pass the meridian of life, entirely escape. In this class of 
ailments there is generally no immediate danger, and, therefore, 
time may be taken by the invalid for studying his disease and 
employing those remedies which are best suited for its removal. 



INTRODUCTION. 389 

Or, if of a dangerous or complicated character, and, therefore, 
not so readily understood, he may consult either personally or 
by letter, some learned and well-known physician, who makes 
a specialty of the treatment of such cases, and whose lai-ge 
experience enables him to excel therein. 

In consideration, therefore, of the foregoing facts, we deem 
it most profitable for our readers that Part Fourth of this 
volume should be arranged in the following manner: 

The milder forms of uncomplicated, acute diseases, which may 
be readily and unmistakably recognized, and successfully man- 
aged without professional aid, will receive that attention which 
is necessary to give the reader a correct idea of them, and their 
proper remedial treatment. 

We shall devote only such attention to the severe and hazard- 
ous forms of acute diseases as is necessary in order to consider 
their initial stage, with their proper treatment, not attempting 
to trace their numerous complications, or portray the many 
pathological conditions which are liable to be developed. For, 
even by devoting much space to the latter, we could not expect 
to qualify our unprofessional readers for successfully treating 
such obscure and dangerous conditions. 

We shall devote the largest amount of space to a careful 
and thorough consideration of those chronic diseases, which, by 
a little study, may be readily recognized and understood by the 
masses, and for the cure of which we shall suggest such hygi- 
enic treatment and domestic remedies as may be safely em- 
ployed by all who are in quest of relief. In the more dangerous, 
obscure, or complicated forms of chronic diseases, the correct 
diagnosis and successful treatment of which tax all the skill 
possessed by the experienced specialist, the invalid will not be 
misled into the dangerous policy of relying upon his own 
judgment and treatment, but w'ill be counseled not to postpone 
until too late, the employment of a skillful physician. 

The apportionment of space which is made in considering 
the various diseases and their different stages, as well as the 
course which the people are advised to pursue under the differ- 
ent circumstances of affliction, is not always in accordance with 
the plans and recommendations which have been made by others 
who have written works on domestic medicine. Most of these 



390 COMMON SENSE MEDICAL ADVISER. 

authors have attempted, by lengthy disquisitions, to teach 
their readers how to treat themselves without the services of 
a physician, even in the most liazardouf^ forms of disease. In 
such dangerous maladies as typhoid, typhus, yellow, and scarlet 
fevers, typhoid pneumonia, and many others, in which life is 
imminently imperiled, such instruction and advice is decidedly 
reprehensible, as it may lead to the most serious consequences. 
We are confident, therefore, that the manner of disposing of 
the different subjects which are discussed in the succeeding 
chapters, and the course of action which is advised, Avill com- 
mend themselves to our readers as being such as are calculated 
to promote and subserve their best interests. 

MEDICAL DIAGNOSIS. 

Skill in the art of healing is indicated in three ways: (1.) by 
ascertaining the symptoms, seat, and nature of the disease, 
which is tenned diagnosis' (2.) by foretelling the probable 
termination, wJiich is termed prognosis; (3.) by the employ- 
ment of efficacious and appropriate remedies, which is called 
treatment. Of these three requisites to a prosperous issue, 
nothing so distinguishes the expert and accomplished physician 
from the mere pretender as his ready ability to interpret cor- 
rectly, the location, extent, and character of an affection from 
its symptoms. By medical diagnosis, then, is understood the 
discrimination betwden diseases by certain symptoms which are 
distinguishing signs. Every malady is accompanied by its 
characteristic indications, some of which are diagnostic, i. e., 
they particularize the affection and distinguish it from all others. 

Medical diagnosis is both a science and an art/ a science 
when the causes and symptoms of a disease are understood, 
and an art when this knowledge can be applied to determine 
its location and exact nature. Science presents the general 
])rin(i)>les of practice; art detects among the characteristic 
symptoms the differential signs, and a})})lies the remedy. Da 
Costa aptly remarks: "No one aspiring to become a skillful 
observer can trust exclusively to the light reflected from the 
writings of others; he must carry the torch in his own hands, 
and himself look into every recess." 

Tlie critical investigation of sym])toms, with the view of 



MEDICAL DIAGNOSIS. 391 

ascertaining their signs, is essential to successful pi'actice. 
Without closely observing them, we cannot accurately trace 
out the diagnosis, and a failure to detect the right disease is 
apt to be followed by the use of wrong medicines. 

General diagnosis considers the surroundings of tha patient 
as well as the actual manifestations of the disease. It takes 
into account the diathesis, i. e., the predisposition to certain 
diseases in consequence of peculiarities of constitution. We 
recognize constitutional tendencies, which may be indicated 
by the contour of the body, its growth, stature, and tempera- 
ment, since all these facts greatly modify the treatment. 
Likewise the sex, age, climate, habits, occupation, previous 
diseases, as well as the present condition, must be taken into 
account. 

Auscultation, as practiced in detecting disease, consists in 
listening to the sounds which can be heard in the chest. 

Percussion consists in striking upon a part with the view 
of appreciating the sound which results. The part may be 
struck directly with the tips of the fingers, but more generally 
one or more fingers of the other hand are interposed between 
the points of the fingers and the part to be percussed, that 
they, instead of the naked chest, may receive the blow; or, 
instead of the fingers, a flat piece of bone or ivoiy, called 
a pleximeter, is placed upon the chest to receive the blow. 

Latterly, improved instruments greatly assist the practitioner 
of medicine in perfecting this art. The microscope assists the 
eye, and helps to reveal the appearance and character of the 
excretions, detecting morbid degenerations; chemistry discloses 
the composition of the urine, which also indicates the morbid 
alterations occurring in the system; by percussion we can de- 
termine the condition of an internal organ, from the sound given 
when the external surface is percussed; the ear, with the aid 
of the stethoscope, detects the strange muraiurs of respiration, the 
fainter, more unnatural pulsations of life,, and the obscurer 
workings of disease; with the spirometer we determine the 
breathing capacity of the lungs, and thus ascertain the extent 
of the inroads made by disease; the dynamometer records the 
lifting ability of the patient; the thermom.eter indicates the mor- 
bid variation in the bodily temperature; various instruments 



392 



COMMON SENSE MEDICAL ADVISER. 




l)r. IJrown's Spirometer. 



inform us of the structural changes causing alterations in 
the specific gravity of fluids, e. g., the urinometer indicates 
those occurring in the urine; and thus, as the facilities for cor- 
rect diagnosis increase, the art of distinguishing and classifying 

diseases becomes more perfect, 
Ftg. 146. ,^nd their treatment more cer- 

tain. While physiology treats 
of all the natural functions, 
pathology treats of lesions and 
altered conditions. 

By the term symptoms we 
mean the evidence of some 
morbid effect or change occur- 
ring in the human body, and 
it requires close observation 
and well-instructed experience 
to convert these symj^toms 
into diagnostic signs. Suppose 
"Old Probabilities" (as we 
commonly designate the inval- 
uable Signal Department) hangs out his warning tokens all 
along our lake borders and ocean coasts; our sailors behold 
the fluttering symbols indicating an approaching storm, but if 
no one understood their meaning, a fearful disaster migl)t fol- 
low. But if these signals are understood, a safe harbor is 
sought and the mariner is protected. So disease may hang- 
out all her signals of distress, in order that- they may be seen, 
but unless correctly intei'preted, and a remedial harbor is 
sought, these symptoms are of little practical value. 

Undoubtedly the reason why so many symptom-doctors blunder 
is because they prescribe according to the ajjparent symptoms, 
without any real reference to the nature of the affection. They 
fail to discover how far a symptom points out the seat, and also 
the progress of a disease. They do not distinguish the relative 
importance of the different symptoms. The practical purpose 
of all science is to skillfully apply knowledge to salutary and 
profitable uses. The patient himself may carefully note the 
indications, but it is only the expert physician who can tell the 
import of each symptom. 



MEDICAL DIAGNOSIS. 393 

Symptoms are within every one's observation, but only the 
physician knows the nature and value of signs. We have read 
an anecdote of Galen, who was a distinguished physician in 
his day, which illustrates the distinction between sign and 
symptom. Once, when dangerously ill, he overheard two of 
his friends in attendance upon him recount his symptoms, 
such as "Redness of the face, a dejected, haggard, and in- 
flamed appearance," etc. He cried out to them to adopt every 
necessary measure forthwith, as he was threatened with de- 
lirium. The two friends saw the symptoms well enough; but 
it was only Galen himself, though the patient, who was able to 
deduce the sign of delirium — that is, he alone was able to 
translate those symptoms into signs. To determine the value 
of symptoms, as signs of disease, requires close observation. 

INTERPRETATIOISr OF SYMPTOMS. 

We shall refer to a few symptoms which any unprofessional 
reader may readily observe and understand. 

POi^itioil or Patient. When a patient is disposed to 
lie upon his back continually during the progress of an acute 
disease, it is a sign of muscular debility. If he manifests no 
desire to change his position, or cannot do so, and becomes 
tremulous at the least effort, it indicates general prostration. 
When this position is assumed, during the progress of continued 
fever, and is accompanied by involuntary twitching of the 
muscles, picking of the bed-clothes, etc., then danger is immi- 
nent and the patient is sinking. Fever, resulting from local 
inflammation, does not produce muscular prostration, and the 
patient seldom or never assumes the supine position. If this 
inflammation is in the extremities, those parts are elevated, in 
order to lessen the pressure of the blood, which a dependent 
position increases. 

For example, let us change the scene, and introduce a patient 
with head and shoulders elevated, who prefers to sit up, and 
who places his hands behind him and leans back, or leans for- 
ward resting his arms and head upon a chair. The next week 
he is worse, and no longer tries to lie in bed, but sits up all the 
time; note the anxious expression of countenance, the diflicult 
or hurried breathing, the dry and hacking cough, and observe 



394 COMMON SENSE MEDICAL ADVISEE. 

that the least exertion increases the difficulty of respiration and 
causes palpitation of the heart. These plain symptoms signify 
thoracic effusion, the collection of water about the lungs. 

The Cotlllteiiaiice displays diagnostic symptoms of 
disease. In simple, acnte fevers, the eyes and face are red and 
the respiration is hurried; but in acute, sympathetic fever, these 
signs are wanting. We cannot forget the pale, sharp, con- 
tracted, and pinched features of those patients whose nostrils 
contract and expand alternately with the acts of respiration. 
How hard it was for them to breathe. The contraction and 
expansion of the nostrils indicate active congestion of the 
lungs. 

As a general rule, chronic inflammation of the stomach, 
duodenum, liver, and adjacent organs, imparts a gloomy ex- 
pression to the countenance, at the same time the eye is dull, 
the skin dusky or yellow, and the motions are slow. But in 
lung diseases, the spirits are buoyant, the skin is fair, and the 
cheeks flushed with fever and distinctly circumscribed with 
white, for delicacy and contrast, almost exceed the hues of 
health in beauty. Note, too, the ])early lustre and sparkling 
light of the eye, the quivering motion of the lijjs and chin, all 
signs of puhuonary disease. 

The Story of Ne\lial Ahll»$e is plainly told by the down- 
cast countenance, the inability to look a person fairly in the 
face, the peculiar lifting of the upper lip and the furtive glance 
of the eye. The state of the mind and of the nervous system 
corroborates this evidence, for there seems to be a desire to 
escape from conversation and to elude society. The mind seems 
engrossed and abstracted, the individual a])j)ear8 absorbed in 
a constant meditation, he is forgetful and loses nearly all 
interest in the ordinary affairs of life. The whole appearance 
of a patient, suftei-ing from spermatorrhea, is perfectly under- 
stood by the experienced physician, for the facial expressions, 
state of mind, and movements of the body, all unconsciously 
betray, and unitedly proclaim his condition. 

Tongue. Much may be learned from the appearance, color, 
and form of the tongue, and the manner of its protrusion. If 
pale, moist, and coated white, it indicates a mild, febrile con- 
dition of the system. If coated in the center, and the sides 



MEDICAL DIAGNOSIS. 395 

look raw, it indicates gastric irritation. If red and raw, or dry 
and cracked, i% is a sign of inflammation of tbe mucous mem- 
brane of the stomach. If the inflammation is in the large 
intestine, the tip of the tongue presents a deep red color, while 
the middle is loaded with a dark brown coating. When the 
tongue is elongated and pointed, quickly protruded and with- 
drawn, it indicates irritation of the nerve-centers, as well as of 
the stomach and bowels. If tremulous, it denotes congestion 
and lack of functional ability; this may be observed in conges- 
tive fevers. 

Pulse. Usually the pulse beats four times during one 
respiration, but both in health and disease its frequency may be 
accelerated or retarded. In adults, there are from sixty-five to 
seventy-five beats in a minute, and yet in a few instances we 
have found, in health, only forty pulsations per minute. But 
when the heart beats from one hundred and twenty to one hun- 
dred and forty times a minute, there is reason to apprehend 
danger, and the case should receive the careful attention of a 
physician. 

Iri-egularity of the pulse may be caused by disease of the 
brain, heart, stomach, or liver; by the disordered condition of 
the nervous system; by lack of muscular nutrition, as in gout, 
rheumatism, or convulsions ; by deficiency of the heart's effective 
power, when the pulse-wave does not reach the wrist, or when 
it intermits and then becomes more rapid in consequence of 
septic changes of the blood, as in diphtheria, erysipelas, and 
eruptive fevers. 

Pain. The import of pain depends on its seat, intensity, 
nature, and duration. An acute, intense pain usually indicates 
inflammation of a nerve as well as the adjacent parts. Sharp, 
shooting, lancinating pains occur in inflammation of the serous 
tissues, as in pleurisy. A smarting, stinging pain attends 
inflammation of the mucous membrane. Acute pain is gen- 
erally remittent and not fixed to one spot. Dull, heavy pain is 
more persistent, and is present in congestions, or when the sub- 
stance of an organ is inflamed, and it often precedes hemor- 
rhage. Burning pain characterizes violent inflammations in- 
volving the skin and subjacent cellular tissue, as in case of 
boils and carbuncles. Deep, perforating pain accompanies 



396 COMMON SENSE MEDICAL. ADVISER. 

inflammation of the bones, or of their enveloping membranes. 
Gnawing, biting, lancinating pain attends cancers. 

The location of pain is not always at the seat of the disease. 
In hip-disease, the pain is not first felt in the hip, but in the 
knee-joint. In chronic inflammation of the liver, the pain is 
generally most severe in the right shoulder and arm. Disease 
of the kidneys occasionally produces numbness of the tliigh and 
drawing up of the testicle, and commonly causes colicky pains. 
Inflammation of the meninges of the brain is often indicated 
by nausea and vomiting before attention is directed to the head. 
These illustrations are suflicient to show that pain often takes 
place in some part remote from the disease. 

In chronic, abdominal affections, rheumatic fevers, gout, and 
syphilis, the entire system is thrown into a morbid state, the 
nervous system is disturbed, and wandering pains manifest 
themselves in different parts of the body. Fixed pain, which 
is increased by pressure, indicates inflammation. If it be 
due only to irritation, pressure will not increase it. Some 
rheumatic affections and neuralgia not only bear pressure, but 
the pain diminishes under it. Permanent pain shows that 
the structures of an organ are inflamed, while intermittent pain 
is a sign of neuralgia, gout, or rheumatism. Absence of pain 
in any disease, where ordinarily it should be present, is an 
unfavorable sign. Internal pain, after a favorable crisis, is a 
bad omen. Or, if pains cease suddenly without the other 
symptoms abating, the import is bad. If, however, pain and 
fever remit simultaneously and the secretions continue, it is a 
favorable sign. 

A dull pain in the head indicates fullness of the blood-vessels 
from weakness, low blood, or general debility. It may be 
caused by taking cold, thus producing passive congestion of the 
brain. It may proceed from gastric disturbance, constipation 
of the bowels, or derangement of the liver. Heaviness of the 
head sometimes precedes inflammation of the brain, or chronic 
disease of its membranes. A dull, oppressive pain in the head 
indicates softening of the brain, and is generally accompanied 
by slowness of the pulse and of the speech. A pulsating pain 
of the head occurs in heart disease, hysteria, and frequently 
accompanies some forms of insanity. 



MEDICAL DIAGNOSIS. 397 

The Eye indicates morbid changes and furnishes unmis- 
takable signs of disease. Sinking of the eye indicates waste, as 
in consumption, diarrhea, and cholera. In fevers it is regarded 
as a fatal symptom. A dark or leaden circle around the eye, 
seen after hard work, indicates fatigue and overdoing. If the 
mucous covering of the inner surface of the lids and the ball of 
the eye is congested and inflamed, it exhibits redness, and may 
indicate congestion or even inflammation of the brain. 

A dilated pupil is often observed in catarrhal consumption, 
congestion of the biain, low fevers, and chlorosis. 

The pupil contracts in inflammation of the meninges, when 
there is increased sensibility and intolerance of light, also in 
spinal complaints. In some diseases the lustre of the eye 
increases, as in consumption. But if it decreases with the 
attack of violent disease, it indicates great debility and 
prostration. 

Examination of the Urine. All medical authors and 
physicians of education, freely admit and even insist upon the 
importance of critically examining the patient's urine, in all 
cases in which there is reason to suspect disease of the kidneys 
or bladder. In chronic affections it is particularly serviceable, 
especially in derangements of the liver, blood, kidneys, bladder, 
prostate gland, and nervous system. Many scholarly physicians 
have sadly neglected the proper inspection of the urine, because 
they were afraid of being classed with the illiterate "urosco- 
pian " doctors, or fanatical enthusiasts, who ignorantly pretend 
to diagnose correctly all diseases in this manner, thus subject- 
ing themselves and their claims to ridicule. Nothing should 
deter one from giving to this excretion the attention it deserves. 

The urine which is voided when the system is deranged or 
diseased is altered in its color and composition, showing that its 
ingredients vary greatly. So important an aid do examinations 
of the urine furnish in diagnosing many chronic ailments, that 
at the Invalids' Hotel and Surgical Institute, where many 
thousands of cases are annually treated, a chemical laboratory 
has been fitted up, and a skillful chemist is employed, who makes 
a specialty of examining the urine, both chemically and micro- 
scopically, and reporting the result to the attending physicians. 
His extended experience renders his services invaluable. With 



398 COMMON SENSE MEDICAL ADVISER. 

his assistance, maladies which had hitherto baffled all efforts put 
forth to determine their true character, have frequently been 
quickly and unmistakably disclosed. 

inicroscopical Examination. This method of 
examination affords a quicker and more correct idea of a deposit 
or deposits than any other method. The expert, by simply 
looking at a specimen, can determine the character of the urine, 
whether blood, mucus, pus, uric acid, etc., are present or not. 
But when no deposit is present, then it is necessary to apply 
chemical tests, and in many cases the quantity of the suspected 
ingredient must be determined by analysis. As a detailed 
account of the various modifications which the urine undergoes 
in different diseases, would be of no practical use to the masses, 
since they could not avail themselves of the advantages which 
it would afford for correct diagnosis, except by the employment 
of a physician who does not ignore this aid in examining his 
patients, we shall omit all further details upon the subject. For 
the same reason we shall not often, in treating of the different 
diseases in which examinations of the urine furnish such 
valuable aid in forming a diagnosis, make mention of the 
changes which are likely to have occurred. 

INFLAMMATION. 

The term Lifiammation signifies a state in which the infected 
part is hotter, redder, more congested, and more painful than is 
natural. Inflammation is limited to certain parts, while fever 
influences the system generally. Inflammation gives rise to 
new formations, morbid products, and lesions, or altei-ations 
of structure. The morbid products of fever, and its modifica- 
tion of fluids are carried away by the secretions and excretions. 

The susceptibility of the body to inflammation may be natural 
or acquired. It is natural when it is constitutional ; that is, when 
there is an original tendency of the animal economy to manifest 
itself in some form of inflammation. We may notice that some 
children are far more subject to boils, croups, and erysipelatous 
diseases than others. This susceptibility, when innate, may be 
lessened by careful medication, although it may never be wholly 
eradicated. When acquired, it is the result of the influence of hab- 
its of life, climate, and the state of mind over the constitution. 



INFLAMMATION. 399 

Phlegmonous inflammation is the active inflammation of the 
cellular membrane, one illustration of which is a common boil. 
The four principal symptoms are redness, swelling, heat, and pain; 
and then appears a conical, hard, circumscribed tumor, having 
its seat in the dermoid texture. At the end of an indefinite 
period, it becomes pointed, white or yellow, and discharges pus 
mixed with blood. When it breaks, a small, grayish, fibrous 
mass sometimes appears, which consists of dead, cellular tissue, 
and which is called the core. 

There are certain morbid states of the constitution which lead 
to local inflammation, subsequent upon slight injury; or, in some 
cases, without any such provocation, as in gout, rheumatism, and 
scrofula. One of the first results of the inflammation, in such 
cases, is a weakening of the forces which distribute the blood to 
the surface and extremities of the body. It is generally admit- 
ted that in scrofulous persons the vascular system is weak, the 
vessels are small, and because nutrition is faulty, the blood is 
imperfectly organized. The result is failure in the system, for 
if nutrition fails, there may be lacking earthy matter for the 
bones, or the unctious secretions of the skin; the sebaceous 
secretion is albuminous and liable to become dry, producing 
inflammation of the parts which it ought to protect. 

Disorder of the alimentary canal and other mucous surfaces 
are sometimes reflected upon the skin. We have occasionally 
observed cutaneous eruptions and erysipelas, when evidently they 
were distinct signs of internal disorder. 

Inflammation may be internal as well as external, as inflamma- 
tion of the brain, lungs, or stomach, and it is frequently the 
result of what is called a cold. No matter how the body is 
chilled, the blood retreats from the surface, which becomes pale 
and shrunken, there is also nervous uneasiness, and frequently a 
rigor, accompanied with chattering of the teeth. After the cold 
stage, reaction takes place and fever follows. The sudden change 
from a dry and heated room to a cool and moist atmosphere is 
liable to induce a cold. Riding in a carriage until the body 
is shivering, or sitting in a draft of air when one has been 
previously heated, or breathing a very cold air during the 
night when the body is warm, especially when not accustomed 
to doing so, or exposing the body to a low temperature when 



400 COMMON SENSE MEDICAL ADVISER. 

insufficiently clothed, are all different ways of producing inflam- 
mation. 

Inflammation may result in consequence of local injury, caused 
by a bruise, or by a sharp, cutting instrument, as a knife or an axe, 
or it may be caused by the puncture of a pin, pen-knife blade or 
a fork-tine, or from a lacerated wound, as from the bite of a dog, 
or from a very minute wound poisoned by the bite of a venomous 
reptile. Local inflammations may arise from scalds, burns, the 
application of caustics, arsenic, corrosive sublimate, canthar- 
ides, powerful acids, abrasions of the surface by injuries, and 
from the occurrence of accidents. 

The swellmr/ of the part may be caused by an increase of the 
quantity of blood in the vessels, the effusion of serum and 
coagulating lymph, and the interruption of absorption by the 
injury, or by the altered condition of the inflamed part. 

The character of the paiti depends upon the tissue involved, 
and upon the altered or unnatural state of the nerves. Ordi- 
narily, tendon, ligament, cartilage, and bone are not very 
sensitive, but when inflamed they are exquisitely so. 

The heat of the inflamed part is not so great, when measured 
by the thermometer, as might be supposed from the patient's 
sensations. 

Termination of Inflammation. Inflammation ends 
in one of six different ways. Inflammation may terminate in 
resolution, i. e., spontaneous recover}'; by suppuratio?i, in the 
formation of matter; by effusion, as the inflammation caused 
by a blister-plaster terminates by effusion of water ; by 
adhesio7i, the part inflamed forming an attachment to some 
other part; by induration, hardening of the organ; or by 
gangrene, that is, death of the part. 

Thus, inflammation of the lungs may terminate by recovery, 
that is, by resolution, by suj)puration and raising of "matter," 
by hardening and solidification of the lung, or by gangrene. 
Inflammation of the endocardium, the lining membrane of the 
heart, may cause a thickening of it, and ossification of the 
valves of the heart, thus impairing its function. Inflammation 
of the pericardium may terminate in effusion, or dropsy, and 
inflammation of the liver may result in hardening and adhesion 
to adjacent parts. 



PEVER. 401 



GENERAL PRn^CIPLES FOR TREATMENT OF ESTFLAaiMATIOlS", 

Remove the exciting causes as far as practicable. If caused 
by a splinter or any foreign substance, it should be withdrawn, 
and if the injury is merely local, apply cold water to the parts ' 
to subdue the inflammation. If caused by a rabid animal, the 
wound should be enlarged and cupped, and the parts cleansed 
or destroyed by caustic. The patient should remain quiet and 
not be disturbed. The use of tincture of aconite internally, 
will be found excellent to prevent the rise of inflammation. 
A purgative is also advised, and four or five of Dr. Pierce's 
Pleasant Purgative Pellets will be suflicient to act upon the 
bowels. If there is pain, an anodyne and diaphoretic is proper. 
Dr. Pierce's Compound Extract of Smart-weed will fulfill this 
indication. In local inflammation cold water is a good remedy, 
yet sometimes hot water, or cloths wrung out of it, will be 
found to be the appropriate application. When the inflamma- 
tion is located in an organ within a cavity, as the lungs, hot 
fomentations will be of great service. Bathing the surface 
with alkaline water must not be omitted. Whenever the in- 
flammation is serious the family physician should be early 
summoned. 

FEVER. 

In fever all the functions are more or less deranged. In 
every considerable inflammation there is sympathetic fever, 
but in essential fevers there are generally fewer lesions of 
structure than in inflammation. Fever occasions great waste 
of the tissues of the body, and the refuse matter is carried 
away by the organs of secretion and excretion. The heat 
of the body in fever is generally diffused, the pidse is quicker, 
there is dullness, lassitude, chilliness, and disinclination to take 
food. We j^ropose to give only a general outline of fevers, 
enough to indicate the principles which should be observed 
in domestic treatment. 

Most fevers are distinctly marked by four stages: 1st, the 
forming stage; 2d, the cold stage; 3d, the hot stage; 4th, the 
sweating or declining stage. During the first stage the indi- 
vidual is hardly conscious of being ill, for the attack is so slight 
that it is hardly perceptible. True, as it progresses, there is a 



402 COMMON SBN8E MEDICAL ADVISEE. 

feeling of languor, an indisposition to make any bodily or 
mental effort, and also a sense of soreness of the muscles, 
aching of the bones, chilliness, and a disposition to get near 
the fii'e. There is restlessness, disturbed sleep, bad dreams, 
lowness of spirits, all of which are cliaracteristic of the form- 
ative stage of fever. 

The next is the cold stage, when there is a decided mani- 
festation of the disease, and the patient acknowledges tliat 
he is really sick. In tyjDhus and typhoid fever the chills are 
slight; in other fevers they are more marked; while in ague 
they are often accompanied by uncontrollable shaking. When 
the chill is not so distinct the nails look blue and the skin 
appears shriveled, the eye is sunken and a dark circle circum- 
scribes it, the lips are blue, and there is pain in the back. The 
pulse is frequent, small, and depressed, the capillary circulation 
feeble, the respiration increased, and there may be nausea and 
vomiting. These symptoms vary in duration from a few min- 
utes to more than an hour. They gradually abate, reaction 
takes place, and the patient begins to throw off the bed-clothes. 

Then follows the hot stage, for with the return of the circu- 
lation of the blood to the surface of the body, there is greater 
warmth, freer breathing, and a more comfortable and quiet 
condition of the system. The veins fill with blood, the counte- 
nance brightens, the cheeks are flushed, the intellect is more 
sprightly, and if the pulse is frequent, it is a good sign; if 
it sinks, it indicates feeble, .vital force, and is not a good symp- 
tom. If there is considerable determination of blood to tlie 
head it becomes hot, the arteries of the neck jjulsate strongly, 
and delirium may be expected. During the hot stage, if the 
fever runs high, the patient becomes restless, frequently changes 
his position, is wakeful, uneasy, and complains of pain in his 
limbs. In low grades, the sensibility is blunted, smell, taste, 
and hearing are impaired. 

Tlie patient in the hot stage is generally thirsty, and if he 
is allowed to drink much, it may result in nausea and vomiting. 
Moderate indulgence in water, however, is permissible. There 
is aversion to food, and if any is eaten, it remains undigested. 
The teeth are sometimes covered with dark sordes (foul accumu- 
lations) early in the fever, and the appearance of the tongue 



T-EVKB, 403 

varies, sometimes being coated a yellowish brown, sometimes 
red and dry, at other times thickly coated and white. The 
condition of the bowels varies from constipation to diarrhea, 
although sometimes they are quite regular. The urine is gen- 
erally diminished in quantity, but shows higher color. 

The sweating stage in some fevers is very marked, while in 
others there is very little moisture, but an evident decline of the 
hot stage, the skin becoming more natural and soft. The pulse 
is more compressible and less frequent, the kidneys act freely, 
respiration is natural, the pains subside, although there remains 
languor, lassitude, and weariness, a preternatural sensibility to 
cold, an easily excited pulse, and a pale and sickly aspect of the 
countenance. The appetite has failed and the powers of diges- 
tion are still impaired. 

Domestic Haiia^^eiiient of Fevers. It is proper to 
make a thorough study of the early, insidious symptoms of 
fever, in order to understand what ought to be done. If it 
arises in consequence of malaria, the treatment must be suited 
to the case. If from irritation of the bowels and improper 
articles of diet, then a mild cathartic is required. If there is 
much inflammation, a severe chill, and strong reaction, then the 
treatment should be active. If the fever is of the congestive 
variety and the constitution is feeble, the reaction imperfect, a 
small, weak pulse, a tendency to fainting, a pale countenance, 
and great pain in the head, apply heat and administer diaphor- 
etics, and procure the services of a good physician. 

As a general rule, it is proper to administer a cathartic, 
unless in typhoid fever, and for this Dr. Pierce's Purgative 
Pellets answer the purpose, given in doses of from four to 
six, according to the state of the bowels. If these are not at 
hand, a tea of sage and senna may be drunk until it produces 
a purgative effect, or a dose of Rochelle salts taken. In nearly 
all fevers we have found that a weak, alkaline tea, made from 
the white ashes of hickory or maple wood, is useful, taken weak, 
three or four times daily, or if there be considerable thirst, 
more frequently. Some patients desire lemon juice, which 
enters the system as an alkali and answers all purposes. 

Diaphoretic medicines are also indicated, and the use of Dr. 
Pierce's Extract of Spiart-weed will prove very serviceable. 



404 COMMON SENSK MEDICAL ADVISER. 

Drinking freely of pleurisy-root tea, or of a strong decoction of 
boneset is frequently useful. After free sweating has been 
established, then it is proper to follow by the use of diuretic 
teas, such as that of spearmint and pumpkin seed combined, or 
sweet spirits of nitre, in doses of twenty to thirty drops, added 
to a teaspoonful of the Extract of Smart-Aveed, diluted with 
sweetened water. 

To lessen the frequency of the pulse, fluid extract or tincture 
of aconite or veratrum may be given in water, every hour. 
During the intermission of symptoms, tonic medicines and a 
sustaining course of treatment should be employed. If the 
tongue is loaded and the evacuations from the bowels are fetid, 
a solution of sn]])hite of soda is proper; or, take equal parts of 
brewer's yeast and water, mix, and when the yeast settles, give 
a tablespoonful of the water every hour, as an antiseptic. Ad- 
ministering a warm, alkaline hand-bath to a fever patient every 
day, is an excellent febrifuge remedy, being careful not to chill 
or induce fatigue. If there is pain in the head, apply mustard 
to the feet; if it is in the side, apply hot fomentations. 

The symptoms which indicate danger are a tumid and hard 
abdomen, difficult breathing, offensive and profuse diarrhea, 
bloody urine, delirium, or insensibility. Favorable symptoms 
are a natural and soft state of the skin, eruptions on the surface, 
a natural expression of the countenance, moist tongue, free 
action of the kidneys, and regular sleep. If the domestic 
treatment which we have advised does not break the force of 
the disease and mitigate the urgency of the symptoms, it will 
be safer to employ a good physician, who will prescribe such 
a course of treatment as the case specially requires. It is our 
aim to indicate what may be done before the physician is called, 
for frequently his serA'ices cannot be obtained when they are 
most needed. Besides, if these attacks are early and properly 
treated with domestic remedies, it will often obviate the 
necessity of calling upon a physician. If, on the other hand, 
fevers are neglected and no treatment instituted, they become 
more serious in character and are more difficult to cure. 

To recapitulate, our treatment recommends evacuation 
through nature's outlets, the skin, kidneys, and bowels, main- 
taining wai-mth, neutralizing acidity, using antiseptics, tonics. 



FBVEB AND AGUE. 405 

and the hand-bath, and the fluid extract or tincture of aconite, 
or veratrum to moderate the pulse by controlling the accelerated 
and unequal circulation of the blood. It is a simple treatment, 
but if judiciously followed, it will often abort a fever, or mate- 
rially modify its intensity and shorten its course. 

FEVER AND AGUE. (Intermittent Fever.) 

The description of fever already given applies well to this 
form of it, only the symptoms in the former stage are rather 
more distinct than in the other varieties. Weariness, lassitude, 
yawning, and stretching, a bitter taste in the mouth, nausea, 
loss of appetite, the uneasy state of the stomach and bowels 
are more marked in the premonitory stages of intermittent 
fevers. The cold stage commences with a chilliness of the 
extremities and back, the skin looks pale and shriveled, the 
blood recedes from the surface, respiration is hurried, the urine 
is limpid and pale, sometimes there is nausea and vomiting, 
and towards the conclusion of the stage, the chilly sensations 
are varied with flushes of heat. The hot stage is distinguished 
by the heat and dryness of the surface of the body and the 
redness of the face; there is great thirst, strong, full, and hard 
pulse, free and hurried respiration and increased pain in the 
head and back. The sweating stage commences by perspiration 
appearing upon the forehead, which slowly extends over the 
whole body, and soon there is an evident intermission of all the 
symptoms. In the inflammatory variety of intermittent fever, 
all these symptoms are acute, short, and characterized by strong 
reaction. Gastric fever, the most frequent variety of intermit- 
tent fever, is marked by irritation of the stomach and bowels, 
and a yellow appearance of the white of the eye. 

Causes. The cause of the malarial fevers, intermittent, 
remittent, and congestive, is supposed to be miasm, a poisonous, 
gaseous exhalation from decaying vegetation, which is generally 
most abundant in swamps and marshes, and which is absorbed 
into the system through the lungs. 

Treatment. During the entire paroxysm the patient 
should be kept in bed, and in the cold stage, covered with 
blankets and surrounded with bottles of hot water. The 
Compound Extract of Smart- weed should be administered in 



406 COMMON SENSE MEDICAL ADVISEB. 

some diaphoretic herb-tea. During the hot stage, the extra 
clothing and the bottles of hot water should be gradually 
removed and cold drinks taken instead of warm. During the 
sweating stage the patient should be left alone, but as soon as 
the perspiration ceases, from two to four of the Purgative 
Pellets should be administered, as a gentle cathartic. A second 
paroxysm should, if possible, be prevented. To accomplish 
this, during the intemiission of symptoms, the Golden Medical 
Discovery should be taken in doses of from two to three 
teaspoonfuls every four hours in alternation with three-grain 
doses of the sulphate of quinine. If the attack is very severe, 
and is not relieved by this treatment, a physician should be 
sunmioned to attend the case. 

REMITTENT FEVER. (Bilious Fever.) 

The distinction between intermittent and remittent fever 
does not consist in a difference of origin. In the former disease 
there is a complete intermission of the symptoms, while in the 
latter there is only a remission. 

Trcatllient. Tlie treatment should consist in the employ- 
ment of those remedial agents advised in intermittent fever, the 
Golden Medical Discovery and quinine being taken during the 
remission of symptoms. During the height of the fever, 
tincture of aconite may be given and an alkaline sponge-bath 
administered with advantage. As in intermittent fever, should 
the course of treatment here advised not promptly arrest the 
disease, the family physician should be summoned. 

CONGESTIVE FEVER. (Pernicious Fever.) 

This is the most severe and dangerous form of malarial fever. 
It may be either intermittent or remittent in character. In some 
instances the first paroxysm is so violent as to destroy life in a 
few hours, while in others it comes on insidiously, the first one 
or two paroxysms being comparatively mild. It is frequently 
characterized by stupor, delirium, a marble-like coldness of the 
surface, vomiting and purging, jaundice, or hemorrhage from the 
nose and bowels. In America this fever is only met with in the 
Mississippi valley, and in other localities where the air contains 
a large quantity of malarial poison. 



TYPHOID PEVEE. 407 

Treatment. This fever is so dangerous that a physician 
should be summoned as soon as the disease is recognized. For 
the benefit of those who are unable to obtain medical attendance, 
we will say that the treatment should be much the same as in 
intermittent fever, but more energetic. Quinine should be taken 
in doses of from five to fifteen grains every two or three hours. 
If it be not retained by the stomach, the following mixture may 
be administered by injection: sulphate of quinine, one-half 
drachm; sulphuric acid, five drops; water, one ounce; dissolve, 
and then add two ounces of starch water. 

CONTINUED FEVERS. 

The symptoms of these fevers do not intei'mit and remit, but 
continue without any marked variation for a certain period. 
They are usually characterized by great prostration of the 
system, and are called putrid when they manifest septic changes 
in the fluids, and malignant when they speedily run to a fatal 
termination. Typhoid and typhus fevers belong to this class. 
We shall not advise treatment for these more grave disorders 
which should always, for the safety of the patient, be attended 
by the family physician, except to recommend some simple 
means which may be employed in the initial stage of the dis- 
ease, or when a physician's services cannot be promptly secured. 

TYPHOID FEVER. (Enteric Fever.) 

In typhoid fever there is ulceration of the intestines and mesen- 
teric glands. This diseased condition of the bowels distinguishes 
this fever from all others, and is readily detected by sensitive- 
ness to pressure, especially over the lower part of the abdomen 
on the right side. The early disposition to diarrhea is another 
characteristic symptom of it, and there is also no intermission of 
symptoms as in intermittent fever. The disease comes on insid- 
iously, with loss of appetite, headache, chilliness, and languor. 
It is usually a week or more before the disease becomes fully 
developed. This dangerous fever is clearly marked by all these 
distinguishing symptoms and its treatment should at once be con- 
fided to the family physician. The evacuations from the bowels 
should be thoroughly disinfected with chloride of lime or 
carbolic acid, that they may not convey the disease to others. 



408 COMMON SKNSB MEDICAL ADVISER. 



TYPHUS FEVER. 

Typhus fever is an epidemic and contagious disease, and has 
seldom appeared in America, except in seaport towns. It has 
received many different names, such as " ship fever," " hospital 
fever," "jail fever," and "camp fever." In typhus fever the 
invasion is sudden and the disease runs a rapid course. It is 
usually ushered in with a short chill, followed by severe, frontal 
headache, and pain in the back and limbs, with great muscular 
weakness. No pain is experienced in the abdomen except over 
the liver. The bowels are constipated. The face is flushed, the 
eyes suffused, the countenance dull, and, as the disease progresses, 
the cheeks assume a dusky hue. Between the fifth and eighth 
days, dirty, pink-colored spots, slightly elevated, make their ap- 
pearance on the sides of the abdomen, gradually extending all 
over the anterior portion of the body. Delirium is a common 
symptom. If no complication occurs, the fever runs its course 
in about two weeks. We shall not recommend any treatment 
except that indicated under the general management of fevers, 
but advise the early attendance of the family physician. 

THE ERUPTIVE FEVERS. 

The eruptive fevers are characterized by a rash, or a more 
distinct vesicular or pustular eruption, as in chicken-pox or small- 
pox. Each is due to a distinct specific poison, and all are con- 
tagious except those called rose-rash and erysipelas. 

SCARLET FEVER. (Scarlatina.) 

This fever takes its name from the scarlet color of the eruption 
on the surface of the body. Sometimes it is comparatively mild, 
and is then called Scarlatina Simplex; when it is accompanied 
by a sore throat, it is termed Scarlatina Anginosa; and when 
the disease is of a low, putrid type, it is called Scarlatina Ma- 
ligna. This disease has three distinct stages: (1), the stage of 
invasion; (2), the stage of eruption; and (3), the stage of des- 
quamation. In the first stage there is pain in the head, 
increased heat of the skin, redness and soreness of the throat, 
and sometimes nosebleed, diarrhea, or vomiting. The average 
duration of this stage is twenty-four hours. The eruptive stage 



SCARLET FEVEE. 409 

generally begins on the second day, though sometimes it is de- 
layed longer, and the scarlet rash rapidly diffuses itself over the 
whole body. The redness is vivid and has been compared to 
the appearance of a boiled lobster. The stage of eruption 
reaches its maximum of intensity on the third day, and it is 
important that it does not recede. Redness of the tonsils and 
throat is one of the early symptoms which precedes any cuta- 
neous eruption. The tongue also is finely spotted with numer- 
ous red points which mark its papillae, presenting an appearance 
which has been compared to that of a strawberry. 

The thirst is urgent, there is no appetite, and vomiting and 
mild delirium are common. This stage continues from four to 
six days, and sometimes longer. Desquamation (scaling off of 
the skin) commences at the decline of the eruption, in the form 
of minute, branny scales. The duration of this stage is indefi- 
nite, and may end in five or six or may continue ten or twelve 
days. 

If the inflammation in the throat is very severe, it may ter- 
minate in an abscess, which may also occur in the glands of the 
neck, and sometimes the inflammation extends to the lips, 
cheeks, and eyelids. Gangrene within the throat occurs in rare 
instances. The disease is easily communicated, and usually 
develops in two to five days after exposure. It occurs most fre- 
quently in the third and fourth years of life. There is no other 
disease so simple, and yet so often liable to prove fatal, as scarlet 
fever; and for this reason we shall advise the attendance of the 
family physician. 

Domestic treatment may be given as follows, until a physician 
can be obtained: Catnip, pennyroyal, or pleurisy-root tea, con- 
taining one teaspoonful of the Extract of Smart-weed, may be 
given, to drive the rash to the surface. Cold drinks are suitable 
to allay the thirst, nausea, and fever. The sick-room should be 
kept at a temperature of about 65=' Fahr,, and fresh air admit- 
ted freely. The patient ought not to be overloaded with bed- 
clothes; and the skin should be sponged over twice daily with 
tepid water, different parts being exposed successively, and 
carefully dried with soft clothes. Soda may be added to the 
water, but no soap should be used. The diet should consist of 
milk, extract of beef, and soups. Injections may be employed 
18 



410 COMMON SENSE MEDICAL ADVISER. 

to relieve constipation, but purgatives should be avoided. We 
repeat that this disease is one which requires the attendance of 
the family physician, and great care should be exercised during 
recovery, that no bad results may follow. 

SMALL-POX. (Variola,) 

Small-pox is produced by a specific poison, which is repro- 
duced and multiplied during the progress of the disease. It is 
contained in the pustules, and in the excretions and exhalations 
of affected individuals. It is established after a period of incub- 
ation varying from nine to thirteen days after infection. 

There are two varieties of this disease, known as confluent 
and distinct variola; in the former, the vesicles run together, in 
the latter, they are separate. 

This fever has three stages. The first is that of invasion^ 
distinctly marked by a chill or a series of chills, which alternate 
with flushes of heat. In this stage the tongue becomes coated, 
there is also nausea and vomiting, pain in the limbs, back, and 
particularly in the loins, the latter symptom being of diagnostic 
importance. This stage continues about two days, and if the 
symptoms are light, it may be expected that the disease will be 
comparatively mild, and of the distinct variety. 

The stage of eruption. The eruption begins to appear on the 
skin, generally on the third day following the attack, though in 
the throat and mouth may be discovered round, whitish, or ashy 
spots, several hours previous to the appearance of vesicles on 
the surface of the body. These are first seen on the face and 
neck, then on the trunk and upper extremities, and, lastly, on 
the lower extremities. The eruption at first appears in the form 
of small, red or purple spots, which change the texture of the 
skin by becoming more hard, pointed, and elevated. On the 
fifth day of the eruption they attain their full size, being soft- 
ened and depressed in the center, and hence are called umbili- 
cated. Now a change takes place, and the vesicles fill with 
" matter " and become pointed, and there is a rise in the fever. 
TTie stage of suppuration commences thus: the pulse quick- 
ens, the skin becomes hotter, and in many cases of the confluent 
variety, swelling of the face, eyelids, and extremities occurs. 
Frequently there is passive delirium in this stage, and if diarrhea 



VACCINIA. 411 

8ets in, it is an unfavorable sign. The duration of this stage of 
the eruption is four or five days. 

The stage of desication, or of the drying of the pustules, 
commences between the tweKth and fourteenth day of the 
disease. In the confluent variety, patches of scab cover all 
the space occupied by the eruption, and the skin exhales a 
sickening odor. 

The Treatllieilt should have reference to the determina- 
tion of the eruption to the surface. If there is thirst, allow 
cold drinks, ice-water, or lemonade. Bathing the surface with 
cold water, breathing plenty of fresh air, using disinfectants in 
the room, and taking antiseptic medicine internally, are proper. 
Add one part of carbolic acid to six parts of glycerine, mix 
from two to three drops of this with an ounce of water, and of 
this preparation administer teaspoonful doses frequently. A 
few drops of carbolic acid and glycerine may be rubbed up 
with vaseline, and the surface anointed with it to prevent pit- 
ting. The malady is so grave that it should be intrusted to 
the care of the family physician. 

VARIOLOID. (Modified Small-pox.) 

Varioloid is a modified form of small-pox. There is less 
constitutional disturbance, and very little or no pitting of the 
skin. Varioloid generally occurs in persons who have not 
been fully protected by vaccination. A person suffering from 
this modification of the disease may, by contagion, communi- 
cate to another genuine small-pox. The treatment is the same 
as that recommended in variola. 

VACCIOTA. (Cow-pox.) 

The important discovery of vaccination is due to Dr. Jenner, 
who ascertained that when the cow was affected by this disease 
and it was then communicated to man, the affection was 
rendered very mild and devoid of danger, and at the same 
time it proved a very complete protection against small-pox. 
Like most other valuable discoveries introduced to the world, 
it encountered bitter prejudice and the most unfair opposition. 
Kow its inestimable value is generally known and admitted. 

In a few cases, in which the quality of the vaccine virus was 



412 COMMOK SENSK MEDICAL ADVISER. 

deteriorated, its effect is only to slightly modify sraall-pox, and 
then the disease resembles that caused by inoculation. The 
operation of infecting the blood with the kine virus is called 
vaccination. All that we know is that when the cow becomes 
affected with this disease, and it is then transferred to man, it 
loses its severity and serves as a protection against small-pox. 
In a great majority of cases this protection is absolute, and only 
in a very few does it leave the subject susceptible to small-pox, 
materially modified. The protection it affords against small- 
})ox is found to diminish after the lapse of an indefinite number 
of years, and hence it is important to be re-vaccinated once or 
twice, for instance, after an interval of five years. Between 
the second and third months of infancy is the best period for 
vaccination, and the place usually selected is the middle of the 
§rm above the elbow-joint. 

CHICKEN-POX. (Varicella.) 

Chicken-pox is an eruptive disease, which affects children, and 
occasionally adults. .It is attended with only slight constitu- 
tional disturbance, and is, therefore, neither a distressing nor 
dangerous affection. The eruption first appears on the body, 
afterwards on the neck, the scalp, and lastly on the face. It 
appears on the second or third day after the attack, and is suc- 
ceeded by vesicles containing a transparent fluid. These begin 
to dry on the fifth, sixth, or seventh day. This disease may be 
distinguished from variola and varioloid by the shortness of 
the period of invasion, the mildness of the symptoms, and the 
absence of the deep, funnel-shaped depression of the vesicles, 
so noticeable in variola. 

Treatment. Ordinarily very little treatment is required. 
It is best to use daily an alkaline bath, and, as a drink, the tea 
of pleurisy-root, catnip, or other diaphoretics, to which may be 
added from one-half to one teaspoonful of the Extract of 
Smart-weed. If the fever runs high, a few drops of aconite in 
water will control it. 

IVIEASLES. (Rubeola.) 

This is generally a disease of less severity and importance 
than the other eruptive fevers, but it is sometimes followed by 



serious complications. The stage of invasion is marked by 
the symptoms of a common cold, sneezing, watery eyes, a dis- 
charge from the nostrils, a dry cough, chilliness, and headache. 
This stage may last four days. Then follows an eruption of 
red dots or specks, which momentarily disappear on pressure. 
On the fourtli day of the eruption the redness of the skin fades, 
the fever diminishes, and the vesicles dry into scales or little 
flakes. The eyes may be inflamed and the bowels may be quite 
lax at this stage. 

Treatment. The great object in the treatment is to 
bi'ing out the eruption. To effect this, sweating teas are 
beneficial. The free use of the Extract of Smart-weed is 
recommended, and the skin should be bathed every day with 
tepid water. Sometimes when warm drinks fail to bring out 
the eruption, drinking freely of cold water and keeping warmly 
covered in bed, will accomplish the desired result. 

False Ifleasles {Jiose Rash) is an affection of very little 
importance and may be treated similarly to a case of ordinary 
measles. 

ERYSIPELAS. 

There are few adult persons in this country who have not, by 
observation or experience, become somewhat familiar with this 
disease. Its manifestations are both constitutional and local, 
and their intensity varies exceedingly in different cases. The 
constitutional symptoms are usually the first to appear, and are 
of a febrile character. A distinct chill, attended by nausea and 
general derangement of the stomach is experienced, followed by 
febrile symptoms more or less severe. There are wandering 
pains in the body and sometimes a passive delirium exists. 
Simultaneously with these symptoms the local manifestations of 
the disease appear. A red spot develops on the face, the ear, 
or other part of the person. Its boundary is clearly marked 
and the affected portion slightly raised above the surrounding 
surface. It is characterized by a burning pain and is vei'j 
sensitive to the touch. It is not necessary for the benefit of the 
popular reader that we should draw a distinction between the 
different varieties of this malady. The distinctions made are 
founded chiefly upon the dejyth to which the morbid condition 
extends, and not on any difference in the nature of the affection. 



414 COMMON SENSE MEDICAL ADVISER. 

Suppuration of the tissues involved is common in the severer 
forms. Should the tongue become dark and diarrhea set in, 
attended with great prostration, the case is very serious, and 
energetic means must be employed to save life. A retrocession 
of the inflammation from the surface to a vital organ is an 
extremely dangerous symptom. 

The disease is not regarded as contagious, but has been known 
to become epidemic. 

Treatllicnt. The treatment during the initial stage of 
this disease should correspond with the general principles laid 
down for the treatment of fever. The spirit vapor-bath, with 
warm, diaphoretic teas, or the Compound Extract of Smart- 
weed may be given to favor sweating. The whole person 
should be frequently bathed in warm water rendered alkaline 
by the addition of saleratus or soda. The bowels should be 
moved by a full dose of the Purgative Pellets. Fluid extract 
of aconite in small and frequent doses, will best control the 
fever. The specific treatment, which should not be omitted, 
consists in administering doses of ten drops of the tincture of 
the muriate of iron in alternation with teaspoonful doses of the 
Golden Medical Discovery, every three hours. As a local 
application, the inflamed surface may be covered with cloths 
wet in the mucilage of slippery elm. Equal parts of sweet oil 
and spu-its of turpentine, mixed and painted over the surface, is 
an application of unsurpassed efficacy. 

DIPHTHERIA. 

This is an exceedingly grave, constitutional disease charac- 
terized by a rapid breaking down of the powers of life, together 
with a peculiar affection of the throat, in which a disposition 
to the formation of false membranes is a prominent feature. 
The formation of these membranes, however, is not limited to 
the throat, but may occur on mucous surfaces elsewhere. In 
this disease the local affection is but the expression of a specific, 
morbid condition of the system, which closely resembles that 
present in the severer forms of scarlet fever. 

Cause. This is an epidemic disease, and, like other epi- 
demics, has its special causes, though precisely what these are, 
has not been determined. It is also considered contagious. 



i)lPHTHERIA, 415 

Symptoms. The symptoms vary in different cases. In 
some the disease comes on gradually, while in others it is 
malignant from the first. The throat feels sore,- the neck is 
stiff and a sense of languor, lassitude, and exhaustion pervades 
the system. Sometimes a chill is experienced at the outset. 
Febrile disturbance, generally of a low, typhoid character, soon 
manifests itself. The skin is hot; there is intense thirst; the 
pulse is quick and feeble, ranging from 120 to 150 per minute. 
The tongue is generally loaded with a dirty coat, or it may be 
bright red. The odor of the breath is characteristic, and pecul- 
iarly offensive, and there is difficulty in swallowing and some- 
times in breathing. Vomiting is sometimes persistent. If we 
examine the throat, we find more or less swelling of the tonsils 
and surrounding parts, which are generally bright red, and 
shining, and covered with a profuse, glairy, tenacious secretion. 
Sometimes the parts are of a dusky, livid hue, and, in rare 
instances, pallid. The false membrane, a peculiar tough ex- 
udation, soon appears and may be seen in patches, large or 
small, or covering the entire surface from the gums back as far 
as can be seen, its color varying from a whitish yellow to a gray 
or dark ashen tint. When it is thrown off, it sometimes leaves 
a foul, ulcerating surface beneath. The prostration soon 
becomes extreme, and small, livid spots may appear on the 
surface of the body. There may be delirium, which is, in fatal 
cases, succeeded by stupor, or coma. The extremities become 
cold; diarrhea, and in some cases convulsions, indicate the 
approach of death. Sometimes the patient dies before the 
false membrane forms. 

Treatllient. The extremely dangerous character of this 
disease demands that the services of a skillful physician be 
obtained at once; and that his efforts should be aided by the 
most thorough hygienic precautions, good ventilation, bathing, 
and a supporting diet. Prior to the arrival of the physician, 
lose no time in using the spirit vapor-bath and hot foot-bath. 

If the former is impracticable, the latter is not. Get the 
patient into a prespiration, and maintain it. For this purpose, 
small doses of the Compound Extract of Smart-weed may be 
given in some diaphoretic infusion, as pleurisy-root or catnip, 
repeated as often as the case demands. Control the vomiting 



416 COMMON SfeNSJE MEDICAL AbVlSER. 

and allay the thirst by allowing the patient to suck small pieces 
of ice every five or ten minutes. Hot fomentations or spirits 
of turpentine should be applied to the throat. If the physician 
does not take charge of the patient by this time, the throat 
should be swabbed out with the following mixture: chlorate 
of potash, four drachms; tincture of muriate of iron, three 
drachms; syrup of orange, two oz.; water sufficient to make 
four oz. ; and two teaspoonf uls of it administered every tAVO or 
three hours. No drinks should be allowed the patient for a fcAV 
minutes after each dose, in order that the full local effect may 
be obtained. Inhaling steam from w^ater to w^hich a few drops 
of the oil of peppermint has been added, is often serviceable, 
although some practitioners regard the vapor of alcohol or 
limewater inhalations as preferable. The use of blisters, 
caustics, active purges, mercurials, or bleeding, should be con- 
demned. Throughout the whole course of the disease the 
strength must be supported by the most nourishing diet, as well 
as by tonics and stimulants. Beef tea, milk, milk punch, 
quinine, and brandy should be freely administered. Although 
we have given a very complete course of treatment, and one 
which has proved eminently successful in this disease, yet we 
would not advise any non-professional person to rely upon any 
course of treatment not under the observation and direction 
of a competent physician, when one can be had. 

QUINSY. (Tonsillitis.) 

This is an acute inflammation of the tonsils, which generally 
extends to, and involves adjacent structures, and is attended 
with general febrile disturbance. Its duration varies from four 
to twenty days. It sometimes terminates by a gradual return to 
health (resolution) ; or by the formation of " matter " within the 
gland (suppuration.) When this latter is the case, the swelling 
sometimes becomes so great before it breaks as to require 
lancing. 

Cail8e!>$. It most frequently results from a cold. In some 
persons there is a predisposition to it, and the individual is 
liable to recurring attacks. Persons of a scrofulous diathesis 
are more liable to it than others. 

Symptoms. Difficulty of swallowing, soreness, and stiffness 



BNI.AKGED TONSILS, 



417 



of tbe throat, are the first monitions of its approach. There 
is fever, quick, full pulse, and dryness of the skin; the tongue 
is furred, and the breath offensive. The tonsils are intensely 
red, swollen, and painful, the pain often extending to the ear. 
Sometimes but one tonsil is affected, though generally both are 
involved. In severe cases the patient cannot lie down, in conse- 
quence of the difficulty of breathing. 

Treatment. In the early stage of the disease, the spirit 
vapor-bath is invaluable. The sweating which it produces 
should be kept up by the use of the Compound Extract of 
Smart-weed in some diaphoretic infusion. Hot wet-packs to 
the throat, covered with dry cloths, are useful. The inhalation 
of the hot vapor of water or vinegar, or peppermint and water, 
is beneficial. A carthartic should be given at night. When 
the disease does not show a disposition to yield to this treat- 
ment, the services of a physician should be obtained. When 
pus, or "matter," is formed in the tonsil, which may be known 
by the increased swelling and the appearance of a yellow- 
ish spot, the services of a physician will be required to 
lance it. 



Fig. U7. 



ENLARGED TONSILS. 

Chronic enlargement of the tonsils, as shown in Fig. 147, 
A A, is an exceedingly common 
affection. It is most common to 
those of a scrofulous habit. It 
rarely makes its appearance after 
the thirtieth year, unless it has 
existed in earlier life, and has been 
imperfectly cured. Both tonsils 
are generally, though unequally 
enlarged. A person affected with \ 
this disease is extremely liable to 
sore throat, and contracts it on 
the slightest exposure; the con- 
traction of a cold, suppression of a ^.—Enlarged Tonsils. B.— Elon- 

, ^ gated Uvula, 

perspiration, or derangement or 

the digestive apparatus being sufficient to provoke inflam- 
mation. 




418 COMMON SBNSB MEDICAL ADVISER. 

Cailiites. Repeated attacks of quinsy, scarlet fever, diph- 
theria, or scrofula, and general impairment of the system, 
predispose the individual to this disease. 

iSyiliptoiII!^. The voice is often husky, nasal or guttural, 
and disagreeable. When the patient sleeps, a low moaning is 
heard, accompanied with snoring and stentorian breathing, and 
the head is thrown back so as to bring the mouth on a line with 
the windpipe, and thus facilitate the ingress of air into the 
lungs. When the affection becomes serious, it interferes with 
breathing and swallowing. The chest is liable to become flat- 
tened in front and arched behind, in consequence of the difficulty 
of respiration, thus predisposing the patient to pulmonary dis- 
ease. On looking into the throat, the enlarged tonsils may be 
seen, as in the figure. Sometimes they are so greatly increased 
in size that they touch each other. 

Treatment. The indications to be carried out in the cure 
of this malady arc: 

(1.) To remedy the constitutional derangement. 

(2.) To remove the enlargement of the tonsil glands. 

The successful fulfillment of the first indication may be readily 
accomplished by attention to hygiene, diet, clothing, and the use 
of the Golden Medical Discovery, together with small daily 
doses of the Pleasant Purgative Pellets. This treatment should 
be persevered in for a considerable length of time after the en- 
largement has disappeared, to prevent a return. 

To fulfill the second indication, astringent gargles may be 
used. Infusions of witch-hazel or cranesbill should be used 
during the day. The following mixture is unsurpassed : iodine, 
one drachm; iodide of potash, four drachms; pure, soft water, 
two ounces. Apply this preparation to the enlarged tonsils 
twice a day, with a ])robang, or soft swab, being careful to paint 
them each time. A persevering use of these remedies, both 
internal and local, is necessary to reduce and restore the parts 
to a healthy condition. 

Sometimes the enlarged tonsils undergo calcareous degenera- 
tion; in this case, nothing but their removal by a surgical opera- 
tion is effectual. This can be readily accomplished by any 
competent surgeon. We have operated in a large number of 
cases, and have never met with any unfavorable results. 



419 



ELONGATION OF THE UVULA. 

Chronic enlargement or elongation of the uvula, or palate, as 
shown at b, Fig. 147, may arise from the same causes as enlarge- 
ment of the tonsils. It subjects the individual to a great deal 
of annoyance by dropping into and irritating the throat. It 
causes tickling and frequent desire to clear the throat, change, 
weakness, or entire loss of voice, and difficulty of breathing, 
frequently giving rise to the most persistent and aggravating 
cough. 

Treatment. The treatment already laid down for en- 
larged tonsils, with which affection, elongation of the uvula is 
so often associated, is generally effectual. When it has existed 
for a long time and does not yield to this treatment, it may 
be removed by any competent surgeon. 

ANEMIA. 

When the blood contains less than the ordinary number of red 
corpuscles, the condition is known as ayimmia, and is char- 
acterized by every sign of debility. A copious hemorrhage, in 
consequence of a cut, or other serious injuiy, will lessen the 
quantity of blood and may produce anaemia. After sudden 
blood-letting, the volume of the circulation is quickly restored 
by absorption of fluid, but the red corpuscles cannot be so 
readily replaced, so that the blood is poorer by being more 
watery. This is only one way in which the blood is impovei-- 
ished. 

The blood may be exhausted by a drain upon the system, in 
consequence of hard and prolonged study. Severe mental em- 
ployment consumes the red corpuscles, leaving the blood thin, 
the skin cool and pale, and the extremities moist and cold. 

Anaemia may arise from lack of exercise, or it may be occa- 
sioned by mental depression, anxiety, disappointment, ti'ouble, 
acute excitement of the emotions or passions, spinal irritation; 
in fact, there are many special relations existing between the 
red corpuscles of the blood and the various states of the mind 
and the nervous system. The latter depends directly upon the 
health and quantity of these red corpuscles for its ability to 
execute its functions. 



420 COMMON SENSE MEDIOAl, ADVISER 

Anaemia may arise in consequence of low diet, or because the 
alimentary organs do not properly digest the food, or when 
there is not sufficient variety in the diet. No matter how anaemia 
is occasioned, whether by labor and expenditure, by hemor- 
rhages, lead poisoning, prolonged exposure to miasmatic influ- 
ences, deprivation of food, indigestion, imperfect assimilation, 
frequent child-bearing, or lactation, the number of the red cor- 
puscles in the blood is materially diminished. 

The diagnostic symptoms of anaemia are pallor of the face, 
lips, tongue, and general surface, weakness of the vital organs, 
hurried respiration on slight exercise, swelling or puffiness of the 
eyes, and a murmur of the heart, resembling the sound of a 
bellows. 

This disorder of the blood tends to develop low inflammation, 
dropsical effusion, tubercular deposits, Bright's disease, derange- 
ments of the liver, diarrliea, leucon-Hea, and is a precursor of 
low, protracted fevers. This condition of the blood predisposes 
to the development of other affections, providing they are in ex- 
istence, and often it is found associated with Bright's disease, 
cancer, and lung difficulties. 

Treatment, (l.) Prevent all unnecessary waste and vital 
expenditure. 

(2.) Place the patient under favorable circumstances for re- 
covery, by regulating the exercise and clothing entertaining the 
mind, and furnishing plenty Of pure air. 

(3.) Prescribe such a nutritious diet as will agree with the 
enfeebled condition of the patient. 

(4.) Regular habits should be established in regard to meals, 
exercise, recreation, rest, and sleep. 

(5.) The use of tonics and stimulants, as much as the stomach 
will bear, should be encouraged. Bathe the surface with a solu- 
tion of a drachm of quinine in a pint of whisky. 

(6.) Iron, in some form, is the special internal remedy in 
anaemia. Meantime, it is proper to treat the patient with gentle, 
manual friction, rubbing the surface of the body lightly and 
briskly with the warm, dry hand, which greatly stimulates the 
circulation of the blood. Anaemia occurs more frequently in 
the female than in the male, because her functions and duties 
are more likely to give rise to it. 



LEITOOCYTH^MIA. 421 

APNCEA. 

Apnoea, or short, hurried, difficult respiration, is occasioned by 
certain conditions of the blood. When anything interferes with 
the absorption of oxygen, or the elimination of carbonic acid, 
the blood is not changed from venous to arterial, and becomes 
incapable of sustaining life. This morbid condition is termed 
asphyxia. We often read of persons going into wells where 
there are noxious gases, or remaining in a close room where 
there are live coals generating carbonic acid gas and thus be- 
coming asphyxiated, dying for want of oxygen. 

Deficiency of oxygen is the cause of apnoea, and sometimes 
the red corpuscles themselves are so few, worn out, or destroyed, 
that they cannot carry sufficient oxygen, and the consequence is 
that the patient becomes short of breath, and when a fatal de- 
generation of the corpuscles ensues, he dies of asphyxia. Many 
a child grows thin and wan and continues to waste away, the 
parents little dreaming that the slow consumption of the red 
corpuscles of the blood is the cause which is undermining the 
health. Sometimes this disease is the result of starvation, 
irregular feeding, improper diet, want of care, and, at other 
times, want of fresh air, proper exercise, and sunlight. 

TreatlllCIlt. The first essential to success in the treat- 
ment of this disease, is the removal of the exciting cause. Exer- 
cise in the outdoor air and sunlight, with good, nutritious food, 
and well-ventilated sleeping aj^artments, are of the greatest 
importance. The bitter tonics, as hydrastin, with pyrophosphate 
of iron, should be employed to enrich the blood and build up 
the strength. 

LEUCOCYTHJEMIA. 

This term is used to designate a condition in which there is 
an excess of colorless blood-corpuscles. In health, the colorless 
corpuscles should exist only in the proportion of one, to one or 
two hundred of the red corpuscles. These colorless corpuscles 
increase when there is disease of the lymphatic glands, but 
whether this is the cause of their increase or perversion is not 
known. 

They have been found abundant in the blood in diseases of 
the spleen and of the liver. Diarrhea usually attends this 



42^ COMMON SKNSB MEDICAL AJDVISEK. 

complaint, together with difficult breathing, loss of strength, 
gradual decline, fever, diminution of vital forces, and finally 
death. The recovery of a well-marked case of this disease is 
very doubtful. Its average duration is about one year. 

DROPSIES. 

Transtidation is the passage of fluid through the tissue of any 
part of the body without clianging its liquid state, while exuda- 
tion means, medically, the passage of matter which coagulates 
and gives rise to solid deposits. When transudations are un- 
healthy, they may accumulate in serou* cavities or in cellular 
structures, and constitute dropsy. Exudation is the result of 
inflammation, and the product eflfused coagulates and becomes 
the seat of a new growth of tissue. Exosmosis means the pas- 
sage of fluid from within outward, and is a process constantly 
taking place in health; while transudation takes place because 
the blood is watery and the tissues are feeble and permeable, 
permitting the serum and watery elements of the blood to pass 
into certain cavities, where they accumulate. 

The cause of dropsies may be low diet, insufficient exercise, 
indigestion, hemorrhages, wasting diseases, in fact, any thing 
which impoverishes the blood and increases the relative amount 
of serum. The tardy circulation of blood in the veins, or its 
obstruction in any way, is a condition highly favorable to the 
development of dropsy. 

General dropsy is called anasarca, and is readily distinguished 
by bloating or puffiness of the skin all over the body. This 
condition is also called cedema. The skin is pale, yields under 
the finger without pain, and preserves the impression for some 
time. The oedema usually appears first in the lower extremities, 
next in the face, and from thence extends over the body. 

General dropsy is commonly due to an impoverished condition 
of the blood, and this may be the result of albuminuria, a dis- 
ease of the kidneys. Albuminuria is frequently the sequel of 
scarlatina. Hence, the utmost care should be taken against 
exposure of a patient recovering from scarlatina, and the same 
caution should be exercised during convalescence from measles; 
erysipelas, and rheumatism. Dropsies may be general, as in 
anasarca, or local, as dropsy of the heart, called cardiac dropsy; 



DROPSIES. 42S 

dropsy of the peritoneum, the serous membrane which liaes the 
abdominal cavity, called ascites; dropsy of the chest, called 
hydrothorax; dropsy of the head, called hydrocephalus; di'opsy 
of the scrotum, called hydrocele. 

Dropsy is not, therefore, of itself a disease, but only the 
symptom of a morbid condition of the blood, kidneys, liver, 
or heart. Thus disease of the valves of the heart, may obstruct 
the free flow of blood and thus retard its ckculution. In con- 
sequence the pulse grows small' and weak, and the patient cannot 
exercise or labor as usual, and finally the lower limbs begin 
to swell, then the face and body, the skin looks dusky, the 
appetite is impaired, the kidneys become diseased, there is 
difficulty in breathing, and the patient, it is said, dies of dropsy, 
yet dropsy was the result of a disease of the heart, which 
retarded the circulation and enfeebled the system, and which 
was actually the primary cause of death. 

Xreatment. Dropsy being only a symptom of various 
morbid conditions existing in the system, any treatment to be 
radically beneficial must, therefore, have reference to the dis- 
eased conditions upon which the dropsical effusion, in each 
individual case, depends. These are so various, and frequently 
so obscure, as to require the best diagnostic skill possessed by 
the experienced specialist, to detect them. There are, however, 
a few general principles which are applicable to the treatment 
of neai'ly all cases of dropsy. Nutritious diet, frequent alkaline 
baths to keep the skin in good condition and favor excretion 
through its pores, and a general hygienic regulation of the daily 
habits, are of the greatest importance. There are also a few 
general remedies which may prove more or less beneficial in 
nearly all cases. We refer to diuretics and hydragogue cathar- 
tics. The object sought in the administration of these is the 
evacuation of the accumulated fluids through the kidneys and 
bowels, thus giving relief. Of the diuretics, queen of the 
meadow, buchu, and digitalis generally operate well. As a 
cathartic, the Purgative Pellets accompanied with a teaspoonful 
or two of cream of tartar, will prove serviceable. Beyond 
these general principles of treatment it would be useless for 
ns to attempt to advise the invalid suffering from any one of 
the many forms of dropsy. The , specialist skilled by large 



424 COMMON 8KN8B MKDICAL ADVISBR. 

experience in detecting the exact morbid condition which causes 
the watery effusion and accumulation, can select his remedies to 
meet the peculiar indications presented by each individual case. 
Sometimes the removal of the watery accumulation by tapping 
becomes necessary, in order to afford relief and give time for 
remedies to act. We have found it necessary to perform this 
operation very frequently in cases of hydrocele, and also quite 
often in cases of abdominal dropsy. The chest has also been 
tapped and considerable quantities of fluids drawn off, and this 
has been followed by prompt improvement and a final cure. 

CASES TREATED. 

Case I. A Canadian gentleman, aged 68, applied at the Invalids" 
Hotel and Surgicnl Institute, for exaniinatiou and treatment. He had 
been dropsical for over two years, and had become so badly affected as 
to be unable to lie down at night. His legs were so filled with water 
and enlarged as to render it almost impossible for liim to walk, and 
there was a general anasarca. The least exertion was attended with 
the greatest difliculty of breathing. He had been undei- the treatment 
of several eminent general practitioners of medicine in Canada but 
found no relief. They were unable to discover the real canse of his 
ailment, but to tiie specialist who has charge of this class of diseases at 
our institution, and who annually examines and treats hundreds of 
such cases, it was at once apparent that the dropsy was caused from a 
weakened condition of the heart, which rendered it unable to perform 
its functions. He was put upon a tonic and alterative course of treat- 
ment, which also embraced the use of such medicines as have been 
found to exert a specific, tonic action upon the muscular tissues of the 
heart. He improved so rapidly that in less than two months he was 
able to lie down and sleep soundly all night. The bloating disap- 
peared, his strength improved, and in three month's more he was 
discharged perfectly cured. 

Case II. A man aged 42. consulted us by letter, stating that he was 
troubled with general bloating which had made its appearance grad- 
ually and was attended by general debility and other symptoms whicli 
have been enumerated as common to general dropsy. He had been 
under the treatment of several home physicians without receivhig^ any 
benefit; he had steadily grown worse until he felt satisfied that if he 
did not soon get relief "he could not live very long. He was requested 
to send a sample of his urine for examination, as we had suspicions, 
from the symptoms which he gave, that tlie cause of his dropsy was 
albumimiria. or Bright's disease of the kidneys. On examination of 
the urine, albumen in very perceptible quantities was found to be 
present. We had, about this time, come into possession of a remedy 
said by very good authority, to be a specific in degeneration of the 
kidneys when not too far advanced, and we determined to test it 
upon this well-marked case. We accordingly prescribed it, together 
with other proper tonics and alteratives, at the same time giving the 
patient important hj'gienic advice, which must be complied with if 
success is attained in the management of this very fatal malady. Our 
patient graduallv improved, and in a few months' time was restored to 
perfect health, which he has continued to enjoy ever since. From our 



RHEUMATISM. 425 

Subsequent experience, embracing the treatment of quite a large 
number of cases of Bright's disease of the Ividueys, we are satistied 
that it is, in its early stage, quite amenable to treatment. 

Case III. A man aged 35, single, consulted us for what he supposed 
to be enlargement of the testicles. The scrotum was as large as his 
head, and it was with difficulty that he could conceal the deformity 
from general observation. The disease was immediately recognized by 
the attending surgeon as hydrocele. The liquid was promptly drawn 
off by tapping, and a stimulating injection was made into the scrotum 
to prevent re-accumulation. We mention this case only because it is 
one among a very large number who have consulted us supposing that 
they were suifering from enlargement of the testicles, cancer, or some 
other morbid growtli within the scrotum, when a slight examination 
has shown the affection to be hydrocele, a disease whicli is speedily 
cured by tapping, with a little after treatment. The operation is 
perfectly safe and almost entu'ely painless. 

Case IV. A lady, aged 24, consulted us by letter enumerating a long 
list of symptoms whicli clearly indicated abdominal dropsy, resulting 
from suppression of the menses. A well-regulated, hygienic treatment 
was advised, and medicines to restore the menstrual function by 
gradually toning up and regulating the whole system, were forwarded 
to her by express. After four months' treatment, perfect recoveiy 
resulted. Cases like this latter are very common and generally yield 
quite readily to proper management. No harsh or forcing treatment 
for restoring the menstrual function should be employed, as it will not 
only fail to accomplish the object sought, but it is also sure to seriously 
and irreparably injure the system. The most difficult cases which we 
have had to deal with, have been those which had been subjected by 
other physicians to the administration of strong emmenagogues in the 
vain effort to bring on the menses, 

RHEUMATISM. 

Prominent among constitutional diseases is the one known as 
rheumatism. It is characterized by certain local symptoms or 
manifestations in fibrous tissues. This term has been applied 
to neuralgic affections and to go^lt, but it differs from each in 
several essential particulars. Rheumatism may be divided into 
(1) Acute, (2) Chronic, (3) Muscular. 

Acute Articular RBieuniatism. Acute articular 
rheumatism implies an affection of the articulations or joints. 
It usually commences suddenly; sometimes pain or soi'eness 
in the joints precedes the disclosure of the disease. The 
symptoms are pain in the joints, tenderness, increased heat, 
swelling and redness of the skin. The pain varies in its 
intensity in different cases, and is increased by the movement of 
the affected parts. Swelling of the joints occurs, especially 
those of the knee, ankle, wu-ist, elbow, and the smaller joints of 
the hands and feet. The swelling and redness are generally in 



426 COMMOif SENSll MEblCAL ADVISES. 

proportion to the acuteness of the attack. Acute articular rheu- 
matism is always accompanied with more or less fever. Sweat- 
ing is generally a prominent symptom, being strongly acid and 
more profuse during the night. The appetite is impaired, the 
tongue is coated, the bowels are constipated, or there is diarrhea. 

The Duration ol* this Di^^case. Unlike fevez-s, its 
course is marked by fluctuations; frequently after a few days 
the pain subsides, the fever disappears, and convalescence is 
apparently established, when, suddenly, all the symptoms are 
renewed with even greater intensity than before. This disease 
rarely proves fatal, unless the heart is involved. 

Causes. Rheumatism is frequently supposed to be oc- 
casioned by a suppression of the functions of the skin, and is 
generally attributed to the action of cold upon the surface of 
the body. But this acts only as an exciting cause. It is a 
disease of the blood. This form of rheumatism usually occurs 
between the age of fifteen and thirty, and prevails most exten- 
sively in changeable climates. Acute articular rheumatism 
seldom terminates in the chronic form. 

Chronic Articular Rheumatism. Articular rheu- 
matism, in the subacute or chronic form, is frequently observed 
in medical practice. The symptoms are pain and more or 
less swelling of the joints, although not of as grave a character 
as in acute rheumatism. There is freqiiently an absence of 
increased heat and redness. As in the acute form, the differ- 
ent joints are liable to be affected successively and irregularly, 
until, after a time, the disease becomes fixed in a single joint, 
and the fibrous tissues entering into the ligaments and tendons 
are liable to be affected. The appetite, digestion, and nutrition 
are often good, and, in mild cases, patients are able to pursue 
their daily vocations. The disease is supposed to be the same 
as in the acute form, but milder, and, strange to say, more per- 
sistent. A diseased condition of the blood is supposed to be 
involved in both instances, but this morbid state is less extended, 
and, at the same time, more obstinate in the chronic than in 
the acute form. Subacute articular rheumatism is not always 
chronic, and may disappear in a shorter time than in the acute 
form. Chronic articular rheumatism is not generally fatal, but 
there is danger of permanent deformities. 



RHEUMATISM. 4^7 

muscular Rheumatism. This affection is closely 
allied to neuralgia, and may properly be called myalgia. It 
exists under two forms, acute and chronic. In acute muscular 
rheumatism, there is at first a dull pain in the muscles, which 
gradually increases. When the affected muscles are not used 
the pain is slight, and certain positions may be assumed with- 
out inducing it constantly; but in movements which involve 
contraction of the muscles the pain is very violent. In some 
cases, the disease is movable, changing from one muscle to 
another, but usually it remains fixed in the muscle fii'st attacked. 
The appetite and digestion are not often impaired, and there 
is no fever. The duration of this form of rheumatism varies 
from a few hours to a week or more. 

In subacute or chronic muscular rheumatism, pain is excited 
only when the affected muscles are contracted with unusual 
force, and then it is similar to that experienced in the acute 
form. The chronic form is more apt to change its position 
than the acute. The duration of this form is indefinite. In 
both the acute and chronic forms some particular parts of the 
body are more subject to the affection than others. 

The muscles on the posterior part of the neck are subject to 
rheumatic affection. It is termed torticollis or cervical rheuma- 
tism in such cases, and should be distinguished from ordinary 
neuralgia. When the muscles of the loins are affected, it is 
commonly known as lumbago. In case the thoracic muscles 
are affected, it is known 2i% pleurodynia. In coughing, sneezing, 
and the like, the pain produced is not unlike that in pleuritis 
and intercostal neuralgia. 

One of the most marked features of muscular rheumatism, 
is the cramp-like pain, induced by the movements of the 
affected muscles, whereas the pain is slight when those muscles 
are uncontracted. This feature is very serviceable in dis- 
tinguishing muscular rheumatism, or myalgia, from neural- 
gic affections. Another trait which distinguishes muscular 
rheumatism from jieuralgia, is that the former is characterized 
by great soreness, while the latter is not. There is also a dis- 
tinction between inflammation of the muscles and muscular 
rheumatism. In the case of the former, there is continued pain, 
swelling of the parts, occasional redness, and the presence of 



428 COMMOi* SBlJSB MEDICAL ADVISEK. 

more or less fever, which conditions do not exist in the latter. 
Persons subject to rheumatism of the muscles, are apt to suffer 
from an attack, after exposure of the body to a draught of 
air during sleep, or wben in a state of perspiration. 

Treatiiieiit of* Acute RheuiiiatiMiii. Administer the 
spirit A'apor-bath to jn-oduce free perspiration, which should be 
maintained by full doses of the Compound Extract of Smart- 
weed. The anodyne properties of the latter also prove very 
valuable in allaying the pain. Tincture or fluid extract of 
aconite root may also be employed, to assist in equalizing the 
circulation, and also to secure its anodyne action. Black co- 
hosh seems to exert a specific and salutary influence in this 
disease, and the tincture or fluid extract of the root of this 
plant may be advantageously combined with the aconite. Take 
fluid extract of aconite-root, thirty drops; fluid extract of black 
cohosh, one drachm; water, fifteen teaspoonfuls; mix. The 
dose is one teaspoonful every hour. The whole person should 
be frequently bathed with warm water, rendered alkaline by 
the addition of saleratus or soda. The painful joints may be 
packed with wool or with cloths wrung from the hot saleratus 
water, and the patient kept warm and quiet in bed. The 
acetate of potash taken in doses of five grains, well diluted 
with water, every three or four hours, is very valuable in acute 
rheumatism. Its alkaline qualities tend to neutralize the acid 
condition of the fluids of the system, and it also possesses diur- 
etic properties which act upon the kidneys, removing the offend- 
ing blood-poison from the system through these organs. If the 
joints are very painful, cloths wet with the Compound Extract 
of Smart-weed and applied to them, and covered with hot 
fomentations, very frequently relieve the suffering. The major- 
ity of cases yield quite promptly to the course of treatment 
already advised, if it is persevered in. The disease, however, 
sometimes proves obstinate and resists for many days the best 
treatment yet known to the medical profession. 

Treatment oV Chronic Rheumatism. The gen- 
eral alkaline baths recommended in the acute affection arc also 
valuable in the chronic. The spirit vapor-bath, the Turkish, as 
well as the sulphur vapor-bath, are all worthy of a trial in this 
obstinate and painful disease. Alteratives are a very valuable 



RHEUMATISM. 429 

class of agents in chronic rheumatism. The following mixture, 
in teaspoonful doses three times a day, in alternation with the 
Golden Medical Discovery, has proved very successful in this 
disease: acetate of potash, one ounce; fluid extract of black 
cohosh, one ounce; fluid extract of poison hemlock, two drachms; 
simple syrup, six ounces. This thorough altei-ative course, if 
well persevered in, together with the use of alkaline and vapor- 
baths, will generally prove very successful. The specialist, 
however, dealing with chronic diseases exclusively, will occa- 
sionally meet with a case which has been the rounds of the home 
physicians without benefit, that will tax his skill and require the 
exercise of all his perceptive faculties to determine the exact 
condition of the patient's system, upon which the obstinacy of 
the disease depends. When this is ascertained, the remedies 
will naturally suggest themselves, and the malady will generally 
yield to them. But, although the treatment of this disease has 
entered largely into our practice at the Invalid's Hotel, and has 
been attended by the most happy results, yet the cases have 
presented so great a diversity of abnormal features, and have re- 
quired so many variations in the course of treatment, to be 
met successfully, that we frankly acknowledge our inability to 
so instruct the unprofessional reader as to enable him to detect 
the various systemic faults common to this ever-varying dis- 
ease, and adjust remedies to them, so as to make the treatment 
uniformly successful. If the several plans of treatment which 
we have given do not conquer the disease, we can not better 
advise the invalid than to recommend him to employ a physician 
of well-known skill in the treatment of chronic diseases. If 
such a one is not accessible for personal consultation, a careful 
statement of all the prominent symptoms, in writing, may be 
forwarded to a specialist of large experience in this disease, who 
will readily detect the real fault, in which the ailment has its 
foundation. Particularly easy wall it be for him to do so, if he 
be an expert in the analysis of urine. A vial of that which is 
first passed in the morning, should be sent with the history of 
the case, as chronic rheumatism effects charactei'istic changes 
in this excretion, which clearly and unmistakably indicate the 
abnormal condition of the fluids of the body upon which the 
disease depends. 



430 COMMON SBNSB MEDICAL ADVISEE. 



GOUT. 

Gout is closely allied to rheumatism, and the two, by some 
authors, have been regarded as identical. They, however, show 
distinct points of contrast, and each affection should have a 
separate place in the catalogue of diseases. Rheumatism 
usually affects the larger joints, while gout attacks the smaller 
ones, for example, the toes. The cause of this disease is an im- 
moderate use of stimulating food and drinks. Plethoric persons 
are its most frequent victims. 

The distinguishing characteristic of gout is a morbid deposit 
within and around the joints. When recent, the deposit is a 
semi-solid, cream-coloi"ed substance, resembling mortar. By the 
aid of the microscope, needle-shaped crystals are seen to have 
fonned around the joint. At length these become hardened 
into masses, assume a chalk-like appearance, and are supposed to 
be salts of soda, which are deposited here instead of being 
naturally expelled from the system through the kidneys. These 
deposits occur in gout, are peculiar to it, and to no other 
disease. Gout may appear in three fonns: Acute, Chronic, 
and Retrocedent. 

Acute Gout. This form of the disease is usually sudden, 
occurring in the night, and is of short duration. The attack is 
marked by pain, which is generally in one of the great toes. 
Often the disease is extended from the toe to the heel, ankle, 
and larger joints. Its duration varies from a few days to 
several weeks. . 

Chronic Gout. In this form, the pain, heat, and redness, 
which characterize the acute form of the affection, are very 
slight or entirely wanting. The chalky concretions are deposited 
about the joints, and sometimes make their way through the 
skin. In some cases, patients become crippled and deformed. 

Retrocedent Gout. This is a foi-m in which the affection is 
transferred from the external parts to some internal organ, as 
the stomach, intestines, lungs, or brain. It is sometimes, though 
seldom, transferred to the heart. 

Treatment. The purpose of the treatment is to rid the 
blood of uric acid, and to render this acid more soluble, alkaline 
remedies are given. The bicarbonate of potash is one of the 



SCKOFULA. 431 

best. In place of this, ten grains of phosphate of ammonia, or 
the urate of lithia, in five-grain doses, may be given three times 
a day. In other respects, the treatment of this affection is 
similar to that suggested for rheumatism. Colchicum has been 
largely employed as a remedy for gout, and is frequently fol- 
lowed by good results. It excites the kidneys to action and 
thus removes the blood-poison from the system through these 
excretory organs. The wine of colchicum may be taken in one- 
half teaspoonful doses three times a day. 

SCROFULA. 

It is estimated that about one-fifth of the human family are 
afflicted with scrofula. A disease so prevalent and so destructive 
to life, should enlist universal attention and the best efforts of 
medical men, in devising the most successful treatment for its 
cure. It varies in the intensity of its manifestation, from the 
slightest eruption upon the skin (scrofulous eczema), to that 
most fatal of maladies, pulmonary consumption. 

The Scrorulous Diathesis. The existence of a certain 
disposition or habit of body, designated as the scrofulous or strxi- 
mous diathesis, cachexia, or dyscrasia, is generally recognized 
by medical practitioners and writers as a constitutional condition 
predisposing many children to the development of this disease. 
Enlargement of the head and abdomen, fair, soft, and trans- 
parent, or dark, sallow, greasy or waxy-looking skin, and preco- 
cious intellect are supposed to indicate this diathesis. 

The characteristic feature of this disease, in all the multi- 
farious forms that it assumes, is the formation of tubercle, 
which, when the malady is fully developed, is an ever-present 
and distinguishing element. 

Thiherculous is therefore almost synonymous with scrofulous, 
and to facilitate an acquaintance with a large list of very preva- 
lent maladies, we may generalize, and classify them all under this 
generic term. As tubercle will frequently be spoken of, playing, 
as it does, a conspicuous part in an important list of diseases, 
which will hereafter be considered, the reader will naturally be 
led to inquire: 

IkWhat is Tubercle? As employed in pathology, the 
term is usually applied to " a species of degeneration, or morbid 



432 COMMON SENSE MEDICAL ADVISER. 

development of an opaque matter of a pale yellow color, hav- 
ing, in its crude condition, a consistence analogous to that of 
concrete albumen." The physical properties of tubercle are not 
uniform, however. They vary with age and other circum- 
stances. Some are hard and calcareous, while others are soft 
and pus-like. The color varies from a light yellow, or almost 
white, to a dark gray. 

It is almost wholly composed of albumen united with a small 
amount of earthy salts, as phosphate and carbonate of lime, with 
a trace of the soluble salts of soda. 

The existence of tubercular deposits in the tissues of the body, 
which characterizes scrofula, when fully developed, must not, 
however, be regarded as the primary affection. Its formation is 
the result of disordered nutrition. The products of digestion 
are not fully elaborated, and pass into the blood imperfected, 
in which condition they are unable to fulfill their normal destiny 
— the repair of the bodily tissues. Imperfectly formed album- 
inous matter oozes out from the blood and infiltrates the tissues, 
but it has little tendency to take on cell-forms, or undergo the 
vital transformation essential to becoming a part of the tissues. 
Instead of nutritive energy, which by assimilation produces 
perfect bodily textures, this function, in the scrofulous diathesis, 
is deranged by debility, and there is left in the tissues an imper- 
fectly organized particle, incapable of undergoing a complete 
vital change, around which cluster other particles of tubercular 
matter, forming little grains, like millet seed, or growing, by 
new accretions of like particles, to masses of more extensive 
size. As tubercle is but a semi-organized substance, of deficient 
vitality, it is very prone to disintegration and suppuration. 
Being foreign to the tissues in which it is embedded, like a thorn 
in the flesh, it excites a passive form of inflammation, and from 
lack of inherent vital energy it is apt to decompose and cause 
the formation of pus. Hence, intilti-ation of the muscles, glands, 
or other soft parts with tuberculous matter, when inflammation 
is aroused by its presence, and by an exciting cause, give rise to 
abscesses, as in lumbar or psoas abscesses. When occurring in 
the joints, tubercles may give rise to chronic suppurative inflam- 
mation, as in white swellings and hip-joint disease. Various 
skin diseases are regarded as local expressions of, or as being 



SCROFULA. 433 

materially modified by, the scrofulous diathesis, as eczema, im- 
petigo, and lupus. The disease popularly known as '■'■fever-sore'''' 
is another form of scrofulous manifestation, affecting the shafts 
of the bones, and causing disorganization and decay of their 
structure. Discharges from the ear, bronchitis, chronic inflam- 
mation of the intestinal mucous membrane, and chronic diarrhea 
are frequently due to scrofula, while pulmonary consumption is 
unanimously regarded as a purely scrofulous affection. Scrofula 
shows a strong disposition to manifest itself in the lymphatic 
glands, particularly in the superficial ones of the neck. The 
most distinguishing feature of this form of the disease is the 
appearance of little kernels or tumors about the neck. These 
often remain about the same size, neither increasing nor dimin- 
ishing, until finally, without having caused much inconvenience, 
they disappear. After a time these glands may again enlarge, 
Avith more or less pain accompanying the process. As the dis- 
ease pi'Ogresses, the pain increases, and the parts become hot and 
swollen. At length the " matter " which has been forming be- 
neath, finds its way to the surface and is discharged in the form 
of thin pus, frequently containing little particles or flakes of 
tubercular matter. During the inflammatory process there may 
be more or less febrile movement, paleness of the surface, lan- 
guor, impaired appetite, night sweats, and general feebleness of 
the system. The resulting open ulcers show little disposition to 
heal. 

l$yiIiptom!>$. There is a train of symptoms characteristic 
of all scrofulous diseases. The appetite may be altogether lost 
or feeble, or in extreme cases voracious. In some instances 
there is an unusual disposition to eat fatty substances. The 
general derangement of the alimentary functions is indicated by 
a red, glazed, or furrowed appearance of the tongue, flatulent 
condition of the stomach, and bloated state of the bowels, 
followed by diarrhea or manifesting obstinate constipation. 
Thirst and frequent acid eructations accompany the imperfect 
digestion. The foul breath, early decay of the teeth, the slimy, 
glairy stools, having the appearance of the white of eggs, and 
an intolerable fetor, all are indicative of the scrofulous tenden- 
cies of the system. ' 

Causes. Scrofula may be attributed to various causes. 
19 



434 COMMON SENSE MEDICAL ADVISER. 

Observation lias shown that ill-assorted marriages, are a prolific 
source of scrofula. Both parents may be not only healthy, 
and free from all hereditary taints, but robust, well-formed 
physically, perfectly developed, and yet not one of their 
children be free from this dire disease. It may present itself in 
the form of hip-disease, white swelling, " fever -sore," suppurat- 
ing glands, curvature of the spine, rickets, ulcers, pulmonary 
consumption, or some skin disease, in every case showing the 
original perversion of the constitution and functions. Scrofula 
is hereditary when the disease, or the diathesis which predisposes 
to its development, is transmitted from one or both parents who 
are affected by it, or who are deficient in constitutional energy, 
showing feeble nutrition, lack of circulatory force, and a 
diminished vitality. All these conditions indicate that a few 
exposures and severe colds are often sufficient to produce a 
train of symptoms, which terminate in pulmonary or other 
strumous affections. Whatever deranges the function of nutri- 
tion is favorable to the development of scrofula, therefore, 
irregularities and various excesses tend to inaugurate it. Deple- 
tion of the blood by drastic and poisonous medicines, such as 
antimony and mercurials, hemorrhages and blood-letting, 
svphilis, excessive mental or physical labor, as well as a too 
early use and abuse of the sexual organs, all tend to waste the 
blood, reduce the tone of the system, and develop scrofula. 

Scrofula may be the consequence of insufficient nourishment, 
resulting from subsisting upon poor food, or a too exclusively 
vegetable diet, with little or no animal food. 

Want of exex'cise and uncleanliness contribute to its produc- 
tion. It is much more prevalent in temperate latitudes, where 
the climate is variable, than in tropical or frigid regions. The 
season of the year also greatly influences this disease, for it 
frequently commences in the winter and spring, and disappears 
again in the summer and autumn months. 

Treatment. The skin should be kept clean by means of 
frequent baths. These assist the functional changes which must 
take place on the surface of the body, permit the stimulating 
influence of the light and air, and facilitate the aeration of 
the blood, as well as the transpiration of fluids through 
the innumerable pores of the skin. All exposure to a low 



SCROFULA. 



435 



Fig. IJfS. 



temperature, especially in damp weather, and the wearing of 
an insufficient amount of clothiag should be avoided. Then 
the food should be generous and of the most nourishing and 
digestible character. Steady habits and regular hours for eating 
and sleep must be observed, if we would restore tone and 
regularity to the functions of nutrition. Moderate exercise in 
the open air is essential, in order that the blood may become 
well oxygenated, that the vital changes may take place. It is 
no doubt true that the occasion of the prevalence of scrofula 
among the lower classes may be ascribed to frequent and severe 
climatic exposures, irregular and poor diet, or want of due 
cleanliness. Every well-regulated family can avoid such causes 
and live with a due regard to the conditions of health. The 
proper treatment of scrofula is important, because we meet with 
its symptoms on every side, showing 
its slow action upon different parts of 
the body and its influence upon all 
the organo. After this disease has 
been existing for an indefinite length 
of time, certain glands enlarge, slowly 
inflame, finally suppurate, and are 
very difficult to heal. These sores 
are very liable to degenerate into 
ulcers. AH of these symptoms point 
to a peculiar state of the blood, which 
continually feeds and strengthens this 
morbid outbreak. All authors agree 

that the blood is not rich in fibrinous elements, but tends to 
feebleness and slow inflammation, which ends in maturation. 
Thus we may trace back this low and morbid condition of the 
blood to debility of the nutritive organs, defective digestion, 
which may be induced by irregular habits, a lack of nourishing 
food, or by the acquirement of some venereal taint. 

The matter that is discharged from these glands is not 
healthy, but is thin, serous, and acrid; a whey-like fluid contain- 
ing little fragments of tuberculous matter, which resembles 
curd. The affected glands ulcerate, look blue and indolent, and 
manifest no disposition to heal. We have thus traced this 
disorder back to weak, perverted, and faulty nutrition, to 




A Scrofulous Tumor. 



43(l COMMON SENSE MEDICAL ADVISER. 

disordered and vitiated blood, the products of which slowly 
inflame the glands, which strain out unhealthy, irritating, 
poisonous matter. The medicines to remedy this perverted 
condition of the blood and fluids must be alteratives which will 
act upon the digestive organs and tone the initritive functions, 
thus enriching and purifying the blood. As this aftection is 
frequently a complication in chronic diseases, it is eminently 
proper for us to refer to a few considerations involved in its 
general treatment. 

An alterative medicine belongs to a class which is considered 
capable of producing a salutary change in a disease, without 
exciting any sensible evacuation. In scrofula, remedies should 
be employed which will improve digestion and also prevent 
certain morbid operations in the blood. 

It is well known to medical men that nearly all medi<Mneh 
belonging to the class of alteratives, are capable of solution in 
the gastric and intestinal secretions, and pass without material 
change, by the process of absorption, through the coats of the 
stomach and intestines, as do all liquids, and so gain an entrance 
into the general circulation; that these same alteratives act 
locally to tone and strengthen the mucous surfaces, and thus 
promote and rectify the process of digestion before being 
absorbed; that alterative medicines, when in the blood, must 
permeate the mass of the circulation, and thus reach the remote 
parts of the body and influence every function; that these 
medicines, while in the blood, may combine with it, reconstruct 
it, and arrest its morbid tendencies to decomposition. 

We should use those alteratives which give tone to the 
digestive and nutritive functions, in order to curtail the constant 
propagation of scrofula in the system; which alter and purify 
the blood through the natural functions, thus reconstructing 
it; and which check the septic, disorganizing changes whicrh 
are evinced by the irritating and poisonous matter discharged 
from the ulcers. 

These are the three ways in which medicines operate upon the 
nutritive functions and the blood. 

Thus alteratives may be specifics, in so far as they are 
particularly useful in certain disorders, and the combination 
which has been made in the Golden Medical Discovery, excels 



SCROFULA. 4B7 

all others with which we are acquainted, for scrofulous diseases, 
particularly in fultilling the foregoing indications. It works out 
peculiar processes in the blood, not like food, by supplying 
merely a natural want, but by strengthening the nutritive func- 
tions and counteracting morbid action, after which operations it 
passes out of the system by exci-etion. 

From what has been said upon the importance of blood 
medicines and their modes of action, the reader must not infer 
that we account for all diseases by some fault of the humors of 
the body, for we do not. But that scrofula, in its vai'ied forms, 
results from imperfect nutrition and disorders of the blood, is 
now universally conceded. It is for this reason that neither 
time nor pains have been spared in perfecting an alterative, 
tonic, nutritive, restox'ative and, antiseptic compound, to which 
Dr. Pierce has given the name of Alterative Extract, or Golden 
Medical Discovery. Not only is it an alterative and a nutritive 
restorative, acting upon the secretions, but it opposes putrefac- 
tion and degenerative decay of the fluids and solids. Hence its 
universal indication in all scrofulous diseases. It will inter- 
cept those thin, watery discharges which are the result of 
weakness, degeneration, and putrescent decay of the blood, 
perpetuated by a low grade of scrofulous inflammation. By 
an adult it can be taken in doses of from one to two teaspoon - 
fuls three or four times per day. 

The bowels should be properly regulated. When constipation 
exists one or two Purgative Pellets taken daily, will fulfill the 
indication. A tea made of equal parts of the bark of tag elder, 
sassafras, and prickly-ash, is a common domestic remedy and 
is supposed to purify the blood. While it can do no harm, it 
will not be found very efficient. A tincture made by putting 
fresh burdock and yellow dock roots into whisky, the dose of 
which is a teaspoonful once a day, in the morning shortly after 
rising, may sometimes be beneficial, yet it cannot always be 
relied upon. The patient ought not to neglect to carry out all 
the hygienic recommendations heretofore given. The treatment 
of local tumors or running sores is very simple. Cleanse the.n 
every day with Castile-soap and water, and apply some mild 
ointment, such as one made by adding together one part each, by 
jveight, of bees-wax and mutton tallow, and two parts of lard. 



438 COMMON SBNSK MBDICAL, ADYISBR. 

LUMBAR AND PSOAS ABSCESSES. 

Lumbar abscess is a form of scrofula, generally commencing 
in the small of the back near the origin of the psoas muscles. 
It then runs down over the pelvis and generally involves the 
tissue in the region of the groin, near the place where the thigh- 
bone articulates with the hip-bone, and the psoas muscle is 
generally affected. 

The l^iyniptoilliS of lumbar abscess are dull, heavy pains, 
extending down the outside of the thigh, sometimes to the foot. 
When the patient is in a reclining position, the thighs are 
generally flexed upon the abdomen. The pain finally becomes 
intense, the appetite impaired, the breath foul, and chills are 
experienced, and there are night sweats and symptoms of fever. 

The swelling is caused by a collection of " matter " in the 
cellular tissue. The cyst or bag which contains the " matter " 
is continually enlarging as it increases. When the abscess is 
opened or bursts the surface of the cyst becomes inflamed. The 
discharge consists of flaky, tuberculous matter, mingled with 
pus and sometimes blood. 

Treatment. The principles to be observed in the treat- 
ment of this affection are to preserve the strength of the patient 
by the plentiful use of nutritious articles of diet, to improve the 
digestive functions and to constantly employ the best altera- 
tives. All the best hygienic recommendations which have been 
suggested under the treatment of scrofula, apply to the manage- 
ment of this affection. No depletive or exhausting treatment 
is permissible but the free use of tonic and antiseptic alteratives 
should be persistently followed. The patient should have plenty 
of fresh air, sunlight, and a nourishing diet. 

If these abscesses are opened, it must be done so as not to 
permit the entrance of air to the suppurating surface, for that 
will only intensify the inflammation. And when injections are 
made with a view to change the character of the morbid action 
already set up, they should be introduced so as not to permit 
the entrance of air. These surgical means should not be 
undertaken without weighing all the liabilities and conse- 
quences, for they are often rashly employed by inexperienced 
surgeons. 



HIP-JOINT DISEASE. 439 

HIP-JOINT DISEASE. (Coxalgia. 

Hip-joint Disease, also known as Coxalgia, is frequently a 
scrofulous affection of the hip-joint. It usually attacks children, 
but may occur at any period of life. The causes of this affec- 
tion are imperfectly understood, yet all the indications point to 
a scrofulous state of the system. Dampness, cold, improper 
diet, severe injuries from blows or falls are all numbered among 
the,exciting causes which are conducive to the establishment of 
this disease. 

The 8yiliptoill§ are usually developed gradually; at first 
there is severe pain in the knee, but finally it is located in the 
hip-joint. Occasionally it is noticed in the hip and knee at the 
same time. As the disease progresses, the general health 
becomes impaired, there is wasting of the muscles, wakefulness, 
disturbed sleep, high fever, profuse and offensive perspiration, 
the hair falls out, and there is an inability to move the limb 
without producing excruciating pain. Frequently pus will be 
formed and discharged at different points, and the limb will 
become greatly emaciated. Since pain in the knee-joint mav 
mislead as to the location of the disease, to determine the seat 
of the affection place the patient in a chair and percuss the 
knee lightly, by giving it a slight blow with the knuckle; if the 
hip be affected, the pain will be readily felt in that joint; if it 
be simply neuralgia of the knee-joint, it will excite no pain 
whatever. If the disease be allowed to progress and dislocation 
of the joint takes place, the affected limb becomes shortened. 

Treat meilt. The treatment of this disease should consist 
in rest for the hip- joint, cleanliness of the person and plenty of 
fresh air and light, a nutritious diet and the use of tonics and 
sustaining alterative medicines. This class of medicines should 
be persistently employed, in order to obtain their full effects. 
It is a disease which progresses slowly and which is not easily 
turned from its course, and its fatality should warn the afflicted 
to employ the best of treatment. 

Many poor, unfortunate victims know too well, from sad 
experience, that the course of treatment frequently recom- 
mended and employed by physicians and surgeons is ineffectual, 
and cruel; they deplete the system, apply locally liniments. 



440 COMMON SENSE MEDICAL ADVISER. 

lotions, iodine, and hot applications; confine the patient in bed 
and strap his hips down immovably, thus preventing all exer- 
cise; then they attach that cruel instrument of torture, the 
weight and pulley, to the diseased limb. 

After many years of practical experience in the treatment 
of hundreds of cases, we have developed a system of treatment 
for this terrible malady which is based upon common sense. 
Instead of depleting, we, by proper constitutional treatment, 
strengthen and fortify the system. We do not confine the 
patient in bed, but permit hitn to go around and take all 
necessary exercise. We adjust an ingeniously devised and 
perfectly fitting appliance or apparatus, by which a gentle 
extension of the limb is maintained, thereby relieving the ten- 
sion of the muscles, and preventing the friction and wearing 
of the inflamed surfaces of the joint, which, without the use 
of our new and improved appliance, are a source of constant 
irritation. The appliances lequired in the successful treatment 
of this disease are numerous and varied in their construction, 
and require skill and experience on the part of the surgical 
mechanic as well as on the part of the surgeon, to take ac- 
curate and proper measurements of the diseased limb, and to 
construct the appliances so that they will be adaj)ted to the 
various requirements of different cases. There are no definite 
rules for taking these measurements, and only a thorough 
examination of the case can indicate to the eye of the experi- 
enced surgeon what measurements are required, and what kind 
of an appliance is suitable for each individual case. At the 
Invalids' Motel and Surgical Institute these measurements are 
all taken by the surgeon in person, and each appliance is 
constructed under his immediate supervision. It is utterly 
impossible for physicians who have but a limited experience 
in the treatment of such cases to take coriv(!t measurements 
and send off for an apparatus which will fulfill the require- 
ments of the case. 

In the light of our vast experience at the Invalids' Hotel and 
Surgical Institute, we feel that we cannot too strongly urge the 
employment of a suitable apparatus for supporting the hip- 
joint, giving it jierfect rest, and enabling the patient to exercise 
and getythe out-door air. As much of the pain in this disease is 



HIP-JOINT DISEASE. 441 

due to the pressure of the head of the femur, or thigh-bone, in 
the acetabulum, or socket, steadily-applied mechanical extension, 
to relieve the inflamed and sensitive joint of the pressure, is of 
the greatest importance. By such application the patient is 
enabled to move about without pain, while the joint is kept 
perfectly at rest — a condition favorable to the reduction of 
inflammation within it. The surgeon specialist of the Invalids' 
Hotel and Surgical Institute is frequently sent for to visit cases 
of this disease hundreds of miles away; and by the employ- 
ment of suitable apparatus, he has been enabled, iii scores of 
eases, to relieve the suffering at once. In cases in which the 
head of the thigh bone, or the bony socket of the joint, has 
become so diseased as to cause it to ulcerate and break down, 
all portions of diseased bone should be thoroxtghly removed by 
a surgical operation. If this be neglected or delayed, a fatal 
termination of the disease may be expected. Parents should 
not put off the employment of a competent specialist in this 
terrible, distressing, and fatal disease. As treated by general 
practitioners, it very often proves fatal; or, after causing intense 
suffering for a series of years, if the active condition of the 
disease subsides, the patient is left with a ruined and broken 
constitution, a result which more prompt and earlier relief 
would have prevented. The following sample cases, selected at 
random from among a large number treated, furnish sufficient 
evidence of the results attained by our method of treatment: 

Case 12,342. A gentleman residing in Chicago sent for our special- 
ist to visit his boy, ten years old, who had been confined to bed 
with liip-joint disease for four mouths. Extension witli strong sup- 
port was applied, aud the lad was able to move and sit uji, with very 
little inconvenience, the first day. Within a week, his father brought 
him to our institution for further treatment, which resulted, in two 
months' time, in his complete recovery. 

Case 11,155. A gentleman of Rochester consulted our specialist 
in the case of his daughter, who had suffered terribly for months, 
aud who was greatly emaciated from the effects of hip-joint disease. 
For a long time, the surgeon treating the case mistook the disease 
for sciatica. At the time our surgeon visited the case, two large 
sinuses, or fistulous openings were discharging large quantities of 
pus, together with pieces of bone, showing a breaking down of tlie 
bony structures entering into the joint. After proper preparatory 
treatment, tlie joint was cut down upon, and the diseased head of 
the thigh-bone removed. The parts readily healed, and the patient 
made a rapid recovery under the supporting, tonic, and blood-purifying 
effects of tlie Golden Medical Discovery. 



442 COMMON SENSE MEDTOAT. AT>VISER, 

Case 13,660. The little daughter of a gentleman living at Toronto, 
Ontario, was brought to our institution, suftering from what had been 
erroneously pronounced disease of the knee-joint by several eminent 
general practitioners. The i)ain in the knee-joint had misled these 
medical gentlemen; for, after careful examination, our specialist dis- 
covered the disease to be in tlie hip-joint. An extension and supporting 
apparatus was carefully adjusted to the lunb, a supporting, tonic, ana 
alterative course of medicines ordered, with tonic baths, and out-door 
exercise. This rational course of treatment restored the patient to 
good health in a few weeks. 

The records of practice at the Invalids' Hotel and (Surgical 

Institute abound in reports of cases similar to the preceding, 

demonstrating the fact, that by careful and judicious manage- 

niiMit, hip-joint disease in all its earlier stages, may be promptly 

arrested, and that cures may be eifected even when the bony 

structure of the joint is seriously diseased. 

WHITE SWELLING. 

White Swelling, otherwise known as Hydrarthrtis, or /Syno- 
vitis, more frequently affects the knee-joint than any other 
part. The joints of the elbow, wrist, ankle, or toes, may, how- 
ever, be affected with this disease, but we shall speak of it in 
this connection as affecting only the knee-joint. Synovitis may 
be acute or chronic. The latter form is sometimes induced 
by blows, sprains, falls, etc., or from exposure to cold; more 
frequently it is the result of rheumatism or scrofula. 

The SyiliptoillS of this affection are generally slow in 
their appearance, being sometimes months in manifesting them- 
selves. The joint at first presents only a slight degree of 
swelling, which gradually increases. Pain is soon felt, mild at 
first, but augmenting until it becomes severe. The skin has a 
smooth, glistening appearance, and there is an increased amount 
of heat in the parts. The affected limb becomes wasted, and 
is sometimes permanently flexed. There is more or less fever 
about the body, impairment *of the digestive organs, and 
sleeplessness. The pulse is low but quick, and night-sweats 
and diarrh(!a often appear. Under this irritation, the patient 
is liable to waste away and finally die. 

A post-mortem examination reveals the effects of the disease 
upon the parts attacked. The cartilages of the joint are soft, 
the synovial membrane is thickened, the ligaments are inflamed 
and often destroyed, the synovial fluid is increased in amount, 



WHITE SWELLING. 443 

sometimes normal In appearance, at others thick and viscous. 
If the bones be diseased, their articular extremities may be 
distended and fatty matter deposited in them. The con- 
ditions depend upon the form, severity, and duration of the 
disease. 

Synovitis may be considered under three heads; Rheumatic, 
Strumous, and Syphilitic. 

Rheumatic Synovitis may arise from exposure to cold, from 
some injury, or from intemperance in eating. The beginning of 
the disease may be distinctly marked, or it may come on so 
gradually that the time of its commencement cannot be noted. 
The pain is of a dull, steady character, and less severe in the 
night. This form of the disease sometimes terminates favor- 
ably, but in scrofulous systems it is liable to end in the 
destruction of the joint. It is more common in early life, 
i-arely occurring after the thirtieth year. 

Strumous Synovitis, or Tuberculosis of the Knee-joint, when 
of a chronic character, shows a wasting of the limb, and the 
swelling is of a pulpy consistence. This form of the disease is 
more liable to occur in children, though occasionally it is met 
with in adults. But little pain accompanies this foira, although 
the limb is liable to become permanently affected. In its 
earlier stages, this disease may be checked. 

Syphilitic Synovitis is the result of syphilis. The pain is 
more severe during the night. It, however, generally term- 
inates unfavorably, especially in scrofulous constitutions. 

The Treatment of white swelling should be both consti- 
tutional and local. Alterative medicines are indicated to purify 
the blood. The following preparation will be found very 
useful: blue flag root, prince's-pine, tag alder, burdock, and 
yellow dock root, one ounce each; good whisky, one quart; 
cold water, one quart; white sugar, one pound. The dose is one 
tablespoonful twenty minutes before meals. The Golden Medi- 
cal Discovery is, however, preferable to the above mixture. 

As local treatment, in the active stage of the disease, the 
knee-joint should be steamed, and hot fomentations applied. 
This should be followed by applications over the joint of solid 
extract of stramonium or belladonna, mixed with glycerine. 
The joint should be wrapped in cotton or wool to keep it 



444 COMMON SENSE MEDICAL ADVIfiER. 

uniformly warm. If there are openings about the joint, dis- 
charging pus, syringe them out once a day with Castile soap- 
suds, whicli may be' improved by adding a little bicarbonate 
of potash (common saleratus). See that the skin is kept active, 
that the bowels are regular, that the kidneys excrete freely, 
and that the diet is nourishing. Tonic medicines should be 
employed to sustain the patient's strength. 

In order to subdue the inflammation of the joint, it is 
necessary to relieve it from motion, giving the diseased surfaces 
perfect rest. This requires nicely adjusted and carefully con- 
structed apparatus, and judgment in its application. Extension 
is necessary to remove tlie pressure on the joint, and, at the 
same time, the parts should be thoroughly supported, so that 
the patient can walk about without giving rise to motion in 
the joint. This is the only Avay to arrest the progress of the 
disease and avert the necessity of sacrificing the limb. 

The following cases illustrate the importance of correct treat- 
ment in this painful malady: 

Case 13,327. The specialist having charge of tlie treatment of 
diseases of the joints, at the Invalids' Hotel and Surgical Institute, 
was summoned to ti-eat a case of white swelling, the patient being a 
young lady of nineteen, whom he found confined to bed and unable 
to move, except with intense suffering. Extension was being 
applied in a crude way by means of a weight attached to the foot 
and suspended so as to produce tension on the joint. This necessi- 
tated perfect confinement of the patient, which had been so long 
continued that she had lost all appetite for food, and had become 
very nervous and much emaciated. By means of a carefully-fitted 
brace, or extension apparatus, the young lady was enabled to get up 
and exercise without pain, and was. In a few days, able to travel 
three hundred miles to become an inmate of our remedial home, 
where she fully recovered her health. 

Case 14,976. A lad of twelve years. He was taken with pain in 
the right knee, supposed to result "from a blow upon the joint received 
from a bat while playing ball. When our specialist visited him he 
had been under treatment for six months, but had gradually grown 
worse, until he had become a great sufferer. Two openings discharged 
unhealthy pus from the joint, which was gieatly swollen and very 
sensitive. The surgeon in" charge had advised amputation. The case 
was certainly not a promising one, but our specialist resolved to make 
an effort to save the limb. Accordingly, he fitted an extension 
apparatus so as to relieve the joint from" pressure, and prevent all 
motion of the parts involved in the diseased ao-tion. The parents were 
advised that the joints would, as the result of the extensive, destructive 
inflammatioj) and breaking down of its tissues, necessarily be left 
stiffened, but that the limb in this condition would be far preferable to 
an artificial one. After the apparatus had been worn for a few days, 
the patient was able to undertake a journey of over five hundred miles 



RICKETS. 445 

which he accomplished, tliat he might be under the direct care of the 
specialist at the Invalids" Hotel and Surgical Institutf. A residence 
of three mouths at this remedial home restored the boy to perfect 
health, and his stiffened limb, being but slightly flexed, is a very 
serviceable member. 

Case 15,302. This case was very similar to the preceding one, 
being a lad of fourteen, of a ver}' scrofulous diathesis, and when first 
seen by one of the surgical staff of the Invalids" Hotel and Surgical 
Institute, he was in a terrible condition; his knee being swollen so 
that it was larger than his head, and so painful that he could get no 
rest, unless when under the influence of very large doses of morphine. 
A similar course of treatment to that employed in case No. 14,976 
resulted, in due time, in his full recovery. 

Cases like the preceding, which have been treated with uni- 
form success, might be cited to the extent of filling a very 
large number of pages like these, but the foregoing are suffi- 
cient to show^ that, when treated by a skilled specialist, this 
otherwise formidable and dangerous disease is readily amenable 
to treatment, and that good and serviceable limbs can be 
promised, even in extreme cases, in which amputation is usually 
advised by general practitioners and surgeons, who desire the 
glory that they imagine they will receive by performing a 
capital operation. 

RICKETS. (Rachitis.) 

Rickets is a scrofulous disease, in which there is derangement 
of the entire system, and it finally manifests itself in disease 
of the bones. It is characterized by a softening of the bony 
tissue, due to a deficiency of earthy or calcareous matter in 
their composition. It appears to be a disease incident to cold, 
damp places, ill-lighted and imperfectly- ventilated rooms, and 
it especially attacks those who are uncleanly in their habits. 

The SyinptoillS of rickets are severe pains in the bones, 
especially during the night, febrile excitement and profuse 
perspiration, paleness of the face, a sallow and wrinkled appear- 
ance of the skin, and derangement of the digestive organs. 
After a time the body becomes emaciated, the face pale, and the 
head unusually large. The bones become soft and unable to 
support the body; various distortions appear; the extremities of 
the long bones are enlarged, while the limbs between the joints 
are very slender. Rickets is a disease peculiar to childhood, 
though it may not be developed until a more advanced period 
of life. It rarely proves fatal, unless the lungs, heart, or other 



44(3 COMMON SENSE MEDICAL ADVISER. 

vital organs, become icvolved. In some instances tlie softening 
and other symptoms continue to increase until every function is 
aflFected, and death ensues. 

Post mortem examinations of those who have died of rickets 
have disclosed morbid changes in the brain, liver, and lymphatic 
wlands. The lungs are often compressed or displaced, and the 
muscles of the body become pale and wasted. Sometimes the 
bones are so soft, on account of the deficiency of the calcareous 
deposit, that they can be easily cut with a knife. 

Tl*e;itl1ieilt. The use of alteratives, iron tonics, and 
preparations rich in phosphate of lime, is indicated in this 
affection. It is a disease usually developed during childhood, 
in consequence of insufficient exercise, deprivation of the 
sunlight, low, innutritions diet, and lack of cleanliness. There- 
fore, it is essential to obviate all known causes, and, at the same 
time supply the patient with food rich in those elements which 
the system seems to demand. The importance of this disease 
requires the employment of some experienced physician. 
Under any plan of treatment the general directions given for 
the hygienic management of scrofula should be followed. We 
might cite many cases that have entii-ely recovered from this 
disease, under our advice and treatment. We shall merely say, 
for the encouragement of the afflicted, that this form of 
scrofula yields to proper medicines, and it may be very suc- 
cessfully treated by skilled and experienced physicians. 

POSTERIOR SPINAL CURVATURE. 
(Humpback.) 

Posterior curvature of the spine, sometimes known as 
Pott's Disease, occurs most frequently in children, and is 
generally developed before the seventh year. Children of 
a scrofulous diathesis are especially liable to this affec- 
tion. It is generally due to disease of the inter-vertebral 
cartilages and bodies of the vertebrse. It comes on in a 
slow, insidious manner, hence, it often makes serious inroads 
upon the spine and system before its true character is even 
suspected. 

Generally the first point of invasion is the cartilaginous 



POSTERIOR SPINAL CURVATURE. 



447 



substances between the bodies of the vertebrae, beginning with 
inflammation, and finally resulting in ulceration and a break- 
ing-down of the cartilages. It next invades the vertebrae them- 
selves, producing caries, or death and decay of the bony 
substance, which softens and wastes away, as shown in Fig. 149. 
The vertebrae become softened and broken down, and the weight 
of the body pressing them to- 
gether produces the deformity ^V- ^■^^• 
known as "humpback." (See 
Fig. 150 and Fig. 151.) 

Syitiptoills. Among the 
various symptoms present in the 
earlier stages of the disease, and 
during its progress, we deem it 
necessary to mention only a few 
of the more prominent ones. 
While the patient is yet able to 
go around, the disease manifests 
itself by occasional pain in the 
bowels, stomach, and chest. 
Often there is a hacking cough, 
nervousness, lassitude, and a 
generally enfeebled condition of 
the whole system. The patient 

.. ^ . J , . The above portion of the spinal col- 

IS easily fatigued; there is ap- umn shows the manner of the brealt- 

parent loss of vitality, impaired i°S down of the vertebrae from caries, 

„ , . /. • 1 *^d the absorption of their bony sti-uet- 

appetite, a feeling ot tightness m-e. 
across the stomach and chest, 

gradually declining health, and loss of flesh and strength, 
torpidity of the liver, deficient secretions, constipation, and 
morbid excretions from the kidneys. The victim, in passing 
chairs, tables, and other objects, instinctively places his hands 
upon them, and, as the disease progresses, when standing, 
leans upon some support whenever possible. In walking, 
he moves very carefully and cautiously, with elbows thrown 
back and chest forward, to assist the body in keeping its 
equilibrium. The body being kept in an upright position, the 
patient bends the knees rather than the back in stooping, 
as illustrated in Fig. 153, and the body is frequently supported 




44)^ 



COMMON SBNSK MEDICAL ADVISER. 



by rile hands being placed upon the thighs or knees. Sudden 
raovenxentg or shocks cause more or less pain. 

The development of the disease then becomes rapid; suffering 
increases, and pain about the joints and lower extremities and 
muscles of the posterior part of the pelvis is experienced; 
numbness and coldness of the extremities is felt; locomotion 
becomes more difficult, and a slight projection is observed upon 
the back. Even in this somewhat advanced stage of the disease, 
when the symptoms are so apparent, many cases are shamefully 
neglected because an ignorant adviser says it is nothing 
serious and that the patient will outgrow it. The pain and 

Fly. 150. 





tenderness not always being in tlio back, the inexperienced are 
very often misled as to the true character of the trouble. The 
distortion or deformity of the back now becomes painfully 
prominent; the diseased vertebrte quickly soften and waste away; 
the pressure upon the spinal cord increases, and paralysis of 
the limbs supervenes; the power of locomotion is lost, and, at 
last, the danger is realized and the struggle for life l)egins. 

Thus, through ignorance, neglect, and improper treatment, 
the poor, helpless victim is doomed to a life of hideous 
deformity and suffering. We would, therefore, urge upon 
parents whose children are afflicted with this terrible disease, 
the great importance of placing them under the care of 
surgeons who have for many years nxftde the treatment of 



POSTERIOR SPINAL CURVATUKK. 



449 



such cases a specialty, and who have every acility and all 
necessary surgical appliances for. insuring success in every case 
undertaken. 

Treatment. The great essentials for the successful treat- 
ment of disease and deformities of the spine are first, a 



Fig. 152. 



Fig. 15S. 





Appearance of a child suffering from 
Pott's disease of the spine. 



Mode of stooping adopted by a child 
suffering from spinal disease. 



thorough knowledge of the structure and parts involved by 
the disease; secondly, the adjustment of mechanical appliances 
perfectly adapted to the requirements and necessities of each 
individual case, and the proper use of our system of " vitaliza- 
tion," applied to the spinal muscles to strengthen the weaker 
and relieve the undue contraction of the stronger. For many 
years our specialists have experimented, and have given the 
various appliances in common use in these cases most thorough 



450 COMMON SENSE MEDICAL, ADVISER. 

and practical tests, and have found them very defective, being 
generally constructed upon wrong principles. The physician 
who sends to a mechanic for an appliance, such as are now 
made in the shops of most instrument makers, and uses the 
same, is doing himself an injustice, and barbarously torturing 
his patient by forcing him to wear an apparatus which is 
heavy, clumsy, and inevitably injurious, instead of being bene- 
ticial in its results. In the treatment of disease and deform- 
ities of the spine, there should be no compromising; the appli- 
ance that fails to give complete support should not be worn. 
In our treatment of these maladies we employ only appliances 
which are constructed under the personal supervision of our 
specialists, upon principles dictated by common sense and the 
actual necessities of the case. We do not confine the body 
in an iron jacket. Our apparatus is light, yet durable, and 
is worn by the most delicate children without pain or incon- 
venience. It gives proper support to all parts, and is so nicely 
adjusted as to produce pressure only upon those points which 
should receive support, leaving the muscles of the spine free- 
dom of action, thereby assisting in their development. In 
many hundreds of cases treated by our specialists, the dis- 
ease has been entirely cured and the deformity removed. After 
seeing the patients and adjusting the appliances, they can gen- 
erally be treated at their homes. 

LATERAL CURVATURE OF THE SPINE. 

(Crooked Back.) 

This deformity appears more frequently in anaemic persons, 
in whom the flexibility and elasticity of the muscles are 
weakened, than in those of a plethoric habit. It is generally 
contracted during youth, between the ages of twelve and 
eighteen. Persons of sedentary and indolent habits are espe- 
cially liable to this deformity, hence, girls are most frequently 
its victims. It is never seen among the natives of tropical 
countries who habitually live in the open air, and seldom among 
the barbarous races of northern latitudes. A distinguishing 
feature of the American Indian is his erect carriage. The 
primary curvature is generallv toward the right side, as 



LATERAL CUBVATURK OF THE SPINE. 



451 



represented in Figs. 154 and 155. Figs. 156 and 157 show the 
disease in a more advanced stage. The ribs are thus forced 
into an unnatural position, and the vital organs contained in 
the cavity of the chest are compressed or displaced, thus dis- 
torting the form of the whole upper portion of the body. 

Syinptoms. The first indication of lateral curvature of 
the spine is a marked projection of the right scapula, or shoul- 
der-blade. It is sometimes first observed by the dressmaker, 
or, accidentally, while bathing. The right shoulder is slightly 



Fiy. 15J^. 



Fig. 155. 





Lateral curvature of the spine. 
E to F, the primary curve. 



A mild case ot lateral cur- 
vature of the spine. 



elevated, while the left hip is depressed and projects upward. 
If not corrected while in its earlier stages, it progresses very 
rapidly, and a second curvature is developed. The symptoms 
vary in different cases, and in the early stages are somewhat 
obscure and undefined, but generally the patient feels a sense 
of uneasiness, languor, stupor, and nervousness, loss of energy 
and ambition, general debility, poor appetite, gradually declining 
health, loss of strength and flesh, and, as the disease progresses, 
a slight elevation of one of the shoulder-blades is noticed, as 
well as the deviation of the spine to one side. The curve, or 



4 A 2 



COMMON SENSE MEDICAL ADVISER. 



distortion, of the spine increases more rapidly as the body 
becomes lieavier, the spine often assuming the shape of the let- 
ter S, and, from compression by torsion of the vertebriB and 
distortion of the ribs, the vital organs are encroached upon, 
causing serious functional derangement of the heart, lungs, 
liver, and stomach, producing, as its inevitable consequence a 
list of maladies fearful to contemplate. 

C/RIIKC^. In rare instances, the lateral curvature of the 
spine is due to defects of certain hones of the pelvis or limbs. 




Fie/. 157. 



Lateral curvature in an 
advanced staMc 




Lat<n-:il uurvatiir*- in an 
iidvunct'd sfas"*'. 



Cases are recorded in which this deformity was caused by 
diseases of the abdominal organs, but, as we have intimated, it 
is generally due to a lack of tonicity of the muscles, or, as a late 
writer has expressed it, " Want of correspondence in the antag- 
onism of those muscles which control the motions of the spinal 
column." Habitual sitting or standing in a leaning posture, 
or standing upon one foot, thus constantly using one set of 
the muscles of the back, while the other becomes enfeebled 
by the lack of exercise, is a common cause of this deformity. 
The habit which so many school-girls contract of drawing up 



DEFORMED FEET, HANDS, AND LIMBS. 453 

one foot under the body while sitting, often produces a lateral 
curvature of the spine. 

Treatment. No disease or deformity of the spine is 
so easily cured and perfectly corrected, if the proper plan 
of treatment is pursued. To correct this deformity, many 
ingenious forms of apparatus have been devised and invented 
by our specialists, which should be carefully adjusted to each 
individual case. In addition to this, our method of treatment 
by " vitalization," and by mechanical movements and manip- 
ulations, is almost indispensable in these cases. It never fails 
to give relief, and, if properly pursued, invariably results in a 
permanent cure. 

DEFORMED FEE1\ HANDS, AND LIMBS. 

There are thousands whose feet, hands, and limbs are almost 
entirely useless, besides having an unsightly appearance. Their 
condition has been helpless so long, their treatment so varied, 
and their hopes of relief or cure have been so often disap- 
pointed, that few can believe the truth of our statement, 
when we positively assert that we can correct and cure nearly 
all cases of talipes, club, or crooked feet and deformed hands, 
and make them as perfect in appearance, and as useful in 
action, as feet and hands which have never been deformed. 
While this may seem miraculous, or even impossible, to those 
who are unacquainted with the wonderful improvements and 
rapid progress made in this department of surgical science, 
it is attested and verified by living witnesses whose feet and 
hands were once deformed and useless, but which have been 
made perfect by our new and improved method of treat- 
ment. We do not make these statements in a spirit of vain 
boastfulness, but having devoted many years to improving and 
perfecting surgical appliances and apparatus, and having had 
practical experience in the successful treatment of thousands 
of cases, we do say that our manner of treatment is original 
and employed only by us. We entirely ignore the ineffectual 
methods usually employed in such cases. Our treatment causes 
no pain, and little inconvenience, yet the curative results are 
speedy and certain, and a hundredfold more satisfactory than 
those obtained by any other course. 



454 



COMMON SENSE MEDICAL, ADVISER. 



We have most thoroughly tested all the best forms of treat- 
ment heretofore devised and employed in this class of diseases, 



Fig. 158. 



fl(f. 159, 





Talipt'8 Ecjiiinus. 



Talipes Calcaneus. 



and have adopted the best features of all the various methods 
heretofore pursued. We have combined these with our own 
improvements and, as the result, we have perfected a thorough 



Mg. mo. 



Fig. 101. 





Talipes ViilfjuH. 



Double Club-toot. 



and efficient system of treatment, based upon scientitic prin- 
ciples. The numerous different mechanical devices, surgical 
appliances, and api)aratus required in the treatment of deform- 
ities of the feet and hanrls, arms and legs, are constructed by 



DEFORMED FEET, HANDS, AND LIMBS. 



455 



Fig. 162. 



Fig. 163. 




The above illustrations represent various Deformities cured by owe Specialiata at 
the Invalids' Hotel and Surgical Institute. 



4n(^ COMMON SENSE MEDICAL ADVISER. 

my. 171. Fig. 172. 





Fig. 17S. 



Fig. 11 J4. Fig. 175. 





Fig. ne. 



Fig. 17", 





The ab«>v« iilubti-atlons repreeeDt various Def<>rnuti«8 of the feet curt'd hy our 
SpeciaJi«ts at thn Ijivaltrts' Hotel and Surgrical Institute. 



HARELIP. 



457 



skilled mechanics uinler tlie personal supervision of our surgeon 
specialists. Perfect drawings of the deformed limbs of every 
patient are made, from which a nicely fitting apparatus is 
constructed, especially adapted to the requirements of each 
individual case. This course is absolutely necessary to insure 
success since no two cases are precisely alike. 

HAREIJP. 

This common deformity is generally congenital, and due to a 
want of development of the tissues forming the upper lip. 
The fissure may be either partial or complete, single or double. 

Fig. 178. 



Fly. 179. 





l)uul)lf Harelip- 



Simple Hai-ellp. 



It may involve the soft tissues only, or both the bone and soft 
tissues. In bad cases the cleft extends completely thiough 
the alveolar process (that part of the bony structure which 
contains the sockets for the teeth), and in others it also involves 
the hard palate, or bony roof of the mouth. 

Cle^ Palate. When the palate, or roof of the mouth, is 
fissured it constitutes what is known as cleft palate. This 
condition may exist either as a complication of harelip or 
independently. 
20 



458 



COMMON SENSE MEDICAL ADVISER. 



Treatment, 'i'he earlier in life the harelip is operated 
upon the more perfect is the result. As a general rule, the 
operation should not be delayed beyond the third or fourth 
month; yet our surgeons succeed in getting very satisfactory 
results in cases of much longer standing. No child, however, 
should be operated upon when in feeble health, as the parts will 
not, under such circumstances, heal so readily, and perfect suc- 
cess will not be so certain. When the infant is, by reason of 
the deformity, unable to nurse, it is best to operate very early, 
within five or six days after birth. If any of the teeth projec^t, 
they must be removed previous to the operation. If the harelip 
be complicated with a separation of the palate, the separation 
will irenerally become less and less after the union of the lips. 
Operation. The edges of the fissure, having been carefully 

pared, are brought well to- 
■-'• • gether and secured with deli- 

cate pins and sutures, as 
represented in Fig. 180. In 
bad cases, and especially 
when the cleft in the pal- 
ate is very extensive, a 
kind of truss or support, sim- 
ilar to that represented in 
Fig. 180, aids materially in 
holding the parts well to- 
gether until the healing 
process makes a firm union 
and perfectly closes up the 
fissure. 

In cases m which cleft pal- 
ate exists independently of 
hare-lip, and especially when 
the fissure is in the back part 
of the roof of the mouth 
only, it is as well to defer operating upon it until the child is a 
few months old. However, if the opening is so great as to 
interfere very seriously with the taking of food, and permits 
liquids to pass into and out of the nostrils, then an operation 
should be performed early. 




The Cheek Truss, or Compressor. 



OLD SORES, 



469 



OLD SORES. (Chronic Ulcers.) 

Under this head we may properly consider tliat class of 
affections known as Fever-sores, Running-sores, Ulcers, etc. 
These sores have eommon characteristics, yet each possesses 
certain peculiarities, which have led to their division into 
irritable^ indolent^ and varicose. These peculiarities arc not 
constant, one form of ulcer often changing into another. One 
feature common to all, however, is their slowness in healing, 
which has sometimes led to the belief that they are incurable. 
Atiother popular notion is, that their cure is detrimental to the 
health of the patient. With equal propriety we might say 
that it is dangerous to cure diarrhea, dysentery, consumption, or 
cancer. As a result of these erroneous impressions, many peo- 
ple suffer from chronic ulcers for years, and even for a life-time, 
-\Nathout attempting to obtain relief. Chronic ulcers usually ap- 
pear upon the lower extremities. The depth and appeai-ance of 
the ulcer depend upon its character and the thickness of tlie tis- 
sues whei*e it is situated. 

Fig. 181 shows a chronic ^^(/- ^^i- 

ulcer, or fever-sore, as it 
appears upon the ankle. 

The Irritable 

IJlcer is painful and 
tender, the slightest in- 
jury causing it to bleed. 
It is of a dark purplish 
hue and filled with spongy, 
sensitive granulations. It 
discharges a thin, bloody 
matter, which is some- 
times very fetid and acrid, 
and excoriates the tissues if it come in contact with them. The 
edges of this species of ulcer are shelf -like and ragged, and turn 
inward. The adjacent structures are red and swollen. Very 
often they are attended by severe constitutional disturbances, 
such as chills, fever, and great nervous prostration and irritability. 
Ill the Indolent Ulcer the edges are not undermined, 
but turned outward, and are rounded, thick, glossy, and regular. 




*'lu-onic Ulcer. 



4K() COMMON 8EN&K MEDICAL ADVISBR. 

The granulations are broad, flat, pale, insensible, and covered 
wnth a grayish, tenacious matter. The surrounding parts arc 
not very sensitive, but the limb on which it is located is apt to 
be swollen. This is the commonest form of ulcei', and often 
remains for years. 

VaricO)«>e Ulcer. This species of ulcer occasions a swollen 
or enlarged condition of the neighboring veins, which are very 
much enfeebled. It almost invariably appears below the knee, 
and may be either indolent or irritable. It is generally sehsitivc 
to the touch, and sometimes excessively painful. Knots of 
superficial veins may often Vjc seen beneath the skin. 

As we have before remarked, these various species of ulcers are 
merely modifications of one form of chronic sore. The patient 
may assert that he enjoys excellent health, but if ^\■e question 
h'un closely, avc find that the sore irritates him, and that there is 
siiffit'ieut constitutional disturbance to prevent the healing pow- 
ers of nature from effecting a cure. 

TrfatlllCllt. The cure of these sores is necessarily slow, 
aud whoever expects to obtain iimnediate n lief Avill be disaj*- 
jiiiinted 

Constitutional treatmeut is of the utmost importance, and 
should, therefore, be thoroughly and persistently applied. The 
nutritive system, especially the aVjsoi-heuts, should be kept active, 
as these are the channels by which the broken-down tissue sur- 
rouuding the sore is replaced by that of a higher grade of 
vitality. For this pnri^ose, the best alteratives are required. IC 
secretion and excretion are not normally performed, the blood 
becomes ])oisoned by the absorption of unhealthy "matter" 
from the sore, and various coustitutional disturbances occur. 
If, at any time during treatmeut, constitutional disturbances be 
manifested by fullness or disagreeable sensations in the head, 
nausea, pain, cough, chills, or fever, a thorough cathartic should 
1)0 wiven. If the patient be robust, a repetition of the same 
once a week will be very beneficial. Dr. Pierce's Golden Med- 
ical Discovery, and Pellets will be productive of the best re- 
sults. If the urine be scanty or loade<l with deposits, add to 
every other bottle of the former remedy one ounce of the acetate 
of potash, and administer according to the directions given. 
The skin is apt to be dry, and requires the daily use of an 



DISKASK OF THE BONES. 461 

alkaline bath followed by a thorough rubbing. Give a spirit 
vapor-bath once a week. 

The local treatment should depend upon the character of the 
ulcer. If the sore be irritable, soothing applications, such as 
warm poultices or steaming it in a vapor of bitter herbs, will be 
found highly beneficial. A poultice of powdered slippery-elm 
and lobelia is very soothing, and hence well adapted to this 
pm'pose. If the ulcer is indolent, a stimulating application is 
necessary. The hardened, callous state of the edges should be 
removed by alkaline applications. A strong solution of saleratus, 
a lye poultice, or even a caustic, prepared by boiling the lye 
from hard-wood ashes to the consistence of syrup, will prove of 
great utility. One or two applications of the latter are gener- 
ally sufficient. 

The sore and surrounding parts may then be stimulated by 
the application of lint saturated in the compound tincture of 
myrrh (which can be obtained at any drug store). If the part 
is flabby and the granulations indolent, the application of 
astringents, after cleansing the ulcer, is often followed by 
excellent results. An application composed of half a drachm 
of carbolic acid and one ounce of glycerine, will greatly hasten 
the healing of indolent ulcers. The sore should be so covered 
as to effectually exclude the light and air, and the dressing need 
not be changed oftener than every other day. A preparation 
known as " Black Salve," the composition of which is given in 
the "American Dispensatory," is both cleansing and healing, 
and one of the best applications that can be made. It is advis- 
able to occasionally replace one application by another, as tlie 
constant use of one preparation is apt to cause it to lose its 
effects. 

The experience of the specialists at the Invalids' Hotel and 
Surgical Institute, in the treatment of chronic ulcers, is very 
extensive, and their practice has been attended wnth the most 
successful results. 

DISEASE OF THE BONES. 

The bones are liable to various diseases. We shall, however, 
in this connection, but briefly consider a few of the affections to 
which they are subject. 



-|(^)'2 COMMON SENSE MEDICAL ADVISER. 

Iiiflaiiiiiiatioii of the Bone« ( (Meitis). The inHam- 
iiiation of a bone is a disease of very rare occurrence. It 
may be caused by external injuries, or by some constitutional 

laint, as syphilis, scrofula, rheumatism, or gout. 

^yill|>foill!>i. The patient experiences an excruciating, deep- 
seated, throbbing jjain, which is increased by any movement, 
and which is usually more severe at night. The flesh over the 
atfected bone is tender, and, as the disease progresses, becomes 
swollen. The constitution sympathizes with the local disease, 
and, consequently, the skin is hot, and the pulse quick. As the 
intiammation approaches suppuration, there are chills, delirium, 
j)rofuse sweating, and all the general indications of hectic fever. 

'JTreatllient. Although the most skillful medical as well 
as surgical aid m.ay be employed, yet a long time is generally 
required to restore a diseased bone to its normal condition. 
The treatment must be prompt and energetic, or the intiam- 
mation will result in suppuration and the destruction of the 
bone. Perfect rest is necessary. Dr. Pierce's Compound Ex- 
tract of Smart-weed may be taken in suitable <loses, to pro- 
duce gentle perspiration. Warm fomentations or poultices, 
me<licated with the Extract of Smart-weed, should be applied 
to the affected part. 

Although the symptoms are less severe in the chronic form, 
yet they are similar to those in the acute, and therefore require 
similar treatment, together with an alterative course of nu'dicine. 
Th(i Golden Medical Discovery is very effe(ttual in chronic 
cases, and tincture of iodine, locally applied, is often found 
beneficial. If "niatter" is formed it must be released, or it will 
burrow and cause an extensive destruction of tissue. All consti- 
tutional taints sliould bo removed, and the general health 
impi'ovcd. 

FEVER-SORE. (Necrosis.) 

IJy the term necro.fis we mean mortification, or the state of a 
bone when it is deprived of life. Dunglison says: "This con- 
dition is to the bone what gatu/rene is to the soft parts." It is 
popularly known as fever-sore^ there being no distinction made 
Itetween this species of sore and those ulcers which affect only 
the soft tissues of the body. When any part of a bone becomes 



FEVER-SORE. 



4()8 



necrosed, it is treated as a foreign body. Nature makes an effort 
for its removal, and at the same time attempts to replace it with 
new and healthy materials. In consequence of this process, the 
dead portion is often inclosed in a case of new, sound bone, 




Hand di-ill for boring' hone. 

termed the involucruin; when this is the case the dead portion 
is termed the sequestrum. If, however, it is superficial, and 
separate from the parts beneath, it is called an exfolidtion. 'J'his 
healing process, by which the involucnim is formed, cannot be 

Fl<l. ]^S. 




^^^^^S^^^ 



Tlie osteotrite, for enlarging- openings and cuttnig- clarions bone. 

completed while the dead portion -remains. Hence, numerous- 
openings are made through the involucrum, to ))ermit the escape 
of the sequestrum. When a sui-gical operation is performe*! 
lor tile removal of the necrosed bone it is called setjuestrotomy. 



Fiij. ISJf. 




Gouge forceps for excavating bone. 



The instruments which our specialists usually employ for this 
practice are represented in Figs. 182, 183, and 184. 

Causes, Fever-sore may be due to inflammation, injuries, 
working in phosphorus, or from the inordinate "and protracted 
use of mercury. 



404 



COMMON SENSE MEDICAL ADVISER. 



SyiliptOlllS. The pain frequently comnieiices in the night, 
and all the different stages succeed, until, finally, the result is fre- 
quently niortitication or death. The entire bone, or only a part of 
it, may be affected; the parts become swollen, "matter" forms, 
and unless it be artificially evacuated, it will in time work its 
way out through a fistulous opening. As the disease progresses, 
the adjacent tissues become thickened and numerous openings 
are formed, which communicate with the bone, and often with 
each other, so that a probe may be passed from 
(me to another, as represented in Fig. 185, copied 
from a drawing by Dr. Howe. The discharge 
from fever-sores varies in character, and usually 
has a fetid odor. The surgeon can readily dis- 
tinguish between healthy and unhealthy bone 
by the use of a probe. The pus discharged in 
necrosis contains minute particles of bone, which 
may be felt by rubbing it between the fingers. 
Sometimes large pieces present themselves at 
the openings. The general health is seriously 
impaired, and the patient becomes debilitated, 
ana?mic, and hectic. 

TreatlllCllt. The process of repair is 
necessarily tedious, and nature should be 
assisted to remove the old l)one and promote 
the formation of the new, Au alterative coui-se 
of treatment is indicated and must be persist- 
ently followed. Give Dr. Pierce's Golden 
Medical Discovery and Purgative Pellets in 
sufficient doses to keep the bowels regular. 
However, all efforts to heal the sores, as long 
as dead bone remains, will prove fruitless, 'ilie 
sores should be thoroughly cleansed with injec- 
tions of an alkaline solution, after which band- 
ages, moistened with glycerine, may be applied. 
If they emit a fetid odor, add a few drops of 
carbolic acid to the glycerine. The dead bone 
can be but slowly removed by suppuration, therefore time, and, 
indeed, sometimes life itself, may be saved by removing it 
with surgiftal instruments. In the operation of sequestrotomy, 




Necrosis of the 
til)ia. A common 
pr<)be is passed 
tlirough tlie sin- 
uses, or openinKS. 



WRY NECK. 



465 



the surgeon must exercise great judgmeut. Carelessness may 
prolong the disease and subsequently necessitate another op- 
eration, or, perhaps, an amputation. 

Usually the dead bone is easily removed by the skilled special- 
ist surgeon, and, when thoroughly taken out, the parts readily 
heal and the patient rapidly recovers. The removal, therefore, 
of the dead bone vrhich is a constant source of irritation, and the 
cause of protracted suffering, should not be delayed, for very 
rarely indeed can it be removed at all without the assistance 
of the surgeon. Besides, delay often results in the loss of 
the limb, and not unfrequently occasions the death of the 
patient. Under the influence of a reliable aniesthetic, carefully 
administered, the operation of removing the decayed and 
offensive bone is speedily and painlessly performed. 



WRY KECK. 

This deformity may be either congenital or acquired, and 
may result from various causes. The head is thrown to out- 
side and approaches the shoulder, as represented in Fig. I8t». 
The inclination of the head may be 
due either to weaknes.s or contraction 
of the muscles. Burns, scrofula, rheu- 
matism, and ulcerated wounds are tlie 
commonest causes of this deformity. 
In rare cases, it is diie to paralysis of 
the muscles of the neck, or malfor- 
mations of the spine. It is often 
caused by contractions of the cervi- 
cal muscles. 

Treatment. This will depend 
upon the cause of the deformity. In 
cases of spasmodic contraction, the de- 
formity is transient, but the natural process of cure may be 
hastened by appropriate surgical and medical treatment. When 
due to muscular paralysis, the "vitalization" treatment, practicetl 
at the Invalids' Hotel, is veiy beneficial. When the contraction 
is peiTuanent, the most effectual method of correcting the de- 
formity is sub-cutaneous division of the contracted muscles or 
tendons. When the contraction is slight, the proper adjustment 




Wry Neck. 



4(l6 COMMON SENSE MEDICAL ADVISER, 

of au ingenious brace of our invention, will correct it. In 
cases due to weakness of the cervical muscles, this appliance 
is very efficient lor holding the head in its normal position, 
until the system becomes so strengthened that the muscles re- 
gain their tonicity. 

Again, when the contracted muscles have been separated, 
it is necessary to devise some means of supporting the head 
while nature completes the operation by healing the severed 
tinsues, and this brace furnishes the desired support. To 
rectify the deformity by mechanical treatment alone, the 
application of strips of adhesive plaster, or bands, is very effi- 
cient. Whatever the mode of correcting the deformity may 
be, mechanical sui)i)ort sliould always be employed. This, how- 
ever, can only be successful when carefully adjusted and adapted 
to each individual case by an experienced operator. 

SCURVY. 

Scurvy is a disease which Avas familiar to the ancients, and 
remarkably destructive to life in their armies and navies. In 
consequence of the improvement in hygienic measures, it is not 
so common at the present day, although it contributed not in- 
considerably to the mortality in our armies during the late 
civil Avar. Scurvy is undoubtedly due to an impaired condition 
of the blood. This deterioration may be caused by an insuffi- 
(•iency of vegetable food. The long-continued use of salted 
meats, unaccompanied with vegetable diet, will induce scurvv. 
Although the diet is one cause of the production of the dis- 
ease, other causes act as powerful aids in establishing this 
affection. Exposure to wet and cold and deficient ventilation 
are favorable to its production. 

The symptoms of scurvy, or scorbutus, are a salloAv appear- 
an(^e of the skin, impaired appetite, feeble and slow pulse, and 
dry skin u])on which are patches of eec.hymosls (black or yel- 
low spots). The gums become swollen, soft, of a dark purple 
color, and are liable to bleed; the teeth loosen, and the breath 
is offensive. As the disease ])rogresses, the sym])toms increase 
in severity. This malady is more apt to occur during the 
winter than in summer. 

The Domestic Treatiiic*iit of scurvy should be of a 



CANCER, 467 

hygienic character. The patient shoukl parta.ke freely of 
fresh, juicy fruit, such as lemons, oranges, grapes, apples, pine- 
apples, etc; also, of onions, radishes, Avater-cresses, fresh meats, 
etc. In short, his diet should he hoth generous and nutritious. 
Attention should also be paid to cleanliness, and the patient 
should bathe regularly every day; he should also be in a dry 
atmosphere, and have a constant supply of pure air. Consti- 
pation should be relieved by mild laxatives; or, if suffering 
from diarrhea, the patient should use moderate astringents or 
the Extract of Smart-weed. 

CANC^ER. 

Cancers are malignant aii'ections manifested by the forma- 
tion of morbid growths, which have a disposition to spread 
and involve contiguous tissues, and at some stage of their 
existence ulcerate and become hideous, open sores. There are 
several varieties of cancers, all of which possess the above 
characteristics, as well as others peculiar to each separate 
variety. Most prominent among these are scirrhus, eneep/ut- 
loicl, epithelial, colloid, uielanoid, and osteoid. The three 
latter are sometimes included with some other varieties, under 
one general head — mixed. In common parlance, the different 
kind of cancers are named from a fancied resemblance to some 
object, or to the character of the object, as stone, rose, spider, 
wolf, and black cancers; or from the locality in which they 
appear, as lip, breast, womb, skin, and l)one cancers. These 
different varieties may exist separately, or may be combined, 
so that several varieties may appear in a single growth; or, 
according to J. Hughes Bennett, Frank H. Hamilton, and 
others, they are sometimes transformed one into another. In 
consequence, it is sometimes very difficult to distinguish and 
classify them. The cancer-cells present almost every conceiv- 
able shape, as round, oval, caudate, spindle-shaped, heart- 
shaped, oblong, square, etc., and vary greatly in size, being 
from Y^'o to ^ig- of an inch in diameter. In some form or 
other, cancers are met with at all stages of human existence, 
from infancy to old age. 

It attacks, by preference, particular structures, though none 
are exempt from its ravages. It occurs more frequently in 



468 



OOMMON SKNSK MKDICAL ADVISER. 



It'iuales thaii in males. The structure's of the womb and breast, 
particularly the former, being favorable to its development, 
accounts for the greater frequency of its occurrence in wonu'n. 
Cail$ies$. Kegarding the cause of cancer, but little is known. 
There is no doubt that its development is due to perverte<l nu- 
trition in the part where it occurs, but tlie nature or cause of 
this perversion is a mystery. 

$iyiliptoillSl. Cancers are characterized by tlu- presence 
of morbid growths, Avhich show a decided tendency to s|)read 
and involve surrounding tissues. The pain exi)erience<l, which 
is usually severe and agonizing, is ))eculiar in its character, 
stinging, l)iting, sharj), and lancinating, generally occurring in 
jiaroxysms, and in tlie advanced stages of the disease is nearly 

continuous, the patient get- 
Fiij. ISI. ' ting but little rest. In the 

earlier stages, pain is sonu'- 
times absent. After a time, 
the growth ulcerates, and 
gives rise to exhaustive dis- 
charges, and in many cases 
to attacks of profuse hem- 
orrhage. As the disease 
progresses, the countenanci- 
presents a peculiar appear- 
ance, sallow, sodden, or 
grayish yellowy wdiich is 
called the cancerous ca- 
chexia. The patient be- 
comes despondent, the general health is deranged, and life is 
beset on every side by this imrelenting foe, and he dies worn 
out bv the pain and exhaustive discharges, literally fretted :ind 
stung to death. 

Curability of Cancers. Since writing the first edi- 
tion of this work, we have, from large observation and much 
study, quite changed our views respecting the nature of this 
malady. From believmg it to be ])riniarily a constitutional 
affection, manifesting itself secondarily in a local tumor, we have 
come to believe that, up to quite an advanced stage, <'.ancer is a 
purely local affection, and if //<oro?<<////y removed is not likely to 




Cancer of the Bi-fast. 



CANCKR. 



469 



reappear. It is a specific, morbid cell-growth, and we are now 
fully satisfied, from obserA-ation, that if this cell-growth can be 
fully and completely destroyed before ulceration and sloughing 
occur, at which stage absorption of the cancer-cells into the 
blood commences, the disease may be arrested. The course 
pursued by most surgeons, of remoAing the cancerous tumor 
with the knife and immediately closing the Avound by stitches, 



Fiff. ISS. 



Fig. ISO. 




Appearance of a ten-ible cancer of 
the breast, measuiing over six inches 
in diameter, before treatment. This 
tumor was \'ery painful, liad com- 
menced to ulcoi"ate, and was pro- 
nounced incin-able by some of the 
best snrg-eons in New York and 
Buffalo. 



Appearance after treatment. During' 
the removal of this enormous tumor 
our patient suffered very little, in 
three months' time the cure was com- 
plete, the parts beiuf? entirely healed. 



is almost always a failure. At the luA^alids' Hotel and Surgical 
Institute, tumors are noAv removed by a method Avhich causes 
the patient no ])ii\n, and a chemical compound is then applied 
Avhich thoroughly destroys any diseased tissue which may re- 
main. The wound readily heals and fills up by granulation. 

We haA'e effected wonderful results by the use of electroly- 
sis, in conjunction with other remedial agents, the tumors 
undergoing degeneration, and their malignant character being 



47() COMJMON SENSE MEDICAL ADVISER. 

destroyed. Eacu in cases in which there was ulceration and 
great enlargement of the lymphatic glands, the pain was re- 
lieved, and the tumors greatly diminished in size by this 
treatment. 

The following cases illustrate the wonderful success which 
has been attained at the Invalids' Hotel and Surgical Insti- 
tute in tlie treatment of this dreadful disease. 

Case 7,942. Mi-s. J., of Syracuse, N. Y., aged 35, applied to our 
specialist for the cure of a cancer of the left breast, first noticed three 
years before. At the time of consultation, it was very painful, prevent- 
ing her from getting much sleep, and so disturbing her system as to 
cause loss of appetite anil considerable emaciation. The tumor was 
very large, but had not yet broken out in ulceration. 8he had con- 
sulted several prominent physicians and surgeons, the last of whom 
advised her to visit our institution for treatment. Her case was 
promptly undertaken, and the diseased mass removed. The parts 
healed very promptly, and in six weeks she returned home well. This 
was one of the first cases treated under our new plan, and was a perfect 
success, as the lady ha< had no symptoms of a return of the disease 
since its removal. ^ 

Case 8,642. Mrs. W., of Brooklyn. X. Y., consulted the Faculty at 
the Invalids' Hotel for the cure of a cancer of the lip. It was promptly 
removed, and the parts healed completelj^ iu six week's time. 

Case 8,972. J., of Baltimore. Md., had cancer of the sciri-hus variety, 
involving a great part of the right cheek. In order to thoroughly erad- 
ii;ate every vestige of the disease, it^became necessary to remove a part 
of the upper jaw. This having been skillfully accomplished by the 
surgeon in charge of this branch of practice at the Invalids" Hotel, the 
wound healed very readily, and only slight disfigurement remains. A 
thorough course of constitutional treatment was kept uj* after the dis- 
eased mass had been removed, to cleanse ami i)iirify the l)lood ami 
system. 

Case 9,847. Six years ago, Mrs. S.. of Pa., applied to the Faculty of 
the Invalids' Hotel and Surgical Institute, for the cure of an immense 
caneerous tumor of the breast, which, after removal, weighed six 
]iounds. On examination with the microscope, our diagnosis of cancer, 
previously made, was fully confirmed. T'here has been no return of 
the disease. 

Case 10,042. In 187"), Mr. K. applied to the Facidty of our Institu- 
tion, for the cure of an inunense cancerous tumor located on the scalp. 
The tumor had grown until it had encroached up<»n, and caused ab- 
sorption of a considerable part of the skull. The tumor was effectually 
removed and the parts healed nicely. A letter from this gentleman, 
five years after treatment, stated that he had experienced no return of 
the disease. 

Case 10,840. Mrs. H. C. L., of Indiana, applied at the Invalids' Ho- 
tel and Surgical Institute for the cuie of an immense cancerous tumor 
of the breast. It had already ulcerated, and was discharging very 
offensive pus. In t\vo months' time she was cured, and returned to her 
home a well wfiman. 

Case 12,003. This was a lady sixty years old, from the State of 
Ohio, aftlieted with cancer of the bre.-ist, of some six years' growth. 



CANCER. 471 

Ulceration had recently set in, and the patient was suffering excruci- 
ating pain. Proper applications were made and the tumor was 
removed without the resort to the knife. Owing to the patient's ad- 
vanced age, the parts were rather slow in healing; but under the influ- 
ence of supporting tonics and a generous diet, she fully recovered, and 
in four months returned home. Only a very slight opening existed 
at that time, which gradually closed, and she" enjoyed good health for 
four years, and finally died of another disease. 

Case 12,925. Mr. J. T. had a cancer removed from his nose, several 
years ago, and has experienced no return of the disease. 

Case 12,962. This was a case of cancer affecting the face and in- 
volving the upper jaw. It was thoroughly removed, and, although the 
healing caused considerable contraction and disfigurement, there has 
been no return of the disease, which was treated six years ago. 

Case 13,153. Mrs. A. was cured of a cancer of the breast, of very 
large size, over five years ago, and has felt no symptoms of the disease 
since. 

Case 15,523. This was a case of epithelial cancer of the lip. The 
tumor had ulcerated and commenced to break down when first seen at 
our institution. It was promptlj-^ removed. The parts healed perfectly, 
and, although nearly two years have intei-vened, there has been no re- 
turn of the disease. 

Case 52,607. Cancerous Testicle Complicated with Hydro- 
cele. Weight twelve pounds. Painlessly removed and a 
cure effected. 

World's Dispensary Medical Association:— Gen^ietnen— I take 
great pleasure in testifying to the skillful treatment and great benefit 
that I liave received at j^our hands.^ 

By a delicate but painless operation, I have been thoroughly and 
permanently cured of an obstinate and dangerous disease from which I 
had suffered for years, and which had battled the skill of a large niuiibei 
of talented physicians. 

The tumor commenced as hydrocele, but finally became of a malig- 
nant nature, gradually assuming greater size, until it was larger than 
a man's head, and weighed nearly twelve pounds. 

After several years of suflering, I visited the Invalids' Hotel and 
consulted the Faculty. A skillful and painless operation was per- 
formed, and the tumor was entirely removed. My health is now 
perfect. I desire to express my sincere thanks to the Faculty of the 
Invalids' Hotel for the care and attention I have received, and I cor- 
dially advise all who need medical or surgical aid to visit the Invalids' 
Hotel, as it is uuequaled in America for the elegance of its appoint- 
ments, the care bestowed upon its patients, and the many marvelous 
cures that are accomplished by its Faculty. With best wishes for its 
prosperity, I remain, very gratefully and sincerely yours, 

S.M., Shamburg, Pa. 
Case 55,272. Cancer of the Breast. 

World's Dispensary Medical Association: — I have great pleas- 
ure in testifying to the benefit that I have received, and the marvelous 
cure eflliected in my case, by one month's treatment at the Invalids' Ho- 
tel and Surgical Institute. For over seven years I had suffered from 
the stead}'^ growth of a large tumor in my left breast, for the cure of 
which I had vainly consulted all the physicians in our vicinity, failing 
to receive any benefit from their ministrations, and knowing that I 
must be cured at once, if at all, X visited Buftalo and placed myself 



472 COMMON SENSE MEDICAL ADVISER. 

under the charge of your Faculty. They assured me that my so-called 
incurable disease was readily curable by proper treatment. I submit- 
ted to an opei-atiou ^yhich was skilliully performed and not at all pain- 
ful. An immense tumor nearly the size of my head was removed, the 
wound rapidly healed, and I am now returnin$j home after four weeks' 
treatment, in "perfect health, not a vestige of my disease left. The skill- 
ful surgeons have renewed my life by curing a disease that I had been 
led to believe was incurable. I advise all in need of medical or surgical 
treatment to visit the magnificent Invalids' Hotel, as cases hitherto 
deemed incurable are cured there almost daily. The Hotel itsell" can 
not be equaled in this countrA' as an Invalids' Home. 

A. M(;K., I.ewistou, I'a. 

Case 56,262. Cancer of the Eyeball. A painless cure. 

AVoRi.D's Dispensary Medical Associatioi^ :—Oentlemen — 1 wish 
to express my thanks for the skillful treatment I have received and the 
remarkable cure effected by j'ou. For several years I suffered from a 
cancerous disease of the left eye, which my physicians were unable to 
remove or relieve. Finding the sight of my other eye commencing to 
fail, I visited the Invalids' Hotel. A painless operation was perfornu'd 
and the disease cured. I was enabled to return home cured in one 
week. Mv physicians cannot understand how I was so speedily cured. 
I am j^ours truly, J. H. D., Clymer, N. Y. 

After removing the tumor from Mr. D.'s eye, and allowing time for 
the parts to heal, we furnished him with an artificial eye which defies 
detection. 

The records of practice at the Invalids' Hotel and Surgical 
Institute abound in cases like the preceding, and did the 
interests of our readers justify *us in occupying more space in 
citing cases, a long chapter could be filled in reporting the 
cures effected by our specialists. A large experience in the 
treatment of this terrible malady convinces us that a thorough 
course of aftei'-treatment should be carried out in these cases. 
We think that the immunity from a return of the disease 
enjoyed by our patients is largely due to the observance of this 
precaution. Under the ordinary method of treating the dis- 
ease, by simply removing the tumor with a knife, and using 
no local applications or after-medication many patients are lost, 
and in nearly all cases the disease soon returns and runs a rapid 
course. 

Tumors supposed to be benign and harmless sliould not \k- 
neglected and allowed to grow, for it has, in our experience, 
been fre<iuently observed, and the best authorities on the sub- 
ject agree, that tumors of a benign nature often degenerate 
into malignant or cancerous growths, and, if long neglected, 
prove fatal. No time, tlierefore, should be lost in consulting 
-an expert physician in such cases. 



THICK NECK. 47P) 

Our large observation furnishes abundant evidence that be- 
nign growths are often pronounced cancerous by charlatans, 
who seek through such devices to acquire a reputation for 
c;urmg malignant tumors. This fact should not, however, 
deter persons suffering from even small tumors from making 
early application for good, ]>rofessional advice. General practi- 
tioners, from their limited opportunities for observation, often 
err in the opposite direction, by pronovmcing cancerous tumors 
benign and harmless, thus, from the sense of security imparted 
to the patient's mind, really endangering his or her life. It 
must be seen, therefore, that it is of the utmost importance 
that a man of large, professional experience be consulted in 
all cases in which cancer is even susj^ected. 

THICK NECK. (Goitre.) 

Thick neck, or goitre, also sometimes called broncliocele, 
consists of an enlargement of the thjToid gland, w^hich lies 
over and on each side of the trachea, or windpipe, between 
the prominence known as "Adam's apple" and the breast bone. 
The tumor gradually increases in front and laterally, until it 
produces great deformity, and often uiter- 
feres with respiration and the act of swal- ^'^V/- -^•^^• 

lowing. From its pressure on the great 
blood vessels running to and from the head, 
there is a constant liability to engorgement 
of blood in the brain, and to apoplexy, epi- 
lepsy, etc. AVhen the enlargement once makes 
its appearance, it continues to increase in size 
as long as the person lives, iinless appropriate 
treatment is resorted to. It never disappears 
spontaneously. These tumors are much larger 
than those not familiar with them would sup- 
pose from then- outward appearance, as they extend under and 
are bound down by the muscles on each side of the neck, so 
that they become embedded in the cellular tissues underneath, 
while the sides of the neck retain, to a considerable extent, 
their round and even appearance, whereby the real magnitude 
of the tumor is not apparent. Fig. 190 represents the appear- 
ance of the neck of a person afflicted with this disease. The 




474 COMMON' SENSE MEDICAL ABVISER. 

form of tlie protuberance varies luaterially with different per- 
sons, that shown in the engraving being the shape which it 
ordinarily assumes. 

The causes of the affection are not well understood. The 
use of snow-water, or water impregnated with some particular 
saline or calcareous matter, has been assigned as a cause. It 
has also been attribiited to the use of water in which there is 
not a trace of iron, iodine, or bromine. A writei* in a Swiss 
iournal, FeHilles (P Hygiene^ states that the disease is often due 
to an impeded circulation in the large veins of tlie neck, from n 
pressure of the clothing, or from the head being bent forward, 
a position Avhich is often seen in school children, when the 
muscles of the back of the neck have become fatigued. 

Treatllieilt. We have obtained wonderful results by a . 
new method of treatment, which consists in the employment of 
electrolysis in conjunction Avith other therapeutic means. There 
is scarcely a case in which this treatment, properly carried out, 
will not effect a radical cure. It is attended with no danger 
whatever. 

Those who are afflicted with this disease and unable to 
avail themselves of special treatment, cannot do better than 
to take Dr. Pierce's Alterative Extract, or Golden Medical iJis- 
coverv, and apply to the skin over and around the tumor, night 
and morning, the following solution, which may he prepared at 
any drug-store: iodine, one drachm; iodide of potassium, four 
drachms; dissolve in three ounces of soft water. A)>ply to the 
tumor twice a day, with a feather or hair pencil. 

MUMPS. (Parotitis.) 

This is an inllammation of the parotid glands and generally 
occurs in childhood. It is often epidemic, and is manifestly 
contagious. It usually, though not always, appears ^i both 
sides of the neck at the same time. 

I^yiliptoni!^. An external, movable swelling, just below and 
in front of the ear, near the angle of the jaw, is tli<^ prominent 
symptom. The enlargement is not circumscribed, but hard and 
painful, and attended with more or less fever, dei-angement of 
the secretions, and difficulty in swallowing. The swelling 
increases until the fourth and hftli day, when it gradually 



BOILS, 475 

diminishes, and by the eighth or tenth is entirely gone. Some- 
times the disease is accompanied by swelling of the breasts, 
in the female, or of the testicles, in the male. 

Treatment. Usually but little treatment is necessary. 
Exposure to cold should be avoided. If severe or painful, with 
febrile symptoms, a hot foot-bath and small doses of the Com- 
pound Extract of Smart-weed in some diaphoi*etic infusion, to 
induce sweating, together with small doses of aconite, will, 
produce good results. If swelling of the testicles threatens 
(which seldom happens except on taking cold), resort should be 
had to mild cathartics, the spirit vapor-bath, stimulating lini- 
ments to the neck, and warm fomentations to the part attacked. 
If delirium occurs, a physician should be summoned. 

BOILS. (FURUNOULUS.) 

These annoying affections are hard, prominent, circumscribed, 
inflamed, suppurating tumors, having their seat in the cellular 
tissue beneath the skin. They vary in size from a pea to a 
hen's egg, and may occur on any part of the body. The color 
of a boil varies from deep red to mahogany. It is painful, 
tender, advances rapidly to maturity, becomes conical, and 
finally bursts and discharges bloody "matter," Through the 
opening, and filling the ca\^y, may be seen a piece of sloughing 
cellular tissue which is called the core. In from four to fifteen 
days it is all expelled and the sore i-apidly heals. The causes 
are an impure condition of the blood, which generally arises 
from imperfect action of the liver or kidneys. 

Treat men t. Spirits of turpentine applied to a boil in 
its earliest stage will almost always cause it to disappear; but 
when suppuration has commenced it should be favored by the 
application of poultices. Next purify the blood to prevent 
subsequent returns in other parts of the body. For this pur- 
pose take the Grolden Medical Discovery. Tincture of bur- 
dock root, made by finely slicing four ounces of the green 
root and covering it with whisky or alcohol, is a reliable 
remedy for boils, and may be taken in teaspoonful doses, alter- 
nately with the Golden Medical Discovery. If the patient is 
anaemic give some of the preparations of iron mentioned under 
the head of tonics in this work, in addition to the foregoing. 



47<1 COMMON SENSK MKDIOAL ADVI6KR. 

CARBUNCLE. (Anthrax.) 

These are more violent, larger, and more painful than boils, 
which they resemble. They may spring from several small 
}»iiiiples which extend deep into tlie tissues, and on the surface 
frequently several small vesicles appear and break. Tlu'y may 
discharge, through one or several openings, a thin acrid, bloody, 
or dark-colored fluid. They most frequently occur upon the 
back of the neck, 1)ack, back part of the limbs, and under the 
arms. Their presence is evidence of a depressed condition ol" 
vitality. These tumors vary in size from one-half an inch 
to six inches in diametei", and rapidl}- proceed to a gangrenous 
(rondition, a grayish slough being detached from tlie healthy 
tissue. 

Treatment. Invigorate the system by every })ossible 
means. Tlie bitter toni(^s such as Golden Seal, Gentian, or 
Willow, together with quinine and iron should be used. Nutri- 
tious diet, pure air, etc., are necessary. Purify the blood to 
remove the causes of the disease. For this purpose, give the 
Golden Medical Discovery in as large doses as can be borne 
without acting too freely on the bowels. Anodynes may be 
necessary to overcome the pain. Poultices are useful to en- 
courage the separation of the de«d from the living tissues. 
Antise])tic dressings are beneficial, of which carbolic acid is to 
l>e ])rererred; yeast, however, may be employed. 

Sometimes powerfid caustics or free incisions arc pi-oductive 
of gratifying results, if followed by ap]>ropriate di'essings, but 
these extreme measures should only be resorted to by the direc- 
tion of a physician. 

For a considerable time after the urgent symptoms have sub- 
sided, the Golden Medical Discovery should be used, to purify 
and ein-ich the blood, and the bitter tcmics and iron may be 
alternated with it, or be used conjointly to good advantage. 

ACU PE CATARRH, OR CORYZA, AND INFLUENZA. 

Acute Catarrh, or Coryza, is an inflammation of the lining 
membrane of the nostrils. The first and most prominent char- 
acteristic symptom is that of "stuffing up of the head." This 
feeling is caused by the swelling of the lining membrane of 



ACUTE CATABRH, OK CORYZA, AJMD INFLUENZA. 477 

the passages, which frequently closes them up. This renders it 
difficult or impossible to breathe through the nose, and affects 
the voice very much. In a day or two the sufferer begins to 
sneeze and the nose discharges copious quantities of clear, hot, 
acrid liquid which often irritates the external orifice, causing it 
to become very sore. In addition to the symptoms already men- 
tioned, there is often " aching of the bones," dryness of the 
skin, and a general derangement of the secretions. It is an 
affection more disagreeable than dangerous. 

IllfllienKa. This is an aggravated form of acute catarrh, 
and is frequently epidemic. When epidemic it is more severe 
than when it occurs sporadically and when complicated with 
other pre-existing disorders it sometimes proves fatal. Suffei- 
ers from consumption, heart disease, or any serious derange- 
ment of a vital organ, are in great danger when attacked by 
infliienza. 

Symptoillisi. This acute affection usually commences with 
chilly sensations alternating with flushes of heat. Sneezing is a 
common symptom; there is pain in the forehead; breathing 
through the nose is difficult; the eyes are red and watery; sore- 
ness of the throat is experienced; there is pain in the back, 
nervous irritation, fever, thirst, hoarseness and general lassitude. 
There is cough, at first dry, afterward attended with free expec- 
toration. 

Caiisesi. The causes of this epidemic are supposed to be 
certain atmospheric changes, the precise nature of which is not 
known. They may or may not be perceptible to the senses, yet 
their effect is painfully apparent to all. Such causes of disease, 
however, are beyond human control. We may mitigate their 
effects, but cannot stay them in their career. 

Treatllieilt. In the milder forms of acute catarrh, or 
coryza, only shnple treatment is required. A hot foot-bath, on 
retiring at night, with" a full dose of the Compound Extract of 
Smart-weed, to produce free perspiratioii, will generally break 
\ip the attacks However, should the discharge from the nostrils 
continue troublesome. Dr. Sage's Catarrh Remedy should be 
freely snuffed four or five times a day, and if the bowels be 
costipated a mild dose of the Pleasant Purgative Pellets will 
materially assist in overcoming the disease. These means, well 



478 COMMON SENSE MEDICAL ADVISER. 

applied, together with the avoidance of exposure to cold, and 
restriction to a spare vegetable diet, will prove most efficacious. 
In the more severe attacks of Influenza, the most decisive 
measures should be employed. The spirit vapor-bath should 
be administered, to niduce profuse sweating, or, if the means 
for its application be not at hand, the patient should be warmly 
covered up in bed, and jugs or bottles of hot water applied to 
his feet and sides. The Compound Exti'act of Smart- weed 
should be given freely, together with plenty of warm drinks, 
by which copious perspiration will be kept up, the circulation of 
the blood ecjualized, and inflammation of the mucous lining of 
the air passages subdued. In very severe attacks, the tijicture 
of aconite will aid in establishing perspiration and subduing the 
inflammation. If severe coughing be a troublesome symptom, 
the Gohlen Medical Discovery should be taken in small and 
frecjuent doses. 

CHRONIC NASAL CATARRH. (Oz^na.) 

In consequence of repeated attacks of acute catarrh, or " cold 
in the head," as it is usually tenned, the mucous membrane of 
the nose and air-passages of the head become permanently 
thickened, the mucous follicles or glands diseased, and their 
fuju'tions either destroyed or very much deranged. Although 
chronic catarrh is most commonly brought on in the manner 
above stated, it sometimes makes its appearance as a sequel and 
result of typhoid fever, scarlet fever, measles or other eruptive 
fevers, or shows itself as a local manifestation of scrofulous or 
syphilitic taints in the system. In the early stages of the dis- 
ease the patient may be annoyed with only a slight " dropping 
in the throat," as many express it, the amount of the discharge 
from the air ]»assages of the head at this stage of the disease 
being only slightly in excess of health. In some cases the dis- 
charge is thick, ropy, and tough, requiring frequent and strong 
efforts in the way of blowing and spitting, to remove it from 
the throat, where it frequently lodges. In other cases, or in 
other stages of the same case, the discharge is thin, watery, 
acrid, irritating, and profuse. The nasal passages may be ob- 
structed by the swollen and thickened condition of the lining 
raucous membrane so as to necessitate breathing through the 



CHRONIC NASAL CATARRH. 479 

iiiouth, giving to the voice a disagreeable nasal twang. From 
the nature of the obstruction in this condition, it is useless for 
the sufferer to endeavor to clear the passage by blowing the 
nose; this only tends to render a bad matter worse, by increas- 
ing the irritation and swelling of the already thickened lining 
membrane. The swelling of the raucous membrane does not in 
all cases become so great as to cause obstruction to respiration 
through the affected passages. In some cases the patient suffers 
from headache a great portion of the time, or may experience a 
dull, heavy, disagreeable fullness or pressure in the head, with a 
confusion of his ideas, which renders him quite unfit for 
business especially such as requires deep thought and mental 
labor. Memory may be more or less affected, and the disposi- 
tion of those who ai'e otherwise amiable, is often rendered 
irritable, or morose and despondent. The mental faculties 
suffer to such an extent in some eases as to result in insanity. 
The sense of smell is in many cases impaired, and sometimes 
entirely lost, and the senses of taste and hearing are not unfre- 
quently more or less affected. 

Ozsena. The ulcerative or more aggravated stage of the 
disease, from the offensive odor which frequently attends it, is 
denominated Ozaena. 

The secretion which is thrown out in the more advanced 
stages of chronic catarrh often becomes so acrid, unhealthy an«l 
poisonous, that it produces severe irritation and inflammation, 
which are followed by excoriation and ulceration of the deli- 
cate lining membrane of the air-passages in the head. Although 
commencing in the lining membrane, the ulceration gradually 
extends in depth, until it frequently involves all the structures 
of the nose, cartilage, bone, and fibrous tissue. As the ulcera- 
tion extends up among the small bones, the discharge generally 
becomes profuse, and often excessively fetid, requiring the fre- 
quent use of the handkerchief, and rendering the poor sufferer 
disagreeable both to himself and those with whom he associ- 
ates. Thick, tough, brownish incrustations, or hardened lumps, 
are frequently formed in the head, by the evaporation of the 
watery portion of the discharge. These lumps are sometimes 
so large and tough that it is ^nth great difliciilty that they can 
be removed. They are usually discharged at intervals of a few 



480 COMMON .SENSE MKDICAL A1>V18EK. 

days. Portions of cartilage and hone, or even entii'e bones, 
often slough away and are discharged, either in large flakes or 
blackened, half-decayed, and crumbly pieces, or, as is much 
more commonly the case, in the form of numerous minute par- 
ticles, which escape Avith the discharge unol)served. It is pain- 
fully unpleasant to witness the ravages of this terrible disease, 
and observe the extent to which it sometimes progresses. Holes 
are eaten through the roof of the mouth, and great cavities ex- 
cavated into the solid bones of the face; in such cases only th<^ 
best and in<»st thorough treatment will check the progress and 
fatal termination of the disease. 

COMPLICATIONS. 

C^atan'h, or ozfena, is liable to be complicated not only with 
scrofulons or other taints, as has already been pointed out, but 
also by an extension of the diseased condition to other parts 
beyond the air-passages of the head. 

Di»«ca!!ie of the Throat. The acrid, irritating, and 
poisonous discharge which, in some stages of the dis<>ase, almost 
constantly runs down over the delicate lining membrane of the 
jdiarynx is liable to produce in the lining membrane a diseased 
condition similar to that existing in the air-passages of the 
head. The throat may feel dry, husky, and at times sliglitly 
sore or "raw;" or, from the muco-purulent discharge wljich 
is almost constantly dropping down over its surface, the patient 
may feel \ery little inconvenience from the disease of the 
throat until it is far advanced, the moistening and lubricating 
efl'ect of the "matter" which <lrops on the surface tenduig to 
bhnit the sensibility of the parts. The bac^k of the throat may 
be pale, or of a dark red color. In the advanced stages, its sur- 
face is studded with \('ry small ulcers which, as seen through 
the mouth, look like small pimples or "cank-er sores," for which 
they are often mistaken. The patient may at times experience 
a tickling sensation in the throat, with ))erhaps a slight cough. 
The voice may be more or less affected, especially on exposure 
to cold or through over exertion. The tonsils often participate 
in the diseased condition, becoming more or less enlarged from 
the organization of the plastic matter, thrown out from the 
substance of these glands by the inflannnatory process. 



CHEONIC NASAL CATARRH. 481 

Extemsion of the Disease to the Ijarynx. The 

larynx is that portion of the air-passages which, in the male, is 
indicated by " Adam's apple." The acrid, poisonous discharge 
which drops into the throat from the head, is not all removed 
by hawking and spitting. More or less of it is, by the act of 
inspiration, drawn into the larynx, or still lower down into the 
trachea, wind-pipe. In this way the disease creeps along the 
continuous mucous surface of the air-passages, the acrid, poison- 
ous discharge arousing in its track the same irritation, inflam- 
mation, thickening, and ulceration of the lining membrane, 
which characterize the disease in other portions of the air-pas- 
sages. When affecting the larynx the case is usually attended 
with more or less of a cough, which is sometimes very severe, 
at other times only a slight hacking. Tenderness in these re- 
gions, more or less hoarseness, and loss or partial suppression of 
voice, are common to this stage of the disease. 

Bronchitis and Consumption. We have already 
detailed the manner in which the throat, larynx, and trachea, 
in succession, become affected from catarrh or ozaena. By the 
same process of extension, the bronchial tubes, and lastly the 
parenchyma or substance of the lungs, in their turn, are dis- 
eased, and bronchitis and consummation firmly established, 
Tightness in the chest, with difficulty of breathing, soreness, 
darting, sharp, or dull, heavy pain, or a prickly, distressing sen- 
sation accompanied with more or less cough or expectoration, 
are evidences that the bronchial tubes have become affected, 
and should admonish the sufferer that he is now standing 
upon the stepping-stone to consumption^ over which thousands 
annually tread, in their slow yet sure journey to the grave. 

Deafness. By means of a small canal called the eustachian, 
tube, an air-passage and communication between the throat and 
middle ear is formed. This passage is lined by a continuation of 
the mucous membrane which covers the throat and nasal pas- 
sages. The catarrhal, inflammatory process, by continuity of 
surface, follows the mucous membrane, thickening its structure 
until the eustachian tube is closed, and the beautiful mechanism 
of the internal ear is rendered useless. While the thickening 
of the lining, mucous membrane is going on, and the passage 
is slowly becoming closed, the patient occasionally, while 
21 



482 COMMON SENSE MEDICAL ADVISER. 

blowing the nose, experiences a crackling sound in one or 
both ears, and hearing becomes dull, but returns suddenly, ac- 
companied with a snapping sound. This may be repeated 
several times, until, finally, hearing does not return, but remains 
permanently injured. In other cases, the hearing is lost so 
gradually that a considerable degree of deafness may exist be- 
fore the person is really aware of the fact. Either condition is 
often accompanied with noises in the head, of every conceiv- 
able description, increasing the distress of the sufferer. The 
delicate bones of the ear are sometimes detached from their 
articulations, the drum is ulcerated and perforated, and through 
the orifice thus made, the bones or small spicula, may escape 
with the thick, purulent, and offensive discharge. 

Closure of the Tear Duct. The lachrymo-nasal, or 
tear duct, or passage, which, when in a healthy condition, serves 
to convey the tears from the eye into the nose, may be closed 
by the same inflammatory and thickening process which we 
have already described. This condition is usually attended 
with watery and weak eyes, the tears escaping over the cheeks, 
and sometimes producing irritation and excoriation. The nasal 
branch of the ophthalmic nerve sometimes participates in the 
ulcerative process going on in the head, so that the eyes are 
sympathetically affected. They sometimes become congested or 
inflamed, and sharp pain in the eyeballs may be experienced. 

Symptoms. Dull, heavy headache through the temples 
and above the eyes, indisposition to exercise, difficulty of think- 
ing or reasoning or concentrating the mind uj)on any subject, 
lassitude, indifference respecting business, lack of energy, ob- 
struction of nasal passages, discharges falling into the throat, 
consisting of profuse, water}', acrid, thick, and tenacious mucus, 
or purulent, muco-purulent, bloody, putrid, offensive matter are 
the most frequent symptoms of catarrh. In the most severe 
cases, a dryness of the nasal passages, dry, watery, weak, or 
inflamed eyes, ringing in the ears, deafness, discharge from the 
ears, hawking and coughing to clear the throat, ulcerations, 
death, and decay of bones, expectoration of putrid matter, 
spicula of bones, scabs from ulcers, a constant desire to clear 
the nose and throat, nasal twang, offensive breath, impairment 
or tytal deprivation of the sense of smell and taste, dizziness. 



CHRONIC NASAL CATARRH. 483 

mental depression, loss of appetite, nausea, indigestion, dyspep- 
sia, enlarged tonsils, raw throat, tickling cough, are all common. 

All the above symptoms, as well as some others which have 
been given previously, and which it is not necessary here to re- 
peat, are common to this disease in its different stages or com- 
plications, yet thousands of cases annually result in consumption 
or chronic bronchitis, and end in the grave, without ever having 
manifested one-half of the symptoms enumerated. 

Varieties. People often suppose that there are a great 
many varieties of catarrh. This is an error. The nature of 
the disease is the same in all cases, the symptoms only varying 
with its different stages, and the various complicated, diseased 
conditions which are liable to arise, and which we have already 
pointed out. 

Causes. Anything which debilitates the system, diminishes 
its powers of evolving animal heat and withstanding cold or 
sudden changes of atmospheric temperature and other disease- 
producing agencies, renders the individual thus enfeebled liable 
to catarrh. Among the most common predisposing influences 
are a scrofulous condition of the system, or other impurities 
of the blood, exhausting fevers and other prostrating acute 
diseases, exhausting, unnatural discharges, intemperance, excess- 
ive study, self-abuse, adversity, grief, want of sleep, syphilitic 
taints of the system, which may have been contracted inno- 
cently, or which may have been inherited, too sudden rest after 
great and fatiguing exercise, and Kving in poorly-ventilated 
apartments. These are among the most fruitful causes of those 
feeble, deranged, or impure conditions of the system to which 
catarrh so frequently owes it origin. The immediate or excit- 
ing cause is generally repeated attacks of " cold in the head," 
which have been neglected or improperly treated. Some people 
are convinced with difficulty that there exists in their system 
a weakness, impurity, or derangement of any kind which has 
permitted the disease to fasten itself upon them. They may 
not feel any great weakness, may not have any pimples, 
blotches, eruptions, swellings, or ulcers upon any part of their 
person; in fact, nothing about them which would, except to 
the skilled eye of the experienced physician, indicate that 
their constitution is deranged, and yet such is generally .the 



484 COMMON SENSE MEDICAL ADVISER. 

case. As an ulcer upon the leg, or a " fever-sore," or an erup- 
tion upon the skin, may be the only outward sign of a derange- 
ment of the system, so chronic catarrh is frequently the only 
sign by which a bad condition of the system manifests itself 
in a manner which is perceptible to the sufferer himself or 
to the unprofessional observer. The educated physician, whose 
constant practice perfects his perceptive faculties in this direc- 
tion, detects the constitutional fault, as an experienced banker 
detects a finely-executed counterfeit bank-note which the un- 
practiced eye would receive as genuine. 

Treatment. As the predisposing cause of catarrh is, 
in the majority of cases, some weakness, impurity, or otherwise 
faulty condition of the system, our chief aim should be directed 
to the removal of this cause. The more we see of this disease, 
the more do we see the importance of combining, with the 
use of a local, soothing, and healing application, a thorough 
and persistent internal use of alterative and tonic medicines. 

As a local application for healing the diseased condition in 
the head, Dr. Sage's Catarrh Remedy is beyond all comparison 
the best preparation ever discovered. It is mild and pleasant 
to use, producing no smarting or pain, and containing no strong 
irritating or caustic drug or poison. Its ingredients are simple 
and harmless, yet when scientifically and skillfully combined 
in proper proportions, they form a most efiicient and valuable 
healing remedy. Like gunpowder, which is formed of a com- 
bination of saltpetre, sulplmr, and charcoal, the ingredients are 
simple, but the product of their combination is wonderful in 
its effects. This remedy is a powerful antiseptic, and speedily 
destroys all unpleasant odors, which accompanies so many cases 
of catarrh, thus affording great relief to those who suffer from 
this disease. 

The reader's mind cannot be too strongly impressed with 
the importance of combining thorough constitutional with local 
treatment of this disease. Not only will the cure be thus more 
surely, speedily, and permanently effected, but other forms of 
disease will thereby be prevented from breaking out, as the 
result of constitutional derangement or weakness. 

In the treatment of catarrh and all the various affections 
with which it is so frequently complicated, as throat, bronchial. 



CHKONIC NASAI. CATAEEH. 486 

and lung diseases, weak stomach, catarrhal deafness, weak or 
inflamed eyes, impure blood, scrofulous and syphilitic taints, the 
wonderful virtues of the Golden Medical Discovery cannot be 
too highly extolled. It has a specific effect upon the lining 
mucous membranes of the nasal and other air passages, pro- 
moting the natural secretion of their follicles and glands, there- 
by softening and restoring the diseased and thickened mem- 
brane to its natural thin, delicate, moist, healthy condition. As 
a blood purifier, it is unsurpassed. As those affections which 
complicate catarrh are diseases of the lining mucous membranes, 
or of the blood, it will be very clear why this medicine is so 
well adapted to cure them. 

The Golden Medical Discovery is the natural auxiliary of Dr. 
Sage's Catarrh Remedy. It not only cleanses, purifies, regulates, 
and builds up the system to a healthy standard, and conquers 
throat, bronchial, and lung complications, when any exist, but, 
from its specific effects upon the lining membrane of the nasal 
passages, it aids materially in restoring the diseased, thickened, 
or ulcerated membrane to a healthy condition, and thus eradi- 
cates the disease. When a cure is effected in this manner it is 
permanent. The system is so purified, regulated, and strength- 
ened as to be strongly foi-tified against the encroachments of 
catarrh and other diseases. In taking the Golden Medical 
Discovery the effects upon the system are gradual, and the 
alterative changes of tissue and function generally somewhat 
slow. They are, however, not less complete, radical, and perma- 
nent, and this constitutes its great merit. Under its use, all the 
secretions are stimulated, the blood-poisons carried out of the 
system, the nutrition is promoted, and the patient finds himself 
gradually improving in flesh; his strength is built up, his linger- 
ing ailments disappear, and he soon finds that his whole system 
has been renovated and repaired, and he feels like a new and 
perfect being. 

The Clothing^. With most pei-sons suffering from chronic 
nasal catarrh, there is a great disposition to take cold, even slight 
exposure being sufiicient to produce an acute attack, which 
greatly aggravates the chronic affection, and tends to render 
it permanent. To obviate the evil effects which are liable to 
result from this predisposition, great attention should be paid to 



486 COMMON SENSE MEDICAL ADVISER. 

clothing; it should thoroughly protect the person from sudden 
changes of temperature. For more particular and practical 
suggestions in regard to this matter, the reader is referred to the 
article on clothing in Part Tliird of this volume. 

The Diet has an important bearing upon this disease, as 
with consumption and many other chronic affections. It should 
be largely composed of those articles which are rich in the car- 
bonaceous elements. Fat meats, rich, sweet cream, good butter, 
and other similar articles of diet should be largely eaten. By 
furnishing the elements for the production of animal heat, they 
counteract the predisposition to take cold, and thus become most 
valuable remedial agents — ^not less essential than the medical 
treatment which has been advised. A person suffering from 
chronic catarrh should study well the hygienic instructions to be 
found in Part Third of this volume, and govern himself accord- 
ingly- 

Treatment of Coiiiplicatioiis. There are various 
complications of this disease which require modifications of 
treatment. Yet rules cannot be made which would enable un- 
professional readers to vary the treatment to suit peculiarities of 
the constitution, or complications of the disease. When con- 
sulted, either in person or by letter, we have been able to so 
modify the treatment as to adapt it to peculiar, individual cases 
which had resisted all ordinary treatment, and have thus cured 
hundreds who had otherwise failed to find relief. 

Time Required to EflTect a Cure, A person should 
not expect to be speedily cured, esj)ecially if the case be one of 
long standing. It is true that strong, irritating, and drying 
preparations frequently suddenly arrest the discharge from the 
nose, but the thickened or ulcerated condition of the lining, 
mucous membrane, which really constitutes the disease, is not 
removed by such treatment, and the discharge soon comes on 
again. Besides, there is danger attending the use of strong, 
irritating, or drying preparations. The disease, by their use, is 
frequently driven to the throat, bronchial tubes, lungs, or brain. 
Not less irrational and unsuccessful is the plan of treating the 
disease with inhalations of "carbolized iodine," and other sim- 
ilar preparations. Such treatment may mask the disease for a 
time; but T)y reason of its constitutional nature they cannot 



CHRONIC KA8AL CATARRH. 



487 



effect a perfect and permanent cure. Dr. Sage's Catarrh Rem- 
edy, on the other hand, cures the disease upon rational and 
scientific principles, by its mild, soothing, and healing properties, 
to which the disease gradually yields, when the system has been 
put in order by the use of the Golden Medical Discovery. Our 
clinical experience has convinced us that this is the only per- 



Fig. 191. 




This cut illustrates the manner of using Dr. Pierce's Nasal Douche. 

fectly safe, scientific, and successful mode of acting upon and 
healing it. 

This remedy, when prepared according to the directions which 
accompany each package, may be poured into the hollow of the 
hand, and snuffed up the nostrils, one after the other; but a 
much more effectual method of applying it, is to use Dr. Pierce's 
Nasal Douche in the manner illustrated by Fig. 191. The 
remedy should be thoroughly applied to all the affected parts, 
which can only be accomplished by the douche. 



488 COMMON SENSE MEDICAL ADVISER, 

HAY CATARRH. 

This affection, known also as Hay Asthma, and Hay Fever, 
differs but little in its manifestations, from coryza, save in its 
inciting cause, and in its element of periodicity. In this lati- 
tude there are a few persons who, between the middle and last 
of August, are invariably attacked with acute inflammation of 
all the air-passages, giving rise to sneezing, watery discharges 
from the nose and eyes, difticult respiration, fever, and general 
prostration. These symptoms are supposed to be induced by 
the inhalation of the odor of grasses or flowers, which at that 
time are supposed to give off certain exhalations of an irritating 
character. Unless arrested by medical treatment, the disease 
lasts until cool weather, or the occurrence of a hard frost, 
rids the atmosphere of the irritating perfume. 

Some feather beds give off an odor which excites all the 
aggravated symptoms of this disease. Thus it appears that 
certain emanations have the power of inciting these inflamma- 
tory conditions in certain sensitive constitutions. A case or 
two are on record, in which the odor from the body of a horse 
so induced these symptoms that the individual could never ride 
nor drive him. 

Treatment. This disease may generally be prevented by 
the daily use of Dr. Sage's Catarrh Remedy, which neutralizes 
and washes away the particles which poison the mucous mem- 
brane. The Remedy should, for this purpose, be used with the 
Nasal Injector, or Douche, Wlien the disease already exists, 
and has advanced so far that it is accompanied with asthma, the 
Golden Medical Discovery is required to effect a cure, and 
should be used in conjunction with the Catarrh Remedy. Two 
or three drops of tincture or fluid extract of lobelia, with 
the same quantity of tincture or fluid extract of gelsemi- 
num repeated three or four times daily, will assist in control- 
ling this very disagreeable malady. Generally, by a vigorous 
application of this treatment, the patient will observe that 
the disease is yielding by degrees, and the improvement will 
continue until a complete cure is effected. If the exciting 
cause can be determined, it should, of course, be avoided, if 
possible. 



NA.SAL POLTPUS. 489 

NASAL POLYPUS. 

Nasal Polypi are tumors which grow from the mucous mem- 
brane of the nasal passages, to which they are generally 
attached by a small pedicle, or neck. There are two varieties, 
gelatinoid and fibroid. The former closely resembles an oyster 
in appearance, color, and consistence. This form rarely bleeds. 
The latter is more rare, of a firmer consistence, and more apt 
to bleed than the former, and is of a deep red or purple color. 
In either variety there is usually more than one tumor present, 
and they are frequently found in both nostrils. They often 
attain considerable size, and, by pressure upon and displace- 
ment of the surrounding structures, occasion hideous deformity 
of the face. Polypi are very often complicated with nasal 
catarrh, the successful treatment of which necessitates their 
removal. 

Causes. Nothing is definitely known regarding their causes, 
but they are generally supposed to originate in some constitu- 
tional derangement, impairing the nutrition of the mucous 
membranes. 

Symptoms. These are such as attend stoppage of the 
nose from any cause. There is a sense of obstruction, more or 
less complete, with fullness and weight in one or both nostrils, 
which is increased in damp weather. The voice becomes un- 
natural, as when a cold obstructs the nose, and the sleep is fre- 
quently embarrassed by its interference with breathing. The 
nasal discharge is usually increased, and is of a variable char- 
acter. The diagnosis of polypus is not certain unless it can be 
seen or felt. By forcing the breath through the nostril in 
which it is supposed to exist, it will generally, if present, come 
in sight, which decides the matter at once. Polypi sometimes 
grow backward into the throat, obstructing the posterior open- 
ings of the nose. 

Treatinent. Either before or after the removal of the 
tumor, the constitutional derangement should be rectified. For 
this purpose the Golden Medical Discovery is unequaled. The 
removal of the polypus may sometimes be accomplished by 
snuffing powdered blood-root. When this fails it may be 
readily removed by any competent surgeon, by torsion or the 



490 COMMON SENSK MEDICAL ADVISER. 

ligature, and the operation is but slightly painful, for as no 
nerves are distributed to these morbid growths, they are not 
sensitive. After their removal tlie use of Dr. Sage's Catarrh 
Remedy will prevent their return. 

CASES TREATED. 

Case I. A gentleman presented himself at the Invalids' Hotel and 
Surgical Institute seeking treatment for what hv supposed to be 
catarrh. He complained of a sense of weight, fullnef^s, and obstruction 
of the nostrils, with discliarge Examiuation revealed the existence 
of polypus, and constitutional derangement. 

We removed the polypus, advised ntteutiou to diet and bathing, and 
reconiiuended the use of the Golden Medical Discovery internally, with 
Dr. Sage's Catarrh Remedy, to be used with the Nasal Douche. The 
jiolypus never returned. 

Case II. Several years ago a middle-aged gentleman called at the 
Invalids' Hotel supposing tliat he was laboring under an aggravated 
form of catarrh. On examination both nasal passages were found to 
be perfectly filled with polypi, which had enlarged until they had 
pressed out the sides of tlie nose to such an extent as to produce great 
deformity, giving him a hideous look. The tumors were promptly 
i-emoved by the attending surgeon, proper treatment advised, and we 
learned not long since, through a neighbor of the gentleman oi)erated 
upon, that he has experienced no return of the morbid growths. 

Nasal polypi are so frequently mistaken for chronic catarrh, the 
treatment of which enters so largely into our practice, that it has also 
been our fortune to be consulted very frequently by those suffering 
from the former disease, and the two cases cited are but fair samples of 
a large number on the case books of the Invalids' Hotel Avhich have 
been successfully treated. 

ACUTE LARYNGITIS. 

This is an acute inflammation of the upper portion of the 
windpipe, and is attended with considerable danger. Its causes 
are colds, suppression of perspiration, and such as generally 
give rise to inflammation. 

The Symptoms are those common to inflammation else- 
where. There is soreness or stiffness of the throat, a difliculty 
in swallowing, and a desire to clear the disoi-dered organ. 
There is fever, the sense of constriction in the throat inc)(>ases, 
the voice is harsh, hoarse, or croaking, and thei-e is frequently a 
hackint; cough. The throat is red and swollen, the voice alters 
and becomes shrill or whispering and surpressed, and the breath- 
ing more difiicult. If not relieved, delirium and coma come on, 
and the patient dies of suffocation. 

Treatment. This should be prompt and thorough, and 
similar in character to that recommended for inflammations 



CHRONIC LARYNGITIS. 



491 



elsewhere, viz: the use of the spirit vapor-bath and hot foot- 
bath, to induce sweating, which should be kept up by the 
Compound Extract of Smart-weed. The employment of Dia- 
phoretic infusions and tincture of aconite, with mucilaginous 
drinks, hot packs to the throat, and the inhalation of steam, is 
proper. The affection being very rapid in its course jind 
dangerous, if it does not quickly yield to this treatment, no time 
should be lost in securing skillful medical aid. 



CHRONIC LARYNGITIS. 

This is of much more frequent occurrence than the acute 
form, and is often associated with tuber- 
cular affections, and constitutional syphi- ^Hf- -^^^• 
lis. It is characterized by an inflamma- 
tory condition, ulceration, or hardening 
of the mucous membrane of the larynx, 
most frequently the latter. There is also 
a chronic form known as follicular lar- 
yngitis, or clergymen's sore throat, to 
which public speakers are subject. 

The Causes of chronic laryngitis 
are various, as prolonged use of the vocal 
organs in reading or speaking; using 
them too long on one pitch or key, with- 
out regard to their modulation; improper 
treatment of acute diseases of the throat; 
neglected nasal catarrh; the inordinate 
use of mercury; syphilis; repeated colds 
which directly cause sore throat, injuries, 
etc. It is also frequently due to tuber- 
cular deposits, and in these cases it gen- 
erally terminates in consumption. 

Symptoms. The affection often 
comes on insidiously. There is soreness 
of the throat, noticeable particularly 
when speaking, and immediately there- 
after; a "raw" and constricted feeling, 
leading to frequent attempts to clear the throat, in order to 
relieve the uneasy sensation. The voice becomes altered, hoarse, 




Pocket Inhaler, 



492 COMMON SENSE MEDICAL ADVISER. 

and husky, and there is a slight, peculiar cough, with but little 
expectoration. At first, the matter expectorated is mucus, but 
as the disease advances, and ulceration pi-ogresses, it becomes 
muco-purulent, perhaps lumpy, bloody, or is almost wholly pure 
pus. The voice becomes more and more impaired, and is finally 
lost. In the latter stages, it resembles consumption, being at- 
tended with hectic fever, night-sweats, emaciation, cough, pro- 
fuse expectoration, and sometimes hemorrhage, 

Tre:itlllCllt. Thorough hygiene should be at once insti- 
tuted, and the patient should avoid using his voice. At the 
same time, attention should be paid to the diet, the bathing, 
and the clothing. Every thing should be done that is calculated 
to build up and improve the general health. The Golden Medi- 
cal Discovery is well adapted to remove morbid states of the 
disease, in consequence of its direct action on the mucous mem- 
branes of the air-passages, and its efficacy in allaying irritation 
of the laryngeal, pharyngeal, and pneumogastric nerves. It 
should be perseveringly employed. Iodine inhalations, admin- 
istered with the pocket inhaler, illustrated by Fig. 192, and the 
application of tincture of iodine to the forepart of the neck, 
are efficacious in many cases. Inhalations of chloride of am- 
monia, administered with a steam-atomizer, in the form of spray, 
are frequently of great benefit. Perseverance is necessary, and 
the afflicted are cautioned against discontinuing the treatment 
too soon, for the disease is very liable to return. 

CASES TREATED. 

Case I. A public speaker applied at the Invalids' Hotel for treat- 
ment. He had been a sufferer for years. His voice was reduced to a 
whisper, except an occasional hoarse or croaking sound. There was 
dr5'ness, and a frequent desire to clear the tliroat; short, frequent, irri- 
tating cough, with expectoration of minute particles of tubercle. 
There was general debility, emaciation, and loss of strength. 

The Golden Medical Discovery was given internally, and local ajipli- 
cations made to the laiynx, where the laryngoscope showed extensive 
ulceration. In three rnonths he had so far improved that local treat- 
ment was discontinued, and he returned home and continued the use of 
the Discovery for six months longer. He was fully restored to health, 
resumed his profession, and, two years after, was perfectly well. 

Case II. The Rev. T. H. F. consulted us by letter, giving his symp- 
toms in detail, which did not differ materially from those of the pre- 
ceding case. 

We directed him to take the Golden Medical Discovery, and faith- 
fully observe the hygienic rules heretofore given. Inhalations were 



CROUP, MEMBKANOUS AND SPASMODIC. 



493 



Fig. 193. 



also advised. A letter was received a few months subsequently, an- 
nouncing the patient's perfect recovery under the course of treatment 
advised. 

CROUP, MEMBRANOUS AND SPASMODIC. 

Every family should be made acquainted with the sym.ptoms 
and treatment of this disease. Especially is this true in the 
case of those living remote from a phy- 
sician. From the lack of this knowledge 
on the part of parents, mjvny a little one 
has perished before medical assistance could 
be obtained. In some of its forms its pro- 
gress is very rapid, and, unless relief is 
obtained in a few moments, or hours at the 
most, death ensues. 

There are several quite distinct patho- 
logical conditions of the vocal and respira- 
tory organs which have, in popular parlance, 
been designated as croup. But two of these 
ai*e worthy of consideration here. These 
are true or membranous croup, in which a 
false, semi-organized membrane is formed, 
and spasmodic croup. Both may result 
fatally, but the former is much the most 
dangerous. P^^ Membrane in 

lleiIlbrailOll<$ Croup is supposed to Croup. From a speci- 
originate in the trachea, from which, as it ^^e° i^ D^. Gross' cabi- 
progresses, it often extends upward to the 
larynx, and downward to the bronchial tubes. It is the result 
of severe inflammation of the mucous membrane, and is char- 
acterized by the formation of a false membrane, which covers 
or lines the inner surface of the true structure (see Fig. 193). 
It is formed of a coagulable, semi-fluid exudation from the 
mucous membrane. On being brought to the surface and into 
contact with the inspired air, this substance grows thick and 
tough, or leathery, as we find it. It is the obstruction in the 
respiratory canal which this foreign matter causes that gives 
rise to the labored breathing, and the ringing, brassy cough, 
together with the crowing or whistling inspiration characteristic 
of croup. Before recovery can take place this membrane must 




494 COMMON SEKSE MEDICAL ADVISER. 

be detached and expelled. The cough is nature's effort to 
accomplish this work. 

The formation of this adventitious membrane in the larynx 
is attended with more danger than when it is confined to the 
trachea. In most cases in which the disease has had a very 
speedily fatal tei-mination, an examination has shown that the 
larynx was its chief seat. 

Symptoms. True croup is generally preceded by what is 
known as " a cold." The child coughs, sneezes, and is hoarse. 
It is the hoarseness and the peculiar character of the cough 
which indicate the tendency to croup. This has been already 
described. In addition, the child is restless, fretful, and fever- 
ish. The disease makes rapid strides. Finally the cough ceases 
to be loud and barking, and is very much su})prcssed; the voice 
is almost gone; the face is very pale; the head thrown back; 
the nostrils dilated and in perpetual motion, the pulse at the 
wrist very feeble, great exhaustion, more or less delirium, and, 
finally, death comes to the relief of the little sufferer. Convul- 
sions sometimes occur in the last stages, and soon terminate 
fatally. 

Treatment. No time should be lost in commencing treat- 
ment. Hot fomentations should be applied to the throat and 
upper portions of the chest. The free inhalation 'of steam should 
be employed early. The following treatment has been found 
very effectual in membranous croup, and is recommended by the 
highest authorities: yellow sub-sulphate of mercury, or turpeth 
mineral, three to five grains, depending upon the age of the 
child, for one dose. If it does not cause vomiting in fifteen 
minutes, give a second dose. This, however, is seldom necessary. 
If the turj^eth mineral cannot be obtained, sulphate of copper or 
sulphate of zinc may be given instead, as directed under the 
head of Emetics, in Part III, Chapter II. If there be a quick 
pulse, hot skin, a hurried breathing, and an occasional ringing 
cough, the child should be kept in bed, comfortably covered, but 
not overloaded with clothes, and the tincture or fluid extract of 
veratrum viride administered as follows: Take fluid extract of 
veratrum, five drops; sweet spirits of nitre, one teaspoonful; 
pure water, twenty teaspoonfuls; mix, sweeten with white sugar, 
and give a teaspoonful of the mixture eveiy half-hour to two 



CEOUP, MEMBRANOUS AND SPASMODIC. 495 

hours, according to the age of the child and the severity of the 
case. If there be great prostration, with cold extremities, the 
carbonate of ammonia should be administered, in doses of from 
one to two g)-ains, every second hour, in gum arabic mucilage. 
Quinine is a valuable remedy, and is tolerated in large doses. 
The patient's body should be frequently sponged with warm 
water in which a sufficient quantity of saleratus or ordinary 
baking-soda has been dissolved to render it quite strongly alka- 
line. If the bowels be constipated they should be moved by an 
injection of starch- water. Beef tea and other concentrated, sup- 
porting diet should be freely administered. In those cases in 
which there is a tendency to croup, the Golden Medical Discov- 
ery, together with iron and the bitter tonics, should be given to 
build up the system and counteract such tendency. The treat- 
ment which we have advised has been put to the severest tests 
in the most severe forms of the disease, and has resulted most 
successfully. K, however, in any case it does not give prompt 
relief, our advice is to lose no time in summoning a physician 
who is know^n to be skilled in the treatment of diseases of 
children. 

Spasmodic Croup. In this affection no false membrane 
is formed. It seems to have a nervous origin. Most frequently 
the child is awakened in the night by a sense of suffocation. He 
may ciy out that he is choking. The countenance is livid, the 
breathing is hurried and each respiration is attended by a crow- 
ing sound. The child has fits of coiighing or crying, and makes 
vehement struggles to recover his breath. This complaint, un- 
like true croup, is unattended by fever, it being of a purely sj^as- 
modic character with no inflammation. 

Apply hot fomentations to the throat, and give frequent small 
doses of tincture or fluid extract or syrup of lobelia, to produce 
slight nausea; or, better still, an acetic syrup of blood-root, 
made by adding one teaspoonful of the crushed or powdered 
root to one gill of vinegar and four teaspoonfuls of white 
sugar. Heat this mixture to the boiling point, strain, and ad- 
minister from one-fourth to one teaspoonful every half-hour 
or hour. Slight nausea should be kept up, but it is unnecessary 
to produce vomiting. This is usually all the treatment that is 
required. 



496 COMMON SENSE MEDICAL ADVISER. 

CONSUMPTION. (Phthisis Pulmonaxis.) 

By this we understand a constitutional affection, characterized 
by a wasting away of the body, attended by the deposition of 
tubercular matter into the lung tissue. Hence the appellations, 
Phthisis Pulmonalisj Pulmonary Tuberculosis; Tubercular Con- 
suniption. Tubercles may form in other organs and result in 
a breaking do^VTi of their tissues, but the emplojmient of the term 
Consumption in this article is restricted to the lungs. The gen- 
eral prevalence, the insidious attack, and the distressing fatality 
of this disease, demand the special attention and investigation of 
every thinking person. It preys upon all classes of society. Rich 
and poor alike furnish its victims. 

Some idea of its prevalence may be formed when we consider 
that, of the entire population of the globe, one in every three 
hundred and twenty-three persons annually dies of consumption. 
It may not be definitely known just what proportion of all the 
deaths in this country and Europe occurs from this one disease. 
Those who have gathered statistics differ somewhat, some claim- 
ing one-fourth, while others put the ratio at one-sixth, one- 
seventh, and even as low as one-ninth. A fair estimate, and one 
probably very near the truth, would be one-sixth or one-seventh 
of the whole number. In New York City, for five consecutive 
years, the proportion was three in twenty. In New England, 
about twenty thousand annually succumb to this destroyer, and 
in the State of New York as many more. These figures may 
appear to be exaggerations, but investigations of the subject 
prove them to be the simple truth. Epidemics of cholera, yel- 
low fever, and other diseases of similar character, so terrible in 
their results, occasion wide-spread alarm, and receive the most 
careful considerations for their prevention and cure, while con- 
sumption receives scarce a thought. Yet the number of their 
victims sinks into insignificance when compared with those of 
consumption. Like the thief in the night, it steals upon its vic- 
tim unawares. In a large proportion of cases, its ai)proach is so 
insidious that the early symptoms are almost wholly disregarded; 
indeed, they excite but little, if any, attention, and perhaps for 
a time disappear altogether. Thus the patient's suspicions, if 
they have been aroused, are allayed and appropriate measures 



CONSUMPTION. 497 

for his relief are discontinued. This may be the case until 
renewed attacks firmly establish the disease, and before the 
patient is fully aware of the fatal tendency of his malady, he is 
progressing rapidly towards that " bourne from which no trav- 
eler returns." 

As has already been stated, consumption is a constitutional 
disease, manifested by feeble vitality, loss of strength, emacia- 
tion — symptoms which are too often classed under the name of 
general dehility, until local symptoms develop, as cough, difficult 
breathing, or hemorrhage, when examination of the chest reveals 
the startling fact that tubercular deposits have been formed in 
the lungs. Invalids are seldom willing to believe that they have 
consumption, until it is so far advanced that all medicine can 
do is to smooth the pathway to the grave. Another character- 
istic of this disease is hope, which remains active until the very 
last, flattering the patient into expectation of recovery. To the 
influence of this emotion, the prolongation of the patient's life 
may often be attributed. 

I^fature of the Disease. It is an error to suppose that 
the disease under consideration is confined to the lungs. " Pul- 
monary Consumption," as has been remarked, " is but a frag- 
ment of a great constitutional malady." The lungs are merely 
the stage where it plays its most conspicuous part. Every part 
of the system is more or less involved, every vital operation more 
or less deranged ; especially is the nutritive function vitiated and 
imperfect. The circulation is also involved in the general 
morbid condition. Tubercles, which constitute a marked featui-e 
of the disease, are composed .of unorganized matter, deposited 
from the blood in the tissue of the lungs. They are small 
globules of a yellow, opaque, friable substance, of about the con- 
sistency of cheese. After their deposition, they are increased in 
size by the accretion of fresh matter of the same kind. They 
are characteristic of all fonns of scrofulous disease. 

The most plausible theory in regard to them is, that they 
are the result of impei-fect nutrition. Such a substance cannot 
be produced in the blood when this fluid is perfectly formed. 
It is an unorganized particle of matter, resulting from the 
imperfect elaboration of the products of digestion, which is 
not, therefore, properly fitted for assimilation with the tissues. 



498 COMMON SENSB MEDICAL ADVISER. 

The system being unable to appropriate it, and powerless to 
cast it off through the excretory channels, deposits it in the 
lungs or other parts of the body. There it remains as a 
foreign substance, like a splinter or thorn in the flesh, until 
ejected by suppuration and sloughing of the surrounding parts. 
It might be supposed by some that when the offending 
matter was thus eliminated from the lungs, they would heal 
and the patient recover; but, unfortunately, the deposition of 
tubercular matter does not cease. Owing to the morbid action 
of the vital forces, it is formed and deposited as fast or faster 
than it can be thrown off by expectoration. Hence arises the 
remarkable fatality of pulmonary consumption, 

Cail§e§i. The causes of consumption are numerous and 
varied, but may all be classed under two heads, viz: Constitu- 
tional, or predisposing, and local, or exciting. Of just what 
tubercular matter consists, is still a subject of controversy, but 
that its existence depends upon certain conditions, either congen- 
ital or acquired, is generally conceded; and one of these con- 
ditions is impaired vitality. Constitutional predisposition must 
first give rise to conditions which will admit of the formation of 
tubercular matter, before any cause whatever can occasion its 
local deposition. It must first modify the vitality of the whole 
system, when other causes may determine in the system thus 
impaired, the peculiar morbid action of which tubercular matter 
is the product. The general division of causes into predisposing 
and exciting, must ever be more or less arbitrary. Individuals 
subject to predisposing causes may live the natural term of life 
and finally die of other disease. Indeed, when predisposing 
causes are known to exist, they should constitute a warning for 
the avoidance of other causes. Again, among the so-called 
exciting causes, some may operate in such a manner, with some 
individuals, as to predispose them to consumption, and the result 
will be the same as if the disposition had been congenital. The 
causes which in one individual are exciting, under other circum- 
stances and in other individuals, would be predisposing, because 
they act so as to depress the vitality and impair the nutritive 
processes. 

The Predisposing Causes, then, are hereditary pre- 
disposition, scrofula, sexual excesses and debility of the parents, 



CONSTTMPTION. 499 

climatic influences, sedentary habits, depressing emotions, in 
fact, anytJdng which impairs the vital forces and interferes with 
the perfect elaboration of nutritive material. 

The Elxciting' Causei^ are those which are capable of 
arousing the predisjiosing ones into activity, and which, in some 
instances, may themselves induce predisposition; as spermator- 
rhea, dyspepsia, nasal catarrh, colds, suppressed menstruation, 
bronchitis, syphilis, retrocession of cutaneous affections, measles, 
scarlatina, malaria, whooping-cough, small-pox, continued fevers, 
pleurisy, pneumonia, long-continued influence of cold, sudden 
prolonged exposure to cold, sudden suspension of long-continued 
discharges, masturbation, excessive venery, wastes from excessive 
mental activity, insufficient diet, both as regards quantity and 
quality, exposure to impure air, atmospheric vicissitudes, dark 
dwellings, dampness, prolonged lactation, depressing mental emo- 
tions, insuflficient clothing, improper treatment of other diseases, 
exhaustive discharges, tight lacing, fast life in fashionable soci- 
ety, and impurity and impoverishment of the blood from any 
cause. This list might be greatly extended, but the other causes 
are generally in some manner allied to those already named. 

Symptoms. The symptoms of consumption vary with the 
progress of the disease. Writers generally recognize three 
stages, which so gradually change from one to the other that a 
dividing line cannot be drawn. As the disease progresses, new 
conditions develop, which are manifested by new symptoms. 
Prior to the advent of jjulmonary symptoms, is the latent period, 
which may extend over a variable length of time, from a few 
months to several years; and, indeed, may never be developed 
any farther. Until sufiicient tubercular matter has been depos- 
ited in the lungs to alter the sounds observed on auscultation 
and percussion, a definite diagnosis of tubercular consumption 
cannot be made, even though there may have been hemorrhage. 
Nevertheless, when we find paleness, emaciation, accelerated and 
difficult breathing, increased frequency of the pulse, an increase 
of temperature, and general debility coming on gradually with- 
out any apparent cause, we have sufiicient grounds for grave sus- 
picions. These are increased if tenderness under the collar-bone, 
with a slight, hacking cough is present. These symptoms should 
be sufiicient to warn any individual who has the slightest reason 



500 COMMON SBNSE MEDICAL ADVISEE. 

to believe that he is disposed to consumption, to lose no time in 
instituting the appropriate hygienic and medical treatment, for 
it is at this stage that remedies will be found most effective. 
Unfortunately, this period is too apt to pass unheeded, or receive 
but trifling attention; the patient finds some trivial excuse for 
his present condition, and believes that he will soon be well. 
But, alas for his anticipations ! The disease goes onward and 
onward, gradually gaining ground, from which it will be with 
great difiiculty dislodged. 

The cough now becomes sufficiently harassing to attract atten- 
tion, and is generally worse in the morning. The expectoration 
is slight and frothy; the pulse varies from ninety to one hundred 
and twenty beats in a minute, and sometimes even exceeds this. 
Flushes of heat and a burning sensation on the soles of the feet 
and palms of the hands are experienced. A circumscribed red- 
ness of one or both cheeks is apparent. These symptoms increase 
in the afternoon, and in the evening are followed by a sense of 
chilliness more or less severe. The appetite may be good, even 
voracious; but the patient remarks that his food "does not seem 
to do him any good," and, to use a popular expression, " he is 
going into a decline." As the strength wanes the cough becomes 
more and more severe, as if occasioned by a fresh cold, in which 
way the patient vainly tries to account for it. Expectoration 
increases, becomes more opaque, and, perhaps, yellow, with 
occasionally slight dots or streaks of blood. The fever increases, 
and there is more pain and oppression of the chest, particularly 
during deep respiration after exercise. Palpitation is more 
severe. There may now be night-sweats, the patient waking in 
the morning to find himself drenched in perspiration, exhausted, 
and haggard. Bleeding from the lungs occurs, and creates alai-m 
and astonishment, often coming on suddenly without warning. 
The hemorrhage usually ceases spontaneously, or on the admin- 
istration of proper remedies, and in a few days the patient feels 
better than he has felt for some time previously. The cough is 
less severe, and the breathing less difficult. Indeed, a complete 
remission sometimes occurs, and both patient and friends deceive 
themselves with the belief that the afflicted one is getting well. 

After an indefinite length of time, the symptoms return with 
greater severity. These remissions and aggravations may be 



CONSUMPTION. 501 

repeated several times, each successive remission being less per- 
fect, each recurrence more severe, carrying the patient further 
down the road toward the " dark valley." Now the cough in- 
creases, the paroxysms become more severe, the expectoration 
more copious and purulent, as the tubercular deposits soften and 
break down. The voice is hollow and reverberating; the chest 
is flattened, and loses its mobility; the collar-bones are promi- 
nent, with marked depressions above and below. Auscultation 
reveals a bubbling, gurgling sound, as the air passes through the 
matter in the bronchi, with a click to the air cells beyond. Per- 
cussion gives a dull sound, or if there are large cavities, it is 
hollow, and auscultation elicits the amphoric sound, as of blowing 
into a bottle. Hectic fever is now fully established; the eye is 
unusually bright and pearly, with dilated pupils, which gives a 
peculiar expression; the paroxysms of coughing exhaust the 
patient, and he gasps and pants for breath. The tongue now 
becomes furred, the patient thirsty, the bowels constipated, and 
all the functions are irregularly performed. Another remission 
may now occur, and the patient be able to resume light employ- 
ment, for an indefinite length of time, which we have known to 
extend over three or four years, when the symptoms again 
return. 

If the patient is a female, and deranged or suppressed men- 
struation has not marked the accession of pulmonary symptoms, 
the flow now becomes profuse and clotted, or is scanty and color- 
less, sometimes ceasing altogether. In the male, the sexual 
powers diminish, and copulation is followed by excessive and 
long-continued prostration. From this time onward, the progress 
of the disease is more rapid. The liver and kidneys are impli- 
cated. In addition to the pallor, the complexion becomes jaun- 
diced, giving the patient, who is now wasted to a mere skeleton, 
a ghastly look. The urine is generally copious and limpid, 
though occasionally scanty and yellow. The pulse increases to 
one hundred and thirty or one hundred and forty beats in the 
minute, and is feeble and thread-like. The cough harasses the 
patient so that he does not sleep, or his rest is fitful and unre- 
freshing; whenever sleep does occur, the patient wakes to find 
himseK drenched with a cold, clammy perspiration. The throat, 
mouth, and tongue now become tender, and occasionally ulcerate. 



502 COMMON SENSE MEDICAL ADVISER. 

Expectoration is profuse, purulent, and viscid, clinging tena- 
ciously to the throat and mouth, and the patient no longer has 
strength to eject it. The hair now falls off, the nails become 
livid, and the breathing difficult and gasping; the patient has no 
longer strength to move himself in bed and has to be propped 
up with pillows, and suffocates on assuming the recumbent posi- 
tion. Drinks are swallowed with difficulty. Diarrhea takes the 
place of constipation. The extremities are cold, swollen, and 
dropsical; the voice feeble, hollow, grating, husky, the patient 
gasping between each word; the respiration is short and quick. 
A slight remission of these symptoms occurs. The patient is 
more comfortable, lively, cheerful, and perhaps forms plans for 
the future. But it is the last effort of expiring vitality, the last 
flicker of the lamp of life, the candle burns brilliantly for a mo- 
ment, and with one last effort goes out, and death closes the 
scene. 

The duration of the active stage of consumj^tion varies from 
a few weeks to several years, the average time being about 
eighteen months. 

Cough is always a prominent symptom throughout the entire 
course of the disease, varying with its progress. 

Expectoration^ at first scanty, then slightly increased, color- 
less, frothy, and mucous, is also a characteristic. After a time 
it becomes opaque, yellow, and more or less watery; then muco- 
purulent and finally purulent, copious, and viscid. When tuber- 
cular matter is freely expectorated, with but little mucus, it 
sinks in water. This symptom continues to the very last. 

Haemoptysis (bleeding from the lungs) may occur at any stage 
of the disease, often being the first pulmonary symptom noticed, 
again being delayed until late; and there are cases in which it 
does not happen at all. It seldom occurs in any other disease. 

Night-sweats may occur at any stage, though they are rarely 
experienced until the disease is pretty well established, and are 
very exhausting. 

Hectic Fever generally occurs soon after the pulmonary symp- 
toms are developed, and increases in intensity with the progress 
of the disease. There are usually two paroxysms in the twenty- 
four hours, one of which occurs towards evening and is fol- 
lowed by night-sweats. 



CONSUMPTION. 503 

Dyspnoea (difficult breathing) is at first slight, except after 
exertion, amounting to only a sense of oppression; but it be- 
comes more and more severe as the disease advances, until the 
very last, when it is agonizing in the extreme. 

Aphthae, sometimes extending to the pharynx and larynx, 
generally occurs towai-ds the last. The mouth and throat 
become so very sore and tender that nourishment and medicine 
are taken with difficulty. 

Emaciation and Debility are characteristic of the disease. 
They fluctuate as the disease advances or is retarded, increasing 
to the very last. 

Auscultation and Percussion constitute valuable means of 
diagnosis from the time tubercular matter begins to be deposited 
to the very last, and, when correctly practiced, reveal the 
extent and progress of the disease. As a knowledge of the 
sounds elicited can only be acquired by practical experience, 
with proper instruments, they will not be described here. The 
only diseases with which consumption is likely to be confounded 
are general debility in the early stage, bronchitis, chronic 
pleurisy, chronic pneumonia, and abscess in the lungs, after the 
advent of pulmonary symptoms. 

Curability. Notwithstanding the prevailing opinion that 
consumption is incurable, there exists ample, incontrovertible 
evidence to the contrary. Its curability is established beyond 
the shadow of a doubt. Individuals have recovered in whom 
there was extensive destruction of pulmonary tissue, and, indeed, 
entire destruction of one lung. Numerous instances are on 
record in which persons have suffered from all the symptoms 
of confirmed consumption, and have regained their health and 
subsequently died of other diseases. The case of the late Dr. 
Joseph Parish, of Philadelphia, affords a striking example of 
this kind. In early life, he manifested all the symptoms of 
confirmed consumption, including frequent hemorrhages, yet he 
fully regained his health, and, after a very useful life, died at an 
advanced age of another disease. Post-mortem examination 
revealed the existence of cicatrices, or scars, in his lungs where 
tubercular matter had been deposited. Dr. Wood, in his Prac- 
tice of Medicine, mentions another instance of a medical gentle- 
man in Philadelphia, who in early life suffered from consumption 



504 COMMON SENSE MEDICAL ADVISER. 

with haemoptysis, from which he recovered, and afterwards 
died, at an advanced age, of typhoid fever, when the knife 
revealed the presence of cicatrices. Post-mortem examinations 
of individuals who have died of other diseases, have revealed, 
in numerous instances, the presence of consumption at some 
period of their existence. In these cases the lungs were per- 
fectly healed by cicatrization, or by the deposit of a chalky 
material. A French physician made post-mortem examinations 
of one hundred women, all of whom were over sixty years of 
age, and who had died of other diseases, and in fifty of them 
he found evidences of the previous existence of consumption. 

Professor Flint says that consumption sometimes tenninates 
in recovery, and that his observations lead him to the conclusion 
that the prospect of recovery is more favorable in cases charac- 
terized by frequent hemorrhages. Drs. Ware and Walshe are 
also led to the same conclusion. 

Professor J. Hughes Bennett, of Edinburgh, has thoroughly 
investigated the subject, and adds his testimony to that of 
others, citing numerous cases that have resulted in perfect 
recovery. If such testimony is not suflScient, we may mention 
the following, whose names are well known and respected in 
professional circles, and all of whom declare that consumption 
is a curable disease. The list includes Laennec, Andral, 
Cruveilhier, Kingston, Presat, Rogee, Boudet, and a host of 
others. 

No farther back than 1866, on page 145, of the proceedings 
of the Connecticut Medical Society, we find " observations. 
Ante-mortem and Post-mortem, upon the case of the late Presi- 
dent Day, by Prof. S. G. Hubbard, M. D., New Haven," from 
which we learn that Jeremiah Day, LL. D., who was for twenty - 
nine years President of Yale College, was, while a mere youth, 
a victim of pulmonary consumption. During his infancy and 
boyhood his vitality was feeble. He entered Yale College as a 
student in 1789," but was soon obliged to leave the institution 
on account of pulmonary diflficulty, which was doubtless the in- 
cipient stage of the organic disease of the lungs which subse- 
quently developed itself." He remained in feeble health for 
two years, but returned to college, and graduated in 1797. For 
the next six years his lung diflSculties were quite severe, and he 



CONSUMPTION. 505 

repeatedly bled in large quantities, l)ut he had so far recovered 
in 1803, as to accept a Professorship, He was afterwards 
chosen President of the college, which office he held for many 
years, in the enjoyment of good health. He died from " old 
age," as we are told, in 1867, aged 94 years. 

Statistics show that under the improved methods of treating 
this disease, the mortality, as compared with previous years, has 
been greatly reduced. Clinical observation proves that injuries 
to the lungs are not so fatal as was once supposed. 

Treatment. The earlier the treatment of this disease is 
undertaken, the greater is the probability of success. The 
reason of this is obvious; at first the disease is general or 
constitutional, but as it advances, by the deposit of tubercular 
matter, it becomes both constitutional and local. Hence the 
treatment must be both general and local. The occurrence of 
certain prominent and distressing symptoms, either from the 
natural progress of the disease, or from complications with 
other affections, often renders it difficult, even for physicians, 
to determine how far their treatment should be general and how 
far local. 

Treating the symptoms instead of the general disease, or 
treating the constitutional disease without regard to the symp- 
toms which arise from it, is an error into which many phy- 
sicians have fallen. The constitutional affection, the local 
manifestations and complications, and the circumstances and 
individual peculiarities of the patient, must all be carefully 
considered; bearing in mind all the while, that tubercular 
matter is the product of a morbid action, which, in every case, 
must exist before its deposition in the lungs, or any other 
tissue, can take place. 

In every case in which curative treatment is to be instituted, 
the hearty and persistent co-operation of both patient and 
friends is absolutely necessary; and the treatment, which is 
both hygienic and medical in character, should have in view 
the following aims: 

(1.) The avoidance of the causes concerned in the produc- 
tion and perpetuation of the disease. 

(2.) The restoration of healthy nutrition, in order to stop 
the formation of tuberculous matter. 
2? 



506 COMMON SENSE MEDICAL ADVISER. 

(3.) The arrest of the abnormal breaking down of the 
tissues, and the prevention of emaciation. 

(4,) The relief of local symptoms, and the complications 
arising from other diseases. 

The fulfillment of the first indication, the avoidance of 
causes, is of the utmost importance, for if they have been 
sufficient to x/roduce the disease, their continued operation must 
certainly be sufficient to perpetuate it. A single individual is 
very often subjected to the operation of several of the causes 
already enumerated, some of which, in consequence of circum- 
stances and surroundings, are unavoidable. Of these, the one 
most diflficult to overcome is climate; i. e. the frequent varia- 
tions of temperature. 

Upon the subject of climate much has been written. But 
that which is best adapted to the cure of consumption, is that 
which will enable the patient to pass a certain number of hours 
every day in the pure open air, without exposure to sudden 
alterations of temperature. There are very few persons who 
change their place of residence, except as a last resort, when the 
disease is in the last stage. It is then productive of little or no 
good. This is one reason why so many people having consump- 
tion die in Florida, and other warm countries. If a change of 
climate is to be effected at all, it should be made early. 

To avoid danger, and maintain a perfect standard of health, 
the hygienic rules laid down in Part 11. of this work should be 
carefully followed. 

The most powerful stimulant to health is well-regulated 
exercise. It assists the performance of every function, and is 
of paramount importance to promote good digestion and proper 
assimilation, conditions essential for recovery. It should not, 
however, be carried beyond the powers of endurance of the 
individual, so as to exhaust or fatigue. Every thing that can 
invigorate should be adopted; every thing that exhausts should 
be shunned. 

To fulfill the second indication, to restore healthy nutrition, 
requires not only a proper diet, both as regards quantity and 
quality, but demands that the integrity of the organs concerned 
in the process of digestion and assimilation, shall be maintained 
at the highest standard of perfection possible. 



CONSUMPTION. . 507 

That the diet be sufficient in quantity should be ob^aous to 
all. It is also necessary that it be nutritious, and that it should 
contain carbonaceous elements. Food of a starchy or sacchar- 
ine character is apt to increase acidity, and interfere with the 
assimilation of other elements, therefore, articles, rich in fatty 
matters, should enter largely into the diet. The articles of 
food best adapted to the consumptive invalid are milk, rich 
cream, eggs, bread made from unbolted wheat-flour, and raised 
with yeast, cracked wheat, oatmeal, good butter, beef, game, 
and fowls. These contain the necessary elements for assimila- 
tion. Oily food is of great importance, and the beef eaten 
should contain a good proportion of fat. Plenty of salt should 
always be eaten with the food, and a desire for it is often ex- 
perienced. Over-eating should be avoided, lest the stomach be 
induced to rebel against articles of diet rich in important ele- 
ments. 

Derangement of the process of nutrition requires careful at- 
tention, and, if necessary, correction. For this purpose, nothing 
can excel the Golden Medical Discovery. It increases the appe- 
tite, favors the nutritive transformation of the food, enriches 
the blood, and thus retards the deposition of tubercular mat- 
ter. It is so combined that, while it meets all these indications, 
it relieves or prevents the development of those distressing 
symptoms so common in this disease. 

The Golden Medical Discovery is adapted to fulfill the third 
indication in the management of this disease, which is to check 
the abnormal breaking down and waste of tissues, which consti- 
tute such a prominent feature in this malady. The antiseptic 
properties of the Discovery are unmistakably manifested in pre- 
venting such abnormal decomposition. The emaciation, excess- 
ive expectoration, profuse perspiration, diarrhea, and hectic 
fever, common to consumption, are all due to a too rapid dis- 
integration and waste of the tissues. It is in this condition of 
the system that this medicine, by its powerful antiseptic prop- 
erties, manifests its most wonderful curative ability. When, as 
in this disease, the \dtal forces of the system have, in a degree, 
lost their restraining influence over the processes of disintegra- 
tion, waste, and decay, which go on so rapidly that nutrition 
cannot compensate for the loss to the system, then it is that the 



508 COMMON SENSE MEDICAL ADVISER. 

Golden Medical Discovery, by its antiseptic influence, checks 
this rapid waste of the tissues, and thus arrests the disease. 
To the lack of employment of such a remedy in the treatment 
of consumption, the unparalleled fatality of the disease is 
largely due. In their anxiety to improve digestion and nutri- 
tion, and thus build up the tissues, physicians often lose sight 
of the no less important indication of restraining the destruc- 
tive waste going on in the system, which overbalances the sup- 
plies furnished by absorption. The gradually increasing emaci- 
ation and loss of strength renders perpetuity of the organism 
impossible. 

The fulfillment of the fourth indication, to relieve local 
symptoms, and the complications with other diseases, is often 
attended with no little difficulty. 

The Cough is a secondary symptom, arising from the irrita- 
tion caused by the tubercular deposits. Medicated inhalations 
may give temporary relief, but cannot cure it. They strike at 
the branches of the disease, while the root is left to flourish 
and develop new branches. 

Expectorants have been employed to a great extent, and tlje 
theories, which have been advanced in favor of their use, are 
sometimes very ingenious. That they modify the cough, we 
do not attempt to deny; but it is usually at a great expense, 
for they derange the stomach and interfere with digestion and 
assimilation. 

Improvement of the general health is always attended with 
amelioration of the cough. If the patient did not cough at all, 
the lungs would soon fill up with broken-down tissue, and death 
from suffocation would result. Irritation of the nerves supply- 
ing the lungs sometimes occurs, and causes the patient to cough 
immoderately, when it is not necessary for the purpose of ex- 
pectoration. This condition is readily controlled by the Golden 
Medical Discovery, which exerts a decidedly quieting and tonic 
influence upon the pneumogastric nerve, which, with its ramifi- 
cations, is the one involved. An infusion of the common red 
clover, in tablespoon ful doses, will also be found a valuable ad- 
junct in overcoming this condition. 

Hbemoptysis. Hemorrhage from the lungs is generally sudden 
and unexpected in its attack, though sometimes preceded by 



CONSUMPTION. 509 

difficulty of breathing, and a salty taste in the mouth. Although 
it very rarely destroys life, it often occasions alarm. Common 
table salt, given in one-fourth to one-half teaspoonful doses^ re- 
peated every ten or fifteen minutes, is generally suflicient to 
control it. Ligatures applied to the thighs and arms, sufficiently 
tight to arrest the circulation of blood in the veins, but not 
tight enough to impede it in the arteries, is a useful proceeding. 
Ergot, in teaspoonful doses of the fluid extract, hamamelis, 
and gallic acid, all are valuable for this purpose. 

Night-sweats can only be regarded as a symptom of weakness, 
and are to be remedied by an improvement of the general 
health. Bathing in salt water is sometinies attended with good 
results. The practice of giving acids for this symptom can 
only be regarded as irrational. It may arrest the sweating, but 
it will do harm in other ways. Belladonna, given at bedtime, 
is an effectual remedy. 

Frequency of the pulse is generally a prominent symptom in 
this disease. It sometimes points to a condition of sufficient 
importance to i-equire a remedy. Although the Discovery is 
combined to meet this condition, its value may be greatly en- 
hanced by adding one-half to one teaspoonful, according to the 
urgency of the case and the frequency of the pulse, of the 
fluid extract of veratrum to each bottle. The benefit of this, 
when persisted in, will be apparent in the amelioration of all 
the symptoms, and in the general improvement. 

Diarrhea is sometimes a troublesome symptom, and particu- 
larly so in the latter stages of the disease. It is generally due 
to acidity of the alimentary canal, to which the treatment must 
be directed. Great care should be taken in the selection of the 
diet to improve the quality and avoid everything which disa- 
grees with the patient. Improve digestion by every possible 
means. Carbonate of soda and rhubarb, in the form of a 
syrup, ai-e sometimes excellent. The Compound Extract of 
Smart-weed, in small doses, will generally diminish the fre- 
quency of the discharges. 

Derangement of the Liver is often a complication requiring 
attention, and the timely relief of which goes very far in amel- 
iorating the general condition of the patient. The Golden Med- 
ical Discovery is generally sufficient to relieve this complication. 



510 COMMON SENSE MEDICAL ADVISEE. 

Its influence, however, may be considerably increased in this 
direction by the use of Dr. Pierce's Pleasant Purgative Pellets, 
according to the directions which accompany them. They 
should only be taken in the smallest doses, one or two pellets 
every day. 

Uterine Derangements. In the female, derangement of the 
menstrual function is generally an early complication of con- 
sumption, if indeed it does not occur at the outset. It deserves 
early attention, and, in addition to the remedies already advised. 
Dr. Pierce's Favorite Prescription is so compounded as to 
meet the requirements of this condition, and at the same time 
exert a favorable influence upon the constitutional disease. 

The following cases, taken from the many hundreds on record 
in our books at the Invalids' Hotel and Surgical Institute, illus- 
trate the results obtained by the course of treatment which we 
pursue in this disease. 

REPORT OP CASES TREATED. 

Case I. J. W„ aged 28, had been subject to poor health for several 
years, during which time his mother and only sister had died of con- 
sumption. The principal symptoms were a poor appetite, considerable 
emaciation, debility, quick pulse, considerable cough, and expectora- 
tion, with difficulty of breathing, and palpitation on exercise. The 
spirometer showed diminished breathing capacity. Upon examination 
of the chest by auscultation, the respiratory sounds were indistinct, 
with numerous rales^ and percussion revealed dullness of sound under 
the collar-bones. 

We advised him to take considerable outdoor exercise, taking care to 
protect himself from the vicissitudes of the weather by wearing plenty 
of flannel clothing next to the skin, and by bathing regularly. A 
diet of eggs, milk, cream, beef, and wheat bread, was ordered. To 
each bottle' of the Golden Medical Discovery we added a drachm of 
fluid extract of veratrum viride, and of this medicine he took a tea- 
spoonful every three hours during the day and evening. In two months 
he wrote, stating that he was improving. We advised him to continue 
the same treatment. He continued to improve, and at the end of 
four months wrote as follows: "I am feeling better than I have for 
ten years; I have gained strength and flesh, and can do a day's work. 
I consider myself well. 1 think my disease is permanently arrested, 
and I shall endeavor to profit by your advice, and change to a moie 
favorable climate, to prevent a relapse." 

This is but one among thousands of cases that we might mention, m 
which there was no doubt as to the nature of the disease. The results 
of the treatment speak for themselves. Had the disease run on unin- 
terruptedly, it w ould soon have become much more formidable, if not 
incurable. 

Case n, Mr. S. W. H., aged forty, applied to us for advice. He 
had been in a decline for a considerable length of time; debility 
and emaciation were well marked, continued cough with profuse 



CONSUMPTION. 51 i 

expectoration, and shortness of breath, loss of appetite, night-sweats, 
all spoke in unmistakable terms. He also had severe attacks of bleed- 
ing from the lungs. 

The hygienic and dietetic treatment already recommended was 
advised and thoroughly carried out. The Golden Medical Discovery 
was the only medicine prescribed. After taking one dozen bottles, 
he wrote: "I feel like a new man; my improvement is wonderful; 
my friends can scarcely believe the evidence of their senses." He 
continued the treatment for eight months and then wrote that he was 
a well man. 

Case III. Mrs. S. N., aged thirty, mother of two children, applied 
to us for examination and treatment. The principal symptoms were 
emaciation, great debility, rapid pulse, no appetite, pain in the chest, 
a severe cough, and expectoration. The respiratory sounds were 
indistinct and confused, mixed with a bubbling noise as the air passed 
through the mucus in the air passages. Percussion showed a dull 
sound over the upper part of the lungs. In addition, there was 
uterine derangement, in the form of prolapsus, enlargement, and 
ulceration. 

Thorough hygienic precautions and a proper diet were recom- 
mended. The Golden Medical Discover}^ with a drachm of fluid 
extract of veratrum viride to each bottle, a teaspoonful four times a 
day, was prescribed. Local applications, to heal the uterine ulcers, 
and to reduce the inflammation of that organ and restore its normal 
function, were advised. We also recommended that the Favorite 
Prescription be taken three times a day. She remained under our 
care five weeks, and left for home considerably improved. The 
journey, however, reduced her somewhat, but in four weeks she had 
regained what she had lost, and was feeling better, with cough 
modified, and strength and appetite slightly increased. We prescribed 
a special tonic, prepared for her individual case, and continued the 
Golden Medical Discovery and veratrum with the Favorite Prescrip- 
tion at night. Eight weeks later she wrote: "I have improved so 
much you would scarcely know me, am gaining strength, and all my 
old troubles are fast disappearing. I have an excellent appetite and 
have gained thirty pounds in weight." After four months' continuation 
of treatment she was pronounced cured. 

This was a confirmed case, and badly complicated, but it is only a fair 
sample of hundreds annually treated at the Invalids' Hotel and Surgi- 
cal Institute. 

Case IT. Mr. E. K,., aged twenty-six, a lawyer, consulted us by letter. 
His symptoms were general debility, loss of flesh, and cough of sev- 
eral months' standing, which annoyed him most soon after rising in 
the morning; there were very little expectoration, but quite a profuse 
discharge dropping into the throat from the nasal passages; he took 
cold easily, was troubled with creeping chills running up and down 
the back; his pulse, for four months, averaged one hundred and ten 
beats per minute; he had night-sweats, and had had three attacks of 
bleeding from the lungs. He had been examined by several medical 
men, and his disease had been pronounced consumption by all. 

We prescribed the general hygienic course heretofore recommended, 
with strict orders to eat largely of sweet cream and good butter. We 
directed that Dr. Sage's Catarrh Eemedy be used with Dr. Pierce's 
Nasal Douche, and that teaspoonful doses of the Golden Medical Dis- 
covery, mth one teaspoonful of fluid extract of veratrum viride added 
to each bottle, be taken five times a day. In two months he wrote 
that he was greatly improved in health; that he had experienced one 



5i2 COMMON SENSE MEDICAL ADVISEit. 

slight hemorrhage since commencing treatment, but had promptly 
arrested it by eating largely of common salt, and by taking fluid ex- 
tract of hamamelis, as we had advised him to do, in case it should 
retura. He was advised to continue the same treatment, which he did 
for about six months, when he left off" all medicines. He has since 
enjoyed good health, as we have been informed by a letter received 
from him, three years after he was under our treatment. 

Case V. S. F., aged 23, a book-keepei', applied at the Invalids' Hotel 
and Surgical Institute. On examination, the percussion over the upper 
portion of the left lung gave a dull sound, while auscultation revealed 
an unnatural respirator}' murmur in the same localitj-. The pulse beats 
were one hundred a minute; respiration was rather short, hurried, 
and quite feeble. Food distressed him, his bowels were constipated, 
he had frequent nightly emissions of semen, and was gloomy and de- 
spondent. 

This was a well-marked case of consumption, complicated with sper- 
matorrhea, the result of masturbation, which he acknowledged having 
practiced from the time he was fourteen years of age. 

As the digestive organs were weak, he could not take sweet cream 
and other oleaginous diet, so beneficial in the preceding cases, until 
after the digestion was improved by tonics. We therefore advised 
Graham bread, rare-cooked beef, eggs, fish, and oysters; enjoined out- 
door exercise, bathing, and other hygienic treatment, and gave the 
Golden Medical Discovery, with half a teaspoonfnl of the fluid extract 
of veratrum viride to each bottle. We also prescribed a stomach tonic 
in teaspoonfnl doses four times a day, to overcome the dyspeptic symp- 
toms and strengthen the stomach. A sjiecific for the nocturnal emis- 
sions was given at bed-time. This treatment operated well, and was 
continued for two months without alteration, except as the stomach be- 
came stronger the diet was changed to one including a liberal quantity 
of sweet cream, rich milk, good butter, and fiit beef. At the end of 
three months, all medicines except the Golden Medical Discovery 
were omitted, and its continued use for four months longer resulted in 
a perfect restoration of health. 

Case VI. S. A., of Windermere, Out., writes: "Dr. Pierce: Dear 
Sir — I had pain in my back and side, with severe cough. Three doctors 
told me they could not cure me. I was reduced to utter weakness, and 
nobody thought I could live. Being recommended to try your Discov- 
ery and Pellets, I sent to Toronto and got two bottles of each, and 
found, to mj' surprise, they did me more good than all else I had taken. 
I took eight bottles of each, and I now feel well and strong, and can 
recommend them to all suff"ering with disease of the lungs." 

Case VII. Mrs. R. E., Jonesboro, Tcnn., writes as follows: "Dr. 
Pierce: My father died Mitli consumption and I thought I was going 
the same way. My cough could not be stopped until I took your Dis- 
covery. It stopped the cough and cured me, and I have remained well 
for two years." 

Case Vni. J. P. McG., 50 Wight Street, Chicago, 111., writes us as 
follows: "World's Dispensary Medical Association: Gentlemen — 
For years I have been a great sufferer. My trouble first started with 
terrible a«?ue chills and constipation. I also had a racking cough and 
frequent bleeding fiom the lungs. I had been continually doctoring, 
consulting physicians without number. From them I received no bene- 
fit or encouragement. The most noted physicians of our city expressed 
tiieir opinions in the brief but hopeless words, 'Take good care of your- 
self the few days you have to live, we cannot help you.' I grew 



CONSUMPTION. 5l3 

Steadily worse under their treatment. One day, througli reading your 
Memorandum Book, I learned of the Golden Medical Discovery. With 
but little hope of relief, I purchased a bottle and took it. To my sur- 
prise and satisfaction it did me more good than all the drugs I had 
taken before. 1 am now steadily using it with benefit, and recommend 
it to all to be just what it is advertised to be." 

Case IX. Mrs. R. G., of London, Ont., writes: "R. V. Pierce, M. 
D. : Dear Sir — I write to express my gratitude for the benefits ob- 
tained from your medicines. I was treated for years by several of the 
first physicians of Philadelphia, without benefit. Soon after I com- 
menced taking your Golden Medical Discovery and Pellets, the cough, 
constipation, and racking pains, the bane of my life, left me, and I have 
since been enjoying health." 

Case X. Mrs. E. A. R., of Washington, D. C, writes as follows: 
"Hon. R. V. Pierce: Dear Sir — I hope you will pardon my delay in 
not writing you of the arrival of your priceless Golden Medical Dis- 
covery. I am now on the last bottle you sent me. May Heaven 
bless you for your kindness in sending it when you did. My cough 
has ceased, and I feel like a new woman in every way. I have given 
birth to a little girl since last I wrote, and had it not been for your 
valuable medicine, my children would to-day be motherless. As long 
as I am able to purchase it I shall never be without it. If any one 
doubts the curative qualities contained in the Discovery, if you will 
refer them to me I will give them ample proof in my condition. May 
God ever bless and protect you, and spare you for many, many years 
to come." 

Case XI. Mrs. T. V., of Brighton, Ont., writes as follows: "R. V. 
Pierce, M. D., Buffalo, N. Y. : Dear Si7'—I have long felt it my duty 
to acknowledge to you what your Golden Medical Discovery and Pleas- 
ant Purgative Pellets have done for me. These medicines cannot be 
too highly praised. They almost raised me from the grave. I had 
three brothers and one sister die of consumption, and I was speedily 
following after them. I had severe cough, pain, copious expectoration, 
and other alarming symptoms, and my friends all thonght I had but a 
few months to live. At this time I was persuaded to try your Discov- 
ery, and the first bottle acted like magic. Of course I continued on 
with the medicine, and as a result I gained rapidly in strength. My 
friends were astonished. When I commenced the use of your medi- 
cines, six years ago, I weighed but 120 pounds, and was sinking rapidly; 
I now weigh 135, and my health continues perfect. I have a copy of 
your People's Common Sense Medical Adviser, and neither money 
nor friends could ever induce me to part with it. There is truly a 'drop 
of joy in every word' that it contains. I can but poorly express my 
gratitude to you, but that God may prolong your life and ever bless 
you, is my constant prayer." 

Case XII. T. R.. of East Benton, Lackawanna County, Pa., writes: 
"R. V. Pierce, M. D., Buffalo, N.T. : Dear Sir— Three years ago I was 
a dreadful sufferer from consumption and liver complaint. I exhausted 
the skill of several physicians and was quite discouraged. Doctors and 
friends alike thought that I must die. I had a dreadful cough and 
raised a considerable amount of blood and matter; besides, I was 
very thin and so weak that I could scarcely walk around the house. 
At this time I read in the Neto York Weekly of the wonderful cures 
performed by your Golden Medical Discovery. I procured the medi- 
cine named and began using it in connection with the Pleasant Purga- 
tive Pellets. Under their influence I recovered my health completely. 



514 COMMON SKNSB MEDICAL ADVISEK. 

I would also say that your Discovery cured my grandchild of heart 
disease." 

Case XIII. E. U., of Douoho, S. C, writes as follows: "Hou. R. V. 
Pierce: Dear Sir — I wish to inform you that my cough has ceased 
since taking your Golden Medical Discovery in connection with the 
Purgative Pellets. For several years I coughed up matter from my 
lungs three or four times daily, but since using your remedies I am en- 
tirely free from this sj^mptom, and my general health has improved in 
every waj'." 

Case 31,920, (New Series, as Numbered in the Record Books 
OF THE Invalids' Hotel and Surgical Institute.) Consump- 
tion. Considered Incurable. 

Mr. S., of New York City, writes as follows: "World's Dispen- 
sary Medical Association: Oentlemen — I give you full credit for 
your success in curing my case after so many had failed. I feel myself 
to be a healthy man again, and am very thankful. The medicines you 
sent me caused a steady improvement in my case. At the end of three 
months I had gained sixteen pounds. I am now fully cured." 

Case 33,943. Hereditary Consumption. Considered Hopeless. 
Miss C, of Bath, Me., writes us as follows: "I take groat pleasure in 
expressing mj- gratitude to you for the excellent health I now enjoy. Be- 
fore going to your place, consumption had placed its deadly mark upon 
me, and my friends said, 'She is going just like her two sisters,' wlio had 
died a shoi't time before. A few months' treatment under your spe- 
cialist at the Invalids' Hotel, and the invigorating climate of Buffalo, 
liave restored me to the full vigor of health and strength, and now I 
have a strong desire to live, whereas before I did not care whether I 
lived or died. Accept the gratitude of an overflowing heart, and my 
best wishes." 

Case 35,528. Consumption Pronounced Incurable. 

Mr. M., of Syracuse, N. Y., writes us as follows: "In January, 1877, 
I visited the Invalids' Hotel and was examined by the council of 
physicians, connected with the Institution. My disease was consump- 
tion. Several physicians had pronounced me incurable. After a care- 
ful examination, you said my case was a bad one, and while you would 
not promise to cure, j'et you thought, with my co-operation, a cure 
could be elfected. As drowning men grasp at straws, so I quickly 
commenced your treatment. Well, I cannot now recite how, step by 
step, the signs and realities of returning health gradually, but surely, 
developed themselves; suffice it to say that I consider myself saved 
from an early grave, for which I shall ever be grateful to you." 

Case 36,031. Consumption. 

Mr. W., of Lake Amelia, Minn. This gentleman probably inherited 
consumption from liis mother, who died of it in spite of the efforts of 
her family physicians. 

When he first wrote us, he was merely able to walk a few steps, 
being extremely weak and emaciated, with a severe rackino- cough, 
profuse expectoration, night-sweats, and no appetite or digestion. He 
had been unable to work for some time, and had been for several 
weeks confined to his bed. He writes after five months' treatment as 
follows: 

'•World's Dispensary Medical Association: Gentlemen— The 
neighbors all say, ' We did not think you would be a live man to-day, 
but you look well again.' " 



OOifSUMPTION. 515 

l)octors you have done me more real good thau all the other physi- 
cians I have ever had. With the first month's treatment, I so far re- 
gained my lost strength that I commenced work, my family being in 
need of support. After five months' treatment, I will say that my 
health and strength is far beyond anything I had expected. I work 
hard without undue fatigue. My bad symptoms are gone, cough and 
all. I am satisfied that I am cured, and feel deeply grateful to you for 
the good you have done me. 

Case 38,614. As numbered on the World's Dispensary Records. 

Severe case of Hereditary Consumption. 

Mr. T., of Kansas City, Mo., writes as follows: "World's Dispen- 
sary Medical Association: Oentlemen — I wish to thank you for the 
remarkable cure you have effected in my case. 

For years I had suflcred from that terrible disease, hereditary 
consumption. But a few years since my mother, a brother, and a sister, 
fell victims to its terrible malignancy. Slowly I was following in their 
footsteps. The gradual loss of strength, embarrassed breathing, harass- 
ing, hollow cough, that gave me no rest, night-sweats, and diarrhea, 
all told the story of my condition. My wife and children looked for- 
ward hopelessly to a life of destitution and want. They, as well as 
m}'^ friends, saw me drifting toward the grave, unable to stretch forth 
a hand for ray relief I was a doomed man. My means were ex- 
hausted by mj'' long illness and the excessive demands of physicians, 
who, thougli paid, could not benefit me. I became discouraged mj— 
self, and could only look forward to death to relieve me of my cares 
and pain. One day, I was induced by the success of your Favorite 
Prescription, in relieving my wife, to write to you. Need I say your 
slight encouragement made me fearful that I would only again be dis- 
appointed. How different has been the result. With four months' 
treatment I find myself sound and well. I weigh ten pounds more 
than I ever did. The cough and all other symptoms have entirely left 
me, and I find myself in the enjoyment of perfect health and 
strength." 

Case 40,485. Consumption. Considered a Hopeless Case. 

Mr. M.. of Hibbert, Ont., writes: "I had uselessly employed many 
physicians, and had fully expected to die with consumption. Having 
heard of your Invalids' Hotel, I made up my mind to visit you. To 
your advice and treatment I owe my life and present good health. 
Hoping that you and your eminent Faculty may be spared many 
years to cure the afflicted, I am, etc." 

Case 41,236. Pulmonary Consumption. Severe Cough, Hectic 
Fever, Uterine Derangement, and Increasing Debility. 
Mrs. H., of Buffalo, writes us as follows: "I feel it my duty to give 
my unsolicited testimony as to your skillful treatment of pulmonary 
and uterine diseases, from both of which I was a great sufferer, when 
first placing myself under your treatment. To your skill and your 
valuable medicines I owe the past three years of my life. Where others 
had failed you were successful, and I wish suffering humanity in gen- 
eral, and women in particular, to know of it, that they may also come 
and be healed." 

Case 43,415. Consumption in an Advanced Stage. 

Mr. N., of Buffalo, N. Y., writes as follows: "On the third of last 
November, I hopelessly commenced the treatment prescribed and ad- 
vised by yourself and the Faculty of the Invalids' Hotel and Surgical 



516 COMMON SENSE MEDICAL, ADVISEIt. 

Institute. Under other physicians I had continued to run down. My 
disease was genuine consumption. 1 had frequent and copious hem- 
orrhages; I had lost nearly lifty pounds in weight; my stomach and 
bowels were nearly dead, or useless; I couched and raised continually; 
my breathing was hurried and difficult. The medicines wliich you gave 
were productive of the most satisfactory results. I persevered for four 
months, at the end of whicli time I found not only my disease arrested, 
but my health, flesh, and strength restored. I hope you may live long 
to lengthen out the days of your fellow-men." 

Case 46,552. General Debility and Consumption. 

Mr. B., of Beallsville, Pa., writes us as follows: " World's Dispen- 
sary Medical Association: Gentlemen — With pleasure I testify to 
your skill and successful treatment. For eighteen months I was unable 
to do any thing. I tried doctor after doctor without benefit. 

I am now, after a few weeks' treatment, entirely relieved of my com- 
plicated troubles, and able to work as hard as any one." 

Case 47,277. Consumption. 

Mr. S., of Linlithgo, X. Y., writes as follows: "World's Dispen- 
sary Medical Association: Gentlemen — For the great good you have 
done me in stopping the bleeding, and the still greater good your med- 
icines have done my general health, I cannot be sufficiently grateful. 
Their effect in my case was wonderful. I used only one month's medi- 
cine, but it has done everything for my health. My family and friends 
are astonished at my improvement. All thought I was going to die of 
consumption. I hope all the sick and afflicted of the land may hear of 
you and feel the virtues of your treatment as I have. Though I 
had been sick and unable to work for a long time, after the first 
month's treatment I labored right along, and now feel as well as ever 
I dia." 

Case 49,631. Consumption. 

Mr. H., of Jamestown, N. Y., says: "Your month's treatment cured 
me. I am very grateful to you. I have tried six leading physicians In 
the different places where I have lived. Some did no good, others re- 
lieved me only for a short time, then I was worse than ever. I will do 
all in my power to help you to relieve disease and suffering